ID

Question 1

Meds that ⬆️ or ⬇️ metabolism of transplant meds like cyclosporine or tacro

Answer 1

⬆️ metabolism (low levels)
- phenobarb. - fospheny
- carbamazepine - rifampin

⬇️metabolism (higher levels)
- abx: clarithro, azithro
- nifedipine, verapamil
- methylpred

Question 2

Organisms causing sinusitis

Answer 2

Strep pneumo-
H flu, nontypeable
M Catarrhalis

Question 3

Organisms causing AOM

Answer 3

Strep pneumo
H flu, nontypeable
M catarrhalis

Question 4

Causes of exudative pharyngitis

Answer 4

Group a strep
Adeno viruses
Epstein-Barr virus
C diphteria
N Gonorrhea

Question 5

DDX for acute bacterial sinusitis

Answer 5

Mucopurulent rhinitis
Allergic rhinitis
Pharyngitis
Nasal foreign body
Adenoiditis
Poor dental hygiene

Question 6

Viral causes of myocarditis
Viral causes of endocarditis
Viral causes of pericarditis

Answer 6

Myo: Enteroviruses, Adenoviruses, influenza, CMV, EBV
Endo: none
Peri: enteroviruses

Question 7

Bacterial causes of
Endocarditis
Myocarditis
Pericarditis

Answer 7

Endocarditis: Strep viridans, strep pneumonia, enterococcus, Staph CONS, gram-negative bacilli
Myocarditis: Staph aureus, salmonella, borrelia burgdorferi [lyme], N meningitidis,
Pericarditis: S aureus, N meningitidis, strep pneumo

Question 8

Endocarditis: Symptoms,signs And lab findings

Answer 8

Symptoms: fever, malaise, anorexia/weight loss, arthralgias
Signs: fever, petechiae, splenomegaly, new or changed murmur, Embolic phenomenal, heart failure
Lab: positive blood culture, ESR, anemia, hematuria, positive RF, low compliment

Question 9

Specific physical exam findings of infective endocarditis

Answer 9

Petechiae
Splenomegaly
Murmur
Osler nodes: painful, red, nodular lesions on pulp of distal digits
Janeway lesions: small, red, nontender areas on palms and soles
Roth spots: retinal hemorrages w central clearing
Splinter hemorrhages
Conjunctival haemorrhages

Question 10

Criteria for clinical diagnosis of infective endo carditis
Modified Duke criteria

Answer 10

2 major criteria Or
1 major+3 minor
or 5 minor

Major: positive blood culture, evidence of endocardial involvement by echo
Minor: 1) predisposing cardiac condition or history of IVDU, 2) fever > 38, 3) vascular manifestations, 4) immunologic manifestations, 5) microbiological evidence is not including the major criteria

Question 11

Antibiotic choice for infective endocarditis

Answer 11

 Amp Tobra +/- vanco

Question 12

Pericarditis ECG findings in stages TV

Answer 12

Stage one: diffuse ST elevation and PR depression
Stage two: normal lazization of STNPR segments