Infectious Disease Qs

Question 1

Necessary adjunctive Therapy for bacterial meningitis?

Answer 1

Steroids

Question 2

CD4 count necessary to develop Primary CNS lymphoma?

Answer 2

<50

Question 3

ethambutol side effect?

Answer 3

retrobulbar neuritis manifesting as decreased green-red color discrimination

Question 4

TB drug that can cause gout?

Answer 4

Pyrazinamide

Question 5

Continuation treatment for TB after initial 2 month, 4 drug treatment? When should the continuation length increase?

Answer 5

4 months of isoniazid and rifampin

If not given pyrazimnamide;
OR sputum cultures are still positive OR drug resistance

Question 6

Patients with late (terminal) complement component deficiencies (C5, C6, C7, C8, C9) may present with?

Answer 6

recurrent, invasive meningococcal or gonococcal infections.

Question 7

Common variable immunodeficiency (CVID) involves which cell lines? Lab findings? Types of infections?

Answer 7

B- and T-cell abnormalities;

hypogammaglobulinemia.

Bacterial infections, often of the sinus tract and lungs, are common

Question 8

Selective IgA deficiency presents as?

Answer 8

sinopulmonary infections or gastrointestinal involvement with inflammatory bowel disease, sprue-like illness, or celiac disease

Question 9

Classical complement pathway (C1, C4, C2) deficiencies are associated with?

Answer 9

Rheumatologic disorders (SLE, vasculitis, scleroderma)

Question 10

Patients suspected of having brain abscess from a likely odontogenic source should begin empiric antibiotic therapy wit?

Answer 10

intravenous penicillin and metronidazole.

Question 11

Uncomplicated cutaneous anthrax should be treated with?

Answer 11

ciprofloxacin, levofloxacin, moxifloxacin, or doxycycline

Question 12

UTI drug to avoid in last 30 days of pregnancy? Why?

UTI in pregnanct patients the last 30 days should be treated with?

Answer 12

Nitrofurantoin; higher rates of neonatal jaundice;

Amoxicillin

Question 13

How does West Nile Neuroinvasive disease present?

Answer 13

Fever, headache, and focal limb weakness following outdoor activities

Question 14

When are transplant patients at highest risk for CMV?

Answer 14

in the first few months after transplantation when (immunosuppression is typically highest, and patients who have just finished prophylaxis against cytomegalovirus)

Question 15

disseminated zoster infection - contact precautions?

Answer 15

Airborne and contact

Question 16

Who gets prophylactic antibiotics to reduce the risk of travelers diarrhea?

Answer 16

IBD, immunosuppressive illnesses, or chronic diseases that could become more severe or be exacerbated by dehydration

Question 17

When is an active TB patient considered non-contagious?

Answer 17

adequate tuberculosis treatment for at least 2 weeks, demonstrate improvement of symptoms, and have three consecutive negative sputum smears

Question 18

Disseminated candidemia - treatment?

Answer 18

echinocandins such as caspofungin, anidulafungin, and micafungin

Question 19

Disseminated fungal infections that manifest as skin lesions?

Answer 19

blastomycosis and coccidiomycosis

Question 20

Hep A ppx for travel given to? What exactly is given?

Answer 20

any person planning travel to developing parts of South Asia, Africa, and South and Central America

Hepatitis A virus vaccine AND if leaving within 2 weeks: a dose of intramuscular immune globulin

Question 21

Posttransplant lymphoproliferative disease is caused by? presents when? Lab suggestive? Confirm with/? Management?

Answer 21

EBV; 1 year after transplant;

EBV PCR; biopsy

Reduce immunosupression and maybe chemo/rituximab

Question 22

When to give antibiotic ppx for a dog bite? what is the med/duration?

Answer 22

1. immunosuppressed (including those with asplenia or significant liver disease);
2. have moderate to severe wounds (particularly on the face or hand);
3. have wounds near a joint or bone;
4. or have wounds associated with significant crush injury or edema.

3- to 5-day with amoxicillin-clavulanate

Question 23

Sacral infection that may cause episodes if aseptic meningitis?

Answer 23

HSV

Question 24

live-attenuated influenza vaccine given by nasal mist is approved only for?

Answer 24

age 2 to 49 years

Question 25

Med can inhibit tubular secretion of creatinine but does not actually affect glomerular filtration rate? Drug treats?

Answer 25

Cobicistat (pharmacokinetic enhancer.for HIV)

Question 26

Smallpox presentation?

Pt contagious until?

Answer 26

begins as small red dots on the pharyngeal and buccal mucosa

spread in centripetal fashion to the hands and face, followed by the arms, legs, and feet.

from macules to papules to vesicles and pustules before crusting over.

Patients remain contagious until all crusts are shed.

Question 27

Lyme arthritis is excluded if

Answer 27

symptoms have been present for longer than 1 month and Western blot IgG result is negative

Question 28

Treatment for selective IgA deficiency?

Answer 28

no treatment

Question 29

Autoimmune that causes psychiatric symptoms, seizures, autonomic instability, and choreoathetoid movements? Associated with?

Answer 29

anti-NMDAR receptor encephalitis; Ovarian teratomas

Question 30

Treatment for disseminated Mycobacterium avium complex infection in patients with HIV/AIDS whose CD4 cell counts are less than 50/µL?

Answer 30

clarithromycin, ethambutol, and rifabutin

Question 31

Immunocompromised patients, particularly those with liver disease are at increased risk for this infection?

Answer 31

Vibrio vulnificus

Question 32

Empiric therapy for Patients admitted to the hospital with community-acquired pneumonia thought be caused by Pseudomonas aeruginosa?

Answer 32

antipseudomonal β-lactam, an aminoglycoside, and a respiratory fluoroquinolone,

Question 33

Likely CXR finding in a patient with Staphylococcus aureus postinfluenza community-acquired pneumonia?

Answer 33

Cavitary lesions

Question 34

Chikungunya v dengue? (Main v 3 other)?

Answer 34

severe joint pain and stiffness.

Other distinguishing features include

• high fever, which often recurs after a brief afebrile period (“saddle-back fever”);
• more significant polyarticular and migratory joint pains involving the small joints of the hands, wrists, and ankles; and
• much less thrombocytopenia.

Question 35

Treatment for PID?

Answer 35

cefoxitin or cefotetan plus doxycycline.