2

Question 1

Dysphasia in hiv: the different endoscopic features of the 3 common causes, their Rx

Answer 1

Candidal: white plaques, usu have associated oral trash. Fluconazole
HAV: small, round/ ovoid ulcers, intranuclear inclusions. Acyclovir
CMV: large, linear ulcer, intranuclear n intracytoplasmic inclusions. Ganciclovir

Question 2

MAC nCMV diarrhea in AIDS, they occur with CD4 count of?

Difference in clinical presentation?

Answer 2

<50 CD4
CMV- hematochezia, low grade fever
MAC- watery, high grade fever(>39), abd pain

Question 3

A cystic hepatic lesion with eggshell calcification is suggestive of ?

Answer 3

Echinococcus granulosus/hydatid

Question 4

Empiric therapy in a native valve endocarditis?

Answer 4

Vancomycin

Question 5

IE after dental procedure: usual causitive agents? Mention examples from the group, at least 3

Answer 5

Streptococcus viridans

S mitis, s sanguinis, s mutans

Question 6

Strept gallolyticus is associated with

Answer 6

AKA strept bovis

ā with colon ca n IBD

Question 7

Eikenella corrodens is associated with IE after———?

Answer 7

It’s a gram negative anaerob, normal oral flora. Poor dentition or periodontal infection along with dental procedures…

Question 8

Difference in the causative organisms of epididymitis based on age

Answer 8

<35- sexually transmitted infections chlamydia trachomatis, N gonorrhoeae
>35- ascending organisms from bladder outlet obstruction eg. E. Coli

Question 9

Febrile neutropenia definition

Empiric therapy?

Answer 9

Fever with no obvious focus of infection but neutropenia (<1500g)
Rx- anti paeudomonal betalactam agents will do. Eg cefepime, meropenum, piperacillin-tazobactam

Question 10

Hep C in pregnancy

• maternal mx?
• regarding prevention of vertical transmission, what is the recommendation about c/s n breastfeeding?

Answer 10

Hep A and B vaccines should b given, ribavirin should b avoided
CS is not protective, breastfeeding should b encouraged unless there’s maternal blood eg nipple injury

Question 11

Herpangina Vs herpetic gingivostomatitis

Etiology, seasonality, c/f, Rx

Answer 11

Herpangina- cocxsakie A virus, 3-10yrs, summer/early fall, grey vesicles/ulcers on posterior oropharynx, supportive mx
Herpetic- HSV-1, 6mo-5yr, no seasonality, clusters of small vesicles on anterior oropharynx, acyclovir

Question 12

How do u prevent HSV vertical transmission in a pregnant woman with hx of genital HSV infection and a woman in labor wit active genital HSV lesions?

Answer 12

Px- should receive prophylactic acyclovir or valacyclovir beginning at 36wks of px to reduce outbreaks around the time of delivery
Active lesions around the time of labor- C/S

Question 13

In pts with HIV, HAV vaccine is indicated if? 3 reasons

Answer 13

Men who have sex with men
IV drug users,
CLD pts

Question 14

Prophylaxis recommendation for pertussis contacts

Answer 14

For all contacts despite vaccination status

Question 15

A 6 yr old girl presented with vulvovaginal and perinatal itching scotch tape test revealed eggs of parasite
What’s the dx?
Rx
Who should b treated

Answer 15

Enterobius vermicularis (pinworm)
Albendazole including all household contacts

Question 16

When do u use corticosteroids in pcp?

Answer 16

If PaO2 <70 and A-ā gradient <35