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ID Flashcards

1
Q

Is HIV screening recommended for all pt 15-65 regardless of risk factors?

A

yep, with HIV p24 Ag and Ab testing

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2
Q

HA, confusion, breathing symptoms, diarrhea + hyponatremia and elevated LFTs

A

legionella

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3
Q

Legionella tx

A

macrolide or fluorgoquinolone

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4
Q

UTI with alkaline urine and struvite stone

A

proteus infection

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5
Q

Undercooked meat + foreign travel + GI complaints followed by periorbital edema, edema, myositis, eosinophilia + roundworm parasite

A

Trichinellosis

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6
Q

Fever, abdominal pain, salmon-colored rash, hepatosplenomegaly

A

Typhoid fever

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7
Q

camping, diarrhea, flatulence, abdominal cramps, weight loss, nausea

A

giardia

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8
Q

fever, HA, retro-orbital pain, rash, significant myalgia and arthralgias

A

Dengue fever

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9
Q

Risk factors for bacillary angiomatosis

A

cat exposure, homelessness, CD4 <100

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10
Q

How does bacillary angiomatosis manifest

A

Skin
Systemic - fever, night sweats, fatigue
Organs - liver, bone, CNS

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11
Q

Bacillary angiomatosis treatment

A

Doxy or erythromycin + INCREASE CD4 with ART

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12
Q

Locations of nocardia infection

A

lung + brain

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13
Q

interstital pneumonia when CD4 < 200

A

Pneumocysits jiroveccin

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14
Q

colorectal disease + IE

A

s gallolyticus, s bovis

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15
Q

tx of mucormycosis (nasal infection + poorly managed DM)

A

surgical debridement plus amphotericin B `

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16
Q

+ RF, elevated ESR, normocytic anemia + constitutional sx + dyspnea, cough, edema, osler nodes + septic embolic to brain, spleen, lung + glomerulonephritis

A

variety of IE symptoms given its potential to transform into acute, subacute, chronic manifestations

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17
Q

Adult Still disease

A

inflammatory disorder - recurrent high fevers, arthritis/arthralgias, salmon-colored rash, + ESR

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18
Q

Patient presents with indolent course of cough, fever, dyspnea and has XR suspicious for PCP which is confirmed with BAL. What treatment to start?

A

TMP-SMX and steroids, also test for HIV and start ART if appropriate

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19
Q

Tx for CAP

A

Ceftriaxone + azithromycin

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20
Q

Tx for HAP

A

Vancomycin + piperacillin-tazobactam

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21
Q

Travelers’ diarrhea that is prolonged, profuse, water

A

cryptosporidium parvum, cyclospora, giardia

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22
Q

Diarrhea quality with entamoeba histolytic and shigella

A

dysentary - bloody and mucoid

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23
Q

HIV +, subacute fever, HA, increased ICP sx

A

cryptococcal meningitis

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24
Q

cognitive and personality changes, focal neuro deficitys, seizures, temporal lobe involvement

A

HS encepahlitis

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25
Q

MRI with patchy areas of white matter, HIV, JC virus

A

progressive multifocal leukoencephalopathy (PML)

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26
Q

fever, back pain, focal spinal tenderness

A

osteomyelitis - get blood cx, inflammatory markers, MRI then CT guided bone biopsy

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27
Q

List two main opportunistic infections and the ppx tx

A

Pneumocystis pneumonia - TMP-SMX

CMV - ganciclovir or valganciclovir

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28
Q

great lakes, pulmonary illnes, verrucuous nodules and plaques

A

blastomycosis

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29
Q

When and how ppx against pneumocystic jirovecci

A

CD4 < 200 + TMP-SMX

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30
Q

When and how ppx against toxoplasma gondii

A

CD4 < 100 + TMP-SMX

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31
Q

When and how ppx against MAC

A

CD4 < 50 + Azithromycin

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32
Q

When and how ppx against Histoplasma capsulatum

A

CD4 < 150 + Itraconazole

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33
Q

Which HIV OI require TMP-SMX tx and when

A

Pneumocystis ( < 200) and Toxo ( < 100)

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34
Q

You ppx against this OI with Azithromycin when CD4 < 50

35
Q

pulmonary disease in immunocompromised host + nodular, cavitary lesions in upper lobes + sputum with filamentous, gram positive, weakly acid-fast rods

A

Nocardia, tx with TMP-SMX

36
Q

pulmonay disease + acid-fast negative hyphae

A

Aspergillus

37
Q

Tx of penicillin sensitive IE

A

IV abx like ceftriaxone for 4 weeks

38
Q

Recent immigtation, abdominal pain, fever, leukocytosis, liver abscess preceded by bloody diarrhea

A

amebic abscess by entamoeba histolytica - treat with metronidazole

39
Q

Tx of hydatid liver cyst due to echinococcus

A

aspiration + albendazole

40
Q

are pt with HIV at increased risk of CAP with s pneumo

41
Q

recent flu with acute worsening with high fever, productive cough, hemoptysis, leukopenia and found to have multilobar cavitary lesions on XR

A

post viral s aureus pneumonia

42
Q

immunocompromised + fever, pleuritic CP, hemoptysis

A

Aspergillus

43
Q

high fever and GI sx prior to pulmonary sx

A

LEgionella, will see hyponatremia

44
Q

rapid onset fever, myalgias, nuchal rigidity, petechial rash, shock, CSF with low glucose and high protein

A

Meningococcal meningitis, treat with ceftriaxone + vancomycin

45
Q

Hiv + HA, confusion, focal deficits, fever + MRI with ring-enhancing lesions

A

Toxo, should be on ppx if CD4 < 100, TMP-SMX

46
Q

bug in epididymitis of old man

47
Q

3 bacteria that can cause bloody diarrhea

A

e coli, shigella, campylobacter

48
Q

duration of tick attachment o ppx for Lyme

A

36 hrs, remove with tweezers

49
Q

ppx vs treatment of Toxo

A

ppx = TMP-SMX, tx = sulfadiazine and pyrimethamine

50
Q

CD4 < 100 with HA, fever, focal neuro deficits, AMS

A

Toxo, tx with Sulfadiazine and Pyrimethamine

51
Q

MRI findings of Toxo

A

ring enhancing lesion

52
Q

MRI findings of CMV

A

multifocal micronodules or ventricular enhancement

53
Q

immunocompromised + lung or brain + filamentous, aerobic, gram-positive, partially acid fast

A

nocardia, tx with TMP-SMX

54
Q

NE united states + flu-like symptoms + anemia, thrombocytopenia + blood smear with Maltese cross

A

Babesiosis - ixodes scapularis

55
Q

Two treatments for babesiosus

A

Atovaquone + azithromycin

Quinine + Clindamycin

56
Q

4 types of tick-borne illness

A

Lyme
Babesiosus
Erlichiosis
RMSF

57
Q

Tick-borne illness that causes hemolysis and anemia

A

Babesiosis - look at peripheral smear to diagnose

58
Q

Tick-borne illness that has prominent rash that spreads centripetally and includes the palms and soles

59
Q

Tick-borne illness that causes flu-like symptoms and leukpenia/thrombocytopneia

A

Ehrlichiosis

60
Q

This lung infection can present similarly to sarcoid

A

histoplasmosis

61
Q

cough, hilar adenopathy, erythema nodosum, non-caseating granulomas, african american

62
Q

two Tb-mimicking infections

A

histoplasmosis, blastomycosis

63
Q

Infection of lungs in Mississipi and Ohio River basins

A

Histoplasmosis, also Blastomycosis

64
Q

SW united states

A

Coccidioides

65
Q

Symptoms of progressive disseminated histoplasmosis

A

febrile, wasting disroder, dyspnea, cough, papules, nodules, lymphadneopathy, hepatosplenomegaly, pancytopneaia, XR with hilar adenopathy and reticulonodular infiltrates

66
Q

PPD size for HIV infected pt

A

> 5 mm is +

67
Q

PPD size for pt with no risk factors

A

> 15 mm is +

68
Q

If PPD is 8 mm for pt with HIV and CXR is normal, what to do?

A

Pt has latent Tb and needs 9 mo tx of Isoniazid and Pyridoxine

69
Q

Why add pyridoxine to isoniazid tx?

A

prevent peripheral neuropathy

70
Q

traveled to Africa, cyclical fever with nonspecific constitutional and GI symptoms, anemia, thrombocytopenia

71
Q

Symptoms within a week of exposure + muslce and oint pains, retrorbital pain, rash, leukopenia

A

dengue fever

72
Q

skin and bone lesions, pulmonary symptoms, broad-based budding yeast, midwest

A

blastomycosis

73
Q

IE in IVDU

A

tricuspid valve

74
Q

Most common valve in IE

A

mitral valve

75
Q

empiric tx of meningitis in immunocompromised pt

A

cefepime, vacno, ampicillin

76
Q

IVDU with nodular cavitary infiltrates of lungs

A

tricuspid endocarditis with systemic embolization to lungs

77
Q

lobar pneumonia, CAP

78
Q

CD4 <200, diffuse infiltrates, indolent course

A

pneumocystis pneumonia

79
Q

IVDU, fevers and SOB, holosystolic murmur that increase with inspiration, tricuspid valve, splinter hemorrhages

A

IE of tricuspid valve, diagnose with blood culture and TEE, empiric tx of vanco and tailor

80
Q

Gonorrhea treatment

A

azithromycin + ceftriaxone

81
Q

antibiotics with anaerobic coverage

A

amoxicillin, amox-clav, clindamycin

82
Q

mono test

A

heterophile antibody test

83
Q

mucopurulent urethral discharge

A

chlamydial urethritis

IM (17 decks)

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