ID

Question 1

Most common cause of bacterial pharyngitis

Answer 1

Group A beta-hemolytic strep

Question 2

CENTOR criteria for strep

Answer 2

Cough absent 
Exudative tonsils 
Nodes (anterior cervical chain) 
Temperature >38C 
Age <15 (+1) or >45 (-1) 

score 0-2 –> no culture or abx
Score 3 = culture, tx if +ve
score >/=4 = culture, tx with abx on clinical grounds, d/c if culture negative

Question 3

Abx for treatment of strep throat reduces risk of post-strep glomerulonephritis T/F

Answer 3

False

Question 4

Metronidazole and EtOH reaction

Answer 4

Disulfiram-like toxicity

Chest pain, vertigo, vomiting, diaphoresis, metallic taste, erythema, conjunctival injection

Question 5

3 important opportunistic infections related to HIV pts

Answer 5

Pneumocystis jiroveci pneumonia
Mycobacterium avium complex
Toxoplasmosis

Question 6

PCP prophylaxis in HIV starts at CD4 count of

Answer 6

<200cells/mm3

Question 7

Toxoplasmosis prophylaxis in HIV starts at CD4 count of

Answer 7

<100cells/mm3

Causes toxoplasmosis encephalitis (ring-enhancing lesions on CT head)

Question 8

Myocbacterium avium infection prophyalxis starts at CD4 count of

Answer 8

<50 cells/mm3

Question 9

PCP prophylaxis in HIV pts

Answer 9

Trimethoprim-sulfamethoxazole

Question 10

Toxoplasmosis prophylaxis in HIV pts

Answer 10

Trimethoprim-sulfamethoxazole

Question 11

TB prophylaxis

Answer 11

Used in pts with latent TB infection (secondary preventon)

Isonizid + pyridoxine (to avoid vit B6 dficiency) x 9mo

Question 12

Amphotericin B

Answer 12

Tx for cryptococcal neoformans meningoencephalitis in AIDS patients

Question 13

Prophylaxis against opportunistic infection of cryptococcal neoformans meningoencephalitis

Answer 13

Fluconazole

Question 14

Prophylaxis against isoniazid-resistant TB

Answer 14

Rifampin

Question 15

MAC prophylaxis agent

Answer 15

Azithromycin

Question 16

Febrile neutropenia etiology

Answer 16

Pseudomonas (gram -ve)

Gram +ve organisms becoming more common

Question 17

Parasite responsible for malaria

Answer 17

Plasmodium falciparum

Question 18

Screening test for malaria

Answer 18

Falciparum screen

Question 19

Tx for malaria

Answer 19

IV artesunate

Question 20

Empiric abx for febrile neutropenia

Answer 20

Pip-tazo/Meropenem/Cefipime +/- vanco

Question 21

Functional asplenism, increased susceptibility to encapsulated organisms

Answer 21

S.pneumoniae
N. meningitides
H. influenza
Salmonella

Question 22

Pathogen commonly associated with cat bites

Answer 22

Pasterurella multocida (gram -ve rod)

Question 23

Management of cat bite

Answer 23

Wash with water and soap, detergent or povidone iodine.Saline irrigation. debridement. Culture. Leave open (no suture) but banadage)
Only suture of on face or scalp

Question 24

Culprit of Herpes Simplex Encephalitis in neonates

Answer 24

HSV-2

Acquired during birth from infected mother

Question 25

Culprit of Herpes Simplex Encephalitis in children >3mo and adults

Answer 25

HSV-1

Question 26

Abx of choice for E. histolytica

Answer 26

Metronidazole

Question 27

Common causes of C.diff

Answer 27

Clindamycin Fluoroquinolones Cephalosporins Penicillins

Question 28

C. diff tx

Answer 28

Flagyl PO Vanco PO Fecal transplant

Question 29

Most common cause of bacterial gastroenteritis

Answer 29

Campylobacter

Question 30

Most common cause of chronic diarrhea in HIV pt with CD4 <200

Answer 30

Cryptosporidium parvum

Question 31

Dx Cryptosporidium parvum

Answer 31

Acid fast staining of stool | Look for oocytes

Question 32

Risk factors for meningitis

Answer 32

``` Asplenia Complement deficiency Glucocorticoid excess Diabetes mellitus EtOH-use HIV Recent infxn (esp resp or ear) Recent exposure to someone with meningitis IVDU Recent head trauma Otorrhea or rhinorrhea Recent travel ```

Question 33

Empiric tx for meningitis

Answer 33

Adults: Ceftriaxone + Vanco + dex for first 4d | Continue dex if culprit is S. pneumo

Question 34

Prophylaxis for H. influenzae meningitis contacts

Answer 34

Rifampin x 4d

Question 35

Prophylaxis for meningococcal meningitis contacts

Answer 35

rifampin x 2d | OR single dose of cipro if >18yo

Question 36

Prophylaxis for meningitis in pregnant patient contacts

Answer 36

Ceftriaxone 250mg IM single dose

Question 37

Argyll Robertson Pupil

Answer 37

Accomodating but not reactive to light in neurosyphilis

Question 38

Screening tests for syphilis

Answer 38

VDRL Rapid plasma reagin Enzyme immunoassay

Question 39

Confirmatory tests for syphilis

Answer 39

T. pallidum immobilization assay Fluorescent treponema Ab-absorption Microhemagglutination assay T. pallidum particle agglutination assay

Question 40

Prophylactic abx for dental procedures in high risk pts

Answer 40

Amoxicillin 1h before

Question 41

Most common primary immunodeficiency in adults characterized by increased susceptibility to bacterial infections

Answer 41

Common variable immunodeficiency | Dx: Quantitative measurement of immunoglobulin levels

Question 42

Neurosyphilis positive serum VDRL result

Answer 42

>1:32

Question 43

Most common cause of neutropenic enterocolitis

Answer 43

Clostridium septicum

Question 44

HIV testing in neonate to positive mom

Answer 44

HIV DNA PCR | 48h after birth, >/= 1 mo and >/= 4mo

Question 45

Botulism toxin MOA

Answer 45

Blocks ACh release at NMJ

Question 46

Listeria gram stain

Answer 46

Gram + rods

Question 47

H. influenza gram stain

Answer 47

Gram - coccobacilli

Question 48

Empiric abx for meningitis for =28d

Answer 48

Amp + cefotaxime

Question 49

Empiric abx for meningitis for 29d-3mo

Answer 49

Cefotaxime + Vanco

Question 50

Empiric abx for meningitis for >3mo

Answer 50

Ceftriaxone + Vancomycin +/- ampicillin if risk for L-monocytogenes + dex IV within 20min prior to or with first dose of abx (continue in pts with pneumococcal meningitis)

Question 51

Acute pulmonary TB treatment

Answer 51

Isoniazid + rifampin + pyrazinamide + ethambutol x 2mo (initiation phase) then isoniazid + rifampin x 4mo in fully susceptible TB (continuation phase) Extend for extra month if >65yo, pregnant or risk of hepatotoxicity

Question 52

Latent TB test

Answer 52

Tuberculin skin test or IGRA

Question 53

Active TB test

Answer 53

Sputum