Micro 1-Liners Skin (Rashes), Soft Tissue, & Musculoskeletal Infections (Also Sepsis)

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323. What are the SIX red rashes of childhood (acute, febrile exanthema illnesses)? (Clue1: maculopapular rash; off-white lesions on buccal mucosa, MMRV vaccine prevents)

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Measles

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323. What are the SIX red rashes of childhood (acute, febrile exanthema illnesses)? (Clue2: maculopapular rash starting on face moving to foot; MMRV prevents)

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Rubella

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323. What are the SIX red rashes of childhood (acute, febrile exanthema illnesses)? (Clue3: scarlatina rash post pharyngitis)

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Scarlet fever (GAS)

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323. What are the SIX red rashes of childhood (acute, febrile exanthema illnesses)? (Clue4: vesicular rash, moderate pain)

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Chicken pox (VZV)

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323. What are the SIX red rashes of childhood (acute, febrile exanthema illnesses)? (Clue5: maculopapular “slapped face” appearance in a young child)

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Parvovirus B19

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323. What are the SIX red rashes of childhood (acute, febrile exanthema illnesses)? (Clue6: maculopapular rash and systemic Dz in immunocompromised pt)

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HHV-6

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324. Worldwide rubella infection, with only human reservoirs known this infectious agent is a

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RNA togavirus

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325. >95% seropositive after MMRV if >12mos age and lifelong protection against rubella is conferred with?

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Single dose

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326. Cause of single or multiple scaly and/or crusted patches and/or plaques, affecting the scalp or beard area +/- inflammation.

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Dermatophytes

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327. KOH prep of scales from the scalp and plucked hairs from cutaneous mycoses may reveal?

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hyphae and spores

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328. Most common cause of cutaneous mycoses

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Trichophyton spp.

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329. Common cause of cutaneous mycosis with animal contact

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Microsporum spp.

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330. Oral DOC of cutaneous mycoses

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itraconazole

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331. Topical DOC of cutaneous mycoses

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terbinafine

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332. Dz w/ subcutaenous lesions w/ slow spread by lymphatic system producing nodules in a gardener, or from rose-thorn injury.

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Sporotrichosis

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333. Cause of subcutaenous lesions w/ slow spread by lymphatic system producing nodules in a gardener, or from rose-thorn injury.

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Sporothrix schenckii

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334. Dimorphic fungus that grows at 37°C as cigar-shaped yeast, and produces septate hyphae and conidia (in daisy arrangement) at 25°C is

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Sporothrix schenckii

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335. DOC of sporotrchosis

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itraconazole.

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336. Cause of deeper and wider lesions with interconnecting subcutaneous abscesses arising from infection of several neighboring hair follicles, in young children.

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Staphylococcus aureus (Curbuncle)

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337. Cause of superficial pustules progressing to erosions covered by honey-colored crusts, surrounded by erythematous halo, in young children.

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Staphylococcus aureus >> Streptococcus pyogenes (non-bullous impetigo)

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338. Dz characterized by bullae and denuded areas after the blisters rupture, covered by thin, varnish-like light brown crusts; regional lymphadenopathy, in children.

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Bullous impetigo

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338. Dz characterized by bullae and denuded areas after the blisters rupture, covered by thin, varnish-like light brown crusts; regional lymphadenopathy, in children. DOC if lab: gram stain and culture of pus or base of the lesions yields GPC in chains.

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Penicillin G

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338. Dz characterized by bullae and denuded areas after the blisters rupture, covered by thin, varnish-like light brown crusts; regional lymphadenopathy, in children. DOC if lab: gram stain and culture of pus or base of the lesions yields GPC in clusters.

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Nafcillin

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339. mecA (SCC) genes which encode PBP2a, w/ low affinity for β-lactams; confers resistance in Staphylococcus aureus against what?

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Nafcillin

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340. Cause of spreading (butterfly-wing) erythema on the face that responds to empirical penicillin.

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Streptococcus pyogenes (Erysipelas)

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341. Cause of severe pain on his knee w/ site of injury is tender and erythematous. Blood culture may yield?

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Streptococcus pyogenes. (Cellulitis)

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342. What is the microbial factor that promotes degradation of C3b by binding to factor H, the serum β globulin factor

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M protein

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343. Other epidemiologically linked or risk-associated causes of cellulitis are: Clue1: cat/dog bite. What?

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Pasteurella multocida / Capnocytophaga canimorous

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343. Other epidemiologically linked or risk-associated causes of cellulitis are: Clue2: Salt water exposure. What?

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Vibrio vulnificus

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343. Other epidemiologically linked or risk-associated causes of cellulitis are: Clue3: Fresh water exposure. What?

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Aeromonas hydrophila

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343. Other epidemiologically linked or risk-associated causes of cellulitis are: Clue4: Neutropenia. What?

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Pseudomonas aeruginosa

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343. Other epidemiologically linked or risk-associated causes of cellulitis are: Clue5: Human bite. What?

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Eikenella corrodens

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344. Most likely cause of fever/chills/ night sweats, localizing pain/tenderness or swelling/erythema (lab: ↑ESR, ↑CRP; ↑WBC w/ left shift. Radiology: periosteal elevation.) is

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Staphylococcus aureus (Osteomyelitis)

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345. Major antiphagocytic virulence factor of drug-resistant organism that causes osteomyelitis is

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protein A

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346. Major neutrophil-damaging virulence factor of drug-resistant organism that causes osteomyelitis is

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Penton-Valentine leukocydin

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347. Cause of vertebral, sternoclavicular or pelvic bone infections (in pt w/ IVDU) or osteochondritis of foot (following penetrating injuries through tennis shoes)?

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Pseudomonas aeruginosa

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348. Cause of osteomyelitis in pt w/ underlying sickle cell Dz; blood culture +)?

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Salmonella typhimurium

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349. Cause of chronic, vertebral osteomyelitis (blood culture negative)?

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Mycobacterium tuberculosis

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350. Cause of osteomyelitis in pt. w/ hx of cat bites; GNSR; fastidious growth of wound culture?

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Pasteurella multocida

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351. Cause of fever, chills, malaise, joint pain, swelling. PE: tenderness, erythema, heat, swelling, decreased ROM. CBC: leukocytosis w/ neutrophils predominating; joint aspirate: no crystals.

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Septic arthritis

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351. Cause of fever, chills, malaise, joint pain, swelling. PE: tenderness, erythema, heat, swelling, decreased ROM. CBC: leukocytosis w/ neutrophils predominating; joint aspirate: no crystals. Clue1: sexually active; BLCx (-); responds to ceftriaxone

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Neisseria gonorrhoeae

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351. Cause of fever, chills, malaise, joint pain, swelling. PE: tenderness, erythema, heat, swelling, decreased ROM. CBC: leukocytosis w/ neutrophils predominating; joint aspirate: no crystals. Clue2: Rheumatoid arthritis?

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S. aureus

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351. Cause of fever, chills, malaise, joint pain, swelling. PE: tenderness, erythema, heat, swelling, decreased ROM. CBC: leukocytosis w/ neutrophils predominating; joint aspirate: no crystals. Clue3: IVDU?

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S. aureus, P. aeruginosa

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351. Cause of fever, chills, malaise, joint pain, swelling. PE: tenderness, erythema, heat, swelling, decreased ROM. CBC: leukocytosis w/ neutrophils predominating; joint aspirate: no crystals. Clue4: Unpasteurized dairy products

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Brucella spp.

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351. Cause of fever, chills, malaise, joint pain, swelling. PE: tenderness, erythema, heat, swelling, decreased ROM. CBC: leukocytosis w/ neutrophils predominating; joint aspirate: no crystals. Clue5: Diabetes

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S. agalactiae (GBS)

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352. Dz is characterized by arthritis in up to 6 joints (especially knees, feet), low back pain/stiffness, irritable eyes w/ or w/o redness, conjunctivitis, iritis, malaise. TOW?

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Reactive arthritis

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352. Dz is characterized by arthritis in up to 6 joints (especially knees, feet), low back pain/stiffness, irritable eyes w/ or w/o redness, conjunctivitis, iritis, malaise. TOW? sexually acquired

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C. trachomatis, N. gonorrhoeae

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352. Dz is characterized by arthritis in up to 6 joints (especially knees, feet), low back pain/stiffness, irritable eyes w/ or w/o redness, conjunctivitis, iritis, malaise. TOW? non-sexually acquired

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Campylobacter, Salmonella

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353. Cause of bacteremia in neutopenic pts with central line or pts with prosthetic devices and catheters; blood culture (+)

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Staphylococcus epidermidis

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354. Cause of intraabdominal abscess w/ putrid pus; anaerobic bacteremia in pt with trauma or solid GI tumor?

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Bacteroides fragilis.

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355. A woman with obstetric infection has fever > 102oF, SBP < 90; diffuse sunburn-like rash or desquamation of palms and soles; multisystem Sx/Sns; vomiting, and diarrhea; BLCx (-). TOW?

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Staphylococcal Toxic shock Syndrome

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356. What is the toxin associated with staphylococcal toxic shock syndrome?

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TSST-1 (a superantigen)

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357. Cause of severe, watery diarrhea in a woman with toxic shock syndrome?

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Enterotoxin (coregulated with TSST-1)

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358. Cause of toxic shock syndrome, which responds to vancomycin and clindamycin?

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MRSA

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359. Hx of fever > 38.9oC, SBP < 90 ; diffuse sunburn-like rash or desquamation of palms and soles, in a man w/ necrotizing fasciitis or myositis; multisystem involvement; BLCx (+). TOW?

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Streptococcal toxic shock syndrome

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360. What is the toxin associated with streptococcal toxic shock syndrome?

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SpeA (superantigen)

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361. DOC for streptococcal toxic shock syndrome

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PenG + clindamycin

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362. Hx of fever, chills, and hypotension. Blood culture yields a GNR, oxidase (-), lactose fermenting organism on MacConkey agar. Immunological mediators of sepsis.

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IL-1 and TNF