PANRE PANRE Infectious Disease 2 — Questions and Answers
Question 1: CSF analysis shows neutrophilic pleocytosis, elevated protein, and markedly decreased glucose. What is the most likely diagnosis?
- Viral meningitis
- Bacterial meningitis (Correct answer)
- Fungal meningitis
- Subarachnoid hemorrhage
Correct answer: Bacterial meningitis
Bacterial meningitis is characterized by CSF with neutrophilic pleocytosis, elevated protein, and low glucose due to bacterial metabolism.
Question 2: What is the most common cause of community-acquired bacterial meningitis in adults in the United States?
- Haemophilus influenzae
- Listeria monocytogenes
- Neisseria meningitidis
- Streptococcus pneumoniae (Correct answer)
Correct answer: Streptococcus pneumoniae
Streptococcus pneumoniae is the leading cause of bacterial meningitis in adults and elderly patients in the United States.
Question 3: A child develops fever, malaise, and a bright red 'slapped cheek' rash followed by a lacy reticular rash on the trunk. What is the causative agent?
- Rubella virus
- Parvovirus B19 (Correct answer)
- Varicella-zoster virus
- Epstein-Barr virus
Correct answer: Parvovirus B19
Parvovirus B19 causes erythema infectiosum (fifth disease), characterized by the classic slapped cheek appearance followed by a lacy truncal rash.
Question 4: Oseltamivir for influenza is most effective when started within how many hours of symptom onset?
- 12 hours
- 24 hours
- 48 hours (Correct answer)
- 72 hours
Correct answer: 48 hours
Oseltamivir (Tamiflu) significantly reduces illness duration and severity when initiated within 48 hours of influenza symptom onset.
Question 5: An adult patient presents with erythema migrans (bull's-eye rash) after hiking in Connecticut. What is the most appropriate treatment?
- Doxycycline 100 mg twice daily for 14-21 days (Correct answer)
- Amoxicillin 500 mg three times daily for 7 days
- Azithromycin 500 mg daily for 5 days
- Ceftriaxone 2g IV daily for 14 days
Correct answer: Doxycycline 100 mg twice daily for 14-21 days
Doxycycline for 14-21 days is the preferred oral treatment for early localized Lyme disease in non-pregnant adults.
Question 6: Which antifungal is first-line for treating oropharyngeal candidiasis in an immunocompromised patient?
- Amphotericin B
- Fluconazole (Correct answer)
- Voriconazole
- Caspofungin
Correct answer: Fluconazole
Fluconazole is the preferred agent for oropharyngeal candidiasis due to high efficacy and a favorable side effect profile.
PANRE PANRE Infectious Disease 2
CSF analysis shows neutrophilic pleocytosis, elevated protein, and markedly decreased glucose.
What is the most likely diagnosis?