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Step 2 Last Minute > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Potential complication of retropharyngeal abscess

A

Acute necrotizing mediastinitis (spread through “danger space” through the alar fascia)

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2
Q

X-ray findings in epiglottitis and retropharyngeal abscess.

A

Epiglottitis: Thumbprint sign

Retropharyngeal abscess: Widened prevertebral space (may be unable to extend neck)

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3
Q

Treatment for tinea capitis

A

Oral griseofulvin or terbinafine

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4
Q

Treatment for tinea corporis

A

Topical clotrimazole or terbinafine (if widespread, treat with oral griseofulvin or terbinafine)

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5
Q

Most common predisposing factor for orbital cellulitis

A

Bacterial sinusitis

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6
Q

Treatment for rhino-orbital-cerebral mucormycosis

A

Surgical debridement + Ampho B

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7
Q

Who gets oseltimivir for flu?

A

Over 65, pregnant, chronic illness (prevent complications), or <48 hours since symptom onset (shorten duration)

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8
Q

Additional empiric treatment for aspiration pneumonia

A

Include anaerobe covereage with amoxicillin-clavulunate, clindamycin, or amoxicillin+metronidazole

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9
Q

Empiric treatment of CAP

A

No comorbidities or recent antibioticx: Doxycycline or azithromycine
If so: Add ceftriazone or just use respiratory quinolone

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10
Q

Treatment of Legionella

A

Respiratory quinolones (Levofloxacin for Legionella) or macrolides (e.g. azithromycin)

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11
Q

Immunocompromised person with CT showing pulmonary nodules with surrounding ground-glass opacities

A

“Halo sign” seen in invasive aspergillosis

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12
Q

Fungal lung disease with ulcerated skin lesions and lytic bone lesions in immunocompetent hosts

A

Blastomycosis (Wisconsin)

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13
Q

Fungal lung disease in the midwest with hilar lymphadenopathy, arthralgias, and erythema nodosum

A

Histoplasmosis

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14
Q

Treatment for histoplasmosis

A

Ampho B in severe disease

Otherwise itraconazole or voriconazole

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15
Q

Fungal lung disease in the southwest with arthralgias, erythema nodosum, and/or erythema multiforme

A

“Valley fever” due to Coccidioides

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16
Q

Treatment of penicillin-allergic syphilis patients

A

Primary, secondary, latent: Doxycycline
Tertiary without neurosyphilis: Ceftriaxone
Neurosyphilis: Penicillin desensitization

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17
Q

Sensitivity of testing for primary syphilis

A

RPR/VDRL have high false negatives. FTA-ABS much more sensitive (>97%)

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18
Q

Disseminated gonorrhea

A
  1. Septic monoarthritis
    and/or
  2. Migratory polyarthralgias, tenosynovitis, dermatitis (papules and pustules)
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19
Q

Malabsorption with migratory arthritis and low-grade fever

A

Whipple’s disease - PAS-positive macrophages

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20
Q

Treatment of Giardia

A

Metronidazole

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21
Q

What medication other than antibiotics carries a risk of C. diff colitis?

A

PPIs

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22
Q

Filamentous gram positive anaerobic rods with sulfur granules. Organism and treatment?

A

Actinomyces, treat with penicillin (even though an anaerobe)

Causes cervicofacial infections after dental surgery or trauma

23
Q

Filamentous gram positive aerobic rods that stain weakly acid-fast. Organism and treatment?

A

Nocardia, treat with TMP-SMX (for 6-12 mo)

Can cause respiratory infections

24
Q

Itchy butt and scotch tape test. Organism and treatment?

A

Enterobius vermicularis, treat with albendazole (or pyrantel pamoate) for patient and household contacts

25
Q

Myositis, periorbital edema, and eosinophilia. Organism?

A

Trichinellosis.

26
Q

Asymptomatic, afebrile liver cyst unless huge or ruptures. Organism? Treatment? Imaging appearance?

A

Organism: Echinococcus granulosus (dog tapeworm)
Treatment: albendazole
Imaging: Internal septations (daughter cysts) in US, “eggshell” calcifications on CT

27
Q

Febrile liver cyst with RUQ pain. Organism? Treatment? Imaging appearance?

A

Organism: Entamoeba histolytica
Treatment: Metronidazole and intraluminal antibiotic (e.g paramomycin)
Imaging: Single subcapsular cyst

28
Q

Empiric treatment for cat bites? What organism do you need to be sure to cover?

A

Amoxicillin-clavulunate. Watch for Pasteurella multocida

29
Q

Treatment for tick-borne diseases: babesiosis, ehrlichiosis, lyme, and RMSF

A

Babesiosis: Atovaquone + azithromycin (typical) or quinine + clindamycin (severe)
Others: doxycycline

30
Q

Cells infected by RMSF

A

Endothelial cells (leads to vasculitis-like illness)

31
Q

Cells infected by Ehlichiosis

A

WBCs

32
Q

UTI with alkaline urine. Possible organism?

A

Proteus mirabilis

33
Q

Morbilliform rash after patient with pharyngitis takes amoxicillin

A

EBV (not true allergy)

34
Q

Infections associated with cold-agglutin AIHA

A

EBV, HIV, and Mycoplasma pneumonia

35
Q

What infections are solid organ transplant patients especially at risk for?
Prophylaxis?

A

PCP pneumonia and invasive CMV

Prophylaxis with TMP-SMX and valganciclovir

36
Q

Acute airway obstruction during a febrile infection. Cause? Treatment?

A

Rare complication of EBV. Give steroids.

37
Q

Infection associated with focal GI dilatation and heart disease

A

Chagas disease due to Trypanosoma cruzi.
(GI dilatation: megaesophagus or megacolon)
(Heart: cardiomegaly, CHF, arrhythmias)

38
Q

Infection associated with high fever, diffuse lymphadenopathy, maculpapular rash, severe polyarthralgias, lymphopenia and thrombocytopenia

A

Chikungunya fever

39
Q

Leprosy treatment

A

Dapsone and rifampin (also clofazimine in severe disease)

40
Q

CI to yellow fever vaccine

A

Immune compromise (live attenuated vaccine)

41
Q

What do you need to test for before diagnosing ITP when isolated thrombocytopenia is seen?

A

HIV and HCV

42
Q

CSF finding in primary CNS lymphoma

A

EBV DNA

43
Q

Solitary weakly ring-enhancing periventricular brain mass in an AIDS patient

A

Primary CNS lymphoma

44
Q

White matter lesions with no edema or enhancement in an AIDS patient

A

PML

45
Q

Treatment for cryptococcal meningitis

A

2 weeks ampho B + flucytosine

Then consolidation/maintenance with fluconazole

46
Q

Empiric treatment of bacterial meningitis in adults <50?
Over 50?
Immunocompromised?

A

<50: Vanc + 3rd-gen cephalosporin (ceftriaxone or cefotaxime)
>50: Add ampicillin (Listeria)
Immunocompromised: Vanc + cefepime (Pseudomonas), + ampicillin

47
Q 
Organism behind the chronic diarrhea, plus the CD4 range for each:
Watery, no fever
Watery, low-grade fever
Watery, high fever
Bloody
A

Watery, no fever: Micro/Isosporidium, CD4 < 100
Watery, low-grade fever: Cryptosporidium,CD4 < 180
Watery, high fever: MAC, CD4 < 50
Bloody: CMV, CD4 <50

48
Q

AIDS patient with painless blurred vision and fundoscopy showing hemorrhages surrounded by yellow-white fluffy lesions.

A

CMV retinitis

49
Q

AIDS patient with painful vision changes with fundoscopy showing central retinal necrosis with peripheral pallor

A

HSV or VZV retinitis (usually associated with keratitis and uveitis as well)

50
Q

Major toxicities of aminoglycosides (e.g. gentamicin and amikacin)

A
  1. Ototoxicity
  2. Vestibulopathy (no vertigo since symmetric, but has oscillopsia (sensation of objects moving in visual field), abnormal head thrust)
  3. Nephrotoxicity (AKI due to intrinsic kidney damage)
51
Q

Electrolyte abnormalities due to TMP-SMX

A
  1. Hyperkalemia (blocks ENaC, like the K-sparing diuretic amiloride)
  2. Elevated creatinine due to competitive inhibition of creatinine secretion (not decreased GFR)
52
Q

Empiric treatment for fight bite

A

Amoxicillin-clavulanate

53
Q

Delayed (1-2 weeks) antibiotic reaction with fever, rash, polyarthralgia, and lymphadenopathy.
Name? Associated antibiotics?

A

Serum sickness-like reaction

Caused by TMP-SMX and beta-lactams

Step 2 Last Minute (19 decks)

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