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Infectious Disease > MKSAP ID > Flashcards

MKSAP ID Flashcards

1
Q

What are the treatment options for early Lyme disease?

A

Doxycycline 100 mg bid x 10-21 days
Amoxicillin 500 mg tid x 14-21 days
Cefuroxime 500 mg bid x 14-21 days

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2
Q

What is the treatment for mild-moderate babesiosis? Severe babesiosis? When is exchange transfusion needed?

A

Atovaquone + Azithromycin for mild-moderate disease (symptomatic, or asymptomatic with persistent parasitemia for >3 months)
Clindamycin + Quinine for severe disease
Also need exchange transfusion if parasitemia >10%, Hgb <10, liver failure, or kidney failure

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3
Q

What is the treatment for Lyme disease c/b 1st degree block w/ PR >300 msec, 2nd or 3rd degree block, myocarditis, or meningitis?

A

IV penicillin or ceftriaxone x 28 days

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4
Q

How do you treat bacterial meningitis if there is a beta lactam allergy?

A

IV moxifloxacin instead of cephalosporin

IV bactrim instead of ampicillin

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5
Q

How do you diagnose HSV encephalitis? West nile neuroinvasive disease?

A
  1. HSV PCR

2. Serum and CSF IgM antibody to WNV (PCR is not sensitive)

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6
Q

What causes symmetric, pink-born patches in intertriginous areas? How is it treated?

A
  1. Corynebacterium minutissimum - causes erythrasma

2. Topical erythromycin or clindamycin

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7
Q

What bacteria that can cause CAP is associated w/ travel to SE or East Asia?

A

Burkholderia pseudomallei (melioidosis)

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8
Q

Which tick transmits Ehrlichia chaffeensis and where is it typically found? What type of cell does it infect? What type of cells does Anaplasma infect?

A
  1. Lone star tick
  2. South central and southeastern U.S
  3. Monocytes
  4. Granulocytes
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9
Q

What type of tick transmits Lyme, Babesia, and Anaplasma?

A

Ixodes or black legged tick

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10
Q

How do Ehrlichia and Anaplasma appear on a smear? What are the characteristic lab findings? Which is more likely to have a rash? How does Babesia appear?

A
  1. Morulae (clumps of organisms) in the cytoplasm - ehrlichia in monocytes, anaplasma in granulocytes
  2. Leukopenia, thrombocytopenia, elevated LFTs
  3. Ehrlichia has rash (macular, maculopapular, petechial) in 30%; rash is rare in anaplasma (<5%)
  4. Tetrads/maltese cross
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11
Q

What antibiotic is used to treat RMSF in a pregnant patient?

A

Chloramphenicol

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12
Q

What are the treatment options for MAC?

A

Clarithromycin or Azithromycin + Ethambutol and either Rifampin or Rifabutin

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13
Q

What is the protocol for post-exposure to anthrax?

A

60 days of Doxycycline or FQN (Ciprofloxacin, Levofloxacin)

Three injections of vaccine at 2 week intervals

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14
Q

How does Yersinia pestis present? How is it transmitted? How does it look on gram stain? What is the first line treatment? What is used for prophylaxis?

A
  1. Primary pneumonic plague: fever, cough, SOB; Bubonic plague: buboes (infected, swollen lymph nodes); Septicemic plague: DIC and multiorgan system failure
  2. Usually by fleas; associated w/ rats, squirrels, rabbits; can also be from bioterrorism
  3. Gram stain: gram negative coccobacilli with bipolar staining; safety pin appearance
  4. Streptomycin or Gentamicin
  5. Doxycycline or Levofloxacin for 7 days
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15
Q

What can be contracted by contact with saltwater marine life and causes cellulitis of the hand/arm esp in those handling fish/shellfish or occasionally contaminated meat?

A

Erysipelothrix rhusiopathiae

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16
Q

What can be contracted by contact w/ dogs and can cause cellulitis and sepsis, especially in patients w/ asplenia?

A

Capnocytophaga canimorsus

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17
Q

What can be contracted by contact with infected mules or horses, and can cause pustules w/ suppurative localized lymph nodes or ulcerative nodules?

A

Burkholderia mallei

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18
Q

What can be contracted by exposure to freshwater footbaths/pedicures or after shaving, and can cause furuncles?

A

Mycobacterium fortuitum

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19
Q

What is the treatment for Histoplasmosis?

A

Itraconazole for 6-12 weeks for acute asymptomatic or mild pulmonary infection, or 12 months for chronic cavitary pulmonary infection
Liposomal amphotericin B for severe lung disease or disseminated disease (pancytopenia, hepatosplenomegaly) followed by itraconazole for 12 weeks

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20
Q

Which STI presents as as a single, sometimes painful ulcer, w/ tender unilateral LAD which may suppurate?

A

Lymphogranuloma venereum (Chlamydia trachomatis)

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21
Q

What is the alternative treatment for syphilis for penicillin-allergic patients?

A

Doxycycline or tetracycline (14 days for primary, secondary and early latent; 28 days for late latent or unknown duration)
Ceftriaxone for neurosyphilis (10-14 days)

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22
Q

What immunodeficiency is associated with invasive skin infections? Benign or intracellular viral or fungal infections?

A
  1. Granulocyte (chronic granulomatous disease)

2. Cell mediated

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23
Q

What are the risk factors for anthrax? How is it transmitted? How does it look on gram stain? How does it appear on CXR?

A
  1. Travel to Middle East, Africa, South America, or Asia; exposure to wool, hides, or animal hair from endemic areas; bioterrorism
  2. Inhalation, cutaneous contact, or ingestion - no person to person transmission
  3. “Box-car” shaped, gram positive
  4. Widened mediastinum
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24
Q

How do you treat cutaneous anthrax? How do you treat inhalational, meninigits, or severe cutaneous disease (involving head and neck)?

A
  1. PO Ciprofloxacin
  2. IV Ciprofloxacin + two other abx (penicillin, ampicillin, imipenem, meropenem, clindamycin, linezolid, rifampin, vancomycin)
    * Raxibacumab is a monoclonal antibodies also approved for prophylaxis and treatment of inhalational anthrax
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25
Q

How does Zika present? How do you diagnose it?

A
  1. Fever, rash, joint pain, conjunctivitis, muscle pain, HA

2. PCR/NAAT testing on serum or urine in first 7-14 days; afterwards IgM antibody

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26
Q

What is the treatment for Cyclospora? Vibrio cholerae?

A
  1. Bactrim

2. FQN or azithromycin

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27
Q

When should testing be performed for someone exposed to HIV?

A

Immediately, 6 weeks, 12 weeks, and 6 months

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28
Q

What is the treatment for PJP for those w/ a sulfa allergy?

A

IV pentamidine or IV clindamycin + PO primaquine

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29
Q

What is the inhaled anti-viral used for influenza and in whom is it contraindicated?

A
  1. Zanamivir

2. Associated w/ bronchospasm; contraindicated in pulmonary or CV disease

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30
Q

What antibiotics should be avoided in patients w/ epilepsy? Name 3 groups.

A

Carbapenems, FQNs, and 4th generation cephalosporins

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31
Q

How long is coag-negative staph bacteremia 2/2 central line infection treated for?

A

7 days if catheter is removed, 10-14 days if catheter remains

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32
Q

What ID precautions are needed for chickenpox? For N. meningitidis? Measles?

A
  1. Airborne 2. Droplet 3. Airborne
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33
Q

What is the treatment for pertussis?

A

Macrolide

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34
Q

What are the indications for endocarditis prophylaxis?

A

Prosthetic heart valves, previous endocarditis, unrepaired cyanotic congenital heart disease, CHD w/ repair in past 6 months, valve regurgitation in heart transplant recipients. Has to be high risk procedure

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35
Q

What are the major and minor Duke criteria?

A

Major: Vegetation, abscess, new valve regurgitation, or new partial dehiscence of prosthetic valve on TTE; positive blood cultures x 2 with typical bacteria; Q fever serology >1:800
Minor: fever >38 C, pre-disposing condition or injection drug use, vascular (emboli, pulmonary infarcts, janeway lesions, conjunctival hemorrhage), immunological (osler’s, GN, roth’s spots, positive RF), positive culture not meeting major criteria

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36
Q

Who needs meningococcal prophylaxis? What are the regimens for meningococcal prophylaxis for close contacts?

A
  1. Household members, roommates/intimate contacts, persons directly exposed to respiratory or oral secretions (intubation, kissing, resuscitation), person seated next to affected person for >8 hours up to 7 days prior to onset of symptoms and until 24 hours after initiation of abx
  2. Ciprofloxacin, CTX, or Rifampin
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37
Q

What anti-fungal is associated with hypokalemia, hypomagnesemia, type 1 RTA, and/or nephrogenic DI?

A

Amphotericin B

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38
Q

What 4 medications can be used against ESBL?

A

Imipenem, Meropenem, Ceftolozane-Tazobactam (Zerbaxa), Ceftazidime-Avibactam (Avycaz)

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39
Q

What 4 medications can be used for VRE?

A

Linezolid, Daptomycin, Tigecycline, Fosfomycin

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40
Q

What bacteria does Telavancin, Oritavancin, Dalbavancin, and Delafloxacin work against?

A

MRSA

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41
Q

What is endemic to Mediterranean, Middle East, and Central America and can present w/ meningitis, cranial neuropathies, myelopathy, radiculopathy, stroke, or brain abscess? What is the treatment?

A

Neurobrucellosis

Ceftriaxone, Rifampin, and Doxycycline for at least 6 months

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42
Q

What are the criteria for diagnosis of rheumatic fever?

A

Major: polyarthritis, carditis, subcutaneous nodules, erythema marginatum, sydenham chorea
Minor: arthralgia, fever, elevated ESR, elevated CRP, evidence of group A infection, prolonged PR
* Need 2 major, or one major + minor manifestations

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43
Q

For sporotrichosis what is seen on biopsy, what is the diagnostic gold standard, and what is the treatment?

A
  1. Mixed pyogenic and granulomatous inflammation
  2. Culture
  3. Itraconazole - treat for 2-4 weeks after resolution of lesions
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44
Q

When is antibiotic ppx needed for animal bite wounds? What is the treatment for cat bite?

A
  1. Wounds near lymphatics and blood vessels, deep puncture wounds, on the hand or face or genitalia, close to joints and/or bones, requiring surgical intervention, and/or in immunocompromised hosts (including cirrhosis or asplenia)
  2. Augmentin is first line; alternatives include doxycycline, moxifloxacin, or bactrim PLUS clindamycin or metronidazole
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45
Q

What is the treatment for vibrio vulnificus?

A

Ceftriaxone + Doxycycline, or FQN

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46
Q

What is miltefosine used for?

A

Treatment of certain parasitic infections including leishmaniasis, naegleria, and balamuthia

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47
Q

What is the empiric treatment for a brain abscess? How long should it be treated? When should it be drained?

A
  1. Ceftriaxone + metronidazole
  2. 4-8 weeks
  3. > 2.5 cm
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48
Q

Which pathogen can cause encephalitis presenting w/ facial or arm tremors, parkinsonism, and/or myoclonus and can have hypodense lesions or enhancements in the thalamus, basal ganglia, and midbrain?

A

West nile virus

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49
Q

What presents after a bite from an infected animal (cats, rabbits) w/ an ulcerative lesion w/ central eschar and localized tender LAD +/- constitutional symptoms? How may the CXR look?

A
  1. Francisella tularensis

2. Infiltrates, hilar LAD, and pleural effusions

50
Q

What causes cellulitis after contact w/ freshwater lakes, streams, rivers (including brackish water), or contact w/ leeches? How is it treated?

A
  1. Aeromonas hydrophila

2. Ciprofloxacin and Doxycycline

51
Q

Name the animals associated with the following pathogens: cryptococcus neoformans, bordetella bronchiseptica, rhodococcus equi

A
  1. Cats
  2. Dogs
  3. Horses
52
Q

What is the treatment regimen for CAP in patients w/ significant comorbidities?

A

Respiratory quinolone OR beta lactam (augmentin, cefuroxime, cefpodoxime) + macrolide

53
Q

Name at least 2 cephalosporins of each generation (except 4th & 5th name one)

A

1st: cefazolin, cephalexin
2nd: cefoxitin, cefuroxime, cefotetan, cefaclor
3rd: cefdinir, ceftazidime, ceftriaxone, cefotaxime, cefpodoxime
4th: cefepime
5th: ceftaroline

54
Q

Which respiratory FQN does NOT have activity against pseudomonas?

A

Moxifloxacin

55
Q

What presents as a chronic nodular infection of distal extremities w/ exposure to fish tanks or marine environments?

A

Mycobacterium marinum

56
Q

What presents w/ fevers, allergic type sx (urticarial lesions, angioedema), and eosinophilia after freshwater exposure? What is the treatment?

A

Acute schistosomiasis syndrome (Katayama fever)

Tx: steroids then praziquantel

57
Q

What is the criteria for giving a single dose doxycycline 200 mg as prophylaxis for lyme disease? Name 4.

A

Tick reliably identified as black-legged deer tick, attachment >36 hours, abx can be started less than 72 hours after tick removal, prevalence of B. burgdorferi exceeds 20%, and doxycycline is not contraindicated

58
Q

How does late disseminated (>6 months) lyme disease present? Name 4 manifestations. What is the initial treatment for rheum disease then for recurrent arthritis? What is the treatment for neurologic disease?

A

Recurrent large joint arthritis, peripheral neuropathy, encephalopathy, derm sx (acrodermatitis chronica atrophicans)
Initial tx same as early localized but for 30 days
Recurrent arthritis after initial tx: IV ceftriaxone
Neuro disease: IV ceftriaxone for 28 days

59
Q

What is the induration at which TST is positive in the following groups? Recent contacts of persons w/ active TB, recent (<5 years) arrivals from high prevalence countries, patients w/ DM/CKD/certain cancers, patients immunocompromised or receiving 4 weeks of prednisone >15 mg daily?

A

5 mm for recent contacts of persons w/ active TB, patients immunocompromised or receiving 4 weeks of prednisone >15 mg daily
10 mm for recent (<5 years) arrivals from high prevalence countries, patients w/ DM/CKD/certain cancers

60
Q

What are the 4 regimens for latent TB?

A

Rifampin daily for 4 months
Isoniazid daily or twice weekly for 6 months, or for 9 months
Isoniazid and Rifapentine once weekly for 3 months

61
Q

What are some side effects of TB meds? Name 4 for each except for ethambutol name 2.

A

Isoniazid: hepatitis, neuropathy, rash, lupus-like syndrome
Pyrazinamide: hepatitis, hyperuricemia, GI upset, rash, glucose control difficult
Rifampin/Rifapentine: hepatitis, GI upset, rash, drug-drug interactions, orange body fluid
Rifabutin: hepatitis, thrombocytopenia, leukopenia, severe arthralgia, uveitis, rash
Ethambutol: optic neuritis, rash

62
Q

When should ART be started in patients w/ active TB?

A

Within 2 weeks if CD4 count <50

Within 8-12 weeks if CD4 count >50 or has TB meningitis

63
Q

What is the treatment for cryptococcus? How long should HIV patients be treated?

A

Amphotericin B + flucytosine

HIV patients require maintenance therapy until CD4 counts >100 for a minimum of 3 months and suppressed viral load

64
Q

What is the treatment for coccidiodes?

A

Fluconazole; in those who do not respond can try intrathecal amphotericin B
In patients w/ meningitis they need fluconazole for life

65
Q

What is the treatment for blastomycosis?

A

Mild-moderate infection: itraconazole for 6-12 months

CNS, severe pulmonary, and disseminated infections: liposomal amphotericin B

66
Q

What appears with broad, nonseptate hyphae w/ acute angle branches? What is the treatment?

A
  1. Mucormycosis - diagnosis requires visualization of this + high index of suspicion; no use of serologic tests and blood cultures
  2. High dose liposomal amphotericin B -> posaconazole or isavuconazole
67
Q

What is the treatment for candidemia and invasive candidasis? What is the treatment for CNS or eye disease?

A
  1. Echinocandin (caspofungin, micafungin, anidulafungin)

2. Azole or Amphotericin B

68
Q

What are the differences between Haemophilus ducreyi (chancroid) and lymphogranuloma veneruem? What is the treatment for both?

A
  1. Chancroid is PAINFUL genital ulcer w/ tender inguinal lymph nodes which often suppurate
    LGV is PAINLESS genital papules or ulcers w/ unilateral tender inguinal LAD
  2. Chancroid - tx w/ azithromycin single dose or CTX single dose or ciprofloxacin x 3 days or erythromycin x 7 days
    LGV tx w/ doxycycline (preferred) or erythromycin for 21 days
69
Q

What is the treatment for pelvic inflammatory disease?

A

IV: Cefotetan or Cefoxitin + Doxycycline OR
Clindamycin + Gentamicin
PO/IM: CTX single dose + Doxycycline +/- Metronidazole x 14 days

70
Q

What increases risk of upper & lower respiratory tract infections by encapsulated bacteria, and GI infections (may have chronic giardia or norovirus)? How can you test for this besides measuring immunoglobulin levels?

A
  1. Common variable immunodeficiency (CVID)

2. Measuring antibody response to pneumococcal and tetanus vaccines

71
Q

What lab should be checked in a patient w/ a personal or family history of recurrent Neisseria infections?

A

Total hemolytic complement (CH50) level

72
Q

What is the management for potential exposure to smallpox? When is the vaccine contraindicated? What is the treatment for smallpox?

A
  1. Vaccination within 7 days
  2. Within 4 months of bone marrow transplant, CD4 count <50, severe combined immunodeficiency; in these cases use immune globulin instead
  3. Tecovirimat
73
Q

What should be suspected in an elderly, thin white woman that may have a connective tissue defect (scoliosis, pectus excavatum, or MVP) w/ a right middle lobe or left lingular lobe infection? How do you diagnosis this? What is the treatment?

A
  1. Mycobacterium avium complex
  2. At least 2 positive sputum culture results OR BAL w/ one wash w/ positive culture OR lung biopsy
  3. Macrolide, ethambutol, rifamycin
74
Q

What do topical trifluridine/trifluorothymidine, vidarabine, or acyclovir treat?

A

Primary herpes keratoconjuncitivitis

75
Q

Which immunodeficiency presents w/ invasive skin infections? How do you test for it?

A
  1. Chronic granulomatous disease

2. Dihydrohodamine (DHR) oxidation test

76
Q

How do you diagnose tularemia? What animals is it associated with? What is the treatment?

A
  1. IgM and IgG antibodies 2 or more weeks after infection
  2. Tick or deer fly bites, rabbits, muskrats, prairie dogs
  3. Ciprofloxacin or Doxycycline for mild-moderate disease; Streptomycin or Gentamicin for severe disease
77
Q

What are 3 options for malaria ppx in chloroquine resistant P. falciparum areas? What are 3 additional options for chloroquine-sensitive P. falciparum areas?

A
  1. Atovaquone/proguanil, mefloquine, doxycycline

2. Chloroquine, hydroxychloroquine, primaquine

78
Q

What are 3 abx treatment options for typhoid fever? What has been shown to decrease mortality in severe illness (shock, encephalopathy)? Which patients are at greatest risk for chronic carrier state and what is the management?

A
  1. Ceftriaxone, FQNs, azithromycin
  2. Dexamethasone
  3. Those w/ gallstones and chronic biliary disease
  4. 28 days of ciprofloxacin; cholecystectomy may be needed in cholelithiasis
79
Q

What presents w/ frontal HA, retro-orbital pain, myalgia, arthralgia, severe lumbosacral pain, saddleback pattern of fever, and macular rash that may evolve into areas of petechiae? What are some lab findings? How do you diagnose this?

A
  1. Dengue fever
  2. Elevated liver enzymes, leukopenia, thrombocytopenia
  3. Serology (IgM and IgG), reverse transcriptase PCR
80
Q

What is found in Southeast Asia, Africa, and the Americas and presents w/ fever, severe and symmetric polyarthralgia, and maculopapular rash on limbs & trunk? What are some lab findings? How do you diagnose this?

A
  1. Chikungunya virus
  2. Elevated liver enzymes, lymphopenia, thrombocytopenia
  3. Serologic assays or reverse transcriptase PCR
81
Q

What is found in Africa and presents w/ HA, malaise, conjunctivitis, pharyngitis, rash (maculopapular, vesicular, or petechial), and an eschar w/ regional LAD at the site of inoculation?

A

Rickettsia africae

82
Q

What presents w/ fever, myalgia, arthralgia, fatigue, HA, night sweats, depression, and may have focal infection in the CNS, osteoarticular, CV, and GU systems? It may also have hepatosplenomegaly and LAD with granuloma formation. How do you diagnose this? What is the treatment?

A
  1. Brucellosis
  2. Serum agglutination test - need titer 1:160 or greater
  3. Doxycycline, Rifampin, and Streptomycin (or Gentamicin) for several weeks
83
Q

Which anti-virals are only effective against influenza A?

A

Amantadine and rimantadine

84
Q

What presents after eating uncooked pork w/ fever, abdominal pain, diarrhea (possibly bloody), +/- pharyngitis or RLQ pain mimicking appendicitis? What is the treatment?

A
  1. Yersinia enterocolitis

2. Bactrim is first line; alternatives include FQN or Ceftriaxone

85
Q

What is the treatment for cryptosporidium diarrhea?

A

Supportive care
If severe or prolonged infection use nitazoxanide
In HIV patients give ART

86
Q

What 2 parasites can be visualized using a modified acid-fast stain?

A

Cryptosporidium

Cyclospora

87
Q

What should be suspected in a patient >1 month after transplant with LAD or an extranodal mass? What is the management?

A
  1. PTLD

2. Rituximab and decreasing immunosuppression

88
Q

What can presents w/ hyperinfection syndrome (pneumonia, gram negative bacteremia, GI sx) in immunosuppressed patients, esp those on high dose steroids?

A

Strongyloides

89
Q

Above what percentage parasitemia is considered high for malaria? Which types have high levels?

A

> 2%

Falciparum and knowlesi (SE Asia)

90
Q

What is the treatment for leptospirosis?

A

Most are self-limited

Penicillin or doxycycline for severe disease

91
Q

What is the treatment for toxoplasmosis in immunosuppressed patients? How long is the treatment in HIV patients?

A

Pyrimethamine + sulfadiazine (or clindamycin), Folic acid

Treat until asymptomatic and CD4 >200 for 6 months

92
Q

Which HIV drugs should not be used in pregnancy?

A

Elvitegravir-cobicistat
Bictegravir and TAF (not enough data)
Dolutegravir cannot be used in first 8 weeks due to issues w/ neural tube defects

93
Q

What prophylaxis is needed after HSCT?

A

Bactrim - PJP and toxoplasmosis
Posaconazole - Candida and Aspergillus
*Valgancyclovir is only if they develop CMV infection

94
Q

What is baloxavir used for?

A

Treatment of patients at high risk for influenza complications

95
Q

What is the management for postexposure to varicella?

A

Vaccination in immunocompetent

Immune globulin in immunocompromised and pregnant women

96
Q

Which antibiotic can be used against acinetobacter and stenotrophomonas maltophilia, and has the SE of photosensitivity, GI disturbance, and skin pigmentation changes?

A

Minocycline

97
Q

When can HIV patients receive the MMR and varicella vaccines?

A

CD4 count >200

Other live vaccines contraindicated

98
Q

How do you test for EBV?

A 
Monospot test (heterophile antibody test)
If negative, repeat in 2 weeks or do EBV serology
99
Q

Which patients should have pre-op decolonization of staph aureus?

A

Those undergoing cardiothoracic or orthopedic surgery - test for S. aureus nasal carriage 2 weeks prior; need 5 days of mupirocin ointment +/- chlorhexidine body wahs

100
Q

How long should influenza prophylaxis be given during an outbreak?

A

For 14 days, or for 10 days after onset of illness in the last person infected

101
Q

What is most common in Europe (but can also occur in Africa, India, and Middle East) and can present w/ fever, myalgia, HA, maculopapular (and sometimes petechial) rash beginning on ankles & wrists and involving palms and soles, eschar at site of inoculation, and localized regional LAD?

A

Mediterranean spotted fever caused by Rickettsia conorii

102
Q

What is found in soil and plant debris and presents in immunosuppressed patients with fever, skin lesions (multiple, painful, erythematous papules or nodules sometimes w/ central necrosis), sinusitis, and pneumonia? What is seen on blood cultures? What is the treatment?

A
  1. Fusarium moniliforme
  2. Mold-like organisms
  3. Amphotericin B and/or voriconazole
103
Q

What are some bacteria that grow as gram positive rods in blood cultures? Name 4.

A

Corynebacterium (diphtheroid), clostridium, nocardia, listeria

104
Q

What are some side effects of colistin? Name 2.

A

Nephrotoxicity, paresthesias

105
Q

What is the treatment for cat scratch fever?

A

Azithromycin

Alternatives include doxycycline, rifampin, clarithromycin, bactrim, and ciprofloxacin

106
Q

Catheter-related infections w/ which pathogens require removal of the catheter? Name 4.

A

Staph aureus, Pseudomonas, Fungi, Mycobacteria

107
Q

What presents w/ a chronic, slowly progressive, non-tender indurated mass in the neck that extends through tissue planes to form abscess, fistula, and draining sinus tract? What are some risk factors? What is the treatment?

A
  1. Cervical actinomycosis
  2. Dental caries, gingivitis, diabetes, immunosuppression, malnutrition, local tissue damage from cancer or radiation
  3. IV penicillin 4-6 weeks then 6-12 months of oral penicillin
108
Q

What can be given to treat traveler’s diarrhea?

A

FQNs (preferred), Azithromycin (recommended for those traveling to Southeast Asia b/c of high quinolone resistance), Rifaximin

109
Q

What presents w/ an acute, flu-like illness w/ dyspnea, cough, malaise, and fever especially after exposure to contaminated hot tube water? What is the treatment?

A
  1. Mycobacterium avium complex - causes a hypersensitivity pneumonitis
    * Exposure can also occur via soil, food, and animals (birds)
  2. Observation, supportive care; if severe sx can do short course of prednisone
110
Q

What is the treatment for Coxiella burnetti (Q fever)?

A

Doxycycline

111
Q

What toxin is found in fish and can cause GI symptoms, weakness of limbs, perioral paresthesias, and sensation of hot/cold temp reversal?

A

Ciguatera toxin

112
Q

What type of cancer is associated with long term voriconazole treatment?

A

Non-melanoma skin cancer

113
Q

What type of stain is a Ziehl-Neelsen stain?

A

Acid fast; can also identify some fungi and protozoa

114
Q

How many doses of tetanus toxoid should patients w/ a history of tetany (that haven’t been vaccinated) receive?

A

Three doses, each dose at least 2 weeks apart

115
Q

When should a patient who hasn’t received Tdap since childhood receive Tdap vaccine if they’ve received Td sometime in the past 10 years?

A

Now regardless of time that has elapsed since previous Td dose

116
Q

When should tetanus immunoglobulin be administered?

A

Dirty wound and unknown vaccination history OR <3 tetanus toxoid doses

117
Q

What is the difference between early and late latent syphilis? What is the treatment for primary, secondary, and early latent syphilis?

A
  1. Early latent is <12 months, late latent is >12 months

2. 1 dose benzathine penicillin G

118
Q

What are contraindications to mefloquine, and atovaquone/proguanil use?

A

Mefloquine cannot be used in psych disorders

Atovaquone/proguanil cannot be used in CKD

119
Q

What pathogen causes cutaneous larve migrans, especially after contact with infected cat or dog feces?

A

Ancylostoma larvae

120
Q

What typically has restricted diffusion in the center of lesion on DWI MRI, brain abscesses or CNS lymphoma?

A

Brain abscesses

Infectious Disease (1 decks)

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