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1
Q

Cruise ship diarrhea

A

Norovirus

mostly vomiting

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2
Q

When to give abs for sinusitis?

A

Syx > 10 days
Deterioration after improving for a few days
Tx - Amox - Clavulanate

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3
Q

Tx for latent TB

A

Isoniazid x 9 months
OR
Rifampin x 4 months

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4
Q

Viral cause of meningitis after camping

A

West Nile Virus

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5
Q

Pt has previous been exposed to rabies and undergone treatment. Now presenting with re-exposure

A

Booster course (rabies vaccine x 2)

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6
Q

First exposure to rabies

A

Rabies IG + rabies vaccine series (4x)

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7
Q

Recent camping trip
Now HA, fever
erythematous macular + petechial rash over wrists and ankles

A

Rocky Mountain Spotted Fever

Tx - doxycycline

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8
Q

Best diagnostic test for abdominal abscess

A

abdominal ultrasound

14-21 days s/p abd surgery

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9
Q 
Pt on antiretroviral therapy develops:
buffalo hump
increased abdominal girth
insulin resistance
Why?
A

HIV-associatedlipodystrophy

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10
Q

Etiology of PNA In patients with CF

A

Pseudomonas or Staph aureus

Tx - Vanc, cefepime, amikacin

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11
Q

Chronic cough, frequent PNAs, intestinal obstruction as a newborn is concerning for?

A

Cystic Fibrosis

Hyperinflation on CXR

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12
Q

High suspicion for TB d/t abnormal Xray, whats the best test to confirm

A

Sputum acid fast bacilli smear and culture

However, low sensitivity and can be falsely negative

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13
Q

CURB 65

A 
Confusion
Urea > 20
Respiration > 30
BP <90
Age >65
1 point for each, score of 1-2 likely for inpatient treatment
Score 3-4 Admission vs ICU
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14
Q

Treatment for latent TBI

A

Isoniazid x 9 months OR

Rifampin x 4-6 months

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15
Q

Unvaccinated child that is tripoding concerning for

A

Epiglottitis
H. flu
If you suspect this, prepare for intubation as their airway can be lost in a hurry

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16
Q

Treatment for mastitis?

A

po dicloxacillin or cephalexin

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17
Q

If mastitis doesn’t improve with abx, what is likely to happen?

A

Progress to abscess
Looks for induration/fluctuance
Need u/s to tell if mastitis vs abscess
If abscess needs aspiration + abx

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18
Q

Male with UTI syx > 3 months refractory to appropriate treatment. Concern for?

A

Chronic bacterial prostatis

Tx with 6 weeks of fluoroquinolone (cipro) or Bactrim

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19
Q

HIV pt with multiple papular lesions with central umbilication and central hemorrhage/necrosis

A

Cutaneous Cryptococcosis

Dx with biopsy

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20
Q

Most common pathogens in AOM

A

Strep pneumo
Nontypable H flu
Moraxella

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21
Q

HIV pt with worsening of symptoms weeks after starting anti-retrovirals. Worry about?

A

Immune Reconstitution Inflammatory Syndrome (IRIS)

Self-limited, no adjustments needed

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22
Q

Empiric abx for possible central line infection

A

Vanc, cefepime

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23
Q

Treatment for Strep Pharyngitis

A

po Penicillin x 10 days

Rationale for 10 day course is to prevent Rheumatic fever

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24
Q

Newly diagnosed HIV pt should receive which vaccines?

A

Pneumovax 13 and 23
Hep A
Hep B

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25
Q

Patient scratched by plant and has new nodules with central umbilication. Dx and Tx?

A

Sporotrichosis

3-6 months of itracanazole

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26
Q

Ipsilateral conjunctivities and lymphadenopathy
Owns a kitten
concerning for?

A

Cat scratch disease
Oculoglandular syndrome (Parinaud syndrome) - Characterized by unilateral conjunctivts and adenopathy
Most common complication - Lymph node suppration

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27
Q

Most common cause of cellulitis?

A

Strep pyogenes

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28
Q

Guy cut his hand cleaning a fish tanks and now has a lac with hemorrhagic bullae, tachy and febrile. Dx?

A

Vibrio vulnificus
Get blood/wound cultures
Highly fatal in chronically ill pts (T2DM, liver dz, RA)
Tx - IV CTX and doxycycline

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29
Q

Pts on immunosuppression should also be taking which abx?

A

Bactrim

PCP prophylaxis

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30
Q

Viral cause of hand foot and mouth

A

Coxsackievirus

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31
Q

Prophylactic Treatment for cat bites

32
Q

Human bites are at risk of which infection

A

Eikenella corrodents (GN anaerobe)
Usually polymicrobial
Tx - Augmentin

33
Q

Pt has IgM Ab against HCV. VSS. What do you do?

A

Active HBV infection

If stable, can have close follow up as outpatient

34
Q

What is the risk of getting chronic HBV?

A

Depends on age
Adults - 5%
kids<5 - 20-50%
Perinatal - 90%

35
Q

For a HIV + that starts antiretrovirals, approx how long does it take for them to have a viral load <50copies/mL

A

6 months

If the viral load is not <200 within this time frame, then need to adjust their ART therapy

36
Q

1st line treatment for syphilis during pregnancy

A

Penicillin

De-sensitize if you must

37
Q

Centor criteria

A 
Tonsillar exudates
Tender anterior cervical lymphadenopathy
Fever
NO cough
If pt has >3 Centor criteria recommend rapid strep
If <3 likely to have viral pharyngitis
38
Q

preggo gets HBV during pregnancy, howdy you treat the babe?

A

Give HBV vas and IG in first 12 HOL
Then give the normal HBV vaccines (0, 2, 6 mo)
Check serology at 9 months

39
Q

How do you r/o infection in a diabetic foot ulcer?

40
Q

Pt with HBV gets fever, polyarthritis, dermatitis. why?

A

sick serum like illness. Immune complex mediated hypersensitivity reaction

41
Q

Unvax kiddo
Fever, sore throat
Pharyngitis with grey exudate that coalesces
Dx and risk of getting?

A

Diphtheria

Toxin mediated damage to heart, nervous system, and kidneys

42
Q

etiology of CLABSI?

A

skin organisms
Staph, candida, aerobic GNRs
Reduce CLABSI with sterile technique

43
Q

Greatest side effect of Isoniazid?

A

transaminitis

usually asymptomatic

44
Q

In STI world azithromycin treats?

A

Chlamydia

Typically aseptic on Gram stain

45
Q

In STI world, CTX treats?

46
Q

Young male pt with urethritis, doesn’t improve after CTX/Azithro and NAAT negative for G/Ch infection. Now what?

A

Repeat urethral fluid gram stain

Suspect M genitalium which improves with moxifloxacin

47
Q

Tx of cat scratch dz?

A

Azithromycin

Bartonella henselae

48
Q

Most common cause of acquire chorea in kids?

A

Sydenham chorea
2/2 acute rheumatic fever
Emotionally labile, irregular rapid jerking movement of extremities and face
JONES criteria
Usually 1-8 months after strep infection
See carditis and arthritis shortly after
Tx - PCN - need long acting IM until they reach adulthood to prevent heart dz

49
Q

untreated chlamydia in pregnancy increases risk of?

50
Q

Recent travel to 3rd well presenting with belly pain and bloating
Eosinophilia
FOBT +
Dx and Tx?

A

Helminths
Dx - Stool O&P
Tx - albendazole

51
Q

best way to prevent C. diff other than limiting abx?

A

limit PPI use

52
Q

tx for latent tb

A

isoniazid x 9 months

53
Q

post exposure hep b prophylaxis for people with low titers?

A

Hep B IG + HBV vaccine

54
Q

HIV post-exposure ppx?

A

Tenofovir, Emtricitabine, raltegravir x 4 weeks

Should start tiple therapy within 72 hours of exposure

55
Q

Immunocompromised patient with rash that started as erythematous macule that developed into a pustule or bullae and ultimately a non painful ulcer
Dx?

A

Ecthyma gangrenosum
Caused by pseudomonas
Tx - IV zosyn + gentamicin

56
Q

Tx for mono

A

NSAIDs for comfort
no antiviral
If they show signs of airway obstruction –> admit for iV steroid

57
Q 
IVDU
Fever
Petechiae
\+ HA, lethargy, neck stiffness
Suspect?
A

Subarachnoid hemorrhage 2/2 mycotic (infected) arterial aneurysm
Complication of infective endocarditis

58
Q

Tx for salmonella bloody diarrhea?

A

supportive

abx don’t improve outcomes

59
Q

CAP tx for a kiddo?

A

amoxicillin

60
Q

How to tx close contact of meningococcal meningitis?

A

Rifampin
Cipro
CTX

61
Q

Pt with nasal packing has diffuse red macular rash on the palms and soles and in septic shock. Dx?

A

Toxic shock syndrome
D/t Staph aureus bacterial exotoxin
Tx - IVF + IV vanc

62
Q

Can HIV + women breastfeed?

A

Nope :/
In poor countries it can be considered but not here
All babes born to HIV + moms should get zidovudine pptx for first 6 wks of life

63
Q

Male immigrant from Africa has UTI syx resistant to treatment and hematuria at the end of his voiding Dx?

A

Schistosomiasis
Dx - parasite eggs in urine sediment
peripheral eosinophilia
Tx - praziquantel

64
Q

Recent third world travel
DIC
transaminitis

A

Dengue hemorrhagic Fever

Mortality d/t respiratory and circulatory failure

65
Q

Leading cause of dilated cardiomyopathy in South America?

A

Chagas dz

LV apical aneurysm

66
Q

diabetic
sinus congestion with eschar
Dx and tx

A

rhino cerebral mucormycosis
associated with DKA
Tx - debride and IV liposomal amphotericin B

67
Q

How to treat a preggo with active TB?

A

Isoniazid, Rifampin, ethambutol x 2 months followed by Isoniazid and Rifampin x 7 months

68
Q

Immunocompromised patient
Cavitory lesion in upper lung
Most common cause?

A

Aspergillisis

69
Q 
Newborn 
SGA
Prupuric lesions over trunk
absent red reflex b/l
Murmur
A 
Congenital rubella
Blueberry muffin rash
Hearing loss
Cataracts
PDA
70
Q

tx for syphillis?

A

CTX qwk x 3 wks

71
Q

Tx for strep throat

A

Amoxicillin

72
Q

Why should you not give abx to someone with mono?

A

They get a rash

Resolves after abx is stopped

73
Q 
Young kid
Meningitis syx
CSF c/w bacterial infection
CN palsy
Yellow white nodules on optic disc on funds exam
A

TB meningitis
Brain imaging with basilar meningeal enhancement
Usually 2-3 weeks of infectious prodrome with meningeal syx later
Tx - RIPE, follow by 12 months of RI. Should also get steroids to reduce treatment related CNS problems

74
Q

New born with hydrocephalus and diffuse intracranial calcifications?

A

Toxo

Dt consumption of undercooked pork or lamb, contaminated soil, or cat feces

75
Q

Is lyme dz in a preggo bad?

A

Nah, just take your amoxicillin

76
Q

Tx for erysipelas?

A

ampicillin, amoxicillin

77
Q

How long does it take for purulent fluid from AOM to resolve?

A

Up to 3 months

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