ID questions Flashcards
Which of the following statements is false?
A) Most acute fevers are due to infection
B) Pathogens create disease in humans as a
result of the interaction between the host immune
system, mechanism of exposure, and virulence of
the infecting organism
C) There is little risk to using antimicrobials in
situations where the chance of benefit is low;
prescribing ‘just in case’ can be an important part
of keeping patients healthy
D) An immunocompetent person is less prone to
infections than an immunodeficient person
C
A 32-year-old presents to urgent care with a severe sore throat, a generalized rash and
lymphadenopathy. For each item, select TRUE or FALSE:
- Consider acute HIV in the differential diagnosis
- An HIV ELISA and/or Western blot test should be diagnostic
- Obtain a sexual history.
- If this is HIV, the disease will likely progress rapidly to develop an AIDS-defining illness
1- true
2- false
3- true
4- false
Regarding prevention of HIV transmission, which of the following is true?
A. Condoms are effective in preventing many sexually transmitted diseases, but not HIV
B. Health care workers who are exposed to blood-borne pathogens (e.g. accidental needle stick) are discouraged from seeking care since it reflects carelessness in patient care
C. Post-exposure prophylaxis can be effective for people exposed to HIV
D. Universal precautions should be undertaken by all health care workers with all patients,
regardless how low the patient’s risk for HIV
C, D
Which of the following is true regarding when to initiate HIV treatment with HAART
(highly active antiretroviral therapy)?
- Treatment is based upon CD4 cell counts
- Treatment is based upon total white blood cell count
- Treatment is based upon the extent of opportunistic infections
- Treat everyone
4
For a patient initiating HAART with favorable clinical results, the patient should be monitored for which of the following?
A) Progression of the HIV infection
B) Increase in CD4 cell counts indicating successful suppression of HIV replication
C) Immune recovery uveitis
D) Drop in HIV viral load
E) Excellent tolerability with no side effects
F) Decreased HIV transmission risk
A,B, D, F
Which of the following regarding toxoplasmosis is true?
A. Pregnant women without HIV should not be concerned about toxoplasmosis
B. Many immunocompetent people in this auditorium may have been infected with toxoplasmosis but are asymptomatic
C. Toxoplasmosis can produce enhancing CNS lesions in immunocompromised patients
D. Ocular exam can demonstrate retinochoroiditis and vitritis
B
C
D
A severely immunocompromised patient (CD4 cell count = 49) presents with a
headache, neck stiffness and lethargy.
Possible infectious causes include:
A. Pneumocystis jiroveci
B. Cryptococcus neoformans
C. Pneumococcal pneumonia
C (cryptococcal meningitis)
A 60-year-old patient with diabetes presents to their primary care doctor after acute
onset of fevers, chills and cough with chest pain. No risks for HIV infection are
identified. Chest x-ray reveals a right lower lobe infiltrate.
Labs: WBC = 16,000/mm3
Of the following, the most likely diagnosis is:
A. Pneumococcal pneumonia
B. Pneumocystis jiroveci pneumonia
C. Primary HSV
A Pneumococcal - sudden onset
(Pneumocyctis - slowly progress, more imunocompromised, lower WBC)
A 38-year-old patient with HIV infection has a CD4+ cell count of 91. They present with a cough of a month’s duration, progressive shortness of breath and fevers. On exam, tachypnea, tachycardia and hypoxia are present. Chest x-ray reveals diffuse air space disease bilaterally. Which of the following pathogens is likely?
A. Pneumococcal pneumonia
B. Herpes zoster
C. Pneumocystis jiroveci pneumonia
D. Human herpesvirus 8
C - slow progression
(Pneumococcal sudden onset)
Which of the following is true regarding HSV (herpes simplex virus)?
A) HSV-1 only causes labial (lip) infections
B) There is no treatment to eradicate HSV
C) There is no treatment for symptomatic HSV
D) HSV causes molluscum
A- false
B True
C false
D false
Regarding encephalitis:
A) Can be caused by mosquito-borne viruses
B) Can be caused by HIV
C) Can be caused by HSV
D) Can be caused by Neisseria
A- true
B- true
C- true
D- false (meningitis)
Regarding sinusitis:
A) Antibiotics are always required
B) Most infections are viral and will resolve without antibiotics
C) Symptomatic treatment (e.g. with decongestants and nasal irrigation) is
generally the first line treatment
A-false
B- true
C- true
Indications for antibiotic use in patients with acute rhinosinusitis include all of the
following except:
A) Severe symptoms
B) Fewer than 5 days of symptoms
C) “Double sickening” (initial improvement followed by worsening)
D) Complication of orbital cellulitis
A- Yes
B- No (depending on co morbidities)
C- Yes
D- Yes
A 70-year-old who emigrated from Asia works in a retail store with family members. The patient develops a cough with hemoptysis and sees a physician. Evaluation reveals a cavitary process on chest x-ray. Which of the following is true:
A. Penicillin should be initiated immediately
B. Patient should be tested for HIV
C. Patient can return to work while the evaluation progresses
D. All of the above
(Thinking about TB)
B
highly infectious
A 70-year-old who emigrated from Asia works in a retail store with family members. The patient develops a cough with hemoptysis and sees a physician. Evaluation reveals a cavitary process on chest x-ray.
This patient’s infection:
A. Is likely primary
B. Is likely a reactivation of a prior infection
C. Requires 4 weeks of therapy
D. Is an uncommon infection in the global health scene
B
