Infectious Disease

Question 1

Post coital UTI

Answer 1

treat with postcoital abx NOT ppx abx

Question 2

Recurrent erythema multiforme

Answer 2

Acyclovir ppx tx for HSV - painful lesions

Question 3

Non-purulent cellulitis (mosquito bite)

Answer 3

Cephalexin - B-hemolytic strep

Question 4

Typhoid

Answer 4

salmon colored rash, fevers, diarrhea/constipation, abd pain, elev LFTs, leukopenia, anemia, returning from endemic area - vaccine NOT completely effective,

Question 5

Brucellosis

Answer 5

fever, bone/joint sx, neuro/neuropsych, sev weakenss/malaise NO RASH

Question 6

Leishmaniasis

Answer 6

protozoan, bite of sandfly - wt loss, HSM, pancytopenia,

Question 7

Malaria

Answer 7

cyclic fevers, NO GI sx or rash

Question 8

Prevent ventillator associated PNA

Answer 8

Maintain head of bed 30 deg, 48-72hr after intub, daily weaning assessment, chlorohexadine mouth washes

Question 9

Tick exposure with febrile illness no rash

Answer 9

start empiric doxycyline - serology may be neg in acute phase -

Question 10

Rash in RMSF

Answer 10

erythematous macules around wrists and ankles - spread centripitally and become petechial -

Question 11

Manage osteomyelitis

Answer 11

wound cultures NOT reliable - need BONE bx cultures - will then need 6 weeks abx +- debridement +- removal of hardware (3 phase bone scan not reliable with recent surgery with bone healing present - would also light up)

Question 12

Fungal arthritis

Answer 12

indolent subacute monoarthrtis with soil exposure - sporothrix - need synovial biospy (pt also immunocompromised from DM)

Question 13

Acute retroviral syndrome with neg HIV/mono tests

Answer 13

acute HIV - window period - antibody testing (western blot or repeat immunoassay unreliable) - need HIV PCR nucleic acid amplification