NEJM

Question 1

measles clinical syndrome

Answer 1

1. fever
2. rash - cephalocaudal and centrifugal distribution
3. exposure history
4. prodrome of 3C’s (cough, coryza, conjunctivitis)

Question 2

cough, coryza, conjunctivitis

Answer 2

measles prodrome

Question 3

cephalocaudal and centrifugal rash

Answer 3

measles

Question 4

measles transmission

Answer 4

aerosolized droplet (extremely contagious! infectious 4d before and 4d after onset of rash)

Question 5

measles treatment

Answer 5

supportive + Vitamin A supplementation

Question 6

UA - nitrites

Answer 6

E coli, Klebs, and Proteus produce nitrite from nitrate.

Pseudomonas, enterococcus, and S. sapro do NOT.

FYI: 4h bladder incubation required for the conversion, so can be negative.

Question 7

UA - def of pyuria

Answer 7

> 5-10 WBCs

Question 8

UA - def of hematuria

Answer 8

> 3/hpf

Question 9

Outpatient UTI treatment

Answer 9

1. nitrofurantoin 100mg BID for 5-7d (avoid if pyelo or CrCl