TTR

Question 1

lowenstein-jensen

Answer 1

media used to culture m. tuberculosis 18-24h doubling time

Question 2

HIV associated TB

Answer 2

m. avium-intracellulare complex(MAC) disseminated in HIV+ pt population

Question 3

describe empiric therapy for staphylococcal infections

what are good empiric outpatient therapies?

Answer 3

if pt. is sick(bacteremia/pneumonia)-

• vancomyicn
• daptomycin
• linezolid
• ceftaroline

if pt. is not “sick”(outpatient skin/soft tissue) -

• clindamycin
• TMP/SMX
• doxycycline
• linezolid

Question 4

most common species of enterococci how do their treatments differ?

Answer 4

E. faecalis - ampicillin/penicillin are drugs of choice; use ampicillin AND aminoglycoside for endocarditis

E. faecium - vancomycin is drug of choice; resistant to ampicillin; use vancomycin AND aminoglycoside for endocarditis

Question 5

CN palsy

HA

fever

malaise

cardiovascular dysfunciton

arthritis

bug?

Answer 5

burellia burgdorferi

lyme disease

Question 6

disseminated rash(soles, palms)

LAD

granulomatous lesions

AMS

treatment?

Answer 6

treponema pallidum infection

penicillin, doxycycline

ceftriaxone if brain is involved

prolly would use ceftriaxone w/AMS

Question 7

lyme disease treatment

Answer 7

doxycycline

if contraindicated: amoxicilin, cefuroxime

ceftriaxone for disseminated(late)

Question 8

conjunctival suffusion

fevers

myalgia

vomiting

diarrhea

treatment?

Answer 8

this is leptospirosis biphasic disease

treat w/supportive fluids and penicillin, doxy, or ceftriaxone(same as syphillus)

Question 9

when to use abx with diarrhea

Answer 9

1. c. diff(metro or vanc)
2. shigellosis - based on susceptibility; clinda good
3. campylobacter if early - ciprofloxacin
4. v. cholerae - doxy, azithro, cipro [reduces severity after worst has passed]
5. traveler’s - give em cipro or rifaximin

camps call-her different travel gels

Question 10

when do you need a culture for diarrhea?

Answer 10

immunocompromised

outbreaks

dysentery

cholera

>24hr and WBC in stool

Question 11

treatment for bacillus anthracus

Answer 11

COMBOOOOOOO

fluoroquinolone + clindamycin or rifampin + other agent

post exposure treatments: oral cipro or doxy or amoxi right away

Question 12

assocaited with rabbit skinning

low infectious dose

GN rod

BT list

treatment?

Answer 12

francisella tularensis

aminoglycosides, fluoroquinolones, tetracyclines work

Question 13

GP rod is found in LP of neonate

what is bacterial likely resistant to?

treatment?

Answer 13

this is listeria monocytogenes

resistant to cephalosporins and vancomycin

treat with penicillin, ampicillin, TMP-SMX

****gotta add an ampicillin when neonates have meningitis

Question 14

leading cause of meningitis in immunocompromised

Answer 14

listeria monocytogenes

Question 15

predominantly males

increased risk with liver disease

causes: chills, fever, prostration, nec fasc

associated with seawater/seafood

treatment?

Answer 15

vibrio vulnificus

aggressive treatment: debridement, tetracycline+cipro/ceftaxomine

Question 16

presentation for/treatment of aeromonas spp.

Answer 16

disease of wound infection

cellulitis related to water/soil

bacteremia

can cause diarrheal disease

treat w/ TMP-SMX, fluoroquinolones, aminoglycosides

Question 17

vesicoureteral reflux

Answer 17

pediatric UTI complication

use voiding cystourethrography to detect abnormalities

scarring, hydronephrosis

Question 18

has LPS with NO endotoxin activity

which bacteria?

Answer 18

bacteroides fragilis!

GN anaerobe

Question 19

name the “regal” GN coccobacilli that is one of the common causes of infectious arthritis in children

Answer 19

kingella kingae

Question 20

bacteria w/ a type IV pilus co-expressed w/its toxin

Answer 20

• v. cholerae*

toxin co-regulated pilus

both activated by a ‘global regulator’

Question 21

leading cause of seafood-associated gastroenteritis

Answer 21

v. parahaemolyticus

Watery, self-limited diarrhea, w/cramps, NV; sometimes bloody

Question 22

when do you prescribe abx for an asymptomatic bacteriuria?

Answer 22

pregos screened positive in 1st trimester

Question 23

1st line UTI drugs

2nd line UTI drugs

Answer 23

1st line: nitrofurantoin, fosfomycin or TMP-SMX
2nd line: fluoroquinolones
Try not to use a drug they’ve had in the past 3-6 mo.

Question 24

what are the SIRS criteria

Answer 24

temp <36 or >38

puls >90

RR >20

WBC <4000 or >12000 or >10% bands

Question 25

treatment for uncomplicated gonococcal infection

treatment for COMPLICATED?

Answer 25

uncomplicated: ceftriaxone(GC)

ALWAYS COTREAT FOR CHLAMYDIA

add on azithromycin(CHL)

complicated: ceftriaxone(GC) + doxycycline(CHL)

Question 26

Listeria Monocytogenes pathogenesis and virulence factor for each step

Answer 26

1. Invades cell(internalin, inlB)
2. Escapes phagosome(lysteriolysin)
3. Usurps actin(ActA)
4. Spreads cell-to-cell(phospholipases)

Question 27

early infection, acquired in utero, involving large disseminated micro-abscesses and high mortality

name? bug?

Answer 27

granulomatosis infantisepticum

neonatal listeriosis via listeria monocytogenes