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#‼️INTERNAL MEDICINE - PLE TOPNOTCH 2020 > INFECTIOUS DISEASES > Flashcards

INFECTIOUS DISEASES Flashcards

1
Q

the most frequent complication of amebic liver abscess

A

Pleuropulmonary involvement

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2
Q

What is the most common type of infection related to the pathogen Entamoeba histolytica?

A

Asymptomatic cyst passage

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3
Q

benign quartan malaria

A

P. malariae

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4
Q

Chancre (single, painless, papule / ulcers). Stage of syphilis?

A

Primary

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5
Q

Treatment for Uncomplicated falciparum malaria

A

Artemisinin-based combination (ACT) for 3 days

o Artemeter + lumefantrine

o Artesunate + amodiaquine

o Artesunate + mefloquine

o Dihydroartemisinin + piperaquine

o Artesunate + sulfadoxine/pyrimethamine (SP)

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6
Q

What is the best predictor of long-term clinical outcome in HIV infection?

A

plasma viral load

Plasma viral load measurement are a critical element in assessing the effectiveness of antiretroviral therapy.

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7
Q

What is the most common infection site of tetanus in adults?

A

Superficial abrasion to the limbs

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8
Q

What will you ALWAYS rule out if you are entertaining PID?

A

Pregnancy. So always do a pregnancy test

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9
Q

Early physical findings of Enteric (Typhoid) fever:

A

o faint, salmon-colored, blanching, maculopapular rash “rose spots” on trunk and chest

o Bradycardia, hepatosplenomegaly

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10
Q

treatment for malaria in Pregnancy (1 st trimester)

A
  • Uncomplicated falciparum: Quinine + Clindamycin (7 days)
  • Non-falciparum: Quinine
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11
Q

The hallmark of HIV is profound immunodeficiency from progressive deficiency of _________

A

helper T-cells

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12
Q

The most accurate test for syphilis is _____

A

darkfield microscopy

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13
Q

Treatment for PID

A

Single dose Ceftriaxone plus 14 days of Doxycycline and Metronidazole.

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14
Q

Define Fever of Unknown Origin

A

o Fever >38.3°C (101°F) on at least two occasions

o Illness duration of ≥3 weeks

o No known immunocompromised state

o Diagnosis that remains uncertain after thorough history and PE, and the obligatory investigations

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15
Q

What is the most common manifestation of salmonella infection?

A

Enterocolitis

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16
Q

• Occurs after 3-6 weeks of primary infection

• Fever, skin rash, pharyngitis, myalgia

  • Most patients spontaneously recover
  • Many have mildly depressed CD4 count that remains stable
A

acute hiv syndrome

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17
Q
  • Vulvar itching/irritation
  • White clumped discharge

Diagnosis? Treatment?

A

Vulvovaginal Candidiasis (C. albicans)

Fluconazole 150mg PO single dose

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18
Q

Definitive diagnosis of PCP can be established by use of _______

A

Giemsa or silver stain to visualize the organism

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19
Q

What is the preferred treatment of tetanus?

A

Metronidazole

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20
Q

the patient is normothermic but manipulates the thermometer

A

fraudulent fever

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21
Q

Mean survival time from onset of severe dementia is usually ______

A

less than 6 months.

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22
Q

What is the most common opportunistic infection affecting AIDS patients?

A

Pneumocystis pneumonia

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23
Q
  • Dark field microscopy or immunofluorescence or LM with staining
  • Only important in 1st 7-10 days of illness during leptospiremia
A

Microscopic demonstration (Direct detection)

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24
Q

If the patient is allergic to penicillin, what is the DOC for neurosyphilis and pregnant women.

A

desensitization to penicillin

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25
Q

Bacterial disease caused by an enterotoxin elaborated outside the host, such as that due to ____ or ____ has the shortest incubation period (1–6 h) and generally lasts <12 h.

A

Staphylococcus aureus or B. cereus

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26
Q

Without ventilatory support, what is the most common cause of death in tetanus?

A

respiratory failure

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27
Q

Therapy should include single-dose regimen effective for gonorrhea plus treatment for chlamydial infection in cervicitis. What is the treatment regimen?

A

o Ceftriaxone 250mg IM single dose or Cefixime 400mg PO single dose

o Azithromycin 1g PO single dose or Doxycycline 100mg PO twice a day for 7 days

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28
Q

treatment for acute colitis and amebic liver abscess.

A

Metronidazole or Tinidazole + Luminal agent (iodoquinol/paromomycin)

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29
Q

A 20-year-old woman presents to the emergency room with lower abdominal pain and tenderness, fever, leukocytosis, and cervical motion tenderness. Diagnosis?

A

PID

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30
Q

What muscles are affected first in tetanus?

A

Muscles of the face and jaw

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31
Q

What is the toxin responsible for tetanus?

A

Tetanospasmin

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32
Q
  • 4-fold rise in titers is confirmatory for leptospirosis
  • In endemic areas like the Philippines, single titer 1:1600 in symptomatic patient is diagnostic
A

Microagglutination test or MAT (Indirect Detection)

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33
Q
  • Vulvar itching
  • Profuse white/yellow homogenous discharge

Diagnosis? Treatment?

A

Trichomonal Vaginitis (T. vaginalis)

  • Metronidazole 2g PO single dose
  • Metronidazole 500mg BID PO x 7 days
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34
Q
  • Median time: 10 years (if not treated)
  • Ongoing and progressive HIV disease with active virus replication
  • Rate of progression is directly correlated to HIV RNA levels
A

ASYMPTOMATIC STAGE (HIV)

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35
Q

First line NNRTI for AIDS

A

Nevirapine (NVP)

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36
Q

Neurosyphilis (tabes dorsalis), gummas, Argyll Robertson pupil

A
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37
Q

What is the most common diagnosis of FUO among the neoplasms?

A

Malignant lymphoma

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38
Q

benign tertian malaria

A

P. vivax, ovale

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39
Q

single best test for both gonorrhea and chlamydia.

A

Nucleic acid amplification tests (NAATs)

40
Q

When do you start treatment in HIV?

A

o AIDS defining illness / symptomatic regardless of CD4

o CD4 <350

o All HIV-infected pregnant women

o Specific HIV related conditions

  • HIV-associated nephropathy
  • Co-infection w/ HBV infection when HBV treatment is indicated
41
Q

A 40-year-old man complains of fever and right-sided abdominal pain. Diagnostic workup shows liver abscess. Needle aspiration shows characteristic “anchovy paste” material.

A

Amebic liver abscess

42
Q

Alternative drug for syphilis if allergic to penicillin

A

Doxycyclin

43
Q

“multiple vesicular lesions on an erythematous base”

A

HSV

44
Q

As children born with HIV infection are living to adolescence and adulthood due to antiretroviral therapy, many appear to be at high risk for psychiatric disorders. The most common problems are _____

A

anxiety disorders

45
Q

What is the infective stage during asexual cycle of malaria?

A

Sporozoites

46
Q

What is the treatment of choice for schistosomiasis?

A

Ppraziquantel

47
Q

Give examples of Non- inflammatory, inflammatory and penetrating causes of diarrhea.

A
48
Q

Febrile phase of dengue (Day 2-7)

A

o Non-specific signs and symptoms

o Tourniquet test is (+)

o Mucosal bleed and GI bleeding may occur

o decreased WBC count

49
Q

drug of choice for treatment of all stages of syphilis

A

Single dose of IM Penicillin G

50
Q

High yield during leptospiremic phase before appearance of antibodies; Limited use due to cost

A

High yield during leptospiremic phase before appearance of antibodies; Limited use due to cost

51
Q

What is the best initial test for cervicitis?

A

Swab for gram stain

52
Q

• Gold standard in diagnosis

• Time consuming, requires 6-8 weeks for results

A

Culture and isolation (Direct detection)

53
Q

What is the first line of antibiotic for mild cases of leptospirosis?

A

Doxycycline 100mg BID PO

54
Q

What is the earliest CBC abnormality in Dengue?

A

Decrease in Total WBC count

55
Q

most prominent serotype of Enterohemorrhagic E. coli

A

O157:H7

56
Q

Bloody stools without fecal leukocytes should alert to the possibility of infection with ______

A

Shiga toxin–producing enterohemorrhagic Escherichia coli

57
Q

Submucosal extension of ulcerations under viable appearing surface mucosa causes the classic “flask-shaped” ulcer containing trophozoites at the margins of dead and viable tissues.

A

INTESTINAL AMEBIASIS

58
Q

treatment for Nonfalciparum malaria

A
  • ACT or chloroquine
  • Give primaquine for 14 days for eradication of hypnozoites to prevent relapse.
59
Q

Critical phase of dengue (Day 3-7)

A

o Defervescence around this time

o Progressive leukopenia, rapid decrease in platelet count, increase hematocrit.

o Fluid accumulation (effusion, ascites)

o Shock, organ impairment, DIC, hemorrhage

60
Q

What are the are hallmark features of Enteric (Typhoid) fever?

A

Prolonged fever and abdominal pain

61
Q

PROPHYLAXIS REGIMEN for leptospirosis (started within 24-72 hrs of exposure)

A
  • Low risk (- wound): Doxycycline 100mg 2 caps single dose
  • Moderate risk (+ wound): Doxycycline 100mg 2 caps OD x 3-5 days
  • High risk (continuous exposure, +/wound): Doxycycline 100mg 2 caps once weekly until end of exposure
62
Q

In some infected individuals of schistosoma, egg-induced granulomatous responses lead to severe periportal fibrosis known as ______

A

Symmers clay pipestem fibrosis

63
Q

What is the most likely etiology of Mucopurulent Cervicitis?

A

Neisseria gonorrhea or Chlamydia trachomatis

64
Q

(fever artificially induced by the patient—for example, by IV injection of contaminated water) should be considered in all patients but is more common among young women in health care professions.

A

Factitious fever

65
Q

______ is the sudden onset of mononucleosis-like illness with fever, headache, pharyngitis, lymphadenopathy, skin rash occurring 3-6 weeks of primary infection.

A

Acute HIV syndrome

66
Q
  • HIV + CD4 < 200/uL OR
  • HIV + HIV associated diseases indicative of a severe defect in cell-mediated immunity
A

AIDS

67
Q
  • Fishy order with 10% KOH
  • Slightly increased discharge
  • Clue cells: vaginal epithelial cells with coccobacillary organisms giving a granular appearance

Diagnosis? Treatment?

A

Bacterial Vaginosis (Gardnerella vaginalis)

Metronidazole 500mg BID PO x 7 days

68
Q

Specimen for typhoid that is positive in 1st to 2nd weeks

A

Blood

69
Q

What is the toxin responsible in Escherichia coli 0157:H7?

A

Shiga-toxin

70
Q

What is the most infectious stage of syphilis?

A

Secondary syphilis

71
Q

What is the most accurate test to identify salpingitis?

A

Laparoscopy

72
Q

What is the best predictor of short-term risk of developing an opportunistic infection?

A

CD4 lymphocyte count

73
Q

What is the first line of antibiotic for severe cases of leptospirosis?

A

Penicillin G 1.5M units q-68 IV for 7 days

74
Q

Marker for fecal leukocytes

A

Fecal lactoferrin

75
Q

A 20-year-old man complains of non-painful rash on his penis. On examination, there is a non-tender ulcerated nodule with indurated border.

A

Primary syphilis

76
Q

Which plasmodium species is responsible for dormant forms of parasite that can reactivate and cause relapses months to years later?

A

P. vivax or ovale

77
Q

What is the infective stage of schistosoma?

A

Cercaria

78
Q
  • Quick detection of Leptospira genus specific IgM antibodies
  • Better sensitivity if taken >7 days of illness, highly specific
A

Specific IgM Rapid (Indirect Detection)

79
Q

Widely distributed macular rash (also on palms and soles); Condyloma lata (wart like)

A

Secondary Syphilis

80
Q

gold standard for diagnosis of malaria

A

Thick and thin smear

81
Q

This is seen in what stage of Syphilis?

A

Tertiary Syphilis

82
Q

Hemolytic uremic syndrome is characterized by ____

A

§ Acute renal failure

§ Microangiopathic hemolytic anemia

§ Thrombocytopenia

83
Q

What are the dormant forms of malaria responsible for relapse?

A

Hypnozoites

84
Q

What is the most common neurologic syndrome of AIDS (25-65%)?

A

AIDS dementia complex

o Poor memory

o Inability to concentrate

o Apathy

o Psychomotor retardation

o Behavioral changes

85
Q

malignant tertian malaria

A

P. falciparum

86
Q

A 30-year-old male presents with 5 days fever and abdominal pain. He recently travelled in an area that has poor sanitation and lack of clean drinking water. On examination, there’s a faint salmon-colored, maculopapular rash on the trunk.

A

Typhoid fever

87
Q

Chancroid = painful ulcer is caused by what organism?

A

Haemophilus ducreyi

88
Q

What are the warning signs of dengue?

A
89
Q

Treatment for asymptomatic carriage of amebiasis.

A

Luminal agent: Iodoquinol or paromomycin

90
Q

What is most severe complication of hepatosplenic schistosomiasis?

death may result from massive loss of blood

A

Hematemesis

91
Q

The definitive diagnosis of amebic colitis is made by the demonstration of_______

A

hematophagous TROPHOZOITES (not cyst) of E. histolytica.

92
Q

First line NRTI for AIDS

A

Zidovudine (AZT) + Lamivudine (3TC)

93
Q

What is the antibiotic choice for drug-susceptible infection to Salmonella typhi or paratyphi?

A

Ciprofloxacin

94
Q

Recovery phase of dengue

A

Rashes described as “isles of white in the sea of red” is a sign of recovery. (Herman’s rash)

95
Q

Signs of plasma leakage in dengue

A

o Rising hematocrit

o Effusion or ascites

o Shock (decreased pulse pressure)

96
Q

Treatment for Severe falciparum malaria

A
  • Artesunate IV/IM (1st 24 hours), then oral ACT for 3 days
    • primaquine (areas of low transmission)

#‼️INTERNAL MEDICINE - PLE TOPNOTCH 2020 (10 decks)

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