Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GME - Residency > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

A 2011 trial showed that ________ courses of antibiotics led to increased risk of C Diff.

A

longer

Particularly longer than 7 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Studies have shown that treating uncomplicated PNA with 5 days compared to 10 days led to what differences?

A

Fewer adverse effects and lower mortality in the short course group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Even complicated UTIs can be treated with as few as ______ days of antibiotics.

A

5

Studies exclude urologic abnormalities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A study by Yahav showed that ___ days of antibiotics was just as safe as 14 in treating GNR bacteremia.

A

7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Don’t forget to add __________ when people have fever and rash.

A

doxycycline

This is commonly forgotten in coverage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the most common tic-borne illness of NC?

A

Ehrlichia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The classic manifestations of Ehrlichia are what?

A
  • Myalgias
  • Fever
  • Vomiting
  • Maculopapular rash
  • CNS involvement (either meningitis or nerve palsy)
  • ARDS
  • Pancytopenia
  • Hyponatremia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Acute serology in tic-borne illness is unhelpful. Why?

A

Positive serology could be old. Negative serology could be too early.

You need to get convalescent serum to confirm diagnosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What physical exam findings should you look for in those with concern for fungal infections?

A
  • Oropharyngeal (black spots or erythema on the roof of the mouth, sinus pain)
  • Skin (erythematous papules)
  • Lung (invasive pulmonary diseases)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The risk of dying from sepsis goes up ____-fold after age 65.

A

13

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Bloody diarrhea and seizures are associated with what pathogen?

A

Shigella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The most common AIDS-defining illness is _________.

A

PCP

Second most common is esophageal candidiasis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What two treatments (drugs) should you start for PCP pneumonia if diagnosed in the ED?

A

Bactrim (it’s for treatment and PPX) and steroids if they are hypoxic with PaO2 70 mm Hg or less on RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which AIDS medication can cause bone marrow suppression?

A

Zidovudine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Other than infections, what can cause diarrhea in AIDS patients?

A

Medications

Ritonavir frequently causes diarrhea. You still need to rule common opportunistic pathogens but keep this in mind, especially if someone looks well and has negative workup.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

AIDS patients with symptoms of esophagitis should undergo what initial management step?

A

Empiric fluconazole treatment

Esophageal candidiasis is the most common cause of odynophagia in AIDS patients, so treating them with fluconazole and having follow up endoscopy if they fail to improve is reasonable.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

After a high-risk HIV exposure – such as unprotected sex or a needle stick with someone known to have HIV – what regimen is recommended?

A

A three=drug regimen for 28 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The Deertick is scientifically called _____________.

A

Ixodes scapularis

Also called blacklegged tick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which tick caries RMSF?

A

Dermacentor (aka wood tick)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Review qSOFA.

A

The Quick Sepsis-Related (or Sequential) Organ Failure Assessment score is used to predict outcomes in sepsis.

Patients get 1 point for each of the following:
RR >22
AMS
SBP < 100

A score of 2 or greater predicts worse outcomes and longer ICU stay.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

The most typical second-line pressor in septic shock is _____________.

A

vasopressin

0.04 U/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does meningococcal meningitis usually start?

A

As a mild URI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is meningitis dosing of ceftriaxone?

A

100 mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

TB usually affects the __________ of the lungs.

A

apices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Other than babies and adults who eat canned food, what population is at risk of botulism?

A

IV drug users

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is pylephlebitis?

A

Thrombophlebitis of the portal vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Review common organisms that cause infection in human bites (three specific bacteria and one group).

A

Eikenella
Staphylococcus aureus
Streptococcus viridans
Anaerobic bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Seborrheic dermatitis is caused by which organism?

A

Malassezia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

True or false: adult seborrheic dermatitis is usually fixed with a single treatment.

A

False

It is a chronic, relapsing disorder in adulthood and usually requires re-treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

HIV can cause abnormalities in which cell lines?

A

All cell lines

HAART usually is successful in treating HIV-associated anemia, thrombocytopenia, and leukopenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

People typically achieve undetectable HIV viral load after _____ months of HAART.

A

6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

True or false: all patients with zoster should be on airborne precautions.

A

False

Only those with disseminated zoster (two or more non-adjacent dermatomes).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Most US cases of rabies are caused by what animal?

A

Bats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What incubation period does rabies have?

A

20-90 days (hence rabies vaccination)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is involved in rabies prophylaxis?

A

Rabies immune globulin on day 0 and vaccine on days 0, 3, 7, and 14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Babesiosis is treated with what?

A

Atovaquone and macrolide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Why do you need to ask about swimming in rashes?

A

Pseudomonas hot tub folliculitis

Only treat immunocompromised hosts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Human bites are likely to get infected with what organism?

A

Eikenella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Deer tick are also called what?

A

Ixodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What tick transmits alpha gal allergy?

A

Lone Star ticks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What drug is best for Aeromonas hydrophila?

A

Ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

True or false: There is no acute form of HCV.

A

False

Acute HCV presents with abdominal pain, malaise, and severe transaminitis – often in the high hundreds. Notably, the HCV Ab test will not be positive for the first several weeks of the infection, only the RNA PCR.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Review the two types of necrotizing fasciitis and the organisms that cause each.

A
  • Type I: occurs in people with many medical comorbidities and is polymicrobial, can present with crepitus (C. perfringens, Bacteroides, S. aureus, Group A Strep)
  • Type II: occurs in healthy people with antecedent trauma (Group A Strep)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Other than the B6-preventable side effects of neuropathy and seizure, what is an important side effect of isoniazid?

A

Hepatotoxicity

Most people who take isoniazid have transaminitis in the 30-100 range but it is self-limiting. They can continue taking isoniazid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

True or false: HPV vaccine is inactivated.

A

False

It’s a live vaccine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Scabies is caused by what organism?

A

Sarcoptes scabiei

This is a mite.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How can scabies be diagnosed?

A

Light microscopy of skin scrapings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the treatment for scabies?

A

Topical 5% permethrin

One dose left on for 6-12 hours is usually sufficient, but can be repeated weekly if live mites are observed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Compared to viral arthritis, rheumatic fever affects the _______ joints.

A

larger

Viral arthritis (such as Parvovirus) are more likely to affect the PIPs, whereas rheumatic fever is more likely to affect the knees.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Patients who are started on HAART while they have an active infection (such as TB) are at increased risk of _____________.

A

immune reconstitution inflammatory syndrome (IRIS)

Treat this with symptom control unless they are unstable, which you can then start a steroid taper.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Review the stages of syphilis by symptom and timeline.

A

Incubation period:
- No symptoms
- 10 to 90 days after infection

Primary:
- Painless chancre with indurated borders
- Heals in 3-6 weeks

Secondary:
- Nonpruritic rash that spreads from trunk to hands and feet. Fever. Chills. Headache. Condyloma lata.
- Occurs 3-6 weeks after chancre heals.

Latent stage:
- Asymptomatic
- May last years

Tertiary syphilis:
- Neurosyphilis (Argyll-Roberston pupils, tables dorsalis neuropathy, dementia). Meningitis. Aortitis.
- Can be years or even decades after secondary syphilis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Review the treatment of syphilis.

A

Penicillin G 2.4 million units once weekly for three weeks

Be sure they follow up to ensure negative testing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is the treatment for vaginal candidiasis?

A

Fluconazole oral 150 mg x1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What’s the difference between a chancre and a chancroid?

A

A chancre is a painless indurated ulcer that is caused by Treponema pallidum. A chancroid is a painful, pustulent indurated ulcer that is caused by Haemophilus ducreyi.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

The two treatments that are available for genital warts are _____________.

A

podophyllix and imiquimod

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is the treatment for lymphogranuloma venereum?

A

21 days of doxycycline 100 mg BID (longer than the course for cervicitis [7 days] or PID [14 days])

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are the types of tests for C difficile that you might see?

A
  • PCR test for the toxin-producing gene
  • Antigen assay for toxins A and B
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

List the antibiotics that are high and low inducers of C difficile.

A

High:
- Clindamycin
- Fluoroquinolones
- 3rd and 4th generation cephalosporins
- Carbapenems
- Monobactams

Low:
- Bactrim
- Doxycycline
- Macrolides
- Aminoglycosides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

True or false: those with HCV need to wear condoms to prevent transmission.

A

False

The rates of sexual transmission of HCV are so low that condoms are not needed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Which women should be screened for asymptomatic Chlamydia?

A
  • All sexually active women younger than 25
  • Pregnant women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

In addition to honey and canned foods ingestion, ______________ is a risk factor for young children to develop botulism.

A

living on a dusty farm (where soil is turned often and spores can be aerosolized)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Clostridium botulinum works by _________________-.

A

releasing a toxin that inhibits presynaptic acetylcholine release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

An infant presents with botulism. In addition to supportive care, what treatment can you offer?

A

Botulism immune globulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Rubeola is also known as _____________.

A

Measles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

The two childhood viral illnesses that cause fever and then rash are ______________.

A

Parvovirus (fifth disease) and Roseola (HHV6 or sixth disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Review the diagnostic criteria for acute rheumatic fever.

A

It requires two major or one major and two minor criteria.

Major:
- Joints (migratory arthritis)
- Myocarditis
- Nodules in the skin
- Erythema marginatum
- Sydenham chorea

Minor:
- Fever
- Arthralgias
- Elevated CRP/ESR
- PR prolongation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

True or false: children with acute rheumatic fever who have Sydenham chorea should receive penicillin for 3-6 months.

A

False

Children should be given long-term penicillin until ADULTHOOD to prevent secondary recurrence.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

True or false: children of pregnant women should not be given live vaccines like MMRV until after the mother delivers.

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

In addition to tick presence less than 36 hours, you can also assess the likelihood of pathogen transmission by ____________.

A

engorgement status of the tick

If a tick is non-engorged then the risk of transmission is even lower.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Review the three treatment regimens for meningococcus prophylaxis.

A
  • Rifampin 500 mg BID for 2 days
  • Ciprofloxacin 500 mg x1
  • CTX 250 mg x1

Rifampins interact with OCPs so use either of the second two in women taking OCPs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

HPV vaccines are warranted for all women ________.

A

ages 11-26

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Zoster is indicated for all adults older than _______.

A

50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Administration of ____________ to someone with EBV is likely to cause a rash.

A

amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

The best research on COVID and remdesivir shows what?

A

That remdesivir shortens hospitalizations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What criteria are needed for tocilizumab or baricitinib?

A

Worsening disease and CRP greater than 75 mg/dl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

An August 2021 trial showed what about the preemptive use of VTE dose of anticoagulation in COVID showed what?

A

That non-critically ill people had increased survival and reduced use of cardiovascular and respiratory support with full dose anticoagulation.

The effect was most pronounced in those with very elevated d dimers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What labs are needed for the inpatient management of COVID 19?

A

HFP (because remdesivir is contraindicated in those with liver injury)
BMP (renal function needed for meds)
Type and screen (because they’re on anticoagulation)
PT/PTT (again they’re going to be on anticoagulation)
D-dimer, CRP, LDH (gauging severity of disease and trending to help diagnose PEs that present later)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

When can airborne precautions be discontinued in those with mild COVID, sever COVID, and immunocompromised?

A
  • Mild-moderate COVID: 10 days from last positive test
  • Severe disease or immunocompromised: 21 days from positive test

Note: there’s a dot phrase (COVID STOP ISOLATION, or something like that)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Which type of infection precaution is needed for meningitis?

A

Droplet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

When are steroids indicated in those with PCP?

A

When PaO2 is less than 70 or A-a is greater than 35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

The only sensory deficit present in those with botulism is _______________.

A

blurry vision

Botox affects only motor neurons. Sensory nerves will not be affected. Vision is affected only because the ciliary muscles of the eye are paralyzed.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Those with botulism should not be treated with antibiotics because _____________.

A

lysis of bacteria increases toxin release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

The rash associated with Parvovirus is _____________.

A

erythema infectiosum (Fifth disease)

This is a rash that starts on the face and spreads caudally in a reticular fashion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

The rash caused by HHV6 is called _____________.

A

Roseola

This starts on the trunk and spreads to the face, usually after the fever.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What is the treatment for post-streptococcal glomerulonephritis?

A

Supportive therapy (usually salt restriction +/- diuretics)

Antibiotics are not indicated.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

How long after infection does PSGN occur?

A

1-2 weeks after pharyngitis or 3-6 weeks after SSTI.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

The most common cause of death in measles is ____________.

A

pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What organisms are associated with type 1 and type 2 necrotizing fasciitis?

A

Type 1: polymicrobial (GAS, Clostridia, Bacteroides, Enterococcus)

Type 2: GAS

89
Q

LLQ pain, bloody diarrhea, and vesicles on anal exam suggest what diagnosis?

A

HSV proctitis

90
Q

The technical name for pinworms is what?

A

Enterobius vermicularis (treated with albendazole)

91
Q

Recurrent fever and pleuritic chest pain are typical of ______________.

A

familial Mediterranean fever

92
Q

Review the treatment of rabies exposure.

A
  • Rabies immunoglobulin near the wound on day of presentation
  • Rabies vaccine on days 0, 3, 7, and 14
93
Q

True or false: crows are a common source of rabies.

A

False

Rabies is a mammal-only virus.

94
Q

Bacteremia and sepsis after a dog bite is most likely from what organism?

A

Capnocytophaga canimorsus

This is a gram-negative rod that causes blisters and fulminant organ failure after dog bites. Those who are immunocompromised are at increased risk.

95
Q

The treatment for vaginal candidiasis?

A

Diflucan (oral fluconazole) 150 mg x1

96
Q

Explain the diagnostic tests for EBV.

A

EBV antibodies and PCR are most sensitive and specific, but they take longer than heterophile antibodies and are not as widely available. The heterophile is thus first line.

Note: the heterophile antibodies is only 75% sensitive within the first week.

97
Q

The inclusion bodies in neurons of those with rabies are called ____________.

A

Negri bodies

98
Q

Rabies is most concerning with bites to which part of the body?

A

The head and neck

Remember that rabies travels neuron-by-neuron to the brain. The closer it is to the brain, the more dangerous it is.

99
Q

Which fluoroquinolones do not work against Pseudomonas?

A

Levofloxacin and moxifloxacin

100
Q

Which fungi is endemic in the Ohio River Valley?

A

Histoplasma

(“Think OHIstO.”)

101
Q

Those with Lyme disease are at risk of which ocular complication?

A

Keratitis

With paralysis of the facial nerve, the eyelids fail to keep the eye moist.

102
Q

What is the prophylactic dose of doxycycline for Lyme disease (when indicated, of course)?

A

200 mg x1 within 72 hours

103
Q

Tetanus immune globulin is only indicated in patients _____________.

A

who have not completed a primary series of tetanus immunization

If a person has completed their primary series, they do not need tetanus IG even if they have large, dirty wounds.

104
Q

__________ is usually the first symptom of tetanus.

A

Trismus

105
Q

The PPD test has what eponym?

A

Mantoux test

106
Q

Bacterial vaginosis is diagnosed by what criteria?

A

Amsel:
- Thin, white discharge
- Clue cells
- Vaginal pH > 4.5
- Fishy odor

107
Q

What might you see on the US of a child w/ Kawasaki?

A

Hydrops of the gallbladder

108
Q

What are mycotic aneurysms?

A

Aneurysms that result from septic emboli

109
Q

What tick carriers Ehrlichiosis?

A

Amblyomma americanum (aka Lone Star Tick)

110
Q

Smallpox is caused by what virus?

A

Variola major

111
Q

Airborne precautions for shingles are indicated in what two patient populations?

A

Disseminated VZV
Immunocompromised hosts (even with local disease)

112
Q

What is the typical incubation period for malaria?

A

12-14 days

113
Q

When does chorea develop in rheumatic fever?

A

1-8 months after the infection

114
Q

Proctitis in the setting of anal receptive intercourse could be due to what STIs?

A

HSV, Gonorrhea, or Chlamydia

Treat like you would PID.

115
Q

Classically, scabies spares what areas?

A

The back and the head

Though it does present on the head in kids.

116
Q

What is the name of the organism that causes scabies?

A

Sarcoptes scabiei

117
Q

Petechiae after running a BP cuff is what sign?

A

Rumpel-Leede sign – a finding in RMSF

118
Q

In addition to palsy of the 7th cranial nerve, Lyme disease can also cause palsy of which nerve?

A

CN VI

119
Q

In which stage of syphilis can testing be negative?

A

Primary (painless chancre stage)

The first 1-4 weeks can be negative.

120
Q

In addition to S. epidermidis, list two other species that are highly likely to be contaminate.

A

Bacillus
Propionibacterium

121
Q

What class of antibiotics covers Eikenella?

A

Fluroquinolones

122
Q

What is the treatment for botulism?

A

Supportive care

123
Q

The most common bacteria in those with neutropenic fever is what?

A

S. epidermidis

124
Q

Why should you consider treatment of whooping cough with antibiotics?

A

Antibiotics have been shown to decrease the transmission of the bacteria to others.

125
Q

What is the PMN count for peritonitis in PD?

A

50 cells/mm3

126
Q

How long does a peritoneal dialysate need to dwell before sampling?

A

2 hours

127
Q

What is the timeline for treating active TB?

A

RIPE for two months then RI for four months

128
Q

A patient presents with seizures, asymmetric flaccid paralysis, and fever in July. Pathogen?

A

West Nile encephaliitis

129
Q

The most common pathogen for AOM in vaccinated people is _____________.

A

S. pneumoniae (still)

130
Q

The two most common viral causes of myocarditis are ____________.

A

Parvovirus B19 and Coxsackie virus

131
Q

What is the most sensitive test for Lyme meningitis.

A

Borrelia Ab

132
Q

The pathogen that causes Chagas disease is _________________________.

A

Trypanosoma cruzi

133
Q

Review the treatment of malaria from South America, Africa/Asia, and complicated cases.

A

SA: chloroquine
Africa/Asia: artemeter or atovaquone or quinidine + doxy
Complicated: artesunate or IV quinidine

134
Q

The initial test for Malaria is ____________.

A

thick and thin smear

135
Q

What antibiotic treats toxic shock syndrome?

A

Clindamycin (because of the exotoxin process)

136
Q

Elevated _______ (a blood test) is suggestive of PJP.

A

LDH

137
Q

The initial treatment for all amebic liver abscesses is ________________.

A

antibiotics (Flagyl)

Drainage is reserved for refractory cases.

138
Q

What is the empiric treatment regimen for neonatal meningitis?

A

Ampicilin and either cefotaxime or gentamicin

139
Q

True or false: rash is uncommon in Erhlichiosis.

A

True

140
Q

The antibiotic of choice for pregnant patients with ETEC is what?

A

Azithromycin

141
Q

What is scrofula?

A

TB cervical lymphadenitis

142
Q

True or false: S. aureus in blood cultures is frequently a contaminant.

A

False

It can be a contaminant, but it is much less likely than S. epidermidis to be a contaminant and should be consideref a true positive.

143
Q

What are the most sensitive and specific UA findings for UTI?

A
  • LE is the most sensitive (83%)
  • Nitrites are the most specific (98%)

The reason that nitrites are the most specific are that the enzyme nitrate reductase (which is found in Gram-negative bacteria) needs to act on urinary nitrates for 6 hours to convert it to nitrites.

144
Q

Early-onset neonatal sepsis happens before ____________.

A

7 days

145
Q

Review the three types of necrotizing fasciitis.

A

I: Polymicrobial, usually affecting older and immunocompromised hosts
II: GAS
III: Gas-producing organisms (often Clostridioides)

146
Q

Which species of malaria have dormant cycles?

A

Plasmodium ovale and Plasmodium vivax

(think of an EGG lyiing dormant to reVIVe later)

147
Q

What is the CDC-recommended PEP for healthcare workers exposed to HIV?

A

Tenofovir, emtricitabine, and raltegravir

Start ASAP. Do not start 72 hours or more after exposure.

148
Q

The old-fashioned name for the rash caused by HHV6 is _____________.

A

Roseola (fever resolves -> rash)

149
Q

What non-antibiotic therapies can you give in toxic shock?

A

IVIG

150
Q

What are the two major Duke criteria for endocarditis?

A

Presence of vegetation on echo

Positive blood culture with a typical organism or persistent positive blood culture with any organism

151
Q

Which antibiotics treat cholera?

A

Doxycycline (the preferred agent) as well as macrolides and fluoroquinoloness

Only give abx in moderate to severe cases.

152
Q

What infection causes severe myalgias termed “break-bone fever”?

A

Dengue

153
Q

What tropical illness has a short incubation period (4-7 days)?

A

Dengue

154
Q

Dengue causes fever, severe myalgias, vomiting, and ______________.

A

retro-orbital headache

155
Q

The classic triad of malaria is _______________.

A

fever, thrombocytopenia, and splenomegaly

156
Q

Antibiotic of choice for tularemia?

A

Streptomicin

157
Q

What is the usual progression of giardia?

A

Acute diarrhea at the time of infection followed by progressive weight loss and malabsorption

158
Q

What is the usual progression of giardia?

A

Acute diarrhea at the time of infection followed by progressive weight loss and malabsorption

159
Q

What is the treatment for coccidiodes?

A

Fluconazole

160
Q

True or false: fluconazole is the first-line treatment for Sporothrix schenkii.

A

False

Itraconazole

161
Q

What is the average incubation period for Sporotrichosis?

A

3 weeks

162
Q

Oseltamivir only works in the first _______ hours of symptoms.

A

48

163
Q

The most common form of extrapulmonary TB is ___________.

A

lymphadenitis

164
Q

What are the criteria for ppx rifampin in contacts of N. meningitidis?

A

Anyone with direct contact with droplets (e.g., suctioning a patient, intubating a patient) or those with prolonged contact (> 8 hours).

165
Q

True or false: E. histolytica hepatic abscesses require drainage as part of the first line therapy.

A

False

Metronidazole is first-line. Drainage is indicated only in treatment failure.

166
Q

Which of the bloodborne pathogens has the highest conversion rate?

A

HBV – up to 50% among needle sharing!

167
Q

Which ticks do Anaplasmosis and Ehrlichiosis come from?

A

Anaplasmosis: Deer tick (Ixodes scapularis)

Ehrlichiosis: Lone Star tick (Amblyomma americanum)

“Dear Ana…”

168
Q

What are the options for outpatient CAP therapy (2019 IDSA update)?

A

Healthy and younger than 65: any one of the three options below
- Amoxicillin
- Doxycycline
- Azithromycin (but less effective secondary to resistance)

Unhealthy or older than 65: either option
- (Augmentin or cefidinir) and (doxycycline or azithromycin)
- Fluoroquinolone

169
Q

The drug of choice for well-appearing SSSS is ____________.

A

dicloxacillin

170
Q

True or false: in AIDS patients, cryptococcal serum antigen is as sensitive as CSF antigen in diagnosing meningitis.

A

True

171
Q

Which antibiotics are recommended first-line in elderly epididymitis?

A

Fluoroquinolones

172
Q

What is the confirmatory test for HIV?

A

Western blot

Ag is preliminary.

173
Q

According to a 2019 update, what are the three agents for treatment of CAP in healthy adults younger than 65?

A

Amoxicillin (high dose)
Doxycycline
Azithromycin (in areas with low S. pneumoniae resistance)

174
Q

The biggest risk factor for meningitis from West Nile is _______________.

A

advanced age

175
Q

What sexual act has the least risk for HIV transmission?

A

Oral

176
Q

What infection can cause cholangiocarcinoma?

A

Clonorchis sinensis (liver fluke)

177
Q

What is the management for a patient with a CENTOR of 4-5 but negative rapid Strep?

A

Await culture

Even patients with high CENTOR scores have GAS only about 30% of the time, so empiric antibiotics are not warranted.

178
Q

Antibiotic choice for GAS pharyngitis with anaphylaxis to beta lactams?

A

Clindamycin or azithromycin

179
Q

Review the pathophysiology of histamine fish poisoning.

A

Inadequate fish refrigeration causes proliferation of bacteria on the surface of the fish. These bacteria decarboxylate histadine, leading to histamine. People present almost likee anaphylaxis: flushing, vomiting, and with abdominal pain. They generally resolve on their own very rapidly.

180
Q

What are the three trials that showed no benefit between usual care and EGDT?

A

PROCESS
ARISE
PROMISE

181
Q

What is triple therapy for H pylori?

A

Amoxicillin
Clarithromycin
PPI

182
Q

Although most effective if given within 2 days, patients can still be given Tamiflu up to ____ days of symptoms.

A

5

183
Q

How do the warts from HPV differ from those of syphilis?

A

Condyloma acuminata are flat, plaque-like

Condyloma lata are elevated

184
Q

What infection other than E coli and Shigella can produce HUS?

A

S. pneumoniae

185
Q

Disseminated _____________ can cause acral lesions that are pustular and flexor tenosynovitis.

A

gonorrhea

186
Q

Which two strains of malaria require additional medications to treat dormant hepatic forms (hypnozoites)?

A

P. vivax and P. falciparum

187
Q

Rubeola is also called ___________.

A

measles

188
Q

Shedding of the proximal nail (often seen in Coxsackie virus infections) is called what?

A

Onychomadesis

189
Q

In addition to aquaphobia and AMS, rabies also causes what symptoms?

A

Viral prodrome – fever, myalgias

190
Q

What is the current treatment for latent TB?

A

Isoniazid and rifampin x 3 months

191
Q

After how many days of illness will heterophile testing be positive in EBV?

A

Usually after the second week of illness

Prior to then, some hospitals will have Ag testing.

192
Q

What rash is associated with EBV?

A

Papular acrodermatitis (Gianotti-Crosti)

193
Q

How does Entamoeba coli present?

A

Trick question: it is a non-pathogenic species that is frequently mistaken for Entamoeba histolytica on stool studies by doctors. It does not warrant treatment.

194
Q

Other than contaminated streams, giardia can also come from where?

A

Daycare

195
Q

What is the minimum age for prescribing oseltamivir?

A

2 weeks old

196
Q

True or false: offer oseltamivir to household contacts who are high-risk.

A

True

197
Q

What is the max symptom duration that can receive oseltamivir (per the boards)?

A

48 hours

198
Q

Review triple therapy and quadruple therapy.

A

Triple:
- Clathrithromycin
- Amoxicillin
- PPI

Quadruple (for recurrence or concern for resistance to macrolide):
- Tetracycline
- Metronidazole
- PPI
- Bismuth subsalicylate

199
Q

What organism is likely to cause rapid fatal sepsis from a dog bite?

A

Capnocytophagia canimorsus

200
Q

What is the first line treatment for inpatient pediatric CAP?

A

Ampicillin

201
Q

At what age do you switch from the neonatal amp/gent to childhood vanc/cef for meningitis?

A

1 month

“AMp under A Month”

202
Q

Which cells get infected in EBV?

A

B lymphocytes (leading to increased number of T lymphocytes)

203
Q

What two treatments are first line for tinea capitis?

A

Oral terbinafine and oral griseofulvin

204
Q

Up to how long after a potential rabies infection should you treat for rabies?

A

90 days

205
Q

What worm can infect the eye?

A

Loa loa

206
Q

What syndrome does onchocerciasis cause?

A

African river blindness

207
Q

First-line antifungal for coccidiodes?

A

Fluconazole

208
Q

True or false: Zosyn and vancomycin is the treatment of choice for meningitis in the immunocompromised.

A

False

Zosyn doesn’t cross the BBB well and is not recommended for any type of meningitis.

209
Q

When is Lyme disease treated with IV ceftriaxone?

A

When it is disseminated – cardiac involvement, meningoencephalitis

210
Q

What is the treatment for eczema herpeticum?

A

Acyclovir and clindamycin

It’s thought that HSV lesions get superinfected with GPCs.

211
Q

What is the antibiotic choice for saltwater wounds?

A

Cipro or doxy

212
Q

What bacteria causes fishtank granuloma?

A

Mycobacterium marinarum

213
Q

Which pneumonia “classically” presents with sudden onset chills and cough?

A

S pneumoniae

214
Q

True or false: bed bugs can be treated with permethrin.

A

False

They live in the house and only come out at night. There’s nothing to kill on the skin.

215
Q

Which Coronovirus variant has a higher case-fatality rate, SARS or MERS?

A

MERS, by a significant margin

216
Q

Review the Duke criteria for endocarditis.

A

You need either 2 major, 1 major + 3 minor, or 5 minor criteria for a diagnosis:

Major:
- 2 positive cultures with a typical organism
- Positive echo

Minor:
- Predisposing condition (IVDU, prosthetic valve)
- Fever
- Immunologic phenomena (Janeway lesions, Osler nodes)
- Positive culture not meeting major criteria
- Echo not definitively positive but with potentially concerning features

217
Q

What is the pathophysiology of RMSF? That is, by what mechanism does the infection cause symptoms?

A

It leads to vasculitis with microinfarction in the skin, lungs, brain.

218
Q

Empirically, Macrobid is only for patients with cystitis who have ___________.

A

no medical complications that would make it “complicated cystitis”

If they are complicated (e.g., elderly, diabetic, immunocompromised) then they should receive a cephalosporin.

GME - Residency (112 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions