ID

Question 1

pt in hemodyalisis has fever and neutrophilia but no signs of infection - management

Answer 1

vanco + cefepime

do not remove catheter

Question 2

when to remove catheter in HD pts with fever

Answer 2

1. severe sepsis
2. unstable
3. metastatic infection (endoc)
4. pus a tthe exit site of catheter
5. symptoms after 72 hours of empiic

Question 3

syphillis + neuro symptoms

Answer 3

LP

Question 4

syphilis treatment

Answer 4

primary, secondary, early latent (less than 12 months): IV single penicillin
late latent (more than 12 mths), uknown or gumatus CV: 3 IV penicillin

Question 5

neurosyphilis treatment

Answer 5

IV peniciilin q4 for 2 wks

Question 6

com acq pneumonia - outpatient treatment

Answer 6

amoxc or doxyc (healthy

fluoro or betam lactam + macrolide (comorb)

Question 7

com acq pneumonia - inpatient treatment

Answer 7

Fluoroquinolone (IV)

beta lactam + macrolide

Question 8

com acq pneumonia - icu treatment

Answer 8

Fluoroquinolone (IV) + macrolide

beta lactam + macrolide

Question 9

respi fluoroquin

Answer 9

levo / moxi

Question 10

Curb 65 criteria

Answer 10

1. confusion
2. urea more tha 20
3. resp more than 30
   BP less than 90 or 60
   age more than 65
   0-1: outpatient
   2: admit
   3-5: ICU

Question 11

medical personel + for TB skin test and clean chest - next

Answer 11

can go back to work

Question 12

HIV positive - what to step before start anti-retrovial

Answer 12

HBV (some treatments target both)

Question 13

TB medications SE

Answer 13

Rifampin: GI, orange urine, rash, cytpenias
Isoniazide: neuropathy, liver
Pyrazinamide: Liver, uric acid
Ethambutol: optic neuropathy

Question 14

TB exposure - what to do

Answer 14

skin test now and in 10 wks

Question 15

latent tb treatment

Answer 15

rifambin 4 months

Question 16

Diagnostic criteria for acute bact rhinosinusitis

Answer 16

any of the following

1. symptoms more than 10 days witout improvement
2. severe symptoms (high fever more than 39,, purulent discharge, fascial pain more than 3 days
3. worsening symtpoms more than 5 days after initial improvement of viral URI

Question 17

acute bact rhinosinusitis - treatment

Answer 17

amox / clav

altern: fluoroquin or doxo

Question 18

Exposure to HBV - managment

Answer 18

immunized: nothing
nonimmunized: Globulin and vaccine
No antiretrovirals for prophylaxis

Question 19

how many medications for HIV prophylaxis

Answer 19

3

4 weeks

Question 20

HIV associated thrombocytopenia - tretment

Answer 20

anti-retrovirals

Question 21

Inpatient zoster - what precautions

Answer 21

standard for localized disease

contact and airborn if dissaminated

Question 22

IM with airway obstruction

Answer 22

admitt and steroids

Question 23

nasal packing patient with shock and fever

Answer 23

toxic shock syndrome

Question 24

sporotrichosis - treatment

Answer 24

intraconazole

Question 25

role of skin test in TB

Answer 25

can diagnose latent but not active

Question 26

ifn rease in TB

Answer 26

cannot differentiate active from latent

Question 27

invasive pulm aspergilosis diagnosis

Answer 27

1. CT chest: nodules with ground glass opacity (halo sign) and cavitations with air fluid levels
2. serum biomarkers: galactomannan, beta-d-glucan
3. sputum sampling for fungal stain and culture

Question 28

cutaneous cryptococcosis

Answer 28

advance HIV (less than 100)
rapid onset of multiple papular lesions with a central umbilication and central hemorrhage necrosis
REQUIRES BIOPSY

Question 29

PCP with high alv - arterial gradient (more than 35) or O2 less than 70

Answer 29

steroids

Question 30

HIV TMP SXM prophylaxis

Answer 30

to prevent PCP if lower than 200 and toxop if lower than 100