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Uworld Step 2 > block 44, 45: ID > Flashcards

block 44, 45: ID Flashcards

1
Q

Who gets HIV screening?

A

15-65 regardless of risk factors

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2
Q

Preferred HIV screening test

A

4th generation assay

  • confirmatory test: HIV-1/HIV-2 antibody differentiatio immunoassay
  • HIV RNA if first test is negative
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3
Q

Why do we not routine screen for syphilis

A

false positives

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4
Q

do guidelines recommend screening asymptomatic patients for HSV

A

no

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5
Q

what are 3 things to look for in an HIV patient with CMV? What is the CD4 count below

A

CD less than 50

  • retinitis
  • esophagitis
  • colitis
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6
Q

Diagnostic test for CMV colitis in HIV patient

A

colonoscopy with biopsy

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7
Q

clinical feature of HIV patient with cryptosporidium

A

chronic, profuse watery diarrhea

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8
Q

Malaria chemoprophylaxis in areas of high rate of chloroquine resistance

A

atovaquone-proguanil
Doxycycline
Mefloquine

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9
Q

Postexposure HIV prophylaxis treatment

A

3-drug antiretroviral therapy for 4 weeks

- prefer to start treatment in first few hours

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10
Q

Atypical community-acquired pneumonias with GI and central nervous system problems? what bug do I have

A

Legionnaries

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11
Q

how can staph. aureus cause lung problems

A
  • IV drug user
  • tricuspid endocarditis
  • fragments of vegetation can embolize to lungs (cavitary lesions)
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12
Q

where is Chloroquine sensitive

A 
Argentina 
Mexico
Turkey 
Iraq 
Central America 
Caribbean
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13
Q

What is Streptococcus gallolyticus ( S bovis biotype I) is associated with what

A

colonic neoplasms

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14
Q

In humans hepatic hydatid cysts are due to infection with?

A

Echinococcus granulosus

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15
Q

CT of c hepatic hydatid cyst shows

A

eggshell calcification

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16
Q

cutaneous blastomycosis manifests as ?

A

well- circumscribed verrucous nodules and plaques that progress to microabscesses

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17
Q

Patient with diabetes mellitus on INH (isoniazid) is at what risk

A

pyridoxine deficiency: get peripheral neuropathy

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18
Q

Eikenella Corrodens? type of bacteria and where it is found

A

gram-negative anaerobe

normal human oral flora

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19
Q

Enterococi are a common cause of endocarditis associated with

A

nosocomial urinary tract infection

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20
Q

when is 13-valent pneumococcal conjugate vaccine recommended

A

all adults 65 and older followed later by 23-valent pneumococcal polysaccharide vaccine

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21
Q

when is 23-valent pneumococcal polysaccharide vaccine recommended

A
  • less than 65

- smoker, chronic medical condition, heart/lung disease, diabetes, chronic liver disease

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22
Q

what vaccine is given every 10 years

A

Td vaccine

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23
Q

when is Tdap given

A

one-time dose in place of Td for adults

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24
Q

when do you usually test for HSV

A

with patient has active symptoms

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25
Q

Difference between janeway lesions and osler nodes

A

Janeway: vascular, nontender
Osler: Immunologic, painful

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26
Q

Laboratory studies for infective endocarditis

A

normocytic anemia

increase ESR

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27
Q

adult still disease

A
  • high fevers
  • arthritis/arthralgias
  • salmon-colored macular rash
28
Q

when is PPD test considered positive in an HIV-infected patient

A

induration is greater than or equal to 5mm

29
Q

how are HIV patients with no manifestations of active TB treated for latent TB?

A

Isoniazid and pyridoxine

30
Q

how is Babesiosis diagnosed

A

peripheral blood smear

“Maltese cross”

31
Q

treatment for influenza

A

most adults without risk factors ( age greater than 65, chronic medical condition) treat symptoms

32
Q

What is the most common secondary complication of influenza and should be suspected in any patient who develops worsening fever or pulmonary symptoms after initial improvment

A

secondary bacterial pneumonia

  • Streptococcus pneumoniae
  • staphylococcus aureus
33
Q

Clinical features of Staph aureus pneumonia? X-ray?

A

rapid-onset, severe, necrotizing pneumonia with high risk of death
- lobar

34
Q

what is the heterophile antibody test for CMV?

A

negative

- CMV IgM serology is positive

35
Q

What antibiotic covers virulent oral bacteria ( aerobic and anaerobic oral organisms)

A

Amoxicillin-Clavulanate

36
Q

what does ampicillin cover

A

gram-positive and gram-negative

37
Q

What does clindamycin cover

A

gram-positive bacteria and anaerobes

38
Q

What does Ciprofloxacin cover

A

gram-negative

some gram-positive organisms

39
Q

PE for vertebral osteomyelitis

A

tenderness to gentle percussion overs spinous process

40
Q

what lab values are elevated in vertebral osteomyelitis

A

platelets

ESR

41
Q

Miliary tuberculosis Chest-Xray shows

A

diffuse reticulonodular pattern (millet seed)

42
Q

Most common behavioral risk factor for TB in the US

A

substance abuse

- other: incarceration

43
Q

causes of toxic shock syndrome

A
  • Menstruation
  • nasal packing
  • post surgery infection
44
Q

lab values for toxic shock syndrome

A

immature neutrophils

thrombocytopenia

45
Q

when is 13-valent pneumococcal conjugate vaccine recommended

A
  • all over 65 followerd by 23-valent pneumococcal polysaccharide vaccine at least 6-12 months later
46
Q

when is PPSV23 recommended

A

younger 65 with chronic medical condition and smoker

- one time

47
Q

when is tetanus immune globulin given

A

patients with significant or dirty wounds who have not previously received at least 3 doses of tetanus vaccine or vaccine is uncertain

48
Q

Patients with significant puncture wounds who have not received revaccination for tetanus within how many years should be vaccinated?

A

5 years

49
Q

lab values for malaria

A

anemia and thrombocytopenia

50
Q

when can you give live attenuated varicella and MMR vaccines to HIV patients

A

CD count greater than 200

titers must be low

51
Q

Lab values for disseminated histoplasmosis? X-ray?

A

pancytopenia
elevated LFTs
-reticulonodular infiltrates

52
Q

Treatment for disseminated histoplasmosis in HIV

A

Amphotericin B

- 1-2 weeks of clinical improvement transition to oral itraconazole for 1 year maintenance

53
Q

cause of epididmyitis for age 35 and older

A

E. Coli

54
Q

cause of epdidmytis for age less than 35

A

Chlamydia or Neisseria

55
Q

when do you get imaging for pyelonephritis

A

no clinical symptoms improvement for 48-72 horus

56
Q

Proteus mirabilis increases the solubility of element in the urine

A

phosphate

- struvite stones ( magnesium ammonia phosphate)

57
Q

treatment for infective endocarditis for viridans group streptococci

A

IV aqueous Penicillin G OR
IV ceftriaxone
for 4 weeks

58
Q

what does ultrasound for Echinococcus granulosus look like

A

hepatic cyst with daughter cysts ( internal separations)

59
Q

warm, tender, erythematous rash with raised, well-demarcated borders

A

Erysipelas

60
Q

What causes erysipelas

A

Group A streptococcus

61
Q

What area of the body suggests erysipelas as this skin lacks lower dermic level

A

external ear

62
Q

Difference between Td and Tdap

A

Td: booster
Tdap: one-time dose in place of Td

63
Q

For adults age less than 65, with other chronic medical conditions that increase the risk of invasive pneumococcal disease should get what vaccine

A

PPSV23 alone, followed by sequential PCV13 and PPSV23 at age 65

64
Q

most common cause of community-acquired bacterial meningitis

A

Streptococcus pneumonia

65
Q

An effective measure for reducing the risk of catheter-associated urinary tract infection in patients with neurogenic bladder

A

clean intermittent catheterization

Uworld Step 2 (30 decks)

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