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Uworld Step 2 > Block 46, 47,48 ID > Flashcards

Block 46, 47,48 ID Flashcards

1
Q

when does ventilator-associated pneumonia occur

A

48 hours or more after intubation

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2
Q

First step in management for ventilator-associated pneumonia

A

Chest x-ray

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3
Q

clinical features of Ehrlichiosis

A
  • acute febrile illness with malaise and altered mental status
  • not associated with rash
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4
Q

lab values for Ehrlichiosis

A

leukopenia
thrombocytopenia
elevated aminotransferases

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5
Q

treatment for Ehrlichiosis

A

Doxycycline

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6
Q

Second line treatment for Ehrlichiosis

A

Chloramphenicol

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7
Q

Enterococci species are common causes of infective endocarditis associated with

A

procedural manipulation of the urinary tract infection

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8
Q

Indications for corticosteroid use in Pneumocystis pneumonia include

A

PaO2 less than 70 mmHg
OR
A-a gradient greater than 35 on room air

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9
Q

where can one get blastomycosis

A

Great Lakes
Mississippi
Ohio River basin

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10
Q

lumbar puncture for herpes encephalitis

A
  • elevated wbc
  • lymphocytic predominance
  • normal glucose
  • elevated protein
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11
Q

what is Chlordiazepoxide used to treat

A

alcohol withdrawal in hospitalized patients

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12
Q

choice of antibiotics for immunocompromised patients with suspected bacterial meningitis

A

Cefepime, vancomycin, ampicillin

- corticosteroids: discontinue if an organism other than strep. pneumonia shows

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13
Q

When you have infective endocarditis, what is the best next step in management

A
  • Blood cultures before initiating antibiotics
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14
Q

Who and what is mycobacterium avium complex

A

infection found in HIV patients with CD less than 50

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15
Q

what is a PE and lab value finding for mycobacterium avium complex

A

splenomegaly

alkaline phosphatase

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16
Q

what prophylaxis treatment should mycobacterium avium complex patients get

A

azithromycin

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17
Q

what does BCG vaccine stand for

A

Bacille Calmette-Guerin

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18
Q

common antibiotic options for anaerobic coverage include

A
  1. metronidazole with amoxicillin
  2. amoxicillin-clavulanate
  3. clindamycin
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19
Q

Jarisch-Herxheimer reaction

A
  • acute, febrile reaction–> rapid destruction of spirochetes
  • less than 12 hours after initial treatment of syphilis
  • headache, myalgias, rigors, sweating, hypotension, worsening of syphilitic rash
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20
Q

what is immune reconstruction inflammatory syndrome

A

HIV pts initiated on highly active antiretroviral txt,

- paradoxical worsening of infectious symptoms due to immune system improvement

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21
Q

Cryptosporidium parvum is a major cause of what

A

chronic diarrhea in pts with HIV

CD count less than 180

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22
Q

difference between acute HIV and EBV

A

HIV: rash and diarrhea
EBV: tonsillar exudates

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23
Q

what does RPR stand for

A

rapid plasma reagent

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24
Q

highest sensitivity testing for syphillis

A

florescent treponemal antibody absorption

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25
Q

pathergy test is useful for diagnosing what

A

Bechet syndrome: oral ulcers and multiple, painful genital ulcers

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26
Q

many hospitalized patients with pyelonephritis can be transitioned to what after 48 hours of symptom improvement

A

culture-guided oral antibiotics

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27
Q

where is sporothrix schenckii

A

decaying vegetation and soil

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28
Q

treatment for sporothrix schenckii

A

itraconazole

29
Q

infective endocarditis most likely impacts what heart valve

A

mitral regurgitation

30
Q

antinuclear antibody can detect what

A

lupus

31
Q

what secondary bacterial penumonia do younger people get after influenza? Describe what you see on X-ray?

A

Community-associated methicillin-resistant Staph. aureus

- multilobar cavitary infiltrates

32
Q

what does peptostreptococcus cause

A

putrid sputum and abscess/empyema pulmonary infection

33
Q

hilar adenopathy is more suggestive of blastomyces or histoplasmosis

A

histoplasmosis

34
Q

characteristic of brown recluse spider bites

A

red plaque or papule with central clearing

35
Q

how do you get cutaneous larva migrans

A

hookworm larvae

- barefoot on contaminated sand or soil

36
Q

treatment for cutaneous larva migrans

A

Ivermectin

37
Q

how big does a TB skin test must get to be considered positive

A

15mm greater

38
Q

treatment guides for Penumocystis pneumonia

A

Trimethoprim-sulfamethoxazole
- add corticosteroids when pulse ox is less than 92%
PaO2 less 70 and aa greater than 35

39
Q

most common cause of community-acquired Infective endocarditis

A

streptococcal infection

40
Q

most common cause of healthcare-associated infective endocarditis

A

Staphylococcal infection

41
Q

difference between Strept. bovis and Strept. sanguinis

A

bovis: UC of colon
Sanguinis: viridans group of strep found orally

42
Q

how does Giardia physically impact the small intestines

A

blunts microvilli

43
Q

clinical feature of viral gastroenteritis

A

Both vomiting and diarrhea

44
Q

what lab value is increased for penumocystis jirovecii

A

lactate dehydrogenase is elevated

45
Q

anti-cyclic citrullinated peptide antibodies are associated with what

A

rheumatoid factor

46
Q

Anti-double-stranded DNA antibodies associated with

A

SLE

47
Q

mixed cryoglobuliemia associated with

A

chronic hepatitis C

48
Q

risk factors for C. diff

A
  • hospitalization
  • advanced age
  • antibiotic use
49
Q

paitents with plantar puncture wounds through footware are at risk for

A

pseudomonas aeruginosa osteomyelitis

50
Q

condyloma acuminata is associated with what

A

papillomavirus

51
Q

Ludwig angina

A

mandibular molar infections leading to cellulitis of the submandibular space

52
Q

if you see a tick what should you do

A
  • remove tick with tweezers

- no prophylaxis needed for lyme disease of tick is attached for less than 36 hours

53
Q

name 3 bacteria that cause bloody diarrhea

A
  • E. coli
  • Shigella
  • Campylobacter
54
Q

who is recommended to hep A vaccine

A
  • gay men
  • countries where hep A is endemic
  • chronic liver disease
55
Q

when do you not give rabies postexposure prophylaxis

A

Domesticated animals, and animal must be observed for 10 days

56
Q

patients who receive a solid organ transplant are at risk or what opportunistic infections

A
  1. pneumocystis pneumonia

2. CMV (multiple organ involvement)

57
Q

unvaccinated individuals should receive what for hep B infection

A

Both HB vaccine and HB immune globulin

58
Q

Treatment for CMV esophagitis

A

ganciclovir

59
Q

Herpes simplex esophagitis treatment

A

acyclovir

60
Q

difference between herpes simplex esophagitis and CMV esophagitis

A

herpes: small, well-circumscribed round/ovoid ulcer and intracellular inclusions
CMV: large linear ulcers and intranuclear and intracytoplasmic inclusions

61
Q

second line treatment for pneumocystis pneumonia

A

Pentamide

62
Q

treatment for cryptococcal meningoencephalitis

A

amphotericin B plus flucytosine followed by fluconazole

63
Q

Do you usually get fever with echinococcus granulosis

A

no

64
Q

when should one be screened for Hep C

A

blood transfusions before 1992

65
Q

Sulfadiazine and pyrimethamine treat what

A

toxoplasmosis

66
Q

Clarithromycina and Ethambutol is used to treat

A

MAC

Mycobacterium avium complex

67
Q

Bright red, firm, friable, exophytic nodules in an HIV infected patient most likely ave

A

bacillary angiomatosis

68
Q

Penumocystis may cause nodular and papular cutaneous lesions where in HIV patients

A

external auditory meatus

Uworld Step 2 (30 decks)

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