UNIVERSITY OF TEXAS AT ARLINGTON UTA
FAMILY II COMPLETE QUESTION AND ANSWER
Disseminated Lyme - ANSWER -Neurologic Lyme
Can cause meningitis, radiculopathy
Tx: IV Ceftriaxone 2g daily x14-21 days
IV Penicillin G or oral Doxycyline if mild
Lyme Carditis (heart block, myocarditis)
Tx: Doxycycline x14-21 days if mild
Severe is hospitalized with IV Ceftriaxone x2-4 weeks
Lyme Arthritis - ANSWER -Late disease
Tx: Doxycycline 100mg BID x28 days
if no improvement, IV Ceftriaxone x2-4 weeks
Mononucleosis - ANSWER -caused by epstein-barr virus or cmv
s/s: fever, sore throat with exudates, posterior cervical lymphadenopathy, fatigue,
headache, malaise, loss of appetite
pe: pharyngeal erythema, splenomegaly, hepatomegaly, rash
dx: monospot (after 1-2 weeks), EBV antibodies, CBC, LFTs, throat culture
avoid sports ~3-4 weeks d/t splenomegaly
Tx: rest, hydration
NO ABX -- CAUSES RASH
, Group A Strep - ANSWER -s/s: sudden sore throat, tonsillar exudate, anterior
cervical lymphadenopathy, no rash unless scarlett fever
if concomitant (have strep and mono) treat strep with cephalexin or clindamycin,
NO PENICILLIN AS IT CAUSES RASH IN MONO
Measles (Rubeola) - ANSWER -transmission: respiratory droplets, can remain on
surfaces for 2 hours, can spread 4 days before and after rash appears
3 C's of measles: cough, coryza, conjunctivitis
s/s: prodrome is high fever, cough, rhinorrhea, conjunctivitis, photophobia, malaise
Rash appears 3-5 days after prodrome starting at hairline and spreading down to
face, neck, and body, maculopapular and blanching rash, koplik's spots before rash
(bluish white spots surrounded by a red halo on buccal mucosa)
dx: RT-PCR is gold standard
IgM, IgG
post exposure prophylaxis: MMR vaccine to anyone older than 6 months old
within 72 hours of exposure
or IGIM for infants <6months or pregnant women or severely
immunocompromised
Roseola - ANSWER -caused by human herpes virus 6 & 7
transmission: respiratory droplets and direct contact w/ saliva
contagious before fever phase and mulitple days after fever subsides
incubation: 5-15 days
Phase 1: High fever ~3-5 days, irritability, cough, rhinorrhea
,Phase 2: Rash development, fever subsides, rash on trunk then neck, face and
limbs, pinkish red spots and maculopapular, resolves after 2-3 days with no
treatment, mild diarrhea
Tx: supportive, can return to school when fever resolves
Rubella (German Measles) - ANSWER -prodrome: mild or absent, low grade
fever, headache, mild conjunctivitis, URI sx
rash: starts on face, behind ears, spreads to trunk, neck, extremities, maculopapular
and blanches, lasts ~3 days
s/s: posterior cervical and suboccipital lymphadenopathy
dangerous in pregnancy!
congenital rubella can lead to birth defects like cataracts, deafness,
microencephaly, intellectual disabilities, congenital heart defects
arthritis in adults, thrombocytopenia
Tx: supportive, pregnant women should receive MMR vax postpartum
Varicella - ANSWER -transmission: droplet or direct contact with vesicular fluid
spreads 1-2 days before rash and contagious until last vesicle has crusted over
s/s: malaise, headache, fatigue
Rash: red spots that become fluid filled vesicles on face, chest, back, then spreads,
itchy, cropping (new lesions appear as older ones crust over)
macules>papules>vesicles>crust (~4-5 days)
Tx: non-pharm: calamine lotion, oatmeal baths, trimmed nails
pharm: antipyretics, acyclovir (in high risk people), VZIG to autoimmune or at risk
ppl
, Cellulitis - ANSWER -deep skin infection of dermis and subcutaneous tissue,
borders are less defined, swollen, red, warm, painful, may be systemic
organism: Group A strep and staph aureus (MRSA)
Tx: mild case - oral abx
Cephalexin
Dicloxacillin
Clindamycin
Severe: IV abx
Cefazolin
Vancomycin
Clindamycin
Erysipelas - ANSWER -superficial skin infection of epidermis, raised, well
defined borders, shiny, smooth looking, legs and face often, painful, may cause
systemic sx
Organism: strep pyogenes (group A)
Tx: oral abx
Penicillin
Cephalexin
Clindamycin
Meningitis - ANSWER -isolation: droplet
Dx: LP, Blood cultures, CT/MRI, PCR
causative agents
Bacterial: neisseria meningitidis, strep pneumoniae, h. flu, group B strep
Viral: enterovirus, herpes simplex, varicella zoster
Fungal: cryptococcus neoformans, histoplasma, coccidioides, blastomyces