Infectious disease

Question 1

RIPE therapy for TB the most common indication to discontinue therapy?

Answer 1

Rifampin, Isoniazid, Pyrazinamide, and Ethambutol.
The most common indication to alter or discontinue therapy is an elevation of liver enzymes 5 times greater than baseline.

Question 2

Patient with HIV and a CD4+ count less than 50 along with painless vision loss

Answer 2

Is most likely suffering from cytomegalovirus (CMV) retinitis. He should be treated with valgancyclovir.

Question 3

Positive tuberculin test

Answer 3

Low-risk patients: greater than or equal to 15mm in diameter read at 48-72 hours.
Persons with diabetes, malignancy, silicosis, immigrants from high prevalence countries who arrived within five years, and persons who use illicit drugs: > or equal to 10mm.
HIV, fibrotic changes from previous TB, and recent contact with persons with active TB: > or equal to 5mm.

Question 4

Necrotizing fasciitis is most commonly caused by?

Answer 4

Streptococcus pyogenes (Group A strep).

Question 5

Common causes of epiglottitis in vaccinated patients?

Answer 5

Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus.

Question 6

Bordatella pertussis choice of treatment?

Answer 6

Macrolides