ID Flashcards
(153 cards)
1
Q
MCC of bacterial meningitis
A
Strep pneumoniae
H.influenza
N. meningitidis
2
Q
Rx of meningitis
A
Ceftriaxone + Vancomycin
If elderly, neonate or immunocompromised add ampicillin for listeria.
3
Q
Organism in pylonephritis from blood?
A
Staph
4
Q
What to do if pylonephritis caused by staph?
A
Look for focus of infection and culture blood.
5
Q
Hx of travel to South America / Mexico + bloody diarrhea? (Organism)
A
Entamoeba histolytica colitis
6
Q
Amebic colitis classic
A
Gradual onset 1-2 weeks Diarrhea Watery / bloody diarrhea Abdominal pain Fever
7
Q
Rx of influenza + exception
A
Sx < 48 HR
Oseltamivir
Sx > 48 HR
Symptomatic
Rx required for all patient worsening even if it’s > 48 HR.
8
Q
Rx of suspect MRSA in endocritis?
A
IV vancomycin + gentamicin
9
Q
Influenza like classic
A
Sudden
Fever + dry painful cough
Similar findings in family/household
Prostration = exhaustion
10
Q
Risk in herpes zoster ophthalmicus?
A
Corneal infection due to involvement of nasociliary branch of V1
11
Q
Elderly in nursing home with asymptomatic bacteriuria?
A
No need for Rx
12
Q
Risk ass w/ Strp bovis?
A
Colon Ca
13
Q
Rx of herpes zoster
A
High dose acyclovir 800 mg 5xday
14
Q
1st line in otitis media
A
Amoxicillin
15
Q
Rocky Mountain spotted fever classic
A
Camper/hiker
Tick
Rash moves centrally
Paralysis
16
Q
Where is Rocky Mountain spotted fever?
A
Canada: British Columbia + saskatchewan
US: North Carolina + Arkansas + Missouri + Tennessee + Oklahoma
17
Q
Rx of scabies
A
5% permethrin > lindane
Lindane has neurotoxic SE
18
Q
Why a strep pharyngitis must be Rx?
A
Prevent rheumatic fever
19
Q
Staph food poisoning
A
Start 1-6 hr after meal
Resolves 1-2 days
20
Q
Indication of sever or lethal Rocky Mountain spotted fever
A
High creatinine due to renal failure
21
Q
Predictor of vancomycin efficacy
A
Trough serum level > 10mg/L to prevent development of bacterial resistance
22
Q
What derm disease associated w/ GAB infection
A
Guttate psoriasis
23
Q
Center criteria for pharyngitis
A
Tonsillar exudate Tender cervical LN Fever No cough If > 2 points Rx w/ Abx 0-2 Rx symptomatic
24
Q
Splenectomy increases risk of what infections?
A
Encapsulated organisms: S. pneumoniae HiB E. coli Staph Salmonella Klebsiella and
25
Hx of tick bite? Management
Remove parasite w/in 24-48 HR
| By: medium tipped angled forceps
26
Trichinosis classic
10-15 days Hx of infection
1st = diarrhea
2nd = sever muscle weakness +/- CNS
27
Dx trichonsis
Muscle biopsy shows trichinella spiralis.
Other:
High CK
High eosinophils
High LDH
28
Dx of pseudomemebrenous colitis
Stop antibiotics
| Start metronidazole
29
When to use oral vancomycin in pseudpmembrenous colitis?
Pregnancy / breastfeeding
Allergy to metro
Recurrent not responsive to metro
30
Subacute / atypical pneumonia + EM rash + hemolysis + low Na (organism)
Mycoplasma pneumonia
31
Legionella pneumonia clues
1. Immunocompromised
2. Hotels, water tanks
3. Hepatic involvement
4. Low Na + Low PO4
32
HIV classic
```
Young
Oral thrush
Ulcerative esophagitis
Weight loss
LN
```
33
MCC of HIV
Drug use
34
MCC of ulcerative esophagitis in HIV
CMV
| HSV
35
Risk of pneumocystic jirovecii pneumonia?
In HIV (CD4 <200)
36
Rx of C. Botulinum
Antitoxin against neurotoxin A,B,C
37
MCC of bacteremia in elderly?
UTI
38
Risk of pneumocystic jirovecii pneumonia?
In HIV (CD4 <200)
39
MCC of c. Botulinum
Home - canned foods
Preservative that reduce oxygen like vacuum packaging
40
Sx of C. Botulinum
Bulbar paresis:
Dysarthria
Dysphonia
Flaccid facial expression
41
Rx of H. Pylori
Triple Rx for 14 days
Amoxicillin
Clarithromycin
Omeprazole
Other:
BMT = bismuth, metro, tetra
LAC = lansoprazole, amoxicillin, clarithromycin
42
Dx C. Diff
C. Diff cytotoxin essay
43
Dengue Fever
3-14 days Hx of travel to tropical area
+/- Hx of mosquito bite
Pro dorm: erythema mottling, facial flushing
Classic Sx:
Sudden fever, chills <10 days.
Sever headache (breakbone)
Maculopapular or petechial rash
44
Anti-TB needs acidic environment
Pyrazinamide
It's inactive at natural PH 7.4
Work on acidic phagosomes of macrophages PH 5 I.e extra cellular TB
45
EBV association
Burkitts lymphoma
Hodgkin's lymphoma
Large B cell lymphoma
Nasopharyngeal carcinoma
46
Rx of TB
```
8 weeks of:
Rifampin
Isoniazid
Ethambutol
Pyrazinamide
```
47
Infection from rabbits
Tularemia (Francisella tularensis)
48
Rx of tularemia
Streptomycin
49
Dx osteomyelitis
MRI
50
Leprosy classic
AFB +ve
De pigmentation
Loss of fine touch and pain sensation
Disfigured feature due to cartilage infection and granuloma formation
51
Prophylaxis in HIV+ve?
If CD4
< 200 PCP prophylaxis
< 100 toxoplasmosis
< 50 M. Avium
52
Opportunistic infection prophylaxis in HIV
Aziyhromycin for M. Avium
53
What must be r/o before TB prophylaxis
Active TB
54
HSV encephalitis location
Temporal area
55
Sx of HSV encephalitis
Gustatory hallucinations
| Confusion
56
How C. Botulinum causes disease
Works on polysialoganglioside receptor
57
Rx of URTI with strep. Pneumoniae
Erythromycin
58
Most abundant site for HIV replication
GI tract
59
T/F: serum sickness reaction after HBV
T
60
Cause of ehrlichiosis
Lone star tick
| Ixodes tick
61
Rx of pertussis
1st line Macrolides
| 2nd line TMP/SMX
62
Cat scratch disease classic
Few red papules at site of scratch
Painful LN
+/- hepatosplenomegaly
63
Rx of travelers diarrhea
Fluroquinlones 1-3 days
64
What's not a sign of pharyngitis?
Cough
65
What's periodontitis? Rx?
Tooth's roots infection + cellulitis + apical abscess.
Rx: clindamycin, amoxici/clav
66
What's walking pneumonia
Pneumonia doesn't cause patient sever symptoms (patient not confined to bed)
67
Cause of walking pneumonia
M. Pneumoniae
68
+ve PPD in HIV?
> 5 mm
69
What antibiotic not assisted with C. Diff and food for pneumonia
Macrolides
70
Use of chloride in CSF
Dx TB (low in TB)
71
Diarrhea in HIV? MCC
Cryptosporidiosis
72
Prophylaxis against chloroquine-resistant malaria?
Mefloquine
73
Contraindication to mefloquine?
Epilepsy
74
Necrotizing fasciitis
```
Fever
Pain sever
Tenderness
Edema
Bronzed skin
Poorly controlled DM
```
75
Necrotizing fasciitis in perineum called?
Fournier gangrene
76
Rx of necrotizing fasciitis
Surgical debridement + IV antibiotics
77
When to biopsy isolated LN?
> 3 cm
Supraclavicular LN
Constitutional Sx
Patient with risk of malignancy
78
Approach non-tender isolated LN
Wait for 4-6 weeks
79
MCC of pneumonia in HIV
P. Jirovecii
| P. Carinii
80
Dx IE?
Blood cultures
| Transthoracic echo
81
When to go for surgery in IE?
CHF from infection
Abscess
Persistent infection despite RX
82
Antiviral contraindicated in COPD and asthma
Zanamivir
83
Rx of latent TB
Isoniazid mono therapy 9 months.
84
Is rifampin used for LTB in HIV?
No, due to resistance + drug reaction
85
Infection with intermediate host?
Tapewarm (diphyllobothrium latum)
86
Risk factors for necrotizing fasciitis
```
Age > 50
Atherosclerosis
Burn, trauma, post-op
Cancer
Steroids use
DM
Low albumin
IV drugs + alcoholism
```
87
Osteomyelitis classic
Localized pain
Constitutional Sx
Erythema
Tenderness
88
Cause of staph diarrhea
Poultry
| Sliced meat, pudding, egg
89
Dx cryptosporidium
AF stain of stool
90
In HIV + CNS Sx you sus?
Toxo
91
MCC of acute bacterial diarrhea?
Campylobacter > salmonella > E. coli > shigella
92
MC site of osteomyelitis
Foot
93
If you sus pneumonia what to do next?
CXR to confirm
| Rx of hypotension in sepsis
94
Rx of low BP in sepsis
IVF
If fails: vasopressors
Norepinephrine > dopamine
95
Areas of Lyme disease
Ontario
Quebec
New Brunswick
Nova Scotia
96
Dx Lyme disease
ELISA for borrelia burgdorferi
97
Rx Lyme disease
IV ceftriaxone
98
Pain killer contraindicated in sulfa allergy
Celecoxib
99
Timing in chronic vs acute diarrhea
Acute < 15 days
| Chronic > 15 days
100
Types of chronic diarrhea
Watery (osmotic or secretory)
Inflammatory
Fatty
101
Giardiasis classic
```
Malodorous
Greasy stool
WBC < 5/hpf
PH < 5
Use of PPI (low CL)
```
102
Pneumonia
Adolescent / child
Bilateral lower lobe infiltrates
Cold agglutination (organism?)
Mycoplasma peunomniae
103
Legionella pneumonia classic
Pneumonia
+ GI diarrhea Sx
Water exposure (cruise)
Air conditioner (hotel / business building)
104
Organism in cat scratch disease
G-ve
| Bartonella Hensela
105
Rx of cat scratch disease
Supportive
106
MCC of skin infection in DM (Rx or not Rx)
- Previously Rx: polymicrobial
| - Never Rx: staph + strept.
107
Hx / FHx of hemochromatosis
Lymphangitis
GI Sx (diarrhea, RLQ)
Yersinosis
108
Causes of enlarged mesenteic LN?
E. Coli
If Hx hemochromatosis = yersinia
109
Cause of mucormycosis?
Fungus Rhizopus
Mucor
Absidia
110
Rx of mucormycosis
Debridement
| IV amphotricin B
111
Toxic sock syndrome.
Fever
Low BP
Erythema and diffuse macular rash involving palms + soles.
112
Rx of lung abscess
Clindamycin
113
Instructions to infectious mono patients
Stop contact sports until exam is normal and spleen is regressed to its normal size.
114
MCC of diarrhea on cruise
Norwalk virus
115
Rx of asymptomatic bacteriuria in pregnant
Nitrofurantoin
116
MOA of nitrofurantoin
Reduce bacterial flavoprotein = inactivate and alter bacterial ribosomal proteins.
117
Best way to determine stage of HCV?
Liver biopsy
118
HIV + pneumonia + encephalitis + retinitis?
| Organism
CMV
119
Dx Pneumocystis jirovecii
HIV
| Patchy infiltrate on CXR
120
Rx of pneumocystis jirovecii
IV TMP/SMX
121
Complications of otitis media?
Cholesteatoma
Meningitis
Tympanic membrane rupture
Conductive hearing loss
122
a 24hr virus causes diarrhea?
Norovirus / Norwalk virus
123
MCC of non bloody diarrhea
Campylobacter
124
Hantavirus infection classic drug
2 syndromes:
```
- HFRS:
Fever, headache, back pain
Petechial rash
Renal failure (hematuria + proteinuria)
Rx: IV ribavirin
```
```
- HPS:
Deer mouse
Fever, maylagia, resp Sx, GI Sx
Pulmonary edema
Rx: supportive (ribavirin not effective)
```
125
Where to expect hantavirus
Colorado
Arizona
Rural areas
126
2ry syphilis rash
Rash on trunk, palms and soles
| With patch hair loss
127
Stain for 2ry syphilis
Warthin-Starry silver stain is
128
Rx of CAP (Rx or never Rx)
1. Never Rx:
Macrolides esp. azithromycin
2. On Abx last 3 months:
Flouroquinolone
129
What electrolyte imbalance not seen in TSS?
High Ca
130
Organisms could cause lung abscess
```
Pseudomonas
Klebsiella
Staph
Strept. Pneumoniae
Nocardia
```
In HIV: PCP
131
Which serum protein is low in sepsis?
Albumin
| Transferrin
132
High proteins in sepsis?
```
Complement
Haptoglobin
Fibrin split
CRP
Ferritin
```
133
Nursing home acquired pneumonia Rx
Cover G-ve
| Levofloxacin
134
Types of typhus?
Endemic
| Epidemic
135
Other name from r endemic typhus?
Murine typhus
136
Transmission of epi vs endemic typhus
Endemic: rat or cat flea
Epidemic: body lice (louse infestation) + rarely flying squirrels
137
Location of endemic vs epidemic typhus
Endemic: southwest US (New Mexico)
Epidemic: Continent of South America
138
Sx of epi vs endemic
Both fever, chills, headache + rash
Endemic: maculopapular rash
Epidemic: 1st: small pink macule then erythematous maculopapular rash.
139
Dx epi vs endemic typhus
Biopsy rash
140
Rx of epi vs endemic typhus
Doxycycline 200 mg day 1 then 100 mg BID for 7 days
141
Prevention of epidemic typhus?
Louse control
142
What's Brill-Zinsser disease?
Recurrent for of epidemic typhus
143
Epi/endemic typhus vs typhoid (Sx)
All: fever, headache, pains, rash, cough
Epi: maculopapular rash + low BP
Endemic: erythematous maculopapular rash moves peripherally + hacking cough.
Typhoid: rose colored patches on trunk + worsening cough + green "pea-soup" stool
144
Where to get Vibrio Vulnificus?
Raw oyster
| Shellfish
145
Who's at risk of vibrio vulnificus
Alcoholics
CKD
Liver disease
146
Classic vibrio vulnificus?
Watery diarrhea = hypotension
Fever / chills
Rash (bullous)
147
Dx vibrio vulnificus
Blood/stool culture
148
Rx of vibrio vulnificus
Cipro
Or
Doxy
+
IVF
149
Organism in histoplasmosis
Histoplasma capsulatum
150
Classic histoplasmosis
Wooded areas;
- Ohio, Mississippi, penn, NY, Maine
1. Associated with birds / bats litters (farmer, cave, woods)
2. Fever, dry cough, B Sx
3. Erythema nodosum
151
Dx histoplasmosis
- CXR = mass + LN
- Tissue biopsy
- C/S of blood, sputum, urine
- Ag testing > culture!
152
Rx of histoplasmosis
Mild: itraconazole
Sever: amphotricin B
153
Epi/endemic typhus vs typhoid (organism)
Epidemic: R. Prowazekii
Endemic: R. Typhi
Typhoid: salmonella typhi/paratyphi
