Public Health/Vaccines
What is in the center of the essential services of public health wheel?
What are the two Duke major criteria for diagnosis of infective endocarditis?
Imaging findings of vegetation (TTE)
Microbiologic findings of vegetation (Cultures)
A 22-year-old college student develops sudden-onset vomiting and watery diarrhea after attending a dorm party. Symptoms last 36 hours. Several classmates are affected.
What is the MOST LIKELY cause?
Norovirus
CD4 T Cells
Who is going to kill it in their exams this week?
All of us! <3
(Everyone gets these points)
This vaccine type is most effective at triggering the immune system
Live vaccines
A 29-year-old woman presents with chest pain that worsens with inspiration and improves when leaning forward. ECG shows diffuse ST elevations and PR depressions. Troponin is normal.
What is the best initial therapy?
NSAIDs + Colchicine
A 33-year-old man presents with high fever, severe abdominal cramping, and frequent small-volume stools. He also reports painful tenesmus. Stool culture is pending.
What is the most likely organism?
Shigella dysenteriae
What are the diagnostic criteria for AIDS?
CD4 count under 200 or opportunistic infection
What is the initial fluid bolus given to someone with septic shock?
30 mL/kg crystalloids
This is the ability of an infectious agent to cause serious disease.
Virulence
A 50-year-old man with a history of injection drug use presents with fever, pleuritic chest pain, hemoptysis, and multiple cavitary nodules on CXR. A new harsh holosystolic murmur is heard along the left sternal border. What structure is most likely involved?
Tricuspid valve
A 19-year-old traveler returns from Mexico with 3 days of watery diarrhea, nausea, and abdominal cramps. No fever or blood. Stool culture is positive for E. Histolytica.
What is the appropriate next step of treatment? (In the correct order)
Metronidazole followed by paromomycin
A 30 year old male presents with fever, sore throat, and a generalized maculopapular rash. His sexual history reveals he has had multiple male sexual partners within the past 2 weeks.
After confirming his diagnosis with an ELISA test, what treatment regimen would you begin ASAP?
Biktarvy or Dovato
What is the diagnostic criteria for septic shock?
Despite adequate fluid resuscitation, vasopressors are necessary to maintain MAP >65 and a lactate of >2 mmol/L
This type of vaccine uses the body's own cells to produce a peptide rather than a prior cell culture
mRNA vaccine
A 22-year-old patient presents with fever, myalgias, mild chest pain, and palpitations two weeks after a viral illness. Troponin is elevated. ECG shows ST elevations in the lateral leads. Echo reveals mild LV dilation and global hypokinesis.
What is the GOLD STANDARD diagnostic test for his suspected condition?
Endomyocardial biopsy
A 26-year-old patient presents with diarrhea after drinking unfiltered water while camping. Symptoms include upper abdominal pain and watery stools. Stool antigen testing is positive.
This parasite does not invade the epithelium. What is it?
Giardia
An HIV+ patient asks if he should be taking any medication to ensure he does not get any lung infections. His CD4 count is currently 40.
What prophylaxis regimen/s should this patient be on and for what pathogens?
Bactrim PO daily for PJP
Azithromycin 1200mg PO weekly for MAC
What are the "Sepsis 6"?
High flow oxygen, blood cultures, antibiotics, serum lactate, IV fluids, monitor urine output
What are the three core functions of public health
Assessment
Policy Development
Assurance
A 44-year-old woman presents with fever, arthralgia, and a painful, raised erythematous macule on the palm. She also reports vision changes. Fundoscopic exam shows retinal hemorrhages with pale centers.
What is the name of the dermatologic manifestation and what is it a sequela of?
Osler nodes
Infective Endocarditis
A 42-year-old woman presents with fever and abdominal pain after being treated for aspiration pneumonia, for which she was treated with antibiotics.
What antibiotic was most likely prescribed for her aspiration pneumonia and what is the first line treatment for her new onset illness?
Clindamycin
Vancomycin or Fidaxomicin
Cuba was the first country to eradicate this common route of HIV infection
Vertical transmission
A 78-year-old woman with a history of type 2 diabetes (controlled with an SGLT2i and metformin) and mild cognitive impairment is brought to the ED from her assisted-living facility for altered mental status. Her caregiver reports she has been “more confused than usual” for the past day and had reduced oral intake. On arrival, she is lethargic but arousable.
Vitals: T 102.9°F (39.4°C), HR 128 bpm, BP 78/46 mmHg, RR 26/min, SpO₂ 93% on room air.
What is the most likely cause of this patient's septic shock?
Urinary Tract Infection