Sepsis Week | UPDATED Questions with 100% Verified
Answers
Q1: A 65 year old male with chronic venous stasis presents with worsening swelling, pain and erythema of
the lower leg. No venous stasis ulcers, abscess or open wounds. No recent trauma. He has a lowgrade fever
and elevated CRP and WBC. Is this purulent or nonpurulent cellulitis?
A: Nonpurulent cellulitis
Q2: A 25 year old patient presents with a hyperpigmented, scaling lesion on the right hand. It is not pruritic
or painful. This has been present for several weeks and has not been responsive to a course of Cephalexin.
On further questioning you learn that the patient has several pets: a dog, a parrot and tropical fish. What do
you suspect could be the cause of this non healing lesion?
A: Mycobacterium marinum. This nontuberculous mycobacteria is found in salt water.
Known as "fish tank granuloma", skin infection occurs from salt water exposure to an open
wound or break in the skin. A tissue biopsy with histopathology and AFB culture will make
the diagnosis. The organism is not susceptible to Cephalexin.
Q3: A patient who uses IV drugs presents with a 4 cm abscess in the right antecubital fossa. There is
erythema surrounding the abscess and extending proximally to the upper arm. He has tender right axillary
lymphadenopathy. He is afebrile and vital signs are normal. What is your initial approach to management?
A: 1. Incision and drainage of the abscess and send pus to microbiology for gram
stain/culture
2. Start antibiotic therapy due to extensive surrounding cellulitis. This should cover MRSA
until culture results are available.
Q4: A patient presents with purulent cellulitis. His WBC is 16, CRP is > 300. He has a lowgrade fever, normal
blood pressure and his heart rate is 108. Initial empiric antibiotic therapy should be:
A: Vancomycin this is the empiric drug of choice for patients with a purulent cellulitis and
systemic signs of toxicity.
, Q5: The most important immune cell involved in abscess formation is:
A: Neutrophils. They are recruited to the site of infection for phagocytosis of the bacteria.
Q6: A 45 year old female presents with a dog bite to the right hand 3 days ago. The wound is draining
seropurulent fluid and has developed surrounding erythema and significant edema. In addition to wound
care, which antibiotic should you begin empirically?
A: Amoxicillinclavulanate. Bite wounds are polymicrobial and require antibiotic coverage
for gram positive/negative aerobes and anaerobes.
Q7: A 10 year old child has been bitten by their cat this morning. The wound on the thenar eminence is
painful and appears deep, but there is no erythema or drainage. Besides wound care and reassurance, is
there anything else this child needs?
A: Amoxicillinclavulanate. Although there are no overt signs of infection at the moment,
cat bites are very likely to become infected. A tetanus booster is not required if the child
received the standard Tdap booster at school entry (46 years).
Q8: What animal population(s) in British Columbia are a reservoir for rabies?
A: Bats
Q9: A 6 year old child presents to your clinic with yellow crusting perioral lesions. What is the diagnosis and
the most common cause(s)?
A: Nonbullous impetigo. The most common organisms to cause this are Staph aureus and
Group A Strep.
Q10: List 5 ways someone could develop septic arthritis
A: 1. Hematogenous spread most common
2. Open penetrating trauma to the joint
3. Contiguous spread from adjacent osteomyelitis
4. Nosocomial infection from arthrocentesis or joint injection
5. Contiguous spread from overlying deep cellulitis/abscess
Answers
Q1: A 65 year old male with chronic venous stasis presents with worsening swelling, pain and erythema of
the lower leg. No venous stasis ulcers, abscess or open wounds. No recent trauma. He has a lowgrade fever
and elevated CRP and WBC. Is this purulent or nonpurulent cellulitis?
A: Nonpurulent cellulitis
Q2: A 25 year old patient presents with a hyperpigmented, scaling lesion on the right hand. It is not pruritic
or painful. This has been present for several weeks and has not been responsive to a course of Cephalexin.
On further questioning you learn that the patient has several pets: a dog, a parrot and tropical fish. What do
you suspect could be the cause of this non healing lesion?
A: Mycobacterium marinum. This nontuberculous mycobacteria is found in salt water.
Known as "fish tank granuloma", skin infection occurs from salt water exposure to an open
wound or break in the skin. A tissue biopsy with histopathology and AFB culture will make
the diagnosis. The organism is not susceptible to Cephalexin.
Q3: A patient who uses IV drugs presents with a 4 cm abscess in the right antecubital fossa. There is
erythema surrounding the abscess and extending proximally to the upper arm. He has tender right axillary
lymphadenopathy. He is afebrile and vital signs are normal. What is your initial approach to management?
A: 1. Incision and drainage of the abscess and send pus to microbiology for gram
stain/culture
2. Start antibiotic therapy due to extensive surrounding cellulitis. This should cover MRSA
until culture results are available.
Q4: A patient presents with purulent cellulitis. His WBC is 16, CRP is > 300. He has a lowgrade fever, normal
blood pressure and his heart rate is 108. Initial empiric antibiotic therapy should be:
A: Vancomycin this is the empiric drug of choice for patients with a purulent cellulitis and
systemic signs of toxicity.
, Q5: The most important immune cell involved in abscess formation is:
A: Neutrophils. They are recruited to the site of infection for phagocytosis of the bacteria.
Q6: A 45 year old female presents with a dog bite to the right hand 3 days ago. The wound is draining
seropurulent fluid and has developed surrounding erythema and significant edema. In addition to wound
care, which antibiotic should you begin empirically?
A: Amoxicillinclavulanate. Bite wounds are polymicrobial and require antibiotic coverage
for gram positive/negative aerobes and anaerobes.
Q7: A 10 year old child has been bitten by their cat this morning. The wound on the thenar eminence is
painful and appears deep, but there is no erythema or drainage. Besides wound care and reassurance, is
there anything else this child needs?
A: Amoxicillinclavulanate. Although there are no overt signs of infection at the moment,
cat bites are very likely to become infected. A tetanus booster is not required if the child
received the standard Tdap booster at school entry (46 years).
Q8: What animal population(s) in British Columbia are a reservoir for rabies?
A: Bats
Q9: A 6 year old child presents to your clinic with yellow crusting perioral lesions. What is the diagnosis and
the most common cause(s)?
A: Nonbullous impetigo. The most common organisms to cause this are Staph aureus and
Group A Strep.
Q10: List 5 ways someone could develop septic arthritis
A: 1. Hematogenous spread most common
2. Open penetrating trauma to the joint
3. Contiguous spread from adjacent osteomyelitis
4. Nosocomial infection from arthrocentesis or joint injection
5. Contiguous spread from overlying deep cellulitis/abscess
