Infectious Disease

Question 1

What should you do with patients with positive PPD with negative CXR?

Answer 1

Treat with 6 months daily INH, or 9 mo INH + pyridoxine

Question 2

How to treat active pulm TB?

Answer 2

8 weeks INH, rifampin, pyrazinamide, followed by 4 mo. of INH and rifampin

Question 3

When is PPD positive in patients with no risk factors?

Answer 3

> 15 mm induration

Question 4

> 5 mm on PPD is positive in what patients

Answer 4

HIV, recent contact with TB pos person, TB on CXR, immunosuppressed patients

Question 5

> 10 mm on PPD is positive in what patients

Answer 5

Foreignors from endemic TB, Injection drug users, Prisoners/Homeless, DM, CKD, Heme onc, fibrotic lung disease, Children <4 yrs, teens exposed to high-risk adults

Question 6

When to suspect trichinellosis

Answer 6

GI complaints followed by characteristic periorbital edema, myositis, and eosinophilia. Subungual splinter hemorrhages, and conjunctival or retinal hemorrhages

Question 7

What does neurocysticercosis look like

Answer 7

Multiple, small (<1 cm), fluid filled cysts in the brain parenchyma

Question 8

What abx are effective at treating Pseudomonas

Answer 8

Piperacillin-tazobactam, cefepime, ceftazidime (3rd gen.)

Question 9

Most common causes of Typical CAP

Answer 9

1. Strep pneumo 2. H flu, aerobic GNR

Question 10

atypical CAP causes

Answer 10

1. Mycoplasma, chlamydia, legionella

Question 11

Nosocomial PNA causes

Answer 11

1. Staph aureus; pseudomonas, aerobic GNR

Question 12

PNA in alcoholics is

Answer 12

Klebsiella

Question 13

PNA in immigrants

Answer 13

TB

Question 14

PNA in nursing home

Answer 14

Nosocomial infection

Question 15

PNA in aids

Answer 15

Pneumocystis (PCP) or TB

Question 16

Atypical CAP sxs

Answer 16

Insidious onset sore throat, HA, nonproductive cough, dyspnea

Question 17

Typical CAP

Answer 17

sudden-onset fever/chills, productive cough, pleuritic CP

Question 18

test for HIV PNA

Answer 18

silver stain (fungi, PCP)

Question 19

tx for O/p PNA

Answer 19

azithromycin 60 yo

Question 20

tx for i/p PNA

Answer 20

azithromycin + ceftriaxone or fluoroquinolone

Question 21

Lung abscess causes

Answer 21

Oral anaerobes (prevotella, peptostreptococcus, fusobacterium, bacteroides)

Question 22

Lung abscess presentation

Answer 22

Cough, foul smelling sputum, SOB< fever, chills, R lower lobe, IV abx for tx

Question 23

Active TB tx

Answer 23

SPIRE (streptomycin, pyrazinamide, INH, rifampin, ethambutol) for 2 months, then INH+rifampin for 4 months

Question 24

Latent TB tx

Answer 24

INH only