infectious disease

Question 1

why cipro not recommended for pna?

Answer 1

poor lung penetration

Question 2

which med permanently stains children teeth?

Answer 2

doxycycline

Question 3

CAP in children <5 - most common organism?

Answer 3

strep pneumo

Question 4

CAP in children <5 w/lobar findings on CXR - tx?

Answer 4

high dose amoxicillin

Question 5

what age start giving flu vaccine?

Answer 5

> = 6 months

Question 6

PNA in COPD - which organisms?

Answer 6

• strep pneumo
• h flu
• moraxella catarrhalis
• pseudomonas
• viral

Question 7

PNA in immunocompromise?

Answer 7

• strep pneumo
• h flu
• pneumocystis
• atypicals

Question 8

most common organisms in otitis externa

Answer 8

• staph aureus

- pseudomonas

Question 9

how soon do you have to start post-exposure ppx for HIV?

Answer 9

within 72 hours

Question 10

how long is course for post-exposure ppx for HIV?

Answer 10

4 weeks

Question 11

how many drugs do you give for post-exposure ppx?

Answer 11

• 2 NRTIs (nucleotide reverse transcriptase inhibitors)

- 1 integrase strand transfer inhibitor OR protease inhibitor OR NNRTI

Question 12

what antibiotic covers strep viridans?

Answer 12

amoxicillin

Question 13

what antibiotics covers enterococcus?

Answer 13

ampicillin

Question 14

procedures that warrant abx ppx for IE in ts w/high risk include:

Answer 14

• dental procedures
• respiratory tract procedures involving incision/bx
• surgical placement of prosthetic cardiac material

Question 15

classification for hospitalization for pneumonia?

Answer 15

CURB-65

Question 16

components of CURB-65

Answer 16

C - confusion
U - BUN >20
R - RR>30
B - SBP <90
65 - age >65

Question 17

how treat meningovascular syphilis?

Answer 17

IV penicillin

Question 18

fungal etiologies that can cause meningitis + stroke?

Answer 18

• cryptococcus
• coccidiomycois
• histoplasmosis

Question 19

hemorrhagic infarction of temporal lobe w/RBC in CSF dx?

Answer 19

HSV encephalitis

Question 20

CNS lymphoma in HIV pts is linked to which infectious disease?

Answer 20

EBV

Question 21

CNS lymphoma associated w/CD4 count less than what?

Answer 21

50

Question 22

UTI abx contraindicated in pregnancy?

Answer 22

• tetracyclines
• fluoroquinolones
• bactrim

Question 23

UTI abx that are OK in pregnancy?

Answer 23

• cephalexin
• fosfomycin
• augmentin

Question 24

gentamicin poses what risk to developing fetus?

Answer 24

ireversible deafness

Question 25

which vaccines are live?

Answer 25

MMR, zoster, varicella

Question 26

when are live vaccines contraindicated in HIV?

Answer 26

CD4 < 200

Question 27

anterior uveitis - aka?

Answer 27

iritis

Question 28

symptoms of anterior uveitis?

Answer 28

pain, redness, variable vision loss, consricted/irregular pupil.

Question 29

infectious keratitis - symptoms?

Answer 29

severe photophobia, difficulty opening eye, corneal opacity/infiltrate

Question 30

conjunctivitis - how is tx different for contact lens wearers vs non-contact wearers?

Answer 30

topical fluoroquinolones for contact wearers (to cover pseudomonas)

Question 31

keratitis - what is it?

Answer 31

inflammation of the cornea (clear tissue covering the pupil and iris and bordered by the bulbar conjunctivae)

Question 32

endopthalmitis - what is it?

Answer 32

bacterial infection o the deep eye (vitreous)

Question 33

uveitis - what is it?

Answer 33

inflammation of the middle eye (choroid, vitreous, iris, ciliary body)

Question 34

uveitis - what causes it?

Answer 34

usually auto-immune diseases (JRA, reiter syndrome) or systemic infection

Question 35

most common causes of bloody diarrhea in US??

Answer 35

- Salmonella - Shigella - E coli - Cmpylobacter - Yersinia

Question 36

in kids - when treat bloody diarrhea w/abx?

Answer 36

- immunocomporomised - sepsis - age < 3mo

Question 37

erlichiosis - signs/symptoms?

Answer 37

- fever, malaise, HA - nausea, vomiting - arthralgias - leukopenia, thrombocytopenia - high transaminases

Question 38

typhoid - symptoms?

Answer 38

- fever - abdominal pain - cutaneous "rose spots" - hepatosplenomegaly - intestinal bleeding - intestinal perforation

Question 39

pertussis - treatment?

Answer 39

macrolides (azithromycin) - prevents transmission but does not shorten duration of illness

Question 40

which organism causes croup?

Answer 40

paraflu

Question 41

which organism associated with Guillain Barre?

Answer 41

Cmapylobacter

Question 42

treatment for latent TB?

Answer 42

9 mo of isoniazid

Question 43

pt w/ + screening TB test, + cough, fever, night sweats --> what next?

Answer 43

additional evaluation | -- sputum samples for AFB and MB culture

Question 44

pt previously treated for latent TB, now w/fever + cough --> what next?

Answer 44

CXR

Question 45

ramsay hunt syndrome?

Answer 45

- reactivated VZV - ear pain - external auditory vesicles - same sided facial paralysis

Question 46

how treat malignant otitis externa?

Answer 46

- IV cipro until ESR/CRP normalize | - PO cipro x 6-8 weeks

Question 47

malaria is caused by which organism?

Answer 47

plasmodium falciparum

Question 48

fever in returning travler within <10days?

Answer 48

- typhoid - dengue - chikungunya - flu - legionella

Question 49

fever in returning traveler within 1-3 weeks?

Answer 49

- malaria - typhoid - leptospirosis - schistosomiasis - rickettsial dz

Question 50

fever in returning traveler in > 3 weeks

Answer 50

- TB - leishmaniasis - enteric parasitic infection

Question 51

typhoid fever - clinical symptoms?

Answer 51

- stepwise fever - relative bradycardia - rose spots

Question 52

infectious epididymo-orchitis - treatment?

Answer 52

1 dose IM ceftriaxone + 10d doxy

Question 53

postpartum endometritis - what abx?

Answer 53

clinda + gent

Question 54

chorioamnionitis - what abx?

Answer 54

ampicillin + gent

Question 55

MRSA - what abx cover?

Answer 55

- clinda - bactrim - doxy - linezolid

Question 56

cellulitis - abx for MSSA and B-hemolytic strep?

Answer 56

- clinda - amox + bactrim - amox + doxy - linezolid

Question 57

cellulitis - abx course?

Answer 57

- 5-7 days in mild cases | - 14 days in sevre

Question 58

sub-acute headache in HIV - what are the potential causes?

Answer 58

- cryptococcal meningitis - tuberculous meningitis - toxoplasmosis - CNS lymphoma

Question 59

how treat cryptococcal meningitis?

Answer 59

``` - IV amphotericin B (14d) PLUS - oral flucytosine (14d) THEN - fluconazole for 8-10 weeks (can start HAART @ END of acute treatment) ```

Question 60

when positive HIV ELISA - what order next?

Answer 60

- HIV western blot - CD4 count - HIV VL