Pneumonia and TB CIS Kinder

Question 1

dry cough
hemorrhage bullous myringitis (inside ear)

cold agglutinins

Answer 1

mycoplasma pneumonia

no cell wall so can’t be treated with penicillin

Question 2

when you have had a splenectomy what are you most at risk for …

Answer 2

encapsulated organisms

these patients need to have a pneumococcal vaccination

Question 3

rust colored sputum

Answer 3

strep pneumoniae

Question 4

current jelly sputum

Answer 4

klebsiella

Question 5

air conditioning systems

low pulse

grows on charcoal yeast extract (requires cysteine and iron)

gram negative

Answer 5

legionella

Question 6

homeless shelter worker

Answer 6

TB

Question 7

cave explorer

Answer 7

histoplasma capsulatum

Question 8

foamy alveolar exudates
small hat shaped lesions on BAL
predisposing condition –> AIDS

fever, non productive cough, hypotension

Answer 8

pneumocystis jirovecii

Question 9

with sickle cell disease –> these patients are most at risk for what organisms

Answer 9

strep pneumoniae

encapsulated

Question 10

what is clindamycin good for

Answer 10

anaerobes

Question 11

lancet shaped

Answer 11

strep pneumoniae

Question 12

methenamine silver stain of lung tissue

Answer 12

pneumocystis jirovecii

Question 13

at what CD4 level do you start prophylaxis for fungal infection

Answer 13

Less than 200

Question 14

croup

Answer 14

parainfluenza

Question 15

which antibiotic is most appropriate for legionella

Answer 15

erythromycin (Azithromycin) - macrolide

Question 16

bactrim DS used against what organism

Answer 16

pneumocystis jirovecii

Question 17

clindaymcin is used to treat what?

Answer 17

anaerobes - aspiration pneumonia

Question 18

methicillin or nafcillin is used to treat what

Answer 18

staph

Question 19

small, painful rash and red bumps on his lower legs

Answer 19

erythema nodosum

seen in coccidiodes immitis

also seen in sarcoidosis

Question 20

green sputum

HAP

Answer 20

pseudomonas aeruginosa

Question 21

pyocyanin

Answer 21

pseudomonas aeruginosa

Question 22

transmitted by flea bites

Answer 22

yersinia pestis

Question 23

fungus ball

Answer 23

aspergillus flavus

Question 24

AFB culture and stain

Answer 24

tuburculosis diagnosis

Question 25

gram stain of sputum

Answer 25

diagnosis for typical pneumonia

Question 26

if a patient just has a positive ppd test but no active disease... what would you do next...

Answer 26

INH for 6 months

Question 27

bilateral rales, wheezing and intercostal retractions with grunting child at daycare

Answer 27

RSV

Question 28

kidney shaped diplococci capsule seen in elderly usually

Answer 28

moraxella catarrhalis

Question 29

TB medication that causes vertigo sensation/visual impairment

Answer 29

ethambutol

Question 30

orange discolored urine body fluids

Answer 30

rifampin

Question 31

weight loss, fatigue, cough, sputum production, hemoptysis, dyspnea, fever, night sweats

Answer 31

TB

Question 32

broad based buds Louisiana

Answer 32

blastomycosis

Question 33

5 mm or more positive PPD skin test is positive in what patients

Answer 33

HIV positive recent close contacts with TB persons with nodular or fibrotic changes on CXR more...

Question 34

10 mm or positive PPD skin test is positive in what patients

Answer 34

patient traveling from TB endemic country prisons, nursing homes, hospitals injection drug users

Question 35

peripheral neuropathy adverse effect of this TB drug

Answer 35

isoniazid can also be caused by streptomycin and ethambutol

Question 36

rabbits skin manifestations ***

Answer 36

tularemia

Question 37

MAC

Answer 37

CD4 count < 50 abdominal pain and diarrhea

Question 38

most common cause of post-influenzal bacterial pneumonia

Answer 38

staph aureus

Question 39

thumb sign on lateral neck X-ray

Answer 39

h. influenzae causing epiglottitis

Question 40

deer mouse is the primary reservoir rodents shed the virus through urine, droppings and saliva

Answer 40

hanta virus febrile phase:Symptoms include fever, chills, sweaty palms, explosive diarrhea, malaise, headaches, nausea, abdominal pain, back pain, and SOB. Lasts 3-7 days hypotensive phase oliguric phase diuretic phase convalescent phase

Question 41

when you look at a PPD what do you look at ? Induration or erythema?

Answer 41

induration! it has to be 5 mm of induration

Question 42

roth spots, osler's nodes janeway lesions splinter hemorrhages seen in what condition

Answer 42

endocarditis so a patient who has used IV drugs/prostitute with staph endocarditis leading to staph pneumonia

Question 43

35 year old sheep*** rancher, who for the last 10 days has had a high fever of 104.5F***, headache, chills, myalgias, malaise, and dry, non-productive cough. This came on suddenly, and persisted. There are decreased breath sounds bilaterally. The chest x-ray reveals a patchy infiltrate with multiple round, segmental opacities. There is a large area of left lower lobe consolidation. Hepatomegaly is noted, along with elevated AST and ALT levels. Is this caused by? A. An intracellular pathogenic bacteria similar to rickettsia, but with genetic and physiologic differences. B. An aerobic gram positive bacteria that forms spores. C. An alpha-hemolytic gram positive organism D. An organism that stains acid fast E. An organism without a cell wall

Answer 43

A. An intracellular pathogenic bacteria similar to rickettsia, but with genetic and physiologic differences. gram negative this is coxiella burnetii sheep and goats!! Q fever has splenomegaly and hepatomegaly

Question 44

5% of endocarditis cases Normal flora Common Cause of endocarditis in non-IV drug users Difficult to diagnose- often takes 3 months

Answer 44

HACEK organisms ``` Haemophilus spp Actinobacillus actinomycetemcomitans Cardiobacterium hominis Eikenella corrodens Kingella spp ```

Question 45

most common cause of bronchiolitis and pneumonia in children under 1 year of age in the US

Answer 45

RSV

Question 46

``` Which organism listed below is among the most common causing an exacerbation of COPD and patients who have smoked for a very long time? A. Myocoplasma pneumoniae B. Moraxella catarrhalis C. Chlamyida pneumoniae D. TWAR E. Pseudomonas aeruginosa ```

Answer 46

moraxella catarrhalis common cause of pneumonia in elderly and patients with COPD

Question 47

brain abscess causing in HIV patients -ring enhancing brain lesion on CT/MRI cats tachyzoites that stain with H and E

Answer 47

toxoplasma gondii

Question 48

a disorder that begins with a flu symptoms stage that resolves and comes back affecting the liver, lungs, kidneys going to renal failure associated with animal urine

Answer 48

leptospirosis - spirochete

Question 49

strep pneumonia has what type of response by the immune system?

Answer 49

humoral immunity with encapsulated organism antibody mediated

Question 50

CD4 count < 200

Answer 50

PCP

Question 51

CD4 count < 100

Answer 51

toxoplasmosis

Question 52

CD4 count < 50

Answer 52

MAC CMV cryptococcus meningitis

Question 53

in a patient who gets classic pneumonia who has no spleen, how do they acquire the infection?

Answer 53

no longer has the full ability to produce opsonzing IgG antibody to the encapsulated organism

Question 54

dapsone

Answer 54

for patients who are allergic to sulfa

Question 55

bird and bat guano

Answer 55

histoplasma capsulatum

Question 56

Gram stain demonstrates the presence of a gram negative coccus that has a prominent polysaccharide capsule and grows on “ chocolate” agar. can cause petechiae, purpura

Answer 56

n. meningitides

Question 57

what drug do you use as prophylaxis if you have been exposed to n. meningitides

Answer 57

rifampin

Question 58

orange urine

Answer 58

rifampin

Question 59

treat aspiration pneumonia with what

Answer 59

clindamycin

Question 60

Spore forming gram-positive non motile rod that is aerobic or facultatively anaerobic, catalase positive, hemolysis negative Grows on sheep agar Zoonotic infection from goats, sheep, cattle, antelope, kudu, pigs, horses, zebu, and other animals. Animal related products include meat, wool, hides, bones, and hair Soil contaminated with spores

Answer 60

bacillus anthracis

Question 61

what are the signs on EKG of PE?

Answer 61

Most common finding--> sinus tachycardia other finding: S1 Q3 T3 S wave in lead I Q in lead III inverted T wave in lead III