Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

UWORLD ABIM > ID > Flashcards

ID Flashcards

1
Q

tx for toxoplasmosis

A

pyrimethamine (+leucovorin i.e. folic acid) + sulfadiazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

dengue fever

A

breakbone fever (arthralgia, myalgia), retroorbital pain, thrombocytopenia, rash with a white macular appearance.

DANG MY EYE HURTS and BONES BREAK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

etec treatment

A

Ciprofloxacin
Azithromycin
Rifaximin

Might have diarrhea in the CAR when abroad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

mgmt of candidemia

A
  • Echinocandin = Caspofungin, Micafungin or Anidulafungin
  • removal of intravascular catheter
  • opthalmo eval for endopthalmitis in all pt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Centor criteria

A

Fever (subjective)
Tender anterior cervical LN
Tonsillar exudate
Absence of cough

0-1: No test
2-3: Rapid strep test
4: empiric amoxicillin/penicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When do u treat asx candiduria?

A

In neutropenic pt or those undergoing urologic procedure only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Mgmt of acute bacterial meningitis

A

Early empiric abx + dexamethasone + acyclovir. Those who need CT scan (AMS, FND, hx CNS dz, papilledema, seizure) prior to LP should get tx right after cultures without waiting for LP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Minimum induration for positive PPD

A

5mm (HIV pt, recent contact with +TB pt, CXR shows fibrotic changes from prior TB, organ transplant/immunosuppressed)

10-15mm for other individuals

CXR for positive PPD only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Increased opening pressure definition

A

> 200 mm H20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

meningitis in patient with AIDS

A

cryptococcal (usually at CD4 <100)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Management of meningitis in AIDS patient, opening pressure elevated (>200)

A

CRYPTOCOCCAL

Induction: Amphotericin B + Flucytosine (2 weeks)

Maintenance: Fluconazole daily (until 3 months of CD4>100, usually a year)

Increased ICP: Serial lumbar puncture (not steroids/mannitol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ring enhancing lesion in HIV

A

Toxoplasmosis: multiple small lesions. CD4 <100. + mass effect. basal ganglia esp.

Primary CNS lymphoma: solitary lesion, large (>4cm). CD4 <50. EBV virus. +mass effect, also B sxs

  • PMFL no mass effect, enhancement or edema
  • CMV encephalitis is periventricular, no mass effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T/F: Right sided IE patients typically present with new cardiac murmur and septic pulmonary emboli

A

False, usually no heart murmur in right sided IE. Will have bilateral cavitary lesions in lungs from septic emboli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Most common bug right sided IE

A

Staph Aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tx of neurocysticercosis

A

Albendazole (antiparasitics) and/or corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Specific abx in bacterial meningitis treatment

A

Vanc: STREP PNEUMO (covers cephalo-resistant), **Staph aureus and coag neg staph (staph after head trauma, nsx, nsx device)

Cefepime: NEISSERIA (gnr) **pseudomonas (head trauma, nsx, nsx device, immunocompromise)

Ampiciliin: LISTERIA (also tx by penicillin G)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

T/F: Patients with suspected IE and no acutee sxs/good CV f(x), empiric therapy not always necessary

A

True. can be defeeerred until blood culture results available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Main bugs to cover with empiric native valve IE coverage

A

Staph, Strep, Enterococci

Use VANCOMYCIN

  • *If penicillin allergy: Cefazolin. If cx turn strep pneumo, can do ceftriaxone
  • ** Vanc MIC >1 and MRSA: Use Daptomycin (unless MRSA pna)

Alt: Unasyn + gentamicin (gent is not gentle on kidneys)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

HAV post exposure prophylaxis

A

Either HAV vaccine OR IG.

Prefer HAV vaccine usually. Kids or immunocompromise get IG. All household/sexual contacts.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

HBV post exposure prophylaxis

A

HBV vaccine PLUS HBIG

includes sexual/household contacts for patients with HBV and those with needle stick injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

T/F: Latent TB does not need tx if negative CXR

A

False. Latent TB = positive PPD but no sxs and negative CXR.

Tx options:

  1. Rifampin for 4 mo
  2. INH + rifapentene 3 mo
  3. INH 6-9 mo (watch for hepatitis and peripheral neuropathy)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Tx for chronic schisto infx

A

Praziquantel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Mucormycosis vs aspergillus: branching/septations

A

both affect immunocompromised.

mucor: Hyphae with irregular branching, No septations

aSpergillus: Hyphae with regular branching and many septations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Alternatives to penicillin for syphillis

A

Primary and secondary: can use doxycycline or tetracycline

Neurosyphillis: can use IV ceftriaxone for mild pen allergy, otherwise desensitize and admin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

chikugunya sxs

A

unremitting high fever + severe polyarthralgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

T/F: Patients can transmit genital HSV while asymptomatic

A

very true, viral shedding. consider daily valcyclovir or acyclovir to reduce partner transmission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Pulmonary surfactant inhibits efficacy of this MRSA drug against pna

A

Daptomycin. use for skin/soft tissue infxs.

Use Vanc or Linezolid for MRSA pna/VAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

When do you add listeria in empiric meningitis coverage?

A

Age >50 and immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

post-influenza secondary. bacterial pna empiric tx

A

Patients with influenza transiently improve and then more severe sxs. Usually Strep and Staph.

Ceftriaxone, Azithro + Vanc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Tx for Aspergillosis

A

For invasive (i.e. halo sign on CT): Voriconazole

For ABPA (asthma/CF pt with difficult to control sxs): Steroids + itraconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Clues for aspergillosis

A
  • Halo sign (invasive asp): nodules surrounded by ground glass infiltrates
  • asthma/CF (ABPA) with difficulty controlling sxs, hemoptysis
  • fever unresponsive to abx
  • hemoptysis in neutropenic patient
  • EELISA on serum or BAL shows galactomannan antigen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

T/F: FTA-AT test (flurorescent treponemal antibody) remains positive for life

A

True, so retesting this later doesn’t make much sense

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How much should titer for Syphilis decrease to say its a good tx response/

A

4 fold in 6-12 mo.

  • If tx failure, LP to eval for neurosyphilis + retreatment
  • serofast state (baseline titer positive forever after 4 fold decrease): repeat VDRL testing and check HIV status, no tx needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Tx for MAC

A

Clarithromycin (or azithro)
Rifampin
Ethambutol

MACCRE (MAC-RAY)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Disseminated endemic mycosis

A

Blasto: bone, skin (primary skin lesion), genitourinary. “Blasto blasts bones, balls and skin”

Histo: LN, pancytopenia, hepatosplenomegaly

Cocci: erythema nodosum or multiforme, meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Empiric tx for febrile neutropenia (ANC <500)

A

Cover pseudomonas: zosyn or cefepime.

Don’t need vanc unless hemo unstable, pna, catheter related infx, skin/soft tissue infx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How do you treat Lyme disease?

A

Early disease: Doxycycline (14-21 days)
**alternatives: Amoxicillin, Cefuroxime

Late arthritis and facial nerve palsy: Doxycycline

Late carditis or neurologic disease: IV Penicillin or IV Ceftriaxone (28 days)

NO DOXY IN PREGNANCY (amoxicillin or cefuroxime)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Most common persistent manifestation of untreated Lyme dz

A

Arthritis/arthralgia.

Don’t forget that in secondary stage can have meningitis, facial nerve palsy, arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Management of recurrent HSV 1

A
  • minimal sxs: supportive care w/o antiviral therapy
  • recurrent pain/discomfort: oral antiviral at prodrome onset
  • > 4 episodes/year or complications like meningitis: chronic suppressive therapy (daily acyclovir or valcyclovir)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Tx of herpes sequelae

A

Primary herpes keratoconjunctivitis: vidarabine, acyclovir or trifluorothymidine + opthalmo referral

Herpes encephalitis: IV acyclovir

Bells palsy: steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

conjunctival suffusion

A

redness in conjunctiva w/o inflammatory exudates

LeptospiROsis

Red Ocular phenom.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

When do you give antiviral tx for influenza

A

Oseltamavir within 48 hours of sxs. Anyone with severe disease/hospitalization should also get it regardless of sx duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

T/F: Rapid influenza antigen test is highly sensitive

A

False, its a shitty test. Go off of clinical suspicion even if its negative. Hx of immunization also should not deter you.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Sxs of tacrolimus toxicity

A

Acute nephrotoxicity, hypertension, neurotoxicity (i.e. tremor), metabolic disturbance (i.e. glucose intolerance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

common post-transplant infection

A

First 4 weeks: candida, mold (fusarium)

After first month:
**CMV most common**
BK virus ("bad kidney")
EBV (in all patients with lymphoproliferation) 
HBV, HCV, HSV reactivation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Gram positive rods

A

Bacillus
Clostridium
Listeria
Nocardia, Actinomyces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

leading cause of dilated cardiomyopathy in central/south america

A

Chagas disease from Trypanosoma cruzi. Patients will have LV APICAL ANEURYSM (pathognomonic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Acute rheumatic fever

A 
J- joints (migratory arthritis)
O - carditis 
N - subq nodules 
E - erythema marginatum 
S - sydenham chorea

occurs 2-4 weeks after GAS pharyngeal infx

49
Q

Nocardia vs Actinomyces

A

Nocardia: Lung (nodules, consolidation abscess) and Brain (abscess) infection, some skin cellulitis etc. Acid-fast branching rods, aerobic. Bactrim

Actin: affects face (after dental work/infection/trauma) and abdominal. anaerobic gram positive rod part of normal oral flora. sulfur granules. penicllin

50
Q

Neck pain/swelling and fever with recent hx of pharyngitis

A

Suspect Lemierre syndrome - from anaerobic fusobacterium necrophorum.

it is septic thrombophlebitis of internal jugular vein. develops despite appropriate pharyngitis antibiotic tx. may see PE on chest imaging

51
Q

sore throat with gray and white tonsillar exudates, cervical LN

A

Corynebacterium diptheria

52
Q

Posterior cervical LN + sore throat

A

mono

53
Q

When do you add empiric abx after abscess I/D?

A 
Abscess >2cm 
extensive cellulitis 
systemic signs
multiple abscess 
neutropenia

Use Bactrim or Doxy

54
Q

HIV PrEP (pre)

A

2 drug regimen: Tenofovir + Emtricitabine. Give them 3 month supply to ensure good f/u and counseling

-need HIV and HBV testing/vaccination status to qualify

55
Q

When do you DC PJP prophy in HIV patient?

A

CD4>200 for 3 months

56
Q

most common cause pneumothorax in AIDS pt

A

PJP. They can have cystic lesions (thin-walled cavitary lesions) that rupture

57
Q

elevated LDH in HIV patient

A

PJP. Dx using silver stain or IF monoclonal antibody stain

most will have LDH >50…LDH>450 is predictive of PJP

58
Q

Tx for PJP

A

Mild: PO Bactrim
Mod-Severe: IV Bactrim
**If sulfa allergy: IV pentamidine or IV Clindamycin + primaquine

+Steroids: If A-a>35 or arteral PO2 < 70

59
Q

Disseminated gonococcal infection

A

Purulent arthritis w/o skin lesions OR

triad: migratory asymmetric polyarthralgias, tenosynovitis, painless pustular skin lesions

60
Q

T/F: Wait for Lyme serology in suspected lyme before tx

A

false, can start empiric doxy. antibodies to borrelia usually negative in early dz

61
Q

Anti malarial in pregnancy

A

Chloroquine or Mefloquine

62
Q

how do you treat leptospirosis?

A

Lepto has conjunctival suffusion (redness), diffuse myalgia, liver dz, gi sxs seen in tropical areas

Tx with Doxycycline or Penicillin

63
Q

3 stages of syphilis

A

Primary: ulcer (chancre). 3 weeks post inoculation, painless

Secondary: Skin (any type of rash, often palmar/plantar involvement), painless LN, HA/stiff neck/AMS, condylomata lata (wart-like lesions on intertriginous surfaces). 2-8 weeks after primary. widespread hematogenous spread

Latent (tertiary): +RPR/FTA-ABS serology but no sxs. Can manifest years later with AORTITIS, Aortic insufficiency, ascending aorta calcifications, Tabes Dorsalis (posterior columns, sensory ataxia, argyll robertson pupils), stroke in a young patient

64
Q

T/F: FTA-ABS will remain positive indefinitely in syphillis patient

A

true

65
Q

Tx of Syphillis

A

Primary, Secondary: Penicillin G IM x 1 dose (or doxy x 14 days)

Latent/Tertiary: Penicillin G IM weekly x 3 weeks (doxy 28 days)

Neurosyphillis: Pen G IV x 10-14 days (Ceftriaxone 14 days)

Failure of serology to decrease fourfold in 6-12 months = treatment failure or reacquisition

66
Q

college kid with severe myalgias, rash

A

Neisseria meninigitidis

67
Q

empiric meningitis coverage in these patients require cefepime instead of ceftriaxone

A

Immunocompromised

Neurosurgery/penetrating skull trauma

Note: Ampicillin for age >50 and immunocompromised

68
Q

why is dexamethasone added to empiric meninigits coverage?

A

to cover pneumococcal meningitis and reduce neurological sequelae (hearing loss, mortality). it should be DC’ed if CDF gram stain/any cultures indicate nonpneumococcal organism

69
Q

T/F: All patients empirically covered for meningitis should get acyclovir

A

False. Give it if suspect herpes encephalitis/meningitis. Most cases accompanied by genital lesions, absence of nuchal rigidity and hypotension

70
Q

Risk factors for ESBL

A
  • length of hospital/ICU stay
  • catheters: foley, central/arterial, feeding tube
  • ventilator
  • nursing home

Tx with carbapenems (meropenem, iminopenem)

71
Q

Presentation of babesia

A

High fever
hemolytic anemia
thrombocytopenia
jaundice

blood smear shows parasitized rbc: intraerythrocytic parasites in tetrads = maltese cross (BB 4)

can use atovaquone + azithro if needed

72
Q

presentation of ehrlichiosis

A 
severe/prolonged fever
LEUKOPENIA
thrombocytopenia 
elevated LFTs
myalgia, AMS, LN
sometimes rash

peripheral smear shows moruale: intracytoplasmic inclusions in neutrophils

73
Q

T/F: LP Is contraindicated in presence of brain abscess

A

True…potential increased ICP and herniation.

Drain/excise any >2.5cm

74
Q

Recurrent cellulitis

A

tx risk factors, such as lymphedema, tinea pedis, chronic venous insufficiency

75
Q

infection plus hemorrhagic bullae in patient with cirrhosis

A

vibrio

76
Q

New diabetic foot infection

A

ABI and foot imaging for all

77
Q

CURB-65

A 
Confusion
Uremia
RR
BP low
Age >65

0-1 outpatient
2 admit

78
Q

T/F: Never treat asx bacteruria

A

False, treat it in pregnant women and those getting urologic procedure

79
Q

Patient with TB starting on treatment with RIPE. special testing?

A

All need HIV if not already

Pyrazinamide: uric acid levels
Ethambutol: visual acuity/color vision testing

80
Q

T/F: Candidemia occurs most frequently when indwelling catheter

A

true

81
Q

T/F: Candida in sputum and blood usually contaminant

A

False…

In sputum: usually contaminant

In blood: never a contaminant

Don’t tx asx candiduria (unless neutropenic, uro procedure) or candida in sputum of vented pt

82
Q

recurrent disseminated gonococcal infection (arthritis-dermatitis syndrome with migration or purulent monoarthritis)

A

consider terminal complement deficiency (c5, c6, c7, c8)…membrane attack complex MAC

screen with CH50 assay

83
Q

Tx chlamydia/gonorrhea

A

C: Azithro or Doxy
G: Ceftriaxone

GC CAD

84
Q

drug induced fever

A

Anticonvulsants (phenytoin, carbamazepine)
Antibiotics (b-lactam, sulfonamides, nitrofurantoin)
allopurinol

85
Q 
Diplopia
Dysphonia
Dysarthria
Dysphagia
Descending paralysis
A

Botulism (clostridium botulinum)

86
Q

Toxic shock syndrome

A
  • no steroids

- MRSA: vanc + clinda/linezolid

87
Q

X marks the spot for lyme

A

doxycycline
amoxicillin
cefuroxime

88
Q

Babesia, Ehrlichiosis, Rocky

A

Babesia: hemolytic anemia, parasites in rbc = maltese cross

Ehlichiosis: morulae = clumps of organism in wbc, leukopenia and thrombocytopenia

Rocky: rash starts at ankles/wrists and includes palms/soles

89
Q

UTI abx in pregnant women

A

Augmentin
Nitrofurantoin
Cefixime/Cefpodoxime

get a urine culture after treatment

90
Q

TB false neg or false pos

A

NAAAAAT

91
Q

who gets MAC?

A
  • middle age/old male smoker w/ lung dz
  • old thin white healthy ladies
  • xray shows nodular bronchiectatic dz
  • similar presentation to TB

Tx: Macrolide, ethambutol, Rifampin
*clarithromycin susceptibility testing is routinely recommended

*can also get it from nonsterile water (hot tub, cosmetic procedures, tattooing, pedicures, trauama, surgery)

92
Q

T/F: serial galactomannan enzyme assay can be followed serially to assess response to therapy for aspergillosis

A

true

93
Q

How do you tx pulmonary aspergillus?

A

ABPA: Steroids
Aspergilloma: Surgical resection. If asx and stable cxr no therapy needed
Invasive (halo sign, GGO , hemmorhage): Voriconazole

94
Q

when to tx asx candiduria?

A

neutropenic patient

invasive urologic procedure

95
Q

biggest risk for candidemia

A

intravascular catheter

96
Q

CD4 count for cryptococcal meningitis and MAC

A

<100, <50 (MAC)

97
Q

how long do you do fluconazole for maintenance in cryptococcal meningitis?

A

so this is after amphotericin and flucytosine

maintenance for 3 months after CD4>100 and viral load suppressed

98
Q

Tx of endemic mycoses

A

Pick itraconazole (except for coccidi is fluconazole)

99
Q

T/F: Use gram stain to dx gonorrheal cervicitis

A

false, use NAAT testing

100
Q

Most common cause of recurrent erythema multiforme

A

HSV recurrences (it triggers the hypersensitivity rxn)

101
Q

T/F: Recurrent oral HSV infection is generally not treated

A

true

102
Q

osteomyelitis after dog/cat bite

A

pasteurella

103
Q

T/F: Pseudomonas common following foot puncture wound

A

true (through rubber sole of a shoe)

104
Q

Imaging of choice for osteomyelitis if MRI is contraindicated

A

nuclear bone scan

105
Q

most common drug induced fever (FUO)

A

anticonvulsants
antibiotics (sulfonamides, beta lactam, nitro)
allopurinol

106
Q

deficiency of which Ig = increased risk for transfusion rxns?

A

IgA def (they develop anti IgA ab). most patients with selective IgA def don’t need tx

*don’t give standard IVIg to patients with isolated IgA def (may have IgG or IgE ab directed against transfused IgA)

107
Q

most common immunodeficiency

A

CVID (may have giardia diarrhea, bronchiectasis, encapsulated bacteria i.e. pneumococcus/haemophilus)

Tx with IVIg

108
Q

What should you screen all patients with recurrent neiserria (meningococcal or disseminated gonnorhea) infections with?

A

CH50 assay and f/u with individual component measures. this looks for complement def

109
Q

med of choice for anthrax

A

cipro. give them the vaccine as well. if its bad or inhalational, cipro + 2 abx

110
Q

T/F: Cryptococcal associated with increased opening pressure

A

true

111
Q

Test this in young patients presenting with herpes zoster

A

HIV

112
Q

T/F: Morbiliform rash in mono patients after ampicillin is an allergic rxn

A

False, patients can subsequently use ampicillin without rash recurrence

113
Q

Maculopapular rash that turns petechial. Low sodium, high LFTs

A

rocky mountain spotted fever. tx with doxy. in pregnant, choose chloramphenicol.

114
Q

severe hemolytic anemia, jaundice, kidney failure, tick born

A

babesia (maltese cross)

115
Q

T/F: Anthrax is a gram positive bacilli has widened mediastinum

A

true

116
Q

T/F: Yersinia gram negative coccobacilli from fleas that causes bubonic plague

A

true. tx with streptomycin and gentamicin.

“Safety pin shape gets streptomycin or gentamicin”

117
Q

tx babesia with

A

atovaquone + azithromyin

118
Q

T/F: Transfusions and asplenia = risk factors for babesia

A

true

UWORLD ABIM (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions