ID- MKSAP VI

Question 1

When do you post-exposure prophylax for Lyme? What is the ppx?

Answer 1

• 72 hours of tick removal
• tick on for at 36 hours
• doxy 200mg x1

Question 2

What do you do if you are exposed to smallpox (variola)?

Answer 2

Vaccinia vaccination no more than 7 days (but preferably within 3) after presumed exposure

Question 3

Infection of VZV in young person should prompt testing for _____.

Answer 3

HIV

Question 4

How does Creutzfeldt Jakob present?

Answer 4

• rapidly presenting dementia, ataxia, myoclonus
• can have T-tau or 14-3-3 protein in CSF
• MRI findings are nonspecific

Question 5

Do you treat EHEC (AKA Shiga-toxin producing E coli AKA STEC) with antibiotics?

Answer 5

No, increased risk of HUS

Question 6

What can CMV infection cause?

Answer 6

Retinitis (common in AIDS), pneumonitis, hepatitis, bone marrow suppression, colitis with bloody diarrhea, esophagitis, adrenalitis

Question 7

When do most surgical site infections occur?

Answer 7

within 30 days (90 days if it involves implant)

Question 8

What do you sample to guide a superficial incisional infection?

Answer 8

culture of drainage from wound

Question 9

Side effects of FQ

Answer 9

1. tendonitis/tendon rupture
2. CNS- HA, neuropathy, sleep and mood alterations
3. QTC prolongation
4. GI symptoms

Question 10

Treatment for oropharyngeal/esophageal candidiasis

Answer 10

• oral fluconazole (7-14 days or 14-21 days if esophageal)

Question 11

Most appropriate testing for genital ulcers caused by HSV.

Answer 11

NAAT for HSV-1 and HSV-2

Question 12

Treatment of nec fasc for GAS

Answer 12

Clinda and PCN after surgical debridement

Question 13

Treatment of Vibrio vulnificus necrotizing skin infection

Answer 13

Doxy and 3rd gen cephalosporin

Question 14

How does Mediterranean spotted fever present?

Answer 14

Fever, myalgia, HA, maculopapular/petechial rash, distinct black eschar at site of inoculation

Caused by Rickettsia conorii, 2-14 days after tick bite

Often in Europe but also Africa, India, and Middle East

Question 15

When does erythema migrans present after infection?

Answer 15

1-4 weeks afterwards

Question 16

When do cardiac or neurologic symptoms occur in early disseminated disease?

Answer 16

2-10 weeks after erythema migrans rash

Question 17

What is the “rule of 7s” for Lyme disease? (Meaning what makes it less likely Lyme)

Answer 17

HA <7 days, <70% mono in CSF, absence of 7th nerve palsy

Question 18

CMV vs EBV in transplant patients

Answer 18

CMV does NOT cause hepatosplenomegaly or generalized LAD

Question 19

What is posttransplant lymphoproliferative disorder (PTLD) and how does it present?

Answer 19

• caused by EBV and presents several years after transplantation with fever, pancytopenia, generalized LAD and hepatosplenomegaly

Question 20

Abx of choice for purulent skin infections s/p I&D?

Answer 20

Bactrim and doxy (not clinda)

Question 21

TB skin test cut off

Answer 21

High risk (HIV, recent contact, etc): > or = 5mm

High-prevalence countries, IVDU, residents/workers in high-risk settings: > or = 10mm

Low risk: > or = 15mm