Internal Medicine: Infectious Disease

Front 1

MC organism of Community Acquired Pneumonia (CAP)

Back 1

Streptococcus pneumonia

*Also, H. flu, Klebsiella, S. aureus

Front 2

MC organism of Hospital Acquired Pneumonia (HAP)

Back 2

1) Gram-negative rods
2) Staphlococcus aureus

Front 3

Organisms common to Atypical CAP

Back 3

1) Mycoplasma
2) Legionella
3) Chlamydia (pneumoniae, psittaci)
4) Coxiella burnetti (Q fever)
5) Influenza virus, adenovirus, parainfluenza virus RSV

*Non-productive cough

Front 4

Treatment of Pneumonia

Back 4

1) Macrolides
2) Doxycycline
3) Fluroquinolones
4) Ceftriaxone

*Levofloxacin, Moxifloxacin

Front 5

Main risk factor for Lung Abscess

Back 5

Aspiration of oropharyngeal contents

*Alcoholism, drug-addiction, CVA, seizures, general anesthesia, nasogastric or endotracheal tube, poor dental hygiene

Front 6

Treatment of Lung Abscess

Back 6

1) Postural drainage
2) Antibiotics: augmentin, vancomycin (S. aureus), clindamycin, metronidazole (anaerobes), fluoroquinolone or ceftazidime (gram-negatives)

Front 7

MCC of death due to infection worldwide

Back 7

Tuberculosis

*Caused by Myocbacteria tuberculosis

Front 8

Clinical features of Secondary Tuberculosis (TB)

Back 8

1) Fever, night sweats, weight loss, malaise
2) Cough (from dry to productive)
3) Hemoptysis (advanced TB)

Front 9

Classic CXR findings of TB

Back 9

Upper lobe infiltrates with cavitations

*Ghon complex, Ranke's complex

Front 10

First-line therapy for TB

Back 10

Four-drug regimen:
1) Isoniazid (INH)
2) Rifampin
3) Pyrazinamide
4) Ethambutol or Streptomycin

Front 11

Cause of The Flu

Back 11

Orthomyxoviruses A and B

Front 12

Common causes of Chronic Meningitis

Back 12

1) Mycobacteria
2) Fungi
3) Lyme disease
4) Parasites

Front 13

MCC of Bacterial Meningitis in Neonates

Back 13

1) GBS
2) E. coli
3) Listeria monocytogenes

Front 14

MCC of Bacterial Meningitis in Children >3 months

Back 14

1) N. meningitidis
2) S. pneumoniae
3) H. influenzae

Front 15

MCC of Bacterial Meningitis in Adults

Back 15

1) S. pneumoniae
2) N. meningitidis
3) H. influenzae

Front 16

MCC of Bacterial Meningitis in Elderly

Back 16

1) S. pneumoniae
2) N. meningitidis
3) L. monocytogenes

Front 17

MCC of Bacterial Meningitis in Immunocompromised pts

Back 17

1) L. monocytogenes
2) Gram-negative bacilli
3) S. pneumoniae

Front 18

Clinical features of Meningitis

Back 18

1) HA
2) Fever
3) Stiff, painful neck
4) Malaise, n/v, photophobia, AMS

Front 19

Signs of Meningitis

Back 19

1) Nuchal rigidity
2) Rashes (maculopapular with petechiae, vesicular lesions)
3) Increased ICP
4) CN palsies
5) Kerning's sign
6) Brudzinski's sign

Front 20

Diagnosis of Meningitis

Back 20

1) Lumbar puncture
2) CT head (before LP)
3) Blood cultures (before LP)

Front 21

Treatment of Bacterial Meningitis

Back 21

1) Empiric antibiotic therapy (IV)
2) Steroids (for cerebral edema)
3) Vaccination (S. pneumoniae, H. influenzae, N. meningitidis)

*Give prophylaxis to close contacts: Rifampin or Ceftriaxone

Front 22

Treatment of Viral Meningitis

Back 22

No treatment necessary - self-limited

Front 23

Exams to send CSF for when Meningitis is suspected

Back 23

1) Cell count
2) Cytology
3) Protein, glucose
4) Gram stain and culture (including AFB)
5) Cryptococcal antigen

Front 24

Empiric treatment of Meningitis in Neonate

Back 24

1) Cefotaxime +
2) Ampicillin +
3) Vancomycin

*Aminoglycoside instead of Vanc if less than 4 weeks old

Front 25

Empiric treatment of Meningitis in pt 3 months to 50 years

Back 25

1) Ceftriaxone or Ceftaxime +
2) Vancomycin

Front 26

Encephalitis

Back 26

Diffuse inflammation of brain parenchyma
Often associated with meningitis

Front 27

Major causes of Encephalitis

Back 27

1) Herpes (HSV-1)
2) Arboviruses (Eastern/western equine viruses, West Nile virus)
3) Enterovirus (polio)
4) Toxoplasmosis
5) Cerebral aspergillosis
6) Metabolic encephalopathies
7) T-cell lymphoma

Front 28

Risk factors for Encephalitis

Back 28

1) AIDS (toxo w/CD4 <200)
2) Immunocompromise
3) Travel to underdeveloped areas
4) Mosquito bites
5) Bat bites

Front 29

Clinical features of Encephalitis

Back 29

1) HA, malaise, myalgias
2) Signs of meningitis
3) AMS, confusion, delirium
4) FOCAL NEUROLOGIC DEFICITS

Front 30

Diagnosis of Encephalitis

Back 30

1) LP
2) MRI brain
3) EEG
4) Brain biopsy

Front 31

Treatment of Encephalitis

Back 31

1) Antiviral therapy
2) Anticonvulsant therapy
3) Treatment of cerebral edema

Front 32

Common causes of Encephalitis in the Immunocompromised

Back 32

AIDS: Toxoplasmosis, Fungi
Neutropenic: Aspergillus, Candida, Zygomycosis

Front 33

Sequelae of the following may lead to Brain Abscess

Back 33

1) Ear, nose, throat infection
2) Cranial trauma, brain surgery
3) Pyogenic lung infection (hematogenous spread)
4) Dental infection

Front 34

Clinical features of Brain Abscess

Back 34

1) HEADACHE
2) AMS
3) Seizures, n/v

Front 35

Vasculitis associated with Hepatitis B

Back 35

Polyarteritis nodosa (PAN)

*Hep C associated with Cryoglobulinemia

Front 36

Clinical features of Hepatitis

Back 36

1) Jaundice
2) Dark-colored urine (conjugated hyperbilirubinemia)
3) RUQ pain
4) Nausea/vomiting
5) Fever and malaise
6) Hepatomegaly

Front 37

Diagnosis of Hepatitis

Back 37

1) Viral serology
2) PCR
3) Liver function tests

Front 38

Liver Function Tests in Hepatitis

Back 38

ALT > AST except in alcoholic hepatitis
ALT > 1000 in acute hepatitis

Front 39

Treatment of Hepatitis B

Back 39

1) Interferon- alpha
2) Lamivudine

Front 40

Treatment of Hepatitis C

Back 40

1) Interferon- alpha
2) Ribavirin

Front 41

Hepatitis B Surface Antigen

Back 41

Present acute or chronic infection

**Persists in chronic hepatitis regardless of symptomatology; if virus is cleared, HBsAg is undetectable**

Front 42

Hepatitis B e Antigen

Back 42

1) Reflects ACTIVE viral replication
2) Presence indicates INFECTIVITY

Front 43

Anti- HBsAg Antibody

Back 43

Present after vaccination or clearance of HBsAg

*Indicates immunity in most cases

Front 44

Hepatitis B Core Antibody (anti-HBc)

Back 44

1) Assay of IgM and IgG combined
2) Positive during WINDOW period
3) Presence does not indicate immunitiy

Front 45

Botulism

Back 45

Symmetric, descending flaccid paralysis caused by ingestion of preformed toxins of Clostridium botulinum (or wound contamination)

Front 46

Diagnosis of Botulism

Back 46

Identification of toxin in serum, stool, or gastric contents

Front 47

Treatment of Botulism

Back 47

1) Administration of antitoxin (toxoid)
2) Wound cleansing and penicillin

Front 48

Causes of Intra-Abdominal Abscess

Back 48

1) Spontaneous bacterial peritonitis (SBP)
2) Pelvic infection
3) Pancreatitis
4) GI perforation
5) Osteomyelitis of vertebral bodies with extension

*Treat with abscess drainage and broad spectrum coverage (anaerobes, enterococci, gram-negatives)

Front 49

Common organisms of UTI

Back 49

1) E. coli
2) Staphlococcus saprophyticus
3) Enterococcus
4) Klebsiella
5) Proteus spp.
6) Pseudomonas
7) Enterobacter
8) Candida spp

Front 50

Host-dependent risk factors for UTI

Back 50

1) Diabetes - risk for upper UTI
2) Impeding urinary flow (BPH, neurogenic bladder, vesicourethral reflux)
3) Spinal cord injury
4) Immunocompromised state

Front 51

Clinical features of UTI

Back 51

1) Dysuria - burning on urination
2) Frequency
3) Urgency
4) Suprapubic tenderness
5) Gross hematuria
6) NO FEVER W/ lower UTI

Front 52

Diagnosis of UTI

Back 52

1) Urine dipstick (leukocyte esterase, nitrite)
2) Urinalysis
3) Urine gram stain
4) Urine culture
5) Blood culture (w/ suspicion for urosepsis)

Front 53

Complicated UTI

Back 53

Any UTI that spreads beyond the bladder
1) Pyelonephritis (Urosepsis)
2) Prostatitis

*Risks: Diabetes, pregnancy, vesicoureteral reflux

Front 54

Treatment of uncomplicated Cystitis

Back 54

Empiric treatment with Bactrim for 3 days

*Fluoroquinolone (Cipro) for 3 days appropriate if patient has sulfa allergy

Front 55

Treatment of UTI in Pregnancy

Back 55

1) Ampicillin OR
2) Amoxicillin OR
3) PO Cephalosporin for 7 - 10 days

*AVOID FLUOROQUINOLONES --> fetal arthropathy

Front 56

Pyelonephritis

Back 56

Infection of upper urinary tract caused by ascending spread from bladder to kidneys

Front 57

Complications of Pyelonephritis

Back 57

1) Sepsis - 10-20% of patients
2) Emphysematous pyelonephritis - DIABETES: gas-producing bacteria
3) Chronic pyelonephritis and renal scarring (rare)

Front 58

Clinical features of Pyelonephritis

Back 58

1) Fever, chills
2) Flank pain, CVA tenderness
3) Nausea/vomiting

Front 59

Treatment of UTI in men

Back 59

Bactrim for 7 days (not 3 days)

Front 60

Diagnosis of Pyelonephritis

Back 60

1) Urinalysis: pyuria, bacteriuria, leukocyte casts
2) Urine and blood cultures
3) CBC - leukocytosis
4) Imaging studies

Front 61

MC organism causing Pyelonephritis

Back 61

E. coli

*Proteus, Klebsiella, Enterobacter, Pseudomonas

Front 62

Treatment of uncomplicated Pyelonephritis

Back 62

Gram-Negative Rods: Bactrim or Cipro for 10-14 days
Gram-Positive Cocci: Amoxicillin

*Single dose of Ceftriaxone or Gentamicin often given before PO treatment

Front 63

Treatment of inpatient Pyelonephritis

Back 63

Broad-spectrum: Ampicillin + Gentamicin or Cipro
Negative blood cultures: Treat until afebrile for 24 hrs, then complete 14-21 day course PO
Positive blood cultures: Treat with IV antibiotics for 2-3 weeks

Front 64

Organisms common to Prostatitis

Back 64

Gram-negative organisms: E. coli, Klebsiella, Proteus, Pseudomonas, Enterobacter Serratia

Front 65

Clinical features of Acute Prostatitis

Back 65

1) Fever, chills
2) Dysuria, frequency, urgency
3) Perineal pain, low back pain, urinary retention

Front 66

Diagnosis of Prostatitis

Back 66

1) DRE - boggy, exquisitely tender prostate
2) UA
3) Urine cultures

Front 67

Treatment of Prostatitis

Back 67

Acute: Bactrim or Cipro and Doxy for 4-6 weeks
Chronic: Cipro

*Often related to UTI, so treated similarly*

Front 68

Treatment of Chlamydia

Back 68

1) Azithromycin PO x 1 dose
2) Doxycycline PO for 7 days

Front 69

Findings of Disseminated Gonococcal Infection

Back 69

1) Fever, arthralgias, tenosynovitis
2) Migratory polyarthritis/septic arthritis, endocarditis, meningitis
3) Skin rash (distal extremities)

Front 70

Treatment of Gonorrhea

Back 70

1) Ceftriaxone IM x 1 dose
2) Oral Cefixime, Cipro, Ofloxacin

*Treat Chlamydia as well

Front 71

Clinical features of HIV primary infection

Back 71

Mononucleosis-like
Fever, sweats, malaise, lethargy, HA, arthralgia/myalgia, diarrhea, sore throat, lymphadenopathy, truncal maculopapular rash

Front 72

Indications for Antiretroviral therapy in HIV patient

Back 72

1) Any symptomatic patient
2) Asymptomatic patient with CD4 <500

Front 73

Stain for Crytococcal Meningitis

Back 73

India ink

Front 74

CD4 count at which esophageal candidiasis is seen

Back 74

CD4 <100

Front 75

CD4 count at which PCP is seen

Back 75

CD4 </ 200

Front 76

HAART Therapy

Back 76

1) Two nucleoside reverse transcriptase inhibitors and EITHER
2) Non-nucleoside reverse transcriptase inhibitor
3) Protease inhibitor

Front 77

Prophylaxis for Opportunistic Infections in HIV/AIDS

Back 77

PCP: Bactrim
MAC: Biaxin or Azithromycin
TB: Annual PPD (give INH and Pyridoxine if positive)
Toxo: Bactrim

Front 78

Stain used to diagnosis Herpes Simplex

Back 78

Wright's Stain

*Done in association with Tzanck smear
*Culture of HSV is gold standard for diagnosis

Front 79

Treatment of HSV

Back 79

Acyclovir (Valacyclovir and Famciclovir have better bioavailability)

*Foscarnet in immunocompromised patients

Front 80

Herpetic Whitlow

Back 80

HSV infection of the finger caused by inoculation into open skin surface
Tx: Acyclovir

Front 81

Treatment of Syphilis in patients with Penicillin allergy

Back 81

PO Doxycycline or Tetracycline for 2 weeks

Front 82

Causative agent of Chancroid

Back 82

Haemphilus ducreyi - gram-negative rod

Front 83

Treatment of Chancroid

Back 83

Azithromycin PO x 1 dose OR
Ceftriaxone IM x 1 dose

*Painful ulcer distinguishes from syphilis

Front 84

Lymphogranuloma venerum

Back 84

Painless sexually-transmitted ulcer caused by CHLAMYDIA TRACHOMATIS
Leads to obstruction of lymphatics and elephantiasis of genitalia

*Treat with PO doxycycline for 21 days

Front 85

Causative agent of Pubic Lice

Back 85

Phthirus pubis

*Transmitted via clothing, towels, sex
*Treat with Permethrin 1% shampoo (Elimite)

Front 86

Cellulitis

Back 86

Inflammation of skin and subcutaneous tissue often caused by GAS or S. aureus

*Can lead to life-threatening bacteremia

Front 87

Clinical features of Cellulitis

Back 87

1) Erythema
2) Warmth
3) Pain
4) Swelling

Front 88

Treatment of Cellulitis

Back 88

IV meds until signs of infection improve -
Staphylococcal penicillin (Oxacillin, nafcillin)
Cephalosporin (cefazolin)

Front 89

Erysipelas

Back 89

Cellulitis located in the dermis and lymphatics often caused by group A streptococcus

Front 90

Predisposing factors of Erysipelas

Back 90

1) Lymphatic obstruction (radical mastectomy)
2) Fungal infections
3) Diabetes mellitus
4) Alcoholism

Front 91

Necrotizing Fasciitis (Nec Fasc)

Back 91

Life-threatening infection of deep soft tissues that tracks along fascial planes

*Leads to sepsis, TSS, and multi-organ failure

Front 92

Common organisms of Nec Fasc

Back 92

1) Streptococcus pyogenes
2) Clostridium perfringens

Front 93

Treatment of Nec Fasc

Back 93

Surgical debridement and broad-spectrum parenteral antimicrobial therapy

Front 94

Lymphadenitis

Back 94

Inflammation of a lymph node
Fever, tender LNPathy, red streaking of skin from wound
Tx: antibiotics and wound drainage

Front 95

Cause of Tetanus

Back 95

Neurotoxin produced by Clostridium tetani, a GRAM-NEGATIVE ANAEROBE

Front 96

Clinical features of Tetanus

Back 96

1) Hypertonicity and contractions of masseter muscles "Lock-jaw"
2) Risus sardonicus - grin due to contraction of facial muscles
3) Opisthotonos - arched back due to contraction of back muscles

Front 97

Most common organisms of Osteomyelitis

Back 97

1) S. aureus
2) Coagulase-negative Staph

Front 98

Plain radiograph of Osteomyelitis

Back 98

Earliest changes (periosteal thickening or elevation) not evident for at least 10 days

Lytic lesions only apparent in advanced disease

Front 99

Treatment of Osteomyelitis

Back 99

IV antibiotics for 4-6 weeks (or longer)
Surgical debridement

Front 100

Acute Infectious Arthritis

Back 100

Organisms invade joint space and release ENDOtoxins that trigger cytokine release and neutrophil infiltration --> erosion of the joint

Front 101

Most common agent of Acute Infectious Arthritis

Back 101

S. aureus

*N. gonorrheae in young, sexually active adults

Front 102

Clinical features of Acute Infectious Arthritis

Back 102

1) Swollen, warm, painful joint
2) Very limited active and passive range of motion
3) Palpable effusion
4) Constitutional symptoms

Front 103

Diagnosis of Acute Infectious Arthritis

Back 103

1) Joint aspiration (culture, stain, crystal analysis)
2) Blood cultures
3) CBC, ESR, CRP
4) CT or MRI

Front 104

Treatment of Acute Infectious Arthritis

Back 104

1) Prompt antimicrobial therapy
2) Drainage of joint as long as effusion persists

Front 105

Signs of disseminated gonococcal infection

Back 105

1) Fever
2) Chills
3) Rash (macules, papules, and/or pustules)

Front 106

Where are the 3 endemic Lyme Disease areas in the US?

Back 106

1) Northeastern seaboard
2) Midwest
3) West coast

Front 107

Transmission of Lyme Disease

Back 107

Caused by Borrelia burgdorferi, which is transmitted by the deer tick, Ixodidae scapularis

Front 108

Clinical features of Lyme Disease

Back 108

Stage 1: Erythema migrans
Stage 2: Early disseminated infection (flu-like symptoms, meningitis/encephalitis, cardiac manifestations)
Stage 3: Arthritis, Chronic CNS disease, Acrodermatitis Chronica Atrophicans

Front 109

Most important tests to confirm suspicion of Lyme Disease

Back 109

Serologic studies

*ELISA used to detect IgM and IgG; Western blot used to confirm

Front 110

Treatment of early Lyme Disease

Back 110

Oral doxycycline for 21 days

*Contraindicated in pregnancy and in children less than or equal to 12 years of age
**Amoxicillin, Cefuroxime, and Erythromycin are alternatives

Front 111

Treatment of the complications of Lyme Disease

Back 111

Prolonged antibiotic therapy

Front 112

Pathophysiology of Rocky Mountain Spotted Fever

Back 112

1) Organisms enter host cells, multiply in the vascular endothelium, and spread to different layers of vaculature
2) Damage to vascular endothelium results in increased permeability, activation of complement, microhemorrhages, and microinfarcts

Front 113

Clinical features of Rocky Mountain Spotted Fever

Back 113

1) Sudden onset of fever, chills, malaise, n/v, myalgias, photophobia, and HA 1 week after tick bite
2) Papular rash appears 4-5 days after the fever
*Rash starts on wrist, forearms, palms, ankles, and soles and then spreads centrally
3) May lead to INTERSTITIAL PNEUMONITIS

Front 114

Lab abnormalities seen in Rocky Mountain Spotted Fever

Back 114

1) Elevated liver enzymes
2) Thrombocytopenia

Front 115

Treatment of Rocky Mountain Spotted Fever

Back 115

Doxycycline for 7 days (IV if pt is vomiting)

*CNS manifestations or pregnant pts: Chloramphenicol

Front 116

4 organisms of Malaria

Back 116

1) Plasmodium falciparum
2) Plasmodium ovale
3) Plasmodium vivax
4) Plasmodium malariae

*Plasmodium falciparum most serious and life-threatening form

Front 117

Clinical features of Malaria

Back 117

Fever, chills, myalgias, HA, n/v, and diarrhea

Front 118

Fever patterns of Malaria

Back 118

Plasmodium falciparum: constant fever
Plasmodium ovale and Plasmodium vivax: fever spikes every 48 hrs
Plasmodium malariae: fever spikes every 72 hrs

Front 119

Diagnosis of Malaria

Back 119

Peripheral blood smear with GIEMSA STAIN

Front 120

Treatment of Malaria

Back 120

Chloroquine Phosphate
*Quinine Sulfate and Tetracycline if chloroquine resistance
*Atovaquone-proguanil and Mefloquine are alternatives

Front 121

Malaria Prophylaxis

Back 121

Mefloquine is agent of choice in chloroquine-resistant areas

Front 122

Rabies

Back 122

Devastating, deadly viral encephalitis
From bite or scratch of infected animal

Front 123

Clinical features of Rabies

Back 123

Incubation period 30 - 90 days
1) Pain at bite site
2) Prodromal symptoms (sore throat, fatigue, HA, n/v)
3) Encephalitis (confusion, hyperactivity, fever, seizures)
4) Hydrophobia (inability to drink, laryngeal spasm, hypersalivation)
5) Ascending paralysis

*Once symptoms are present, rabies is almost invariably fatal

Front 124

Diagnosis of Rabies

Back 124

1) Virus or viral antigen may be identified in infected tissue and saliva
2) Four-fold increase in serum antibodies
3) NEGRI BODIES in tissue
4) PCR detection of RNA virus

Front 125

Treatment of Rabies

Back 125

1) Thorough cleaning of wound
2) Passive immunization (human rabies IgG in wound and glutes)
3) Active immunization (anti-rabies vaccine in 3 IM doses) over 28 day period

Front 126

Which bacteria causes Rocky Mountain Spotted Fever?

Back 126

Rickettsia rickettsii

Front 127

Treatment of Candidiasis

Back 127

1) Clotrimazole lozenge (oral)
2) Nystatin swish and swallow (oral)
3) Oral ketoconazole or fluconazole (esophagitis)
4) Miconazole or clotrimazole cream (vaginal)
5) Amphotericin B or Fluconazole (systemic disease)

Front 128

3 Main Clinical syndromes associated with Aspergillus

Back 128

1) Pulmonary aspergilloma
2) Allergic bronchopulmonary aspergillosis
3) Invasive aspergillosis

Front 129

Allergic Bronchopulmonary Aspergillosis

Back 129

Type 1 hypersensitivity reaction
Presents with ASTHMA and EOSINOPHILIA

*Tx: avoid exposure

Front 130

Pulmonary Aspergilloma

Back 130

Chronic cough, hemoptysis in pts with sarcoidosis, histoplasmosis, TB, and bronchiectasis

*May resolve spontaneously or invade locally
*Tx: lobectomy if massive hemoptysis

Front 131

Invasive Aspergillosis

Back 131

Hyphae invade lung vasculature and cause thrombosis and infarction in immunocompromised patients

*May invade sinuses, orbits, and brain
*Tx: IV Amphotericin B, voriconazole, or caspofungin

Front 132

Diagnosis of Aspergillus infection

Back 132

1) CXR - fungus ball
2) Tissue biopsy

*Blood cultures rarely positive

Front 133

Cryptococcosis

Back 133

Infection caused by Cryptococcus neoformans inhalation into lungs
Associated with pigeon droppings
Seen in advanced AIDS as meningitis
Fever, HA, irritability, dizziness, confusion, seizures

*Always on differential in HIV pt with fever and HA

Front 134

Diagnosis of Cryptococcosis

Back 134

1) LP - INDIA INK shows encapsulated yeast
2) Tissue biopsy - lack of inflammatory response
3) Urine and blood cultures

Front 135

Treatment of Cryptococcosis

Back 135

1) Amphotericin B with flucytosine for 2 weeks
2) PO fluconazole afterwards

Front 136

Definition of Fever of Unknown Origin (FUO)

Back 136

1) Fever > 101
2) Occurs on several occasions for at least 3 weeks
3) No dx despite 1 week of work-up or 3 outpatient visits

Front 137

Causes of Fever of Unknown Origin

Back 137

1) Infection (MCC)
2) Occult neoplasms (lymphoma, leukemia)
3) Collagen vascular disease

Front 138

True or False: It is the bacteria, not the toxin, that causes Toxic Shock Syndrome (TSS)

Back 138

False; it's the toxin

Front 139

True or False: TSS must involve at least 3 organ systems

Back 139

True:
1) GI - n/v, diarrhea
2) Renal - elevated BUN/Cr, transaminitis
3) Hematologic - thrombocytopenia
4) Musculoskeletal - elevated creatinine kinase
5) CNS - confusion in absence of fever

Front 140

Treatment of TSS

Back 140

1) Hemodynamic stability
2) Anti-staphylococcal therapy (nafcillin, oxacillin, vancomycin)

Front 141

Most common organisms of Catheter-Related Sepsis

Back 141

S. aureus and S. epidermidis

Front 142

Most common infections seen in Neutropenic Individuals

Back 142

1) Septicemia
2) Cellulitis
3) Pneumonia

Front 143

Clinical features of Infectious Mononucleosis

Back 143

1) High fever, sore throat, malaise, myalgias, weakness
2) LNPathy - >90% of pts
3) Pharyngeal erythema or exudate
4) Splenomegaly
5) Maculopapular rash (related to AMPICILLIN!)
6) Hepatomegaly
7) Palatal petechiae and periorbital edema

Front 144

Diagnosis of Infectious Mononucleosis

Back 144

1) Serology - Monospot test for heterophile antibody
2) Peripheral blood smear - lymphocytic leukocytosis with large atypical lymphocytes
3) Throat culture - r/o secondary infection (B-hemolytic strept)

Front 145

Complications of Infectious Mononucleosis

Back 145

1) Hepatitis
2) Meningoencephalitis, Guillian-Barre, Bell's palsy
3) Splenic rupture
4) Thrombocytopenia, hemolytic anemia
5) Upper airway obstruction 2/2 LNPathy

Front 146

Currant Jelly Sputum is seen with which gram-negative PNA?

Back 146

Klebsiella