ID 14

Question 1

What happens during the latent phase of HIV infection?

Answer 1

Virus replicates in lymph nodes.

Question 2

Time course of untreated HIV infection

Answer 2

1) First couple months = Acute phase – flu-like symptoms. CD4 count drops. Viral load rises. Wide dissemination of virus. Seeding of lymphoid organs.
2) 2 months - 8 years = clinical latency. Feeling fine.
3) Falling t-cell count with constitutional symptoms
4) Final crises – opportunistic diseases (9-10 years).

Question 3

moderate immunocompromised with AIDS

Answer 3

less than 400 CD4+ cells/mm

Question 4

JC virus on imaging

Answer 4

Nonenhancing areas of demyelination on MRI

Question 5

aspergillus HIV presentation

Answer 5

hemoptysis + pleuritic pain

Question 6

candida presentation in aids patient with T cell count below 100

Answer 6

esophagitis

Question 7

Histoplasma presentation in AIDS patient with T cell count below 100

Answer 7

fever, weight loss, fatigue, cough dyspnea, nausea vomiting diarrhea

Question 8

M avium presentation in AIDs patient with T cell count below 100

Answer 8

fever, night sweats, weight loss or focal lymphadenitis

Question 9

t gondii presentation in AIDs patients

Answer 9

brain abscesses

Question 10

aspergillus findings in AIDs patient

Answer 10

cavitation or infiltrates on chest imaging

Question 11

CNS lymphoma in AIDS patient findings

Answer 11

ring enhancing

Question 12

differentiating CNS lymphoma from toxoplasma

Answer 12

CNS lymphoma usually solitary vs. toxoplasma

Question 13

Histoplasma path finding

Answer 13

oval yeast cells within macrophages

Question 14

variant CJD

Answer 14

CJD transmitted through food contaminated by BSE-infected animal products

Question 15

How do you kill prions?

Answer 15

can’t autoclave.

Question 16

location of s mutans

Answer 16

dental plaque

Question 17

flora of neonates delivered by C-section

Answer 17

No flora but are rapidly colonized after birth.

Question 18

Food poisoning that starts early and ends early?

Answer 18

1) s aureus

2) b cereus

Question 19

c perfringens source

Answer 19

reheated meat

Question 20

salmonella sources

Answer 20

poultry
*meat
eggs

Question 21

s aureus sources

Answer 21

*meats
*mayonnaise
custard

Question 22

campylobacter shape

Answer 22

comma or S-shaped

Question 23

salmonella lactose?

Answer 23

negative

Question 24

c diff GI presentation?

Answer 24

watery; occasionally bloody

Question 25

protozoa causing watery diarrhea?

Answer 25

giardia | cryptosporidium

Question 26

C perfringens diarrhea type

Answer 26

watery

Question 27

viruses diarrhea type

Answer 27

watery

Question 28

salmonella diarrhea type

Answer 28

bloody

Question 29

EIEC diarrhea type

Answer 29

bloody

Question 30

most common causes of pneumonia in neonates (less than 4 weeks old)

Answer 30

GBS | e coli

Question 31

most common causes of pneumonia in children (4 week - 18 years)

Answer 31

Viruses (RSV) Mycoplasma S pneumonia

Question 32

most common causes of pneumonia in adults (18-40)

Answer 32

Mycoplasma C pneumonia S pneumonia Viruses (influenza)

Question 33

most common causes of pneumonia in adults (40-65)

Answer 33

``` S pneumonia H flu Anaerobes Viruses Mycoplasma ```

Question 34

most common causes of pneumonia in elderly

Answer 34

``` S pneumonia Influenza virus Anaerobes H flu Gram negative rods ```

Question 35

common causes of pneumonia in alcoholics

Answer 35

Klebsiella | *Anaerobes (eg, peptostreptococcus, fusobacterium, prevotella, bacteroides)

Question 36

common causes of pneumonia in IV drug users

Answer 36

1) s pneumoniae | 2) s aureus

Question 37

most common causes of atypical pneumonia

Answer 37

mycoplasma, *legionella, chlamydia

Question 38

common causes of pneumonia in CF

Answer 38

pseudomonas * s aureus * s pneumonia * burkholderia cepacia

Question 39

common causes of pneumonia in immunocompromised

Answer 39

``` *s aureus enteric gram negative rods fungi viruses P jirovecii with HIV ```

Question 40

Causes of meningitis in newborns (0-6 months)

Answer 40

GBS E coli Listeria

Question 41

Causes of meningitis in children (6 mo-6 years)

Answer 41

S pneumonia N meningitides H flu type B enteroviruses

Question 42

Causes of meningitis in 6-60 yr

Answer 42

S pneumo N meningitis enteroviruses HSV

Question 43

Causes of meningitis in 60+

Answer 43

S pneumo gram negative rods listeria

Question 44

meningitis managment

Answer 44

ceftriaxone and vanco empirically (add ampicillin if Listeria is suspected)

Question 45

Viral causes of meningitis

Answer 45

``` Enteroviruses (coxsackie) HSV-*2 HIV WNV VZV ```

Question 46

When is H influenza usually seen?

Answer 46

unimmunized children.

Question 47

Differentiating bacterial from fungal/TB meningitis

Answer 47

cell type

Question 48

opening pressure in viral meningitis

Answer 48

normal or slightly elevated

Question 49

CD4 count with HIV Dementia

Answer 49

200

Question 50

CD4 count with Bacillary angiomatosis

Answer 50

500

Question 51

CD4 count with JC virus/PML

Answer 51

200

Question 52

CD4 count with aspergillus

Answer 52

100

Question 53

CD4 count with t gondii

Answer 53

100

Question 54

CD4 count with Kaposi sarcoma

Answer 54

500

Question 55

CD4 count with Pneumocystis jirovecii

Answer 55

200

Question 56

CD4 count with cryptosporidium

Answer 56

500

Question 57

CD4 count with Candida

Answer 57

500

Question 58

CD4 count with M avium

Answer 58

100

Question 59

CD4 count with histoplasma

Answer 59

100

Question 60

CD4 count with HPV (squamous cell carcinoma)

Answer 60

500

Question 61

CD4 count with cryptococcus

Answer 61

100

Question 62

CD4 count with CMV

Answer 62

100

Question 63

CD4 count with oral hairy leukoplakia (EBV)

Answer 63

500

Question 64

CD4 count with B-cell lymphoma

Answer 64

100

Question 65

Most common cause of pneumonia in infants - 3 yr?

Answer 65

C trachomatis

Question 66

Most common cause of pneumonia in school aged children?

Answer 66

C pneumonia