AAFP Board Review – ID questions well answered
graded A+ updated
1. A 4-week-old white male is
B. Chlamydial pneumonia
brought to your office with a 2-
-usu in infants 3 - 16 wks; pt sick for
week history of increasing weeks
dyspnea, cough, and poor -infant nontoxic & afebrile, tachypneic w/
promi-
feeding. The child appears nontoxic and nent cough
is afebrile. On examination you -physical examination: dittuse crackles with
note conjunctivitis, and a chest few wheezes, and conjunctivitis (50% of
examination cases).
reveals tachypnea and crackles. A chest - CXR: hyperinflation and dittuse
interstitial or
film shows hyperinflation and patchy infiltrates.
diffuse interstitial infiltrates and a Not Staphylococcal pneumonia
WBC count reveals eosinophilia. -fever, initial expiratory wheeze like
What is the most likely etiologic bronchiolitis
agent? (check one) -PE: abdominal distress, tachypnea,
A. Staphylococcus species dyspnea, and localized or dittuse
B. Chlamydia trachomatis bronchopneumonia or lobar disease
C. Respiratory syncytial virus -CBC:
D. Parainfluenza virus leukocytosis. Not
RSV
-rhinorrhea and pharyngitis, followed in 1-
3 days by a cough and wheezing.
Auscultation of the lungs will reveal dittuse
rhonchi, fine crackles, and wheezes, but the
chest film is often normal.
-If the illness progresses, coughing and
wheez- ing increase, air hunger and
intercostal retrac- tions develop, and
evidence of hyperexpansion of the chest
,AAFP Board Review – ID questions well answered
graded A+ updated
is seen.
-WBC count will be normal or elevated, and the
ditterential may be
normal or shifted either to the right or left.
-Chlamydial infections can be ditterentiated from
respiratory
syncytial virus infections by a history of conjunc- tivitis,
the subacute onset and absence of fever, and the
,AAFP Board Review – ID questions well answered
graded A+ updated
mild wheezing. There may also be
eosinophilia. Not Parainfluenza virus
infection
-typical cold symptoms.
-Eight percent of infections attect the upper
res- piratory tract.
-In children hospitalized for severe
respiratory illness, parainfluenza viruses
account for about 50% of the cases of
laryngotracheitis and about 15% each of
the cases of bronchitis, bronchiolitis, and
pneumonia.
2. One day after a nurse performs CPR on B. Rifampin, 600 mg q12 x 12
days
an emergency-department patient, she - Rifampin has been shown to be 90%
ettective in
learns that the patient had E. No prophylaxis
meningo- coccal meningitis. Which
one of the fol- lowing is the most 3. A 30-year-old ill-
appropriate chemo- prophylaxis appearing male pre-
for this condition? (check one) sents with right hand
and arm pain and a
A. Penicillin G benzathine (Bicillin
LA), rapidly expanding area
1.2 million units intramuscularly of red-
B. Rifampin, 600 mg every 12
hours for 2 days
C. Oral prednisone, 40 mg daily
for 5 days
D. Quadrivalent meningococcal
vac- cine
, AAFP Board Review – ID questions well answered
graded A+ updated
eliminating meningococcus from the nasophar- ynx. -
also minocycline and ciprofloxacin
-even high doses of penicillin may not eradicate
nasopharyngeal meningococci.
-Meningococcal vaccine appears to have clinical eflcacy,
but it usually takes more than 5 days to become D. Immediate surgical consultation for
ettective. operative debridement
-Severe pain and skin changes outside the
realm
ness. On examination he temp is 38.9°C of cellulitis, including bullae and
deeper dis-
graded A+ updated
1. A 4-week-old white male is
B. Chlamydial pneumonia
brought to your office with a 2-
-usu in infants 3 - 16 wks; pt sick for
week history of increasing weeks
dyspnea, cough, and poor -infant nontoxic & afebrile, tachypneic w/
promi-
feeding. The child appears nontoxic and nent cough
is afebrile. On examination you -physical examination: dittuse crackles with
note conjunctivitis, and a chest few wheezes, and conjunctivitis (50% of
examination cases).
reveals tachypnea and crackles. A chest - CXR: hyperinflation and dittuse
interstitial or
film shows hyperinflation and patchy infiltrates.
diffuse interstitial infiltrates and a Not Staphylococcal pneumonia
WBC count reveals eosinophilia. -fever, initial expiratory wheeze like
What is the most likely etiologic bronchiolitis
agent? (check one) -PE: abdominal distress, tachypnea,
A. Staphylococcus species dyspnea, and localized or dittuse
B. Chlamydia trachomatis bronchopneumonia or lobar disease
C. Respiratory syncytial virus -CBC:
D. Parainfluenza virus leukocytosis. Not
RSV
-rhinorrhea and pharyngitis, followed in 1-
3 days by a cough and wheezing.
Auscultation of the lungs will reveal dittuse
rhonchi, fine crackles, and wheezes, but the
chest film is often normal.
-If the illness progresses, coughing and
wheez- ing increase, air hunger and
intercostal retrac- tions develop, and
evidence of hyperexpansion of the chest
,AAFP Board Review – ID questions well answered
graded A+ updated
is seen.
-WBC count will be normal or elevated, and the
ditterential may be
normal or shifted either to the right or left.
-Chlamydial infections can be ditterentiated from
respiratory
syncytial virus infections by a history of conjunc- tivitis,
the subacute onset and absence of fever, and the
,AAFP Board Review – ID questions well answered
graded A+ updated
mild wheezing. There may also be
eosinophilia. Not Parainfluenza virus
infection
-typical cold symptoms.
-Eight percent of infections attect the upper
res- piratory tract.
-In children hospitalized for severe
respiratory illness, parainfluenza viruses
account for about 50% of the cases of
laryngotracheitis and about 15% each of
the cases of bronchitis, bronchiolitis, and
pneumonia.
2. One day after a nurse performs CPR on B. Rifampin, 600 mg q12 x 12
days
an emergency-department patient, she - Rifampin has been shown to be 90%
ettective in
learns that the patient had E. No prophylaxis
meningo- coccal meningitis. Which
one of the fol- lowing is the most 3. A 30-year-old ill-
appropriate chemo- prophylaxis appearing male pre-
for this condition? (check one) sents with right hand
and arm pain and a
A. Penicillin G benzathine (Bicillin
LA), rapidly expanding area
1.2 million units intramuscularly of red-
B. Rifampin, 600 mg every 12
hours for 2 days
C. Oral prednisone, 40 mg daily
for 5 days
D. Quadrivalent meningococcal
vac- cine
, AAFP Board Review – ID questions well answered
graded A+ updated
eliminating meningococcus from the nasophar- ynx. -
also minocycline and ciprofloxacin
-even high doses of penicillin may not eradicate
nasopharyngeal meningococci.
-Meningococcal vaccine appears to have clinical eflcacy,
but it usually takes more than 5 days to become D. Immediate surgical consultation for
ettective. operative debridement
-Severe pain and skin changes outside the
realm
ness. On examination he temp is 38.9°C of cellulitis, including bullae and
deeper dis-
