ID & Rheum

Question 0

Most specific antibodies for SLE?

Answer 0

Anti DS DNA and anti smith

Question 1

What serotypes are covered by MCV4?

Answer 1

A, C, Y, W-135

Question 2

Complication of pelvic osteo

Answer 2

abscess, seen in boys ~8 yrs old, right-sided, staph aureus, pain referred to hip/thigh/abdomen, MRI or bone scan studies of choice

Question 4

HIV screening >18 mo of age

Answer 4

EIA is preferred, whether mom is infected or not (prior to 18 mo can use PCR)
Confirm with western blot

Question 4

tx of campylobacter

Answer 4

none needed unless worsening or persistence of symptoms, then use azithromycin

Question 5

Maternal HIV, recommendations on testing baby

Answer 5

HIV DNA PCR at birth, 2 mo, 4 mo, 6 mo

Question 6

primary cause of occult bacteremia (fever without other signs)

Answer 6

strep pneumo

Question 7

most common cause of SBP?

most common cause in nephrotic syndrome pt?

Answer 7

e. coli
s pneumo (encapsulated,low IgG)

Question 8

most common complication of chronic peritoneal dialysis

Answer 8

staph epidermidis peritonitis

Question 9

nitazoxinde is used to treat which diarrheal illnesses?

Answer 9

giardia and cryptosporidium

Question 10

which rickettsial disease is spread by inhalation of infected particles not tick bite

Answer 10

Q Fever

flu sx, PNA, no rash, Tx with doxy

Question 11

when should you treat cat scratch?

Answer 11

supportive care for bartonella henselae unless HSM, large painful adenopathy, immunocompromised host
Tx: Macrolide or Bactrim or rifampin or cipro

Question 12

when to treat salmonella diarrhea?

Answer 12

<3 mo, cancer pt, severe colitis, immunocompromised

tx with cefotaxime or ceftriaxone

Question 13

tx of brucellosis

Answer 13

on a dairy farm with fevers and myalgias

tetracycline or Bactrim plus Rifampin

Question 14

se of methotrexate

Answer 14

hepatitis

Question 15

progression of lyme disease

Answer 15

first 2 weeks: erythema migrans, flu-like sx, arthralgias
several months: Carditis, arthritis, neuro (inc bells palsy)
years: arthritis

Question 16

diffuse papular rash, polyarthritis, granulomatous uveitis

Answer 16

childhood sarcoid

s disease

Question 17

primary side effect of ganciclovir

Answer 17

neutropenia

Question 18

what level is effectiveness of aminoglycosides dependent?

what level is toxicity?

Answer 18

peak = effectiveness
trough = toxicity
measure peak 30 min after dose, trough measure 30 min prior to next dose

Question 19

testing immune response quantitativey/qualitatively

Answer 19

t-cell (cell-mediated): flow cytometry/delayed type hypersensitivity to candida, mumps
b-cell (humoral): Igs/response to vaccines
Protein: diphtheria/tetanus
Polysaccharide: pneumococcus

Question 20

side effects of amphotericin B

Answer 20

hypotension with first dose, HypoK, hypoMag, RTA

Question 21

what infections require airborne precautions

Answer 21

TB, measles, varicella, SARS

N95 plus standard precautions

Question 22

when is someone with measles infectious?

Answer 22

-5 days before and 5 days after rash appears
-prodrome 1-2 days, then Koplik spots
-rash appears ~day 5, worse after about a week, starts to resolve around day 10
-postexposure (w/i 6 days but goal w/i 3 days) to undervaccinated:
vaccine if >6 mo plus Ig

Question 23

recommendations for testing person exposed to HIV

Answer 23

test at time of exposure, 6 weeks, 3 mo, 6 mo

- empiric antiretroviral agents limited to needleticks WITH high likelihood of HIV transmission