Immunology

Question 1

How does Anthrax present?
Common with who?

Answer 1

Small itchy bumps that turn into a black, painless ulceration
Cattle farmers or vets

Question 2

How often to get tetanus booster?

Answer 2

Every 10 years OR

Every 5 years for patients > 7 that have come in contact with a foreign object

Question 3

Klinefelters Syndrome
What is it?
Symptoms?
Major concern?

Answer 3

Males born with extra X chromosome

• gynecomastia, long limbs, lack of secondary sexual characteristics, small testes
• infertility

Question 4

Hispanic spiritual illness causing low appetite, crying, diarrhea, death of kids?

Answer 4

Mal ojo

Question 5

How do Asians feel about surgery?

Answer 5

Last resort, think of blood loss as depletion of vital sources

Question 6

Fragile X syndrome characteristics

Answer 6

• Long and thin with prominent forehead and chin and large ears
• autism common

Question 7

Vaccines not safe for HIV?

Answer 7

Live vaccines

Question 8

What is DPT (diphtheria pertussis tetanus) vaccine

Answer 8

Old version of TDAP

Question 9

What is the jarisch-herxheimer reaction?

Answer 9

Febrile reactions from spirochetes bacteria after an abx injection

Happens with syphilis / Lymes tx

Supportive care, resolves in 24hr

Question 10

Tb test result considered positive if someone had contact with active TB

Answer 10

> 5

Question 11

AIDs criteria

Answer 11

CD4 <200
Hairy leukoplakia
Kaposi sarcoma
Thrush
A LOT of stuff

Question 12

What do ELISA and western blot test for?

Answer 12

HIV antibodies

Question 13

What does anti HCV test for?

Answer 13

Hep C antibodies
Active or previous infection

Question 14

What test is used to distinguish between active or past Hep c?

Answer 14

HCV RNA

Question 15

Common pathogen for PNA in cystic fibrosis patients?

Answer 15

Pseudomonas aeruginosa

Question 16

Common pathogens for AOM?

Answer 16

S. Pneu
H flu
M cat

Question 17

Who should be tested for HIV

Answer 17

Everyone at least once age 13-64

Question 18

Next step after positive TB test?

Answer 18

CXR

Question 19

What is the TB vaccine given in some countries?

Answer 19

Bacillus calmette guerin

Question 20

Way to test mucosal changes in HPV?

Answer 20

Apply acetic acid

Question 21

HPV increases risk of what types of cancers?

Answer 21

Larynx/oropharynx, anus, penis, cervix

Question 22

What screening is used to diagnose gonorrheal pharyngitis or proctitis?

Answer 22

Thayer-Martin culture

Question 23

How long for animals with rabies to be quarantined?

Answer 23

10 days

Question 24

What diagnosis do we see morbiliform rash?

Answer 24

Rubeola

Question 25

When does flu season start?

Answer 25

October to May

Question 26

Medication for AIDS patients to avoid PJP (PCP)

Answer 26

Daily bactrim

Question 27

Fitz Hugh Curtis syndrome is associated with what?

Answer 27

Chlamydia Trachomatis Complication of PID

Question 28

Which med class can cause Steven Johnson syndrome?

Answer 28

Sulfonamides

Question 29

Pregnancy while on HIV therapy Vaginal birth?

Answer 29

- Continue antiretroviral therapy - Safe as long as HIV RNA count is 1000 or less - C section if viral load is unknown

Question 30

How often to monitor HIV RNA while pregnant?

Answer 30

- Every 3 months

Question 31

What to do if newborns are born with HIV?

Answer 31

- Treat them with HIV meds for the first 4-6 weeks of life

Question 32

Pulmonary TB test

Answer 32

- Acid-fast bacilli smear

Question 33

Treatment regimen for newly diagnosed pulmonary TB

Answer 33

- Rifampin - Isoniazid - Pyrazinamide - Ethambutol RIPE

Question 34

What is a second line drug for TB?

Answer 34

- Moxifloxacin

Question 35

What test is used to screen for chlamydia?

Answer 35

- Gen-Probe assay

Question 36

What test is used to detect candida?

Answer 36

KOH

Question 37

What does a wet mount do?

Answer 37

- Differentiate between various causes of vaginitis - (Trich, BV, Candida)

Question 38

A positive titer indicates what?

Answer 38

- Immunity

Question 39

Screening tests for TB

Answer 39

- CXR and PPD

Question 40

Diagnostic test for TB

Answer 40

- QuantiFERON-Gold

Question 41

TB test to confirm the patient is no longer contagious

Answer 41

- Sputum culture for acid-fast bacilli (AFB)

Question 42

Most appropriate antihistamine for an older adult who failed other treatments for allergic rhinitis

Answer 42

- Azelastine nasal spray

Question 43

What to do if a patient got the 13 valent PCV?

Answer 43

- Administer the 23 valent PCV 1 year later

Question 44

What to do if a patient had the 23 PCV valent?

Answer 44

Give the 15 or 20-valent PCV at least a year later

Question 45

What to give if patient had the 15 PCV valent?

Answer 45

- They should get the 23 valent at least 1 year later

Question 46

What to do if the patient had the 20 PCV valent?

Answer 46

- No follow up needed

Question 47

What PCV vaccine should be given first if never vaccinated?

Answer 47

- 20 or 15-valent

Question 48

Gold standard screening test for HIV Old test?

Answer 48

- HIV1/2 antigen/antibody test - ELISA

Question 49

What is the confirmatory and most specific test for HIV? Less expensive? Older test?

Answer 49

- Nucleic acid test - HIV1/2 differentiation test - Western Blot

Question 50

What time frame will HIV RNA show up?

Answer 50

- Very recent HIV infection, less than 2 weeks

Question 51

PPD >/= 5 positive with who

Answer 51

- HIV/immunosuppressed - CXR with suggestive findings - TB exposure

Question 52

PPD >/= 10 positive with who?

Answer 52

- Immigrants - Substance abuse - High risk living conditions (homeless, correctional facility) - <90% ideal body weight - Children < 5 - ESRD, DM, CA

Question 53

What abx is used for PJP prophylaxis?

Answer 53

- Bactrim

Question 54

Which wart is associated with HPV? Tx?

Answer 54

- Condyloma acuminatum - TCA acid

Question 55

How often should CD4 count be checked?

Answer 55

- Every 3-6 months

Question 56

What is Coombs test for?

Answer 56

SLE Hemolytic anemia