Neisseria (gonorrhea, septic arthritis, meningitis) or
Mucoid appearing gram -
Gram + rods that form spores
Mycobacterium TB or
woman with PID and an IUD gram stain shows Sulfur granules
pneumocystis jiroveci and cat scratch disease
Positive India Ink prep
Spirochete on microscopy? on dark field?
Dark: Treponema, Leptospira
Pt stuck with thorn. Rx?
Rx: itraconazole, fluconazole, or oral K iodide
Aplastic crisis in sickle cell disease
Sepsis after splenectomy
S pneumo, H influ, N meningitidis
Pt with PNA from SW US? Rx?
Dx: Coccidioides immitits
Rx: Itraconazole, Fluconazole, or amphotericin B
PNA after cave exploring or seeing birds in Mississippi or Ohio rivers
PNA after exposure to parrot or exotic bird
Fungus ball or hemoptysis after TB-induced cavitary disease
PNA in pt with silicosis
Rx for diarrhea from drinking from stream
Pregnant woman with cats
B12 deficiency and abd symptoms
Seizures with ring enhancing brain lesion on CT
Taenia solium (cysticercosis)
Squamous cell Bladder cancer in Middle east and Africa
Pin worm organism
Fever, myalgias, eosinophilia, periorbital edema, sp eating raw meat
Trichinella spiralis (trichinosis)
Young child with gastroenteritis
Food poisoning after raw seafood
Diarrhea after mexico travel
Rx for pt with diarrhea some time after abx
Oral metronidazole or vancomycin
Genital lesions in child with no signs of abuse
Cellulitis after cat or dog bites? Rx?
Dx: Pasteurella multocida
Rx: Ampicillin prophylactically
Slaughterhouse worker with fever?
Rx for PNA from water source (AC, etc)
Azithromycin and Flouroquinolone
Burn wound infx with blue green color
What illnesses are caused by Staph? What is the Rx for staph?
Septic Arthritis (S. aureus)
Rx: Dicloxacillin, Methicillin (Vancomycin if resistant)
What is the Rx for Bronchitis?
Amoxicillin and Erythromycin
What infections are caused by Strep? Rx for strep?
Meningitis, Pneumonia (S pneumo)
Rx: Dicloxacillin, Methicillin
(S pneumo = third gen cephalosporin)
Rx for Gonococcal arthritis?
Rx for UTI?
Rx for atypical pna?
Causes of PNA? In whom? Rx?
S pneumonia: older adults (3rd gen cephalosporins)
H influ: young children (amp or amox or 3rd gen ceph)
S aureus: nosocomial, CF, IV abuse, granulomatous disease (methicillin or dicloxacillin)
Pseudomonas (CF), Klebsiella (homeless), E coli (noso, aspiration): 3rd gen penicillin or ceph + aminoglycoside
Mycoplasma, Chlam: Young college adults (*thromycins)
Pneumocystis Jiroveci, CMV: HIV (trimethoprim-sulfamethoxazole prophylaxis if CD4 < 200)
HIV pt says 2 days ago he had Macules that changed to papules that changed to vesicles that ruptured and crusted over. They started on his trunk but have spread.
Tzank smear shows multinucleated giant cells.
What is your next step?
Give Vericella Ig because it has been less than 4 days.
Child comes in with slapped looking cheeks for three days and two days ago devp maculopapular rash on his arms legs and trunk. What is the diagnosis and causing agent?
Erythema Infectiosum (fifth disease)
4 yo child comes in with high fever for 5 days; conjunctivitis; an erythematous rash that shows desquamation and some edema on her trunk; a strawberry tongue with cracked lips; Cervical lymphademopathy on physical exam. What is the diagnosis and next step?
Treat with ASA and IV Ig for heart protection
Patient reports starting a fever 4 days ago, yesterday white spots on buccal mucosa, this AM a maculopapular rash that started on her head and has spread to her body. What is the diagnosis?
Pt returns from N Carolina a week ago; 4 days ago started having a high fever, severe headache, and ached all over really bad; this AM rash appeared on palms and soles and has spread to her body and her face. What is the diagnosis? Possible complications? Rx?
Rocky Mtn Spotted Fever (Rickettsia)
Complications: DIC / Delerium
Rx: Doxycycline or Chloramphenicol
What causes Roseola?
Human Herpes Virus 6
Pt with low grade fever and malaise; faint maculopapular rash starts on face and spreads to body. Whats the diagnosis?
Pt had bad sore throat 10 days ago then a few days ago developped sandpaper like rash on stomach and chest with a high fever. Fever has started getting better but her rash is starting to peel. On physical you notice circumoral pallor and a strawberry tongue. What is the Dx? Complication? and Rx?
Can become Rheumatic Fever
Rx with Penicillin
What are the intial steps in epiglottitis?
1. Do not examine the throat.
2. Be prepared to establish an airway.
3. Treat with third gen cephalosporins.
Greyish pseudomembranes on pharynx, tonsils, and uvula. Myocarditis is possible.
Diptheria. Rx with abx and antitoxin
What infections are caused by Strep Pyogens?
1. Rheumatic Fever
2. Scarlet Fever
3. Post strep glomerulonephritis
7. Necrotizing Fasciitis
Which bug causes dental caries and subacute endocarditis?