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Clin Med 2 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Which of the following can cause abscesses and ulcers?
- Histoplasmosis
- Blastomycosis
- Coccidioidomycosis
- Sporotrichosis

A
  • Sporotrichosis
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2
Q

Which infection is contracted from soil with moist rotting wood in the Eastern US?

A
  • Blastomycosis
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3
Q

Treatment for babesiosis

A
  • Azithromycin plus atovaquone
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4
Q

Symptoms of leishmaniasis

A
  • Self-resolving skin ulcers to lethal systemic illness
    (severe infection more likely in immunodeficient patients)
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5
Q

Which of the following is not caused by inhalation of pathogens?
- Histoplasmosis
- Blastomycosis
- Coccidioidomycosis
- Sporotrichosis

A
  • Sporotrichosis: needs skin trauma
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6
Q

Physical exam findings in allergic rhinitis/conjunctivitis

A
  • Tired looking
  • Mouth breathing
  • Red eyes with watery discharge
  • “Allergic shiners”
  • Serous effusion of ears
  • Nasal crease (“allergic salute”)
  • Nasal mucosa swollen, pale, bluish, polyps
  • Clear nasal discharge
  • Cobble-stoning of posterior oropharynx
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7
Q

Pinworm infections are most commonly seen in this type of patient

A
  • Children (age 5-10)
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8
Q

What is a likely cause of angioedema in a patient without urticaria?

A
  • Bradykinin-mediated (ACE inhibitor, C1 inhibitor deficiency)
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9
Q

Symptoms of epidemic (louse-borne) typhus

A
  • More severe than endemic typhus
  • Abrupt onset of intense persistent headache, chills, prostration, and high fever, rash
  • Hypotension, renal failure, and DIC if severe
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10
Q

What condition is diagnosed with the ice cube test?

A
  • Cold-induced urticaria
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11
Q
A
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12
Q

When should you treat acute sinusitis with antibiotics?

A
  • Symptoms fail to improve within 10 days on onset
    OR
  • Symptoms worsen within 10 days after an initial improvement (double worsening)
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13
Q

Which medication should be avoided in campylobacter, salmonella, shigella, and yersinia enterocolitica?

A
  • Avoid loperamide
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14
Q

What is the treatment for a patient who returned from Africa one month ago and has now developed fevers that repeat every 2-3 days, body aches, and has hepatosplenomegaly?

A
  • Artemisinin combination therapy (artemether-lumefantrine) to treat malaria
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15
Q

What infection is most commonly seen December-April in the US and is diagnosed using ELISA and latex agglutination testing?

A
  • Rotavirus

(Norovirus also a winter condition, but tested with PCR)

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16
Q

Which fungus causes pneumonia in patients with lymphopenia?

A
  • Pneumocystis jirovecii
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17
Q

Symptoms of yersinia pestis

A
  • Abrupt onset of fever, headache, GI symptoms
  • Followed by buboes in groin/axilla
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18
Q

Who is most likely to catch Q fever?

A
  • Sheep or goat farmers, or those who live nearby
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19
Q

How long is acute and chronic urticaria?

A
  • Acute: <6weeks
  • Chronic: >6 weeks
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20
Q

Murine (endemic) typhus is carried by fleas that live on …

A
  • Rats (and mice and opposums)
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21
Q

How would someone most likely contract giardiasis?

A
  • Ingestion of contaminated water
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22
Q

Anaphylaxis causes increased vascular permeability which can lead to …

A
  • Hypotension and shock
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23
Q

Which infection is caused by entamoeba histolytica?

A
  • Amebiasis (amebic dysentery)
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24
Q

Treatment for aspergillus fumigatus

A
  • Voriconazole
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25
Q

Name four helminthic infections and their treatment

A
  • Trichinellosis
  • Hookworms
  • Roundworms
  • Pinworms
  • Treat all with mebendazole
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26
Q

Name four conditions that are caused by the inhalation of soil

A
  • Histoplasmosis: soil/dust with bat/bird droppings
  • Blastomycosis: soil with rotting wood (eastern US)
  • Coccidioidomycosis: soil in SW USA and northern Mexico
  • Cryptococcus neoformans: pigeon feces in soil (immunocompromised only)

(hookworms, roundworms, pinworms found in soil but from walking barefoot, not inhaling)

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27
Q

When are West Nile (encephalitis) cases most common?

A
  • Late summer and early fall
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28
Q

Which infection has the unique symptom of retro-orbital headache?

A
  • Dengue
  • Also high fever, body aches, lymphadenopathy
  • After afebrile period, rash and another fever occur
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29
Q

What is the most common cause of chronic urticaria?

A
  • Idiopathic: 80-90% of cases have unknown cause
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30
Q

Treatment for angioedema

A
  • Similar to urticaria for IgE
  • High dose H1 antihistamines first line
  • Oral/IM/IV steroids if severe
  • Epinephrine if concern for airway

For hereditary angioedema
- C1 inhibitor replacement, kallikrein inhibitor, bradykinin B2 receptor antagonists

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31
Q

Which infection, seen in immunocompromised patients, can lead to balanitis?

A
  • Genital candidiasis (candida albicans)
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32
Q

Which patient is most likely to have symptoms of bleeding, purpura, hematemesis, melena, epistaxis, and hepatomegaly from a dengue infection?

A
  • Children aged under 10
  • Develop dengue hemorrhagic fever
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33
Q

Which mosquito-borne illness can cause plasma leakage and abnormal hemostasis?

A
  • Dengue
  • Can cause potential fatal hemorrhagic fever with shock
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34
Q

Diagnostic test to definitively differentiate between enteric infections such as:
- campylobacter
- salmonella
- shigella
- yersinia enterocolitica

A
  • Stool culture
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35
Q

Where is yersinia enterocolitica most commonly found and in what foods?

A
  • Europe
  • Pork (also dairy, oysters/mussels, iceberg lettuce)
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36
Q

What is rhinosinusitis?

A
  • Symptomatic inflammation of the paranasal sinuses and nasal cavity
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37
Q

Which type of toxoplasmosis infection is most dangerous to a baby in utero?

A
  • Primary maternal infection early in pregnancy

(transmission does not occur if mother infected before conception)

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38
Q

When does rhinosinusitis most commonly occur?

A
  • After a viral upper respiratory infection
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39
Q

Symptoms of francisella tularensis (tularemia)

A
  • Skin/eye ulcers, pharyngitis with lymphadenopathy, GI symptoms
  • Can cause pericarditis, meningitis, pneumonia, peritonitis, endocarditis
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40
Q

What is the name of the infection more commonly known as “cat scratch fever”?

A
  • Bartonella
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41
Q

What is the main complication associated with vibrio cholerae infection?

A
  • Dehydration
  • Sunken eyes, dry mouth, cold, clammy skin, decreased turgor, hypotension, lethargy
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42
Q

Which viruses are carried by the Aedes mosquito?

A
  • Dengue
  • Yellow fever

(not malaria = anopheles mosquito)
(not encephalitis = culex mosquito)

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43
Q

Where is vibrio cholerae most commonly found?

A
  • Areas without access to clean water (fecal contamination)
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44
Q

Which infection, seen in immunocompromised patients, is caused by fungi that live in most people’s alveoli?

A
  • Pneumocystis jirovecii
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45
Q

A child presents with an enlarged cervical lymph node one week after being scratched on the neck by her cat. What is the likely diagnosis and treatment?

A
  • Bartonella (cat scratch fever)
  • Azithromycin
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46
Q

Rabies is mostly found in Africa and Asia and associated with dogs.
In America, which five animals most commonly cause rabies?

A
  • Bats
  • Skunks
  • Foxes
  • Raccoons
  • Mongooses
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47
Q

Which mosquito-borne illness has an abrupt high fever, then an afebrile period followed by one more episode of fever (recrudescent)?

A
  • Dengue

(not malaria = cyclic)

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48
Q

Which bacteria causes murine (endemic) typhus?

A
  • Rickettsia typhi
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49
Q

Where in the world are you most likely to see a chagoma?

A
  • South America
  • Chagoma = swelling from bite of kissing bug
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50
Q

Which intestinal nematode is the most common cause of iron deficiency anemia worldwide?

A
  • Hookworms
  • Cause anemia from GI blood loss
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51
Q

Hymenoptera (stinging insects, bees, wasps, hornets, fire ants) cause acute urticaria.
Bed bugs, fleas, and mites cause a slightly different kind of urticaria, what is it?

A
  • Papular urticaria
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52
Q

Describe the appearance of urticaria (hives)

A
  • Well-defined, raised, erythematous wheals/plaques
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53
Q

Which protozoan infection is associated with cats and undercooked pork/lamb?

A
  • Toxoplasmosis
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54
Q

Preferred diagnostic method for allergic rhinitis

A
  • Skin testing for antigen-specific IgE
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55
Q

Shigella is most commonly seen in developing countries. If seen in the US, it most likely started in …

A
  • Day care centers
  • Recreational water
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56
Q

What is the most common cause of viral gastroenteritis in the world?

A
  • Norovirus (the winter vomiting disease)
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57
Q

Treatment for leishmaniasis

A
  • Cryotherapy, wound debridement,
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58
Q

Postexposure prophylaxis treatment for rabies

A
  • Treat any bite from unknown animal that can transmit rabies, or if a bat was in your bedroom
  • Rabies immunoglobulin + four serial vaccine shots
  • Given on days 0, 3, 7, and 14
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59
Q

What is the most effective treatment for anaphylaxis?

A

Epinephrine
- alpha reverses peripheral vasodilation to increase BP and perfusion
- beta-2 relaxes smooth muscle in airways

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60
Q

Where in the world is a person most likely to pick up a roundworm infection?

A
  • Tropical climated
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61
Q

What kind of urticaria is caused by systemic mastocytosis?

A
  • Urticaria pigmentosa (reddish-brown macules)
  • Stroke skin = hive breakout = Darier’s sign
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62
Q

Which condition is also known as “rose handler’s disease”?

A
  • Sporotrichosis
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63
Q

Diagnostic test for toxoplasmosis

A
  • Serology for antibodies

(ophthalmology exam, hearing tests, brain MRI/CT, and lumbar puncture to rule out meningitis)

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64
Q

Treatment for cryptococcus neoformans infection

A
  • IV amphotericin B plus oral flucytosine
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65
Q

Diagnostic test for aspergillus fumigatus

A
  • Transbronchial biopsy or bronchoscopy
  • 1-3-B-D positive
  • CT > CXR
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66
Q

Diagnostic method for:
- Histoplasmosis
- Blastomycosis
- Coccidioidomycosis
- Sporotrichosis

A
  • Culture whatever you can
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67
Q

Treatment for vibrio cholerae

A
  • Rehydration
  • Doxycycline if severe
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68
Q

Which infection is caused by bites from sandflies?

A
  • Leishmaniasis
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69
Q

Resume after protozoans

A
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70
Q

Treatment for:
- Histoplasmosis
- Blastomycosis
- Coccidioidomycosis
- Sporotrichosis

A
  • Itraconazole
  • Amphotericin B if severe
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71
Q

True or false.
Bradykinin-mediated angioedema does not involve mast cells, and so has no hives, but does respond to epinephrine, antihistamines, or corticosteroids.

A

False
- Bradykinin-mediated angioedema does not involve mast cells, and so has no hives, AND DOES NOT respond to epinephrine, antihistamines, or corticosteroids.

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72
Q

Which of the following can cause plaque like lesions on the face and extremities?
- Histoplasmosis
- Blastomycosis
- Coccidioidomycosis
- Sporotrichosis

A
  • Blastomycosis
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73
Q

Histoplasma infections are normally asymptomatic except in the cases of immunosuppression, heavy exposure, age 55+, or infancy. What symptoms do these people get with their severe infection?

A
  • Pulmonary: fever, malaise, non-productive cough
  • Disseminated: Fever, chills, malaise, anorexia, weight loss, hepatosplenomegaly, and skin and mucous membrane lesions (papules)
74
Q

What is the most common zoonotic infection in the world?

A
  • Brucellosis
75
Q

Diagnostic test for intestinal nematodes

A
  • Microscopic exam of stool
  • Adhesive exam for pinworms
76
Q

What is the treatment for:
- Rocky mountain spotted fever
- Murine (endemic) typhus
- Epidemic (louse-borne) typhus
- Q fever
- Human ehrlichiosis

A
  • Doxycycline for all
77
Q

Symptoms of malaria

A
  • Headache followed by febrile paroxysms
  • Cyclic fever every 48-72 hours
  • Cough, body aches, n/v/d
  • Hepatosplenomegaly

Severe malaria:
- Impaired consciousness, inability to sit/stand/walk, convulsions

78
Q

Which infection is associated with soil contaminated with pigeon/chicken feces?

A
  • Cryptococcus neoformans
79
Q

Treatment for trypanosomiasis

A
  • Nifurtimox, benznidazole
80
Q

In which part of the world is dengue found?

81
Q

Treatment for rocky mountain spotted fever

A
  • Doxycycline
  • Do not wait for rash to appear, treat if tick bite and suspected!
82
Q

You suspect anaphylaxis in a patient who is known to be taking a beta-blocker.
As well as epinephrine, what other medication should you also give?

83
Q

Where in the US are you most likely to contract blastomycosis?

A
  • Eastern half of US
    (Arkansas, Mississippi, Kentucky)
84
Q

What is the classic triad of symptoms associated with aspergillus fumigatus?

A
  • Fever, chest pain, hemoptysis
    (not reliable)
  • Also sinusitis: fever, congestion, facial pain
85
Q

Which disease is helicobacter pylori connected with?

A
  • Peptic ulcer disease
86
Q

From which creature is a patient likely to catch yersinia pestis?

A
  • Fleas from rats (or squirrels)
87
Q

Diagnosis for rabies

A
  • Fluorescent antibody staining of neck (nuchal) biopsy
88
Q

Which condition is caused by coxiella burnetti?

89
Q

What are the unique symptoms associate with yellow fever?

A
  • Jaundice and bradycardia (Faget)
    (also sudden fever, malaise, headache)
90
Q

What is the treatment for this zoonotic infection, most commonly seen in the middle east, acquired from unpasteurized milk, undercooked meat, or open wound/GI/respiratory mucosal contact with cattle?

A
  • Doxycycline (+aminoglycoside, rifampin, or fluoroquinolone)
  • To treat brucellosis
91
Q

Diagnostic test for candida albicans infection

A
  • Pseudo-hyphae, budding yeast on KOH microscopy
  • 1-3-B-D antigen
92
Q

Symptoms of giardiasis

A
  • Watery diarrhea
  • Abdominal cramps, malodorous stools, flatulence
93
Q

What treatment is given for level 3 urticaria (hives)?

A
  • 2nd generation antihistamine 4x regular dose
94
Q

Which condition is also known as “valley fever”?

A
  • Coccidioidomycosis
95
Q

Best diagnostic test for malaria

A
  • Blood smear with microscopy

(also see anemia, thrombocytopenia, LFTs)

96
Q

Symptoms of toxoplasmosis

A

Immunocompetent patients:
- A few days fever/malaise
- Then painless lymphadenopathy (bilateral, nontender, cervical)

Immunosuppressed patients:
- CNS effects: encephalitis, seizures, cranial nerve deficits, altered mentation
- Hepatitis, uveitis, myocarditis, pericarditis, polymyositis, pneumonitis (all over the body)

97
Q

In what part of the world are you most likely to catch yellow fever?

A
  • Central/south America
  • Sub-Saharan Africa
98
Q

Which of the following can cause erythema nodosum?
- Histoplasmosis
- Blastomycosis
- Coccidioidomycosis
- Sporotrichosis

A
  • Coccidioidomycosis
99
Q

Symptoms of sporotrichosis

A
  • Starts with minor skin trauma
  • Cutaneous nodule that spreads into lymphatics
  • Leads to abscess and ulcers
100
Q

What are three broad categories of anaphylaxis triggers?

A
  • Medications
  • Foods
  • Insect stings

(drugs, bugs, and grub)

101
Q

Which condition is caused by bites from the lone star tick?

A
  • Human ehrlichiosis
102
Q

What is the most concerning complication of West Nile virus?

A
  • Encephalitis
103
Q

What disease is caused by plasmodium falciparum?

104
Q

Diagnostic criteria for chronic rhinosinusitis

A
  • Duration of symptoms >12 weeks
  • Requires clinical history and sinus inflammation on CT scan or nasal endoscopy
105
Q

How is West Nile virus (encephalitis) transmitted?

A
  • Culex mosquitoes
  • Also blood transfusions, organ transplants, transplacental, breast feeding, lab exposure
106
Q

What is the treatment for the infection that is diagnosed using urea breath testing, stool antigen, and endoscopy?

A
  • PPI + amoxicillin + metronidazole (or clarithromycin)
  • Treating helicobacter pylori
107
Q

How can you use symptoms to differentiate between rocky mountain spotted fever and human ehrlichiosis?

A
  • Same symptoms apart from rash
  • Human ehrlichiosis has no rash
  • Both have fever and headache
108
Q

Is chronic urticaria more common in adults/children and males/females?

A
  • More common in adult females
109
Q

Which condition is associated with the Faget sign, and what is it?

A
  • Yellow fever
  • Bradycardia with fever (normally fever causes tachycardia)
110
Q

Deficiency of C1-esterase inhibitor leads to angioedema in this area of the body

A
  • Gut wall = severe abdominal pain, symptoms of acute abdomen
111
Q

Treatment for pneumocystis jirovecii

A
  • IV bactrim
112
Q

Treatment for allergic rhinitis nasal symptoms

A
  • Nasal steroid sprays most effective for congestion
  • Nasal antihistamine sprays
  • Saline sinus rinses
  • Leukotriene receptor antagonists
  • Oral antihistamines (2nd gen)
  • Oral decongestants (short term)
  • Corticosteroids (short-term, only use if severe)
113
Q

How is someone likely to become infected with francisella tularensis (tularemia)?

A
  • Associated with dressing and eating animals
  • Contracted from rabbits or ticks that live on rabbits
114
Q

Which of the following can cause skin and mucus membrane papules when disseminated?
- Histoplasmosis
- Blastomycosis
- Coccidioidomycosis
- Sporotrichosis

A
  • Histoplasmosis
115
Q

Diagnostic tests for cryptococcus neoformans

A
  • Lumbar puncture: elevated opening pressure, low glucose, high protein
  • 1-3-B-D negative
  • Serum cryptococcal antigen (CrAg)
116
Q

The timing of allergic rhinitis symptoms can suggest particular allergies.
What are some major seasonal and perennial environmental allergens?

A

Seasonal (outdoor)
- Grass/weed/tree pollen
- Mold

Perennial (indoor)
- Dust mite
- Cockroach
- Cat/dog
- Mouse
- Mold

117
Q

Which infection, related with the ingestion of undercooked chicken, has the potential complication of an ascending paralysis?

A
  • Campylobacter
  • Ascending paralysis = Guillain-Barre syndrome
  • Salmonella also associated with chicken, but no paralysis
118
Q

Most common pathogens (bacterial and viral) involved in acute rhinosinusitis

A

Bacterial
- S. pneumoniae
- H. influenzae
- S. suppurativa
- M. catarrhalis
Viral
- Rhinovirus
- Coronavirus

119
Q

Physical exam findings in acute rhinosinusitis

A
  • Pain to palpation/percussion over sinuses
  • Pain with bending over
  • Thick, purulent secretions
  • Visible post-nasal drainage
  • Mucosal edema and erythema
  • Turbinate swelling
  • Polyps
120
Q

Risk factors for sporotrichosis infection

A
  • Alcoholism, diabetes, COPD, HIV infection
121
Q

In which of these infections is fever and abdominal pain often absent?
- Campylobacter
- Salmonella
- Shigella
- Yersinia enterocolitica
- Vibrio cholerae

A
  • Vibrio cholerae
122
Q

Which infection, most commonly seen in the northeast US, causes fatigue and fever (no rash), and is associated with “Maltese cross” RBCs on blood smear?

A
  • Babesiosis
123
Q

Treatment for allergic rhinitis ocular symptoms

A
  • OTC antihistamine-decongestant drops (short term)
  • Topical antihistamines +/- mast cell stabilizers
  • Oral antihistamines
  • Topical NSAIDs such as ketorolac
  • Topical corticosteroids or short course oral steroids for severe symptoms
124
Q

Which form of typhus, the one caused by rickettsia typhi or the one caused by rickettsia prowazekii is more severe?

A
  • Rickettsia prowazekii (causes epidemic (louse-borne) typhus)
125
Q

Symptoms of rabies

A
  • Initially pain/paresthesia (tingling) at bite site with fever, headache, malaise
  • Encephalitis eventually: restlessness, bizarre behavior, insomnia
  • Hydrophobia and excessive salivation
126
Q

Symptoms of encephalitis due to West Nile virus

A
  • Headache, myalgia, GI complaints, erythematous macular, popular morbilliform rash
127
Q

Symptoms of rocky mountain spotted fever

A
  • Fever, headache, and a rash that begins on extremities and spreads to trunk
  • Rash doesn’t show until day 3-5 of illness (so don’t wait for rash to start treatment!)
128
Q

Which parasitic infection causes an itchy foot rash after walking in soil contaminated with human excrement?

A
  • Hookworms (ancylostoma & necator)
129
Q

What is the most common manifestation of cryptococcus neoformans infections in AIDS patients?

A
  • Meningitis
130
Q

Apart from the oropharynx, esophagus, and genitals, where else in the body might an immunocompromised patient be infected with candida albicans?

A
  • In the blood/hematogenous: candidemia
  • Causes skin/eye lesions, also joint, brain, heart, lung, liver, spleen issues
131
Q

Which infection is associated with massive watery diarrhea with flecks of mucus, described as “rice water stools”?

A
  • Vibrio cholerae
132
Q

What are the unique symptoms of yersinia enterocolitica?

A
  • RLQ pain and pharyngitis
  • Also fever, diarrhea
133
Q

Anaphylaxis involves more than one of these five organ systems

A
  • Cutaneous
  • GI
  • Cardiovascular
  • Respiratory
  • Neurologic
134
Q

Which symptoms are seen in both hookworm and roundworm infections?

A
  • Abdominal pain
  • Diarrhea
  • Nausea/vomiting
135
Q

Which infection, seen in immunocompromised patients, has symptoms of painful swallowing, loss of taste, “cottony” feeling in the mouth, retrosternal pain?

A
  • Oropharyngeal/esophageal candidiasis (candida albicans)
136
Q

After ingesting lake water your patient presents with watery diarrhea, what is the quickest test to confirm the suspected diagnosis, and how will you treat it?

A
  • Antigen detection assay (better than stool O&P)
  • Tinidazole to treat giardiasis
137
Q

What are the most common food causes of acute urticaria/anaphylaxis?

A
  • Cow’s milk
  • Egg
  • Peanut/tree nut
  • Soy
  • Wheat
  • Fish/shellfish
  • Sesame
138
Q

Who is most at risk of developing encephalitis from West Nile virus?

A
  • Over 50, immunocompromised
139
Q

What are protozoans?

A
  • Single-celled eukaryotes
  • Parasites
140
Q

This infection, associated with ingestion of chicken, eggs, or milk, causes non-bloody diarrhea in adults and bloody diarrhea in children, as well as nausea, vomiting, and fever.

A
  • Salmonella
141
Q

Physical exam findings of congenital toxoplasmosis

A
  • Chorioretinitis most common
  • Hydrocephalus and fever
  • Intracranial calcification, hearing loss, jaundice, developmental delays
142
Q

Blastomycosis infections are normally asymptomatic except in the cases of immunosuppression. What symptoms do these people get with their severe infection?

A
  • Pulmonary: fever, cough, pulmonary infiltrate, weight loss, night sweats, and fatigue
  • Disseminated: cutaneous lesions, well circumscribed nonpainful papules, nodules, or plaques mostly on face and extremities
143
Q

Treatment for toxoplasmosis

A

Immunocompromised:
- Pyrimethamine and sulfonamides

Pregnant mothers:
- Spiramycin or pyrimethamine-sulfadiazine

Congenital disease:
- Spiramycin, sulfadiazine, leucovorin

144
Q

Which condition, associated with sheep or goat farming, can cause influenza like symptoms, followed by interstitial pneumonitis?

145
Q

What is dermatographism?

A
  • Wheal and flare (urticaria) after stroking/scratching/rubbing the skin
146
Q

Which infection, associated with unsanitary water ingestion, can cause liver abscesses?

A
  • Amebiasis
  • Liver abscesses most common in men 40-60
147
Q

How to prevent toxoplasmosis infection

A
  • Avoid raw/undercooked pork/lamb
  • Don’t touch cat litter
148
Q

Which infection is associated with “pruritis ani” at night?

A
  • Pinworms (enterobius vermicularis)
149
Q

Why should IgE skin testing not be performed in a “screening” fashion to find a specific trigger of anaphylaxis?

A
  • False positives lead to unnecessary avoidances/lifestyle changes
150
Q

Treatment for rhinosinusitis

A
  • Saline irrigation
  • Intranasal glucocorticoids
  • OTC NSAIDs or acetaminophen
  • Oral decongestants/mucolytics

Antibiotics
- Amoxicillin/augmentin
- Doxycycline or fluoroquinolone is PCN allergy

ENT referral if chronic/treatment failure

151
Q

Treatment used in refractory chronic idiopathic urticaria in patients aged 12+ who failed high dose antihistamine treatment

A
  • Omalizumab (xolair)
152
Q

Which bacteria causes epidemic (louse-borne) typhus?

A
  • Rickettsia prowazekii
153
Q

What condition, caused by eating infected pork, seen most commonly in Europe (and Russia), is treated with mebendazole?

A
  • Trichinellosis

(yersinia enterolitica also caused by pork in Europe, but not treated with mebendazole, is self-limited)

154
Q

Symptoms of trichinellosis

A

Intestinal phase:
- asymptomatic to n/v/constipation/abdominal pain

Muscle phase:
- facial edema, hemorrhages, myalgias, muscle edema

155
Q

What lab abnormalities would you expect to see in a case of rocky mountain spotted fever?

A
  • Elevated aminotransferases and bilirubin
  • Thrombocytopenia eventually
  • Hyponatremia if severe
  • Normal WBC
156
Q

Where is a person most likely to catch amebiasis (amebic dysentery)?

A
  • India, Africa, Mexico, C/S America
  • Areas with poor water supply sanitation
157
Q

What is the name of the bacteria that causes rocky mountain spotted fever?

A
  • Rickettsia rickettsii
158
Q

Which of the following is 1-3-B-D antigen negative?
- Candida albicans
- Cryptococcus neoformans
- Pneumocystis jirovecii
- Aspergillus fumigatus

A
  • Cryptococcus neoformans
159
Q

Which infection is associated with the inhalation of dust/soil contaminated with bat/bird droppings?

A
  • Histoplasmosis (histoplasma capsulatum)
160
Q

Name as many tick-borne illnesses as you can (4)

A
  • Rocky mountain spotted fever
  • Human ehrlichiosis
  • Francisella tularensis (tularemia)
  • Babesiosis
161
Q

Which virus causes vomiting, can be found in pools, and is tested for using PCR, and a stool exam that has no leukocytes?

A
  • Norovirus (the winter vomiting disease)
162
Q

Which parasitic infection is associated with eosinophilia, elevated muscle enzymes, and is diagnosed with muscle biopsy?

A
  • Trichinellosis
163
Q

Which condition is associated with the Romana sign?

A
  • Trypanosomiasis
  • Romana sign = chagoma (edema) near eye from bite of kissing bug
164
Q

What infection is caused by kissing bugs?

A
  • Trypanosomiasis (Chagas disease)
165
Q

Symptoms of trypanosomiasis

A

Acute form:
- fever, lymphadenopathy, edema near bit site (“chagoma”, Romana sign if near eye)

Chronic form:
- Heart and GI issues
- Most common cause of non-ischemic heart failure worldwide

166
Q

Treatment for salmonella

A
  • Rehydrate: water + salt + sugar
  • Antibiotics if severely ill: ciprofloxacin, azithromycin, bactrim
167
Q

Symptoms of allergic rhinitis/conjunctivitis

A
  • Nasal congestion
  • Clear rhinorrhea
  • Postnasal drip
  • Sneezing
  • Nasal itching
  • Bilateral itchy/burning eyes
  • Watery/stringy discharge from eyes
168
Q

In which part of America are you most likely to see coccidioidomycosis?

A
  • Southwest USA
  • Northern Mexico
169
Q

If a patient in an anaphylactic episode does not respond to an epinephrine injection, what should you try next?

A
  • Repeat dose every 5 minutes as needed
170
Q

Candida albicans treatments

A
  • Topical: nystatin
  • Systemic: fluconazole
171
Q

What is the primary effector cell involved in urticaria and angioedema reaction?

172
Q

Which of the following are inclusion and which are exclusion criteria for urticaria (hives)?
- Blanching
- Blisters
- Central swelling/surrounding erythema
- Fever
- Persists <24 hours
- Petechiae/purpura
- Pruritic
- Severe joint pain

A

Inclusion
- Blanching
- Central swelling/surrounding erythema
- Persists <24 hours
- Pruritic

Exclusion
- Blisters
- Fever
- Petechiae/purpura
- Severe joint pain

173
Q

Treatment for the infection associated with buboes in the groin/axilla

A
  • Aminoglycoside (or fluoroquinolone or doxycycline)
  • To treat yersinia pestis
174
Q

Which people are more at risk of ACE inhibitor angioedema?

A
  • African Americans = 5x more risk
175
Q

Which infection is associated with flying squirrels in the US?

A
  • Epidemic (louse-borne) typhus
176
Q

Where in America are you most likely to contract murine (endemic) typhus?

A
  • Texas (also California, and Hawaii)
177
Q

Treatment for amebiasis

A
  • Metronidazole + intraluminal paromomycin
178
Q

What type of urticaria is caused by an increase in core body temperature?

A
  • Cholinergic urticaria
179
Q

Treatment for francisella tularensis (tularemia)

A
  • Streptomycin or gentamycin
180
Q

Symptoms of coccidioidomycosis

A
  • Pulmonary: asymptomatic to pneumonia symptoms and erythema nodosum
  • Disseminated: asymptomatic to skin, bone, SQ tissue, and meninges infections
181
Q

Which lab test is the best for confirming a diagnosis of epidemic (louse-borne) typhus?

A
  • IFA assay (antibodies)
182
Q

How long do acute and chronic sinusituses last?

A
  • Acute = <4 weeks
  • Chronic = >12 weeks

Clin Med 2 (5 decks)

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