Infectious Disease Flashcards

1
Q

White curd like vaginal discharge should make you think of what dx?

A

vaginal candida infection

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2
Q

Owl eye inclusion bodies should make you think of what dx?

A

cytomegalovirus (CMV)

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3
Q

If you have a pt with positive blood cultures for candida what is the first line drug?

A

amphotericin B

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4
Q

What is the tx for pertussis?

A

erythromycin x 7d

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5
Q

A leukemia pt has a CT scan of the liver which shows punched out lesions. What dx should you be thinking of?

A

Hepatosplenic candida

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6
Q

What disease does Rickettsia rickettsia cause?

A

Rocky Mountain spotted fever

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7
Q

An India ink stain showing cysts should make you think of what dx?

A

Cryptococcosis

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8
Q

A COPD pt has apical cavities and calcified nodes on his CXR. You also discover he has a pet bat and a few birds. What is the most likely dx?

A

Histoplasmosis

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9
Q

An HIV pt presents with a nonproductive cough and a CXR showing diffuse interstitial infiltrates. What is the most likely dx?

A

Pneumocystis jiroveci pneumonia

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10
Q

Honey and babies should make you think of what dx?

A

Botulism

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11
Q

What type of organism causes botulism?

A

A gram positive rod: clostridium botulinum

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12
Q

What is the treatment for botulism?

A

Antitoxin

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13
Q

A pt presents to the ER with acute progressive weakness, diplopia and a very dry mouth. What organism may be causing this?

A

Clostridium botulinum

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14
Q

Rice water stool should make you think of what dx?

A

Cholera

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15
Q

Is diphtheria a Gram positive or negative organism?

A

Gram positive

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16
Q

Gram positive vs gram negative

A

Despite their thicker peptidoglycan layer, Gram-positive bacteria are more receptive to antibiotics than Gram-negative, due to the absence of the outer membrane.

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17
Q

A stuck on grey membrane in the pharynx should make you think of what dx?

A

Diphtheria

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18
Q

What are 4 steps in dx’ing diphtheria?

A

Antitoxin
penicillin
remove membrane
report the case to CDC

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19
Q

What is the clinical name for whooping cough?

A

Pertussis

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20
Q

What type of organism causes tetanus?

A

A Gram + rod: clostridium tetani

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21
Q

A pt ate out last night and today has cramping and bloody diarrhea. What is the most likely organism?

A

Salmonella

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22
Q

Diarrhea with blood and mucus should make you think of what dx?

A

Shigella

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23
Q

What is the best test to dx malaria?

A

peripheral blood smear

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24
Q

What organism has been linked to reactive arthritis?

A

Shigella

also remember that reactive arthritis has a positive HLA-B27

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25
Q

What is the tx for shigella?

A

Bactrim or fluoroquinolones and hydration

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26
Q

What organism causes Lyme disease?

A

Borrelia burgdorferi

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27
Q

What is the minimum amount of time needed for a tick to transfer Lyme disease to a human?

A

24hrs

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28
Q

What is the drug of choice to tx Lyme disease in kids or pregnant women?

A

Amoxicillin

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29
Q

What is the drug of choice to treat C. difficile?

A

Metronidazole (Flagyl)

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30
Q

A pt was in the woods yesterday and today presents with erythema migrant. What is the most likely diagnosis?

A

Lyme disease

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31
Q

What drug is used for the treatment or prophylaxis of malaria?

A

Chloroquine

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32
Q

A pt was camping a few days ago and now has a rash that began on his wrists and ankles. What is the most likely diagnosis?

A

Rocky Mountain spotted fever

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33
Q

What is the drug of choice for treating Rocky Mountain spotted fever?

A

doxycycline

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34
Q

What is the drug of choice for the treatment of syphilis?

A

Penicillin

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35
Q

Any reference to dark field microscopy should make you think of what organism?

A

Trepenoma pallidum

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36
Q

Is staph gram positive or gram negative?

A

Gram positive

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37
Q

A pt being tx’ed for syphilis infection develops a fever, chills, muscle pain and headaches. Do you stop treatment?

A

No, this is Jarisch-Herxheimer reaction. The pt must be closely monitored, but it is a response to released endotoxin from the death of the spirochetes and not an allergic reaction.

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38
Q

What organism is believed to be the main culprit in creating peptic ulcers?

A

Helicobacter pylori

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39
Q

A painless, clean base chancre should make you think of what dx?

A

Primary syphilis

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40
Q

Is pseudomonas gram + or gram -?

A

Gram -

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41
Q

A pt c/o rash on his palms and soles. He has a fever and chills. in conversation he mentions a strange painless chancre he had a few weeks ago. What is the most likely dx?

A

Secondary syphilis: this is the most contagious stage

42
Q

What is the treatment for cholera?

A

Fluids

43
Q

What is the current drug of choice for the cytomegalovirus?

A

Ganciclovir

44
Q

Which herpes virus causes Epstein-Barr?

A

Herpes 4

45
Q

A 16yo girl presents with an exudative sore throat and general malaise. On PE you observe some posterior chain lymphadenopathy and mild splenomegaly. What is the most likely dx?

A

Epstein-Barr virus

46
Q

What are 2 important pieces of pt edu for anyone dx’ed with mononucleosis?

A
No contact sports (splenic rupture)
No kissing (highly contagious)
47
Q

What is the first symptom of a rabies infection?

A

Pain and anesthesia at the site of the bite

48
Q

How do you definitely dx rabies?

A

pathology of the brain of the animal that performed the bite using fluorescent antibody stain

49
Q

A pt is bitten by a rabies infected raccoon. On what days do you give human diploid cells?

A

0, 3, 7, 14, 28

50
Q

A diaper rash with satellite lesions should make you think of what diagnosis?

A

Candida

51
Q

Name 3 serious reactions a pt may have with the use of vancomycin?

A

Nephrotoxicity
ototoxicity
Stevens-Johnson syndrome

52
Q

What tests are done to screen for HIV?

A

ELISA and then in positive dx is confirmed with a Western blot test

53
Q

What is the drug of choice for the tx of Lyme disease?

A

doxycycline

54
Q

What does trismus mean?

A

Lock jaw, often 2ndary to tetanus

55
Q

How do you tx amebiasis?

A

Metronidazole (flagyl)

56
Q

How do you treat pneumocystis jiroveci pneumonia (PCJ) formerly known as pneumocystis carinii pneumonia (PCP)?

A

Bactrim

57
Q

What is the treatment for tetanus infections?

A

Penicillin
immune globulin
supportive care: esp respiratory support

58
Q

How do hookworm larvae enter the body?

A

They penetrate the skin usually through the soles of the feet.

59
Q

How do you treat hookworm?

A

Azoles

60
Q

What type of mosquitoes carry malaria?

A

Anopheles

61
Q

How do you treat white oral plaques that can be scraped off?

A

This is most likely candida. Topical nystatin or oral fluconazole are first line choices.

62
Q

A CT scan shows ring enhancing lesions in an HIV pt. What is the most likely dx?

A

Toxoplasmosis

63
Q

What is the drug of choice for toxoplasmosis?

A

Bactrium

64
Q

What organism causes toxoplasmosis?

A

Toxoplasma gondii

65
Q

What drug do you use to treat pinworm?

A

You treat everyone in the house with albendazole. Two weeks later you treat them again.

66
Q

The scotch tape test is used to dx what disease?

A

Pinworm

67
Q

Is neisseria gram + or -?

A

Gram -

68
Q

Syphilis is caused by what organism?

A

Treponema pallidum

69
Q

A gram positive organism in chains should make you think of what dx?

A

Strep

70
Q

A gram negative diplococci should make you think of what dx?

A

Neisseria

71
Q

What is the most common prophylactic antibiotic used preoperatively?

A

Cefazolin=Ancef

72
Q

What oral antibiotic can be used for pseudomonas?

A

Ciprofloxacin

73
Q

What is the suffix used for most fluoroquinolones?

A

Oxacin

74
Q

Why aren’t fluoroquinolones used more frequently?

A

they have lots of SE

75
Q

A pt presents with a ruptured Achilles tendon. He states that he was recently in the hospital for a “blood infection and on a ton of antibiotics.” What abx class may he have been on?

A

Fluoroquinolones

76
Q

Why can’t you give fluoroquinolones to kids?

A

they can cause cartilage development problems.

77
Q

What class of antibiotics should you start with for community acquired pneumonia?

A

Macrolides

78
Q

List 2 macrolides.

A

Erythromycin
Azithromycin
Clarithromycin

79
Q

What antibiotic class is the class of choice for chlamyida?

A

Macrolides

80
Q

What class of abx is sometimes prescribed specifically for its effects on increasing GI motility?

A

Macrolides

81
Q

Which medication is worse to give to a pediatric patient: tetracycline or aminoglycoside?

A

Tetracycline

82
Q

Pizza pie retinopathy should make you think of what dx?

A

Cytomegalovirus

83
Q

A pt presents c/o a metallic taste in her mouth and dark brown urine. What antibiotic might she be on?

A

Metronidazole (Flagyl)

84
Q

What antibiotic is most likely to cause C. diff?

A

Clindamycin

85
Q

What is the current drug of choice to tx MRSA?

A

Vancomycin

86
Q

You place a pt on rifampin. What SE should you warn her about?

A

Orange-red discoloration of body fluids

87
Q

What might happen is you infuse vancomycin too fast?

A

Red Man syndrome

88
Q

Name one oral med that can be used for MRSA.

A

Linezolid (zyvox) and Bactrim

89
Q

What organism is most commonly responsible for community acquired pneumonia?

A

Strep pneumoniae

90
Q

What organism is the most common cause of an uncomplicated urinary tract infection?

A

E. coli

91
Q

Gummas or granulomatous nodules should make you think of what dx?

A

Tertiary syphilis

92
Q

Bloody stool with cysts and trophozoites should make you think of what dx?

A

Amebiasis

93
Q

Community acquired carditis is often caused by one of the HACEK organisms. List the HACEK organisms.

A
Haemophilus
Actinobacillus
Cardiobacterium
Eikenella
Kingella
94
Q

What are 3 meds often combined in a first line tx for h. pylori?

A

Omeprazole
clarithromycin
amoxicillin (PPI +2 abx)

95
Q

What is the prophylactic abx most commonly given before a dental procedure if one is necessary?

A

Amoxicillin 2 grams PO given 1 hr before procedure

96
Q

A pregnant woman and cat litter should make you think of what dx?

A

Toxoplasmosis

97
Q

What is the drug of choice to tx urethritis caused by neisseria?

A

Ceftriaxone (Rocephin)

98
Q

Is Klebsiella gram + or -?

A

Gram -

99
Q

A gram positive organism in clusters should make you think of what dx?

A

Staph

100
Q

What is the best test for dx’ing Rocky Mountain spotted fever?

A

Indirect immunofluorescent antibodies

101
Q

A Gram-negative coccobaccili found in the sputum of a pt with pneumonia should make you think of what dx?

A

H. flu

102
Q

What med is used as prophylaxis for meningococcal meningitis?

A

Rifampin