INFECTIOUS DISEASE PANCE REVIEW
Questions and Answers A+ Guide
A 65 year-old patient with steroid-dependent chronic obstructive lung
disease presents with a headache that has been increasing in severity over
the past week, accompanied by nausea and vomiting. He denies fever, but
has had photophobia and a stiff neck. Which of the following is the most
likely diagnosis?
A. Transient ischemic attack
B. Bacterial meningitis
C. Migraine headache
D. Cryptococcosis - correct answers✅✅Explanations
(u) A. Transient ischemic attacks present with focal neurological findings
rather than headaches.
(a) B. Bacterial meningitis is typically acute in onset and causes fever, but
immunocompromised patients may have a slower onset and no fever.
(u) C. Migraines generally do not begin in this age group, and are not
accompanied by nuchal rigidity.
(c) D.Cryptococcus is an opportunistic fungal infection that affects
immunocompromised patients, including those with HIV, chronic steroid use,
organ transplants, diabetes mellitus, and chronic renal or liver disease. The
most common clinical presentation is that of meningitis; fever is present in
only about half of patients.
Cryptococcus dx tests (2) - correct answers✅✅Lumbar puncture -
*cryptococcal antigen in CSF* seen on INDIA INK STAIN
Gram stain: *budding yeast + pseudohyphae*
,INFECTIOUS DISEASE PANCE REVIEW
Questions and Answers A+ Guide
Cryptococcus tx - correct answers✅✅Amphotericin B + Flucytosine
exposure to pigeon/bird droppings
AIDS defining illness - correct answers✅✅cryptococcus
A 29 year-old construction worker presents with cough, fever, and malaise,
two weeks
after demolishing an old chicken coop. Chest x-ray reveals hilar adenopathy.
Gram stain
of the sputum reveals many oval, budding cells. Which of the following is the
most likely
infectious agent?
Answers
A. Cryptococcus neoformans
B. Mycoplasma pneumoniae
C. Streptococcus pneumoniae
D. Histoplasma capsulatum - correct answers✅✅Histoplasmosis
Exposure to bird/bat droppings in Ohio and Mississippi River Valley
Exposure to chicken coops
, INFECTIOUS DISEASE PANCE REVIEW
Questions and Answers A+ Guide
AIDS defining illness - correct answers✅✅histoplasmosis
histoplasmosis x-ray finding - correct answers✅✅hilar adenopathy
histoplasmosis tx (2) - correct answers✅✅itraconazole / ampho B
MC opportunistic infection in HIV pts - correct answers✅✅PCP
Pneumocystis Pneumonia x-ray finding - correct answers✅✅bilateral
diffuse interstitial infiltrates (bat-wing)
Pneumocystis Pneumonia tx - correct answers✅✅Bactrim
grey pseudomembrane over tonsils and pharynx - correct
answers✅✅diphtheria
diphtheria initial tx - correct answers✅✅SECURE AIRWAY
diphtheria medications (2) - correct answers✅✅PCN or erythromycin
A 25 year-old male presents to the emergency department for evaluation of
a wound on his hand. He cut his hand while tearing down a chicken coop. On
examination of his right hand you note a dirty 3cm jagged laceration. The
patient is unaware of his tetanus immunization status. Besides cleaning and
debriding the wound, what is the
recommended clinical intervention in this patient?
Questions and Answers A+ Guide
A 65 year-old patient with steroid-dependent chronic obstructive lung
disease presents with a headache that has been increasing in severity over
the past week, accompanied by nausea and vomiting. He denies fever, but
has had photophobia and a stiff neck. Which of the following is the most
likely diagnosis?
A. Transient ischemic attack
B. Bacterial meningitis
C. Migraine headache
D. Cryptococcosis - correct answers✅✅Explanations
(u) A. Transient ischemic attacks present with focal neurological findings
rather than headaches.
(a) B. Bacterial meningitis is typically acute in onset and causes fever, but
immunocompromised patients may have a slower onset and no fever.
(u) C. Migraines generally do not begin in this age group, and are not
accompanied by nuchal rigidity.
(c) D.Cryptococcus is an opportunistic fungal infection that affects
immunocompromised patients, including those with HIV, chronic steroid use,
organ transplants, diabetes mellitus, and chronic renal or liver disease. The
most common clinical presentation is that of meningitis; fever is present in
only about half of patients.
Cryptococcus dx tests (2) - correct answers✅✅Lumbar puncture -
*cryptococcal antigen in CSF* seen on INDIA INK STAIN
Gram stain: *budding yeast + pseudohyphae*
,INFECTIOUS DISEASE PANCE REVIEW
Questions and Answers A+ Guide
Cryptococcus tx - correct answers✅✅Amphotericin B + Flucytosine
exposure to pigeon/bird droppings
AIDS defining illness - correct answers✅✅cryptococcus
A 29 year-old construction worker presents with cough, fever, and malaise,
two weeks
after demolishing an old chicken coop. Chest x-ray reveals hilar adenopathy.
Gram stain
of the sputum reveals many oval, budding cells. Which of the following is the
most likely
infectious agent?
Answers
A. Cryptococcus neoformans
B. Mycoplasma pneumoniae
C. Streptococcus pneumoniae
D. Histoplasma capsulatum - correct answers✅✅Histoplasmosis
Exposure to bird/bat droppings in Ohio and Mississippi River Valley
Exposure to chicken coops
, INFECTIOUS DISEASE PANCE REVIEW
Questions and Answers A+ Guide
AIDS defining illness - correct answers✅✅histoplasmosis
histoplasmosis x-ray finding - correct answers✅✅hilar adenopathy
histoplasmosis tx (2) - correct answers✅✅itraconazole / ampho B
MC opportunistic infection in HIV pts - correct answers✅✅PCP
Pneumocystis Pneumonia x-ray finding - correct answers✅✅bilateral
diffuse interstitial infiltrates (bat-wing)
Pneumocystis Pneumonia tx - correct answers✅✅Bactrim
grey pseudomembrane over tonsils and pharynx - correct
answers✅✅diphtheria
diphtheria initial tx - correct answers✅✅SECURE AIRWAY
diphtheria medications (2) - correct answers✅✅PCN or erythromycin
A 25 year-old male presents to the emergency department for evaluation of
a wound on his hand. He cut his hand while tearing down a chicken coop. On
examination of his right hand you note a dirty 3cm jagged laceration. The
patient is unaware of his tetanus immunization status. Besides cleaning and
debriding the wound, what is the
recommended clinical intervention in this patient?
