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STEP2 > ID > Flashcards

ID Flashcards

1
Q

AIDS bugs

A

Cryptosporidium parvum
<180 CD4
Chronic diarrhea
Oocysts on acid-fast stool

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2
Q

Viral arthritis path

A

Parvo B19

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3
Q

Viral arthritis hx/pe

A

Daycare worker / kids
Polyarticular, symmetric arthritis @ MCP, PIP, wrists (like RA)
Slapped cheek (kids only)

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4
Q

Viral arthritis dx/tx

A

Normal ESR

Self-resolving in 2months

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5
Q

Disseminated gonococcemia hx/pe*

A 
Often during period
High risk sex practices
Fever, chills
Migratory polyarthralgias
Tenosynovitis
Skin lesions (pustular, hemorrhagic)
Non-swollen joints (unless progressed to septic arthritis)
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6
Q

Disseminated gonococcemia dx/tx*

A

Blood & skin cultures usually negative due to growth requirements

?

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7
Q

Dog/cat/human bite tx

A

Amoxicillin/clavulante

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8
Q

Necrotizing surgical infection hx/pe, dx, tx*

A 
Intense pain
Septic
Reduced sensation
Bullae
Discharge
Crepitus

Don’t culture ==> SURGICAL DEBRIDEMENT

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9
Q

Tetanus ppx*

A

Ig + toxoid: deep (>6cm) or dirty; 3+ vaccines > 5 years ago or less/unknown vaccination

Toxoid only: deep or dirty w/ 3+ vaccines < 5 years ago OR clean/minor w/ 3+ vaccines > 10 years ago

None: clean/minor and 3+ vaccines < 10 years ago

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10
Q

TB path, presentation, dx, precautions*, tx

A

Poor, mexican, incarcerated

Purulent sputum
Hemoptysis
Fever
Weight loss

Reactivation: apical cavitations (look for smaller lung volumes on CT to show apical)

==> IMMEDIATE isolation if suspected…CT afterward

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11
Q

Diabetic foot ulcer management*

A

Any ulcer: requires debridement
Ulcer with cellulitis, abscess or osteo ==> debridement plus IV abc
Ulcer with gangrene ==> amputation

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12
Q

Pneumocystis jirovecii path, presentation, dx, tx

A

Gram ?
Tropism for lung ==> spleen, liver, bone marrow

Immunocompromised host
Dyspnea
NON-productive cough
Fever

Bilateral, perihilar infiltrates

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13
Q

Legionella path, presentation*, dx, tx

A

Non-encapsulated gram negative

Pneumonia + TRIAD:
Fever
GI symptoms
Hyponatremia

Urinary antigen

Macrolide or quinolone

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14
Q

Pneumonia tx* MORE

A

Outpatient: azithromycin, doxycycline

Inpatient:
levofloxacin (not cipro)
clindamycin if aspiration suspicious (alcoholic, stroke, etc.)

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15
Q

Aspergillus path, presentation, dx, tx

A

Fungal infection, often 2/2 underlying disease

Asymptomatic
Hemoptysis
Fever / malaise

CXR: cavitary lesions, mobile* with position change 2/2 debris, air crescent*

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16
Q

Histoplasmosis path w/ geography, presentation*, dx, tx

A

Dimorphic fungus

Ohio and Missippi river valleys
Central America

Usually asymptomatic
Or fever, chills, NON-PRODUCTIVE cough

XR: multiple calcified nodules (lung > spleen)

Local: flucanazole or ketoconazole
Systemic: amphotericin B

17
Q

Ameba path, presentation, dx, tx

A

Solitary abscess, usually liver > lung > brain
Travel history

Metronidazole
DON’T drain

18
Q

Blastomycosis path, geography, presentation, dx, tx

A

Dimorphic fungus

Mississippi and east… not just NE!

Constitutional fever, night sweat, weight loss
Productive cough
Upper lobe lesions
SKIN AND BONE LESIONS!* ==> differentiates from histo and TB

?

Local: fluconazole or ketoconazole
Systemic: amphotericin B

19
Q

Coccidioidomycosis path, geography, presentation, dx, tx

A

Dimorphic fungus

Southwest

Pneumonia
Meningitis
Skin / bone infection

?

Local: fluconazole or ketoconazole
Systemic: amphotericin B

20
Q

Paracoccidioidomycosis path, geography, presentation, dx, tx

A

Spherule

Latin America

Severe pneumonia

?
?

21
Q

Gram negative pneumonia ddx: bugs, presentations, dx

A
  1. E. coli
    Non-encapsulated gram negative bacillus
    Nosocomial pneumonia
2.  Klebsiella 
Encapsulated gram negative bacillus
Alcoholics, nosocomial
Currant jelly sputum
XR:  upper lobe
Culture:  mucoid colonies
  1. Legionella
    Non-encapsulated gram negative bacillus
    Pneumonia + fever, GI upset, hyponatremia
  2. Pseudomonas
    Encapsulated gram negative bacillus
    Nosocomial, CF patients, AIDS, bronchiectasis, neutropenia

X: Enterobacter, Proteus, Serratia

22
Q

Rotavirus path, presentation, dx, tx, tx contraindication*

A

Fecal-oral GI infection

Watery osmotic diarrhea

Clinical?

Live attenuated vaccine
==> don’t administer if hx of intussusception or other GI malformation

STEP2 (16 decks)

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