IM ID - Rd 2

Question 1

What are the defining features of erysipelas?

MC organism?

Answer 1

Superficial dermis and lymph, sharply DEMARCATED edges
Rapid spread and onset, fever is EARLY

GrpA strep

Question 3

How does febrile neutropenia present?

What organism to cover for?

Answer 3

ANC < 1500 microL
Will have anemia, mucosal pallor, low Plts

Pseudomonas

Question 4

What does Ehrlichiosis (tick-borne) cause?

Treat how?

Answer 4

Acute febrile illness w/malaise and AMS
NO rash

Doxycycline

Question 6

What presents w/anemia, thrombocytopenia, inc bilirubin, inc LDH, and inc LFTs after hiking?

Answer 6

Babesiosis

Question 8

Pt w/IE that is highly susceptible to PCN should be treated with what?

Answer 8

IV PCN G or IV Ceftriaxone for 4 weeks

Question 9

What can cause bloody diarrhea in a HIV pt?

Answer 9

CMV

Question 11

What vaccines do you need for chronic liver disease?

Answer 11

Tdap, flu, PPSV23, HepA and HepB

Question 12

HIV pt that presents w/fever, HA, elevated ICP (vomiting, Papilledema), wha it’s the MC cause?

Classic presentation is what?

Answer 12

Cryptococcus

Indolent (progresses over days to weeks)

Question 15

Pt that presents w/noncaseating granuloma, erythema nodusum, but deteriorates after steroid treatment has what?

Answer 15

Histoplasmosis

Question 16

EBV and strep throat can present exactly the same except for what key differences?

Answer 16

Strep will get V bad or resolve in 2 weeks

Strep does NOT have generalized LAD

Question 18

Pt w/pyelonephritis and pH above 8, what is the cause?

Answer 18

Proteus

Question 19

What is a rapidly progressive cellulitis of the submandibular space?

Arises from what?

What kind of pt?

Answer 19

Ludwig angina

Dental infection in mandibular molar and then spread to sublingual space

Alcoholics

Question 21

Rash + symmetric joint pain that resembles R.A. Is what?

Answer 21

Parvo B19

Question 22

What is the alternative treatment for syphilis if there is a PCN allergy?

Who should be desensitized?

Answer 22

Doxycycline

Pregnant, CNS syphilis, multiple treatment failures

Question 24

What is the treatment for HepC?

Answer 24

Ledipasvir-sofosbuvir

Question 25

If the question looks like EBV/mono but the answer choice is not there, what is something that mimics it?

Answer 25

CMV

Question 26

Skin lesions and osteolytic or bone problems indicate what?

Answer 26

Blastomycosis

Question 28

What test for syphilis has the highest diagnostic sensitivity in primary disease?

Can confirm what?

Answer 28

FTA-ABS

VDRL

Question 29

What is the distribution of a TSS rash?

Answer 29

Involves the palms and soles

Question 31

What are some uncommon but possible findings in mono?

What lab value?

Answer 31

Autoimmune hemolytic anemia and thrombocytopenia 2-3 weeks after initial onset

Elevated reticulocyte count

Question 32

HIV pt w/multiple, non enhancing, asymmetric lesions has what?

Answer 32

PML caused by JC virus when CD4 < 200

Question 34

Splenic fluid collection means what?

MC d/t what?

Answer 34

Splenic abscess

IE w/hematogenous spread

Question 35

What is the tourniquet test used for?

Answer 35

Dengue fever

Question 37

How do you differentiate bw disseminated Histoplasmosis and PCP?

When does disseminated Histo occur?

Answer 37

PCP does NOT have LAD, HSM, or pancytopenia
Histo DOES

CD4 < 100

Question 38

What are the major features of Chikungunya fever?

Answer 38

Travel to Caribbean Polyarthritis thrombocytopenia

Question 43

What kind of HIV pt is at risk for disseminated Bacillary angiomatosis?

Answer 43

Cats or homeless (lice) | CD4 < 100

Question 44

How does PCT present? What is strongly associated with it?

Answer 44

Photosensitive skin that develops vesicles w/bullae w/trauma or sun exposure Form hypo and hyperpigmented areas HCV

Question 49

IE w/staph epidermidis will have what pmhx?

Answer 49

Prosthetic valve intravascular catheter Implanted device

Question 50

What presents w/rapid onset of rash, fever, HoTN, diarrhea and thrombocytopenia? Assoc w/what?

Answer 50

TSS Tampon, nasal packing, post-surgery infection

Question 53

Which pts are at higher risk of getting vibrio vulnificus? Why?

Answer 53

Liver disease (cirrhosis, viral hepatitis), hemochromatosis Free iron acts as exponential growth catalyst

Question 55

G+, partially acid fast branching filamentous rods in immunocompromised pt indicates what? Treat how?

Answer 55

Nocardia Bactrim

Question 57

Pt that presents w/symptoms of IE and has a nosocomial UTI, what is the organism?

Answer 57

Enterococcus

Question 61

What disease may mimic TB? MC where?

Answer 61

Histoplasmosis Mississippi and Ohio River basins