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1
Q

HUS

A 
Insult to kidneys caused by shiga toxin (EHEC)
pallor, fatigue, bruising, edema
Hemolytic anema
thrombocytopenia
AKI
decreased haptoglobin

Tx: Fluids, transfusion, dialysis

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2
Q

Zika Syndrome

A

Zika virus targets neuroprogenitor cells
Microcephaly, spasticity, seizures, ocular abnormalities
Imagining: Cortical thinning, ventriculomegaly, calcifications

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3
Q

Tetanus prophylaxis

A 
Dirty/Severe wound: 
   Tetanus within 5 years?: Nothing
   Tetanus at some point?: Single dose Tdap
   No tetanus: TIG + Single dose Tdap
Clean/Minor wound:
   Tetanus within 10 years?: Nothing
   Tetanus at some point: Single dose Tdap
   No tetanus: Single dose Tdap
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4
Q

Syphilis Treatment

A

Primary and Secondary: Penicillin G 1 dose or Doxycycline for 14 days
Asymptomatic: Penicillin G 3 doses or Doxy for 28 days
Tertiary: Penicillin G 14 days or Ceftriaxone 14 days.

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5
Q

Periventricular Calcifications in the Neonate

A

CMV

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6
Q

Parenchymal Calcifications in the Neonate

A

Toxoplasmosis

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7
Q

Neonatal Herpes Simplex

A

Skin, mouth eyes: keratitis, mucocunatneous lesions
CNS: temporal hemorrage/edema, seizures
Disseminated: Hepatitis, sepsis, pneumonia

Tx: Acyclovir

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8
Q

HIV Associated Neurocognitive Disorder

A

Cognitive impairments in multiple domains, mood and behavior changes. MRI shows diffuse white matter changes. CD4 <200

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9
Q

Progressive Multifocal Leukoencephalopathy

A

JC virus, usually in the setting of HIV/AIDS. Altered mental status, motor deficits, ataxia, vision abnormalities. MRI asymmetric white matter changes.

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10
Q

Erysipelas vs Cellulitis

A

Cellulitis onset over days, deeper layers of the dermis, flat edges of swelling with poor demarcation. +/- drainage.

Erysipelas: Sudden onset, involves more superficial dermis, raised edges of swelling with demarcation.

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11
Q

Lyme Disease

A

Initial phases: Doxy or Amoxicillin (children less than 8 and pregnant women)

If +Heart Block: IV Ceftriaxone

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12
Q

Cryptococcus neoformans

A

HA, N/V, confusion, abducens nerve palsy (elevated ICP), scattered umbilicated papules.

Clogs arachnoid vili, increasing intracranial pressure.

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13
Q

Suspected Meningitis Plan

A

CT, LP, BC, Abx.

Infants do not need CT prior to LP

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14
Q

Causative organisms of diarrhea in AIDS

A

Cryptosporidium: Low-grade fever, severe watery diarrhea, low-grade fevers

Microsporidium: watery, crampy, weight loss, fever is rare

MAC: Watery, high fever

CMV: Frequent small volume diarrhea, Hematochezia, abdominal pain, low-grade fever, weight loss.

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15
Q

Shigella

A

Raid onset, high fever
Abdominal pain, watery diarrhea with mucus +/- blood
+/- Seizures in children

Tx: fluids, Abx if immunocompromised, bacteremic, or severely ill.

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16
Q

Early congenital syphilis

A

HSM, Jaundice, IUGR, snuffles, desquamating/bullous rash, abnormal long bones on X-ray.

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17
Q

Pinworms

A

Kids, perianal itching, tape test, mature worms can migrate to the vagina and cause vulvovaginitis.

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18
Q

Cryptosporidium diarrhea

A

Low-grade fever with profuse watery diarrhea

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19
Q

Microsporidium diarrhea

A

Watery, crampy, weight loss, usually no fever

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20
Q

MAC diarrhea

A

Watery, high fever

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21
Q

CMV diarrhea

A

Frequent small volume stools, hematochezia, abdominal pain, low-grade fever, weight loss

22
Q

Chlamydia trachomatis

A

Conjunctival injection, inflamed tarsals, and pale follicles.

Spreads in unsanitary and crowded conditions. Can lead to blindness.

Tx: Azithromycin

23
Q

Bacillary Angiomatosis

A

Bright red, firm, friable, exophytic nodules in an HIV+ patient. Caused by Bartonella.

Tx: Erythromycin

24
Q

Bacterial Conjunctivitis tx

A

Erythromycin, polymyxin, or azithromycin drops

If contacts, fluoroquinolone drops.

25
Q

Viral Conjunctivitis tx

A

Warm or cold compresses +/- antihistamine

26
Q

Allergic Conjunctivitis tx

A

Antihistamine (+mast cell stabilizer for persistent symptoms)

27
Q

Fever and splenomegaly in the setting of infection (chole/endocarditis)

A

Splenic Abscess

More likely in immunocompromised or DM

28
Q

Nasal mass in a Chinese individual

A

Nasopharyngeal carcinoma, caused by reactivation of EBV

29
Q

HIV+ Pregnancy

A

Triple antiretroviral therapy and neonatal zidovudine

C section if viral load >1000

30
Q

C diff risks

A

Abx, PPIs

31
Q

Treatment of active Toxoplasma encephalitis

A

Pyrimethamine and sulfadiazine

32
Q

Puncture wound infection

A

Pseudomonas

33
Q

Intense pain to light tough in an elderly or immunocompromised person.

A

Zoster

34
Q

Chronic osteomyelitis

A

following acute phase (fevers, erythema),
persistent pain, swelling, chronic wound, sinus tract, nonunion of fracture.

Surgical debridement and abx

35
Q

Ecthyma gangrenosum

A

Rare pseudomonas infection. Found in immunocompromised patients. Rapid onset of indurated macules and papules that can become ulcerated. Due to bacteremia.

36
Q

Syphilis

A

Primary: chancre
Secondary: fever, malaise, widespread lymphadenopathy, diffuse maculopapular rash beginning on the trunk and spreading to the extremities including palms and soles. Can have oral lesions.

Dx: serology (nontreponemal (RPR) and treponemal (ELISA))

37
Q

Otitis externa tx

A

cipro

38
Q

Congenital Rubella

A

PDA, cataracts, sensorineural hearing loss

39
Q

Congenital CMV

A

chorioretinitis, periventricular calcifications

40
Q

Prosthetic joint infections

A

less than 3mo post op: S aureus, Gm- rods, anaerobes
3-12 months post op: other staph species, enterococci
12+ months post op: S. aureus, Gm- rods, streptococci

41
Q

Grey watery discharge from a surgical site

A

Necrotizing surgical site infection

debridement and abx

42
Q

Varicella post exposure prophylaxis

A 
Previous Hx of Varicella or 2 doses of vaccine?
Yes: Observe
No: Immunocompetent?
Yes: Varicella vaccine
No: Varicella Ab
43
Q

Travelers diarrhea

A

usually e coli but if prolonged consider C. parvum (even in immunocompetent), cyclospora, and giardia.

44
Q

Invasive Aspergillosis

A 
Immunocompromised patients
Fever, chest pain, hemoptysis
Pulmonary nodules with "halo sign"
Dx: cultures and cell wall biomarkers
Tx: Voriconazole
45
Q

PCP

A

Dyspnea, nonproductive cough, fever

Bilateral diffuse ground glass appearance on xray

46
Q

High lymphocyte count in pleural effusion

A

possible TB

47
Q

The greatest risk of TPN

A

Central line infection

48
Q

High lymphocytes and protein on CSF

A

Tuberculosis

49
Q

Severe diarrhea and rash in a post BMT patient

A

GVHD

50
Q

Breast abscess

A

Presents like a clogged lactiferous duct but more common in the lateral portions of the breast. Fluctuant mass with lymphadenopathy.
Drain and abx
Clogged lactiferous ducts have no LAD.

51
Q

New born with microcephaly, HSM, jaundice and petechiae.

A

CMV
Mother likely had a short term illness during pregnancy
periventricular calcification

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