ID - Random

Question 0

Best diagnostic test for otitis media ? When to order?

Answer 0

Tympanocentisis; multiple recurrences

Question 1

Most sensitive sign for otitis media? Treatment?

Answer 1

Immobile tympanic membrane; axoxicillian

Question 2

Sinusitis – most accurate test? When to do it?

Never do?

Answer 2

Sinus biopsy or aspirate; recurrent sinusitis or no response from empiric therapies

(never do culture of nasal discharge)

Question 3

First-line options for otitis or sinusitis?

Answer 3

#Augmentin
#Doxycycline
#Bactrim

PLUS decongestant

Question 4

Signs of strep pharyngitis?

Treatment?

Answer 4

#tender lymphadenopathy
#fever
#tonsilar exudate
#no cough

Amoxicillin

Question 5

If membranous oropharyngeal exudates, think?

Answer 5

#diphtheria 
#EBV
#vincent angina

Question 6

Influenza treatment?

Answer 6

Under 48 hours: oseltamivir, zanamivir (neuroaminidase to shorten duration)

If over 48 hours: symptomatic treatment

Question 7

Infectious diarrhea – next step?

Answer 7

Look for blood or Stool lactoferrin

Question 8

Bloody diarrhea:

1. Most common? (Complication?)
2. Associated with HUS?
3. Associated with cruise ships
4. Associated with history of liver disease and rash
5. Associated with hemochromatosis or blood transfusions

Answer 8

1. Campylobacter (GBS)
2. E. coli and shigella
3. Vibrio parahaemolyticus
4. Vibrio vulnificus
5. Yersinia

Question 9

Nonbloody diarrhea and vomiting?

Answer 9

Staph or bacillus cereus

Question 10

Patient presents with diarrhea, wheezing, Flushing, and skin rash soon after eating fish dinner - diagnosis? Treatment?

Answer 10

Scombroid

Antihistamines

Question 11

Treatment for cryptosporidium?

Answer 11

Nitazoxanide

Question 12

Elevated lab test in viral hepatitis that is associated with higher mortality?

Answer 12

Elevated PT/INR

Question 13

Assess disease course of Hep C with?

Answer 13

PCR RNA level (use to assess response to treatment, etc)

Question 14

In hep B, finding that suggests that patient is no longer at any risk for transmission?

Which finding indicates need for antivirals in chronic disease?

Answer 14

No surface antigen

E-antigen

Question 15

Best indicator that pregnant woman with hep B will transmit infection to child?

Answer 15

E-antigen or DNA polymerase

Question 16

Only acute hepatitis that gets meds? Treat with?

Answer 16

Acute hep C
#interferon
#ribavirin
#boceprevir OR telaprevir

Question 17

Urethritis - most likely diagnosis if? Best initial test? Most accurate test? Treatment?

Answer 17

Urethral discharge

Urethral swab (for Gram stain)

Urethra culture, DNA probe, amplification for gonorrhea/chlamydia

Ceftriaxone and doxycycline/azithromycin

Question 18

Urethritis – if not chlamydia or gonorrhea?

Answer 18

Mycoplasma genitalium or ureaplasma

Question 19

Female with abdominal tenderness, fever, cervical motion tenderness and leukocytosis – likely diagnosis? First test? Most accurate test? (Do when?)

Answer 19

PID; cervical swab;

laparoscopy (if unclear diagnosis, systems persist despite therapy, recurrent episodes)

Question 20

STD with tender, suppurative lymph nodes? Best test? Treatment?

Answer 20

Lymphogranuloma venereum

Complement fixational titers for amplification

Doxycycline

Question 21

HSV - Best initial test? Most accurate test?

Answer 21

Tzack prep ; Viral culture

Question 22

Treatment for chancroid?

Answer 22

Doxycycline

Question 23

Tx for condylomata acuminata?

Crabs?

Scabies?

Answer 23

Cryotherapy; podophyllin; trichloroacetic acid;

Permethrin (lindane)

Permethrin

Question 24

Treatment for UTI?

Answer 24

Three days nitrofurantoin (seven days if anatomic abnormality)

Question 25

Empiric treatment for Pyelonephritis?

Answer 25

#Ampicillin + gentamicin
#Ceftriaxone

Question 26

Long-term therapy for chronic prostatitis?

Answer 26

6 to 8 weeks of Bactrim

Question 27

Patient with pyelonephritis that does not resolve with appropriate therapy – next step?

Answer 27

Imaging for perinephric abscess or anatomic defect