ID

Question 1

tx of active TB?

tx of latent TB?

Answer 1

active TB → Tx SPIRE (streptomycin, pyrazinamide, INH, rifampin, ethambutol) for 2 months, then INH + rifampin for 4 months

latent TB → Tx INH only

Question 2

HAV:
route?
buzzwords?
dx?

Answer 2

fecal-oral

Asx (usually), daycare, travel

dx HAV IgM = acute infx
HAV IgG = previous infx or immunity

Question 3

HBV:
route?
buzzwords?
dx?
tx?

Answer 3

parenteral or sexual

polyarteritis nodosa, MGN

Dx HBsAg = acute/chronic infx
HBsAb = previous infx or immunity
HBeAg = infectivity
HBcAb IgM = window period

Tx IFN-α

Question 4

HCV:
route?
buzzwords?
dx?
tx?

Answer 4

parenteral

Cryoglobulinemia, Chronic infx, Cirrhosis, Carcinoma, Carriers, IVDA, MPGN

Dx HCV RNA

Tx IFN-α + ribavarin, liver txp if severe

Question 5

HDV:
route?
buzzwords?
dx?
tx?

Answer 5

parenteral or sexual

Deadly, HBV co-infection

Dx HDV Ab

Tx IFN-α

Question 6

HEV:
route?
buzzwords?
dx?

Answer 6

fecal-oral

cruise ships, fatal in pregnancy

Dx HEV Ab

Tx supportive care

Question 7

Diarrhea × fever/blood:

Answer 7

Shigella, Salmonella, Campy, EHEC

Question 8

Diarrhea × mayonnaise:

Answer 8

Staph aureus (<6 hrs), Salmonella

Question 9

Diarrhea × raw chicken:

Answer 9

Salmonella, Shigella

Question 10

Diarrhea × raw seafood:

Answer 10

Vibrio, Salmonella, hep A

Question 11

Diarrhea × travel:

Answer 11

ETEC

Question 12

Erysipelas:
organism?
tx?

Answer 12

Strep pyogenes

Tx PCN or erythromycin

Question 13

Toxic shock syndrome:
presentation?
tx?

Answer 13

fever, rash, desquamation of palms/soles

admit + stabilize + IV nafcillin (prevents recurrence, not current toxin-mediated illness)

Question 14

Disseminated gonoccocal: presentation?

Answer 14

migratory polyarthritis, endocarditis, skin rash

Question 15

Jarisch-Herxheimer rxn =

Answer 15

acute febrile rxn s/p syphilis tx (MC w/ 2° syphilis), due to dead spirochetes → endotoxin release

Question 16

Chancroid:
organism?
presentation?
dx?
tx?

Answer 16

Haemophilus ducreyi

painful chancre + inguinal LN-opathy

Gram stain (“school of fish” appearance)

Tx azithromycin or ceftriaxone

Question 17

Herpetic whitlow =

Answer 17

painful, paronychia-like lesions in fingers of healthcare workers

Question 18

Arthritis × IVDA:

organism?

Answer 18

Pseudomonas

Question 19

Rocky Mountain spotted fever:
presentation?
tx?

Answer 19

triad of HA + fever + rash (vasculitis that starts on extremities and comes inward)

doxycycline

Question 20

Malaria:

presentation?

Answer 20

cyclic fever/chills, headache, anemia, splenomegaly

Question 21

Rabies:

dx?

Answer 21

Dx viral cx, Negri bodies on Purkinje cell bx

Tx emergent passive + active immunization

Question 22

Giardiasis:

tx?

Answer 22

metronidazole

Question 23

Amebiasis:
organism? 
presentation?
dx?
tx?

Answer 23

Entamoeba histolytica

• flask-shaped ulcers in ascending colon → bloody diarrhea
• “anchovy paste” abscess in liver → RUQ pain

Dx stool sample

Tx metronidazole (for diarrhea and abscess)

Question 24

Cryptosporidiosis:

dx?

Answer 24

acid fast stain

Question 25

Ascariasis: can cause... tx?

Answer 25

bowel obstruction mebendazole

Question 26

Hookworm: can cause... tx?

Answer 26

iron-deficiency anemia mebendazole

Question 27

Tapeworm: can cause... tx?

Answer 27

D. latum eats vitamin B12 → macrocytic anemia praziquantel *Taenia saginata (beef), Taenia solium (pork), Diphyllobothrium latum (fish)

Question 28

Schistosomiasis: S. mansoni/japonicum cause... S. haematobium causes... tx?

Answer 28

S. mansoni/japonicum cause fibrosis of liver and spleen S. haematobium causes bladder infx → dysuria, bladder SCC praziquantel

Question 29

Cryptococcosis: found in... dx? tx?

Answer 29

pigeon droppings Dx LP + India ink stain (thick capsules) Tx IV ampho B + flucytosine

Question 30

Histoplasmosis: found in... dx? tx?

Answer 30

bat/bird droppings in caves Dx bx (macrophage-filled spores) Tx itraconazole

Question 31

Blastomycosis: presentation? dx? tx?

Answer 31

inflammatory lung dz, granulomatous nodules in skin and bone Dx bx (Broad Based Buds) Tx itraconazole

Question 32

Coccidioidomycosis: a/w... dx? tx?

Answer 32

s/p earthquakes in SW US (mild resp symptoms) Dx bx (huge spherule w/ endospores) Tx itraconazole

Question 33

Sporotrichosis: | tx?

Answer 33

itraconazole or potassium iodide