TB, MAC, Aspergillosis, Candida, Cryptococcal Infection, Endemic Mycoses

Question 1

TST >5mm is positive in

Answer 1

HIV
recent contact with TB + person
Fibrotic changes on Xray
Organ transplants or immunosuppressed

Question 2

TST >10 is positive in

Answer 2

Recent arrivals from high risk countries
IV Drug users
Residents or employees of prisons, jails, nursing homes, hospitals, homeless shelters
Micro lab personnel, kids <4

Question 3

TST >15 is positive in

Answer 3

everyone with no risk factors for TB

Question 4

Used to exclude TB in patients with false positive sputum results or confirm disease in patients with false negative smears

Answer 4

Nucleic acid amplification test of sputum

Question 5

Infiltrates in the apical-posterior segments of upper lung and superior segments of lower lobe in TB

Answer 5

TB reactivation

Question 6

Hilar LAD or infiltrates in any part of the lung in TB

Answer 6

Primary progressive TB

Question 7

Uniform reticulonodular infiltrate

Answer 7

Miliary TB

Question 8

Treatment for latent TB

Answer 8

Daily Isoniazid for 6 months or daily rifampin for 4 months

Pt with HIV- Daily Isoniazid for 9 months

Question 9

Treatment for Active TB

Answer 9

8 weeks of Rifampin , Isoniazid, Ethambutol, Pyrazinamide

Then 4 or 7 months of Isoniazid and Rifampin

Question 10

Criteria to establish a patient as no longer infectious

Answer 10

Adequate TB treatment
Improvement in symptoms
three consecutive negative sputum smears

Question 11

Labs to check when using ethambutol or pyrazinomide

Answer 11

Uric acid for pyrazinomide.

visual acuity, color vision for ethambutol

Question 12

Healthy white woman with right middle lobe or left lingular lobe lung infiltrate. She has scoliosis, pectus excavatum or MVP suggesting underlying connective tissue defect

Answer 12

MAC

Question 13

Disseminated MAC occurs in HIV patients with CD4 cell count less than

Answer 13

50

Question 14

Treatment for MAC

Answer 14

Azithromycin or Clarithromycin

with ethambutol and either rifampin or rifabutin

Question 15

Mycobacterium abscessus, Mycobacterium fortuitum and Mycobacterium chelonae are causes of

Answer 15

localized skin and soft tissue infections

Question 16

Allergic bronchopulmonary aspergillosis occurs in patients with

Answer 16

Asthma or CT

Question 17

Lab findings for ABPA

Answer 17

elevated IgE, eosinophilia

Question 18

ABPA presents as

Answer 18

difficult to control asthma and recurrent pulmonary infiltrates

Question 19

CT findings in invasive aspergillosis

Answer 19

Halo sign- a target lesion with surrounding ground-glass attenuation (hemorrhage)

Question 20

Testing for aspergillus

Answer 20

culture from deep body specimen, serum galactomannan

Question 21

Treatment for aspergillosis

Answer 21

Voriconazole for invasive aspergillosis, surgical resection for aspergilloma

Question 22

Treatment for ABPA

Answer 22

Glucocorticoids

Question 23

Aspergilloma treatment in asymptomatic patient with stable Xray

Answer 23

None

Question 24

Disseminated crypto can present as

Answer 24

Fungemia and meningitis

Question 25

Cryptococcal meningitis occurs in AIDS patients with CD4 count less than

Answer 25

100

Question 26

Treatment for Crypto

Answer 26

Ampho B with flucytosine

Then fluconazole until CD 4 cound is >100 for 3 months

Question 27

Blasto and Histo occur in

Answer 27

Mid west and MS and Ohio river valleys

Question 28

Skin findings in coccidiomycosis

Answer 28

erythema nodosum or erythema multiforme