Infectious Disease Flashcards
What is the most likely diagnosis for pt presenting with postauricular and suboccipital lymphadenopathy, small pinkish red spots on the soft palate, joint pain and swelling, and discrete pinkish red macular lesions starting on face and spreading distally?
Rubella
Forchheimer spots- pinkish red spots on soft palate
what are the two most common pathogens that cause secondary bacterial infection in pt with Influenza?
- S. aureus
2. Strep pneumoniae
What is the most likely diagnosis of newborn presenting with IUGR, hydrocephalus, microphthalmia, chorioretinitis, hepatosplenomegaly, rash, generalized lymphadenopathy, and generalized cerebral calcifications?
Toxoplasma gondii infection
pregnant mom changing cat litter
what is the treatment to eliminate or diminish MRSA carrying status?
Topical mupirocin in anterior nares BID fro 5 days
What is the most likely diagnosis of pt presenting with small irregular, red spots with bluish white center on buccal mucosa, fever, cough, coryza, conjunctivitis, and confluent erythematous macular rash over the trunk?
Measles (Rubeola)
Koplik spots- redspots with bluish center on buccal mucosa
What is the timeframe for maternal varicella infection that results in severe/ fatal varicella?
2-5 days prior to delivery
infants should receive varicella-zoster IgG
what is the most likely diagnosis for pt presenting with symmetrically distributed, flesh toned to brownish, papules on face, buttocks, and extensor surface of knees and elbows, sparing the trunk, that are flat and without umbilication, and may have associated axiallary/ inguinal lymphadenopathy and hepatosplenomegaly?
Gianotti-Crosti syndrome
(papular acrodermatitis of childhood)
(due to EBV infection)
What two sports are associated with herpes gladiatorum (grouped tender vesicles that ulcerate, erode, and crust localized to abraded area of skin)?
- Wrestlers
2. Rugby
What is the best treatment for malaria prophylaxis for pt traveling to area with chloroquine resistance? (3)
- Doxycycline (1-2 days prior, daily until 4 weeks after)
(avoid prolonged sun exposure, children less than 8) - Malarone (atovaquone/ proguanil) for 1-2 days before, daily until 7 days after)
- Mefloquine (weekly, 1 week before and 4 eks after)
What is the most likely diagnosis for pt presenting with exudative pharyngitis, nonpurulent conjunctivitis, rhinitis, hemorrhagic cystitis, and preauricular and anterior cervical lymphadenopathy in warmer months?
Adenovirus
tx: cidofovir for immunocompromised pt
What is the most likely diagnosis for pt presenting with exudative hemorrhagic lesions of retina, shortness or breath, fatigue, joint pain, malaise, tender pea sized intradermal nodules on finger pads, nonblanching linear brownish red lesion under nail bed, and painless macular blanching erythematous lesion on palms and soles in the setting of cardiac defect and recent dental procedure?
Subacute bacterial endocarditis
Roth spots, Osler nodes, Splinter hemorrhages, Janeway lesions
What is the most likely diagnosis for pt presenting with pruritic fine pinkish red papular rash on face, trunk, and extremities that spares circumoral area/ palms/ soles and feels like gooseflesh/ sandpaper, linear petechiae in flexor surfaces, headache, GI upset and sore throat?
Scarlet fever
Pastia lines
What is the most likely diagnosis for pt presenting with headache, malaise, myalgia, photophobia, erythematous macules and petechiae around ankles, wrists, palms and soles sprading centrallyand hyponatremia?
Rocky Mountain Spotted Fever
What is considered a positive tuberculin test in child under 4 years old, from high TB areas, in close contact with high risk population or have chronic medical conditions?
more than 10 mm
What is the most likely diagnosis for pt presenting with regional lymphadenopathy, painful red ulcer at site, sudden fever, hepatosplenomegaly in the setting of being a hunter?
Tularemia
francisella tularensis from rabbits
what is the most likely diagnosis for pt presenting with firm, discrete, nontender nodes unilaterally on the neck after traveling out of the country?
Cervical tuberculous lymphadenitis (Scrofula)
dx: surgical excision and biopsy
(tx 9 months of therapy)
What is the most common long term complication of bacterial meningitis?
hearing loss
What disorder is associated with a radiographic finding of osteochondritis at the metaphyses and periostitis of the bone in a newborn?
Congenital syphillus
due to treponema pallidum
What is the most likely diagnosis for a pt presenting with erythematous, wet appearing rashh with peripheral crusting within the intertriginous areas (web of finger)?
Cutaneous candidal infection
tx: topical clotrimazole or nystatin
What is the most likely diagnosis for pt presenting with intensely red facial rash associated with circumoral pallor and a symmetric maculopapular lattice like rash on the extremities with associated prodrome of headache, fever, coryza, diarrhea?
Erythema infectiosum due to Parvovirus B19
can result in red blood cell aplasia and severe anemia in sickle cell pt
What infection is commonly associated with uncooked hot dogs and goat cheese?
Listeria
what is the best initial treatment for bacterial meningitis?
Ceftriaxone and vancomycin
When can a child with active varicella infection return to school/ daycarre?
when all lesions are dried and crusted over
contagious 1-2 days prior to rash
What is the most likely diagnosis for pt presenting with chronically draining lesion in the setting of water exposure (swimming pool, fish tank)?
Mycobacterium mariunum
What is the best treatment for pt with severe otitis externa?
Ciprofloxacin PO
What is the most likely diagnosis for pt with progressive hoarseness, intermittent inspiratory stridor, and vocal cord lesion?
Juvenile Larygneal papillomatosis
due to HPV (human papillomavirus)
What is the most likely diagnosis for pt presenting with facial nerve palsy (bell’s palsy- inability to smile or close eye) and complete heart block?
Early disseminated Lyme disease
ELISA for Borrelia burgdorferi IgG and IgM
What is the treatment for rocky mountain spotted fever?
Doxycycline
What is the electrolyte abnormality associated with Rocky Mountain spotted fever?
hyponatremia
What is the most likely diagnosis for an infant with hypoxia, tachypnea, bilateral interstitial infiltrates in the setting of mother with no prenatal care?
Pneumocytis jiroveci (PCP) due to AIDS
tx: steroids and Bactrim
What prenatal infection results in fetal ultrasound showing subcutaneous edema, pleural effusion, pericardial effusion, ascites, and fluid accumulation of major organs, and anemia?
Parvovirus B19
What is the most likely diagnosis for infant presenting with staccato like cough, nasal congestion, rales in absence of wheezing and peripheral eosinophilia?
Chlamydia trachomatis pneumonia
What vitamin deficiency is associated with the treatment with Isoniazid?
Pyridoxine (vitamin B6)
results in peripheral neuropathy
True or false. Perceptual distortions can be presenting symptom of infectious mononucleosis?
True
What is the best initial treatment for neonate with Listeria sepsis?
Ampicillin and gentamicin
What is the most likely cause for pt presenting with fever, anorexia, fatigue, exudative pharyngitis, cervical lymphadenopathy, and negative EBV titers?
CMV (cytomegalovirus)
What is the next best step in management if there are 2 or more cases of invasive HiB infection?
all attendees and workers at a given child care should receive rifampin prophylaxis
Which patients should received measles immunoglobulin via IV in the setting of close measles exposure? (3)
- HIV pts with severe immunosuppression
(regardless of vaccine hx) - less than 1 year old
- pregnant
What is the best treatment for Tularemia?
Gentamicin or Streptomycin
What is the most likely diagnosis for pt presenting with discrete vesicles surrounded by erythema, some of which are ulcerated, on the posterior pharyngeal wall/ uvula/ anterior tonsillar pillar in setting of sudden fever?
Herpangina
due to Coxsackie
What disease is associated with epidemic keratoconjunctivitis (with crusting) and swimming pools?
Adenovirus
What is the treatment for 1st recurrence and 2nd recurrence of C. difficile?
1st: repeat metronidazole
2: oral vancomycin
When can a pt return to work/ school if they have a herpes zoster infection?
immediately as long as lesions are covered
What is the most likely diagnosis for pt presenting with acute rapidly progressive symmetric erythematous swelling of hands and feet that is sharply demarcated at the wrists and ankles, along with painful papules, petechiae adn purpura?
Papular purpuric gloves and socks syndrome
due to Parvovirus B19
Which disease is a vaccine preventable disease for which herd immunity is not a factor?
Tetanus
What is the most likely diagnosis for pt presenting with painful swelling at tips of fingers with fluid-filled blister located at fat pad of fingers in the setting of history of eczema?
Blistering distal dactylitis
due to Group A strep
What bacteria that causes gastroenteritis can also cause purulent vaginal discharge that may be blood tinged?
Shigella
What are the lab findings associated with whooping cough (Bordetella pertussis)? (2)
- Lymphocytosis
2. Thrombocytosis
What treatment for tuberculosis can result in orange colored secretions and urine?
Rifampin
What is the most likely diagnosis for pt presenting with severe ear pain, facial nerve paralysis (inability to close eye, smile, wrinkle forehead) and red vesicles in the external ear car?
Ramsay Hunt
(due to varicella zoster virus)
(tx: acyclovir and steroids)
What test can be used to distinguish latent TB from tuberculin skin testing positive due to BCG vaccination?
Interferon gamma release assay
should do TST testing initially
What is the best diagnositic tool for early diagnosis of osteomyelitis?
MRI
can use Xray after 10-14 days
What is the most likely diagnosis for pt with penetrating eye injury with ring abscess formation in the cornea?
Bacillus cereus
What is the most likely diagnosis for pt presenting with serpiginous, migratory well demarcated plaques that are pruritic after spending time in Florida/ Caribbean/ Mexico?
Dog hookworms
tx: oral abendazole or ivermectin
What are the inpatient isolation requirements for measles infection (airborne)?
standard precautions
private, negative pressure ventilation
N95 respirators at all time