Infectious Disease

Question 1

Rule of 7’s for Lyme meningitis

Answer 1

Headache duration <7 days
<70% monocytes in CSF
No 7th CN palsy

Question 2

WNV meningitis presentation

Answer 2

Acute flaccid paralysis; possibly persists after resolution of infection

Question 3

Mycobacterial tuberculosis meningitis presentation

Answer 3

Basilar meningitis w/ cranial neuropathies (particularly of CN VI), mental status changes, and SIADH

Question 4

Treatment of brain abscess caused by bacterial endocarditis

Answer 4

Vanc + gent

Question 5

MRI w/ vCJD

Answer 5

“Hockey stick sign” = Posterior thalamus abnormality

Question 6

Empiric therapy of mild ersipelas/ellulitis infection

Answer 6

Mild: Penicillin, amoxicillin, keflex, clinda

Question 7

Test for osteomyelitis if you cannot get an MRI or CT w/ contrast

Answer 7

Labeled leukocyte scan combined w/ a radionucleide bone scan

Question 8

Tx for staphylococcal toxic shock syndrome

Answer 8

Nafcillin + Clindamycin

Question 9

Tx for streptococcal toxic shock syndrome

Answer 9

Penicillin + Clindamycin

Question 10

GN cocci in sputum in patient who was just at political event

Answer 10

Bubonic plague (Yersina perstis); Treat w/ streptomycin or gentamicin ASAP

Question 11

Nontreponemal tests

Answer 11

RPR and VDRL

Advantages; These tests will be negative following successful treatment of primary syphilis
-FTA-B, EIA, and other treponemal tests remain positive for life

Question 12

Patients more susceptible to Vibrio

Answer 12

Chronic liver disease patients

Question 13

Initial evaluation testing for HIV patients

Answer 13

Viral resistance testing 
Viral load 
CD4 count 
CBC, CMP, UA (proteinuria)
Lipid profile 
TST, IGRA
Hepatitis panel
RPR, HSV PCR 
Tox testing 
Cervical pap smear

Question 14

Antiretroviral to use in patients w/ increased risk for bone/nephrotoxicity

Answer 14

Tenofovir alafenamide

Question 15

Ceftolazone-tazobactam

Answer 15

Antipseudomonal cephalasporin w/ b-lactamase inhibitors; inhibits cell wall synthesis

Used for complicated UTIs and active against many GNs and multi-drug resistant Pseudomonas; including those w/ carbapenem resistance

Question 16

Ceftaroline

Answer 16

Inhibits cell wall synthesis; used for CAP

Question 17

Dalbavancin

Answer 17

IV medication used once weekly for gram positives including MRSA

Question 18

Televancin

Answer 18

IV once weekly medication for complicated MRSA skin infections

Question 19

Medicine used to treat MRSA and VRE UTIs

Answer 19

Fosfomycin

Question 20

Minocycline

Answer 20

Used for VAP; also used for resistant Acinetobacter and Stenotrophomonas maltophilia strains

Question 21

Thromboprophylaxis in patient’s w/ Staph or Candidal bacteremia

Answer 21

SCDs

***NO ANTICOAGULATION; THESE PATIENTS ARE AT RISK FOR CEREBRAL EMOBLI AND INFARCTION WHICH CAN CONVERT TO HEMORRHAGIC WITH ANTICOAGULATION

Question 22

What to do after incision part of I and D

Answer 22

Use hemostat or probe to insert into lesion and break up loculations

Make sure to make incision deep enough!

Question 23

Patient with shingles and needs precautions

Answer 23

Actually you can just cover the lesion as long as you are not worried about him being immunocompromised