Exam 3 Flashcards
(182 cards)
1
Q
Which of the following can cause abscesses and ulcers?
- Histoplasmosis
- Blastomycosis
- Coccidioidomycosis
- Sporotrichosis
A
- Sporotrichosis
2
Q
Which infection is contracted from soil with moist rotting wood in the Eastern US?
A
- Blastomycosis
3
Q
Treatment for babesiosis
A
- Azithromycin plus atovaquone
4
Q
Symptoms of leishmaniasis
A
- Self-resolving skin ulcers to lethal systemic illness
(severe infection more likely in immunodeficient patients)
5
Q
Which of the following is not caused by inhalation of pathogens?
- Histoplasmosis
- Blastomycosis
- Coccidioidomycosis
- Sporotrichosis
A
- Sporotrichosis: needs skin trauma
6
Q
Physical exam findings in allergic rhinitis/conjunctivitis
A
- Tired looking
- Mouth breathing
- Red eyes with watery discharge
- “Allergic shiners”
- Serous effusion of ears
- Nasal crease (“allergic salute”)
- Nasal mucosa swollen, pale, bluish, polyps
- Clear nasal discharge
- Cobble-stoning of posterior oropharynx
7
Q
Pinworm infections are most commonly seen in this type of patient
A
- Children (age 5-10)
8
Q
What is a likely cause of angioedema in a patient without urticaria?
A
- Bradykinin-mediated (ACE inhibitor, C1 inhibitor deficiency)
9
Q
Symptoms of epidemic (louse-borne) typhus
A
- More severe than endemic typhus
- Abrupt onset of intense persistent headache, chills, prostration, and high fever, rash
- Hypotension, renal failure, and DIC if severe
10
Q
What condition is diagnosed with the ice cube test?
A
- Cold-induced urticaria
11
Q
A
12
Q
When should you treat acute sinusitis with antibiotics?
A
- Symptoms fail to improve within 10 days on onset
OR - Symptoms worsen within 10 days after an initial improvement (double worsening)
13
Q
Which medication should be avoided in campylobacter, salmonella, shigella, and yersinia enterocolitica?
A
- Avoid loperamide
14
Q
What is the treatment for a patient who returned from Africa one month ago and has now developed fevers that repeat every 2-3 days, body aches, and has hepatosplenomegaly?
A
- Artemisinin combination therapy (artemether-lumefantrine) to treat malaria
15
Q
What infection is most commonly seen December-April in the US and is diagnosed using ELISA and latex agglutination testing?
A
- Rotavirus
(Norovirus also a winter condition, but tested with PCR)
16
Q
Which fungus causes pneumonia in patients with lymphopenia?
A
- Pneumocystis jirovecii
17
Q
Symptoms of yersinia pestis
A
- Abrupt onset of fever, headache, GI symptoms
- Followed by buboes in groin/axilla
18
Q
Who is most likely to catch Q fever?
A
- Sheep or goat farmers, or those who live nearby
19
Q
How long is acute and chronic urticaria?
A
- Acute: <6weeks
- Chronic: >6 weeks
20
Q
Murine (endemic) typhus is carried by fleas that live on …
A
- Rats (and mice and opposums)
21
Q
How would someone most likely contract giardiasis?
A
- Ingestion of contaminated water
22
Q
Anaphylaxis causes increased vascular permeability which can lead to …
A
- Hypotension and shock
23
Q
Which infection is caused by entamoeba histolytica?
A
- Amebiasis (amebic dysentery)
24
Q
Treatment for aspergillus fumigatus
A
- Voriconazole
25
Name four helminthic infections and their treatment
- Trichinellosis
- Hookworms
- Roundworms
- Pinworms
- Treat all with mebendazole
26
Name four conditions that are caused by the inhalation of soil
- Histoplasmosis: soil/dust with bat/bird droppings
- Blastomycosis: soil with rotting wood (eastern US)
- Coccidioidomycosis: soil in SW USA and northern Mexico
- Cryptococcus neoformans: pigeon feces in soil (immunocompromised only)
(hookworms, roundworms, pinworms found in soil but from walking barefoot, not inhaling)
27
*When* are West Nile (encephalitis) cases most common?
- Late summer and early fall
28
Which infection has the unique symptom of retro-orbital headache?
- Dengue
- Also high fever, body aches, lymphadenopathy
- After afebrile period, rash and another fever occur
29
What is the most common cause of chronic urticaria?
- Idiopathic: 80-90% of cases have unknown cause
30
Treatment for angioedema
- Similar to urticaria for IgE
- High dose H1 antihistamines first line
- Oral/IM/IV steroids if severe
- Epinephrine if concern for airway
For hereditary angioedema
- C1 inhibitor replacement, kallikrein inhibitor, bradykinin B2 receptor antagonists
31
Which infection, seen in immunocompromised patients, can lead to balanitis?
- Genital candidiasis (candida albicans)
32
Which patient is most likely to have symptoms of bleeding, purpura, hematemesis, melena, epistaxis, and hepatomegaly from a dengue infection?
- Children aged under 10
- Develop *dengue hemorrhagic fever*
33
Which mosquito-borne illness can cause plasma leakage and abnormal hemostasis?
- Dengue
- Can cause potential fatal hemorrhagic fever with shock
34
Diagnostic test to definitively differentiate between enteric infections such as:
- campylobacter
- salmonella
- shigella
- yersinia enterocolitica
- Stool culture
35
Where is yersinia enterocolitica most commonly found and in what foods?
- Europe
- Pork (also dairy, oysters/mussels, iceberg lettuce)
36
What is rhinosinusitis?
- Symptomatic inflammation of the paranasal sinuses and nasal cavity
37
Which type of toxoplasmosis infection is most dangerous to a baby in utero?
- Primary maternal infection *early in pregnancy*
(transmission does not occur if mother infected before conception)
38
When does rhinosinusitis most commonly occur?
- After a viral upper respiratory infection
39
Symptoms of francisella tularensis (tularemia)
- Skin/eye ulcers, pharyngitis with lymphadenopathy, GI symptoms
- Can cause pericarditis, meningitis, pneumonia, peritonitis, endocarditis
40
What is the name of the infection more commonly known as "cat scratch fever"?
- Bartonella
41
What is the main complication associated with vibrio cholerae infection?
- Dehydration
- Sunken eyes, dry mouth, cold, clammy skin, decreased turgor, hypotension, lethargy
42
Which viruses are carried by the Aedes mosquito?
- Dengue
- Yellow fever
(not malaria = anopheles mosquito)
(not encephalitis = culex mosquito)
43
Where is vibrio cholerae most commonly found?
- Areas without access to clean water (fecal contamination)
44
Which infection, seen in immunocompromised patients, is caused by fungi that live in most people's alveoli?
- Pneumocystis jirovecii
45
A child presents with an enlarged cervical lymph node one week after being scratched on the neck by her cat. What is the likely diagnosis and treatment?
- Bartonella (cat scratch fever)
- Azithromycin
46
Rabies is mostly found in Africa and Asia and associated with dogs.
In America, which five animals most commonly cause rabies?
- Bats
- Skunks
- Foxes
- Raccoons
- Mongooses
47
Which mosquito-borne illness has an abrupt high fever, then an afebrile period followed by one more episode of fever (recrudescent)?
- Dengue
(not malaria = cyclic)
48
Which bacteria causes murine (endemic) typhus?
- Rickettsia typhi
49
Where in the world are you most likely to see a chagoma?
- South America
- Chagoma = swelling from bite of kissing bug
50
Which intestinal nematode is the most common cause of iron deficiency anemia worldwide?
- Hookworms
- Cause anemia from GI blood loss
51
Hymenoptera (stinging insects, bees, wasps, hornets, fire ants) cause acute urticaria.
Bed bugs, fleas, and mites cause a slightly different kind of urticaria, what is it?
- Papular urticaria
52
Describe the appearance of urticaria (hives)
- Well-defined, raised, erythematous wheals/plaques
53
Which protozoan infection is associated with cats and undercooked pork/lamb?
- Toxoplasmosis
54
Preferred diagnostic method for allergic rhinitis
- Skin testing for antigen-specific IgE
55
Shigella is most commonly seen in developing countries. If seen in the US, it most likely started in ...
- Day care centers
- Recreational water
56
What is the most common cause of viral gastroenteritis in the world?
- Norovirus (the winter vomiting disease)
57
Treatment for leishmaniasis
- Cryotherapy, wound debridement,
58
Postexposure prophylaxis treatment for rabies
- Treat any bite from unknown animal that can transmit rabies, or if a bat was in your bedroom
- Rabies immunoglobulin + four serial vaccine shots
- Given on days 0, 3, 7, and 14
59
What is the most effective treatment for anaphylaxis?
Epinephrine
- alpha reverses peripheral vasodilation to increase BP and perfusion
- beta-2 relaxes smooth muscle in airways
60
Where in the world is a person most likely to pick up a roundworm infection?
- Tropical climated
61
What kind of urticaria is caused by systemic mastocytosis?
- Urticaria pigmentosa (reddish-brown macules)
- Stroke skin = hive breakout = Darier's sign
62
Which condition is also known as "rose handler's disease"?
- Sporotrichosis
63
Diagnostic test for toxoplasmosis
- Serology for antibodies
(ophthalmology exam, hearing tests, brain MRI/CT, and lumbar puncture to rule out meningitis)
64
Treatment for cryptococcus neoformans infection
- IV amphotericin B plus oral flucytosine
65
Diagnostic test for aspergillus fumigatus
- Transbronchial biopsy or bronchoscopy
- 1-3-B-D positive
- CT > CXR
66
Diagnostic method for:
- Histoplasmosis
- Blastomycosis
- Coccidioidomycosis
- Sporotrichosis
- Culture whatever you can
67
Treatment for vibrio cholerae
- Rehydration
- Doxycycline if severe
68
Which infection is caused by bites from sandflies?
- Leishmaniasis
69
Resume after protozoans
70
Treatment for:
- Histoplasmosis
- Blastomycosis
- Coccidioidomycosis
- Sporotrichosis
- Itraconazole
- Amphotericin B if severe
71
True or false.
Bradykinin-mediated angioedema does *not* involve mast cells, and so has *no* hives, but does respond to epinephrine, antihistamines, or corticosteroids.
False
- Bradykinin-mediated angioedema does *not* involve mast cells, and so has *no* hives, *AND DOES NOT* respond to epinephrine, antihistamines, or corticosteroids.
72
Which of the following can cause plaque like lesions on the face and extremities?
- Histoplasmosis
- Blastomycosis
- Coccidioidomycosis
- Sporotrichosis
- Blastomycosis
73
Histoplasma infections are normally asymptomatic except in the cases of immunosuppression, heavy exposure, age 55+, or infancy. What symptoms do these people get with their severe infection?
- Pulmonary: fever, malaise, non-productive cough
- Disseminated: Fever, chills, malaise, anorexia, weight loss, hepatosplenomegaly, and *skin and mucous membrane lesions (papules)*
74
What is the most common zoonotic infection in the world?
- Brucellosis
75
Diagnostic test for intestinal nematodes
- Microscopic exam of stool
- Adhesive exam for pinworms
76
What is the treatment for:
- Rocky mountain spotted fever
- Murine (endemic) typhus
- Epidemic (louse-borne) typhus
- Q fever
- Human ehrlichiosis
- Doxycycline for all
77
Symptoms of malaria
- Headache followed by *febrile paroxysms*
- *Cyclic fever* every 48-72 hours
- Cough, body aches, n/v/d
- Hepatosplenomegaly
Severe malaria:
- Impaired consciousness, inability to sit/stand/walk, convulsions
78
Which infection is associated with soil contaminated with *pigeon*/chicken feces?
- Cryptococcus neoformans
79
Treatment for trypanosomiasis
- Nifurtimox, benznidazole
80
In which part of the world is dengue found?
- Tropics
81
Treatment for rocky mountain spotted fever
- Doxycycline
- Do not wait for rash to appear, treat if tick bite and suspected!
82
You suspect anaphylaxis in a patient who is known to be taking a beta-blocker.
As well as epinephrine, what other medication should you also give?
- Glucagon
83
Where in the US are you most likely to contract blastomycosis?
- Eastern half of US
(Arkansas, Mississippi, Kentucky)
84
What is the classic triad of symptoms associated with aspergillus fumigatus?
- Fever, chest pain, hemoptysis
(not reliable)
- Also sinusitis: fever, congestion, facial pain
85
Which disease is helicobacter pylori connected with?
- Peptic ulcer disease
86
From which creature is a patient likely to catch yersinia pestis?
- Fleas from rats (or squirrels)
87
Diagnosis for rabies
- Fluorescent antibody staining of neck (nuchal) biopsy
88
Which condition is caused by coxiella burnetti?
- Q fever
89
What are the unique symptoms associate with yellow fever?
- Jaundice and bradycardia (Faget)
(also sudden fever, malaise, headache)
90
What is the treatment for this zoonotic infection, most commonly seen in the middle east, acquired from unpasteurized milk, undercooked meat, or open wound/GI/respiratory mucosal contact with cattle?
- Doxycycline (+aminoglycoside, rifampin, or fluoroquinolone)
- To treat brucellosis
91
Diagnostic test for candida albicans infection
- Pseudo-hyphae, budding yeast on KOH microscopy
- 1-3-B-D antigen
92
Symptoms of giardiasis
- Watery diarrhea
- Abdominal cramps, malodorous stools, flatulence
93
What treatment is given for level 3 urticaria (hives)?
- 2nd generation antihistamine *4x regular dose*
94
Which condition is also known as "valley fever"?
- Coccidioidomycosis
95
Best diagnostic test for malaria
- Blood smear with microscopy
(also see anemia, thrombocytopenia, LFTs)
96
Symptoms of toxoplasmosis
Immunocompetent patients:
- A few days fever/malaise
- Then painless lymphadenopathy (bilateral, nontender, cervical)
Immunosuppressed patients:
- CNS effects: encephalitis, seizures, cranial nerve deficits, altered mentation
- Hepatitis, uveitis, myocarditis, pericarditis, polymyositis, pneumonitis (all over the body)
97
In what part of the world are you most likely to catch yellow fever?
- Central/south America
- Sub-Saharan Africa
98
Which of the following can cause erythema nodosum?
- Histoplasmosis
- Blastomycosis
- Coccidioidomycosis
- Sporotrichosis
- Coccidioidomycosis
99
Symptoms of sporotrichosis
- Starts with minor skin trauma
- Cutaneous nodule that spreads into lymphatics
- Leads to abscess and ulcers
100
What are three broad categories of anaphylaxis triggers?
- Medications
- Foods
- Insect stings
(drugs, bugs, and grub)
101
Which condition is caused by bites from the lone star tick?
- Human ehrlichiosis
102
What is the most concerning complication of West Nile virus?
- Encephalitis
103
What disease is caused by plasmodium falciparum?
- Malaria
104
Diagnostic criteria for chronic rhinosinusitis
- Duration of symptoms >12 weeks
- Requires clinical history *and* sinus inflammation on CT scan or nasal endoscopy
105
How is West Nile virus (encephalitis) transmitted?
- Culex mosquitoes
- Also blood transfusions, organ transplants, transplacental, breast feeding, lab exposure
106
What is the treatment for the infection that is diagnosed using urea breath testing, stool antigen, and endoscopy?
- PPI + amoxicillin + metronidazole (or clarithromycin)
- Treating helicobacter pylori
107
How can you use symptoms to differentiate between rocky mountain spotted fever and human ehrlichiosis?
- Same symptoms apart from *rash*
- Human ehrlichiosis *has no rash*
- Both have fever and headache
108
Is chronic urticaria more common in adults/children and males/females?
- More common in adult females
109
Which condition is associated with the Faget sign, and what is it?
- Yellow fever
- Bradycardia with fever (normally fever causes tachycardia)
110
Deficiency of C1-esterase inhibitor leads to angioedema in this area of the body
- Gut wall = severe abdominal pain, symptoms of acute abdomen
111
Treatment for pneumocystis jirovecii
- IV bactrim
112
Treatment for allergic rhinitis *nasal* symptoms
- Nasal steroid sprays most effective for congestion
- Nasal antihistamine sprays
- Saline sinus rinses
- Leukotriene receptor antagonists
- Oral antihistamines (2nd gen)
- Oral decongestants (short term)
- Corticosteroids (short-term, only use if severe)
113
How is someone likely to become infected with francisella tularensis (tularemia)?
- Associated with dressing and eating animals
- Contracted from rabbits or ticks that live on rabbits
114
Which of the following can cause skin and mucus membrane papules when disseminated?
- Histoplasmosis
- Blastomycosis
- Coccidioidomycosis
- Sporotrichosis
- Histoplasmosis
115
Diagnostic tests for cryptococcus neoformans
- Lumbar puncture: elevated opening pressure, low glucose, high protein
- 1-3-B-D negative
- Serum cryptococcal antigen (CrAg)
116
The timing of allergic rhinitis symptoms can suggest particular allergies.
What are some major seasonal and perennial environmental allergens?
Seasonal (outdoor)
- Grass/weed/tree pollen
- Mold
Perennial (indoor)
- Dust mite
- Cockroach
- Cat/dog
- Mouse
- Mold
117
Which infection, related with the ingestion of undercooked chicken, has the potential complication of an ascending paralysis?
- Campylobacter
- Ascending paralysis = Guillain-Barre syndrome
- Salmonella also associated with chicken, but no paralysis
118
Most common pathogens (bacterial and viral) involved in acute rhinosinusitis
Bacterial
- S. pneumoniae
- H. influenzae
- S. suppurativa
- M. catarrhalis
Viral
- Rhinovirus
- Coronavirus
119
Physical exam findings in acute rhinosinusitis
- Pain to palpation/percussion over sinuses
- Pain with bending over
- Thick, purulent secretions
- Visible post-nasal drainage
- Mucosal edema and erythema
- Turbinate swelling
- Polyps
120
Risk factors for sporotrichosis infection
- Alcoholism, diabetes, COPD, HIV infection
121
In which of these infections is fever and abdominal pain often *absent*?
- Campylobacter
- Salmonella
- Shigella
- Yersinia enterocolitica
- Vibrio cholerae
- Vibrio cholerae
122
Which infection, most commonly seen in the northeast US, causes fatigue and fever (no rash), and is associated with "Maltese cross" RBCs on blood smear?
- Babesiosis
123
Treatment for allergic rhinitis *ocular* symptoms
- OTC antihistamine-decongestant drops (short term)
- Topical antihistamines +/- mast cell stabilizers
- Oral antihistamines
- Topical NSAIDs such as ketorolac
- Topical corticosteroids or short course oral steroids for severe symptoms
124
Which form of typhus, the one caused by rickettsia typhi or the one caused by rickettsia prowazekii is more severe?
- Rickettsia prowazekii (causes epidemic (louse-borne) typhus)
125
Symptoms of rabies
- Initially pain/paresthesia (tingling) at bite site with fever, headache, malaise
- Encephalitis eventually: restlessness, bizarre behavior, insomnia
- Hydrophobia and excessive salivation
126
Symptoms of encephalitis due to West Nile virus
- Headache, myalgia, GI complaints, erythematous macular, popular morbilliform rash
127
Symptoms of rocky mountain spotted fever
- Fever, headache, and a rash that begins on extremities and spreads to trunk
- Rash doesn't show until day 3-5 of illness (so don't wait for rash to start treatment!)
128
Which parasitic infection causes an itchy foot rash after walking in soil contaminated with human excrement?
- Hookworms (ancylostoma & necator)
129
What is the most common manifestation of cryptococcus neoformans infections in AIDS patients?
- Meningitis
130
Apart from the oropharynx, esophagus, and genitals, where else in the body might an immunocompromised patient be infected with candida albicans?
- In the blood/hematogenous: candidemia
- Causes skin/eye lesions, also joint, brain, heart, lung, liver, spleen issues
131
Which infection is associated with massive watery diarrhea with flecks of mucus, described as "rice water stools"?
- Vibrio cholerae
132
What are the unique symptoms of yersinia enterocolitica?
- RLQ pain and pharyngitis
- Also fever, diarrhea
133
Anaphylaxis involves more than one of these five organ systems
- Cutaneous
- GI
- Cardiovascular
- Respiratory
- Neurologic
134
Which symptoms are seen in both hookworm and roundworm infections?
- Abdominal pain
- Diarrhea
- Nausea/vomiting
135
Which infection, seen in immunocompromised patients, has symptoms of painful swallowing, loss of taste, "cottony" feeling in the mouth, retrosternal pain?
- Oropharyngeal/esophageal candidiasis (candida albicans)
136
After ingesting lake water your patient presents with watery diarrhea, what is the quickest test to confirm the suspected diagnosis, and how will you treat it?
- Antigen detection assay (better than stool O&P)
- Tinidazole to treat giardiasis
137
What are the most common food causes of acute urticaria/anaphylaxis?
- Cow's milk
- Egg
- Peanut/tree nut
- Soy
- Wheat
- Fish/shellfish
- Sesame
138
Who is most at risk of developing encephalitis from West Nile virus?
- Over 50, immunocompromised
139
What are protozoans?
- Single-celled eukaryotes
- Parasites
140
This infection, associated with ingestion of chicken, eggs, or milk, causes non-bloody diarrhea in adults and bloody diarrhea in children, as well as nausea, vomiting, and fever.
- Salmonella
141
Physical exam findings of congenital toxoplasmosis
- Chorioretinitis most common
- Hydrocephalus and fever
- Intracranial calcification, hearing loss, jaundice, developmental delays
142
Blastomycosis infections are normally asymptomatic except in the cases of immunosuppression. What symptoms do these people get with their severe infection?
- Pulmonary: fever, cough, pulmonary infiltrate, weight loss, night sweats, and fatigue
- Disseminated: cutaneous lesions, well circumscribed nonpainful papules, nodules, or *plaques* mostly on face and extremities
143
Treatment for toxoplasmosis
Immunocompromised:
- Pyrimethamine and sulfonamides
Pregnant mothers:
- Spiramycin or pyrimethamine-sulfadiazine
Congenital disease:
- Spiramycin, sulfadiazine, leucovorin
144
Which condition, associated with sheep or goat farming, can cause influenza like symptoms, followed by interstitial pneumonitis?
- Q fever
145
What is dermatographism?
- Wheal and flare (urticaria) after stroking/scratching/rubbing the skin
146
Which infection, associated with unsanitary water ingestion, can cause liver abscesses?
- Amebiasis
- Liver abscesses most common in men 40-60
147
How to prevent toxoplasmosis infection
- Avoid raw/undercooked pork/lamb
- Don't touch cat litter
148
Which infection is associated with "pruritis ani" at night?
- Pinworms (enterobius vermicularis)
149
Why should IgE skin testing not be performed in a "screening" fashion to find a specific trigger of anaphylaxis?
- False positives lead to unnecessary avoidances/lifestyle changes
150
Treatment for rhinosinusitis
- Saline irrigation
- Intranasal glucocorticoids
- OTC NSAIDs or acetaminophen
- Oral decongestants/mucolytics
Antibiotics
- Amoxicillin/augmentin
- Doxycycline or fluoroquinolone is PCN allergy
ENT referral if chronic/treatment failure
151
Treatment used in refractory chronic idiopathic urticaria in patients aged 12+ who failed high dose antihistamine treatment
- Omalizumab (xolair)
152
Which bacteria causes epidemic (louse-borne) typhus?
- Rickettsia prowazekii
153
What condition, caused by eating infected pork, seen most commonly in Europe (and Russia), is treated with mebendazole?
- Trichinellosis
(yersinia enterolitica also caused by pork in Europe, but not treated with mebendazole, is self-limited)
154
Symptoms of trichinellosis
Intestinal phase:
- asymptomatic to n/v/constipation/abdominal pain
Muscle phase:
- facial edema, hemorrhages, *myalgias*, muscle edema
155
What lab abnormalities would you expect to see in a case of rocky mountain spotted fever?
- Elevated aminotransferases and bilirubin
- Thrombocytopenia eventually
- Hyponatremia if severe
- Normal WBC
156
Where is a person most likely to catch amebiasis (amebic dysentery)?
- India, Africa, Mexico, C/S America
- Areas with poor water supply sanitation
157
What is the name of the bacteria that causes rocky mountain spotted fever?
- Rickettsia rickettsii
158
Which of the following is 1-3-B-D antigen *negative*?
- Candida albicans
- Cryptococcus neoformans
- Pneumocystis jirovecii
- Aspergillus fumigatus
- Cryptococcus neoformans
159
Which infection is associated with the inhalation of dust/soil contaminated with *bat/bird droppings*?
- Histoplasmosis (histoplasma capsulatum)
160
Name as many tick-borne illnesses as you can (4)
- Rocky mountain spotted fever
- Human ehrlichiosis
- Francisella tularensis (tularemia)
- Babesiosis
161
Which virus causes vomiting, can be found in pools, and is tested for using PCR, and a stool exam that has no leukocytes?
- Norovirus (the winter vomiting disease)
162
Which parasitic infection is associated with eosinophilia, elevated muscle enzymes, and is diagnosed with muscle biopsy?
- Trichinellosis
163
Which condition is associated with the Romana sign?
- Trypanosomiasis
- Romana sign = chagoma (edema) near eye from bite of kissing bug
164
What infection is caused by kissing bugs?
- Trypanosomiasis (Chagas disease)
165
Symptoms of trypanosomiasis
Acute form:
- fever, lymphadenopathy, edema near bit site ("chagoma", Romana sign if near eye)
Chronic form:
- Heart and GI issues
- Most common cause of non-ischemic heart failure worldwide
166
Treatment for salmonella
- Rehydrate: water + salt + sugar
- Antibiotics if severely ill: ciprofloxacin, azithromycin, bactrim
167
Symptoms of allergic rhinitis/conjunctivitis
- Nasal congestion
- Clear rhinorrhea
- Postnasal drip
- Sneezing
- Nasal itching
- *Bilateral* itchy/burning eyes
- Watery/stringy discharge from eyes
168
In which part of America are you most likely to see coccidioidomycosis?
- Southwest USA
- Northern Mexico
169
If a patient in an anaphylactic episode does not respond to an epinephrine injection, what should you try next?
- Repeat dose every 5 minutes as needed
170
Candida albicans treatments
- Topical: nystatin
- Systemic: fluconazole
171
What is the primary effector cell involved in urticaria and angioedema reaction?
- Mast cell
172
Which of the following are inclusion and which are exclusion criteria for urticaria (hives)?
- Blanching
- Blisters
- Central swelling/surrounding erythema
- Fever
- Persists <24 hours
- Petechiae/purpura
- Pruritic
- Severe joint pain
Inclusion
- Blanching
- Central swelling/surrounding erythema
- Persists <24 hours
- Pruritic
Exclusion
- Blisters
- Fever
- Petechiae/purpura
- Severe joint pain
173
Treatment for the infection associated with buboes in the groin/axilla
- Aminoglycoside (or fluoroquinolone or doxycycline)
- To treat yersinia pestis
174
Which people are more at risk of ACE inhibitor angioedema?
- African Americans = 5x more risk
175
Which infection is associated with flying squirrels in the US?
- Epidemic (louse-borne) typhus
176
Where in America are you most likely to contract murine (endemic) typhus?
- Texas (also California, and Hawaii)
177
Treatment for amebiasis
- Metronidazole + intraluminal paromomycin
178
What type of urticaria is caused by an *increase* in core body temperature?
- Cholinergic urticaria
179
Treatment for francisella tularensis (tularemia)
- Streptomycin or gentamycin
180
Symptoms of coccidioidomycosis
- Pulmonary: asymptomatic to pneumonia symptoms and *erythema nodosum*
- Disseminated: asymptomatic to skin, bone, SQ tissue, and meninges infections
181
Which lab test is the best for confirming a diagnosis of epidemic (louse-borne) typhus?
- IFA assay (antibodies)
182
How long do acute and chronic sinusituses last?
- Acute = <4 weeks
- Chronic = >12 weeks
