ID

Question 1

Candida

Answer 1

intertrigo- clotrimazole topical tx

if in blood- amphotericin B

Question 2

Histoplasmosis

Answer 2

AIDS defining illness

• bird/bat droppings
• elderly get it and its called chronic progressive (calcified nodes and pericarditis)
• prostration
• tx: itraconazole (need lifelong if immunocompromised); ampho B if can’t tolerate it
• blood test: anemia of chronic dz, incr. alk-phos, LDH and ferritin in v ill

Question 3

Cryptococcus

Answer 3

AIDS defining

• dried pigeon dung
• presents like pneumonia
• CXR: nodules, pneumonitis
• low sugar, high protein
• india ink- encap yeast
• tx: ampho B and fluconazole for 2wks; then just fluc for 10

Question 4

PCP

Answer 4

-MC in HIV
-fatigue, weakness, wt loss
-CXR: diffuse interstitial infiltrates
-blood- LDH incr., WBC decr.
-spontaneous pneumo from pentamidine use
-tx: Bactrim
alt: dapsone or pentamidine IV/IM (causes abnormal LFT, folate decr. Ca imbalance
Atovaquone take w fatty meal

Question 5

Acute Rheum fever

Answer 5

occurs 15-20d after GAS strep throat infection
5-15 y/o
-J-migratory polyarthritis 2+ joints, from upper to lower
-O- peri-, myo-, endo carditis
-N-odules
-E-rythema marginatum- trunk and extremities
-S-ydenham’s chorea
fever
dx: antitrypsin titer
tx: Aspirin 2-6wk taper; corticosteroid if severe