Old ID Written Exams Flashcards
2 clinical manifestations of Bordetella henslae?
1) Cat Scratch Disease
2) Bacillary Angiomatosis
3 active antibiotics for Bordetella henslae?
1) Doxycycline
2) Azithromycin
3) Erythromycin
4) TMP-SMX (for Peds)
Fever, red eyes, arthritis months after leprosy treatment.
Reversal Reaction
Erythema Nodosum Leprosum
Mode of transmission of leprosy?
Nasal discharge from lepromatous leprosy patients
3 clinical manifestations of Whipples?
1) Culture negative endocardititis
2) Chronic GI illness (Classic whipples)
3) CNS - reversible dementia
Also Asymptomatic carriers and ocular disease
How to detect Whipples disease on biopsy?
Large Foamy macrophages in lamina propria
Electron microscopy, immunostain or PCR
Treatment for Whipples?
Ceftriaxone 2 g IV daily x 2 weeks, then TMP-SMX for 1 year
4 principles to consider when setting up a pet visitation program?
1) Hand hygiene before and after animal contact
2) Written policy
3) Designated trained personnel
4) Suitable animals - no reptiles, not <1 year old animals, vaccinated, in good health, no licking, free of fleas, always leashed, not for patients on isolation
4 elements of MRSA infection control program?
1) Active surveillance
2) Hand hygiene
3) Patient isolation
4) PPE
Treatment of VGS IE with Penicillin MIC of 1?
Ampicillin OR Penicillin G + Gentamycin for 4-6 weeks
Treat like an enterococcus endocarditis
Treatment of MRSA Prosthetic valve IE?
Vancomycin 6 weeks + Rifampin 6 weeks + Gentamicin 2 weeks
Treatment of Enterococcus faecalis IE, Amp S and Gent R
Ampicillin + Streptomycin for 4-6 weeks
2 Treatments for Legionella?
1) Azithromycin x 7-10 days
2) Levofloxacin x 7-10 days
2 measures to stop water associated Legionella outbreaks?
1) Flush pipes with water >65 degrees celcius for 30 minutes
2) UV light treatment
Also copper-silver ionization
4 measures to prevent/manage HBV in diaysis patients?
1) Vaccination of all dialysis patients
2) Designated machines for positive patients
3) Survillance with annual serology
4) Segretate positive patients
2 reasons differences in HBV vaccination for dialysis patients?
1) Double dose of vaccine
2) If titre <10 give a booster dose
2 advantages of live flu vaccine?
1) No needle exposure
2) Increased immunogenicity in children
4 contraindications to live flu vaccine?
1) Children less than 2 years old
2) Immunocompromised patients
3) Pregnancy
4) History of hypersensitivity to any component of the vaccine
2 parasites that cause biliary obstruction?
1) Clonorchis sinensis
2) Opisthorcis viverrini
Also..
3) Fasciola hepatica
4) Ascaris
What organism causes neurocystocercosis?
Taenia solium
Treatment of neurocystocercosis?
Albendazole x 28 days
Treatment of African Tick Bite fever?
Doxycycline x 10 days
Malaria prophylaxis for Haiti:
- Preferred treatment
- 2 alternatives if patient is leaving tomorrow
Preferred = Chloroquine (once a week, start 1 week before, stop 4 weeks after)
2 alternatives:
Atrovaquone/Proguanil (2 days before, 7 days after)
Doxycycline (2 days before, 28 days after)
Malaria prophylaxis for a pregnant woman going to India?
Mefloquine (once a week, start 1 week before, stop 4 weeks after)
Plasmodium vivax in pregnancy:
- 1 test
- 1 treatment
Test = G6PD test (before giving primaquine) Treatment = Chloroquine until delivered then treat for liver form with Primiquine after delivery for 14 days
Can also just give the Chloroquine 0, 6, 24, 48 hours and not treat through the whole pregnancy
4 pseudomonas virulence factors?
1) Pyocyanin
2) Pyoveridin
3) LPS
4) Exotoxin A
5) Pili
6) Adhesins
7) Proteolytic enzymes
8) Alginate
4 Mechanisms of resistance of pseudomonas?
1) Efflux pumps
2) Porin mutations
3) Carbapenemases
4) AmpC
5) Beta lactamases
6) Aminoglycoside modifying enzymes
3 steps of treatment for prosthetic knee MRSA?
1) 2 step revision
2) Vancomycin
3) Rifampin
Trough level for Vancomycin in an MRSA prosthetic joint infection?
15-20
Diagnosis of acute Histoplasma?
Culture organisms
Or serology with positive H band
M band positive in acute and previous infection
Principle of the IGRA test?
Measures cell mediated immune response to TB antigen. Cells are exposed to a TB antigen (ESAT6 or CFP10) and if there is latent infection they will release interferon resulting in a positive IGRA.
3 advantages and 3 disadvantages of the IGRA test?
3 advantages:
- Only requires 1 visit
- No cross reaction with BCG vaccination
- Less subjectivity in reading results
3 disadvantages:
- Cross reaction with M. africum, M. bovis, M. microtti
- Expensive
- Requires a fresh blood sample
- Requires laboratory equipment
List 3 airborne pathogens
1) Mycobacterium tuberculosis
2) Measles
3) SARS
4) Varicella
6 fungi resistant to echinocandins?
1) Cryptococcus
2) Histoplasma
3) Blastomyces
4) Coccioides
5) Fusarium
6) Pseudoalecheria boydii
7) Trichosporon
8) Sporothrix
9) Mucor
4 complications of persistent yeast in the blood?
1) Endocarditis
2) Endophthalmitis
3) Hepatic absecess
4) Splenic absecess
5) Osteomyelitis
6) Death
4 signs of poor prognosis for cryptococcus meningitis?
1) CSF WBC 1:1024
4) Increased ICP
2 natural reservoirs of cryptococcus?
1) Bird droppings
2) Soil
3 drugs to treat CMV and 1 adverse reaction of each?
1) Ganciclovir - Neutropenia
2) Foscarnet - Renal failure, electrolyte imbalances
3) Cidofovir - Nephrotoxicity
3 indications for suppressive HSV genital ulcer treatment?
1) Immunocompromised
2) Decrease transmission to partner
3) Recurrence associated with systemic symptoms
Extragenital complications of genital HSV
- aseptic meningitis
- thigh and buttock lesions
- saccral autonomic nervous system dysfunction
2 non beta lactam regimes for gonorrhoea?
1) 2 g azithromycin x 1
2) Doxycyline 100 mg PO bid x 7 days
4 viruses causing encephalitis from Thialand?
1) HSV
2) Japenese encephalitits
3) Rabies
4) Nipah virus
5) Me Tri virus
6) Far Eastern Virus
4 manifestations of Dengue severity?
1) Hemorrhage
2) Plasma leak
3) AST or ALT >1000
4) Impaired consciousness
4 respiratory viruses that cause severe disease in HSCT?
1) RSV
2) Influenza
3) Adenovirus
4) Parainfluenza
5) Rhinovirus
6) Human Metapneumovirus
Oseltamivir:
- Coverage?
- Dose/Duration?
- Side Effects?
- Age
- Contraindications
Flu A and B 75 mg PO BID x 5 days GI upset >1 year old CI = Hypersensitivity
Zanamivir:
- Coverage?
- Dose/Duration?
- Side Effects?
- Age
- Contraindications
Flu A and B 10 inhaled BID x 5 days GI, Bronchospasm >=7 years old CI: Hypersensitivity
Amantidine
- Coverage?
- Dose/Duration?
- Side Effects?
- Age
- Contraindications
NOT Flu B, H3N2 or pH1N1 100 mg po BID x 5 days CNS side effects (insomnia, dizzy) renal toxicity >1 year Hypersensitivity
4 reasons HIV viral load is not suppressed after 6 months?
1) Resistant virus
2) Non compliance
3) Malabsorption of medications
4) Drug interactions
1 treatments for HIV with TB (other than NRTIs).
Efavrinez
2 classes of HIV drugs contraindicated in TB/HIV?
1) NNRTIs
2) ??
5 manifestations of parvovirus B19?
1) Erythema infectiosum
2) Fetal hydrops
3) Transient aplastic anemia
4) Pure red blood cell aplasia
5) Arthropathy
GNB grows from joint after having monoarthritis after diarrheal illness?
Campylobacter
3 organisms that cause reactive arthritis?
Salmonella
Shigella
Yersinia
Neisseria gonorrhea
Mechanism of action of daptomycin?
Binds to bacterial membrane and causes rapid depolarization of the membrane potential causing inhibition of protein, DNA and RNA synthesis
Spectrum of daptomycin
Staphyloccous, Enterococcus
3 indications for daptomycin?
Complicated skin and soft tissue infection caused by susceptible organism
MRSA or MSSA Bacteremia
MRSA or MSSA Endocarditis
VRE
4 techniques for antimicrobial stewardship?
1) Formulary restrictions
2) Automatic substitutions
3) Audit and feedback
4) Educational programs
Baylisascaris procyonis disease and animal?
Racoon
Acute Eosinophilic meningitis
Monkey disease and organism?
Herpes B Virus
Encephalomyelitis
Organism and vector for relapsing fever?
Borrelia recurrentis (Louse) Borrelia hermsii (Tick)
3 tests before HCV treatment that affect prognosis?
1) HCV viral load
2) Genotype
3) Liver fibrosis stage
4) HIV test
5) Il28 polymorphism (fails interferon)
4 hematological manifestations of TMP-SMX?
1) Agranulocytosis
2) Thrombocytopenia
3) Aplastic anemia
4) Acute hemolytic anemia
5) Leukopenia
6) Methylglounemia
5 microbes associated with cancer?
1) HTLV-1
2) EBV
3) HPV
4) HCV
5) HBV
6) Helicobacter pylori
7) HHV8
Treatment of toxoplasma lymphadenopathy?
Self limiting unless:
Immunocompromised, pregnant or severe
Then: Pyramethamine + Sulfadiazine
