Medicine- Infectious Disease Flashcards
Pain, erythema, and swelling below the medial canthus of the left eye, along with purulent discharge from the lacrimal punctum… Dx?
acute dacryocystitis.
1st line tx of acute dacryocystitis?
Oral antibiotics with gram-positive coverage, such as amoxicillin-clavulanate. (Warm compresses and NSAIDs are also used to decrease pain and inflammation)
First-line treatment for patients with PCP who are allergic to sulfa drugs
IV clindamycin and oral primaquine
The recommended empiric therapy for sepsis?
A regimen of intravenous vancomycin and ceftriaxone covers a broad spectrum of both gram-negative and gram-positive bacteria (including MRSA)
Prophylactic medication of choice for a pregnant patient travelling to an area where P. falciparum is endemic and resistance to chloroquine is likely
1st choice = Mefloquine
Atovaquone-proguanil would be an equally viable prophylactic medication
Which microorganism is often associated with insect bite infections and is the most common cause of erysipelas and lymphangitis.
Strep pyogenes
Initial treatment for febrile neutropenia
monotherapy (anti-pseudomonal coverage) - Cefepime, meropenem and Pip-Tazo
What is the next best test to confirm diagnosis in a patient with suspected primary syphilis and negative VDRL
FTA- ABS
What type of conjunctivitis has unremitting discharge and reappears after wiping?
Bacterial conjunctivitis
What pathogen is the most common cause of bacterial conjunctivitis in adults
Staph Aureus
1st line treatment for penicillin sensitive ineffective endocarditis
IV aqueous penicillin G or IV ceftriaxone
What are the risk factors for influenza complications and the treatment
Age >65, chronic medical conditions and pregnancy
oseltamivir regardless of symptom duration
Manifestations of secondary syphillis
- fever, malaise and sore throat
- oral lesions (grey mucous patches)
- raised grey genital papules (condylomata lata)
- diffuse rash (palms and soles)
- lymphadenopathy (epitrochlear) (sailors handshake)
- hepatitis
Meningococcal vaccination regular schedule?
- primary vaccination at 11-12
2. booster at 16-21 (if primary was before 16)
Contraindications to yellow fever vaccine
- allergy to vaccine components (eg. eggs)
- AIDs (CD4 <200), stem cell transplant, certain immunodeficiencies
- Immunosuppressive therapy (eg, TNF antagonists, high dose steroids)
Recommended Vaccines for chronic liver disease
HAV, HBV, Influenza, PPSV23 (then revaccinate at age 65 with PCV13 first then PPSV23) and Tdap
Which patients are at highest risk for vertebral osteomyelitis
IVDU, Sickle cell patients and immunosuppressed patients
Characteristic Features of “break-bone fever” (dengue).
- Retro-orbital pain, fever, malaise, and myalgia
- exanthem and lymphadenopathy
- leukopenia and thrombocytopenia
A common adverse effect of Idinavir
Urolithiasis (crystallization and stone formation) due to poor renal excretion
First-line treatment of malignant otitis externa
High-dose IV ciprofloxacin
With which risk factor are coagulase-negative staphylococci, such as S. epidermidis, most commonly associated?
S. epidermidis has the ability to adhere to foreign bodies (e.g., intravenous catheters, pacemakers, prosthetic heart valves) and subsequently form a biofilm.
An odontogenic infection and swollen, tender neck in a diabetic patient likely indicates spread of the infection towards the soft tissue of the neck… dx?
Ludwig Angina
1st line treatment for Otitis externa
Topical abx (fluoroquinolone) + steroids (can add acetic acid and water solution to help)
What type organism causes infective endocarditis after exposure to a UTI
Enterococci
What is the best form of diagnosis for PCP
Brochoalveolar lavage (dx requires respiratory sample using specialized stains under microscope)
Etiology, manifestation and treatment of Cutaneous larva migrans
Hookworm (Anclystoma) - barefoot contact in contaminated sand or soil
LE intensely pruritic, migratory reddish brown-tracks
Ivermectin
Indications for steroid use along with original treatment for PCP
PaO2 <70 or A-a gradient >35
Urethritis with negative gram stain and culture
Chlamydia
Lab findings in a patient with contracted Chickungunya fever
Lymphyocytopenia, thrombocytopenia and transaminitis
What is the next best step in a patient who is recovering well from treatment with IV ceftriaxone being treated for acute pyelonephritis
Switch to oral TMP-SMX after 48hrs of improval and discharge
Manifestations of Sporothrix infection
Skin papule –> ulceration with nonpurulent odorless drainage
proximal lesions along lymphatic drainage
The dendritic corneal ulcer in this patient is a typical feature of which organism
Herpes simplex keratitis
This diabetic patient presents with lower back pain, elevated ESR, and CRP. These features, together with the x-ray and MRI findings (bone destruction, sequestrum formation and periosteal reaction) indicate what and next best step?
Spondylodiscitis (vertebral osteomyelitis)
CT guided Bx to confirm
The history of a painless penile lesion, followed by suppurative painful lymphadenopathy 2–4 weeks after the initial lesion has healed
Lymphogranuloma venereum.(serotypes L1, L2, and L3 of Chlamydia trachomatis)
