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- Med School Review 🔥 > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Tx of Syphilis if penicillin allergy

A

Doxycycline

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2
Q

Fever after Tx of early primary syphilis w/ Penicillin G

A

Jarisch-Herxheimer Reaction

(Rapid lysis of spirochetes, causing acute febrile illness 6-48hrs)

  • Self-limited course (48 hours)
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3
Q

Large painful & purulent penile ulcer + Inguinal LAD

A

Haemophilus ducreyi

(chancroid)

  • Sexually transmitted G- rod in developing countries or from commercial sex workers
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4
Q

Most common behavioral risk factor for TB in US

A

​Substance abuse

  • Travel
  • Group living
  • Incarceration
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5
Q

Associated with Vitiligo

A

Hashimoto Thyroiditis

(or any autoimmune disease)

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6
Q

Eosinophilia + Periorbital edema + Myositis

A

Trichinellosis

(Parasitic infection from Mexico, China, or Thailand)

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7
Q

PNA w/ multi lobular cavitary infiltrates following influenza illness

A

CA-MRSA (Staph aureus) PNA

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8
Q

Epiglottitis, most common organism

A

H. flu

(if not vaccinated)

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9
Q

Human bite wound Tx

A
  • Surgical debridement
  • Amox-Clav (polymicrobial coverage: G+, G-, anaerobic beta-lactamase-producing
  • Tetanus Vaccination (if not UTD)
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10
Q

Bright red, firm, friable, exophytic round nodules on HIV pt

A

Bacillary angiomatosis

(Bartonella)

  • Erythromycin
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11
Q

PNA Sx + wartlike lesions, violaceous nodules, skin ulcers +/-osteomyelitis

A

Blastomycosis

(Wisconsin)

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12
Q

C. Difficile Colitis Tx

A

MNZ or Vancomycin

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13
Q

BL diffuse interstitial infiltrates in immunocompromised pt

A

Pneumocystis PNA

PCP)

  • Tx: TMP-SMX + Prednisone if decreased O2 levels (<70)
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14
Q

Most common cause of meningitis

A

Strep pneumo

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15
Q

Meningitis + rapid-onset of hypotensive shock & petechial rash

A

Meningococcal Meningitis

(Neisseria meningitidis)

  • CTX + Vancomycin
  • Strep pneumo (most common) does not have shock or skin manifestations
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16
Q

Acute fevers + Chancre + Myocarditis + CNS involvement + Sleepiness + East Africa

A

Trypanosomiasis

(Tsetse flies)

  • “African Sleeping Sickness”
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17
Q

Fever, HA + Myalgias + Retroorbital pain + Leukopenia + travel

A

Dengue Fever

(Mosquito-borne)

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18
Q

Cyclical/undulating fever + anemia + travel

A
  • Malaria (Africa)
  • Babesiosis (NE or Midwest US; Tick-transmitted)
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19
Q

CD4 <50 + bloody diarrhea

A

CMV Colitis

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20
Q

HA, vomiting, BL Papilledema + HIV

A

Cryptococcal meningoencephalitis

(Cryptococcus neoformans)

  • Dx: CSF antigen testing (or: India Ink or Sabouraud)
  • Tx: Amphotericin B w/ flucytosine + Fluconazole maintenance
  • Normal MRI
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21
Q

Encephalitis + Temporal lobe involvement

A

HSV Encephalitis

  • +cognitive/personality ∆s
  • +seizures or neuro deficits
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22
Q

CD4 <50 + elevated alk phos + splenomegaly

A

Mycobacterium avid complex

(MAC)

  • Tx: Macrolides
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23
Q

Travel + hepatomegaly + unvaccinated

A

HAV

(most common)

  • Fecal-oral
  • MSM/Sexual transmission
  • Illicit drug use
  • Travel
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24
Q

Raw oysters or wound contamination in sailing/marine environment + Rapidly progressive bullous or necrotizing lesion/infection

A

Vibrio vulnificus

(increased in liver disease, especially hemochromatosis due to free iron being catalyst)

  • Bullous lesions
  • Necrotizing fasciitis
  • Tx: CTX + Doxycycline
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25
Immunocompromised + BL diffuse interstitial infiltrates
**Pneumocystis PNA** (PCP) * +Elevated LDH * Dx: Bronchoalveolar lavage (cannot be cultured)
26
Hyponatremia + diarrhea + PNA Sx + confusion/ataxia + travel + high fever
**Legionella PNA** (Tx: fluoroquinolones or macrolides) * Contaminated water from **cruise ships** or hotels
27
Eggshell calcification on liver
**Hydatid cyst** (Echinococcus granulosus; dog tapeworm)
28
Nosocomial UTI + endocarditis. Pathogen?
**Enterococci**
29
Colon carcinoma + endocarditis. Pathogen?
**Strep bovis** | (Strep gallolyticus)
30
Immunocompromised + endocarditis. Pathogen?
**Candida**
31
Post-dental infection + non-painful + yellow sulfur granules + sinus tracts. Dx/Tx?
**Actinomyces** | (Tx: **Penicillin**)
32
Pork + adult seizure
**Neurocysticercosis** (Taenia solium) * Tx: Albendazole
33
Nocardia Tx
**TMP-SMX** | (Bactrim)
34
Ludwig Angina
***Rapidly progressive submandibular cellulitis on the floor of the mouth 2/2 polymicrobial teeth root infection.*** * Usually infected mandibular molar * IV Abx prevents airway compromise (ampicillin-sulbactam or clindamycin)
35
**HIV** pt w/ multiple ring-enhancing lesions, including basal ganglia
**Toxoplasmosis** * Tx: **Sulfadiazine** + **Pyrimethamine** * **PPX: TMP-SMX**
36
Erysipelas
**Upper dermis** (superficial) skin infection, usually **Group A Strep,** that presents w/ warm tender erythematous rash w/ raised, **sharply demarcated borders**
37
Stick from HBV patient. Tx?
**HBV Ig + HBV Vaccination**
38
Unvaccinated rusty nail injury. Tx?
**Tetanus vaccine** (+Tetanus Ig if *symptomatic* or *never received vaccine*)
39
Valvular abnormality w/ Infective Endocarditis
**Mitral Valve Prolapse** **(**MVP) w/ Mitral Regurgitation (MR)
40
Porphyria Cutanea Tarda (PCT)
**HCV-**associated skin changes to sun exposure, with vesicles and bullae
41
Only indication for meningococcal vaccination
**High-risk** | (asplenia, complement deficiency)
42
Ehrlichiosis
**Tick-borne bacterial infection from lone star tick** (Amblyomma americanum) in Southeastern and South central US (e.g. Arkansas) * Reservoir is white tail deer * Leukopenia, Thrombocytopenia, Elevated **LFTs & LDH**
43
Streptococcus mutans
**Strep viridans group** (infective endocarditis from periodontal disease/dental work) * **S** mutans * **S** sanguinis * **S** mitis * **S** oralis * **S** sobrinus
44
Immunocompromised w/ PNA Sx + beaded or branching rods + partially acid fast + aerobic
**Nocardia** (most commonly pulmonary nocardiosis: nodular or cavitary lesions in upper lobes) * Tx: TMP-SMX
45
HAP (Hospital-Acquired Pneumonia) Tx
**Vancomycin + Pip**
46
TB-mimicking diseases
* **Histoplasmosis** (Mississippi/Ohio River - Bird/Bat droppings; Mold in soil) * **Blastomycosis** (Wisconsin, Mississippi - Soil, rotting wood)
47
Reticulated/lace-like rash + flu-like symptoms
**Parvovirus B19**
48
Arthralgias + Painful fingertips/toes + hematuria/RBC casts + Rf+
**Infective Endocarditis (**
49
HIV + Linear ulcers in the distal esophagus
**CMV Esophagitis**
50
Intranuclear and intracytoplasmic inclusions
**CMV**
51
CMV Tx
**Ganciclovir**
52
Mycobacterium Avium presentation
**HIV pt CD4\<100 w/** * **Constitutional** Sx (high fever, night sweats, fatigue, wt loss) * **GI S**x (diarrhea, abd pain)
53
HIV pt CD4\<100 w/ Constitutional symptoms + Vascular cutaneous lesions + Liver/Bone/CNS involvement
**Bacillary Angiomatosis** (Bartonella) * Cat scratch * Head/Body Lice (Homelessness)
54
CD4+ \<50 + bloody diarrhea
**CMV** (CMV Colitis) * Colonoscopy w/ biopsy * Ocular examination to r/o concurrent retinitis
55
Immunocompromised pt w/ suspected bacterial meningitis Tx?
**Cefepime + Vancomycin + Ampicillin**
56
Grey mucous patches
**Syphilis**
57
Epitrochlear LAD
**Syphilis** | (Pathognomonic)
58
Multiple violaceous papules in HIV patient
**Kaposi Sarcoma** | (HHV-8)
59
Most common cause of community-acquired bacterial meningitis
**Strep pneumo**
60
Hypopigmented well-demarcated numb skin lesion
**Leprosy** (respiratory droplet or armadillo) * Dx: Full thickness biopsy * Tx: Dapsone + Rifampin; +Clofazimine if multibacillary
61
Excessive vomiting immediately after eating reheated rice
**Bacillus cereus enterotoxin**
62
School teacher with acute onset symmetric arthralgias
**Parvovirus B19** * Dx: Anti-parvovirus B19 IgM Antibodies
63
Pregnant or lactating woman w/ erythema migrans. Tx?
**Amoxicillin** | (Doxycycline is teratogenic!)
64
Child \<8yo w/ erythema migrans. Tx?
**Amoxicillin** (Doxycycline is contraindicated in children due to adverse effects on bone development)
65
Immigrant with RUQ pain + low-grade fevers
**Amebic Liver Abscess** (Entamoeba histolytica) * Tx: Oral MNZ * Echinococcus (hydatid cysts) not associated with fevers
66
Echinococcus Tx
**Percutaneous aspiration/drainage + albendazole**
67
Heterophile antibody test
**Monospot test** (EBV)
68
Common coinfections w/ G/C
* **HIV** * **HBV** * **Syphilis (Treponema pallidum)**
69
Central & Midwest US (Ohio & Mississippi River Valleys)
**Histoplasmosis** | (bird or bat droppings)
70
Wisconsin
**Blastomycosis**
71
Southwest
**Coccidioidomycosis**
72
Northeast
**Ixodes Tick**
73
Central/South America or Caribbean + flulike illness + symmetric polyarthralgias + macular rash + cervical LAD
**Chikungunya Fever** (Aedes mosquito viral illness) * Self-limited (7-10d) * Dx: Serologic testing
74
Tx of disseminated histoplasmosis
**IV Amphotericin B + 1 year of oral itraconazole**
75
**Tx of Febrile Neutropenia**
**Empiric anti-pseudomonal broad spectrum abx:** * Cefepime * Meropenem * Piperacillin-Tazobactam (Pip/Tazo; Zosyn)
76
Thrush, think
**HIV or immunocompromised** | (opportunistic infections)
77
LP w/ high opening pressure, low WBCs, low glucose, elevated protein
**Cryptococcal meningoencephalitis** (fungal) * Tx: IV Amphotericin B + Fluconazole * Defer treating newly discovered HIV to after antifungal Tx
78
Sabouraud agar
**Fungi** | (“Sab’s a fun guy!”)
79
Elderly diabetic patient with ear canal infection
**Malignant Otitis Externa** (Pseudomonas) * Granulation tissue in ear canal on exam
80
Acute testicular pain during viral illness
**Mumps orchitis**
81
CSF profile in GBS (Guillain-Barre Syndrome)
* Elevated proteins * Normal WBC, RBC, glucose (albuminocytologic dissociation)
82
Are empiric antibiotics recommended for bloody diarrhea in children?
- **No** - because they increase the risk for hemolytic uremic syndrome (HUS) if the causative pathogen is high-risk STEC (E coli O157:H7). - Exceptions are for immunocompromised or severe cases.
83
MCC of viral conjunctivitis (pink eye)
**Adenovirus** * Common in small children and caregivers in late summer, early fall * Self-limited * Warm or cool compresses for symptomatic relief

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