Critters
what is the mc organism & associated pathogen for rabies?
lyssavirus (rhabdovirus family) Most commonly spread through bats!
Antibiotic most commonly implicated in causing C. difficile colitis?
Clindamycin
What pathogens are associated with folliculitis vs hottub folliculitis?
staph & pseudomonas
A 32-year-old man that recently returned from a trip to Haiti. presents with profuse watery diarrhea described as “rice water stools” and signs of dehydration. Stool culture grows comma-shaped, oxidase-positive gram-negative rods. What is the likely diagnosis?
Cholera
How do humans become infected with tapeworms?
eating raw or undercooked meat
Mom presents to the ER with 6 yr old boy who has been experiencing perianal excoriations due to itching that gets worse at night time. A scotch tape test is performed that confirms the dx. What is the dx and indicated tx?
Pinworms (enterobius vernicularis) tx with albendazole x1 then repeat in 2 wks - treat all other family members too!!
A pt presents after stepping a nail in the garage. You see a puncture wound and localized muscle spasm around the injury. On histology you see spores with a tennis racket appearance, what is the likely pathogen?
clostridium tetani
A 29-year-old man presents with a painless genital ulcer and nontender inguinal lymphadenopathy. Darkfield microscopy of the lesion shows motile spirochetes. What is the first-line treatment?
Benzathine penicillin G IM (This is Syphillis!)
Yersinia pestis is what kind of organism?
gram negative coccobacilli (faculative anaerobe with safety pin presentation)
This is the plague!
A 28-year-old hiker in Connecticut presents with fever, arthralgia, and an expanding erythematous rash with central clearing. What is the dx and treatment?
Lyme Disease - treat with doxycycline!
A 7-year-old boy presents with unilateral tender cervical lymphadenopathy and a papule at the site of a scratch from his new kitten. He is otherwise healthy. Which of the following is the most appropriate first-line management?
Azithromycin - this is bartonella!
A 2-month-old infant presents with constipation, poor feeding, weak cry, and generalized hypotonia ("floppy baby"). Parents report they have been giving the baby small amounts of honey. Which of the following best describes the underlying pathophysiology?
A. Exotoxin blocks acetylcholine release at neuromuscular junctions
B. Endotoxin stimulates massive cytokine release
C. Exotoxin increases cyclic AMP levels in enterocytes
D. Exotoxin inhibits glycine release in the spinal cord
A. Exotoxin blocks acetylcholine release at neuromuscular junctions
12 yr old pt come into the office today. Mom states the child has been complaining of head and muscle aches and is now presenting with a papulovesicular rash with lesion all in the same stage of development. On PE you notice oropharyngeal ulceration as well. What is the likely diagnosis?
small pox! (Dx with PCR)
A 26-year-old hiker presents with foul-smelling, greasy diarrhea and bloating. Stool O&P shows pear-shaped trophozoites with flagella. What is the treatment of choice for the likely dx?
Tinidazole (This is Giardia, he drank from a stream nasty hoe)
What organism is responsible for the transmission of malaria? (Bonus: what pathogen?)
anopheles mosquito - plasmodium pathogen (1 of 4 species)
What is the treatment of toxoplasmosis? How does it change for pregnant pts? What about for HIV pts with a CD4 count <100?
Normal: Pyrimethamine and sulfadiazine
Pregnant: Spiramycin
HIV: Bactrim
A pt presents with a shiny, red, warm rash on the left lower extremity with clearly demarcated borders. The pt denies any purulent drainage from the sight. What is the likely dx and tx?
erysipelas tx with pcn v potassium/amox/cephalexin
What type of leprosy presents sooner (shorter incubation time) with a high immune response?
Tuberculoid leprosy has a shorter incubation time and higher immune response
lepromatous has a longer incubation time and lower immune response
After getting bit by a flea on a roadtrip through new mexico and arizona a pt presents with a fever of 102.8, myalgia, and chills. On PE you notice a tense, very tender bubo in the inguinal region. what is the likely dx and treatment.
bubonic plague - streptomycin
A 12-year-old boy presents in July with fever, severe headache, and myalgias. Two days later, he develops a petechial rash that began on his wrists and ankles and spread to his trunk. His mother reports a tick bite while camping in North Carolina. What is the treatment for the likely diagnosis?
Doxy! (This is RMSF)
An 18 yr old girl presents to the office with fever, vomiting and diarrhea. On PE you see suppurative cervical LAD and enlarged spleen. The patient states her only new exposure has a been a new pet bunny she got for college. What is the first line tx for the suspected dx?
streptomycin (This is Tularemia!)
What is the gold standard method of diagnosing poliovirus?
Stool analysis (fecal-oral route transmission)
What are the two etiologies of gas gangrene?
traumatic - trauma/surgery site leading to signs of systemic tox and gas (crepitus) in soft tissue
spontaneous - GI tract lesion allows entry of pathogens into blood stream
A 38-year-old man presents with fever, cough, and fatigue after returning from a spelunking trip in Ohio. Chest X-ray shows mediastinal lymphadenopathy with patchy infiltrates. Histopathology reveals intracellular yeasts within macrophages. What is the diagnosis?
Histoplasmosis
A pt traveled to vietnam about a week ago where he said he got “torn up” by mosquitos despite wearing repellent. On PE the pt has a 102 fever, HA, facial flushing, back pain and a petechial rash that started on his neck and has since moved to his extremities. What medication should be avoided in this patient?
Dengue Virus - tx with supportive care & acetaminophen but AVOID NSAIDs