Infectious Disease

Question 1

What is the likely cd4 count of an aids patient p/w cryptococcal meningitis?

Answer 1

<50

Question 2

Pt with exposure to bats/birds with pulm symptoms and oral ulcers with punctate lesions on X-ray?

Answer 2

Histoplasmosis

Question 3

Tx of choice for PJP?

Answer 3

Bactrim

Question 4

How does botulism act?

Answer 4

Inhibits the release of acetylcholine

Question 5

Rice water stool

Answer 5

Cholera

Question 6

Pt with gastroenteritis with fever, and pain and vomiting. Likely which pathogen?

Answer 6

Salmonella

Question 7

Pea soup floating diarrhea

Answer 7

Salmonella

Question 8

Blood in diarrhea with fever with punctate lesions on colonoscopy

Answer 8

Shigella

Question 9

India ink stain positive

Answer 9

Cryptococcus

Question 10

Pt with history of bird exposure p/w fever, cough, dyspnea. Diagnosis? Tx?

Answer 10

Cryptococcus treat with diflucan for 10+ weeks

Question 11

Fever with rash/petechiae, hyponatremia, thrombocytopenia, elevated LFTs. Diagnosis? Treatment?

Answer 11

Rocky Mountain spotted fever, treat with doxy unless pregnant: chloramphenicol

Question 12

At what temperature fever is irreversible brain damage caused?

Answer 12

> 106.8

Question 13

What are the diagnostic criteria for fever of unknown origin (3)?

Answer 13

Fever > 101.8, > 3 weeks with at least 1 weeks work up for a cause

Question 14

What medium does streptococcus grow on in the micro lab?

Answer 14

blood agar

Question 15

Pt presents with fever, diffuse erythematous rash that blanches and is rough like sandpaper or goose bumps. Her face is flushed with circumoral pallor and strawberry tongue. Diagnosis?

Answer 15

Scarlet fever induced by strep pharyngitis

Question 16

Thick honey colored crust skin lesions

Answer 16

strep/staph impetigo - must be treated with antibiotics

Question 17

15 yo patient presents with a lacunar rash with central clearing and strange purposeless movements. Diagnosis? Names for these sypmtoms. What is the greatest mortality risk of this position.

Answer 17

Acute Rheumatic fever - erythema marginatum and sydenham chorea. Mortality risk: carditis leading to death or irreversible valvular injury

Question 18

What is the treatment for strep pharyngitis for a PCN allergic patient?

Answer 18

macrolides

Question 19

Pt presents with severeal lesions that are vesicular with a purple-to-black center which the patient says were just red bumps before. Cultures of the contents of the vesicle yield gram-positive box-shaped rods in chains. Diagnosis?

Answer 19

Anthrax

Question 20

What is the treatment of choice in a patient with anthrax?

Answer 20

cipro

Question 21

What is the composition of oral rehydration solution?

Answer 21

I cup water, 1 tsp salt, 4 tsp sugar

Question 22

What is the treatment of choice for Shigella?

Answer 22

Bactrim

Question 23

What is the treatment of choice in diphtheria?

Answer 23

PCN or emycin

Question 24

What is the treatment of choice for pertussis?

Answer 24

emycin

Question 25

Pt presents with acute onset fever, malaise, HA and sore throat. On exam, vesicles are seen in the posterior pharynx. What is the likely cause?

Answer 25

Herpes initial infection

Question 26

Pt presents with fever, HA, altered mental status. CSF fromLP shows elevated protein and normal glucose. What is the next step in establishing the diagnosis?

Answer 26

send HSV DNA by PCR and get an MRI

Question 27

What is the risk to the fetus of a mother with herpes? What can be done?

Answer 27

visceral and CNS infection, often C-section is performed

Question 28

11 yo F has just gotten over the flu and presents with vomiting, jaundice and new onset seizures. Labs show increased LFTs, ammonia levels and prolonged PTT. Diagnosis? Tx?

Answer 28

Reye's syndrome reactive to influenza, treatment is supportive

Question 29

What is the recommended time frame to start antiviral medications in a patient with influenza?

Answer 29

48 hours

Question 30

What are the indications/contraindications to zostavax?

Answer 30

indications: > 60, contra: allergy to gelatin or neomycin or other contraindications for live vaccine

Question 31

How is an animal tested for rabies?

Answer 31

Brain dissection and testing using fluorescent antibody markers

Question 32

What is the treatment for a confirmed rabies bite?

Answer 32

infiltration of the wound with immunoglobulin + IM injection and vaccine administrations on days 0, 3, 7, 14 and 28

Question 33

How often is CD4 count monitored in HIV/AIDS patients?

Answer 33

if > 350 q6 months otherwise q3 months

Question 34

What is the typical medication course and effectiveness of post HIV exposure prophylaxis?

Answer 34

4 weeks, 70% effective

Question 35

What should an HIV (+) mother be counseled about with her infant?

Answer 35

Transmission methods including breast milk

Question 36

Pt presents with fever, malaise, splenomegaly no throat pain. Likely diagnosis?

Answer 36

CMV

Question 37

HIV patient has neovascularization on ophthalmic exam looking almost like a pizza pie. Likely diagnosis?

Answer 37

CMV retinitis

Question 38

Tissue biopsy of a patient with vague symptoms and myalgias shows intracytoplasmic inclusions (owl's eyes), diagnosis?

Answer 38

CMV

Question 39

What is the treatment of choice in candidal fungemia?

Answer 39

amphotericin B

Question 40

What is the treatment of choice for histoplasmosis?

Answer 40

Itraconazole PO for weeks to months

Question 41

What is the treatment for cryptococcus?

Answer 41

amph B

Question 42

What do you treat PJP with who have sulfa allergies?

Answer 42

Dapsone pr petamidine

Question 43

What medication should a pregnant woman traveling to a malaria risk country take for prophylaxis?

Answer 43

Chloroquine

Question 44

How long after initial infection are the VDRL/RPR tests effective for syphilis?

Answer 44

4-6 weeks

Question 45

What follow up test is performed with a positive RPR/VDRL to confirm syphillis?

Answer 45

FTA-ABS

Question 46

What is the treatment of syphillis?

Answer 46

PCN

Question 47

What is the treatment of choice for Gonorrhea?

Answer 47

Im Ceftriaxone or Oral cefixime - treat for chlamydia as well with either doxycycline or azithromycin

Question 48

What is the treatment for chlamydia in pregnancy?

Answer 48

Emycin

Question 49

Pt presents with vaginal pruritus and yellow-green malodorous discharge. Red macular lesions are visible on the cervix and flagellates are seen on wet mount. Dx? Tx?

Answer 49

Trichomonas - Flagyl 2g single dose