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Internal Medicine Boards > ID > Flashcards

ID Flashcards

1
Q

Bacterial meningitis empiric treatment

?hospital-acquired

A

Vanc/ceftriaxone (or cefotax)

+ amp (>50 yo)

If hospital acquired, then cefepime or merrem instead of 3rd gen ceph

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2
Q

Encephalitis + ovarian teratoma (50%)

Psych symptoms

Seizures

Autonomic instability

A

Anti-NMDA R encephalitis

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3
Q

Skin ulcer, evolve from painless nodules, in neutropenic patient

A

Pseudomonas (ecthyma gangrenosum)

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4
Q

Empiric tx for non-purulent and purulent cellulitis

A
  1. Dicloxacillin, cephalexin, clinda

2. Bactrim, clinda, doxy, minocycline, linezolid (iv vanc if bad)

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5
Q

Nec fasc treatment

A

Vanc
Imipenem
Clindamycin
Debride

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6
Q

Abscess < 5 cm treatment

A

I&D only

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7
Q

Bat & bird droppings

A

Histo

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8
Q

Rabbits

A

Franciscella

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9
Q

Bird exposure

A

Chlam. Psittaci

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10
Q

Pseudomonas RFs

A

Bronchiectasis
Pred > 10
Broad abx > 7 days in preceding month
Malnutrition

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11
Q

Tick bite
Fever
Lymphocytic meningitis
Petechial rash

Dx & Tx

A

RMSF

Doxycycline

Can have negative antibodies

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12
Q

Tick bite
Erythema migrans
Meningitis

Dx & Tx

A

Lyme

Doxycycline

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13
Q

HIV
Fever,chills,sweats,weight loss after starting therapy
LAD, HSM, anemia, leukopenia, increase ALP

Dx & Tx

A

DMAC and IRIS

Clarithromycin, ethambutol

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14
Q

Coccidioides meningitis

Tx

A

Fluconazole

Second - itraconazole

(Caspo does not penetrate CSF)

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15
Q

Neurosyphilis concerns

Next step…CSF or treat?

A

CSF studies

If positive, then IV PCN

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16
Q

TB treatment duration - reasons to prolong

A

2 mo initiation phase

4 mo continuation

7 mo continuation if:
No pyrazinamide
Cavitation and + sputum after initiation
Once weekly INH and rifapentamine and + sputum after initiation

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17
Q

5 mm positive PPD

10 mm positive PPD

15 mm positive PPD

A

Recent exposure
HIV +
Fibrotic changes on XR c/w old TB
Immunosuppressed > 15 mg pred for 4 weeks

IVDU
Homeless, prisons, LTAC
Recent immigration from country with high prevalence
Lab personnel 
Hospital workers

Anyone

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18
Q

Post-exposure PPx for HIV

Pre-exposure PPx

A

Tenofovir-emtracirabine + raltrgravir

Tenofovie-emtracitabine

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19
Q

Late complement deficiency

A

Recurrent meningococcal meningitis, gonococcal infections

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20
Q

CVID

A

Recurrent sinusitis, pneumonia

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21
Q

Classical complement deficiency

A

Infection with encapsulated bacteria (strep pneumonia) etc

22
Q

Brain abscess

  • from odontogenic source
  • from neurosurgical source

Tx

A

Penicillin + metronidazole
(Mixed organisms)

Vanc + Merrem (pseudomonas)/3rd gen ceph

23
Q

Uncomplicated cutaneous Anthrax

Systemic anthrax

Tx

A

Cipro/levaquin/moxi/doxy

Add one or two bacteriocidal agents (imipenem, rifampin, doxy)

24
Q

Astmptomatic bacteriuria in pregnancy

A

Treat it

Don’t use nitrofurantoin if <30 days from delivery

25
Q

Varicella exposure PPx

1 Immunocompetent

2 Immunocompromised

A

Vaccine

Immune globulin (pregnant women too)

Give if 4 days within exposure

26
Q

Cervicitis treatment

PID treatment (requiring hospitalization)

A

Rocephin + axithromycin x 1

Cefotetan + doxy

27
Q

Outdoors + fever + focal weakness

A

West Nile

Get CSF Ab, not PCR

28
Q

Sudden high fever + frontal/retro-orbital pain + myalgia/low back pain (break bone fever) followed by rash

Usually travel history

Leukopenia, thrombocytopenia, increased lft

A

Dengue

29
Q

Pneumococcal schedule for immunocompromised and HIV

A

PCV-13 now

PCV-23 8 weeks later

30
Q

When is active TB not contagious

A

2 weeks of treatment

Improved symptoms

3 negative sputum smears

31
Q

Drug of choice for candidemia

A

Echinocandins

32
Q

Signs / RFs for disseminated histo

A

Fever

Weight loss

HSM

AIDS patient or heme malignancy

Ohio river valley or Central America

33
Q

Sinus infection

Immunocompromised

Septate hyphae with acute angle branching

Positive galactomannan Ag

A

Aspergillus sinus infection

Voriconazole

34
Q

Rapid dementia

+ 14.3.3 protein in CSF

Myoclonus

A

CJD

35
Q

Small red dots starting in buccal mucosa - spreads to hands and face , then arms legs and feet

Macules –> papules –> vesicles

A

Smallpox (variola)

36
Q

Conjunctivitis

Cough

Coryza

Then rash 2-4 days later (buccal white spots then morbilliform rash to face/neck then extremities)

A

Measles (rubeola)

37
Q

Skin infection

Nail salons - pedicure

Rash 3-4 weeks after

A

Myco fortuitum

Marinum a/w fish tanks

38
Q

RFs for drug-resistant strep pneumonia

Treatment?

A 
Age > 65
Alcoholism
Immunosuppressive
COPD
Chronic liver or kidney disease
Recent (3-6 months) beta-lactam, macrolide, or FQ abx

Moxi + Doxy / macrolide

39
Q

Coinfectuon with Lyme

Fever

Thrombocytopenia

Leukopenia

A

Anaplasmosis (anaplasma phagocyto)

40
Q

Chlamydia treatment

GC treatment

A

Azithro

  Or doxy or FQ

Rocephin

  Or cefixime
41
Q

Latent TB treatment

A

INH 9 months

OR

Rifampin 4 months

42
Q

MAC treatment

A

Clarithromycin/azithromycin

+ ethambutal

+ rifampin/rifabutin

43
Q

Fever

Abd pain

Constipation then diarrhea

Bradycardia

HSM

Africa, Asia, Latin America

Sometimes rash

A

Typhoid fever

44
Q

Western Africa

Fever

Abd pain

Headache

Hemorrhage

A

Lassa fever

45
Q

Travel to Arabian peninsula

Respiratory illness with viral like syndrome

Often progresses to pneumonia

A

Middle East respiratory syndrome

46
Q

CAP coverage suspect pseudomonas

A

Beta lactam

Aminoglycoside

FQ

47
Q

Crypto meningitis treatment

A

AMB + flucytosine

Then flucytosine maintenance

48
Q

Ohio river valley, Mississippi

Pulmonary infection

Skin or bone findings

A

Blasto

49
Q

Ohio river valley, Mississippi

Bad lung infection

A

Histo

50
Q

Osteomyelitis +

  1. Cat or dog bite
  2. Foot puncture
  3. Sickle cell patient
  4. Vertebrae

Organisms?

A

Pasteurella

Pseudomonas

Salmonella (or staph)

Staph aureus

51
Q

Mild babesiosis tx

A

Atovaquone and azithro

52
Q

Severe babesiosis tx

A

Quinine and clinda

Internal Medicine Boards (11 decks)

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