Infectious dz

Question 1

What do you see in an HIV pt with a CD4 of less than 200

Answer 1

PJP, Histoplasmosis

Question 2

Lyme disease is caused by

Answer 2

Caused by Borrelia burgdorferi (gram-negative spirochete) that is spread by Ixodes (deer) tick

Question 3

Early disseminated lyme dz sx

Answer 3

1-12 weeks after bite - musculoskeletal, flu-like syndrome, consisting of malaise, fatigue, chills, fever, headache, stiff neck, myalgias, and arthralgias that may last for weeks, cardiac (AV block).

Question 4

When would an ELISA test be positive after lyme dz exposure

Answer 4

• ELISA testing will be positive by 3rd week

Question 5

Meningitis vs encephalitis difference

Answer 5

• Unlike encephalitis, meningitis has no mental status changes

Question 6

2 physical exam findings of meningitis

Answer 6

• Kernig sign (watch video) - knee extension causes pain in the neck
• Brudzinski sign (watch video) - leg raise when bend neck

Question 7

MC bugs in meningitis

Answer 7

S. pneumoniae (gram-positive diplococci), N. meningitidis (gram-negative diplococci)

Question 8

CSF on LP for meningitis

Answer 8

• Bacterial: ↑ Protein ↓ Glucose (bacteria love to eat glucose)
• Viral: No specific characteristics but may have lymphocytes

Question 9

Tx of meningitis

Answer 9

Treatment: Dexamethasone + Empiric IV antibiotics (Cephalosporin, Vancomycin, Penicillins)

Question 10

classic triad of fever + lymphadenopathy + pharyngitis

Answer 10

Mono

Question 11

heterophile antibody screen

Answer 11

Mononucleosis

Question 12

Left upper quadrant pain secondary to splenomegaly and are at risk for splenic rupture

Answer 12

Mono

Question 13

Diarrhea from poultry or pork

Answer 13

Salmonella = salmonellosis

Question 14

Salmonellosis divided into 2 categories

Answer 14

two broad categories: those that cause typhoid and enteric fever and those that primarily induce gastroenteritis

Question 15

a flu-like bacterial infection characterized by fever, GI symptoms, and headache. Transmitted via the consumption of fecally contaminated food or water

Answer 15

Enteric fever

Question 16

Rash associated with salmonellosis

Answer 16

• Rose spots may be present (2-3 mm papule on trunk usually)
• More common in the developing world (usually immigration cases)

Question 17

improperly handled food that has been contaminated by animal or human fecal material

Answer 17

Salmonellosis

Question 18

Tx of salmonellosis

Answer 18

Treat with ceftriaxone or other medications based on the sensitivity

Question 19

watery diarrhea or dysentery (the frequent and often painful passage of small amounts of stool that contains blood, pus, and mucus)

Answer 19

Shigellosis

Question 20

In the US, shigellosis predominantly affects children and is often spread in areas with

Answer 20

crowded conditions (like daycare centers

Question 21

The stool is positive for leukocytes and red blood cells

Answer 21

Shigellosis

Question 22

Tx of shigellosis

Answer 22

Treat with TMP-SMX or ciprofloxacin