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UWorld Medicine Ultra-HY > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Empiric treatment for “fight-bite”

A

Amoxicillin-clavulunate (cover polymicrobrial infection with oral flora)

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2
Q

Origin of infection of Ludwig angina?

A

Direct spread from dental infection (extract tooth in addition to broad-spectrum IV antibiotics)

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3
Q

Tender, indurated submandibular area with upwards displaced tongue, crepitus, and airway compression

A

Ludwig angina

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4
Q

Empiric treatment for viral encephalitis

A

IV acyclovir

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5
Q

Empiric treatment of febrile neutropenia without known source

A

Broad-spectrum anti-Pseudomonal beta-lactam: pip/tazo, cefepime, or meropenem

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6
Q

Other diseases to test for in a patient newly diagnosed with gonorrhea or chlamydia

A

HIV, syphilis, and hepatitis B

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7
Q

Polyarthralgia, tenosynovitis, and painless vesiculopustular skin lesions

A

Disseminated gonococcal infection

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8
Q

Epitrochlear lymphadenopathy

A

Secondary syphilis

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9
Q

Painless genital ulcer with regular borders and hard base

A

Primary syphilis

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10
Q

Painless genital ulcers followed by painful lymphadenopathy

A

Lymphogranuloma venerum (Chlamydia trachomatis L1-L3)

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11
Q

Painful genital ulcer with painful lymphadenopathy

A

Chancroid (Haemophilus ducreyi)

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12
Q

Empiric treatment of bacterial meningitis in a typical adult?
Over 50?
Immunocompromised?

A

General: Vanc + ceftriazoxone (+ steroids if PC suspected)
Over 50: Add ampicillin for Listeria
Immunocompromised: Add ampicillin for Listeria and use antipseudomonal (e.g. cefepime) instead of ceftriaxone

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13
Q

Large basophilic lymphocytes with vacuolated appearance

A

Atypical lymphocytes in EBV or less commonly CMV

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14
Q

N/V/D followed by fever, myositis, eosinophilia, and elevated CK

A

Trichenella (pork roundworm)

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15
Q

Nematode that travels from small bowel to lungs via blood and leads to cough, and then is swallowed and returns to bowel

A

Ascaris

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16
Q

Liver cyst with internal septations on US and eggshell calcifications on CT

A

Hydatid cyst due to Echinococcus granulosus

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17
Q

Liver cyst without pain or fever

A

Hydatid cyst due to Echinococcus granulosus

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18
Q

Liver cyst with fever and RUP pain

A

Amebic liver abscess due to Entamoeba histolytica

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19
Q

Single subcapsular cyst in right hepatic lobe

A

Amebic liver abscess due to Entamoeba histolytica

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20
Q

Treatment for amebic liver abscess

A

Metronidazole followed by intraluminal antibiotic (e.g. paromycin)

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21
Q

Liver fluke causing biliary disease

A

Clonorchis sinensis

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22
Q

New seizures with intraparenchymal brain cysts with surrounding edema

A

Neurocystiercosis (Taenia solium pork tapeworm)

Treat with albendazole, steroids, and anticonvulsants

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23
Q

Tropical disease: Megacolon / megaesophagus

A 
Chagas disease (Trypanosomi cruzi)
(Can also lead to cardiomegaly / CHF / arrhythmias)
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24
Q

Tropical disease: High fever, HA, vomiting, myalgia, arthralgias, rash, and retro-orbital pain

A

Dengue fever

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25
Q

Tropical disease: fever, lymphadenopathy, severe polyarthralgias, magulopapular rash, lymphopenia, and thrombocytopenia

A

Chikungunya fever

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26
Q

Fungal pulmonary infection with ulcerated skin lesions and lytic bone lesions in an immunocompetent host?

A

Blastomycosis

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27
Q

Fungal pulmonary infection with hilar lymphadenopathy

A

Histoplasmosis

28
Q

Fungal pulmonary infection that disseminates with CD4 < 100 with fever, weight loss, mucocutaneous papules/nodules, and pancytopenia

A

Histopasmosis

29
Q

Fungal pulmonary infection with erythema nodosum, erythema multiforme, arthralgias, and conjunctivitis

A

“San Joaguin Valley Fever” due to Coccidiomycosis

30
Q

Partially acid-fast aerobic filamentous bacteria

A

Nocardia

31
Q

Anaerobic filamentous bacteria

A

Actinomyces

32
Q

Treatment for pulmonary nocardiosis

A

6-12 months of TMP-SMX

33
Q

Treatment for Actinomyces

A

Penicillin G

34
Q

Infection of jaw after dental infection or trauma

A

Actinomyces

35
Q

Fever, chest pain, and hemoptysis in immunocompromised patient, with “halo sign” around pulmonary nodules on CT

A

Invasive aspergillosis

36
Q

Galactomannan and beta-D-glucan

A

Invasive aspergillosis

37
Q

Treatment of rhino-orbital-cerebral mucormycosis

A

Surgical debridement and amphoterocin B

38
Q

Fever, nasal congestion and discharge, and sinus pain in a poorly controlled diabetic

A

Rhino-orbital-cerebral mucormycosis, most likely due to Rhizopus fungus

39
Q

Early disseminated Lyme

A

Multiple erythema migrans, CN palsy, meningitis, AV block, migratory arthalgias

40
Q

Late lyme

A

Arthritis, encephalitis, peripheral neuropathy

41
Q

Standard lyme treatment?

When do you escalate, and what to?

A

Standard: oral doxycycline

With neurological or cardiac involvement, go to IV ceftriaxone

42
Q

Lyme treatment in pregnant women and children under 8

A

Oral amoxicillin

43
Q

RMSF treatment

A

Doxycycline (like Lyme)

44
Q

Sudden fever, HA, myalgias, followed by a blanching maculopapular rash that begins on distal limbs and spreads inwards

A

RMSF (Rickettsia rickettsi)

45
Q

Gram-negative bacteria that infects endothelial cells and can lead to a vasculitis-like illness with thrombocytopenia and prolonged PT/PTT

A

RMSF (Rickettsia rickettsi)

46
Q

Tick-borne illness due to bacteria that infects WBCs

Treatment?

A

Erhlichiosis

Treat with doxycycline (same as Lyme and RMSF)

47
Q

Babesia treatment

A

Atogaquone and azithromycin

48
Q

Mltese cross in RBCs

A

Babesia

49
Q

Test for acute HIV

A

Viral load (serologies negative early)

50
Q

Primary prophylaxis in AIDS

A

CD4 <200: TMP-SMX for PCP (also covers Toxo at <100)

CD4 <50: Azithro/clarithromycin for MAC

51
Q

Diagnostic test for PCP

A

Need direct visualization on stain (can’t culture).

Induce sputum, and if this fails do BAL.

52
Q

Treatment for PCP pneumonia?

When do you add steroids?

A

TMP-SMX

Add steroids with significant hypoxemia: PaO2 < 70 mm Hg ORA or A-a gradient >35 mm Hg

53
Q

Treatment of CNS Toxo in an AIDS patient

A

Sulfadiazine-Pyrimethamine w/ leucovorin rescue

54
Q

AIDS: Multiple ring-enhancing brain lesions with surrounding edema

A

CNS Toxoplasmosis (treat with sulfadiazine-pyrimathemine)

55
Q

AIDS: Multiple non-enhancing brain lesions without surrounding edema

A

PML

56
Q

AIDS: Single enhancing brain lesion

A

Primary CNS lymphoma

57
Q

AIDS: Painless retinitis with fluffy granular retinal lesions and retinal hemorrhages

A

CMV retinitis (HSV and VZV are painful)

58
Q

AIDS: Painful retinitis following keratitis with central retinal necrosis

A

HSV or VZV retinitis (CMV is painless)

59
Q

Treatment for Cryptococcal meningitis

A

2 weeks amphotericin B/flucytosine (induction), followed by consolidation (8 weeks) and maintenence (>1 year) with fluconazole

Do NOT initiate antiretrovirals until 2 weeks of treatment due to risk of IRIS (immune reconstitution inflammatory syndrome)

60
Q

AIDS: Watery diarrhea with low-grade fever and weight loss

A

Cryptosporidium (CD4 <180, stains acid-fast)

61
Q

AIDS: Watery diarrhea with abdominal pain but no fever

A

Microsporidium / Isosporidium (CD4 < 100)

62
Q

AIDS: Watery diarrhea with high fever and weight loss

A

MAC (CD4 < 50)

63
Q

AIDS: Bloody diarrhea with low-grade fever, abdominal pain, and weight loss

A 
CMV Colitis (CD4 < 50)
(Confirm with colonoscopy, screen for CMV retinitis, and start ganciclovir and HAART)
64
Q

AIDS: Fever, night sweats with vascular cutaneous lesions. Cause?
Treatment?

A

Bacillary angiomatosis due to Bartonella

Treat with doxy or erythromycin

65
Q

When can you empirically treat an AIDS patient with esophagitis symptoms for Candida?
What do you do if this is not appropriate or fails?

A

If there is oral thrush, treat empirically w/ 3-5 days of fluconazole to see if improves
If no thrush or this fails, go to endoscopy

66
Q

AIDS: Odynphagia with deep round ulcers on endoscopy

A

HSV

67
Q

AIDS: Odynophagia with deep linear ulcers on endoscopy

A

CMV

UWorld Medicine Ultra-HY (13 decks)

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