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UWorld > Infectious Disease 3 > Flashcards

Infectious Disease 3 Flashcards

1
Q

Best tetanus prophylaxis in clean wound, patient has received 3+ tetanus vaccines?

A

TDAP if last dose was 10+ years ago; No Tetanus Ig

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2
Q

Best tetanus prophylaxis in clean wound, patient has received uncertain tetanus vaccination?

A

TDAP; No Tetanus Ig

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3
Q

Best tetanus prophylaxis in dirty wound, patient has received 3+ tetanus vaccines?

A

TDAP if last dose was 5+ years ago; No Tetanus Ig

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4
Q

Best tetanus prophylaxis in dirty wound, patient has received uncertain tetanus vaccination?

A

TDAP + Tetanus Ig

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5
Q

Pathogen responsible for Chagas disease?

A

Dilated cardiomyopathy, GI disease

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6
Q

2 most common complications of Chagas disease?

A

Trypanosoma cruzi

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7
Q

ECHO finding that is pathognomonic for dilated cardiomyopathy due to Chagas disease?

A

L ventricular aneurysm

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8
Q

In addition to L ventricular aneurysm what are 2 other cardiac complications of Chagas disease?

A

AV block, ventricular tachycardia

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9
Q

4 people who should receive ABX prophylaxis for exposure to Neisseria meningitis?

A

Household members, Child care workers, People directly exposed to oral/respiratory secretion (intubation), People seated next to infected patient for >8 hours

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10
Q

DOC for ABX prophylaxis for exposure to Neisseria meningitis?

A

Rifampin

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11
Q

2 alternative DOCs for ABX prophylaxis for exposure to Neisseria meningitis?

A

Ciprofloxacin, Ceftriaxone

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12
Q

Best management of spontaneous splenic rupture in setting of EBV infection?

A

Resuscitation + stabilization with IV fluids

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13
Q

What accounts for splenomegaly in setting of EBV infection?

A

Lymphocytic infiltration into splenic capsule

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14
Q

2 most common routes by which healthcare professionals contract HIV from patients?

A

Percutaneous injury (needlestick); Mucous membrane or non-intact skin exposure

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15
Q

3 high-risk fluids involved in transmission of HIV from patient to healthcare professionals?

A

Blood, semen, vaginal secretions

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16
Q

4 bodily fluids that are considered non-infectious for HIV?

A

Urine, feces, vomit, tears

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17
Q

Epidemiology of Allergic Bronchopulmonary Aspergillosis (ABPA)?

A

Asthma, Cystic fibrosis

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18
Q

3 aspects of diagnosis for Allergic Bronchopulmonary Aspergillosis (ABPA)?

A

(+) aspergillosis skin test, Eosinophilia, Elevated serum IgE

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19
Q

2 aspects of management for Allergic Bronchopulmonary Aspergillosis (ABPA)?

A

Corticosteroids + Antifungals

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20
Q

2 antifungals that can be used in treatment of Allergic Bronchopulmonary Aspergillosis (ABPA)?

A

Itraconazole, Voriconazole

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21
Q

Additional medication that can be used in treatment of Allergic Bronchopulmonary Aspergillosis (ABPA)?

A

Omaluzimab … monoclonal antibody against IgE

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22
Q

Pathogen responsible for shingles?

A

VZV

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23
Q

Description of localized shingles?

A

Appearance of lesions within single or adjacent dermatomes

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24
Q

Description of disseminated shingles?

A

Appearance of lesions outside primary or adjacent dermatomes

25
Q

Best management of shingles?

A

Oral valacyclovir

26
Q

Precautions for localized shingles?

A

Standard precautions + lesion covering

27
Q

Precautions for disseminated shingles?

A

Standard precautions + Contact + Airborne precautions

28
Q

Role of oral valacyclovir in treatment of shingles?

A

Reduce transmission risk, prevent new lesion formation, decrease risk of post-herpetic neuralgia

29
Q

How is shingles diagnosed?

A

Clinically

30
Q

54 yo male presents for 3 months of increased urinary freuquency/urgency, pelvic pain, pain with ejaculation; Symptoms improved after 1-week course of TMP-SMX, but then quickly recurred; PE shows mild enlargement of prostate; UA shows 20 WBCs, moderate bacteruria - diagnosis?

A

Chronic bacterial prostatitis

31
Q

Diagnostic findings for Chronic bacterial prostatitis?

A

Pelvic pain, urine leukocytosis, bacteruria for 3+ months

32
Q

Best management of Chronic bacterial prostatitis?

A

6 week course of ciprofloxacin, TMP-SMX

33
Q

Compared to the general population, patients with HIV are at increased risk of ___ pulmonary infections, most commonly with …

A

Bacterial; Strep pneumoniae

34
Q

29 yo female presents after unprotected sexual intercourse with man she just learned is HIV (+); Immediate HIV and pregnancy tests are negative - what is best next step in management?

A

Post-Exposure Prophylaxis with HAART for 4 weeks

35
Q

Optimal timing of initiation of HIV Post-Exposure Prophylaxis?

A

Within 72 hours of exposure

36
Q

64 yo female with HX of myasthenia gravis presents for 2 days of worsening fever, neck pain; Treated 12 days ago for UTI with ceftriaxone and IVIG; T101; PE reveals neck pain, stiffness; Labs show WBC 13; LP is performed, CSF analysis reveals pressure 300, glucose 30, protein 180, WBC 2,000 with PMN predominence; CSF Gram stain and culture are negative, cryptococcal Ag is negative - diagnosis?

A

Bacterial meningitis … negative Gram stain and culture due to recent ABX treatment

37
Q

17 yo male presents for 3 days of productive cough, chest pain with deep inspiration; HX of multiple hospitalizations for PNA; Also has HX of SBO as newborn; PE reveals crackles; Diagnosis?

A

Cystic fibrosis

38
Q

17 yo male presents for 3 days of productive cough, chest pain with deep inspiration; HX of multiple hospitalizations for PNA; Also has HX of SBO as newborn; PE reveals crackles; What is most appropriate ABX therapy?

A

Cefepime + Amikacin … total = vancomycin + 2 anti-pseudomonal drugs

39
Q

2 most common pathogens responsible for pulmonary exacerbations?

A

Pseudomonas, Staph aureus

40
Q

What is best strategy for TB screening in patients who have receieved BCG vaccine? |

A

IFN-gamma release assay … BCG vaccine can cause false (+) TB skin test

41
Q

Patient who has receieved BCG vaccine tests (+) for IFN-gamma release assay; CXR is negative - diagnosis?

A

Latent TB

42
Q

Patient who has receieved BCG vaccine tests (+) for IFN-gamma release assay; CXR is negative - what is best management?

A

Treatment with INH for 9 months

43
Q

DOC for bartonella infection?

A

Clindamycin, Azithromycin

44
Q

6 yo female presents with R sided, painful cervical LAD; Reports increased fatigue, now FB sensation in R eye with increased tearing; PE shows injection of R conjunctiva, TTP of cervical and preauricular LNs - diagnosis?

A

Bartonella infection

45
Q

Complicaiton of Bartonella infection?

A

LN suppuration

46
Q

Best treatment for Bartonella infection?

A

Azithromycin

47
Q

Bartonella infection leads to ___ syndrome

A

Oculoglandular

48
Q

57 yo male returns from cruise to Bahamas; Now has fever, cough, SOB, HA, abdominal pain, D; CXR shows BL interstitial infiltrates - diagnosis?

A

Leigonella

49
Q

ABX of choice for treatment of Leigonella?

A

Fluoroquinolones, Macrolide

50
Q

Clinical presentation of Leigonella infection?

A

PNA + diarrhea

51
Q

8 yo female presents after brother develops active TB infection; Patient’s IFN-gamma assay is positive, CXR is negative; Brother’s TB infection is resistent to isoniazid, but susceptible to other drugs - diagnosis?

A

Latent TB infection

52
Q

8 yo female presents after brother develops active TB infection; Patient’s IFN-gamma assay is positive, CXR is negative; Brother’s TB infection is resistent to isoniazid, but susceptible to other drugs - what is best management?

A

9 months INH … OR 4-6 months of rifampin (if INH resistent)

53
Q

4 aspects of clinical presentation for congenital rubella?

A

Sensorineural hearing loss, PDA, cataracts, blueberry muffin rash

54
Q

34 yo female presents after new diagnosis of HIV; CD4 550, Viral load 20,000; Positive for toxoplasma IgG - what is best step in management?

A

Initiate HAART

55
Q

Which HIV patients should be started on HAART?

A

All … regardless of CD4 count

56
Q

What is best recommendation for HC workers exposed to patient with active TB infection, if HC workers then had negative TB test?

A

Repeat TB test in 8-10 weeks

57
Q

6 yo male presents with new difficulty breathing after mild sore throat, fever; PE shows tripod position, inspiratory stridor - what is best next step of management? | Prepare for intubation
Pathogen responsible for epiglottitis?

A

H. flu (type B)

58
Q

6 do male presents for poor feeding, difficulty waking, jaundice; Vitals show fever, tachycardia; Labs show WBC 18 with PMN 80%, T. bili 12.8, Alk phos 250; UA shows (+) leukocyte esterase, 15 WBCs - diagnosis?

A

Neonatal infection with … E. coli or GBS

59
Q

DOC for neonatal infection?

A

Ampicillin + Cefotaxime/Gentamycin

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