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Emergency Medicine Examination & Board Review

Susan Promes

Chapter 13

Infectious Disease Emergencies - all with Video Answers

Educators

Chapter Questions

01:02

Problem 1

Which of the following is acceptable antimicrobial therapy for gonorrhea?
(A) Doxycycline $100 \mathrm{mg}$ by mouth twice a day for 14 days.
(B) Benzathine penicillin G 6.2 million units intramuscularly.
(C) Azithromycin $1 \mathrm{~g}$ by mouth.
(D) Ceftriaxone $125 \mathrm{mg}$ intramuscularly.

Narayan Hari
Narayan Hari
Numerade Educator
03:14

Problem 2

A 19-year-old male comes to the ED with a small, indurated, painless ulcer on the glans of his penis. The base of the ulcer is clean and is starting to heal. Firm, rubbery inguinal lymph nodes are present. What is the BEST treatment plan for this patient?
(A) Obtain a culture, then call the patient back if the culture is positive.
(B) Give benzathine penicillin G 2.4 million units intramuscularly.
(C) Tell the patient to follow up with his primary care provider if the lesion does not heal.
(D) Give acyclovir $400 \mathrm{mg}$ by mouth 3 times a day for 7 days.

Jennifer Stoner
Jennifer Stoner
Numerade Educator
01:35

Problem 3

Which of the following is TRUE of the majority of toxic shock syndrome (TSS) cases?
(A) They are unrelated to menses and cross all segments of society.
(B) They have gram-positive rods on blood culture.
(C) They have a diffuse, painful, sunburnlike rash that results in bullae.
(D) They are associated with hyperkalemia and hypercalcemia.

Joanna Quigley
Joanna Quigley
Numerade Educator
00:47

Problem 4

Which of the following is the herpes virus associated with?
(A) Meningitis.
(B) Bell's palsy.
(C) Baker's cyst.
(D) Pustular lesions of the fingers that need drainage.

Grant Castaneda
Grant Castaneda
Numerade Educator
01:58

Problem 5

What is the most common mechanism of acquired immunodeficiency syndrome (AIDS) transmission in adults and adolescents?
(A) Male homosexual contact.
(B) Injection drug use.
(C) Heterosexual contact.
(D) Blood product transfusion.

Alexa Moschella
Alexa Moschella
Numerade Educator
01:17

Problem 6

Which of the following $\mathrm{CD}^{+} \mathrm{T}$-cell counts and viral loads are associated with increased risk of progression to an AIDS-defining illness?
(A) CD4 ${ }^{+}$T-cell count of $100 \mathrm{cells} / \mu \mathrm{L}$ and a viral load of 500 .
(B) $\mathrm{CD}^{+} \mathrm{T}-\mathrm{cell}$ count of $1000 \mathrm{cells} / \mu \mathrm{L}$ and a viral load of 5000 .
(C) $\mathrm{CD} 4^{+} \mathrm{T}-c e l l$ count of $1000 \mathrm{cells} / \mu \mathrm{L}$ and a viral load of 500,000.
(D) CD4 $4^{+}$-cell count of $100 \mathrm{cells} / \mu \mathrm{L}$ and a viral load of 50,000.

Carlene Jimenez
Carlene Jimenez
Numerade Educator
01:23

Problem 7

Which of the following is TRUE of cryptococcal central nervous system (CNS) infections?
(A) They can often be identified on CT scan.
(B) They are associated with elevated intracranial pressure, which should be treated by cerebrospinal fluid lumbar puncture drainage.
(C) They are initially treated with oral fluconazole.
(D) They cause meningeal signs.

Joanna Quigley
Joanna Quigley
Numerade Educator
01:07

Problem 8

Which of the following is the MOST appropriate postexposure prophylaxis (PEP) for needle stick injuries to health care workers?
(A) Begin prophylaxis within 48 hours of exposure.
(B) Use only a 1-drug regimen if the source is known to be low risk.
(C) Treat for 4 weeks.
(D) Use a 4-drug regimen if the source is known to be high risk.

Dennis Howard
Dennis Howard
Numerade Educator

Problem 9

A 26-year-old Hispanic male construction worker presents for evaluation of a 2-dayold puncture wound to his foot and muscle stiffness. His pulse is 112 beats per minute and temperature is $39.5^{\circ} \mathrm{C}$, and he is diaphoretic. His wound does not appear infected. He has stiffness and extension of his lower extremities. He also has pain and stiffness in his masseter muscles. Which of the following should be the initial treatment of this patient?
(A) Tetanus immunoglobulin.
(B) Tetanus-diphtheria toxoid.
(C) Wound debridement.
(D) Penicillin.

Check back soon!
07:04

Problem 10

Which of the following patients should receive rabies postexposure prophylaxis?
(A) A child who was found petting a stray neighborhood dog.
(B) A forestry worker who was bitten on the face by a squirrel.
(C) A spelunker who inadvertently put his hand into bat guano while caving.
(D) A homeowner who was bitten on the hand by a skunk he was chasing out of a shed.

Josh Trinidad
Josh Trinidad
Numerade Educator
02:03

Problem 11

Which species of the genus Plasmodium infecting humans with malaria parasites is becoming increasingly resistant to antimalarial medications?
(A) P. ovale.
(B) P. malariae.
(C) P. vivax.
(D) P. falciparum.

Asma Venkitta
Asma Venkitta
Numerade Educator
01:40

Problem 12

Which of the following parasites is most likely to cause respiratory symptoms?
(A) Trichuris.
(B) Giardia.
(C) Ascaris.
(D) Leishmania donovani.

Qudsiya Anis
Qudsiya Anis
Numerade Educator
02:42

Problem 13

Which of the following is TRUE of infestation with fish tapeworm?
(A) It may cause birth defects by competing with the host folic acid.
(B) It may cause liver granulomas.
(C) It may cause extremity paresthesias.
(D) It may cause a papular pruritic rash.

Christina Sorrentino
Christina Sorrentino
Numerade Educator
01:08

Problem 14

What is the most common cause of bacterial foodborne illnesses in the United States?
(A) Campylobacter.
(B) Salmonella.
(C) Shigella.
(D) Escherichia coli.

Joanna Quigley
Joanna Quigley
Numerade Educator

Problem 15

Normal physiologic defense mechanisms that exist to prevent disease from food and waterborne pathogens may be disrupted by which of the following?
(A) Over-the-counter vitamin use.
(B) $\mathrm{H}_2$ blockers and proton-pump inhibitors.
(C) Foods treated with pesticides.
(D) Extensive exercise.

Check back soon!
01:32

Problem 16

The usual incubation period for Shigella, Campylobacter, and E. Coli 0157:H7 is:
(A) 7-14 days.
(B) $>14$ days.
(C) 2-6 days.
(D) 2-6 hours.

Sylvia Puglisi
Sylvia Puglisi
Numerade Educator
02:17

Problem 17

Tick removal is safely achieved by which of the following?
(A) Apply viscous lidocaine, then use gentle traction on the tick with fine forceps, ensuring that all parts are removed.
(B) Carefully apply a burning match or cautery, which causes the tick to remove its mouth parts.
(C) Crush the tick with fine forceps, then remove the tick with a quick pulling motion.
(D) Apply petroleum jelly to cause suffocation, then remove the tick with fine forceps.

Courtney Burson
Courtney Burson
Numerade Educator
02:35

Problem 18

What is the MOST common vectorborne zoonotic infection in the United States?
(A) Rocky Mountain spotted fever.
(B) Lyme disease.
(C) Colorado tick fever.
(D) Ehrlichiosis.

Ali Crampton
Ali Crampton
Numerade Educator
02:35

Problem 19

What is the MOST common vectorborne zoonotic infection in the United States?
(A) Rocky Mountain spotted fever.
(B) Lyme disease.
(C) Colorado tick fever.
(D) Ehrlichiosis.

Ali Crampton
Ali Crampton
Numerade Educator
01:20

Problem 20

Which of these diseases follows peripheral nerve tracts after inoculation?
(A) Ehrlichiosis.
(B) Babesiosis.
(C) Rabies.
(D) West Nile virus.

Kamila Zakarian
Kamila Zakarian
Numerade Educator
02:08

Problem 21

Which of the following is TRUE of a Hantavirus infection?
(A) It is caused by inhalation of dried, particulate feces, contact with urine, or by rodent bite.
(B) It should be treated with fluoroquinolones or doxycycline.
(C) It causes development of a bubo followed by pneumonia and sepsis from hematologic spread.
(D) It may cause extrapulmonary manifestations involving the heart, central nervous system, and liver.

Ali Crampton
Ali Crampton
Numerade Educator
01:54

Problem 22

What are the two MOST common household pet sources for zoonotic infections?
(A) Small rodents and pet birds.
(B) Reptiles and aquarium fish.
(C) Dogs and cats.
(D) Ferrets and hedgehogs.

Brett Donadeo
Brett Donadeo
Numerade Educator
02:35

Problem 23

Which of the following infections can ticks and fleas inhabiting dogs and cats transmit?
(A) Campylobacter and Bordetella.
(B) Cryptococcus and Giardia.
(C) Bartonella and Salmonella.
(D) Tularemia, plague, and Rocky Mountain spotted fever.

Ali Crampton
Ali Crampton
Numerade Educator

Problem 24

What is the MOST important factor in preventing clostridial wound infections?
(A) Wound care at the time of initial evaluation and treatment.
(B) Hyperbaric oxygen therapy.
(C) Use of vasoconstrictors.
(D) Antibiotic therapy.

Check back soon!
00:25

Problem 25

Which of the following is the MOST appropriate antibiotic therapy for gas gangrene?
(A) Potassium penicillin.
(B) Sodium penicillin.
(C) Sulfonamides.
(D) Fluoroquinolones.

Maryam Riaz
Maryam Riaz
Numerade Educator
01:53

Problem 26

Which of the following is TRUE of necrotizing fasciitis?
(A) It is characterized by widespread necrosis involving the subcutaneous tissue and fascia.
(B) It often involves underlying muscle.
(C) Treatment of choice is medical management.
(D) It is usually caused by a single organism.

Joanna Quigley
Joanna Quigley
Numerade Educator

Problem 27

Which of the following is TRUE of erysipelas?
(A) It presents in pediatric patients as a red or "slapped cheek" appearance.
(B) Toe-web intertrigo has the highest attributable risk for development of this disease.
(C) It most often presents as a rash distal to skin entry.
(D) It is diagnosed primarily by blood cultures.

Check back soon!
01:48

Problem 28

Which of the following is TRUE concerning most cases of superficial and localized abscesses?
(A) Infiltration of a local anesthetic is the best way to relieve pain prior to incision and drainage.
(B) Fluctuance is always easy to identify in abscesses.
(C) Antibiotic treatment following incision and drainage speeds healing in otherwise healthy patients.
(D) The American Heart Association recommends prophylactic antibiotics for those patients in high-risk categories prior to incision and drainage.

Joanna Quigley
Joanna Quigley
Numerade Educator
01:12

Problem 29

Which of the following is a nationally reportable communicable disease?
(A) Trichomonal infections.
(B) Giardiasis.
(C) Herpes simplex type 2.
(D) Infectious mononucleosis.

Jorge Villanueva
Jorge Villanueva
Numerade Educator
01:48

Problem 30

Which of the following statements about rubeola is TRUE?
(A) It is the most common vaccine-preventable cause of death among children.
(B) It causes miscarriages, stillbirths, and fetal anomalies.
(C) It is primarily transmitted by bodily fluids.
(D) It is best prevented by postexposure administration of immunoglobulin.

Joanna Quigley
Joanna Quigley
Numerade Educator
00:53

Problem 31

Which of the following is TRUE of patients with possible exposure to severe acute respiratory syndrome (SARS) ?
(A) They should be admitted for infection control.
(B) They should have a surgical mask applied and be kept away from other patients.
(C) They should be given immunoglobulin.
(D) They should be started on acyclovir, penciclovir, or ganciclovir.

Paras Aggarwal
Paras Aggarwal
Numerade Educator