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ID Flashcards

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1
Q

Positive TB skin test

A

> 5mm HIV, known contact
10 risk factors (hosp worker, prison)
15

Get CXR —> latent TB (R x4 OR isoniazid x6), active TB (RIPE x 2mo, IR x4)

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2
Q

Endocarditis w UTI

A

Enterococcus

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3
Q

Osteomyelitis foot

A

Pseudomonas

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4
Q

Hep C

A

dx anti-hC ab PLUS confirmatory PCR (some ppl clear have only Ab test x2)
Pregnancy: Give hep A+B vaccines, Csection not protective, BF ok unless bleeding

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5
Q

MC causes of esophagitis in HIV

A

CD4<100
Candida tx fluconazole
Viral PAIN HSV (round ulcers), CMV (linear ulcers)
Rx esophagitis NSAID bisphosphonates, tetracyclines, K supplements

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6
Q

Post op fever

A

Hrs - normal infl, malignant hyperthermia, nonhemolytic transfusion rxtn (cytokines in stored blood)
<1 week - nosocomial UTI PNA
>1 week - infx/abscess of IV catheter, surgical site, PE, drug fever

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7
Q

Kaposi sarcoma

A

Viollaceous

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8
Q

Septic PE

A

IVDU, staph tricuspid OFTEN NO MURMUR

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9
Q

MC cause of sepsis in sickle cell

A

Strep pneumo (SHiN) blood, meningitis, pneumonia, osteo=staph a + salmonella

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10
Q

Central line —> bacteremia

A

Staph epidermidis/aureus, 10% candida

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11
Q

Acute HIV infx sx

A 
MR GU
Mono sx (LAD, arthralgias)
Rash
GI
Ulcers (oropharyngeal)
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12
Q

Tetanus ppx

A

If 3x vaccine give another dose if >10y ago or if severe injury >5y
If unsure hx AND severe give IG also

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13
Q

Meningitis

A 
<1 mo GBS, E. coli, HSV, listeria
1 mo-10y strep pneumo, neisseria
>10y neisseria
IC GIVE AMP
Bruzig/Kernig signs-->knee ext + hip flexion, neck flexion
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14
Q

CMV sx (immunocomp)

A

Pneumonitis, bloody diarrhea

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15
Q

HIV lung stuff

A

TB

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16
Q

PCP treatment

A

TMP-smx, steroids if PaO2<70 or Aa gradient>35

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17
Q

Bloody diarrhea

A

Ecoli, shigella, campy

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18
Q

Ehrlichosis

A

Rocky mt spotted fever w o the spots, lone star tick, s central/SE us, thrombocytopenia, leukopenia, ^AST ALT, LDH, tx doxy

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19
Q

HSV pregnancy

A

Treat w acyclovir 36 w, if active lesions c section

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20
Q

Babesiosis

A

Same tick as Lyme, intravascular hemolytic anemia/thrombocytopenia, dx smear

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21
Q

Oral ulcers/vesicles

A

HSV-1 oral mucosa/lips, anterior

Coxsackie A herpangina posterior, oropharynx, grey ulcers, late summer/early fall

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22
Q

Mono

A

Cervical LAD, SORE THROAT, autoimmune hemolytic anemia/thrombocytopenia, splenomegaly, abnormal lymphocytes

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23
Q

Neutropenic fever, no focal infx

A

Pseudomonas

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24
Q

Anti-pseudomonal abx

A

(CCMP) Cefepime, cipro, meropenem, pip-tazo

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25
Impetigo
Topical abx mupirocin if local skin infx, PO cefalexin if widespread, PSGN
26
Nocardia
Acid-fast, branching filamentous rod, gram pos IC pt, systemic sx (TB-like) + lung nodules + brain Tx TMP-smx x6-12 mo
27
Abx for cervicitis vs PID
CTX + azithromycin, PID + metro
28
Neonatal conjunctivitis
Ppx topical erithromycin, gon more purulent
29
Epididymitis
<35 gon/chlamydia, >35 E. coli
30
Syphillis tx
PenG, if allergic doxy
31
HIV screening
Anyone 15-65 once, p24 antigen + Ab for early detection, then confirmatory testing
32
Post op surgical site infx
Urgent debridement esp if gray dishwater exudate
33
Pyelonephritis tx
IV CTX, if improvement 48 h, can switch to PO TMP-smx (check sensitivities)
34
STD no organisms seen
Chlamydia
35
MC risk factor for bacterial sinusitis
URI
36
HACEK
3% IE, haemophilus aphrophilus, aggregatobacter actinomy....who cares??, cardiobacterium hominis, eikenella corrogens, kingella kingae Gram neg, dental procedures
37
Prevent catheter-associated UTI
CLean intermittent catheterization
38
Probe to bone
Bone biopsy for osteo
39
Malaria ppx
Mefloquine, atovaquone, doxy 2 w prior-4 w after
40
Rubella lymph nodes
Post auricular and occipital lymphadenopathy
41
Blastomycosis
Can affect immunocompetent, Mississippi valley, violaceous skin lesions, well circumscribed, heaped-up
42
UTI in pregnancy tx
You CAN use, cephalexin, amox-clav, NF (bactrim 2nd tri)
43
Hep C derm sx
Porphyria cutanea tarda=painful blisters on sun-exposed skin (photosens)
44
Bacillus cereus
Rice, preformed exotoxin
45
Trichinella
1w GI, 2-4w myositis, periorbital edema, eos>20%
46
Ludwig angina
Submandibular cellulitis, oral flora, tooth infx
47
Gonococcal pharyngitis
Fever + pharyngitis + lower abd pain
48
Prosthetic joint infection bugs
<3 mo staph aureus, 3-12 mo staph epi (no fever), >12 mo staph a
49
Measles vaccine
Can have mild sx 1-3 weeks after, vaccine at ages 1 and 4
50
Rabies PEP
Vaccine + IgG, give if can’t confirm animal, otherwise wait 10 day quarantine or euthanize and brain bx
51
Congenital toxo
DIFFUSE intracranial calc (periventricular CMV)
52
Actinomyces tx
Penicillin (PO, IV +\- surgery if severe=fistula)
53
Pneumococcal vaccine
>=65 OR <65 w IC, asplenia, CKD —> 13 x1, then 23 8w, 5y, age 65 <65 w/ DM, heart/lung/liver probs, smoker —> 23
54
Tdap Td schedule
Tdap once (+ every pregnancy), then Td q10y
55
When to give azithro for MAC ppx in HIV
CD4<50
56
Zoster vacc
60, maybe 50, <50 NO
57
Indications for meningococcal vacc
11-12, BOOSTER 16-21 | Asplenia/complement def, sub Saharan Africa, dorm/military
57
Live vaccines
``` Varicella Influenza (intranasal) MMR Yellow fever Rotavirus ``` Can give CD4>200
58
Management of infective endocarditis
BLOOD CLX x3, if stable vitals can wait for result before abx
59
Sickle cell osteo
Salmonella 2/3 staph a 1/4, vanc + CTX
60
Human bite abx
Amox-clav
61
Rhinosinusitis MC bugs
Moraxella, strep pneumo, h flu nontypable, tx amox-clav
62
Erysipelas
Superficial dermal layer (cellulitis is deeper), well demarcated borders, often involves external ear, strep pyo, IV CTX or PO Amox if no systemic sx
63
Syphillis s/s
EPITROCHLEAR NODES Primary chancre, tertiary CNS + gummas, secondary everything else (Rash palms/soles truncal—> spreads outward to extremities, gray stuff in oropharynx, gray papules on genitals Condyloma lata, Hepatitis, Flu-like sx)
64
CMV
Transmission Bodily fluids, renal transplant pts, colonic ulcers, abnormal leukocytes, bloody diarrhea (other diarrhea in pts w HIV not bloody)
65
Cryptococcus
Increased ICP, indolent course, no mass lesion on CT, India ink, sabouraud, tx Ampho B + flucytosine + fluconazole
66
Vertebral osteomyelitis
IVDU, exquisite pt tenderness, not imp w rest, may not have a white count, w/u XR (may not show < 3w), blood clx/ESR/CRP --> MRI, bone bx to confirm
67
Histoplasmosis
Mimics sarcoidosis, hilar LAD, pt from Mississippi gets way worse w steroids, HIV disseminated tx AmphoB x2w, itraconazole x1y
68
Varicella PEP
Vacc ages 1 and 4, give vacc if not immune, immunosuppressed give IG, if <1yo don’t need PEP
69
Lyme dz
AV block!! Spirochete
70
PCP pneumonia
Can’t be cultured, need sputum or BAL
71
Aspergillosis
In HIV nd bx and clx to confirm
72
Influenza virus
Primary=diffuse opacities, PT >65 | Secondary bacterial=lobar, high fever
73
Ecthyma gangrenosum
Skin lesions in chemo/immunosuppressed pts, start as non painful pustules—>gangrenous ulcers, usually pseudomonas infiltrates blood vessels **NOT PYODERMA GANGRENOSUM=IBD painful***
74
Vaccinate for hep A?
YES
75
Meningitis bact vs viral vs fungal
(nl = glu 40-70, pro <40) Bact —> glucose<40, protein>250, PNMs Fungal —> looks like bact (glu<40, pro>250) BUT lymphs Viral —> nl glucose 40-70, nl-slightly high protein <150, lymphs ***dirty tap = 500-1,000 RBCs/1 WBC
76
Anaerobic coverage abx
CAMA Clindamycin, Amox-clav, Meropenem, ampicillin**** PLUS SULBACTAM
77
HIV in a baby
lots of diarrhea, PJP
78
MC congenital valve dz, most highly a/w IE
Mitral prolapse/regurg
79
septic arthritis in a baby
staph, also GBS and pseudomonas < 3 mo old, baby will hold hip in a weird position
81
abx ppx for ortho surg
cefazolin (2nd line vanc or clinda), bugs s aureus, epi, only if foreign body implantation
82
Laryngeal papilloma
HPV vertical transmission kids, finger-shaped lesions on vocal chords, irreg, exophytic punctate, surg
83
Roseola infantum
Fever 3-5d VERY HIGH, then blanching macular rash HHV-6
84
Toxic shock syndrome
STAPH A, macular rash palms + soles, tx clinda +/- vanc (MRSA)
85
Acute otitis media (vs serous)
>3 in 6mo, >4 in 1y consider tympanoplasty, serous no s/s infx common in HIV
86
Epiglottitis
Attempt intubation ONCE, cricothyrotomy, CTX (Hib strep pneumo) + vanc (staph a)
87
Cavernous sinus thrombosis
Infx, 2d later HA/inc ICP, periorbital edema, u/l facial nerve probs—>b/l, dx MRV, tx IV abx, check for herniation
88
Aminoglycosides
SN hearing loss
89
Entamoeba histolytica
Travel bloody diarrhea liver lesion, tx metro + paromomycin
90
IS MALASSEZIA A DERMATOPHYTE
No fucking, NO. Selenium sulfide ketoconazole
91
Hep B screen
Sex, finger stick
92
Hep C screen
Transfusion <1992
93
Mumps
Non-specific prodrome --> PAROTITIS, orchitis
94
Afebrile no WBCs watery stools
ETEC
95
Meningococcemia
pt in close quarters w/ others (camp, military, college), sore throat URI sx fever, RASH
96
Cutaneous larva migrans AKA
HOOKWORM
97
Infective endocarditis complications
ABSCESS (brain, kidney), can have elev ESR

STEP 2 AG (16 decks)

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