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Infectology Flashcards

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1
Q

Serologic test results after Hepatitis B vaccination:
A) HBsAg positive
B) anti-HBs positive
C) anti-HBc positive
D) anti-HCV positive

A

B) anti-HBs positive

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2
Q

Definition of sepsis:
A) intermittent fever
B) bacteraemia
C) elevated ESR (erythrocyte sedimentation rate) and fever
D) a condition involving organ disfunction due to systemic immune response in which the role of infection can be seen or suspected

A

D) a condition involving organ disfunction due to systemic immune response in which the role of infection can be seen or suspected

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3
Q

Which of the following statements is true about antibiotic therapy in severe sepsis?
A) definitive antimicrobial therapy based on the results of blood culture and sensitivity test
B) initial empiric therapy with the intent to cover multiple possible pathogens commonly associated with the septic focus
C) combination of at least two bactericidal antibiotics
D) the newest and the most expensive antibiotic should be administered

A

B) initial empiric therapy with the intent to cover multiple possible pathogens commonly associated with the septic focus

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4
Q

The role of Streptococcus pneumoniae should be considered in community acquired pneumonia in which of the following cases?
A) always
B) if the patient underwent splenectomy
C) if the patient has chest pain when breathing and has purulent sputum
D) if there is a lobar consolidation on the chest X-Ray

A

A) always

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5
Q

A patient has trismus, risus, sardonicus and opisthotonus. What is the most likely diagnosis?
A) plague
B) gas gangrene
C) tetanus
D) rabies

A

C) tetanus

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6
Q

A 60-year-old patient presents to his primary care provider with headache and severe muscle pain. He has fever, itchy skin, and periorbital oedema. Two weeks ago he ate wild boar (which was cooked rare). His blood tests reveal elevated CK (creatine kinase) and eosinophilia. What is the most likely diagnosis?
A) Salmonellosis
B) Trichinellosis
C) Echinococcosis
D) Dysentery

A

B) Trichinellosis

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7
Q

A 19-year-old student boy has had sore throat for two weeks. A few days after the first symptoms he became febrile and generalized lymphadenopathy developed. He has lymphocytosis, thrombocytopenia and elevated liver enzymes. He lives in the countryside with a dog and a cat. Insects bite him frequently. What is the most likely diagnosis?
A) Lyme-disease
B) lymphoma
C) infectious mononucleosis
D) cat scratch disease
E) tularaemia

A

C) infectious mononucleosis

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8
Q

Tetanus prophylaxis should be administered in which of the following cases?
A) Every type of injury apart from the age and the vaccination status of the patient.
B) Every type of injury if the patient has been vaccinated but the last dose had been given more than 5 years ago
C) Every type of injury if the patient has never been vaccinated.
D) In every case.
E) B+C

A

E) B+C

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9
Q

Adequate treatment of uncomplicated infectious mononucleosis is:
A) Doxycyclin
B) Ampicillin
C) Steroids
D) Symptomatic
E) Penicillin+ Steroids

A

D) Symptomatic

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10
Q

A patient has periodic attacks of sequential chills and fever, dark urine and hepatosplenomegaly. He has a history of returning from the tropics. What is the most likely diagnosis?
A) hepatitis A
B) malaria
C) plague
D) leprosy
E) none of the above

A

B) malaria

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11
Q

Which of the following treatment should be chosen in severe systemic enterococcal infection?
A) penicillin G + amikacin
B) vancomycin + ceftriaxon
C) ciprofloxacin + oxacillin
D) ampicillin + gentamicin
E) high-dose ampicillin

A

D) ampicillin + gentamicin

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12
Q

Screening and treatment of asymptomatic bacteriuria is required in which one of the following cases?
A) after catheter insertion
B) in diabetic females
C) in pregnant women
D) in patients using intermittent catheter due to transverse cord lesion
E) in patients who have permanent indwelling catheter

A

C) in pregnant women

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13
Q

What is the acceptable efficacy probability of an empiric (combined) antibiotic treatment chosen in severe life-threatening infection?
A) 50%
B) 60%
C) 80%
D) more than 90%

A

D) more than 90%

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14
Q

How can you diagnose urinary tract infection in a febrile patient who has no other symptoms?
A) urinalysis shows pyuria and bacteriuria
B) urinalysis shows pyuria and urine culture is positive with the presence of uropathogen bacteria at high colony counts
C) permanent catheter using patient
D) the patient has pyuria and elevated CRP

A

B) urinalysis shows pyuria and urine culture is positive with the presence of uropathogen bacteria at high colony counts

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15
Q

A 63-year-old patient had been treated with COPD for 2 weeks at the division of pulmonology where he got antibiotics and steroid bolus. Two days ago profuse diarrhea and fever have been started a few hours after eating chicken soup. Other members of his family (who ate with him) have no symptoms. Which of the following is the most likely cause of his symptoms?
A) salmonellosis
B) Clostridium difficile associated diarrhea
C) campylobacteriosis
D) intestinal tumor

A

B) Clostridium difficile associated diarrhea

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16
Q

Which of the following is the most accurate step in diagnosis of Clostridium difficile associated diarrhea?
A) stool sample culture test
B) detection of Clostridium difficile A+B toxins in stool specimens
C) detection of Clostridium difficile antigen and pus in stool
D) history is enough

A

B) detection of Clostridium difficile A+B toxins in stool specimens

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17
Q

Which of the following antimicrobial agents is recommended for use in methicillin-sensitive Staphylococcus aureus caused severe sepsis?
A) vancomycin
B) flucloxacillin
C) clindamycin
D) gentamycin
E) ceftriaxon

A

B) flucloxacillin

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18
Q

Which of the following diagnostic steps is required for the diagnosis of erythema migrans?
A) serology
B) culture
C) clinical features
D) histology

A

C) clinical features

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19
Q

Which of the following prophylaxis is recommended for patients underwent splenectomy?
A) pneumococcal, meningococcal and Haemophilus influenzae type b vaccines
B) crystalline penicillin for 2 weeks
C) pneumococcal vaccine
D) amoxicillin therapy for years

A

A) pneumococcal, meningococcal and Haemophilus influenzae type b vaccines

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20
Q

Which of the following antibiotics has no efficacy against Pseudomonas?
A) piperacillin/tazobactam
B) ciprofloxacin
C) ceftazidime
D) ceftriaxone
E) colistin

A

D) ceftriaxone

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21
Q

Which of the following laboratory tests is the most specific for sepsis?
A) white blood cell differential count
B) complete blood count
C) erythrocyte sedimentation rate
D) CRP
E) PCT

A

E) PCT

22
Q

Which of the following bacteria is the most common cause of toxic shock syndrome?
A) Streptococcus agalactiae
B) Streptococcus pyogenes
C) Streptococcus bovis
D) Group C and group G Streptococci
E) Streptococcus pneumoniae

A

B) Streptococcus pyogenes

23
Q

Tuberculous meningitis is suspected. What is the most appropriate initial step in management?
A) making decision based on culture
B) administer antituberculous drugs immediately
C) there is nothing to do because TB meningitis does not exist
D) symptomatic treatment can be enough

A

B) administer antituberculous drugs immediately

24
Q

Which of the following conditions is not a risk factor of community acquired pneumonia?
A) patient more than 65 years old
B) hypertension
C) diabetes mellitus
D) uraemia
E) long-term steroid treatment

A

B) hypertension

25
Q

Which of the following bacteria is the most common cause of purulent meningitis?
A) E. coli
B) Haemophilus influenzae
C) Streptococcus pneumoniae
D) Listeria monocytogenes

A

C) Streptococcus pneumoniae

26
Q

Which of the following signs is one of the major criteria of infective endocarditis?
A) fever
B) positive blood culture
C) murmur
D) erythrocyte sedimentation rate
E) skin signs

A

B) positive blood culture

27
Q

Terminal ileitis and mesenteric adenitis mimicking acute appendicitis can be seen in which of the following diseases?
A) abdominal typhus
B) campylobacteriosis
C) E.coli associated gastroenteritis
D) yersiniosis

A

D) yersiniosis

28
Q

Which of the following diseases is associated with hydrophobia?
A) plague
B) tetanus
C) rabies
D) all of the above
E) none of the above

A

C) rabies

29
Q

Which of the following conditions can be a manifestation of Lyme-disease?
A) erythema chronicum
B) carditis
C) arthritis
D) neurological signs
E) all of the above

A

E) all of the above

30
Q

Which of the following statements is true if PCT decreases during treatment?
A) antibiotic therapy is adequate
B) lack of PCT production results from multiple organ failure
C) PCT is stored in the cells as a result of antibiotic therapy
D) supportive steroid therapy stops the production of PCT

A

A) antibiotic therapy is adequate

31
Q

Which of the following statements is false about the transmission of tularemia?
A) can be acquired by tick or horse-fly bite
B) may be spread through microtrauma during meat preparation
C) fecal-oral transmission from person to person
D) can be transmitted through inhalation of contaminated dust

A

C) fecal-oral transmission from person to person

32
Q

Which of the following statements is true about empiric antibiotic treatment for severe nosocomial Gram-negative bacterial infections?
A) combination of antibiotics is needed
B) it is important to know the local flora and antibiotic resistance rates
C) antibiotic treatment should last for 10 days

A

B) it is important to know the local flora and antibiotic resistance rates

33
Q

Is it necessary to collect blood cultures when FUO is suspected?
A) it is not, because the most common cause of FUO is cancer
B) it is not, because viral infections are more common than bacterial infections
C) yes it is, because endocarditis is one of the most common causes of FUO
D) yes it is, because rickettsiosis and mycoplasma endocarditis can be detected by blood cultures

A

C) yes it is, because endocarditis is one of the most common causes of FUO

34
Q

Which of the following diagnostic tests should be performed in Staphylococcus aureus bacteremia?
A) chest X-ray
B) blood cultures if the patient is febrile despite of treatment
C) abdominal ultrasound
D) echocardiography
E) all of the above

A

E) all of the above

35
Q

Early recognition of herpes simplex encephalitis is critical, because it can be cured with acyclovir and early administration of acyclovir decreases mortality.
A) true
B) false

A

A) true

36
Q

Patients suffering diabetes mellitus are susceptible for Staphylococcus aureus caused infections.
A) true
B) false

A

A) true

37
Q

Pulmonary symptoms of ascariasis are associated with urticaria, eosinophilia and angioneurotic edema.
A) true
B) false

A

A) true

38
Q

The most common cause of acute exacerbation of COPD is Haemophilus influenzae because of its persistent colonization on the respiratory mucosa.
A) true
B) false

A

A) true

39
Q

Ceftriaxone is effective against penicillin resistant S. pneumoniae in most cases because resistance mechanism is based on beta-lactamase production.
A) both the statement and the explanation are true and a causal relationship exists between them
B) both the statement and the explanation are true but there is no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

C) the statement is true, but the explanation is false

40
Q

Antibiotic prophylaxis in Lyme disease is not needed because the side-effects of prophylactic antibiotics have greater risk than the chance of developing Lyme disease.
A) both the statement and the explanation are true and a causal relationship exists between them
B) both the statement and the explanation are true but there is no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

A) both the statement and the explanation are true and a causal relationship exists between them

41
Q

Antibiotics should be avoided in salmonella gastroenteritis because antibiotic treatment may prolong the duration of fecal excretion results in higher resistance and more severe infection.
A) both the statement and the explanation are true and a causal relationship exists between them
B) both the statement and the explanation are true but there is no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

A) both the statement and the explanation are true and a causal relationship exists between them

42
Q

Aminoglycosides must be administered once a day because the once-daily dosing of aminoglycosides is associated with higher peak concentration, higher efficacy, and less toxicity due to complete excretion within 24 hours.
A) both the statement and the explanation are true and a causal relationship exists between them
B) both the statement and the explanation are true but there is no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

A) both the statement and the explanation are true and a causal relationship exists between them

43
Q

The incubation period of Lyssa virus infection depends on how far the virus entry is from the brain because the virus travels along the axons at a rate of 1-2cm/day to enter into the central nervous system.
A) both the statement and the explanation are true and a causal relationship exists between them
B) both the statement and the explanation are true but there is no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

A) both the statement and the explanation are true and a causal relationship exists between them

44
Q

Macrolides are recommended in urinary tract infections in pregnant women, because macrolides can be administered in pregnancy.
A) both the statement and the explanation are true and a causal relationship exists between them
B) both the statement and the explanation are true but there is no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

D) the statement is false, but the explanation itself is true

45
Q

Empiric antibiotic therapy in aspiration pneumonia should cover anaerobes, because typical pathogens origin from the oral flora where there is a significant number of anaerobes.
A) both the statement and the explanation are true and a causal relationship exists between them
B) both the statement and the explanation are true but there is no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

A) both the statement and the explanation are true and a causal relationship exists between them

46
Q

Treatment for leptospirosis has to be started within 48 hours, because antibiotics are often ineffective during leptospiremia.
A) both the statement and the explanation are true and a causal relationship exists between them
B) both the statement and the explanation are true but there is no causal relationship between them
C) the statement is true, but the explanation is false
D) the statement is false, but the explanation itself is true
E) both the statement and the explanation are false

A

C) the statement is true, but the explanation is false

47
Q

A 20-year-old woman presents to her primary care provider with the following symptoms. Match each clinical presentation with one diagnosis!
A) stomatitis
B) epidemic parotitis
C) infectious mononucleosis

INT - 18.55 - fever, tonsillopharyngitis, cervical lymphadenopathy, hepatosplenomegaly, right shift in white blood cell count
INT - 18.56 - sharing drinks, mucosal hyperemia, sore throat, painful chewing, swollen cervical lymph glands
INT - 18.57 - lethargy, headache, fever, asymmetric facial swelling, dysphagia, painful chewing, meningeal irritation signs

A

55- C
56- A
57- B

48
Q

A patient has pneumonia confirmed by chest X-ray. Match each clinical presentation with one or more pathogen(s)!
A) Mycoplasma pneumoniae
B) Streptococcus pneumoniae
C) Influenza virus
D) Legionella spp.

INT - 18.58 - severe headache, sore throat, and earache
INT - 18.59 - diarrhea, and hyponatraemia
INT - 18.60 - sore throat, muscle pain, joint pain, WBC count: 3,6 G/L, CRP: 2mg/l
INT - 18.61 - shivering, chest pain when breathing, leukocytosis, elevated CRP, and PCT
INT - 18.62 - erythema multiforme
INT - 18.63 - splenectomy 1 month ago

A

58- A
59- D
60- C
61- B, D
62- A
63- B

49
Q

Match each clinical presentation with the most likely pathogen!
A) adenovirus
B) Norwalk-virus
C) rotavirus

INT - 18.64 - A disease mainly occurs in infants and toddlers characterized by fever, vomiting and watery diarrhea. It peaks in fall/winter, it is highly contagious and can lead to dehydration.
INT - 18.65 - A mild disease in adults associated with diarrhea, headache, abdominal and muscle pain.
INT - 18.66 - A mild disease involving fever, upper respiratory symptoms, vomiting and diarrhea. Most commonly affects toddlers and it is often followed by lactose intolerance.

A

64- C
65- B
66- A

50
Q

Match each of the following bacteria with the most likely effective antibiotic treatment!
A) imipenem/cilastatin
B) penicillin
C) ceftriaxone
D) vancomycin
E) ampicillin

INT - 18.67 - MRSA
INT - 18.68 - Enterococcus faecalis
INT - 18.69 - Streptococcus pyogenes
INT - 18.70 - Streptococcus pneumoniae
INT - 18.71 - ESBL-producing E.coli

A

67- D
68- E
69- B
70- C
71- A

Internal states (17 decks)

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