Infectious Disease Management Flashcards
7 cards from real Internal Medicine Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Infectious Disease Management flashcards as text
A 45-year-old HIV-positive patient with CD4 count of 80 cells/μL presents with headache and fever. CSF India ink stain is positive. What is the initial treatment of choice?
Answer: Amphotericin B deoxycholate plus flucytosine
Cryptococcal meningitis induction therapy is liposomal amphotericin B (or deoxycholate) plus flucytosine for 2 weeks, followed by fluconazole consolidation.
Which antibiotic class is the treatment of choice for community-acquired pneumonia caused by atypical organisms such as Mycoplasma pneumoniae in an otherwise healthy outpatient adult?
Answer: Macrolides
Macrolides (e.g., azithromycin) are first-line for atypical CAP in healthy outpatients because they cover Mycoplasma, Chlamydophila, and Legionella.
A 30-year-old woman returning from sub-Saharan Africa presents with cyclic fevers every 48 hours, anemia, and splenomegaly. Blood smear shows ring forms with banana-shaped gametocytes. What is the appropriate treatment?
Answer: Artemether-lumefantrine
Banana-shaped gametocytes indicate Plasmodium falciparum; artemisinin-based combination therapy (e.g., artemether-lumefantrine) is first-line for uncomplicated falciparum malaria.
A patient with penicillin allergy (anaphylaxis) requires treatment for neurosyphilis. What is the recommended management?
Answer: Penicillin desensitization followed by IV penicillin G
Penicillin G remains the only proven therapy for neurosyphilis; patients with penicillin allergy should undergo desensitization and then receive IV penicillin G.
A 65-year-old diabetic man develops a rapidly spreading, painful necrotizing infection of the perineum with crepitus on exam. What is the MOST critical initial intervention after resuscitation?
Answer: Emergency surgical debridement
Fournier's gangrene (necrotizing fasciitis) requires urgent surgical debridement as the cornerstone of treatment; antibiotics are adjunctive but cannot replace surgery.
Which mechanism best explains vancomycin resistance in Enterococcus faecium (VanA phenotype)?
Answer: Substitution of D-Ala-D-Lac for D-Ala-D-Ala in peptidoglycan precursors
VanA resistance results from replacing the terminal D-Ala-D-Ala with D-Ala-D-Lac, dramatically reducing vancomycin binding affinity.
A 28-year-old man presents with urethral discharge. Gram stain shows intracellular gram-negative diplococci. Which treatment regimen addresses both gonorrhea and likely co-infection?
Answer: Ceftriaxone 500 mg IM plus doxycycline 100 mg BID × 7 days
CDC guidelines recommend ceftriaxone for gonorrhea plus doxycycline (or azithromycin) to treat concurrent Chlamydia trachomatis co-infection.