IM ID - Rd 2 Flashcards
What are the defining features of erysipelas?
MC organism?
Superficial dermis and lymph, sharply DEMARCATED edges
Rapid spread and onset, fever is EARLY
GrpA strep
How does febrile neutropenia present?
What organism to cover for?
ANC < 1500 microL
Will have anemia, mucosal pallor, low Plts
Pseudomonas
What does Ehrlichiosis (tick-borne) cause?
Treat how?
Acute febrile illness w/malaise and AMS
NO rash
Doxycycline
What presents w/anemia, thrombocytopenia, inc bilirubin, inc LDH, and inc LFTs after hiking?
Babesiosis
Pt w/IE that is highly susceptible to PCN should be treated with what?
IV PCN G or IV Ceftriaxone for 4 weeks
What can cause bloody diarrhea in a HIV pt?
CMV
What vaccines do you need for chronic liver disease?
Tdap, flu, PPSV23, HepA and HepB
HIV pt that presents w/fever, HA, elevated ICP (vomiting, Papilledema), wha it’s the MC cause?
Classic presentation is what?
Cryptococcus
Indolent (progresses over days to weeks)
Pt that presents w/noncaseating granuloma, erythema nodusum, but deteriorates after steroid treatment has what?
Histoplasmosis
EBV and strep throat can present exactly the same except for what key differences?
Strep will get V bad or resolve in 2 weeks
Strep does NOT have generalized LAD
Pt w/pyelonephritis and pH above 8, what is the cause?
Proteus
What is a rapidly progressive cellulitis of the submandibular space?
Arises from what?
What kind of pt?
Ludwig angina
Dental infection in mandibular molar and then spread to sublingual space
Alcoholics
Rash + symmetric joint pain that resembles R.A. Is what?
Parvo B19
What is the alternative treatment for syphilis if there is a PCN allergy?
Who should be desensitized?
Doxycycline
Pregnant, CNS syphilis, multiple treatment failures
What is the treatment for HepC?
Ledipasvir-sofosbuvir
If the question looks like EBV/mono but the answer choice is not there, what is something that mimics it?
CMV
Skin lesions and osteolytic or bone problems indicate what?
Blastomycosis
What test for syphilis has the highest diagnostic sensitivity in primary disease?
Can confirm what?
FTA-ABS
VDRL
What is the distribution of a TSS rash?
Involves the palms and soles
What are some uncommon but possible findings in mono?
What lab value?
Autoimmune hemolytic anemia and thrombocytopenia 2-3 weeks after initial onset
Elevated reticulocyte count
HIV pt w/multiple, non enhancing, asymmetric lesions has what?
PML caused by JC virus when CD4 < 200
Splenic fluid collection means what?
MC d/t what?
Splenic abscess
IE w/hematogenous spread
What is the tourniquet test used for?
Dengue fever
How do you differentiate bw disseminated Histoplasmosis and PCP?
When does disseminated Histo occur?
PCP does NOT have LAD, HSM, or pancytopenia
Histo DOES
CD4 < 100
What are the major features of Chikungunya fever?
Travel to Caribbean
Polyarthritis
thrombocytopenia
What kind of HIV pt is at risk for disseminated Bacillary angiomatosis?
Cats or homeless (lice)
CD4 < 100
How does PCT present?
What is strongly associated with it?
Photosensitive skin that develops vesicles w/bullae w/trauma or sun exposure
Form hypo and hyperpigmented areas
HCV
IE w/staph epidermidis will have what pmhx?
Prosthetic valve
intravascular catheter
Implanted device
What presents w/rapid onset of rash, fever, HoTN, diarrhea and thrombocytopenia?
Assoc w/what?
TSS
Tampon, nasal packing, post-surgery infection
Which pts are at higher risk of getting vibrio vulnificus?
Why?
Liver disease (cirrhosis, viral hepatitis), hemochromatosis
Free iron acts as exponential growth catalyst
G+, partially acid fast branching filamentous rods in immunocompromised pt indicates what?
Treat how?
Nocardia
Bactrim
Pt that presents w/symptoms of IE and has a nosocomial UTI, what is the organism?
Enterococcus
What disease may mimic TB?
MC where?
Histoplasmosis
Mississippi and Ohio River basins
