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M3 > Lbrdo IDS > Flashcards

Lbrdo IDS Flashcards

1
Q

Major reservoir of bacteria in the body

A

GI tract

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2
Q

T/F infections are mostly normal flora

A

T

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3
Q

True about social history when considering infectious disease EXCEPT

a. ask for high risk behaviors like IV drug use, unsafe sexual behavior
b. potential gardening exposure to Sporotrix schenkii
c. risk of TB in funeral service worker
d. NOTA

A

D; all are true

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4
Q

Infections from raw or undercooked meat

a. E. coli
b. Toxoplasma Gondii
c. both
d. neither

A

C

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5
Q

Infection from unpasturized milk EXCEPT

a. Salmonella typhimurium
b. Legionella
c. L. Monocytogenes
d. M. Bovis

A

B

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6
Q

Infection from unpurified water EXCEPT

a. Leptospira
b. Vibrio
c. E. coli
d. NOTA

A

D; all are included

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7
Q

Infection from raw seafoods (3)

A

Norovirus
Helminths
Protozoa

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8
Q

What infections can be obtained from exposure to dog ticks?

A

Lyme disease
Rocky Mountain Spotted Fever
Erlichiosis

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9
Q

you can get Bartonella henselae from

A

Cats

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10
Q

reptiles:______

A

salmonella

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11
Q

rodents:______

A

leptospirosis

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12
Q

rabbits:______

A

tularemia

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13
Q

most likely infections from fresh water swimming

A

cryptosporidium
Giardia intestinalis
Amoebiasis

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14
Q

Definition of fever

A

T>38.3 deg celsius

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15
Q

For every 1degC increase in core temp, HR rises to

A

15-20bpm

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16
Q

Palpable epitrochlear lymph nodes

a. pathologic
b. physiologic
c. both
d. neither

A

A

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17
Q

T/F diagnostic testing should be limited to conditions that are likely lethal, important in terms of public health, providing differential diagnosis

A

F; not lethal, treatable dapat

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18
Q

elevations in neutrophils

a. bacteria
b. virus
c. parasite

A

A

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19
Q

Elevations in eosinophils

a. bacteria
b. virus
c. parasite

A

C

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20
Q

Elevations in lymphocytes

a. bacteria
b. virus
c. parasite

A

B

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21
Q

True about inflammatory markers

a. ESR and CRP are indirect but not direct markers
b. ESR and CRP are sensitive and spicific for inflammation
c. Elevated ESR of >90 has a 100% predictive value of a serious underlying pathology
d. NOTA

A

D

a. both direct and indirect
b. sensitive but not specific
c. Elevated ESR >100 has 90% predictive value

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22
Q

CSF gram stain _____ bacteria /ml –reliable positivity- specificity ~ 100%

A

> 10^5

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23
Q

Lymphocytic pleocytosis and low glucose- infection (3)

A

MTB
Listeria
Fungus

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24
Q

Non-infectious cause of CSF pleocytosis

A

malignancy
meningitis
sarcoidosis

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25
Q

True of obtaining cultures

a. culture of infected specimen or fluid mainstay of diagnosis
b. specimens should be collected before administration of antibiotics
c. culture of organism is important for identification, susceptibility, testing and for isolate typing during outbreaks
d. AOTA

A

D

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26
Q

mainstay of diagnosis in infectious diseases

A

culture

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27
Q

True of radiology EXCEPT

a. it is an adjunct to PE
b. it allows evaluation for LAD in mediastinum and intraabdominal sites
c. assessment for internal organs for evidence of infection
d. facilitates image guided percutaneous sampling of deep spaces
e. AOTA

A

B

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28
Q

The following should obtain an infectious disease consult

a. difficult to diagnose patient with presumed infections
b. patients not responding to treatment as expected
c. immunosuppresed
d. patients with exotic diseases
e. AOTA

A

E

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29
Q

True about treatment of infectious diseases EXCEPT

a. empirical antibiotic treatment should be given regardless of medical condition
b. for antibiotic treatment, general rule is to use a narrow spectrum as possible
c. empirical regimens are broad
d. AOTA
e. NOTA

A

A

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30
Q

In a febrile patient, this info on general appearance can give clue to critical illness

A

visible agitation or anxiety

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31
Q

These patients may not present with fever

a. elderly px
b. px with cirrhotic liver
c. px in glucocorticoid tx
d. px on NSAID
e. AOTA
f. NOTA

A

E

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32
Q

Importance of BP, HR, RR measurements

A

determines degree of hemodynamic and metabolic compromise

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33
Q

Skin finding seen meningococcemia or Rocky Mountain Spotted Fever, erythroderma

A

petechial rashes

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34
Q

Soft tissue examination- should be done to look for

A

areas of duskiness, edema, tenderness- necrotizing fasciitis

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35
Q

In acute endocarditis, how many sets of blood culture should be taken?

A

3 sets

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36
Q

Asplenic patients should have a buffy coat examined for

A

examined for bacteria - >10^6 organisms per ml of blood

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37
Q

A patient for lumbar tap but have papilledema, what should be done?

A

imaging first to evaluate risk of herniation

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38
Q

timing of antibiotics in patient with CNS infection

A

before imaging, after blood cultures have been drawn

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39
Q

Other infections require surgical intervention, give 2

A

necrotizing fasciitis

clostridial myonecrosis

40
Q

adjunctive options for treatment:

bacterial mgt

A

dexamethasone

41
Q

adjunctive options for treatment:

IV IgG given for

A

TSS

nectorizing fascitis by GA strep

42
Q

In bacterial meningitis. which one is given first: steroids or antibiotics?

A

Steroid before antibiotics

43
Q

glucocorticoids can be harmful with bad outcomes in

a. cerebral malaria
b. viral hepatitis
c. meningitis

A

All except C

44
Q

True of sepsis without an obvious focus of infecion

a. patients with brief prodrome of non specific signs and symptoms which quickly progresses to hemodynamic instability
b. DIC is a poor prognostic sign
c. both
d. neither

A

C

45
Q

True of septic shock EXCEPT

a. patients with bacteremia will progress to septic shock may have a focus of infection that is not evident initially
b. narrow spectrum antibiotics should be given within 2 hours of presentation
c. CRP/procalcitonin is not proven reliably in dx
d. CRP is helpful in de escalation of tx

A

B; broad spectrum, within the first hour

46
Q

When should glucocorticoids be considered in severe sepsis?

A

Glucocorticoids should only be considered in severe sepsis who do not respond to fluid and vasopressor therapy

47
Q

infections common in post/splenectomy

A

H influenza

48
Q

Symptoms of babesiosis

A 
SOB
ecchymoses
HA
fever
chills
49
Q

Babesiosis symptoms will occur when?

A

1-4 weeks after tick bite

50
Q

tick transmits borrelia Borgdorferi ( Lyme disease) and anaplasma

A

Ixodes scapularis

51
Q

will present with febrile syndrome with hemolysis, jaundice, renal failure , hemoglobinuria. Mortality rate - >40 %

A

Babesia divergens

52
Q

True about Babesiosis EXCEPT

a. sever babesiosis can happen in normal splenic function with underlying immunosuppression and malignancy with >55 y.o.
b. Babesia transmits borrelia borgdorferi
c. Ixodes scapularis will present with febrile syndrome with hemolysis, jaundice, renal failure, hemoglobinuria
d. NOTA

A

D

a. >60 y.o.
b. Ixodes scapularis - borrelia borgdorferi - lyme disease
c. Babesia divergens

53
Q

True of meninggococcemia

a. presents with fever, headache, nausea, vomiting, myalgias, change in mental status, meningismus
b. rashi is pink, non-blancing, maculopapular
c. 20% of patients die
d. NOTA

A

A

b. blanching
c. 60% of patients die

54
Q

in meninggococcemia:

Hypotension with petechiae for ______ associated with significant mortality

A

> 12 hours

55
Q

T/F correction of protein S deficiency may improve outcome in meninggococcemia

A

F, protein C deficiency

56
Q

T/F early initiation of treatment in meninggococcemia is life saving

A

T

57
Q

infectious agent of rocky mountain spotted fever

A

Ricketsia ricketsii

58
Q

True of rocky mountain spotted fever EXCEPT

a. History of travel or outdoor activity
b. half of patients with skin findings
c. nonblanching macules - wrist and ankles - trunk/extremities
d. lesions become petechial
e. AOTA

A

C

59
Q

Treatment of rocky mountain spotted fever

A

Doxycycline

60
Q

Cutaneous manifestation of DIC with large hemorrhagic bullae and ecchymotic areas
Associated primarily by N. Meningitides

A

Purpura fulminans

61
Q

Purpura fulminans in spelenectomized patients etiologic agents

A

S. pneumo
H. influenza
S. aureus

62
Q

Septic shock caused by pseudomonas/aeromonas hydrophila

Hemorrhagic vesicles surrounded by a rim of erythema with central necrosis and ulceration

A

Ecthyma gangrenosum

63
Q

Ecthyma gangrenosum associated with (3)

A

burns
neutropenia
hypogammaglobulinemia

64
Q

arthropod vector:

Lassa fever

A

arenaviridae

65
Q

arthropod vector:

Rift valley fever

A

Bunyaviridae

66
Q

arthropod vector:

hantavirus hemorrhagic fever

A

Bunyaviridae

67
Q

arthropod vector:

ebola

A

filoviridae

68
Q

arthropod vector:

yellow fever

A

flaviviridae

69
Q

arthropod vector:

dengue

A

flaviviridae

70
Q

arthropod vector:

margburg

A

filoviridae

71
Q

often associated with trauma or surgery/can develop spontaneously
Incubation -12 to 24 hours and progress to massive necrotizing gangrene within hours

A

Clostridian myonecrosis

72
Q

Gas gangrene etiologic agent

A

Clostridial myonecrosis

73
Q

Clostridial myonecrosis:

skin over the affected area is

A

bronze-brown, mottled, and edematous

74
Q

Clostridial myonecrosis:

Bullous lesions with serosanguineous drainage and a __________ odor can develop.

A

mousy or sweet

75
Q

The following has poor outcome except:

a. coma
b. hypotension
c. meninggococcal etiology
d. respiratory distress

A

C; pneumococcal etiology

76
Q

The following has poor outcome except:

a. CSF glucose level 0.3mmol/L
b. CSF protein level 3 g/L
c. peripheral WBC count 3000
d. serum sodium 136mmol/L

A 
D
Poor outcome:
CSF glucose level of <0.6 mmol/L
CSF protein level of >2.5 g/L
peripheral white blood cell count of <5000/µL serum sodium level of <135 mmol/L
77
Q

Most common symptom of brain abscess

A

headache 70%

78
Q

Second most common symptoms of brain abscess

A

altered mental status 50%

79
Q

Patient with brain abscess develop -sudden and severe deterioration in clinical status, what could have happened?

A

abscess rising hematogenously rupture into ventricular space

80
Q

What are the stages of brain abscess?

A

encephalitis
localization
enlargement
rupture

81
Q

Who are at risk of intracranial and spinal abscess?

A 
Diabetes mellitus
IV drug use
chronic alcohol abuse; recent spinal trauma, surgery, or epidural anesthesia;
and other comorbid conditions
such as HIV infection
82
Q

Intracranial Epidural Abcess (ICEAs) typically present as (3)

A

fever
mental status changes
neck pain

83
Q

Spinal Epidural Abcess (SEAs) often present as (4)

A

fever
localized spinal tenderness
back pain

84
Q

fever, mental status changes, and neck pain

a. Intracranial epidural Abscess
b. Spinal Epidural Abcess

A 
A; 
B.
fever
localized spinal tenderness
back pain
85
Q

Outcomes -worse for

a. SEA due to MRSA
b. ICEA

A

A

86
Q

Outcomes worse for SEA due to MRSA

a. higher vertebral body level
b. lower vertebral body level

A

A

87
Q

Outcomes -worse for SEA due to MRSA

a. dorsal location
b. ventral location

A

A

88
Q

Organisms involved in Acute bacterial endocarditis

A 
S. aureus
S. pneumoniae
L. monocytogenes
Haemophilus species
streptococci of groups A, B, and G
89
Q

Presentation of acute bacterial endocarditis

A

fever,
fatigue
malaise <2 weeks after onset of infection

90
Q

PE findings in acute bacterial endocarditis

A 
changing murmur and CHF
Janeway lesions
Petechiae
Roth's spots
Splinter hemorrhages
91
Q

Swine flu

a. H5N1
b. H7N9
c. both
d. neither

A

D; H1N1

92
Q

Avian flu

a. H5N1
b. H7N9
c. both
d. neither

A

C

93
Q

high fever, an influenza-like illness, and lower respiratory tract symptoms; progress rapidly to bilateral pneumonia, acute respiratory distress syndrome, multiorgan failure, and death.

A

Avian flu/Swine flu

94
Q

patients most at risk for swine/avian flu

A

children <5 years of age, elderly persons, patients with underlying chronic conditions, and pregnant women. Obesity also has been identified as a risk factor for severe illness.

95
Q

Occurs in rural areas – WITH EXPOSURE TO RODENTS -present with a nonspecific viral prodrome of fever, malaise, myalgias, nausea, vomiting, and dizziness - to pulmonary edema and respiratory failure.

A

Hantavirus pulmonary syndrome

M3 (66 decks)

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