exam 3

Question 1

pneumocystis

Answer 1

possibly airborne

fever, dyspnea, nonprod. cough

Question 2

cryptoccosis

Answer 2

MCC of fungal meningitis

inhaled budding yeast in soil and dried pigeon DUNG

Question 3

histoplasmosis

Answer 3

soil with bird/bat droppings inhaled
common in river valleys
mild flu like illness 1-4 days
military pattern on CXR

Question 4

aspergillosis

Answer 4

MCC of non candidal fungal infections in organ transplant and stem cells
CT “halo scan”

Question 5

coccidoidomycosis

Answer 5

inhaled mold in southwest US, Mexico, central America
knee and ankle swelling
erythema nodosum

Question 6

fragile X s/s

Answer 6

S/S-
•	Autism, impulsivity, aggressiveness, repetitive behaviors
•	Macro-orchidism 
•	Large ears
•	Prominent jaw

Question 7

Kleinfelter

Answer 7

XXY
•	Long arms/legs
•	Sparse body hair
•	Small testes
•	Infertility

Question 8

Lyme disease: s/s and tx

Answer 8

ticks!
red patch with clear margin
mild fever, HA, stiff neck
neuro s/s
joint involvement
TX: doxy

Question 9

Rocky mtn spotted fever: s/s and tx

Answer 9

ticks!
frontal HA
rash 3-5 days of illness, red macules
chills
tx: 7 days doxy/tetra

Question 10

chronic fatigue syndrome

Answer 10

new onset relapsing/persistent fatigue lasts at least 6 consecutive months’ w/o hx fatigue

Question 11

heat stroke

Answer 11

Temp over 105 F, altered sensorium, coma, cessation of sweating *MUST rapidly cool

Question 12

mucosal candidiasis s/s

Answer 12

1- esophageal involvement
-Odynophagia, gerd, Nausea
2- vulvovaginal candidiasis
-pregnancy, dm, antibx, corticosteroids,
-W/ itching, burning, dysuria (Most women 75%)

Question 13

candidal fungaria s/s

Answer 13

• Mostly asymptomatic and from contamination

- Indistinguishable from bacterial UTI (urgency, chills, hesitancy, fever, flank pain)

Question 14

Macrocytic anemias

Answer 14

Pernicious anemia & Folate deficiency

Question 15

Microcytic anemias

Answer 15

IDA & Thalassemia

Question 16

IDA s/s

Answer 16

Beefy red tongue, difficulty walking, paresthesias, lemon yellow skin

Question 17

Folate deficiency s/s

Answer 17

MC occurrence in ETOH abusers and chronic malnourishment

s/s: smooth thick tongue, cheilosis, stomatitis

Question 18

Aplastic anemia

Answer 18

characterized by pancytopenia

Question 19

Polycythemia vera

Answer 19

Elevated RBC, WBC, and platelets; HA, tinnitus, fatigue, sweating, pruritus after warm bath, gouty joint symptoms, deep red appearance (ruddy), thrombus risk
tx: remove blood and replace with normal saline

Question 20

CML

Answer 20

Philadelphia chromosome marker, median age 55 years, fatigue, night sweats, chronic low-grade fever

Question 21

AML

Answer 21

primarily an adult disease, large number of blast cells, treat with chemo

Question 22

CLL

Answer 22

Disease of older patients, hallmark is isolated lymphocytosis & wbc over 20,000

Question 23

HIV stages/tests

Answer 23

Elisa & western blot

1. ) after transmission: 2-8 weeks flu-like illness
2. ) asymptomatic sero: will have + test but no s/s, lasts for 4-8 years
3. ) symptomatic sero: lymphadenopathy, fungal infections, oral hairy leukoplakia, warts, molloscum, night sweats, wt loss, diarrhea; last 1-3 years
4. ) AIDS: significant immune depression, CD4 cells low

Question 24

cervical lymph node enlargement?

Answer 24

head and neck infections, pharyngitis, dental abscess

Question 25

supraclavicular lymph node enlargement?

Answer 25

usually indicates malignancy, immediate referral to general surgery for biopsy

Question 26

axillary lymph node enlargement?

Answer 26

breast cancer or cat scratch fever (don nuh nuh)

Question 27

(herb) echinacea

Answer 27

cold s/s; immune booster

Question 28

cinnamon

Answer 28

used for DM, hyperglycemia

Question 29

fish oil

Answer 29

hyperlipidemia

Question 30

garlic

Answer 30

hyperlipidemia

Question 31

red yeast rice

Answer 31

hyperlipidemia

Question 32

st. john’s wort

Answer 32

depression