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Step 2CK > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Diagnosis:

  1. Fever
  2. Leukopenia/thrombocytopenia
  3. Elevated aminotransferases
  4. History of tick bite
A

Ehrlichiosis

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2
Q

Treatment:

Ehrlichiosis

A

Doxycycline

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3
Q

What disease presents similarly to Rocky Mountain Spotted Fever, but lacks a rash?

A

Ehrlichiosis

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4
Q

Treatment:

TB in a patient who is pregnant, suffering from malnutrition or has diabetes mellitus

A

TB treatment plus pyridoxine (Vitamin B6)

Active TB: Isoniazid (INH), rifampin, ethambutol and pyrazinamide for 2 months followed by, INH and rifampin alone for 7 months

Latent TB: Isoniazid only (?)

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5
Q

Why should you add pyridoxine (Vitamin B6) to the medical therapy for TB in a patient who is pregnant, suffering from malnutrition or has diabetes mellitus?

A

INH-induced peripheral neuropathy

INH binds the active form of pyridoxine and results in renal excretion. This can lead to pyridoxine deficiency in certain at risk patients.

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6
Q

Initial evaluation:

Amebiasis

A
  1. Imaging
  2. Serologic testing for Entamoeba histolytica antibodies
  3. Empiric treatment with Metronidazole
  4. Luminal agent (F: to eradicate intestinal colonization)
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7
Q

Treatment:

Amebiasis (Entamoeba histolytica)

A

Metronidazole + luminal agent to eradicate intestinal colonization

Cyst drainage is not recommended routinely.

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8
Q

Diagnosis:

  1. Abdominal pain
  2. Fever
  3. Leukocytosis
  4. Liver abscess on imaging
  5. Hx of dysentery
  6. Recent travel from Mexico
A

Amebiasis (Entamoeba histolytica)

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9
Q

Differential:

Bloody diarrhea in the absence of recent travel

A
  1. Escherichia coli (EHEC)
  2. Shigella
  3. Campylobacter
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10
Q

What is the most common cause of bloody diarrhea in the absence of fever?

A

E. coli (EHEC)

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11
Q

True or False:

Antibiotics are the mainstay of treatment for Enterohemorrhagic E coli (EHEC).

A

FALSE! Treatment is generally supportive. Antibiotics may increase the risk of hemolytic uremic syndrome.

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12
Q

How can you confirm the diagnosis of Enterohemorrhagic E. coli (EHEC)?

A

Stool assay for Shiga toxin

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13
Q

Management:

Suspected Infective Endocarditis

A

Acute illness: obtain 3 blood cultures from 3 different venipuncture sites over a 1-hour period before beginning empiric antibiotic therapy.

Stable Subacute Illness (malaise without fever): obtain 3 blood cultures from 3 different venipuncture sites over several hours. Wait for cultures to return before starting antibiotic therapy.

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14
Q

What diagnostic tool can be used to make a clinical diagnosis of infective endocarditis?

A

Modified Duke criteria

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15
Q

What pathogen causes Toxic Shock Syndrome?

A

Staphylococcus aureus

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16
Q

Diagnosis:

  1. Fever
  2. Myalgia
  3. Marked hypotension
  4. Diffuse erythematous macular rash (erythroderma)
  5. Recent history of nasal packing
A

Toxic Shock Syndrome

TSS is associated with: (1) use of tampons during menstruation (2) nasal packing (3) post-surgical infections.

If left untreated, TSS can lead to multi-organ involvement.

17
Q

Treatment:

PPX against Mycobacterium avium complex in a patient with HIV

A

Azithromycin

18
Q

At what CD4 count is prophylaxis against Mycobacterium avium complex recommended for HIV patients?

A

CD4 <50

  • CD4 <200 = Pneumocystis*
  • *CD4 <100 = CMV**
19
Q

What are the key distinctions between primary HIV and Infectious mononucleosis?

A

Rash and diarrhea are less common in infectious mononucleosis.

Exudative pharyngitis is less common in HIV.

20
Q

The febrile illness seen in primary HIV also closely resembles __________.

A

Infectious mononucleosis

21
Q

Diagnose:

Infectious mononucleosis

A

Heterophile antibody test

22
Q

Treatment:

Splenic abscess

A

Splenectomy

Antibiotics alone have a high mortality rate (up to 50% in some studies) .

23
Q

What is the classic triad of splenic abscess?

A
  1. Fever
  2. Leukocytosis
  3. Left upper-quadrant abdominal pain
24
Q

Diagnosis:

Signs/Symptoms

  1. Fever
  2. Leukocytosis
  3. Left upper-quadrant abdominal pain
  4. Left sided pleuritic chest pain

Imaging:

  1. Left-sided pleural effusion
  2. Splenic fluid collection
A

Splenic abscess.

Treatment=splenectomy

25
Q

List the risk factors for splenic abscess.

A
  1. Infection with hematogenous spread (eg infective endocarditis)
  2. Immunosuppression
  3. IV drug use
  4. Trauma
  5. Hemoglobinopathies
26
Q

How long do the symptoms of influenza typically last?

A

<1 week

*Influenza is a self-limited infection. *

27
Q

What are the systemic and respiratory signs of influenza?

A

Systemic:

  1. Fever
  2. Malaise
  3. Myalgia
  4. Headache

Respiratory:

  1. Rhinorrhea
  2. Pharyngitis
  3. Non-productive cough
28
Q

What patients are at risk for complications of the flu?

A
  1. Patients with advanced age (age >65)

2. Patients with chronic illness (eg coronary artery disease, diabetes mellitus)

29
Q

Differentiate between primary influenza pneumonia and Streptococcus pneumoniae pneumonia/Pseudomonas aeruginosa pneumonia.

A

Influenza pneumonia:

  1. Acute worsening of cough and dyspnea
  2. Leukocytosis, but <15,000
  3. Hypoxia
  4. Bilateral, diffuse interstitial infiltrates on CXR

Streptococcus pneumoniae/Pseudomonas aeruginosa pneumonia:

  1. High fever
  2. Significant leukocytosis (>15,000)
  3. Lobar infiltrates on CXR
30
Q

What are the possible complications of Influenza.

A
  1. Pneumonia (primary influenza vs. Strep pneumoniae vs. Pseudomonas aeruginosa)
  2. Myositis
  3. Rhabdomyolysis
  4. Myocarditis
  5. Pericarditis
  6. Encephalitis
  7. Transverse myelitis

Step 2CK (10 decks)

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