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Emergency Med > Infectious Disease > Flashcards

Infectious Disease Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

areas affected by meningitis

A

arachnoid, subarachnoid space and CSF

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2
Q

Most common bacterial pathogens of meningitis

A

Streptococcus pneumoniae
Neisseria meningitidis
Haemophilis influenzae

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3
Q

Most common fungal cause of meningtitis

A

cryptococcus

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4
Q

Classic triad of meningitis

A

fever, nuchal rigidity, change in mental status

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5
Q

Which pathogen that causes meningitis is associated with a petechial rash?

A

N. meningitidis

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6
Q

If any of the following are present what needs to be done before doing an LP: abnormal level of consciousness, h/o CNS dz, papilledema, focal neuro deficits?

A

head CT (if ICP is to high an LP will result in brainstem herniation)

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7
Q

What WBC level in CSF is considered diagnostic of meningitis?

A

> 1000 if PMNs make up 85%

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8
Q

What abx should be given empirically prior to lab results being back for meningitis?

A

2 G Rocephin (Ceftriaxone) IV

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9
Q

What are normal glucose levels of CSF?

A

50 - 80 mg/100 mL

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10
Q

What ages does bacterial meningitis occur more frequently in?

A

2 months - 2 years

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11
Q

What is suggestive of meningitis in a young child/infant?

A

Paradoxical irritability (crying worsens when being held)

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12
Q

Most common cause of encephalitis

A

viral infections

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13
Q

What is the difference between encephalitis and meninigitis?

A

Encephalitis has altered brain function and neurologic findings like personality changes, paralysis, hallucinations, altered smell, problems with speech

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14
Q

What additional cultures should you order with LP for suspected encephalitis?

A

PCR for HSV1, serology: IgM ab for West Nile virus, mumps, EBV

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15
Q

What is the treatment for encephalitis?

A

Acyclovir 10mg/kg IV q 8 h

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16
Q

Which pathogen is the most deadly cause of encephalitis?

A

HSV

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17
Q

What must you do on any red, hot, swollen joint?

A

arthrocentesis

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18
Q

What might not show in gram stain of joint fluid even when it’s the cause of septic arthritis?

A

gonococcal organisms (test for STDs)

19
Q

What is the abx treatment for severe sepsis +/- shock?

A

Gentamicin or tobramycin or amikacin PLUS antipseudomonal cephalosporin like Cefepime

20
Q

What abx should be added to treatment for bacteremia until cultures come back?

A

vanco

21
Q

Leading cause of gram + bacteremia

A

s. aureus

22
Q

What should the work-up for bacteremia include to rule out infective endocarditis and is the most sensitive test for infective endocarditis?

A

Transesophageal echo

23
Q

Clinical syndrome from a dysregulated inflammatory response to an infection. Can have low urine output, anemia, low platelets, hyperglycemia, high LFTs, ect

A

sepsis/septicemia

24
Q

Describe the three situations when superficial soft tissue infections are emergencies

A

Infection around the face and hand. Cellulitis in the presence of diabetes or PVD. Local infection with the presence of leukemia or HIV

25
Q

Pathogen most commonly involved with impetigo that causes small vesicles which quickly rupture and form “honey-colored” crusts

A

strep

26
Q

What is the drug of choice for all cellulitis, folliculitis, furnuclosis until MRSA is ruled out?

A

BACTRIM. Alternate=Clindamycin

27
Q

Patients at high risk are those with previous valve damage, valve replacement or history of IV drug use. Subacute may present with anorexia, night sweats and weight loss

A

endocarditis

28
Q

Nontender red or maroon macules or nodules on the palms and soles that are characteristic of endocarditis

A

janeway lesions

29
Q

tender, erythematous nodules with opaque centers which appear on pulp of fingers/toes associated with endocarditis

A

osler nodes

30
Q

pale oval areas surrounded by hemorrhage near optic disc characteristic of endocarditis

A

Roth spots

31
Q

Increasing number of cases now seen from wound or sinus infections. A diffuse, blanching, macular erythema appears with signs of pan-mucosal inflammation. T > 102 with multiple organ failure

A

Toxic Shock Syndrome

32
Q

Why are blood cultures negative with TSS?

A

cause is from toxin not the bacteria. need to find source to grow out culture

33
Q

Occurs in all states, but South Atlantic, South Central, and Oklahoma most common. Usually during warm months.
Sudden onset fever, chills, malaise, myalgias, severe frontal headache

A

Rocky Mountain Spotted Fever

34
Q

Where is the pink, macular rash that appears on the 5th day of RMSF located?

A

palms of hands and soles of feet spreading centrally

35
Q

Treatment of choice for RMSF?

A

doxy (in kids use chloramphenicol)

36
Q

Empiric treatment of lyme disease

A

Tetracycline 500mg QID X 30 days at minimum

37
Q

potentially life threatening neuroparalytic syndrome. Usually ingested through the GI tract. Gram + rod shaped anerobes

A

botulism

38
Q

How is the acute onset of botulism classically described?

A

bilateral cranial neuropathies associated with symmetric descending weakness

39
Q

What abx may be helpful for wound botulism?

A

PCN G and metronidazole

40
Q

Droplet transmission from person to person. Spreads most readily during cool, dry winter. Caused by variola

A

smallpox

41
Q

How does smallpox rash differ from varicella?

A

most prominent on face and extremities (including palms and soles) in contrast to truncal distribution of varicella

42
Q

Begins as a papule, progresses through a vesicular stage to a depressed black necrotic ulcer (eschar)

A

cutaneous anthrax

43
Q

A brief prodrome resembling a “viral-like” illness, characterized by myalgia, fatigue, fever, with or without respiratory symptoms, followed by hypoxia and dyspnea, often with radiographic evidence of mediastinal widening

A

inhalational (pulmonary) anthrax

Emergency Med (19 decks)

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