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1
Q

MCC of bacterial meningitis

A

Strep pneumoniae
H.influenza
N. meningitidis

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2
Q

Rx of meningitis

A

Ceftriaxone + Vancomycin

If elderly, neonate or immunocompromised add ampicillin for listeria.

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3
Q

Organism in pylonephritis from blood?

A

Staph

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4
Q

What to do if pylonephritis caused by staph?

A

Look for focus of infection and culture blood.

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5
Q

Hx of travel to South America / Mexico + bloody diarrhea? (Organism)

A

Entamoeba histolytica colitis

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6
Q

Amebic colitis classic

A 
Gradual onset 1-2 weeks
Diarrhea 
Watery / bloody diarrhea 
Abdominal pain
Fever
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7
Q

Rx of influenza + exception

A

Sx < 48 HR
Oseltamivir

Sx > 48 HR
Symptomatic

Rx required for all patient worsening even if it’s > 48 HR.

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8
Q

Rx of suspect MRSA in endocritis?

A

IV vancomycin + gentamicin

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9
Q

Influenza like classic

A

Sudden
Fever + dry painful cough
Similar findings in family/household
Prostration = exhaustion

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10
Q

Risk in herpes zoster ophthalmicus?

A

Corneal infection due to involvement of nasociliary branch of V1

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11
Q

Elderly in nursing home with asymptomatic bacteriuria?

A

No need for Rx

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12
Q

Risk ass w/ Strp bovis?

A

Colon Ca

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13
Q

Rx of herpes zoster

A

High dose acyclovir 800 mg 5xday

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14
Q

1st line in otitis media

A

Amoxicillin

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15
Q

Rocky Mountain spotted fever classic

A

Camper/hiker
Tick
Rash moves centrally
Paralysis

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16
Q

Where is Rocky Mountain spotted fever?

A

Canada: British Columbia + saskatchewan

US: North Carolina + Arkansas + Missouri + Tennessee + Oklahoma

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17
Q

Rx of scabies

A

5% permethrin > lindane

Lindane has neurotoxic SE

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18
Q

Why a strep pharyngitis must be Rx?

A

Prevent rheumatic fever

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19
Q

Staph food poisoning

A

Start 1-6 hr after meal

Resolves 1-2 days

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20
Q

Indication of sever or lethal Rocky Mountain spotted fever

A

High creatinine due to renal failure

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21
Q

Predictor of vancomycin efficacy

A

Trough serum level > 10mg/L to prevent development of bacterial resistance

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22
Q

What derm disease associated w/ GAB infection

A

Guttate psoriasis

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23
Q

Center criteria for pharyngitis

A 
Tonsillar exudate 
Tender cervical LN
Fever
No cough 
If > 2 points Rx w/ Abx 
0-2 Rx symptomatic
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24
Q

Splenectomy increases risk of what infections?

A 
Encapsulated organisms:
S. pneumoniae
HiB
E. coli
Staph
Salmonella 
Klebsiella and
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25
Q

Hx of tick bite? Management

A

Remove parasite w/in 24-48 HR

By: medium tipped angled forceps

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26
Q

Trichinosis classic

A

10-15 days Hx of infection
1st = diarrhea
2nd = sever muscle weakness +/- CNS

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27
Q

Dx trichonsis

A

Muscle biopsy shows trichinella spiralis.

Other:
High CK
High eosinophils
High LDH

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28
Q

Dx of pseudomemebrenous colitis

A

Stop antibiotics

Start metronidazole

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29
Q

When to use oral vancomycin in pseudpmembrenous colitis?

A

Pregnancy / breastfeeding
Allergy to metro
Recurrent not responsive to metro

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30
Q

Subacute / atypical pneumonia + EM rash + hemolysis + low Na (organism)

A

Mycoplasma pneumonia

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31
Q

Legionella pneumonia clues

A
  1. Immunocompromised
  2. Hotels, water tanks
  3. Hepatic involvement
  4. Low Na + Low PO4
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32
Q

HIV classic

A 
Young 
Oral thrush 
Ulcerative esophagitis 
Weight loss
LN
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33
Q

MCC of HIV

A

Drug use

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34
Q

MCC of ulcerative esophagitis in HIV

A

CMV

HSV

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35
Q

Risk of pneumocystic jirovecii pneumonia?

A

In HIV (CD4 <200)

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36
Q

Rx of C. Botulinum

A

Antitoxin against neurotoxin A,B,C

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37
Q

MCC of bacteremia in elderly?

A

UTI

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38
Q

Risk of pneumocystic jirovecii pneumonia?

A

In HIV (CD4 <200)

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39
Q

MCC of c. Botulinum

A

Home - canned foods

Preservative that reduce oxygen like vacuum packaging

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40
Q

Sx of C. Botulinum

A

Bulbar paresis:
Dysarthria
Dysphonia
Flaccid facial expression

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41
Q

Rx of H. Pylori

A

Triple Rx for 14 days
Amoxicillin
Clarithromycin
Omeprazole

Other:
BMT = bismuth, metro, tetra
LAC = lansoprazole, amoxicillin, clarithromycin

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42
Q

Dx C. Diff

A

C. Diff cytotoxin essay

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43
Q

Dengue Fever

A

3-14 days Hx of travel to tropical area
+/- Hx of mosquito bite
Pro dorm: erythema mottling, facial flushing

Classic Sx:
Sudden fever, chills <10 days.
Sever headache (breakbone)
Maculopapular or petechial rash

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44
Q

Anti-TB needs acidic environment

A

Pyrazinamide
It’s inactive at natural PH 7.4
Work on acidic phagosomes of macrophages PH 5 I.e extra cellular TB

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45
Q

EBV association

A

Burkitts lymphoma
Hodgkin’s lymphoma
Large B cell lymphoma
Nasopharyngeal carcinoma

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46
Q

Rx of TB

A 
8 weeks of:
Rifampin 
Isoniazid 
Ethambutol 
Pyrazinamide
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47
Q

Infection from rabbits

A

Tularemia (Francisella tularensis)

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48
Q

Rx of tularemia

A

Streptomycin

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49
Q

Dx osteomyelitis

A

MRI

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50
Q

Leprosy classic

A

AFB +ve

De pigmentation

Loss of fine touch and pain sensation

Disfigured feature due to cartilage infection and granuloma formation

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51
Q

Prophylaxis in HIV+ve?

A

If CD4
< 200 PCP prophylaxis
< 100 toxoplasmosis
< 50 M. Avium

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52
Q

Opportunistic infection prophylaxis in HIV

A

Aziyhromycin for M. Avium

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53
Q

What must be r/o before TB prophylaxis

A

Active TB

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54
Q

HSV encephalitis location

A

Temporal area

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55
Q

Sx of HSV encephalitis

A

Gustatory hallucinations

Confusion

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56
Q

How C. Botulinum causes disease

A

Works on polysialoganglioside receptor

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57
Q

Rx of URTI with strep. Pneumoniae

A

Erythromycin

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58
Q

Most abundant site for HIV replication

A

GI tract

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59
Q

T/F: serum sickness reaction after HBV

A

T

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60
Q

Cause of ehrlichiosis

A

Lone star tick

Ixodes tick

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61
Q

Rx of pertussis

A

1st line Macrolides

2nd line TMP/SMX

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62
Q

Cat scratch disease classic

A

Few red papules at site of scratch
Painful LN
+/- hepatosplenomegaly

63
Q

Rx of travelers diarrhea

A

Fluroquinlones 1-3 days

64
Q

What’s not a sign of pharyngitis?

65
Q

What’s periodontitis? Rx?

A

Tooth’s roots infection + cellulitis + apical abscess.

Rx: clindamycin, amoxici/clav

66
Q

What’s walking pneumonia

A

Pneumonia doesn’t cause patient sever symptoms (patient not confined to bed)

67
Q

Cause of walking pneumonia

A

M. Pneumoniae

68
Q

+ve PPD in HIV?

69
Q

What antibiotic not assisted with C. Diff and food for pneumonia

A

Macrolides

70
Q

Use of chloride in CSF

A

Dx TB (low in TB)

71
Q

Diarrhea in HIV? MCC

A

Cryptosporidiosis

72
Q

Prophylaxis against chloroquine-resistant malaria?

A

Mefloquine

73
Q

Contraindication to mefloquine?

74
Q

Necrotizing fasciitis

A 
Fever 
Pain sever 
Tenderness 
Edema 
Bronzed skin 
Poorly controlled DM
75
Q

Necrotizing fasciitis in perineum called?

A

Fournier gangrene

76
Q

Rx of necrotizing fasciitis

A

Surgical debridement + IV antibiotics

77
Q

When to biopsy isolated LN?

A

> 3 cm
Supraclavicular LN
Constitutional Sx
Patient with risk of malignancy

78
Q

Approach non-tender isolated LN

A

Wait for 4-6 weeks

79
Q

MCC of pneumonia in HIV

A

P. Jirovecii

P. Carinii

80
Q

Dx IE?

A

Blood cultures

Transthoracic echo

81
Q

When to go for surgery in IE?

A

CHF from infection
Abscess
Persistent infection despite RX

82
Q

Antiviral contraindicated in COPD and asthma

83
Q

Rx of latent TB

A

Isoniazid mono therapy 9 months.

84
Q

Is rifampin used for LTB in HIV?

A

No, due to resistance + drug reaction

85
Q

Infection with intermediate host?

A

Tapewarm (diphyllobothrium latum)

86
Q

Risk factors for necrotizing fasciitis

A 
Age > 50
Atherosclerosis 
Burn, trauma, post-op
Cancer 
Steroids use 
DM
Low albumin 
IV drugs + alcoholism
87
Q

Osteomyelitis classic

A

Localized pain
Constitutional Sx
Erythema
Tenderness

88
Q

Cause of staph diarrhea

A

Poultry

Sliced meat, pudding, egg

89
Q

Dx cryptosporidium

A

AF stain of stool

90
Q

In HIV + CNS Sx you sus?

91
Q

MCC of acute bacterial diarrhea?

A

Campylobacter > salmonella > E. coli > shigella

92
Q

MC site of osteomyelitis

93
Q

If you sus pneumonia what to do next?

A

CXR to confirm

Rx of hypotension in sepsis

94
Q

Rx of low BP in sepsis

A

IVF
If fails: vasopressors
Norepinephrine > dopamine

95
Q

Areas of Lyme disease

A

Ontario
Quebec
New Brunswick
Nova Scotia

96
Q

Dx Lyme disease

A

ELISA for borrelia burgdorferi

97
Q

Rx Lyme disease

A

IV ceftriaxone

98
Q

Pain killer contraindicated in sulfa allergy

99
Q

Timing in chronic vs acute diarrhea

A

Acute < 15 days

Chronic > 15 days

100
Q

Types of chronic diarrhea

A

Watery (osmotic or secretory)
Inflammatory
Fatty

101
Q

Giardiasis classic

A 
Malodorous 
Greasy stool
WBC < 5/hpf 
PH < 5
Use of PPI (low CL)
102
Q

Pneumonia
Adolescent / child
Bilateral lower lobe infiltrates
Cold agglutination (organism?)

A

Mycoplasma peunomniae

103
Q

Legionella pneumonia classic

A

Pneumonia
+ GI diarrhea Sx
Water exposure (cruise)
Air conditioner (hotel / business building)

104
Q

Organism in cat scratch disease

A

G-ve

Bartonella Hensela

105
Q

Rx of cat scratch disease

A

Supportive

106
Q

MCC of skin infection in DM (Rx or not Rx)

A
  • Previously Rx: polymicrobial

- Never Rx: staph + strept.

107
Q

Hx / FHx of hemochromatosis
Lymphangitis
GI Sx (diarrhea, RLQ)

A

Yersinosis

108
Q

Causes of enlarged mesenteic LN?

A

E. Coli

If Hx hemochromatosis = yersinia

109
Q

Cause of mucormycosis?

A

Fungus Rhizopus
Mucor
Absidia

110
Q

Rx of mucormycosis

A

Debridement

IV amphotricin B

111
Q

Toxic sock syndrome.

A

Fever
Low BP
Erythema and diffuse macular rash involving palms + soles.

112
Q

Rx of lung abscess

A

Clindamycin

113
Q

Instructions to infectious mono patients

A

Stop contact sports until exam is normal and spleen is regressed to its normal size.

114
Q

MCC of diarrhea on cruise

A

Norwalk virus

115
Q

Rx of asymptomatic bacteriuria in pregnant

A

Nitrofurantoin

116
Q

MOA of nitrofurantoin

A

Reduce bacterial flavoprotein = inactivate and alter bacterial ribosomal proteins.

117
Q

Best way to determine stage of HCV?

A

Liver biopsy

118
Q

HIV + pneumonia + encephalitis + retinitis?

Organism

119
Q

Dx Pneumocystis jirovecii

A

HIV

Patchy infiltrate on CXR

120
Q

Rx of pneumocystis jirovecii

A

IV TMP/SMX

121
Q

Complications of otitis media?

A

Cholesteatoma
Meningitis
Tympanic membrane rupture
Conductive hearing loss

122
Q

a 24hr virus causes diarrhea?

A

Norovirus / Norwalk virus

123
Q

MCC of non bloody diarrhea

A

Campylobacter

124
Q

Hantavirus infection classic drug

A

2 syndromes:

- HFRS:
Fever, headache, back pain 
Petechial rash
Renal failure (hematuria + proteinuria)
Rx: IV ribavirin 
- HPS:
Deer mouse 
Fever, maylagia, resp Sx, GI Sx
Pulmonary edema 
Rx: supportive (ribavirin not effective)
125
Q

Where to expect hantavirus

A

Colorado
Arizona
Rural areas

126
Q

2ry syphilis rash

A

Rash on trunk, palms and soles

With patch hair loss

127
Q

Stain for 2ry syphilis

A

Warthin-Starry silver stain is

128
Q

Rx of CAP (Rx or never Rx)

A
  1. Never Rx:
    Macrolides esp. azithromycin
  2. On Abx last 3 months:
    Flouroquinolone
129
Q

What electrolyte imbalance not seen in TSS?

130
Q

Organisms could cause lung abscess

A 
Pseudomonas 
Klebsiella 
Staph
Strept. Pneumoniae 
Nocardia

In HIV: PCP

131
Q

Which serum protein is low in sepsis?

A

Albumin

Transferrin

132
Q

High proteins in sepsis?

A 
Complement 
Haptoglobin 
Fibrin split 
CRP
Ferritin
133
Q

Nursing home acquired pneumonia Rx

A

Cover G-ve

Levofloxacin

134
Q

Types of typhus?

A

Endemic

Epidemic

135
Q

Other name from r endemic typhus?

A

Murine typhus

136
Q

Transmission of epi vs endemic typhus

A

Endemic: rat or cat flea

Epidemic: body lice (louse infestation) + rarely flying squirrels

137
Q

Location of endemic vs epidemic typhus

A

Endemic: southwest US (New Mexico)

Epidemic: Continent of South America

138
Q

Sx of epi vs endemic

A

Both fever, chills, headache + rash

Endemic: maculopapular rash

Epidemic: 1st: small pink macule then erythematous maculopapular rash.

139
Q

Dx epi vs endemic typhus

A

Biopsy rash

140
Q

Rx of epi vs endemic typhus

A

Doxycycline 200 mg day 1 then 100 mg BID for 7 days

141
Q

Prevention of epidemic typhus?

A

Louse control

142
Q

What’s Brill-Zinsser disease?

A

Recurrent for of epidemic typhus

143
Q

Epi/endemic typhus vs typhoid (Sx)

A

All: fever, headache, pains, rash, cough

Epi: maculopapular rash + low BP

Endemic: erythematous maculopapular rash moves peripherally + hacking cough.

Typhoid: rose colored patches on trunk + worsening cough + green “pea-soup” stool

144
Q

Where to get Vibrio Vulnificus?

A

Raw oyster

Shellfish

145
Q

Who’s at risk of vibrio vulnificus

A

Alcoholics
CKD
Liver disease

146
Q

Classic vibrio vulnificus?

A

Watery diarrhea = hypotension
Fever / chills
Rash (bullous)

147
Q

Dx vibrio vulnificus

A

Blood/stool culture

148
Q

Rx of vibrio vulnificus

A

Cipro
Or
Doxy

+
IVF

149
Q

Organism in histoplasmosis

A

Histoplasma capsulatum

150
Q

Classic histoplasmosis

A

Wooded areas;
- Ohio, Mississippi, penn, NY, Maine

  1. Associated with birds / bats litters (farmer, cave, woods)
  2. Fever, dry cough, B Sx
  3. Erythema nodosum
151
Q

Dx histoplasmosis

A
  • CXR = mass + LN
  • Tissue biopsy
  • C/S of blood, sputum, urine
  • Ag testing > culture!
152
Q

Rx of histoplasmosis

A

Mild: itraconazole

Sever: amphotricin B

153
Q

Epi/endemic typhus vs typhoid (organism)

A

Epidemic: R. Prowazekii

Endemic: R. Typhi

Typhoid: salmonella typhi/paratyphi

CanQB (16 decks)

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