Dx and Tx's exam 2

Question 1

Rubeola tx

Answer 1

no cure.
post exposure MMR vaccine within 72 hours of exposure to babies or non vaccinated people.

supportive - tylenol. no aspirin! Abx for any bacterial infections like otitis media

measels

Question 2

mumps tx & dx

Answer 2

IgM and IgG titers for diagnosis.

Question 3

Yeast and Dermatophytes -

& which one can’t be diagnosed clinically?

Answer 3

• Order KOH prep, culture
  Esophageal Candidiasis

Question 4

Taeniasis Dx

Answer 4

Best - proglottids and eggs in feces.

Question 5

Nectar americans, Ancyclostoma duodenale

Answer 5

aka hookworms
Rapid stool PCR, stool micro/OPeggs in feces

Question 6

Enterobius vermicularis

Answer 6

pinworms
best- scotch tape in AM
eggs on perianal skin, not in feces

Question 7

Trichinella spiralis

Answer 7

best - ELISA assay positive 2 weeks after infection
-also good - elevated serum muscle enzymes (CK, IDH, AST)
- muscle bx

Trinchinosis

Question 8

Ascaris lumbriocoides

Answer 8

roundworms
- adult worms through nose anus feces mouth
- stool OP eggs in feces

a car = round tires

Question 9

Entamoeba Histolytica

Answer 9

Amebic dysentery
Hepatic Abcess & Intestinal testing

GI- stool antigen test, stool PCR for parasites, stool OP

Hepatic - anti-ameic antibodies serological best
imaging of CT or US

Question 10

Giardia lamblia

Answer 10

Stool OP + for cysts and trophozoites
Stool antigen assay
Stool PCR

Question 11

Cryptosporidosis

Cryptosporidium parvum/hominis

Answer 11

• OP acid fast
• stool antigen assay
• stool PCR test

Question 12

Cyclospora Cayetanensis

Answer 12

stool OP acid fast
colonoscopy

Question 13

Trichomoniasis

Answer 13

wet prep of vagina/urethra. presence of motile, flagellated organisms
best- nucleic acid assay (PCR)

Question 14

Toxoplasmosis

Answer 14

Serum Igm IgG
bx tissue
PCR amniotic fluid
Cx body fluids
NEVER a pregnancy screening

Question 15

Plasmodium falciparum/Malaria

Answer 15

Giemsa Stained Blood smears

Question 16

Cryptococcus neoformans/gatti

Answer 16

Cryptococcosis
serum - cryptococcal antigens
Bronchscope cx sputum
CSF budding, encapsulated yeast, + cryptococcal antigen
can culture urine, blood, sputum

pigeon dung

Question 17

Blastomyces dermatidis

Answer 17

Labs - Leukopenia, anemia
Urine antigen test cross reactive with histoplasma
- bronchoscope bx cx
- CXR - airspace consolidation

Question 18

Coccidioides immitis/posadasii

Answer 18

best - bronchoscopy with biopsy and culture most relable

Question 19

Histoplasma capsulatum

Answer 19

bronchoscope
cx
Labs- pancytopenia
anemia, high LDH ferritin and AST

Question 20

Pneumocystitis jrovecii

Answer 20

Best - bronchoscopy w/ special testing. giemsa, methanamine silver, PCR, monoclonal antibody

Question 21

Rubeola

Answer 21

post exposure vac given to non immunized. no aspirin

the measels virus

Question 22

Rubella

Answer 22

only clinical diagnosis.

3 d german measles

can order IgM if needed to confirm

Question 23

Mumps

Answer 23

Clinically only

can have IgM and IgG titers if needed

Question 24

Parvovirus B19

Answer 24

clinically only

Question 25

Roseola

Answer 25

clinical

also HSV6/7

Question 26

Varicella

Answer 26

PCR swab of lesion and IgM titers

Question 27

coxsackievarius

Answer 27

clinical

Question 28

HSV1 or HSV2

Answer 28

• Culture is more accurate but longer
• Tzank Smear - multinucleated cells
• if suspect encephalitis, PCR CSF for HSV
• only serology for missed HSV cases in the past

Question 29

EBV

Answer 29

monospot or EBV. EBV for all ages. monospot CI in young

Question 30

HPV

Answer 30

clinical

Question 31

Influenza

Answer 31

viral culture , NP swab takes 3-10 d

Question 32

West Nile Virus

Answer 32

serologic, LP with CSF