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1
Q

Occurs in South and Southeast Asia. Flu-like febrile illness, myalgias, joint pains, HA and Retro-Orbital Pain, Rash, petechial, thrombocytonepia, elevated LFTS. Dx? Rx?

A

Dengue Fever. Supportive Care.

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2
Q

Fever, anemia, splenomegaly, cerebral endema can occur. Dx? Rx?

A

Plasmodium Falciparum Malaria.

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3
Q

Intestinal perforation is a complication of this condition, fever, chills, bradycardiac, Abdominal Pain, Rose Spots. Dx? Rx?

A

Typhoid Fever.

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4
Q

Associated with outpatient exposure, Fresh water swimming, household pets. GI symptoms, Conjunctival suffusion, Juanidce, renal failure.

A

Leptospirosis. Jaundice and renal failure is Weils syndrome.

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5
Q

Infection arises in soil and organic matter, associated with outdoor activities or occupations. Starts as a papular lesion then ulcerates over time, non purulent dishcarge. Dx? Rx?

A

Sporotrichosis (fungal infection). Itracanazole.

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6
Q

Candidal infeciton that can cause pneumonia or manifest on skin and bones. Dx?

A

Blastomycosis.

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7
Q

Associated with cervicofacial disease (gingivitis, dental caries, extraction). Humans are the only reservoir. Dx?

A

Actinomycosis.

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8
Q

Airbone fungus that causes cough, hemoptysis and erythema nodosum.

A

Coccidioidmycosis.

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9
Q

Rx for Mild C. diff? Rx Severe? Rx if patient has illeus? Rx? for Toxic megacolon?

A

Oral flagyl. PO Vanc (and IV flagyl). IV flagyl and Rectal Vanc. Surgery.

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10
Q

Fever, hypotension, swelling and erythema of leg. Pain out of proportion to findings. Dx? Rx?

A

Necrotizing Fascitis. Urgent Surgical debreidement and abx (Zosyn or Carbepenem +Vanc +Clindamycin)

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11
Q

Fever, pharyngitis, posterior or diffuse cervical lymphadenapathy, hepatosplenomegaly. Dx? What is a possible complication after treatment?

A

Infectious Mononucelosis. Viral exanthema after improper administration of abx, immune mediated due to antibodies to penicillin.

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12
Q

Associated with foreign body insertion, pt become febrile, lethargic, tachy, hypotensive Dx? Rx?

A

TSS. Clindamycin (prevents release of staph exotoxin) +/- Vanc

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13
Q

What is the appropriate antimicrobial ppx to give pts who have been in close contact with a pt with neisseria meningitidis?

A

Rifampin, cipro, ceftriaxone

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14
Q

Fever, cervical and occipital lymph nodes, maculopapular rash that begings on face and spreads caudally.

A

German measles Rubella. Supportive rx.

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15
Q

Fever, malaise, HA, petechial rash that begins on the distal extremities palms and soles and then spreads to trunk.

A

Rocky Mountain Spotted Fever.

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16
Q

High fever that rapidly resolves. Then eruption of rosy non pruritic rash that begins on trunk and spreads to extremities.

A

Roseola.

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17
Q

Severe illness associated with cough, conjunctivitis and coryza, blue-white koplik spots found on buccal mucosa. Rash that begins on face and spreads down.

A

Measles.

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18
Q

Occurs in HIV pt with CD4 count < 100 charastetic lesion is umblicaiton with central necrosis resembling molluscum contagiousum. Dx?

A

Disseminated Cryptococcus. Cutaneous Cryptococcus

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19
Q

Pt underwent appendectomy now presents 2 weeks later with swinging fever, cough and shoulder pain. Dx? Next step in management?

A

Possible intra abdominal abscess or subphrenic abscess. Get US.

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20
Q

What is the next step in mangement when health care workers have been exposed to a TB pt whose results come back positive on aFb?

A

PPD if first result negative then repeat PPD in 3 months.

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21
Q

CSF analysis for bacterial meningitis ?

A

WBC > 1,000 Glucose <40 Protein > 250 (low glucose, high protein)

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22
Q

CSF analysis for viral meningitis ?

A

WBC 100-1,000 Glucose > 40 Protein <100 (normal glucose, low protein)

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23
Q

CSF analysis for TB meningitis ?

A

5-1,000 Glucose <10 Protein>250 (very low glucose, high protein)

24
Q

Immunocompromised pt, HIV develops focal neurological deficits MRI shows non-enhancing demyleinating lesions. Dx?

A

PML. CNS lymphoma and Toxo have ring enhancing lesions.

25
Q

Pt has watery discharge and no organism seen on gram stain. Dx? Rx?

A

Urethritis. Chlamidya. Azithromycin po 1g x1 or doxy for 7 days. Co infection is common so treat with ceftriaxone im x 1 for gonnorrhea.

26
Q

Appropriate abx for pregnant UTI pts ? For pregnant pylonephritis pts?

A
  1. Amoxicillin, Nitrofurantoin, Keflex. 2. IV ceftriaxone, ampcillin, gentamicin.
27
Q

Occurs in children during the summer, characterized by painful red vesicles in the posterior oropharynx. Dx?

A

Herpagina from Cocksackie A virus.

28
Q

How do you treat an infant born to Hepatitis B mother?

A

Give immunoglbulin and Vaccine after the birth. 2nd vaccine at 2 months and 3rd at 6 months then check titers at 9 months.

29
Q

Bone marrow transplant p/w pulmonary symptoms and nasal bleeding/congestion. Dx?

A

Invasive aspergillous

30
Q

Treatment for latent TB?

A

Isoniazid and Rifapantine weekly for 3 months (not recommended in HIV pts) Isoniazid for 6-9 months, isoniazid and rifampin for 4 months

31
Q

Rx for CF pt with pneumonia?

A

Cefepime, Amicakin (2 drugs against pseudomonas) + Vanc if pt has hx of MRSA.

32
Q

Pt who was previously vaccinated against rabies gets a cat bite. Whats the management?

A

Give vaccine only. If no prior immunization, then vaccine and immunoglobulin are needed.

33
Q

Rx for cat scratch disease?

A
  1. Azithromycin to kill Bartonella Henselea
34
Q

Difference between Rubella (German Measles) and Rubeola (Measles)

A

Rubeola has higher fevers and darker rash.

35
Q

Rx for strept pharyngitis? Dx?

A

Amoxcillin. Fever, Exudate, Cervical lymphadenopahthy, No cough. Centor criteria. Rapid strept, if negative then throat culture.

36
Q

Rx for uncomplicated pediatric pneumonia?

A

Amoxcillin.

37
Q

Rx for PID?

A

IV ceftriaxone/cefoxitin and IV doxy

38
Q

Common viruses that cause menigitdits and encephalitis in children?

A

Arbo or Enterovirus.

40
Q

Rx for endocarditis?

A

Vanc + gent

41
Q

Man developes fever, fatigue, myalgia, sore throat, lymphadenopathy, painful mucocutaenous ulcre and generalized rash (including palms and soles), leukopenia, thrombocytopenia 2 weeks after sexual encounter. Dx?

A

Acute HIV viral infection

42
Q

pt w/ multiple sex partners p/w fever, malaise, N/V, increase AST/ALT, enlarge liver. Dx?

A

Acute Hep B infection

43
Q
  1. Rx for 1st recurrence CDI? 2. 2nd recurrence? 3. Subsequent recurrences?
A
  1. Flagyl 2. Po Vancomycin 3. Fidoxamicin, fecal transplant
44
Q

Management of pregnant pt with Heb B infection.

A

Antiviral therapy and vaccination to mom. Vaccination and IVIF w/in 12 hrs for neonate.

45
Q
  1. Rx for Primary, Secondary and early latent syphilis 2. Rx for late latent syphilis? 3. Rx for neurosyphilis? Complication of rx?
A
  1. Pen G IM single dose 2. Pen G IM weekly for 3 weeks 3. Aqueous Pen G 4. Jarisch-Herxheimer reaction (supportive care)
46
Q

Fever, mayagias, athralgias, splenomegaly, glomerulonephritis (hematuria, proteinuria) + RF, splinter hemorrhages, janeway lesions. Dx?

A

Infective Endocarditis

47
Q

Dysuria, frequency, hematuria, eosinophilia in emigrant from US. Dx? Test? Rx?

A

Schistosomiasis. Urine sediment microscopy. Praziquental

48
Q

Rx for latent TB in adults? In kids ?

A

Isoniazid for 9 months in children and adults. Rifampin for 6 months in kids and 4 months in adults.

49
Q

Rx for post-exposure prophylaxis for HIV ?

A

2 nucleoside (tenovir, emtricitabine, lamuvidine, zidovudine) + 1 non-nucleoside (ripilivirine), integrase inhibitor raltegravir, protease inhibitor( atazanavir, ritonavir) w/ 72 hrs give it, continue for a month

50
Q

Flu like illness, myalgias, joint pain, retro-orbital pain, rash, thrombocytoenpia, petechia. Dx? Management?

A

Dengue Hemorrhagic fever. Supportive care.

51
Q

Associated with occupational eposure, fresh water swiming, conjunctival suffusion, GI symptoms, Jaundice, hepatosplenomegaly. Dx?

A

Leptospirosis

52
Q

fever, chills, abdominal pain, rose spots (faint-salmon-colored macules on trunk and abdomen) Dx?

A

Typhoid fever.

53
Q

Chorioretinitis, intracranial calcifications, hydrocephalus, hearing impairment. Dx?

A

Congenital Toxo. (mother eating undercooked meat.) Check maternal serology or amniocentesis.

54
Q

Involves lungs and proceeds verrucous skin lesions.

A

Blastomycosis

55
Q

Chemo/neutropenic pt developing glistening off white lesions of eyes? Chemo/neutropenic patient develops ulcerative rash.

A
  1. Candida endopthalmitis. 2. Ecthyma gangrenosum caused by pseudomonas.
56
Q

Garderners, landscapers ulcerated nonpurulent odorless skin papule. Dx? rx?

A

Sporotrichosis. 3-6 months po itracanazole.

57
Q

Name the diferent stages of lyme disease. Dx? Rx?

A

Lyme disease caused by spirochete borrelia burgdorferi transmitted via ixodes (deer tick) Early symptoms ( erthema migrans) Early disseminated: Bells payls, cardiits Late: Athritis, neuropathy. Dx. Serology (ELISA and Western blot.) Doxycycline for 28 days. Amoxcillin for pregnant pts.

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