Infectious Disease

Question 1

The 3 most common causes of fever of unknown origin (FUO).

Answer 1

Infection, cancer, and autoimmune disease.

Question 2

Four signs and symptoms of streptococcal pharyngitis.

Answer 2

Fever, pharyngeal erythema, tonsillar exudate, lack of cough.

Question 3

A nonsuppurative complication of streptococcal infection that is not altered by treatment of primary infection.

Answer 3

Postinfectious glomerulonephritis.

Question 4

The most common predisposing factor for acute sinusitis.

Answer 4

Viral URI.

Question 5

Asplenic patients are particularly susceptible to these organism.

Answer 5

Encapsulated organisms - pneumococcus, meningocuccus, Haemophilus influenzae, Klebsiella.

Question 6

The number of bacteria needed on a clean catch specimen to diagnose a UTI.

Answer 6

10^5 bacteria/mL.

Question 7

Which healthy population is susceptible to UTIs?

Answer 7

Pregnant women. Treat this aggressively because of potential complications.

Question 8

A patient from California or Arizona presents with fever, malaise, cough, and night. Diagnosis? Treatment?

Answer 8

Coccidioidomycosis; amphotericin B.

Question 9

Nonpainful chancre.

Answer 9

Primary syphilis.

Question 10

A “blueberry muffin” rash is characteristic of what congenital infection.

Answer 10

Rubella.

Question 11

Meningitis in neonates. Causes? Treatment?

Answer 11

Group B strep (GBS), E coli, Listeria. Treat with gentamicin and ampicillin.

Question 12

Meningitis in infants. Causes? Treatment?

Answer 12

Pneumococcus, meningococus, H. Influenzae. Treat with cefotaxime and vancomycin.

Question 13

What should always be done prior to LP?

Answer 13

Check for increased ICP; look for papilledema.

Question 14

CSF findings:

• Low glucose, PMN predominance.
• Normal glucose, lymphocytic predominance.
• Numerous RBCs in serial CSF samples.
• Increased gamma globulins.

Answer 14

Bacterial meningitis.
Aseptic (viral) meningitis.
Subarachnoid hemorrhage (SAH).
MS.

Question 15

Initially presents with a pruritic papule with regional lymphadenopathy; evolves into a black eschar after 7-10 days. Treatment?

Answer 15

Cutaneous anthrax. Treat with penicillin G or ciprofloxacin.

Question 16

Findings in tertiary syphilis.

Answer 16

Tabes dorsalis, general paresis, gummas, Argyll Roberston pupil, aortitis, aortic root aneurysms.

Question 17

Characteristics of secondary Lyme disease.

Answer 17

Arthralgias, migratory polyarthropathies, Bell’s palsy, myocarditis.

Question 18

Cold agglutins.

Answer 18

Mycoplasma.

Question 19

A 24 year old man presents with soft white plaques on his tongue and the back of his throat. Diagnosis? Workup? Treatment?

Answer 19

Candidal thrush. Workup should include and HIV test. Treat with nystatin oral suspension.

Question 20

At what C4 count should Pneumocystis jiroveci pneumonia prophylaxis be initiated in and HIV + patient? Mycobacterium avium-intracellulare (MAI) prophylaxis?

Answer 20

</= 50-100 for MAI (with clarithromycin/azithromycin).

Question 21

Risk factors for pyelonephritis.

Answer 21

Pregnancy, vesicoureteral reflux, anatomic anomalies, indwelling catheters, kidney stones.

Question 22

Neutropenic nadir postchemotherapy.

Answer 22

7-10 days.

Question 23

Erythema migrans.

Answer 23

Lesions of primary Lyme disease.

Question 24

Classical physical findings for endocarditis.

Answer 24

Fever, heart murmur, Osler’s nodes, splinter hemorrhages, Janeway lesions, Roth’s spots.

Question 25

Aplastic crisis in sickle cell disease.

Answer 25

Parvovirus B19.

Question 26

Ring-enhancing brain lesion on CT with seizures.

Answer 26

Taenia solium (cystercercosis).

Question 27

Name of organism:

• Branching rods in oral infection.
• Weakly gram +, partially acid fast in lung infection.
• Painful chancroid.
• Dog or cat bite.
• Gardener.
• Raw pork and skeletal muscle cyst.
• Sheepherders with liver cysts.
• Perianal itching.
• Pregnant women with pets.
• Meningitis in adults.
• Meningitis in elderly.
• Meningoencephalitis in AIDS pt.
• Alcoholic with pneumonia.
• “Currant jelly” sputum.
• Malignant external otitis.
• Infections in burn victims.
• Osteomyelitis from a foot wound puncture.
• Osteomyelitis in sickle cell patient.

Answer 27

Actinomyces israelli.
Nocardia asteroides.
Haemophilus ducreyi.
Pasteurella multocida.
Sprothrix schenckii.
Trichinella spiralis.
Echnococcus granulosus.
Enterobius vernicularis.
Toxoplasma gondii.
Neisseria meningitidis.
Streptocuccus pneumoniae
Cryptococcus neoformans
Klebsiella
Klebsiella
Pseudomonas
Pseudomonas
Pseudomonas
Salmonella.

Question 28

A 55 year old man who is a smoker and a heavy drinker present with a new cough and flulike symptoms. Gram stain shows no organisms; silver stain of sputum shows gram - rods. What is the diagnosis?

Answer 28

Legionella pneumonia.

Question 29

A middle aged man presents with acute onset monoarticular joint pain and bilateral Bell’s palsy. What is the likely diagnosis, and how did he get it? Treatment?

Answer 29

Lyme disease, Ixodes tick, doxycycline.

Question 30

A patient develops endocarditis 3 weeks after receiving a prosthetic heart valve. What organism is suspected?

Answer 30

S. aureus or staphylococcus epidermidis.

Question 31

A patient develops endocarditis in native valve after having a dental cleaning.

Answer 31

Streptococcus viridans.