Board Review. Paul O’Keefe April 16, 2003. Skin/Soft Tissue Infections. Impetigo Cellulitis Fasciitis. Impetigo. Group A streptococcus, Staphylococcus arueus Superficial blisters honey colored crusts on erythematous base No systemic signs Mainly in children
April 16, 2003
Coagulase negative staphylococcus
A three year old boy presents with an itchy rash that is spreading. Afebrile with numerous cursted lesions in erythematous base involving left shoulder and upper chest and back with few lesions in the right thigh. Culture growing gram positive coccus, beta hemolytic on SBA, catalase negative, inhibited by bacitracin disc. The isolated agent is
A 15 year old presents with fever, sore throat and extreme
fatigue. Temperature is 103.2 and there is a yellowish exudate
covering both enlarged tonsils. Submandibular, anterior cer-
vical, and posterior cervical lymph nodes are enlarged on both
sides. Which of the following is most characteristic of infectious
A 15 yo woman presents with fever, facial pain and severe
nasal congestion. She has been suffering with hay fever.
CT showed opacification of the R maxillary sinus and an air-
fluid level in the left. Gram stain of material obtained by
antral puncture disclosed gram negative coccobacilli. Which of
the following characterizes the organism most likely respon-
sible for the infection?
A 9 month old child with fever and congestion is diagnosed
with right otitis media. Common causes of this infection are?
A 33 year old male presents with fever and cough 3 weeks
after his 7 year old son was treated for pneumonia. X-ray
shows a patchy bronchopneumonia involving the right middle
and lower lung field. Cold agglutinin test is positive
What is the likely cause?
A 26 year old woman complained of fever, night sweats and
cough for 2 months. She had occasional hemoptysis and 15
pound weight loss. Chest x-ray showed fibronodular infiltrates
with a cavity in the posterior segment of the right upper lobe.
Please answer the following:
What type of isolation would you order?What diagnostic tests would you order?
Sputum smear returned positive for AFB.
What treatment would you order?
Why are multiple drugs necessary for treatment of tuberculosis?
A 23 year old woman presents with acute dysuria one
day after intercourse. Urinalysis discloses 15-20 WBC’s
/HPF. Gram stain discloses gram negative rods.
What is the recommended treatment?
A 6 year old boy presents with fever and lethargy. He has
nuchal rigidity on examination. Lumbar puncture discloses
many PMN’s and Gram positive cocci in pairs.
Which of the following characterizes this organism?
A 22 year-old woman with sickle cell disease presents with
fever and pain in the left upper arm. X-ray of the humerus
shows a lytic lesion. Biopsy is growing gram negative
Which of the following best describes the organism?
A 16 year old man presents with burning on urination and a
scant urethral discharge 3 days after intercourse with a new
partner. Gram stain of discharge discloses many PMN’s but
The organism most likely responsible for the infection is
A 29 yo female presents with fever, rash and arthritis 5 days
after onset of menses. She has a new sex partner. Exam
discloses about 25 papular lesions on distal extremities and
inflamed tendon sheaths of the wrists and ankles with painful
motion but no fluid in the joints.
Cultures of blood and endocervix are growing
A 32 yo homosexual man presents with a painless lesion on
the penis of one week’s duration. It developed 3 weeks after
unprotected sex with an anonymous partner.
The cause of the infection is identified from a specimen obtained
from the lesion which shows.
A 20 yo asymptomatic woman in the 6th week of pregnancy has
a positive RPR of 1:16. FTA Abs is positive. She is treated with
3 doses of benzathine penicillin.
Follow up testing after treatment should demonstrate
A 33 yo sexually active woman complains of vaginal discharge.
Examination of the greenish frothy discharge discloses pH of
5.5 with numerous WBC’s and organisms with a jerking motion
on saline wet mount.
Treatment is best accomplished with
An 18 yo woman presents with fever and lower abdominal pain.
She has recently had intercourse with a new partner. Pelvic
examination discloses vaginal discharge, pain on motion of the
cervix and bilateral adnexal fullness.
Causes of these symptoms include?
A 35 year old woman complains of scant vaginal discharge and
itching. Exam discloses erythema of the vaginal mucosa with
patches of white discharge. The pH is 4.3.
What is appropriate treatment for this condition?