ID 1 Flashcards

1
Q

Rx for Pseudomonas Aeruginosa Pneumonia?

A

Cefepime or Levofloxacin or Gentamicin

(Anti-Psuedomonal Beta-lactam, Respiratory Fluoroquinolone or Aminoglycoside)

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2
Q

Travel to LIBERIA now presents with Coagulopathy?

A

Ebola

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3
Q

Presents in NON-Immunocompromised, Chronic dz pts. Skin infection on person exposed to Saltwater or Freshwater, Fish tanks?

A

Mycobacterium Marinum

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4
Q

Next step in management of a patient positive for Babesiosis but Asymptomatic?

A

Repeat PCR in 3 months to ensure Clearance.

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5
Q

Pt presenting with persistent draining wound, previous open fracture years ago, now has eschar over wound that intermittently drains whitish fluid through a sinus tract.
No fevers, chills, WBC count, left shift.

Management ?

A

Bone biopsy and Culture for Chronic Osteomyeltitis in ordered to isolate causative agent.

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6
Q

Bacteria that cause infections with Pedicures at Nail Salons?

A

Mycobacterium Fortuitum Furunculosis (MFF)

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7
Q

Difference btw Small Pox and Chicken Pox?

A

Small pox the Pharynx and Buccal Mucosa that spread to face

Chicken pox on Trunk and spread to Extremities

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8
Q

70 yo pt presenting with Ataxia, Spasticity, Myoclonus and Elevated 14-3-3 protein.

A

Creutzfeldt-Jakob disease

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9
Q

Who should be treated for Salmenolla Gastroenteritis with abx therapy?

A

Sickle cell disease, Elderly, Immunocompromised.

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10
Q
  1. Pt presents with respiratory illness (dry cough, low grade fever) after being in Northen Mexico, Southwest texas, Arizona.
    Dx?
    Test?
    Rx?
  2. Ohio/Mississippi River Valley, fungating skin lesions and joint pain ?
    Dx?
    Test?
    Rx?
  3. Endemic to Ohio, Missouri, Indiana and Mississippi. Occurs in severely immunocompromised patients. CXR shows bilateral infiltrates. Hepatosplenomegaly and thrombocytoenia and anemia can be present.
    Dx?
    Test?
    Rx?
  4. Occurs in diabetic and neutropenic patients. Mainly presents with rhinocerebal infection but can affect lung, stomach, pevlis, skin.
    Dx?
    Test?
    Rx?
A
  1. Cocciodiodomyocsis
    CXR, Sputum Culture
    Itraconazole
  2. Blastomycosis
    (Blast Bones, Balls and Skin)
    CXR, Fungal Stain and confirmed by Sputum Culture
    Serology for Blasto Antibodies
    Itraconazole
  3. Histoplasmosis
    Histoplasma Urinary Antigen
    Amphotericin B
  4. Mucormycosis
    High index of clinical susupcicion
    Amphotericin B
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11
Q

Management of Post-exposure Prophylaxis with Varicella in immunocompetent and immunocompromised individual?

A

Immunocompetent:
Live-attenuated vaccine
(Administer Vaccine within 3 to 5 days of exposure)

(it Prevents dz or Decreases Severity of dz)

Immunocompromised: Varicella-Zoster Immune Globulin (passive immunity)

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12
Q

Abx for Brain Abscess from
Dental source?

A

IV PCN and Metronidazole. (Streptococci, Fusobacterium, Provetella, Bacteroides)

PEN Met the Dentist

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13
Q

Hx of Syphilis now presenting with Memory loss.

Dx?
Test?
Rx?

A

CSF analysis to r/o Neurosyphilis.

VDRL

IV Aqueous crystalline penicillin G x 14 days

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14
Q

Pt presents with Dysarthria, Confusion, Left Hemiparesis, Poor vision, recently diagnosed with HIV infection CD4 count 82, CT scan shows diffuse demyelination.

Dx?
Management?

A

PML (JC polymovirus).

Get CD4 count up.

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15
Q

Name the 3 indications for treatment of Asymptomatic Bacteriuria?

A
  1. Pregnancy (Bactrim, Nitrofurantoin)
  2. Urologic procedure
  3. Recent Renal Transplant Patient
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16
Q
  1. Rx for Uncomplicated UTI?
  2. Rx for Complicated (DM2, immunocompromised, structure, foreign body, resistant organism)
A
  1. Bactrim x 3d
  2. Bactrim x 7d , Cipro x 7d
17
Q

CSF Analysis:

WBC 50-1,000
Predominantly Lymphocytes
Glucose > 45
Protein < 200

Gram stain and culture negative?

Dx?
Rx?

A

Viral meningitis

Supportive can rx with Empiric abx until bacterial meningitis is r/o

18
Q

CSF Analysis:

WBC 1,000 - 5,000
Neutrophil Predominate
Protein 100-500
Glucose < 40

Positive Gram Stain and Culture

Rx?

A

Bacterial meningitis

19
Q

Occurs in early summer and fall, transferred by mosquitoes pt presents with meningitis, encephalitis, myelitis, starts with acute flaccid paralysis that can progress to respiratory failure.

Dx?
Test?
Rx?

A

West Nile Virus

LP for CSF IgM antibody (only time with viral serology is helpful).

Supportive

20
Q

Erythematous, Serpiginous, Pruritic skin lesions with travel from the Carribbean. Dx?

A

Larva Migrans

21
Q

Protozoan Parasite transmitted via Sandfly Bites.
Pt presents with ulcer with granulomatous tissue

A

Cutaeneous leshmaniasis

22
Q

This is caused by a Water-Borne Parasitic blood fluke. Pt presents with pruritic maculopapular rash within hours from being in Contaminated Water.

Dx?

A

Swimmers Itch (Schistosome cercarial dermatitis)

23
Q

Pt with a recent hx of Pharyngitis develops neck pain, swelling and fevers despite antibiotic therapy.

Dx?
Management?

A

Septic Thrombophlebitis of the Internal Jugular Vein caused by Fusobacterium Necrophorum

Needs 4 weeks Anaerobic Coverage.

24
Q

Pt presents with Fever, Migratory Arthritis, Subcutaneous Nodules, Heart Murmur and elevated ESR, CRP. Dx?

A

Acute Rheumatic Fever. Jones Criteria. Aso titers

25
Q

Pt presents with myalgias, arthralgias, headaches, cognitive complaints and Completed 21 days of Doxycycline for Lyme disease. ESR and CRP are negative.

Dx?

A

Post lyme disease syndrome

26
Q
  1. HIV patient presenting Multiple ring-enhancing lesions with mass effect and edema.
    Dx?
  2. HIV patient presenting Solitary ring enhancing lesions with mass effect & edema. Large lesions > 4cm.
    Dx?
  3. HIV pt presenting with rapidly progressive neurologic deficits. There is Bilateral white matter lesions with No mass Effect.
    Dx?
A
  1. Toxoplasma Encephalitis
  2. Primary CNS Lymphoma
  3. Progressive Multifocal Leukoencephalopathy (PML JC Virus)
27
Q

Abx that can be given for patients Traveling to endemic regions to prevent Travelers Diarrhea

A

Flouorquinolones and Azithromycin

28
Q

Management of Cryptococcal Meningitis ?

A

Amp B + Flucytosine for induction. Fluconazole for maintenance until CD4 > 100.

Needs Serial LPs to reduce intracranial pressure.

29
Q
  1. > 5mm PPD?
  2. > 10mm PPD?
A
  1. HIV, Solid Organ Transplant, Severe immunosuppression, Active TB
  2. Countries, Injection, Healthcare, DM
30
Q

Treatment for epididymitis for older men who practice insertive anal intercourse (risk for gram negative organisms E. Coli)

A

Ceftriaxone and Levofloxacin ( Gram negative E. Coli coverage.

31
Q

Tick Infections:

  1. Tick in Northeast, associated with Leukopenia, thrombocytopenia, and Elevated AST and ALT
  2. Tick in Northeast, associated with hemolysis
  3. Occurs in North Carolina to Oklahoma. Rash is the hallmark of disease. Rash starts near ankles and wrist and spreads centrally.
  4. Associated with ulceroglandular, glandular, oropharyngral and pneumonic presentations.
A
  1. Anaplasmosis
  2. Babesiosis
  3. Rocky Moutain Spotted Fever
  4. Tuleremia.
32
Q

Name Side Effects of Flouroquinolones.

A
  1. QTC prolongation 450 males, 460 Females
  2. Tendonitis
  3. Hyper or Hypoglycemia
  4. Neuropathy
  5. Neuro (agitation, dizziness)