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Infectious Disease Flashcards

1
Q

k[Inf/Virus/Influenza]

High Risk age group for Influenza Complications
Thus Recommended for Antiviral Treatment of Suspected or
Confirmed Influenza

Children < ___ years old (Especially < ___ )

A

Children <5 (Especially <2)

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2
Q

[Inf/Bacteria/GI/C.Diff]

Treatment for C difficile infection

Mild to moderate: __
Severe (with fever and leukocytosis): __

A

Mild to Mod: Oral metronidazole (30 mg/kg per day) every 6 hours for 10 days
Severe: Oral vancomycin (40 mg/kg per day) every 6 hours for 10 days

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3
Q

[Inf/Bacteria/GI/C.Diff]

Complications of C difficile infection? (3)

A

Hypotension or shock
Pseudomembranous colitis on endoscopy
Ileus, or toxic megacolon

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4
Q

[Inf/Bacteria/Tick/Lyme]

Lyme disease
Indication of prophylaxis?
Choice of drug for tick bite?

A
  • Indication:
    When tick attached ≥ 36 hours and removed ≤ 72 hours
  • Choice of drug:
    Doxycycline single dose for all ages and pregnant women
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5
Q

[Inf/Basic/Antibiotics]

Bacteriostatic agents?

E
C
S
T

A

Erythromycin
Clindamycin
Sulfonamide
Trimethoprim, Tetrachyclines

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6
Q

[Inf/Antibiotics/Cell Wall]

Antibiotics for cell wall synthesis inhibitor? (3)

A
  1. β-lactams: penicillin, cephalosporins, carbapenems, monobactams
  2. Vancomycin
  3. Daptomycin
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7
Q

[Inf/Antibiotics/Cell Wall/β-lactams]

Class of β-lactams antibiotics (4)?

A

Penicillin
Cephalosporin
Carbapenem
Monobactam

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8
Q

[Inf/Antibiotics/Cell Wall/β-lactams]

Which bacteria for natural penicillins (Pen G, Pen V) (3)?

A
  1. Streptococcus (Group A, Group B, Viridans, Pneumococcus)
  2. Listeria
  3. Treponema pallidum (syphilis)
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9
Q

[Inf/Antibiotics/Cell Wall/β-lactams]

Examples of cephalosporin groups?

1st generation (2): ___
2nd generation (3): ___
3rd generation (2): ___
4th generation (1): ___

A

1st generation (2): cefazolin, cephalexin
2nd generation (3): cefuroxime, cefoxitin, cefotetan
3rd generation (2): ceftriaxone, ceftazidme
4th generation (1): cefepime

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10
Q

[Inf/Antibiotics/Cell Wall/β-lactams]

1st generation cephalosporin (cefazolin, cephalexin)

Susceptable bacteria (3)?
Indication (2)?

A
  • Bacteria:
    Staphylococcus: MSSA
    Streptococcus: most aerobic
    Enterobacteriaceae (PEcK): Proteus, E. Coli, Klebsiella
  • Indication:
    Skin and soft tissue infections
    Most surgical prophylaxis (cefazolin)
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11
Q

[Inf/Antibiotics/Cell Wall/β-lactams]

Which bacteria for 3rd generation cephalosporin (ceftriaxone, ceftazidime) (4)?

S
H
E
N

A

Strep pneumococcus
Haemophilus
Enterobactericeae (PEcK): Proteus, E. Coli, Klebsiella
Neisseria

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12
Q

[Inf/Antibiotics/Cell Wall/β-lactams]

Pseudomonas covering antibiotics

Penicillin (1): ___
Cephalosporin (2): ___

A

Penicillin (1): piperacillin/tazobactam
Cephalosporin (2): ceftazidime (3rd), cefepime (4th)

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13
Q

[Inf/Antibiotics/Cell Wall/β-lactams/carbapenem]

Imipenem toxicity? (2)

A

Lowering seizure threshold
Nephrotoxicity

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14
Q

[Inf/Antibiotics/Protein Synthesis]

Class of antibiotics for protein synthesis inhibitor (5)?

A

Aminoglycoside: gentamicin, tobramycin, amikacin
Macrolides: erythromycin, clindamycin
Tetrachyclines: doxycycline, minocycline
Clindamycin
Oxazolidinones: Linezolid

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15
Q

[Inf/Antibiotics/Protein Synthesis]

Side effect of Oxazolidinones (Linezolid) (4)?

A

Reversible bone marrow suppression (anemia, thrombocytopenia)
Irreversible neuropathy (optic neuritis)
Lactic acidosis
Serotonin syndrome

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16
Q

[Inf/Antibiotics/DNA Synthesis]

Class of antibiotics for DNA synthesis inhibitor (4)?

A

Fluoroquinolone: ciprofloxacin, levofloxacin, ofloxacin,
Rifampin
Trimethoprim/Sulfamethoxaxole (TMP/SMX)
Nitrofurantoin

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17
Q

[Inf/Antibiotics/DNA Synthesis/Fluoroquinolone]

Side effect of fluoroquinolone (2)?

A

Akilles tendon rupture
QT-interval prolongation

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18
Q

[Inf/Antibiotics/DNA Synthesis/TMP/SMX]

Indications for TMP/SMX in pediatrics (2)?

A

UTI outpatient
Pneumocystis jiroveci pneumonia

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19
Q

[Inf/Antibiotics/DNA Synthesis/TMP/SMX]

Side effect of TMP/SMX (3)?

A

Bone marrow suppression
Hypersensitivity reactions (Stevens Johnson syndrome)
Jaundice in < 2 months

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20
Q

[Inf/Antibiotics/Lactation]

Safe antibiotics for lactating women (4)?

A

Amoxicillin
Cephalosporin
Macrolides: erythromycin, azithromycin
Aminoglycosides: gentamicin

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21
Q

[Inf/Fever without source]

Initial workup for up to 28 days

A

Regardless of appearance: ill-appearing, well-appearing

< 8 days: Full sepsis workup and early sepsis management
8 to 21 days: Full sepsis workup +/- HSV
22-28 days: Partial sepsis with UA +/- LP depending on risk factor and prelim workup

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22
Q

[Inf/Fever without source]

Initial workup for 29 days to 90 days

A

If ill-appearing: full sepsis workup

If well-appearing: Invasive Bacterial Infection (IBI) Risk factor
- Low risk
- 29-60 days: CBC, BCx, inflammatory markers, UA
- 60-90 days: UA and UCx
- With risk factor
- 29-60 days: Full sepsis workup
- 60-90 days: CBC, Blood culture, inflammatory markers, UA

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23
Q

[Inf/Fever without source]

Initial workup for 3 to 36 months

A

Incomplete, unimmunized, if fever > 102.2 F (39C)
CBC, procalcitonin

+/- UA and UCx depending on risk factor

Blood culture if procal ≥ 0.5, WBC ≥ 15K, ANC ≥ 10K
CXR if WBC ≥ 20K

Completely immunized (3 doses of PCV, complete Hib 2-3)
+/- UA and UCx depending on risk factor

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24
Q

[Inf/Fever without source]

Initial workup for 3 to 36 months
UTI risk factors for UA/UCx investigation (5)

Boys - Circumcised ≤ ___ months
Boys - Uncircumcised ≤ ___ months
Girls ≤ ___ months
Prolonged fever > ___ hours
Children with ___

A

Boys - Circumcised ≤ 6 months
Boys - Uncircumcised ≤ 12 months
Girls ≤ 24 months
Prolonged fever > 48 hours
Children with prior UTI, urogenital anomaly,

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25
# [Inf/Lymphadenopathy] Bacterial cause? Cat: ___ Rabbit: ___ Rose throne: ___ Marine: ___ Shellfish: ___ Fishermen/meat handlers: ___
Cat: Bartonella Rabbit: Francisella Rose throne: Sporothrix Marine: Mycobacterium marinum Shellfish: Vibrio Fishermen/meat handlers: Erysipelothrix rhusiopathiae
26
# [Inf/CNS infection] Cause? CSF finding: Mild to moderate WBC elevation Monocytic predominance High protein Low glucose High opening pressure CT scan: basilar enhancement
Tuberculous meningitis
27
# [Inf/CNS infection] Cause? Treatment? CN 7 (facial palsy) Foot drop Mild to moderate WBC elevation Lymphocytic predominance
Lyme meningitis - Treatment: Ceftriaxone for 21 days
28
# [Inf/CNS infection] Cause? Treatment? Recent immigrant from latin America New onset seizure Ring enhancing lesion on CT scan
Neurocysticercosis - Treatment: Albendazole +/- steroid
29
# [Inf/GI infection] Traveler's diarrhea Most common cause? Treatment?
EnteroToxigenic E. Coli - Treatment: Azithromycin (No treatment for EHEC, Shiga toxin)
30
# [Inf/GI infection] Treatment for Campylobacter (2)?
1. Microlides: erythromycin, azithromycin 2. TMP/SMX
31
# [Inf/UTI] Positive CFU for urine culture? Bagged sample: ___ Clean void: ___ Catheter specimen: ___ Suprapubic: ___
Bagged sample: only rule out when negative Clean void: > 100K CFU/mL Catheter specimen: > 50K CFU/mL Suprapubic: any growth of uropathogen
32
# [Inf/Osteomyelitis] Drug of choice for osteomyelitis?
Ceftriaxone + vancomycin
33
# [Inf/Endocarditis] Subacute bacterial endocarditis HACEK organism?
Haemophilus Aggregatilbacter actinomycetemcomitans Cardiobacterium hominis Eikenella Kingella
34
# [Inf/Endocarditis] Modified duke criteria? 2 major, 1 major + 3 minor, 5 minor Major (2) Minor (5)
Major (2) 1. Positive blood culture, 2 separate, 12 hours apart 2. Abnormal echocardiogram Minor (5) 1. Predisposing condition 2. Fever > 100.4 F 3. Vascular phenomena (Janeway lesions, conjunctival hemorrhages) 4. Immunologic phenomena (Osler nodes, Roth spots) 5. Positive blood culture (not meeting major criteria)
35
# [Inf/Prevention/When to return] When to return to school Measles returns ____ after onset of rash Mumps returns ____ after onset of parotid swelling Rubella returns ____ after onset of rash Varicella returns ____ after onset of rash Hep A returns ____ after onset of illness
Measles returns 4 days after onset of rash Mumps returns 5 days after onset of parotid swelling Rubella returns 7 days after onset of rash Varicella returns 6 days after onset of rash Hep A returns 7 days after onset of illness
36
# [Inf/Prevention/When to return] When to return to school Strep pharyngitis ___ after antibiotics started Impetigo returns ___ after starting antibiotics Pertussis returns ___ after antibiotics are completed
Strep pharyngitis 12 hours after antibiotics started Impetigo returns 24 hours after antibiotics started Pertussis returns 5 days after antibiotics are completed
37
# [Inf/Prevention/Transmission] Airborne transmission agents? (3)
Mycobacterium tuberculosis Measles Varicella
38
# [Inf/Prevention/Transmission] Infectious agents expressed in breast milk? (3)
HIV HTLV (Human T cell lymphotropic virus) Brucellosis
39
# [Inf/Prevention/Transmission] Mothers with ___ can express milk (3)
TB HSV Varicella
40
# [Inf/Bacteria/G(+) Cocci] Examples of Gram (+) Cocci and classification?
Staphylococcus - Coagulase (-): S. aureus - Coagulase (+): S. epidermidis, S. saprophyticus Streptococcus - α-hemolysis: S. pneumoniae, Viridans - β-hemolysis: Group A (S. pyogenes), Group B (S. agalactiae) - γ-hemolysis: Enterococci, S. bovis
41
# [Inf/Bacteria/G(+) Cocci] Treatment for Coagulase negative Staphylococci (CNS, S. epi) for prosthetic device infection?
Vancomycin +/- Rifampin
42
# [Inf/Bacteria/G(+) Cocci] Treatment for S. pneumoniae meningitis?
Vancomycin + Ceftriaxone till susceptibility
43
# [Inf/Bacteria/G(+) Cocci] Diangosis? Mechanism? Sandpaper rash, starting from neck and chest to palms and soles followed by desquamation Acute pharyngitis with strawberry tongue, circumoral pallor Pastia lines (petechial lines in folds)
Scalret fever - Mechanism: Pyrogenic exotoxin
44
# [Inf/Bacteria/G(+) Cocci] Treatment for streptococcal pharyngitis
Penicillin V potassium (PCN VK) Or Pen G IM, amoxicillin PO
45
# [Inf/Bacteria/G(+) Rods] Examples of Gram (+) Rods? L A B C C
Listeria Arcanobacterium (Corynebacterium) haemolyticum Bacillus cereus, B. anthrax Corynebacterium diphtheriae Clostridium difficile, botulinum, tetani, perfringens
46
# [Inf/Bacteria/G(+) Rods] Which bacteria Treatment? Prophylaxis? Low fever Pharyngitis with whitish membrane Cervical lymphadenitis (bull neck) Conjunctivitis
Corynebacterium diphtheriae (Diphtheria) - Treatment: Equine antitoxin PO Erythromycin or IV/IM PCN - Prophylaxis: Close contacts, regardless immunization status PO Erythromycin or IM PCN
47
# [Inf/Bacteria/G(+) Rods] Toxin-mediated effects for Corynebacterium diphtheriae (2)?
Myocarditis within the first week Neural involvement: Guillain-Barre syndrome or peripheral nerve palsies
48
# [Inf/Bacteria/G(+) Rods] Which bacteria? Treatment? Acute pharyngitis Scarlatiniform rash Lymphadenopathy without palatal petechiae/strawberry tongue _similar to S. pharyngitis, Not improved with penicillin_
Arcanobacterium haemolyticum - Treatment: Macrolides (Erythromycin, azithromycin)
49
# [Inf/Bacteria/G(+) Rods] Which bacteria? Treatment? Prophylaxis? Painless pruritic papule becomes painless ulcer with black eschar Fever, myalgia Painful lymphadenopathy
Bacillus anthracis (Cutaneous anthrax) - Treatment: Amoxicillin or ciprofloxacin Plus Antitoxin - Prophylaxis for aerosol exposure: Ciprofloxacin or doxycycline for 60 days
50
# [Inf/Bacteria/G(+) Rods] Gas gangrene treatment for Clostridium perfringens?
High dose penicillin G
51
# [Inf/Bacteria/G(+) Rods] Treatment for Clostridium tetani?
Human tetanus immunoglobulin TIG Plus Metronidazole (or Pen G)
52
# [Inf/Bacteria/G(-) Cocci] Examples of Gram (-) Cocci (2)?
Neisseria Moroxella
53
# [Inf/Bacteria/G(-) Cocci] Indications for meningococcus prophylaxis (2)? ___ days prior of onset
7 days prior of onset 1. Close contacts Living together, flight > 8 hours, Attending same child care 2. Direct exposure Invasive procedure like intubation, suction
54
# [Inf/Bacteria/G(-) Cocci] Treatment options for meningococcus prophylaxis (3)?
Rifampin for 2 days Ceftriaxone IM 1 dose Ciprofloxacin 1 dose (>18 years old)
55
# [Inf/Bacteria/G(-) Coccobacilli] Examples of Coccobacilli (11)?
Haemophilus influenza Camplyobacter Ellas (except Kleb/Sal/Shi) Bordetella pertusis Kingella kingae Yersinia pestis Francisella tularensis Legionella pneumophila Coxiella burnetii Brucella Bartonella Pasteurella
56
# [Inf/Bacteria/G(-) Coccobacilli] Treatment and prophylaxis for Bordetella pertussis?
Treatment: Macrolide (Azithro for infants) Prophylaxis: Macrolide +/- Tdap (Eligible, infant, pregnancy)
57
# [Inf/Bacteria/G(-) Coccobacilli] For Haemophilus influenzae Prophylaxis indication: ___ Prophylaxis options: ___
Prophylaxis: Rifampin x 4 days - Indication: Close contacts, child care, unimmunized or incompletely immunized, immunocompromised Child care center ≥ 2 patients within 60 days
58
# [Inf/Bacteria/G(-) Coccobacilli] Treatment options for Kingella kingae?
Penicillin
59
# [Inf/Bacteria/G(-) Coccobacilli] Diagnosis? Which bacteria? Exposed to cattle placenta/birth product Fever, malaise, pneumonia Infective endocarditis
Q fever Coxiella burnetii
60
# [Inf/Bacteria/G(-) Coccobacilli] Which bacteria/disease? Treatment? GI: Diarrhea CNS: Headache, delirium, confusion Renal: azotemia, hematuria Pulm: pneumonia
Legionella pneumophila Legionellosis (Pontanic fever for milder, without pneumonia) - Treatment: Azithromycin
61
# [Inf/Bacteria/G(-) Coccobacilli] Which bacteria/disease? Treatment? Unpasteurized milk Heart: endocarditis GU: orchitis, abortion Endocrine: thyroiditis, adrenal insufficiency, SIADH Lung/GI: pneumonia diarrhea
Brucella Brucellosis - Treatment: Doxycycline + aminoglycoside Or Doxycycline + Rifampin
62
# [Inf/Bacteria/G(-) Coccobacilli] Which bacteria/disease? Treatment? Cat scratch or bite If near eye: conjunctivitis, preauricular lymphadenopathy, ocular granuloma
Bartonella henselae Catscratch disease (Parinaud oculoglandular syndrome for near the eyes) - Treatment: Azithromycin
63
# [Inf/Bacteria/G(-) Rods] Examples of G(-) Rods (6)?
Pseudomonas aeruginosa Helicobacter pylori Klebsiella Salmonella Shigella Escherichia coli
64
# [Inf/Bacteria/G(-) Rods] Which bacteria/disease? Treatment? Nail-puncture wound in the shoe Endocarditis in IV drug user Ecthyma gangrenosum (round black lesion, central ulceration)
Pseudomonas aeruginosa - Treatment: pseudomonas covering antibiotics Penicillin: Piperacillin/tazobactam Cephalosporin: Ceftazidime, cefepime Carbapenem: imipenem, meropenem Aminoglycosides Quinolones
65
# [Inf/Bacteria/G(-) Rods] Which bacteria/disease? Slowly rising fever with relative bradycardia Abdominal pain and constipation Rose spots Leukopenia
Salmonella Typhi Typhoid fever
66
# [Inf/Bacteria/Atypical] Classes of atypical bacteria (4)?
Mycoplasma Chlamydia Spirochetes: syphilis, lyme, leptospirosis Rickettsiae: Rickettsiae, Ehrlichia
67
# [Inf/Bacteria/Atypical] Which bacteria? Treatment? Exposed to birds (parrots, parakeets, pigeon) High fever > 105F Pneumonia Splenomegaly
Chlamydia pisttaci - Treatment: Macrolides
68
# [Inf/Bacteria/Atypical] Which bacteria? Treatment? Exposure to ticks in Arkansas, Georgia, Oklahoma Rash starting from wrists/ankles, spread to trunk, palms/soles Petechial to purpuric Myalgias, arthralgias, diarrhea, photophobia Hyponatremia, thrombocytopenia
Rickettsia rickettsii Rocky Mountain Spotted Fever - Treatment: Doxycycline (Even < 8 years old)
69
# [Inf/Bacteria/Atypical] Which bacteria? Treatment? Exposure to ticks in Arkansas, Oklahoma +/- rash Viral syndrome Hepatitis Pancytopenia Morulae in WBC
Ehrlichia (Human monocytic ehrlichiosis) Or Anaplasma (Human granulocytic anaplasmosis) - Treatment: Doxycycline
70
# [Inf/Bacteria/Gram-variable] Example of gram variable bacteria (1)?
Gardnerella vaginalis
71
# [Inf/Bacteria/Anaerobes] Examples of anaerobes (4)?
Fusobacterium Actinomyces Peptostrepcoccus Bacteroides
72
# [Inf/Bacteria/Anaerobes] Which bacteria? Diangosis? Treatment? Pharyngitis Internal jugular vein thrombophlebitis Septic lung emboli
Fusobacterium necrophorum Lemierre syndrome - Treatment: Ceftriaxone plus metronidazole
73
# [Inf/Bacteria/Anaerobes] Which bacteria/disease? Treatment? After dental procedure Yellow sulfur granule/abscess
Actinomyces (Actinomycosis) - Treatment: Penicillin
74
# [Inf/Bacteria/Acid-Fast] Examples of Acid-Fast bacteria (2)?
Mycobacterium (tuberculosis, leprae, avium complex) Norcadia
75
# [Inf/Bacteria/Acid-Fast] Diagnostic test for TB by age?
< 2 years of age: Tuberculin skin testing ≥ 2 years of age or BCG recipients: Interferon gamma release assay (IGRA)
76
# [Inf/Bacteria/Acid-Fast] Tuberculin skin test reading ≥ 4 years of age without any risk factors Positive when induration ≥ ___ mm
**≥ 4** years of age without any risk factors Induation ≥ **15** mm
77
# [Bacteria/Acid-Fast] Tuberculin skin test reading < 4 years of age Increased risk: - Co-morbidities (DM, CKD) - Travel to high prevalence regions - Exposure to high risk adults (HIV, homeless) Positive when induration ≥ ___ mm
Positive when induration ≥ **10** mm **< 4** years of age Increased risk: - Co-morbidities (DM, CKD) - Travel to high prevalence regions - Exposure to high risk adults (HIV, homeless)
78
# [Inf/Bacteria/Acid-Fast] Tuberculin skin test reading Close contact with active case HIV infection or immunosuppressive conditions Clinical signs or positive CXR Positive when induration ≥ ___ mm
Positive when induration ≥ 5 mm Close contact with active case HIV infection or immunosuppressive conditions Clinical signs or positive CXR
79
# [Inf/Bacteria/Acid-Fast] Tuberculin skin test reading Who is positive when induration < 5 mm (1)
HIV infection plus close contact of active case (any reading is positive)
80
# [Inf/Bacteria/Acid-Fast] Latent TB infection treatment options (3)?
1. Isoniazid and _rifapentine_ 1/week for 3 months 2. Isoniazid and _rifampin_ daily for 3 months 3. Rifampin daily for 4 months (Discouraged isoniazid for 9 months due to compliance)
81
# [Inf/Bacteria/Acid-Fast] TB infection treatment?
RIPE for 2 months and RI for 4 months R: Rifampin I: Isoniazid P: Pyrazinamide E: Ethambutol or streptomycin
82
# [Inf/Bacteria/Acid-Fast] Side effects of TB antibiotics? R: Rifampin: ___ I: Isoniazid: ___ P: Pyrazinamide: ___ E: Ethambutol: ___
R: Rifampin: Orange discoloration I: Isoniazid: Liver toxicity P: Pyrazinamide: N/V/abdominal pain, hypersensitivity E: Ethambutol: decreased in visual acuity
83
# [Inf/Bacteria/Atypical/Spirochetes] Which bacteria? Diagnosis? Treatment? Swim in the pond with dogs, rats Fever, myalgia Conjunctival suffusion Hepatitis (disproportionally high bilirubin) Renal failure
Leptospirosis Weil disease - Treatment: PO doxycycline for mild IV doxy or pen G, ceftriaxone for severe
84
# [Inf/Bacteria/Atypical/Spirochetes] Stages of lyme disease (3)?
1. Early localized erythema migrans 2. Early disseminated heart block, nerve palsy 3. Late disseminated arthritis
85
# [Inf/Fungi] Coccidioides vs Histoplasma vs Blastomyces From Arizoma Flu-like illness Arthralgias, erythema multiforme/nodosum Pulmonary coin lesion
Coccidioides (Valley fever)
86
# [Inf/Fungi] Coccidioides vs Histoplasma vs Blastomyces From Kansas, Missouri Soil with bat and bird Calcified granuloma, interstitial pneumonia Splenomegaly Pancytopenia
Histoplasma
87
# [Inf/Fungi] Coccidioides vs Histoplasma vs Blastomyces From Minnesota, Michigan, Canada Exposed to decaying wood Fever, myalgia, cough, nonspecific symptoms
Blastomyces
88
# [Inf/Fungi] Which fungus? Pricked by rose thorn
Sporotrichosis (Sporothrix)
89
# [Inf/Parasite/Protozoa] Protozoa classes and their examples (3)? Protozoa: single cell, eukaryocyte Helminth: multicells (worms)
Protozoa 1. Sporozoa: Toxoplasma, Cryptosporidium, Cyclospora, Plasmodium, Babesia 2. Ameba: Entamoeba 3. Flagellates: Giardia, Trichomonas, Trypanosoma, Leishmania
90
# [Inf/Parasite/Protozoa] Which parasite? Treatment? Contaminated water park, swimming pool outbreaks Watery diarrhea for 1-2 weeks Stool O&P: small round oocytes
Cryptosporidium - Treatment: nitazoxanide
91
# [Inf/Parasite/Helminth] Helminth classes and their examples (2)? Protozoa: single cell, eukaryocyte Helminth: multicells (worms)
Helminth 1. Nematodes (Roundworms): Pinworms, hookworms, whipworms, Trichinella, Strongyloides, Ascaris 2. Platyhelminths: Cestodes (tapeworms), trematodes (flukes)
92
# [Inf/Parasite/Protozoa] Which parasite? Fever, vomiting, myalgia Jaundice, splenomegaly
Plasmodium falciparum (Malaria)
93
# [Inf/Parasite/Protozoa] Which parasite? Especially in asplenic patients Tick from rodents in Northeast (NH, Vermont) Fever Hemolytic anemia, hemoglobinuria
Babesiosis
94
# [Inf/Parasite/Protozoa] Which parasite and its treatment? Especially in anal sex, IgA deficiency, cystic fibrosis patients Watery, smelly diarrhea, flatulence
Giardia Treatment: Metronidazole
95
# [Inf/Parasite/Protozoa] Which parasite? Diagnosis? From Mexico, South America Heart block, heart failure Achalasia, megacolon Unilateral firm edema of the eyelids (Romana sign) Generalized lymphadenopathy
Trypanosoma T. Cruzi: Chagas disease (T. brucei: sleeping sickness)
96
# [Inf/Parasite/Protozoa] Which parasite? Cutaneous: cigarette paper scar Mucosal: granulomatous inflamation Visceral: hepatosplenomegaly
Leishmania
97
# [Inf/Parasite/Helminth] Which parasite? Abdominal: diarrhea, anorexia Respiratory: migratory infiltrates (Loffler syndrome), hemoptysis
Ascaris lumbricoides (round worm)
98
# [Inf/Parasite/Helminth] Which parasite? Treatment? Anal pruritus Adhesive tape test
Enterobius vermicularis (Pinworm) - Treatment: Albendazol for all household members
99
# [Inf/Parasite/Helminth] Which parasite? Walking barefoot Cutaneous larva migrans
Necator americanus (Hookworm)
100
# [Inf/Parasite/Helminth] Which parasite? Undercooked pig/bear meat Muscle pain, calcification in x-ray Myocarditis, periorbital edema, eosinophilia
Trichinella spiralis
101
# [Inf/Parasite/Helminth] Which parasite? Pica Migratory pneumonia Hypergammaglobulinemia, eosinophilia Visceral larva migrans, ocular larva migrans Larva currens (Itchy, serpiginous, erythematous tracks)
Strongyloides stercoralis
102
# [Inf/Parasite/Platyhelminths/Cestodes] Which parasite? Multiple cysts, calcified granulomas
Neurocysticercosis
103
# [Inf/Parasite/Platyhelminths/Trematodes] Which parasite? Treatment? Swimming in the contaminated water Hematuria After 2 months of inoculation, serum-sickness like symptoms (LAD, diarrhea, HSM)
Schistosoma haematobium (hematuria) Acute schistosomias (Katayama fever) - Treatment: praziquantel for 1 day
104
# [Inf/Virus/Herpesviruses] Which virus? Neurologic: Alice in Wonderland syndrome Skin: papular acrodermatitis (Gianotti-Croti syndrome)
Epstein-Barr virus (EBV)
105
# [Inf/Virus/Herpesviruses] Which virus and its disease? Fever then erythematous rash Febrile seizure with febrile stage Erythematous papules in the soft palate, uvula (Nagayama spots)
Human Herpersvirus 6 (HHV-6) Roseola, exanthem subitum, roseola infantum, sixth disease (Parvo: Erythema infectiosum, fifth disease)
106
# [Inf/Virus/Herpesviruses] Which virus and its disease? Children: Slapped cheek rash, Fever, Arthritis Adolescents, adults: papular purpuric gloves and sock syndrome
Parvovirus B19 Erythema infectiosum, fifth disease (HHV6: roseola infantum, sixth disease)
107
# [Inf/Virus/Herpesviruses] Which virus's complication? Subacute sclerosing panencephalitis: Dementia, myoclonus, new-onset seizures at 10 years of age
Measles (Rubeola)
108
# [Inf/Virus/Herpesviruses] Which virus? Floria, Puerto Rico High fever, polyarthralgia, +/- maculopapular rash Lymphopenia, thrombocytopenia, elevated LFTs, elevated Cr
Chikungunya virus (Dengue: retro-orbital pain, saddle back fever, hemorrhage, shock)
109
# [Inf/Virus/Herpesviruses] Which virus? Mexico, South America, Puerto Rico Saddle back fever (biphasic) Severe myalgias, arthralgias, headaches, conjunctivitis Retro-orbital pain, macular rash Hemorrhagic, or shock
Dengue virus (Chikungunya: severe joint pain, conjunctivitis, no hemorrhage or shock)
110
# [Inf/Virus/Herpesviruses] Which virus? Desert Southwest Severe hemorrhagic pneumonia Thrombocytopenia, increased hematocrit
Hantavirus
111
# [Inf/Virus/Herpesviruses] Which virus? Congo Fruit bats Fever, myalgia, diarrhea, headache Hiccups, conjunctival injection, dar red discoloration of the palate Leukopenia, thrombocytopenia, elevated LFTs, coagulopathy, CKD
Ebola
112
# [Inf/Virus/HIV/Complications] Which causal organism? Fever, cough, hypoxia Elevated LDH, normal LFT X-ray of diffuse bat-wing infiltrates
Pneumocystis jiroveci pneumonia (PJP)
113
# [Inf/Virus/HIV/Prophylaxis] Indications for PJP prophylaxis 1. All HIV-infected asymptomatic infants until from ____ to ___ of age (until confirm negative) 2. HIV-infected (1-5 years of age) if CD4 count is <___ cells/pL 3. HIV-infected (> 6 years of age) if CD4 count is <___ cells/pL 4. History of prior PJP infection
1. All HIV-infected asymptomatic infants until 1 year of age 2. HIV-infected (1-5 years of age) if CD4 count is <500 cells/pL 3. HIV-infected (> 6 years of age) if CD4 count is <200 cells/pL 4. History of prior PJP infection
114
# [Inf/Virus/HIV/Immunization] live vaccine candidates extra immunization?
1. Live vaccines: 1-13 years: CD4+ T-cell > 15% >13 years: CD4+ T-cell > 200/µL 2. Rota vaccines: can be given regardless CD4 counts 3. PCV23 after 24 months 4. Menacwy after 2 months
115
# [Inf/Virus/HIV/Treatment] All infants born to mothers with HIV infection should receive ___ therapy for ___ weeks. If an HIV-positive woman has not received antepartum antiretroviral therapy (ART) or received ART only at delivery, 3 doses of ___ is also given in the 1st week of life along with ZDV.
All infants born to mothers with HIV infection should receive _zidovudine_ therapy for _4-6 weeks_ (before test results). If an HIV-positive woman has not received antepartum antiretroviral therapy (ART) or received ART only at delivery, 3 doses of _nevirapine_ is also given in the 1st week of life along with ZDV.
116
# [Inf/Virus/exanthem] Which virus? Postauricular, suboccipital lymphadenopathy Maculopapular rash, coming from face down Soft palate petechiae and reddish spots (Forchheir sign)
Rubella (German measles, three day measles)
117
# [Inf/Bacteria/Atypical] Which bacteria and treatment?? Infant between 4 and 12 weeks of age Staccato-like cough, nasal stuffiness Afebrile, tachypnea, rales in the absence of wheezing Eosinophilia CXR Hyperinflation interstitial infiltration
Chlamydia trachomatis Treatment: erythromycin (even for infants)
118
# [Inf/Bacteria/G(-) Coccobacilli] Which bacteria? Immunocompromised hosts or excessive iron storage (sickle cell disease, β thalassemia) Undercooked pork Diarrhea, abdominal pain after 4-7 days
Yersinia enterocolitica gastroenteritis Treatment: Supportive If severe, ciprofloxacin for adults, ceftriaxone for children
119
# [Inf/Prevention/precuations] Which precautions/isolation? Contact/Droplet/Airborne Multidrug-resistant bacteria, Shigella species, and Staphylococcus aureus (cutaneous infection or draining abscesses) Herpes simplex virus, respiratory syncytial virus, parainfluenza virus, enteroviruses Scabies
Contact precautions
120
# [Inf/Prevention/precuations] Which precautions/isolation? Contact/Droplet/Airborne Influenza, parvovirus B19 (before the onset of rash), rhinovirus, mumps, and adenovirus (pneumonia) Pertussis, Neisseria meningitidis (invasive)
Droplet precautions
121
# [Inf/Prevention/prophylaxis] Indication for Varicella-zoster immune globulin (VZIG) (3)?
1. Immunocompromised 2. Pregnant ladies 3. Newborns with mother infected 5 days before through 2 days after delivery (If VZIG not available, give IVIG)
122
# [Inf/Prevention/prophylaxis] Hep A postexposure prophylaxis: ≥ 12 months: ___ < 12 months: ___
≥ 12 months: Hep A vaccine < 12 months: Hep A immunoglobulin (within 2 weeks of exposure)
123
# [Inf/Prevention/prophylaxis] TB postexposure prophylaxis indications (2)?
< 5 years old Immunocompromised (TB test first, start chemoprophylaxis, discontinue after 8-10 weeks of retest)
124
# [Inf/Virus/EBV] Serology early and/or past infection EBV VCA IgM: ___ EBV VCA IgG: ___ EBV nuclear antigen (EBNA): ___
EBV VCA IgM: early infection EBV VCA IgG: early and/or past infection EBV nuclear antigen (EBNA): past infection
125
# [Inf/Bacteria/G(+)] Which disease? Severe malabsorption, arthritis, polyserositis, CNS symptoms PAS positive granules in the lamina propria Gram positive Actinomycete
Whipple disease (Tropheryma whipplei)

1. Pediatrics (22 decks)

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