Case Conferences

Question 1

What is the most common infectious cause of pyelonephritis?

Answer 1

E. coli

Question 2

What is Faget’s sign?

Answer 2

-Unusual pairing of fever with bradycardia

*normally we expect heart rate to increase by 8-10 per 1 degree celcius increase in fever

Question 3

Everybody with TB also gets a test for ______/

Answer 3

HIV

Question 4

What is the special way TB is cultured?

Answer 4

• treated with Sodium Hydroxide (to kill all other bacteria)
• Culture on liquid media in Bactec bottle

Question 5

How does treatment for TB differ between HIV negative and positive patients?

Answer 5

HIV negative = 2 DOT/week

HIV positive = 3 DOT/week

Question 6

What do you give with TB treatment, due to Isoniazid (INH) toxicity?

Answer 6

Pyrodoxine (for neuropathy)

Question 7

Where in the lung, usually, is infiltrate seen on CXR for 1’ vs 2’ TB?

Answer 7

1’ = base of lung

2’ = apex of lung (reactivation of simon complex)

Question 8

What is the expected CD4 count in an AIDS patient with disseminated MAC?

Answer 8

<50

Question 9

“High alkaline phosphatase”

Answer 9

Mycobacterium Avium Complex (MAC)

Question 10

What causes anemia in an AIDS patient with disseminated MAC?

Answer 10

Overwhelming infection is in bone marrow

Question 11

What is immunity to mycobacteria and nocardia dependent on?

Answer 11

T cells