ID

Question 1

Diagnosis and treatment of invasive aspergillosis

Answer 1

Get galactomannan antigen. Treat with voriconazole first line. Ampho is second line

Question 2

Coccidiodomycosis

Answer 2

SW US and Central and S America. Respiratory symptoms can also develop erythema nodosum. Treat with ketoconazole, fluconazole or itraconazole. If severe ampho. Fluconazole for mengitis.

Question 3

Blastomycosis

Answer 3

Mississippi River and Ohio River basin. Broad based budding. Treat with itraconazole PO if mild, if severe ampho first. Can also have cutaneous lesions.

Question 4

Histoplasmosis

Answer 4

Same area as Blasto (Ohio and Miss river valley). Itra for mild, ampho for severe. If patient is healthy might not even need to treat.

Question 5

Common cause of hemorrhagic colitis

Answer 5

Shiga producing E coli (no fever)

Question 6

Campylobacter

Answer 6

Diarrhea, FEVER, abdominal pain, several days after exposure. Reactive arthritis and GB can develop

Question 7

Nosocomal meningitis

Answer 7

Vancomycin + Meropenum (agent that is active against resistant gram negatives)

Question 8

EBV post transplant

Answer 8

Usually presents with lymphadenopathy, EBV associated posttransplant lymphoproliferative disease

Question 9

Pyrazinamide side effects

Answer 9

Elevated uric acid
Hepatitis
Rash
GI upset

Question 10

Isoniazide side effects

Answer 10

Rash
Peripheral neuropathy
Hepatitis
Lupus like syndrome

Question 11

Rifampin side effects

Answer 11

Rash
hepatitis
GI upset
Orange body fluids

Question 12

MAC infection

Answer 12

Need 2 positive cultures even with CT evidence of disease

Seen in people with underlying lung disease AS well as healthy middle aged women

Question 13

Empiric therapy of candidemia

Answer 13

Caspofungin

Question 14

Lyme testing results

Answer 14

Start with ELISA, if positive then go with Western Blot. If IgM is positive and IgG is negative and symptoms have been present for >1 month it is likely that it is a false positive

Question 15

Tb pericarditis

Answer 15

4 drug regimen (firampin, isoniazid, pyrazinamide, ethambutol) as well as steroids (do not give steroids in other forms of pericarditis)

Question 16

Dx of fungal arthritis

Answer 16

Requires a synovial biopsy

Question 17

Strep pneumonia bacteremia

Answer 17

Only need to treat for 7-10 days

Question 18

Tb skin testings and BCG vaccination

Answer 18

• interpret as if they did not get it as long as >10 years prior
• Interferon gamma release assay will NOT be effected by vaccination

Question 19

Dx of pleural Tb?

Answer 19

If culture are negative proceed to pleural biopsy

Question 20

PCP pneumonia complications?

Answer 20

Can result in pneumothorax

Question 21

Severity of PCP PNA?

Answer 21

Severe A-a >35 mmHg and PO2

Question 22

Rocky mountain spotted fever tx

Answer 22

Doxy

If pregnant chloramphenicol

Question 23

Babesiosis treatment?

Answer 23

Quinine and clindamycin
OR
Atovaquone and azithromycin

Question 24

Malaria treatment during pregnancy

Answer 24

Okay to use: quinine, chloroquine, mefloquine

Do not use: tetracylines, primaquine

Question 25

Babesiosis

Answer 25

Can have hemolytic anemia as it infects RBCs

Question 26

Ehrlichiosis and anaplasmosis

Answer 26

Both infect leukocytes, so can have leukopenia (also thrombocytopenia)

Question 27

Treatment of toxo

Answer 27

sulfadiazine, pyrimethamine and folic acid