ID Flashcards
1
Q
What’s herpetic whitlow
A
Herpes of the hand, often due to hand jobs or dental work. Have focal area of grouped vesicles on an erythematous base.
2
Q
In pts with widespread molluscum contagiosum, consider testing for
A
Hiv
3
Q
Side effect of ethambutol
A
Optic neuritis
4
Q
Side effect of isoniazid
A
Peripheral neuropathy And hepatitis
5
Q
If pt in septic shock doesn’t respond to abx and fluid resus, whAt should you do
A
Administer vasopressors and admit to icu
6
Q
Ppx meds of choice for close contacts of pts with meningococcal meningitis
A
Rifampin and cipro
7
Q
Rbcs jn csf without hx of trauma is highly suggestive of
A
Hsv encephalitis
8
Q
Two most common causes of encephalitis
A
Hsv and adenovirus
9
Q
Tx of cmv encephalitis
A
Iv ganciclovir and possiby foscarnet
10
Q
Most common postviral pneumonia bug in elderly
A
S aureus
11
Q
Tx of brain abscess
A
Broad spec iv abx and surgical drainage
12
Q
Triad of headache, fever, and focal neuro deficit, think
A
Brain abscess
13
Q
Hiv destroys what cells
A
Cd4+ t lymphocytes
14
Q
Dx of hiv
A
Elisa and then western blot to confirm
If Elisa is neg and pt had acute exposure do hiv rna pcr
Rapid hiv test also available
15
Q
Babes of hiv positive moms should receive ___ six weeks postpartum
A
Zidovudine
16
Q
Which are the only live vaccines that should be given to hiv pts
A
Mmr and Varicella
17
Q
Should you give oral polio vaccine to aids pts
A
No
18
Q
Mac in aids pts occurs when cd4 count is under
A
50
19
Q
In Mac, serum alk phos and ldh Are
A
High
20
Q
Biopsy of bone marrow, intestine or liver in Mac reveals
A
Foamy macrophages with acid fast bacilli
21
Q
Ppx against Mac in aids pts
A
Azithromycin
22
Q
Tx of gonorrhea
A
Ceftriaxone Im and azithro P.O. (for chlamydia tx)
23
Q
Primary Syphillis occurs ___ after infection and presents with a ___
A
10-90 days
Painless ulcer
24
Q
Secondary Syphillis occurs ___ after chancre and presents with a ___
A
4-8 wks
Low grade fever, headache, lymphadenopathy, maculopapular rash on soles and palms and condyloma lata
25
Tertiary Syphillis appears ___ after initial infection
1-20 years
26
What is tabes dorsalis
Posterior column degeneration seen in tertiary Syphillis
27
treatment of Syphillis can result in acute flulike illness (headache, fever, chills, myalgias) known as ___, which results from ___
Jarisch-herxheimer reaction, release of endotoxins by the killed organisms
28
Criteria of sirs
- temp below 36 or over 38
- tachypnea >20 breaths per minute
- tachycardia
- leukocytosis or leukopenia
29
Uncomplicated malaria can be treated with
Chloroquine
30
In cases of p vivax, p ovale or unknown species, how do you treat malaria
Chloroquine plus primaquine
31
Ppx against chloroquine resistant malaria
Atovaquone-proguanil
32
Tx of neutropenic fever
Empiric antibiotic therapy with anti-pseudomonal agent (cefepime, pip-tazo)
Admit if high risk
33
Most common causes of otitis externa (swimmers ear)
Pseudomonas and enterobacter
34
Pain with movement of the tragus/pinna, think
Otitis externa
35
Infective endocarditis in an iv drug user is due to
S aureus
36
Infective endocarditis in pts just having undergone dental procedure is due to what bug
Strep viridans
37
S bovis endocarditis is associated with
Gi malignancy
38
Presentation of endocarditis
```
From Jane
Fever
Roth spots
Osler nodes
Murmur
Janeway lesions
Anemia
Nail hemorrhage
Emboli
```
39
Noseptate dangerous fungi
Mucormycosis
40
Most common organism for osteomyelitis? How about in scd pts?
Normally s aureus
| For scd salmonella
41
Long standing chronic osteomyelitis with a draining sinus may lead eventually to
Squamous cell carcinoma (marjolin ulcer)
42
Labs in acute rheumatic fever
High esr and Crp
43
Clinical features of acute rheumatic fever
```
Jones
Joints
Carditis
Nodules (subcutaneous)
Erythema marginatum
Sydenham chorea
```
44
Demographic in acute rheumatic fever
Age 5-15, girls>boys
45
Condylomata acuminata are caused by
Hpv
46
Verrucous papilliform lesions that are pink or skin colored
Condylomata acuminata
47
Preseptal cellulitis is usually due what
Break in periorbital skin eg abrasion or insect bite
48
Orbital cellulitis is an infection of what space
Space posterior to orbital septum
49
How can preseptal cellulitis be differentiated from orbital cellulitis
Preseptal cellulitis does not have:
- painful or impaired eom
- proptosis (no orbital fat involvement)
50
Inability to extend neck and widened prevertebral space in a kiddo suggests a diagnosis of
Retropharyngeal abscess
51
Name three viruses that can cause thrombocytopenia
Ebv
Hep c
Hiv
52
all pts with presumed itp should be tested for what viruses
Hiv and hep c
53
If preggo has hep c what should you do
Give hep a and b vaccines ; ribavirin is teratogenic
54
Most common viruses causing myocarditis (2)
Coxsackie b and adenovirus
55
Viral prodrome preceding worsening resp distress from acute left heart failure and pulm edema, possibly with a holosystolic murmur and hepatomegaly. Think
Viral myocarditis
56
Treatment of viral myocarditis
Supportive measures eg diuretics and inotropes
57
What is asymptomatic bacteruria
Growth of > 10,000 colony units from a clean catch without uti sx
58
First line treatments for asymptomatic bacteriuria
Cephalexin, augmentin, nitrofurantoin
59
Bactrim is ___ in first tri and ___ in second tri
Contraindicated
| Safe
60
Fluoroquinolones are __ in preg
Contraindicated
61
What age do you get mmr
1 and 4
62
Measles is spread by
Respiratory particles
63
Tx of Lyme dz in preggos and kids under 8
Amoxicillin
64
Do you get fever and leukocytosis with osteomyelitis
Sometimes not always
65
Are most cases of vertebral osteo chronic and insidious
Yes
66
Old man with mild leukocytosis, and bilateral diffuse reticular infiltrates on cxr likely has pneumonia due to
Influenza
67
Old man with sig leukocytosis, high fever and lobar infiltrates on cxr likely has pneumonia due to
S pneumo, s aureus or pseudomonas
68
Parvo presents with __ arthralgias in adults
Symmetric polyarticular
69
Positive anti-hbs and negative all other hep b markers means
Person has been immunized against hep b
70
Tic that causes flu-like sx, anemia, thrombocytopenia, dark urine, increased bili/ldh/lfts
Babesiosis
71
Causes of meningitis in babes under three months (4)
GBs
E Coli
Listeria
Hsv
72
Causes of meningitis in kids 3 months to 10 years
S pneumo
| N meningitidis
73
Causes of meningitis in Children over eleven
N meningitis
74
Fever headache focal neuro deficits and seizure, plus rfs of congenital heart disease and or recurrent sinusitis. Think
Brain abscess
75
Sporotrichosis is due to ___ infection
Fungal
76
How do you treat Syphillis in a pt with a penicillin allergy
Doxy
77
Is cmv retinitis painful?
No
78
Fundoscopy in cmv retinitis shows
Fluffy/glandular retinal lesions near retinal vessels and associated hemorrhage
79
Describe presentation of mumps
Viral infection that presents with fever and parotitis after nonspecific prodrome in school aged children.
80
Two complications of mumps
Aseptic meningitis and orchitis
81
How do you rule out septic arthritis
Synovial fluid analysis
82
Bartonella is gram __ and is seen with ___ stain
Negative
| Warthrin starry stain
83
Presentation of cat scratch disease
Fever
Regional lymphadenopathy esp in axilla or groin
Localized papules or nodular skin lesion
84
Tx of cat scratch disease
Usually self limiting but can be treated with azithromycin
85
Most common causes of pneumonia in copd (2)?
H flu and klebsiella
86
Are s pneumo, s aureus and h flu encapsulated
Yes
87
Can you give neonates ceftriaxone? Justify
No
| Risk of biliary sludging and kernicterus
88
Tx of confirmed chlamydia
Azithromycin
89
Tx of confirmed gonorrhea
Azithro + cef
90
Cysts, msm, liver abscess and ruq pain think
Entamoeba histolytica
91
Anchovy paste consistency of liver abscess. What am I?
Entamoeba histolytica
92
Dx of entamoeba histolytica
Trophozoite with endocytosed rbcs on stool o&p
93
Tx of entamoeba histolytica
Metronidazole
94
Pertussis is associated with ___cytosis
Lymphocytosis
95
Catarrhal phase of pertussis sx
Injected conjunctiva and lacrimation
96
What causes whooping cough
Pertussis
97
Tx of pertussis
Azithromycin
98
Pertussis vaccine is what kind of vaccine
Acellular
99
Pneumocystis pjiroveci is associated with cd count under
200
100
What kind of pneumonia does Pneumocystis pjiroveci cause
Diffuse interstitial causing dyspnea and fever but not productive cough
101
What do you see on cxr in Pneumocystis pjiroveci
Sometimes nothing otherwise ground glass infiltrate with crushed ping pong balls
102
Dx of Pneumocystis pjiroveci
Bronchoalveolar lavage then methamine silver stain
103
Ppx against and tx of Pneumocystis pjiroveci
Bactrim or pentamidine
104
How many doses of vzv vaccine do you need
Two
| Age 1 and 4
105
If you suspect endocarditis what do you do
Serial blood cultures BEFORE starting antibiotics
106
HbsAg indicates
Antibody to hbsag; immunity (eg immunized)
107
What does IgM HBcAb indicate
Antibody to hbcag; igM positive in window period between when antigen disappears and antibody arrives
108
What does IgG HBcAb indicate
Indicates prior or current hep B infection
109
HBsAb and HBcAb positive means
Person has hep b and is now immune
110
Positive HBsAb and neg HBcAb means
Immunized against hep b
111
Pp with solid organ transplants on immunosuppression are at risk for what two opportunistic infections
Pcp and cmv
112
Triad of congenital rubella
Pda, hearing loss, cataracts
113
What do you see on ct of nec fas?
Air in the deep tissue
114
Tx of aspiration pneumonia
Anaerobic coverage including metronidazole with amoxicillin, augmentin and clinda
115
Abx for human bite wounds
Augmentin
116
Most common bacterial colonization in cf patients under twenty? Over twenty?
Under: staph aureus
Over: pseudomonas
117
Who gets legionella pneumonia?
Those in the hospital or have traveled (eg cruise)
118
Hyponatremia, diarrhea and pneumonia, think
Legionella
119
Dx of legionella
Urine legionella antigen
120
Tx of legionella
Fluoroquinolone or macrolide
121
Ldh level in pc pneumonia?
Very high
122
Pcp is seen in hiv pts with cd4 counts under
200
123
Can autoimmune hemolytic anemia and thrombocytopenia be seen in mono pts
Yes
124
Can you get a maculopapular rash with ebv
Yes, If mistakenly given amoxicillin or ampicillin
125
What is bacillary angiomatosis
Friable papules and plaques in immunocompromised pts as a result of Bartonella species, often associated with fever and other systemic sx
126
Types of strep viridans
Momms
```
Mitis
Oralis
Mutans
Sanguinis
Milleri
```
127
Viral esophagitis is more common than candida esophagitis in pts who have what sx
Severe odynophagia (pain with swallowing) but no dysphagia
128
Infant botulism is caused by
Botulism spores
129
Food borne botulism is caused by
Ingestion of preformed botulinum toxin
130
Can rpr be negative in early Syphillis infection
Yes
131
Confirm dx of genital herpes with what test?
Pcr
