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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
Patient scratched by plant and has new nodules with central umbilication. Dx and Tx?
Sporotrichosis | 3-6 months of itracanazole
26
Ipsilateral conjunctivities and lymphadenopathy Owns a kitten concerning for?
Cat scratch disease Oculoglandular syndrome (Parinaud syndrome) - Characterized by unilateral conjunctivts and adenopathy Most common complication - Lymph node suppration
27
Most common cause of cellulitis?
Strep pyogenes
28
Guy cut his hand cleaning a fish tanks and now has a lac with hemorrhagic bullae, tachy and febrile. Dx?
Vibrio vulnificus Get blood/wound cultures Highly fatal in chronically ill pts (T2DM, liver dz, RA) Tx - IV CTX and doxycycline
29
Pts on immunosuppression should also be taking which abx?
Bactrim | PCP prophylaxis
30
Viral cause of hand foot and mouth
Coxsackievirus
31
Prophylactic Treatment for cat bites
Augmentin
32
Human bites are at risk of which infection
Eikenella corrodents (GN anaerobe) Usually polymicrobial Tx - Augmentin
33
Pt has IgM Ab against HCV. VSS. What do you do?
Active HBV infection | If stable, can have close follow up as outpatient
34
What is the risk of getting chronic HBV?
Depends on age Adults - 5% kids<5 - 20-50% Perinatal - 90%
35
For a HIV + that starts antiretrovirals, approx how long does it take for them to have a viral load <50copies/mL
6 months | If the viral load is not <200 within this time frame, then need to adjust their ART therapy
36
1st line treatment for syphilis during pregnancy
Penicillin | De-sensitize if you must
37
Centor criteria
``` 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
preggo gets HBV during pregnancy, howdy you treat the babe?
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
How do you r/o infection in a diabetic foot ulcer?
MRI
40
Pt with HBV gets fever, polyarthritis, dermatitis. why?
sick serum like illness. Immune complex mediated hypersensitivity reaction
41
Unvax kiddo Fever, sore throat Pharyngitis with grey exudate that coalesces Dx and risk of getting?
Diphtheria | Toxin mediated damage to heart, nervous system, and kidneys
42
etiology of CLABSI?
skin organisms Staph, candida, aerobic GNRs Reduce CLABSI with sterile technique
43
Greatest side effect of Isoniazid?
transaminitis | usually asymptomatic
44
In STI world azithromycin treats?
Chlamydia | Typically aseptic on Gram stain
45
In STI world, CTX treats?
Gonorrhea
46
Young male pt with urethritis, doesn't improve after CTX/Azithro and NAAT negative for G/Ch infection. Now what?
Repeat urethral fluid gram stain | Suspect M genitalium which improves with moxifloxacin
47
Tx of cat scratch dz?
Azithromycin | Bartonella henselae
48
Most common cause of acquire chorea in kids?
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
untreated chlamydia in pregnancy increases risk of?
PPROM
50
Recent travel to 3rd well presenting with belly pain and bloating Eosinophilia FOBT + Dx and Tx?
Helminths Dx - Stool O&P Tx - albendazole
51
best way to prevent C. diff other than limiting abx?
limit PPI use
52
tx for latent tb
isoniazid x 9 months
53
post exposure hep b prophylaxis for people with low titers?
Hep B IG + HBV vaccine
54
HIV post-exposure ppx?
Tenofovir, Emtricitabine, raltegravir x 4 weeks | Should start tiple therapy within 72 hours of exposure
55
Immunocompromised patient with rash that started as erythematous macule that developed into a pustule or bullae and ultimately a non painful ulcer Dx?
Ecthyma gangrenosum Caused by pseudomonas Tx - IV zosyn + gentamicin
56
Tx for mono
NSAIDs for comfort no antiviral If they show signs of airway obstruction --> admit for iV steroid
57
``` IVDU Fever Petechiae + HA, lethargy, neck stiffness Suspect? ```
Subarachnoid hemorrhage 2/2 mycotic (infected) arterial aneurysm Complication of infective endocarditis
58
Tx for salmonella bloody diarrhea?
supportive | abx don't improve outcomes
59
CAP tx for a kiddo?
amoxicillin
60
How to tx close contact of meningococcal meningitis?
Rifampin Cipro CTX
61
Pt with nasal packing has diffuse red macular rash on the palms and soles and in septic shock. Dx?
Toxic shock syndrome D/t Staph aureus bacterial exotoxin Tx - IVF + IV vanc
62
Can HIV + women breastfeed?
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
Male immigrant from Africa has UTI syx resistant to treatment and hematuria at the end of his voiding Dx?
Schistosomiasis Dx - parasite eggs in urine sediment peripheral eosinophilia Tx - praziquantel
64
Recent third world travel DIC transaminitis
Dengue hemorrhagic Fever | Mortality d/t respiratory and circulatory failure
65
Leading cause of dilated cardiomyopathy in South America?
Chagas dz | LV apical aneurysm
66
diabetic sinus congestion with eschar Dx and tx
rhino cerebral mucormycosis associated with DKA Tx - debride and IV liposomal amphotericin B
67
How to treat a preggo with active TB?
Isoniazid, Rifampin, ethambutol x 2 months followed by Isoniazid and Rifampin x 7 months
68
Immunocompromised patient Cavitory lesion in upper lung Most common cause?
Aspergillisis
69
``` Newborn SGA Prupuric lesions over trunk absent red reflex b/l Murmur ```
``` Congenital rubella Blueberry muffin rash Hearing loss Cataracts PDA ```
70
tx for syphillis?
CTX qwk x 3 wks
71
Tx for strep throat
Amoxicillin
72
Why should you not give abx to someone with mono?
They get a rash | Resolves after abx is stopped
73
``` Young kid Meningitis syx CSF c/w bacterial infection CN palsy Yellow white nodules on optic disc on funds exam ```
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
New born with hydrocephalus and diffuse intracranial calcifications?
Toxo | Dt consumption of undercooked pork or lamb, contaminated soil, or cat feces
75
Is lyme dz in a preggo bad?
Nah, just take your amoxicillin
76
Tx for erysipelas?
ampicillin, amoxicillin
77
How long does it take for purulent fluid from AOM to resolve?
Up to 3 months

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