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Infectious Diseases Flashcards

1
Q

Triad of typhoid fever

A

Step-wise fever, rose spots and relative bradycardia

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2
Q

Time to development of C.dif post antivioic exposure

A

Upto 6 weeks

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3
Q

3 treatment regimens for LTBI

A

Rifapentine + INH x 12 weeks
INH alone for 6-9 months
Rifampin x 4 months

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4
Q

Classification of C.diff colitis

A

Non-severe
Severe: Cr >1.5 or WBC >15000
Fulminant: ileus, megacolon or hypotension

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5
Q

Hypoalbuminemia in c.diff

A

Protein losing inflammatory enteropathy

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6
Q

Causative agents of viral meningitis in children

A

Enterovirus (coxsackie)
HSV
Arbovirus (west nile)

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7
Q

Treatment of RMSF

A

Doxycycline

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8
Q

CD4 count for PCP

A

200

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9
Q

CD4 count for cryptococcal meningitis

A

100

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10
Q

Treatment of PCP

A

TMP-SMX + Steroids

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11
Q

Triage for influenza with high risk features

A

ED evaluation

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12
Q

Rx o acute bacterial sinusitis

A

Amoxi-clav (1st line)

FQs and doxy (2nd line)

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13
Q

Diagnostic criteria for acute bacterial sinusitis

A

Persistent symptoms for >10 days
Purulent nasal discharge or facial pain >3 days
Worsening of symptoms after resolution of viral URI >5 days

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14
Q

Age for HPV vaccine in males and females

A

Female 26 and male 21

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15
Q

8 criteria for Hep B vaccination

A
  1. High risk sexual practices or personal history of STD
  2. MSM
  3. IVDU
  4. H/O CKD, HIV or Hep C
  5. Household contacts of patients with chronic HBV
  6. All pregnant females
  7. HCW
  8. Incarcerated facilities
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16
Q

Mode of HBV transmission in endemic areas and low prevalence countries

A

Endemic - Vertical transmission

Low prevalence regions - IVDU and sexual transmission

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17
Q

Most common cause of viral diarrhea

A

Norovirus

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18
Q

Difference between erysipelas and cellulitis

A

Erysipelas - sharp demarcation between normal and involved skin
Cellulitis - poorly defined margins

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19
Q

What is diaper impetigo

A

Diaper rash -> Infected by stool and urine -> Staph and strep infection -> Erythematous papules and pustules with honey crusted lesions

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20
Q

Signs of sepsis in diaper impetigo

A

Irritable and crying child

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21
Q

Rx of diaper impetigo not complicated by sepsis

A

Oral cephalexin and mupirocin ointment

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22
Q

Rx of diaper impetigo with sepsis

A

Parenteral antibiotics

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23
Q

Types of diaper rashes

A

Candida rash
Impetigo
Strep dermatitis
HSV

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24
Q

Diagnostic test for west nile encephalitis

A

CSF West nile IGM positive

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25
Q

Test for C.diff

A

Stool EIA and GDH

Stool NAAT

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26
Q

Causes of non-inflammatory diarrhea

A

Viral: Norovirus and rotavirus
Bacteria: ETEC, Vibrio,
Parasites: Giardia, cryptosporidium and cryptococcus
Intestinal tape-worms

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27
Q

Approach to diarrhea

A

Vomiting predominant vs diarrhea predominant
Inflammatory vs on-inflammatory
Invasive/blood diarrhea

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28
Q

Stool leukocytes and RBC in non-inflammatory diarrhea

A

Negative

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29
Q

Causes of inflammatory diarrhea

A

Salmonella, shigella, yersinia, STEC

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30
Q

Pustules with central umblication

A

Molluscum contagiosum

Cryptococcus

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31
Q

Cutaneous cryptococcosis

A

Preferentially affects head and neck

Sign of disseminated infection

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32
Q

What is pyoderma gangrenosum

A

Occus in IBD and inflammatory arthritis

Purple papule that degenerate into ulcers

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33
Q

Dx of cutaneous cryptococcus

A

Skin biopsy

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34
Q

Rx of cutaneous cryptococcus

A

2 weeks of AMP B + Flucytosine —> 1 year of Fluconazole oral

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35
Q

Rx of trichomonas vaginitis

A

Rx patient and partner with oral metronidazole

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36
Q

Strawberry cervix Dx

A

Trichomonas vaginitis

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37
Q

Trichomonas vaginitis increases the risk of which STD

A

HIV

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38
Q

Fever with relative bradycardia DDx

A

Typhoid and legionella

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39
Q

Rx of legionella

A

Respiratory FQs and newer macrolides

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40
Q

Triad of clinical symptoms in legionella

A

Neurological: Confusion and ataxia
Pulmonary: Bilateral unilobar or interstitial pneumonia
GI: Diarrhea

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41
Q

Metabolic abnormalities in legionella

A

Hepatic dysfunction and hyponatremia

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42
Q

Which antibiotics achieve high intracellular concentration

A

Azithromycin and levofloxacin

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43
Q

Sputum findings characteristic of legionella

A

Many WBC with no organisms

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44
Q

Rx of chlamydia

A

Doxycycline or azithromycin

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45
Q

Rx of chlamydia in pregnancy

A

Azithromyci

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46
Q

Pregnancy and neonatal complication of chlamydia

A

Pregnancy: Preterm labor and premature ROM
Neonatal: Conjunctivitis and pneumonia

47
Q

Non AIDS defining illness in HIV

A

CVD, CKD, Malignancy

48
Q

Contraindications for VZV vaccine

A
  1. Neomycin allergy
  2. Gelatin allergy
  3. Pregnancy
  4. Immunocompromised state `
49
Q

What should be monitored if VZV vaccine is administered to houselhold contact of an immunocompromised person

A

Rash which may be contagious

50
Q

Rx of asymptomatic bacteriuria and UTI in pregnancy

A

Fosfomycin
Cephalexin
Amox-clav

51
Q

Organisms causing UTI in pregnancy

A

E.Coli, Proteus, and Klebsiella

52
Q

TMP-SMX fetal complications

A

1st trimester: NTDs

3rd trimester: Neonatal kernicterus

53
Q

Suppressive therapy post PN in pregnancy

A

Low dose nitrofurantoin or cephalexin till 6 weeks post partum

54
Q

Most common cause of chronic unilateral lymphadenitis in children

A

Perinauds oculoglandular lymphadenopathy which is a manifeststion of CSD

55
Q

Characteristic feature of oculo-glandular LN

A

Unilateral LN + conjunctivitis

56
Q

Characteristic presentation of Strep throat in children

A

Exudative tonsillitis without URI symptoms + Tender cervical LN

57
Q

Rx of strep throat in children

A

Amoxicillin or cephalosporins in penicillin allergy

Not amoxi-clav

58
Q

What is HIV associated lipodystrophy

A

HIV Rx—>

(a) Lipoatrophy —> Skeleton like appearance
(b) Fat accumulation —> buffalo hump and increased abdominal girth

59
Q

Complications associated with HIV lipodystrophy

A

Insulin resistance, dyslipidemia, and increased CVD risk

60
Q

Medication a/w HIV lipoatrophy

A

Nucleoside reverse transcriptase inhibitor

61
Q

Criteria for acute liver failure

A

INR >1.5, encephalopathy, and elevated LFT

62
Q

Prognosis of acute Hep B infection

A

Self-limited with rare progression to acute liver failure

63
Q

Triage of acute Hep B

A

Outpatient with close follow-up

64
Q

Indications for hospital admission in acute hep B

A
  1. HD instability

2. ALF

65
Q

Indications for antiviral in acute Hep B

A
  1. Immunocompromised
  2. ALF
  3. Severe hepatitis
  4. Concurrent Hep C
66
Q

Criteria for chronic Hep B

A

Failure to clear HBsAG after 6 months of acute infection

67
Q

% of children and adults who develop chronic Hep B after acute Hep B

A

Children: 10-20%
Adults: 5%`

68
Q

What is ecthyma gangrenosum?

A

Chemotherapy patients with indwelling port —> Psuedomonas bacteremia —> bacteria invades adventitia and medial layers of BV wall —> Painless macule followed by bulla formation which ulcerates

69
Q

DDx of ecthyma gangrenosum

A

Candidemia skin lesions
Mycosis fungoides
Clostridium myonecrosis

70
Q

Rx of pseudomonas bacteremia in immunocompromised patient

A

Pip-Tazo + gentamicin

71
Q

First step after active TB diagnosis

A

Drug senstivity testing

72
Q

Rx of LTBI in close contact

A

Guided by drug sensitivity results of the contact

73
Q

Rx of cat scratch disease

A

Azithromycin

74
Q

How long should contact sports be avoided after IM diagnosis

75
Q

Duration of fatigue after IM infection

A

> 6 months

76
Q

Airway obstruction after IM

A

Corticosteroids

77
Q

Most common causative agents of acute otits media and Rx

A

Strep pneumo, non typable Hinf, moraxella

Amoxicillin

78
Q

Recurrence of OM within 1 month after 10 day course of amoxicillin

A

Beta lactamase producing organisms. Rx with amoxicillin-clavulinic acid

79
Q

Indications for tympanostomy tube placement for OM

A

Recurrent OM >3 in 6 month and >4 in a year

80
Q

Screening test for HIV

A

4th gen - p24 antigen and HIV antibody

81
Q

Risk factors for invasive candida infection

A

Lines
ICU admission
Neutropenia

82
Q

Sensitivity of induced sputum analysis for PJP

A

Very poor 50-90%

83
Q

Indications for steroids in PJP

A

A-a gradient >35 mm Hg

PaO2 <70

84
Q

Indications for prophylaxis of meningococci

A

Close contact
Exposure to respiratory or oral secretions
Seated next to affected individual for >8 hours

85
Q

Prophylactic antibiotic for meningococcus

A

Rifampin BID x 2 days —> Interacts with OCPs
Ciprofloxacin 500 one dose
CTX 250 mg 1 dose

86
Q

Rx of lactational mastitis

A

Dicloxacillin and cephalexin

87
Q

Dx of breast abscess

A

Ultrasound

88
Q

Induration in lactational mastitis DDx and test

A

Mastitis and abscess

USG

89
Q

Rx of chronic bacterial prostatitis

A

6 weeks of ciprofloxacin

90
Q

Presentation of chronic bacterial prostatitis

A

Young middle aged males

>3 months of recurrent UTI, pain in GU area, and/or pain with ejaculation

91
Q

Rx of huntingtons disease

A

Tetrabenzine

92
Q

Neck stiffness DDx

93
Q

Only indications for Rx of salmonella

A

Age <12 months

Immunocompromised individuals

94
Q

Two types of necrotizing fasciitis

A

Type 1- DM and PVD —> Polymicrobial

Type 2-No prior Dx—> Group A strep is more common

95
Q

Crepitus in necrotizing fasciitis

A

Anaerobes: C perfringens or B fragilis

96
Q

Absent red reflex

97
Q

Congenital defects in rubella

A

Cataract, patent ductus arteriosus, SNHL

98
Q

Skin lesion and neurological abnormality in congenital rubella

A

Blueberry muffin rash and microcephaly

99
Q

Rx of sporotrichosis

A

3-6 months of oral itraconazole

100
Q

Causes of serum sickness like reaction

A

Acute Hep B, antibiotics - sulf and beta lactams

101
Q

Which autoimmune disease does serum sickness resemble and what is the mechanism

A

Type III hypersensitivity and SLE

102
Q

Vasculitis associated with acute Hep B

103
Q

Causative agent of herpangina

A

Coxsackie group A

104
Q

Differentiate between oral vesicular lesions of herpes gingivostaomatitis and herpangina

A

Gingivostomatitis: Anterior oral mucosa
Herpangina: Posterior mucosa and pharynx

105
Q

Radiographic features of invasive pulmonary aspergillosis

A

Halo sign - lung cavity with surrounding ground glass opacities
Air crescent sign - cavity with air fluid levels

106
Q

Rx of TB in pregnancy

A

3 drug regimen - all drugs can cross placenta but do not have toxic effects on fetus

107
Q

TB drug C/I in pregnancy

A

Pyrazinamide

108
Q

Duration of antibiotics for strep throat

A

10 days to prevent ARF

109
Q

What is HIV associated thrombocytopenia

A

HIV not on Rx —> low platelets without an apparent cause

110
Q

Frequency of viral load and CD4 monitoring after ART initiation

A

3-6 months

111
Q

Expected decline in viral load post ART initiation

A

4 weeks: <5000
4 months: <500
6 months: <50

112
Q

Define virological failure after ART Rx

A

Viral load >200 after 6 months

113
Q

Management of VZV

A 
Typical presentation - Oral acyclovir 
Atypical rash (immunocompromise) - PCR lesion
114
Q

Rx of Jarisch-Herxheimer reaction

A

Supportive

Uworld (5 decks)

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