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ID Flashcards

1
Q

What drugs cover MRSA?

A

daptomycin
linezolid
vanc
bactrim

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2
Q

Describe coverage of doxycycline

A

good for outpatient CAP

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3
Q

Describe cipro coverage

A

good gram neg coverage

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4
Q

What is the drug of choice for pneumocystis pneumonia?

A

TMP + SMX

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5
Q

What is the coverage of ampicillin and gentamicin

A

good against gram negative aerobes, used for abdominal infections

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6
Q

What is the treatment for a patient with latent TB? (no chest X ray findings)

A

9 months of treatment with isoniazid

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7
Q

what is the treatment for a tick found 24 hours after a hike?

A

doxycycline

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8
Q

What are the side effects of INH and how can they be prevented?

A

neuropathy - give pyroxidine

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9
Q

A patient shows up with fever, sore throat and thumbprint sign on lateral films. What should be your next steps?

A

admit to ICU and ENT consult

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10
Q

A type 2 diabetes patient complains of ear pain with purulant discharge. This is likely…

A

pseudomonas aeruginosa

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11
Q

A patient presents with fever, headache, retro-orbital pain, severe musculoskeletal pain and rash after travel to the Carribean. Wht is this and what causes this?

A

this is the immunologic phase of dengue (also get aseptic meningitis, HSM). caused by leptospirosis, a spirochete

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12
Q

A patient presents with influenzea illness, abdominal discomfort, constipation and some bloody diarrhea. they later develop rose colored macules. This is…

A

typhoid fever

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13
Q

A patient is suspected to have active TB. What should be your next steps?

A

respiratory isolation, sputum culture/AFB stain to confirm

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14
Q

What are the stages of lyme disease?

A

stage 1: erythema migrans,
stage 2: facial nerve palsy
stage 3: recurrent and destructive oligocarticular arthritis

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15
Q

What is the appropriate course of tx for uncomplicated cystitis?

A

3 days trimethoprim -sulbactam

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16
Q

A patient presents with low back pain after tx for pyelonephritis. What study should you do next?

A

MRI for osteo - commonly hematogenous spread to spine

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17
Q

What is the presentation of yersinia enterocolitica?

A

fever, abdominal cramps, no diarrhea - pseudoappendicitis

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18
Q

A patient presents with papules, vesicles and scabs in various stages of development. It is accompanied by pneumonia like process. This is

A

chickenpox

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19
Q

A patient with PMH HIV pw CD4 count 50, chronic bloody diarrhea. Biopsy shows large cells with eosinophilic intranuclear inclusions. This is likely…

A

CMV

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20
Q

A patient with HIV presents with bloody diarrhea and flask shaped colonic ulcers. This is…

A

entameba histolytica

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21
Q

A patient who was in septic shock presents with symmetric duskiness and coolness in the fingertips. This is likely caused by…

A

norepinephrine induced vasospasm

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22
Q

A patient in the south presents with tick bite, febrile illness, leukopenia and thrombocytopenia as well as elevated liver enzymes. This is …

A

ehrlichiosis

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23
Q

C3 deficiency predisposes patients for..

A

recurrent bacterial infections

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24
Q

C5-C8 deficiencies predispose patients for…

A

recurrent neiserria infections

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25
Q

Phagocytic deficienices (chronic granulomatous disease, etc) predipose patients for…

A

pyogenic bacterial infections

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26
Q

What vaccines should not be given to HIV positive patients?

A

BCG, anthrax, oral thyphoid, polio, varicella, zoster

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27
Q

A diabetic patient presents with right sided nasal congestion, necrosis of the right nasal turbinate and tenderness of the maxillary sinus as well as chemosis and proptosis. This is likely caused by…

A

rhizopus species - mucormycosis

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28
Q

What organisms most frequently cause osteomyelitis?

A

staph, pseudomonas

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29
Q

What antibiotic regimen can cover human bites?

A

amoxicillin clavulonate

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30
Q

What is the drug of choice for legionella?

A

erythromycin

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31
Q

What is the antibiotic regimen recommended for patients with febrile neutropenia?

A

IV cefipime - should cover pseudomonas

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32
Q

a patient presents with fatigue, fever, muscle aches. PBS shows large basophilic lymphocytes with vacuolated appearence. this is…

A

CMV

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33
Q

A patient with diabetes presents with slow growing non tender mass in the face with yellow pus. Culture shows gram pos branching bacilli. Tx with?

A

penicillin - this is cervicofacial actinomyces

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34
Q

A patient presents with fever and crusting lesions following an injury in the garden. What is the tx?

A

trimethroprim sulbactam for Nocordia (aerobic filamentous gram + rod)

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35
Q

A patient with cats presents with a rash over the right hand (pruritic vesicles) and swollen lymph nodes in the axilla. Positive Warthin Starry stain. Tx with

A

azithromycin for 5 days- this is cat scratch disease caused by bartonella hensale

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36
Q

What are the characteristics for pneumonias that should be hospitalized?

A

Confusion Uremia RR>30, BP65

37
Q

A patient with AIDs from Ohio presents with fever, fatigue, weight loss, cytopenias, lymphadenopathy, and hepatosplenomegaly. What test should you order next and what treatment is preferred?

A

urine antigen test for Histoplasma - prescribe intraconazole

38
Q

A patient presents with DM presents with painful swelling of her face as well as a warm tender red rash. What is this?

A

Erypselas - a specific type of cellulitis that affects epidermis. Caused by streptococcus

39
Q

A patient presents with recurrent gross hematuria, proteinuria and sensorineural deafness as well as a history of renal disease. This is..

A

Alport’s syndrome

40
Q

What medications are recommended for HIV patients?

A

influenza, hep B, pneumococcal, Hep A if MSM

41
Q

Describe Tdap vaccination

A

TDAP and a booster ever 10 years afterward

42
Q

A patient presents with chronic foul smelling stools after a trip to south America. Tx?

A

metronidazole - for tx of giardia

43
Q

A patient presents with cramps, gas and fatigue and biopsy shows blunting of villi with chronic inflammatory cells. This is..

A

tropical sprue

44
Q

A patient who is HIV pos. presents with hematuria and needle shaped crystals likelly caused by..

A

indinavir (protease inhibitor)

45
Q

What is a common life threatening side effect of didanosine? (reverse transcriptase inhibitor)

A

pancreatitis

46
Q

What is a common lt effect of abacavir?

A

hypersensitivity syndrome

47
Q

What are common lt effects of NRTIs? (nucleoside reverse transcriptase inhibitors)

A

lactic acidosis

48
Q

What are common lt effects of NNRTs? (non nucleoside)

A

steven johnson

49
Q

What is a common lt effect of nevirapine? (NNRTI)

A

liver failure

50
Q

A patient presents with symptoms of IE, a congenital heart murmer and no drug use. What valvular disorder is there?

A

mitral regurg

51
Q

Severe odynophagia in an HIV infected patient is likely due to …

A

viral esophagitis

52
Q

A patient with HIV presents with linear ulcers. this is… (how do you treat it?)

A

CMV esophagitis - treat with ganciclovir

53
Q

What medications are effective against pseudomonas?

A

pip tazo, azneotram, cipro, carbapenum, tobramycin, gentamicin, amikacin

54
Q

A patient presents with a painless ulcer on his hand while gardening that eventually becomes ulcerated. He then has subcutaneous nodules extending up his right forearm. This is..

A

sporotrichosis

55
Q

A patient presents with fever, weight loss and malaise in addition to several exophytic purple skin lesions on his abdomen and CT showing intrahepatic lesions. This is..

A

bartonella - bacillary angiomatosis

56
Q

What malaria chemoprophylaxis should be used in areas with chloroquine resistant malaria?

A

mefloquine, doxy, atovaquone

57
Q

What malaria chemoprophylaxis should be used in areas without P. falciparum?

A

primaquine

58
Q

A patient was recently taking cipro and noticed achilles tendon pain.

A

fluoroquinolones are associated with tendinopathy

59
Q

A patient shows up with elevated white count in the CSF, normal glucose, normal opening pressure and elevated protein in the setting of altered mental status, and a high fever. There are no organisms present in CSF. this is..

A

viral meningitis

60
Q

A patient presetns with difficulty swallowing as well as vesicles and round ulcers. This is…

A

herpes simplex virus - treat with acyclovir

61
Q

A patient presetns with severely pruritis lesions on his hands after changing the sand in the sandbox. The pruritic papules progress to serpinginous reddish brown lesions evident on the upper extremities. This is..

A

cutaneous larva migrans - helminthic disease (hookworm)

62
Q

Describe tx recommendations for the flu

A

treat all confirmed or suspected within 48 hours or if at high risk of complications

63
Q

What are the centor criteria?

A

tonsillar exudates, tender cervical lymphadenopathy, fever, absence of cough

64
Q

A patient who recently traveled to Arizona presents with low grade fever, joint pain, dry cough and chest pain. He has tender nodules on both legs. This is…

A

coccidiomycosis

65
Q

A patient who recently traveled to Mexico presetns with fever, malaise, weakness and unintentional weight loss. He has pleuritic chest pain and left pleural effusion as well as splenomegaly with splenic fluid. What is the cause?

A

endocarditis causing splenic abscess

66
Q

A pig farmer presents with headaches and seizures and is found to have fluid filled cysts in his head. This is..

A

neurocystericosis - occurs when humans consume eggs of T solium and larvae spread hematogenously

67
Q

A patient is discovered to have cryptococcal meningitis - how long should you wait before initiating antiretroviral therapy?

A

at least 2 weeks to px immune reconstitution syndrome

68
Q

A patient presents with elevated opening pressure and CSF shows encapsulated yeast. What treatment should be initiated?

A

cryptococcus - amphoteracin plus flucytosine

69
Q

What drugs can cause crystal induced kidney injury and how can it be avoided?

A

acyclovir, methotrexate, ethylene glycol, protease inhibors

70
Q

A patient presents with dysuria and increased urinary frequency, multiple sexual partners. urine culture shows less than 100 colonies. this is..

A

chlyamdial urethritis

71
Q

A patient presents with hematuria following a respiratory infection. How can IgA nephropaty be distinguished from post infectious glomerulonephritis?

A

IgA nephropathy - presents immediately afterwards

post infections - presents a few days later

72
Q

A patient presents with pharyngitis, low grade fever, nasal discharge. there are pseudomembranes on the pharynx. this is..

A

diptheria

73
Q

A patient with HIV presents with difficulty hearing. exam shows a hypomobile tympanic membrane. this could be due to..

A

a noninfectious effusion - otitis media from lymphadenopathy

74
Q

A non-compliant diabetic patient presents with difficulty eating and ear discharge. exam shows ear granulations. she has facial assymetry and mouth downward droop. this is..

A

malignant otitis externa from pseudomonas

75
Q

What is Ludwig’s angina?

A

infection in the submandibular space that can extend to the airway

76
Q

What are the major complications of an infection in the parapharyngeal space?

A

involvement of carotid sheath, jugular thromblophlebitis

77
Q

A patient presetns with progressively worsening sore throat, a harsh shrill on respiration, and palpable cervical lymph nodes. This could be..

A

epiglottitis caused by H. Flu or Strep pyogenes

78
Q

A patient presents wtih blood and sputum cultures that grow partially acid fast gram positive branching rods - this is…

A

nocordia - tx with trimethoprim - sulfa

79
Q

A patient presents with severe vomiting, diarrhea and dizziness. she had nasal bleeding that required packing 3 days ago and recently started feeling pressure under her eye. He has diffuse erythematous macules on her trunk and thrombocytopenia. this is..

A

toxic shock syndrome

80
Q

A patient presents with fever, nausea, vomiting and a maculpapular rash on the hands and soles. Suspect

A

rocky mountain spotted fever

81
Q

A young child presents with fever, headache sore throat. Over time, fine blanching papules appear all over the neck and trunk. This is..

A

scarlet fever

82
Q

A patient has primary syphillis - what are the options for tx if he’s allergic to penicillin?

A

doxycycline

83
Q

What is the preferred tx for herpes zoster?

A

valacyclovir or acylclovir

84
Q

A patient without a spleen presents with body aches, fevers, loss of appetitie as well as hemolytic anemia. This could be…

A

babesiosis - RBC parasite

85
Q

A patient presetns with HIV and a CD4 count of less than 30. She’s on antiretrovirals - what else should be added to the regimen?

A

azithromycin for MAC coverage

86
Q

What is the tx for MAC complex?

A

clarithromycin and ethambutol

87
Q

An HIV pos patient presents with acute onset high grade fever and pleural effusion. Suspect…

A

streptococcus pneumoniae

88
Q

An immunocompromised patient presents with fever, dyspnea and the “halo sign” on CT - this is..

A

aspergillosis

89
Q

A patient presents with diffuse watery diarrhea 7 days after surgery. What is the best test ot diagnose? What is the best course of tx?

A

dx with c diff toxin, tx with metronidizole

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