Differentials

Question 1

Causes of Loefflers syndrome

Answer 1

Hookworms, strongyloides, schistosomiasis (acute) (in chronic causes portal pulm HTN and AV fistuals), ascaris

Question 2

Causes of eosinophilic pneumonia

Answer 2

Loefflers (ascaris, hookworm, strongy, schisto),paragonimus, tropical pulmonary eosinophilia (immune hyperresponse - filariasis - wuchereria, brugia, etc)

Question 3

Infectious but non eosinophilic causes of pneumonia/lung involvement

Answer 3

1. Lepto (tropical, poor sanitation)
2. Melioidosis - SE asia, w africa, N australia 3. Salmonella typhi
3. Brucellosis (pulm in 5-10%)
4. Tularemia & pneumonic plague - consider 6. when severe rapidly progressive bronchopna when more common causes are ruled out
5. Coxiella - slaughter house, meat handling
6. Coxsackie - Bornholm disease
7. Kawasaki (kids)
8. Cryptococcus neoformans/gatti
9. TB

Question 4

Pathogens causing elevated LFT (acute hepatitis)

Answer 4

spirochetes - lepto, borrelia (relapsing fever)
gram neg - melioidosis, typhoid, tularemia
tb (rarely miliary, more so granulomatous hep - tb/brucella/q fever)

Question 5

Eosinophilia + Symptomatic hepatitis/hepatomegaly

Answer 5

schisto, trichinella, capillariasis, fascioliasis

Question 6

Elevated unconjugated hyperbilirubinemia (acute hemolysis) caused by?

Answer 6

malaria, babesia, oroya fever (bartonella bacillaformis), HUS (e.coli/shigella), sepsis (c perfringens)

Question 7

Obstructive jaundice

Answer 7

ascaris, clonorchis, fasciola (liver flukes), cryptosporidium hominis/parvum

Question 8

Infectious Causes of Cystic Liver Lesions

Answer 8

Abscess (focal liver abscess in melioidiosis is complication), pyogenic (Klebsiella pneumoniae, streptococcus milleri, ameobic, hydatid

Question 9

causes of solid liver lesions

Answer 9

TB, syphilitic gummas, HCC, adenoma, Flukes (fasciolar/clonorchis/opstorchis)

Question 10

Biliary Obstruction causes?

Answer 10

Flukes, microsporidium, cryptosporidium

Question 11

HIV and Liver: CD4<100

Answer 11

MAC, crypto, CMV, KS, NHL

Question 12

HIV and Liver: CD4>200

Answer 12

Tb, NHL, KS

Question 13

HIV and Liver: CD4 >500

Answer 13

Viral hepatitis, HCC, drug induced liver injury, lipodystrophy, NAFLD, IRIS

Question 14

Rapid onset n/v/d after food

Answer 14

s aureus, c perfrigens, b cereus

Question 15

Large volume watery diarrhea

Answer 15

= small bowel pathology
-rotavirus
-cholera
-entertoxigenic e coli
Small and large bowel - cryptosporidium

Question 16

Dysentery ddx

Answer 16

Colonic involvement

• campylobacter (colicky pain)
• enterohemorrhagic e coli
• salmonella
• shigella
• yersinia (colicky pain)
• e histolytica
• balantidium coli

Question 17

Chronic diarrhea = persistent infection

Answer 17

giardia
e histolytica
coccidians - cystoisospora, cyclospora, crypto
microsporidium
strongyloides
capillaria

Question 18

DDx of chronic diarrhea in an HIV patient (and top 4 MC)

Answer 18

Top 4 = m avium, crypto, CMV, microsporidium

1. Bacteria - tb, m avium, salmonella (chronic), campy, enteroadherent e coli (common in kids), aeromonas, shigella
2. Parasites - crypto (in low CD4 can present like cholera), strongy, cyclospora, cystoisospora (new name clostridioides)
3. Virus - CMV
4. Yeast - histo, paracocci, microsporidum

Question 19

Causes of migratory paniculitis

Answer 19

gnathostomiasis, toxocariasis, baylisascardiasis

Question 20

Cutaneous larva migrans

Answer 20

gnathostoma, ancyclostoma braziliense (MCC), strongyloides

Question 21

watery diarrhea + eosinophilia

Answer 21

capillaria philippinensis (SE Asia)

Question 22

Causes of eosinophilic meningitis

Answer 22

angiostrongylus, baylisascaris, toxocariasis, cysticerosis, schistosomiasis, paragonimus
more rare - schistosoma, hydatid, trichinella, strongy, filariasis, myiasis

Question 23

Trichinella epidemiology & transmission

Answer 23

cosmopolitan

undercooked meat