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MKSAP KEY POINTS > Infectious Disease KPs > Flashcards

Infectious Disease KPs Flashcards

1
Q

Spinal epidural abscesses often arise from? Risk factors?

A

infected vertebral discs or intervertebral body disc spaces;

Needles (injections, acupuncture, tattoos); HIV, DM, alcoholism

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2
Q

Temporal lobe encephalitis - likely infection? CSF will likely show?

A

HSV; lymphocytic pleocytosis

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3
Q

All patients suspected of having encephalitis should be given?

A

Empiric intravenous acyclovir

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4
Q

preferred diagnostic test for West Nile neuroinvasive disease?

A

Cerebrospinal fluid serology (IgM)

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5
Q

In community-associated methicillin-resistant Staphylococcus aureus infections, the primary treatment of a cutaneous abscess?

A

I&D (no abx)

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6
Q

Monomicrobial (type II) necrotizing fasciits - causal agents?

A

Streptococcus pyogenes&raquo_space;> S. aureus, Vibrio vulnificus, or Streptococcus agalactiae

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7
Q

Treatment for all human bites?

A

Prophylactic amoxicillin-clavulanate

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8
Q

Hospitalize a patient with PNA?

A

CURB-65 -

confusion, blood urea nitrogen >20 mg/dL (7.14 mmol/L), respiratory rate ≥30/min, blood pressure (systolic <90 mm Hg, diastolic ≤60 mm Hg), and age 65 years or older

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9
Q

Do not treat community acquired PNA for more than?

A

5 days

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10
Q

Minimal findings to diagnose lyme disease?

what may be falsely negative in localized disease?

A

erythema migrans with a compatible epidemiologic history

serologic testing is not indicated and may be falsely negative in localized disease.

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11
Q

best way to confirm the diagnosis of disseminated Lyme disease?

A

two-step serologic testing strategy that uses an enzyme-linked immunosorbent assay as an initial screening test followed by a confirmatory Western blot

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12
Q

illness that is clinically indistinguishable from localized Lyme disease?

A

Southern tick-associated rash illness (STARI);

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13
Q

Treatment for Babesiosis?

A

atovaquone plus azithromycin (mild to moderate disease)

clindamycin plus quinine (for severe disease)

Exchange transfusion if 10% or greater parasitemia or organ failure

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14
Q

Treatment for RMSF in pregnancy?

A

chloramphenicol

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15
Q

A culture of midstream, clean-void urine should be reserved for patients with?

A

suspected pyelonephritis,
complicated urinary tract infection,
recurrent urinary tract infection, or
multiple antimicrobial allergies and in those in whom the presence of a resistant organism is suspected.

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16
Q

Fosfomycin has lower efficacy and is more expensive than? (these drugs can be used for)

A

nitrofurantoin or trimethoprim-sulfamethoxazole

UTI ppx in women with recurrent UTIs

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17
Q

Treatment choice and duration of uncomplicated prostatitis?

A

FQ for 4-6 weeks

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18
Q

Role of nucleic amplification testing for TB?

A

Faster diagnosis, not not recommended yet

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19
Q

BCG is contraindicated in

A

patients who are pregnant or immunosuppressed (live attenuated)

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20
Q

Mycobacterium kansasii infection mimics?

A

TB ( cough, fever, weight loss, and cavitary lung disease.)

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21
Q

Mycobacterium abscessus, Mycobacterium fortuitum, and Mycobacterium chelonae infections are seen in? Typical infection?

A

immunosuppressed patients; Skin/soft tissue infection after trauma or surgery or cosmetic procedures (tattoo, piercings)

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22
Q

Do not use an echinocandin to treat this candidal infection?

A

meningitis or endophthalmitis because of poor organ penetration.

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23
Q

Treatment of asymptomatic candiduria is indicated only in?

A

neutropenic patients and those undergoing urologic procedures.

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24
Q

most common presentation of mucormycosis?

A

apidly fatal rhinocerebral infection, with

1) headache
2) epistaxis
3) ocular findings (proptosis, periorbital edema, and decreased vision).

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25
Q

Assay for cryptococcus? Use when suspect?

A

latex agglutination assay; Meningitis

26
Q

Maintenance therapy is indicated for patients with AIDS and cryptococcal meningitis until?

A

CD4 cell count ≥100/μL for ≥3 months) and have been receiving antifungal therapy for at least 1 year.

27
Q

Pulmonary complications of histoplasmosis?

A

granulomatous mediastinitis, fibrosing mediastinitis, broncholithiasis, pulmonary nodules (histoplasmomas)

28
Q

Primary coccidioidomycosis infection most frequently presents as?

A

community-acquired pneumonia occurring 1 to 3 weeks after exposure

29
Q

therapy of choice for cutaneous and osteoarticular sporotrichosis

A

Itraconazole

30
Q

Exserohilum rostratum? How does one get the infection? Treat with?

A

Mold, meningitis in patients who received epidural or paraspinal injections (contamined methylpred); Treat with voriconazole

31
Q

Who gets annual Chlamydia screening?Gonorrhea?

A

MSM; Sexual active women under 24

High risk women; MSM

32
Q

Pt with syphillis - who else gets tx?

A

Sexual partners exposed within the preceding 90 days of diagnosis should receive treatment regardless of serologic results.

33
Q

presents with a genital papule or ulcer followed by tender unilateral inguinal lymphadenopathy.

A

Lymphogranuloma venereum

34
Q

pathognomonic of chronic osteomyelitis infection in the bone?

A

draining sinus tract

35
Q

Treatment difference between acute and chronic osteo?

A

chronic osteomyelitis can be treated with oral agents alone

36
Q

Signs of osteo in a diabetic foot ulcer?

A

Ulcers present for 2 weeks or longer, ulcer size greater than 2 cm, grossly visible bone or the ability to probe to bone, and an erythrocyte sedimentation rate greater than 70

37
Q

Common variable immunodeficiency is diagnosed by?

A

confirming low levels of total IgG and IgA or IgM, as well as by a poor antibody response to vaccines.

38
Q

What does an abnormal CH50 mean? Who should be screened for CH50 activity?

A

Deficit in a complement pathway.

Patients with recurrent bloodstream infection with encapsulated bacteria or invasive meningococcal or gonococcal disease

39
Q

Postexposure prophylaxis for anthrax?

A

Cipro or doxy

40
Q

Symptoms of botulism?

A

classic triad of symmetric, descending flaccid paralysis with prominent bulbar signs, absence of fever, and normal mental status.

41
Q

Preferred antibiotics for typhoid fever?

A

ceftriaxone, fluoroquinolones, and azithromycin.

42
Q

brucellosis - key features?

A

fever, myalgia, arthralgia, fatigue, headache, and night sweats, often with depression

43
Q

Problem of Abx for salmonella? When to treat?

A

may lead to prolonged asymptomatic shedding

Severe salmonellosis

44
Q

Treatment of giardiasis?

A

metronidazole

45
Q

Test of choice for amebiasis?

A

stool antigen&raquo_space; O&P

46
Q

Treatment for cyclospora? If intolerant?

A

Bactrim; Cipro

47
Q

Diagnosis of acute HIV infection relies on detecting the virus by?

A

RNA polymerase chain reaction or p24 antigen testing.

48
Q

Fourth-generation HIV testing?

A

HIV antibody enzyme immunoassay + a test for HIV p24 antigen;

a positive test result is followed by HIV-1/HIV-2 antibody differentiation immunoassay.

49
Q

Before treatment for latent tuberculosis?

Before prophylaxis against Mycobacterium avium complex (MAC) infection begins?

A

active tuberculosis infection must be ruled out in patients with a positive tuberculin skin test result or a positive result on interferon-γ release assay;

active MAC infection must be ruled out in patients with a CD4 cell count less than 50/μL.

50
Q

Main side effects of HIV and its meds?

But Interrupting HIV therapy is associated with increased infections and also?

A

hyperlipidemia, glucose intolerance, and diabetes mellitus

Increased cardiovascular events

51
Q

If IRIS is severe, can add?

A

steroids

52
Q

When should HIV resistance testing be done?

A

when antiretroviral therapy is initiated and when treatment failures occur

53
Q

Preexposure reigmen?

Postexposure prophylaxis for HIV should include?

A

tenofovir-emtricitabine

3 drug regimen

54
Q

EBV with compromised airway or hemolytic anemia - start this med?

A

steroids

55
Q

New zoster vaccine?

A

Inactivated for everyone

56
Q

typically indicated in cases of cytomegalovirus reactivation in immunocompromised patient?

A

Ganciclovir

57
Q

Tedizolid v linezolid?

A

more potent, works against linezolid resistant organisms, and lower risk of thrombocytopenia

58
Q

active against multidrug-resistant strains of Pseudomona?

A

Ceftolozane-tazobactam

59
Q

Tigecycline effective against?

A

MRSA, VRE, and penicillin-resistant S. pneumoniae, CRE, mycoplasma

(not pseudomonas)

60
Q

colistin - used for? Toxicity?

A

MDR GNRs (pseudomonas)

Nephrotoxic

MKSAP KEY POINTS (19 decks)

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