ID

Question 1

Pneumonia sx, night sweats, recent travel to the Southwestern U.S.

Answer 1

Coccidioidomycosis

Tx: amphotericin, fluconazole

Question 2

Pneumonia, hilar adenopathy/calcifications, exposure to bird/bat droppings or construction sites in Ohio, Mississippi

Answer 2

Histoplasmosis

Tx: itraconazole

Question 3

Pneumonia sx, night sweats, patient from the Midwest around the Great Lakes

Answer 3

Blastomycosis

Question 4

Flu-like sx followed by pulmonary edema, hypotension, patient from the Southwest w/ exposure to rodents

Answer 4

Hantavirus

Question 5

Tropical med: fever, HA, myalgias, conjunctival injection, exposure to freshwater

Answer 5

Leptospirosis (spirochete)
Tx: amoxicillin or doxycycline
Weil syndrome: complication leading to aseptic meningitis, renal failure, hepatitis, uveitis, rash

Question 6

Tick-borne illness causing fever, HA, myalgias, leukopenia and transaminitis

Answer 6

Ehrlichiosis (obligate intracellular bacteria)

Tx: doxy or chloramphenicol

Question 7

Tick-borne illness causing hemolytic anemia, hepatomegaly, jaundice

Answer 7

Babesiosis

Tx: quinine + clinda OR atovaquone + azithro

Question 8

Fever, LAD, ulcerations, exposure to rabbits

Answer 8

Tularemia

Tx: streptomycin

Question 9

Suboccipital LAD, rash, Forchheimer spots

Answer 9

Rubella

Forchheimer spots are petechiae on soft palate

Question 10

Sandpaper rash and pastia’s lines

Answer 10

Scarlet fever

Question 11

Tropical med: fever, HA, myalgias, GI hemorrhage, and rash

Answer 11

Ebola virus

Question 12

Tropical med: fever, HA, vomiting, transaminitis x3-4 days, 48 hr remission than return of fever + GI hemorrhage, multiorgan failure

Answer 12

Yellow fever

Tx: supportive care

Question 13

Diarrheal illness associated with swimming in lakes and HIV/AIDS

Answer 13

Cryptosporidium

Question 14

What is triple therapy for H pylori?

Answer 14

Amoxicillin + clarithromycin + PPI

Question 15

Urethritis/cervicitis followed by migratory arthralgias, tenosynovitis, rash

Answer 15

Gonococcemia

Tx: IV ceftriaxone

Question 16

White oral plaques that do not scrape off (name and cause?)

Answer 16

Oral hairy leukoplakia, caused by EBV

Question 17

First line tx for Lyme in pregnant women and children < 8 yo

Answer 17

Amoxicillin

Question 18

Sx and tx for acute disseminated Lyme

Answer 18

Sx: meningoencephalitis, Bell’s palsy, carditis, presents 4 weeks after initial infection
Tx: IV ceftriaxone

Question 19

Side effects of Ethambutol

Answer 19

Optic neuritis, red-green color blindness

Question 20

STDs: shallow, painless ulcer or vesicles + tender inguinal LAD

Answer 20

Lymphogranuloma venereum (chlamydia)

Question 21

STDs: painful, ulcerating papules, inguinal bubo

Answer 21

Chancroid (haemophilus ducreyi)

Question 22

STDs: beefy red ulcer, painless papules, and subq granulomas in inguinal nodes

Answer 22

Granuloma inguinale (klebsiella granulomatis)

Question 23

Incubation period for syphilis

Answer 23

10-90 days

Question 24

Treatment for primary, secondary, late/tertiary syphilis and neurosyphilis

Answer 24

Primary, secondary: penicillin G x1
Late secondary (>1 year) or tertiary: penicillin qwk x 3 wks
Neurosyphilis: IV penicillin q4 hr x 10-14 days

Question 25

Tick-borne illness with high fever, HA, arthralgias, thrombocytopenia, hypoNa, centripetal rash

Answer 25

RMSF

Tx: doxycycline

Question 26

Treatment for dog bites

Answer 26

Can close unless on hand or foot

Give augmentin if closing or if on hand/foot, joints, genitalia, immunocompromised

Question 27

Most common bacteria from dog and cat bites

Answer 27

Pasturella multocida

Question 28

Bacteria from dog bite leading to fulminant bacteremic illness

Answer 28

Capnocytophaga canimorsus

Question 29

Treatment for cat bites

Answer 29

Never close, give augmentin

Question 30

Treatment for human bites

Answer 30

Never close, give augmentin

Question 31

Most common bacteria from human bites

Answer 31

Eikenella, staph, strep

Question 32

Tropical med: fever, edema, LAD, transaminitis, can be complicated by HF or arrhythmia

Answer 32

Chagas disease (trypanosoma cruzi)
Tx: nifurtimox or benznidazole

Question 33

What types of wounds are considered high risk for tetanus?

Answer 33

> 6 hours old, contaminated, puncture or crush wounds, foreign bodies, burns, frostbite
Require dT if >5 years since last dose

Question 34

When should tetanus immunoglobulin be given?

Answer 34

When the wound is high risk and vaccination status is unknown or never vaccinated (low risk wound can get dT alone)

Question 35

What are indications for steroids in patients w/ PCP pneumonia?

Answer 35

PaO2 < 70 mmHg or A-a gradient > 35 mmHg

Question 36

Treatment for pertussis

Answer 36

Azithromycin (both patient and close contacts)

Question 37

Prophylaxis for close contacts of patients with Neisseria or H flu meningitis

Answer 37

Rifampin or cipro

Question 37

What is the treatment for meningitis in an immunocompromised patient?

Answer 37

Vanc + ceftazidime + ampicillin

And decadron

Question 38

Treatment for pulmonary anthrax

Answer 38

Amoxicillin, doxy, or cipro

Give ppx to close contacts and HCWs with cipro