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Medicine > ITE Infectious Disease > Flashcards

ITE Infectious Disease Flashcards

1
Q

Abx of choice for Campylobacter?

A

Azithromycin

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2
Q

Immunocompromised patient would need what type of vaccinations?

A

Hep A if traveling and non-live/live-attenuated

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3
Q

Polyoma BK virus can cause what organ dysfunction?

A

primarily kidneys in renal transplant patients

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4
Q

Fulminant C diff infection happens in what 4 scenarios ?

A

1) hypotension
2) shock
3) ileus
4) megacolon

if it sounds serious (ICU criteria), they get fulminant C diff treatment

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5
Q

If ileus is present in C diff infection, what alteration can you make in treatment regimen?

A

instead of oral vancomycin, you can have rectal vancomycin

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6
Q

treatment of fulminant c diff

A

oral vanc

IV flagyl

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7
Q

treatment of CMV infection in immunosuppressed

A

severe: IV ganciclovir

non-severe: oral valganciclovir

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8
Q

Foscarnet and cidofovir are used in what context?

A

severe CMV infection; if IV ganciclovir fails

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9
Q

Flu diagnostic test of choice?

A

nucleic acid amplification test (rapid)

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10
Q

“undulant fever” fever/chills, severe headache, joint and back pain, malaise, lethargy; depression; location: Mediterranean countries, as well as, Middle East/South and Central Asia

Physical Exam: hepatosplenomegaly and lymphadenopathy

Labs: cytopenia and abnormal liver enzymes

A

Brucellosis

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11
Q

What pathology can develop with Q fever? (Think long-term)

A

endocarditis

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12
Q

Developed from inhalation of soil contaminated with excrement/birth products from infected goats, sheep and cattle

causes mild, self-limited febrile illness with pneumonia and hepatitis

A

Q fever (Coxiella burnetti)

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13
Q

How to manage cryptococcal meningitis?

A

Combination: amphotericin B and flucytosine

MOST IMPORTANT: lumbar puncture to relieve ICP

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14
Q

Groups with flu-like illness and diarrhea who have been exposed to a common water source?

A

Legionella; always be suspicious even if Urine legionella is negative (only tests serogroup 1)

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15
Q

Mycobacterium avium (MAC) should not be suspected in HIV patients with CD4 cell counts above what?

A

50

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16
Q

What is the ID differential for a patient with fever, headache, myalgia, arthralgia, malaise?

Labs: leukopenia (lymphopenia), thrombocytopenia, and elevated liver transaminases

A

Ehrlichiosis or Heartland virus infection

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17
Q

How to distinguish between Ehrlichiosis and Heartland Virus infection?

A

Ehrlichiosis will respond to Doxycycline; if no improvement in 48 hours with doxy, you have to test for Heartland virus via CDC

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18
Q

How to treat herpes zoster outbreak in a patient who is immunocompromised?

A

IV anti-virals: IV acyclovir or others

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19
Q

If patient is NOT immunocompromised, what is the treatment of choice for herpes zoster?

A

oral acyclovir, valacyclovir, famciclovir

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20
Q

How to treat CAP in an otherwise healthy outpatient?

A

Amoxicillin or Doxycycline

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21
Q

Guidelines recommend that TB screening be repeated in persons with HIV when the CD4 cell count rises to what level?

A

200; you would order a repeat interferon-gamma release assay (IGRA)

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22
Q

A patient with fever, tremors, parkinsonism, myoclonus, and a maculopapular rash in the SUMMER months

A

West Nile virus

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23
Q

How to diagnose West Nile virus?

A

CSF fluid or serum: IgM for West Nile

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24
Q

MRI findings of brain for West Nile Virus?

A

enhancement in basal ganglia

25
Q

How to diagnose HSV encephalitis ?

A

CSF fluid: HSV PCR

26
Q

Nonspecific symptoms like fever, weight loss, fatigue and lymphadenopathy in post-transplant patient would be a cause for concern for what virus?

A

Epstein-Barr Virus (EBV); also think of CMV

27
Q

The most appropriate first step in management of brain abscess in immunocompetent patient would be?

A

stereotactic brain aspiration; will need Gram stain and cultures before initiating abx?

28
Q

A reaction of __ mm or greater to a tuberculin skin test indicates a positive result?

A

15mm or greater

29
Q

If there is a positive TB skin test but, no evidence of active infection, what is the treatment regimen?

A

Latent TB treatment: shorter = better so, Isoniazid and Rifampin for 3 months

2nd Line Treatment: Isoniazid for 6-9 months

30
Q

What is the most common cause of aseptic meningitis in the US?

A

HSV-2!!

31
Q

How to differentiate HSV-1 and HSV-2 with brain infections?

A

HSV-1: encephalitis (seizures, FND)

HSV-2: meningitis (stiff neck, photophobia)

follow the alphabetic order (HSV-1 = E; HSV-2 = M)

32
Q

What is Ramsay Hunt Syndrome? What are the symptoms?

A

Herpes Zoster reactivation (oticus); facial nerve palsy (VII) with erythematous vesicular rash (EAR) and/or lesions on the mouth/tongue

33
Q

Differential Diagnosis for an infectious cause of peripheral facial nerve palsy includes what?

A

1) HSV-1
2) Lyme disease
3) Varicella-Zoster virus

34
Q

Posttransfusion fever and hemolysis on labs would point to what infection?

A

Babesiosis

35
Q

Posttransfusion illness with fever, absolute lymphocytosis, and thrombocytopenia (no evidence of anemia though)

A

CMV

36
Q

Profound and prolonged neutropenia, especially in association with hematopoietic stem cell transplantation or chemo, is a risk factor for what?

A

invasive aspergillosis

37
Q

What diagnostic tests are indicated with suspicion of invasive pulmonary aspergillosis?

A

bronchoalveolar lavage and serum galactomannan assay

38
Q

Empiric antibiotic therapy for Health Care-Associated Ventriculitis or Meningitis (HCAVM)

A

Vancomycin, and either, Cefepime or Meropenem (can also use Ceftazidime); must take out shunt though

39
Q

What are the preferred agents for patients with Pelvic inflammatory disease who need to be hospitalized? (2 different regimens)

A

1) Clindamycin and gentamicin

2) Cefotetan/Cefoxitin and doxycycline

40
Q

Post exposure prophylaxis is not useful after how long?

A

72 hours

41
Q

What causes up to 30% of seizure events in endemic regions (Central/South America, India, sub-Saharan Africa)?

A

neurocysticercosis

42
Q

Findings of neurocysticercosis on head imaging?

A

parenchymal cyst

43
Q

Treatment of neurocysticercosis?

A

1) Manage seizures and increased ICP (glucocorticoids)

2) anti-parasitics

44
Q

Severe C diff infection?

A

WBC: >15,000

Serum Cr: >1.5

45
Q

Treatment of severe c diff infection?

A

regardless if severe or non-severe, oral fidaxomicin or oral vancomycin

46
Q

C diff treatment when fulminant? (ICU, shock, megacolon)

A

oral vancomycin and IV metronidazole plus surgery consultation

47
Q

Treatment of C diff infection with ileus present on radiography?

A

oral and rectal vancomycin plus IV metronidazole

48
Q

When is pulsed and tapered vancomycin used in C diff infections?

A

if initial C diff episode was treated with oral vancomycin or oral fidaxomicin

49
Q

What is considered a complicated UTI?

A

UTI while pregnant

50
Q

What abx are indicated in UTI during pregnancy?

A

Cephalosporins; single dose of fosfomycin; avoid nitrofurantoin, TMP-SMX and fluoroquinolones

51
Q

Pre-exposure prophylaxis for HIV?

Post-exposure prophylaxis for HIV?

A

PrEP: tenofovir-emtricitabine

Post-exposure: tenofovir-emtricitabine AND raltegravir (or dolutegravir)

52
Q

The 4 D’s of botulism: ?

A

diplopia (double vision), dysphonia (hoarse voice), dysarthria (slurring speech), dysphagia (unable to swallow); deficits start high and fall down

53
Q

Other signs of botulism?

A

UE weakness that goes downward

GI: constipation (no bowel sounds)

54
Q

HIV/AIDS patients with CD4 counts less than 50 should be prophylactically treated with what abx? (for what disease)?

A

TMP-SMX (pneumocistis j)

55
Q

What cutoff do you use to prophylactically treat someone for pneumocystis jiro?

A

CD4 less than 200

56
Q

Traveler’s diarrhea: when is prophylaxis indicated? What do drug do you use?

A

Immune compromised, inflammatory bowel disease, CKD; daily rifaximin

57
Q

Summer/Fall months with myalgia, sore throat, cough, and maculopapular rash along with meningitis?

A

Enterovirus meningitis

58
Q

How to differentiate enterovirus meningitis and HSV-2 meningitis?

A

There will be genital lesions preceding meningitis by ~7 days

59
Q

Untreated syphilis that shows up positive from testing should be treated with what?

A

benzathine penicillin once weekly for three doses

Medicine (7 decks)

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