Infectious Disease Emergencies

Question 1

This is one of the most common presenting sx and should prompt infectious and non-infectious DX?

Answer 1

Fever

Question 2

When a PT presents to the ED with fever, what are five HX, SX, or medication questions you should ask? (i can pick five from any category)

Answer 2

SX: headache, neck pain, N/V/D, abdominal PX

Drugs: Immunosuppressive drugs; ABX; recreational drugs

HX: recent travel; diabetes; HIV; sick contacts

Question 3

What are the two gram negative ABX that should be used in the ED?

Answer 3

cephalosporin or pip/taxo

Question 4

What are the 3 gram positive pathogens likely to cause sepsis?

Answer 4

s. pneumoniae; S. aureus; GAS

Question 5

What are the 3 gram negative pathogens likely to cause sepsis?

Answer 5

pseudomonas, Klebsiella, Enterobacter

Question 6

A PT presents to the ED with fever, headache, dysuria, N/V/D, back pain, cold mottled skin, a low body temp, and AMS. What is the likely dx?

Answer 6

sepsis

Question 7

When a PT presents with sepsis, which type of antibiotics should be giver first?

Answer 7

Cephalosporins and Pip/Tazo for gram negative pathogens which will kill pt sooner

Question 8

Presentation: Fever; stiff neck; AMS;
nuchal rigidity; petechiae; rash?

Answer 8

Neurologic meningitis

Question 9

What is the management for a pt dx with neurologic meningitis?

Answer 9

Admit/isolation
Ceftriaxone & vancomycin

Question 10

Presentation: Pronounced AMS; seizure, neuro deficit; requires lumbar puncture, MRI, and viral PCR studies?

Answer 10

neurologic encephalitis

Question 11

Most common pathogen of neurologic encephalitis?

Answer 11

HSV

Question 12

Treatment for neurologic encephalitis?

Answer 12

Acyclovir

Question 13

Presentation: New cough with sputum, dyspnea, chest px, back px, hypoxia, weird breath sound

Answer 13

respiratory pneumonia

Question 14

Treatment for community acquired pneumonia

Answer 14

azithromycin

Question 15

Presentation: fever most common, chills, weakness, dyspnea, chest px, Janeway lesions

Answer 15

infective endocarditis

Question 16

Most common pathogen causing infective endocarditis?

Answer 16

staph aureus

Question 17

Presentation: urinary urgency, frequency, dysuria, can have fever, CVA, abd tenderness

Answer 17

UTI

Question 18

Treatment for complicated UTI?

Answer 18

ceftriaxone and pip/tazo (zosyn)

Question 19

Presentation: Dysuria, pelvic px, scrotal px, discharge, itching, postcoital bleed

Answer 19

STI

Question 20

Treatment for gonorrhea?

Answer 20

ceftriaxone 500mg IM

Question 21

treatment for chlamydia?

Answer 21

doxycycline

Question 22

Presentation: Erythema, tenderness, induration, fever, chills

Answer 22

cellulitis

Question 23

Treatment for cellulitis without MRSA?

Answer 23

cephalexin or Augmentin

Question 24

treatment for cellulitis with MRSA?

Answer 24

bactrim (TMP/SMX) or clindamycin

Question 25

Presentation: feel like rice crispies in skin; rapid growing infection; extreme px; discoloration?

Answer 25

necrotizing fasciitis

Question 26

Pathogens of necrotizing fasciitis?

Answer 26

GAS & Staph aureus

Question 27

Treatment for necrotizing fasciitis?

Answer 27

Surgical debridement;
Vancomycin + meropenem

Question 28

What is the dx for ANC <500 + fever?

Answer 28

Neutropenic fever

Question 29

Animal reservoir presentation: GI sx and rash ankle and rash on wrist

Answer 29

rocky mountain spotted fever

Question 30

Microorganism responsible for RMSF?

Answer 30

Rickettsia rickettsii

Question 31

treatment for RMSF

Answer 31

doxycycline

Question 32

Zoonotic reservoir presentation: lymph enlargement and ulcers caused by aerobic gram negative pathogen?

Answer 32

Tuleremia

Question 33

What does SIRS stand for and what is the definition?

Answer 33

Systemic inflammatory response syndrome
Sepsis that has an identifiable pathogen/microorganism