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Flashcards in ID Uworld Deck (290):
1

what causes bacillary angiomatosis

bartonella gram neg bacillus

2

tx for bacillary angiomatosis in HIV patient

oral erythromycin

3

most common secondary bacterial pneumonia

Staph, strep, H flu

4

blood streaked sputum with multiple midfield lung cavities on CXR

acute necrotizing pneumonia with secondary penumatoceles

5

what pathogen causes post viral URI necrotizing pulmonary bronchopneumonia

Staphylococcus aureus

6

severe watery diarrhea in AIDs patient with CD4

cryptosporidium

7

watery diarrhea in AIDs patient with high fever and CD4

MAC

8

small volume frequent diarrha
with hematochezia and abdominal pain in AIDs patient with CD4

CMV

9

what antibiotics can you use for UTI in pregnancy

nitrofurantoin
amoxicillin
augmentin
cephaexin

10

differene of preseptal and orbital cellulitis

preseptal there is no paint with eye movement or vision impairment

11

+HbsAg
+HbeAg
+antiHbcAg IgG

chronic hep B

12

Tx chronic hep B

entecavir and tenofovir

13

rubella

german measles

14

congenital rubella

sensorineural hearing loss
intellectual disability
cardiac anoamlies
cataracts, glaucoma (leukocoria)

15

congenital CMV

unilateral deafness, blindness from chorioretinitis
HSM purpura and jaundice

16

congenital toxo

chorioretinits, hydrocephalus, intracranial calcifications

17

empiric Tx for meningitis in immunocompromised

vanco, ampicillin cefepime

18

Tx meninigitis 2-50 years old

vanco and third generation cephalosporin

19

14 day old infant with spasms of whole body
poor suckling
no antenatal care
swollen and erythematous umbilical cord

tetanus

20

tx cat bites

augmentin

21

pathogen in cat bites

pasteurella multocida

22

complication meningococcemia

waterhouse friederichsens syndrome

23

what is waterhouse friederichsen syndrome

sudden vasomotor collapse and skin rash due to adrenal hemorrhage

24

most common ventilator associated pneumonias

Pseudomonas, E coli, klebsiella, MRSA and strep

25

pregnant lady with erythema migrans and Hx tick bite

amoxicillin

26

common extrapulmonary findings in coccidiomycosis

erythema multiforme and erythema nodosum

27

hep C in pregnancy, next step

hep A and B vaccinations

28

disseminated histo

lymphadenopathy, pancytopenia and HSM

29

how to Dx Histo

urinary antigen testing and careful fungal stains

30

Tx mucormycosis by rhizopus

debridement and IV amphotericin B

31

ludwig angina

rapidly progressive bilateral cellulitis of submandicular and sublingual spaces
arise in molars

32

pathogen for submanidbular cellulitis

strep and anaerobes

33

next step for HIV stick in healthcare setting

blood testing and triple therapy

34

Bone marrow transplant in AML patient now has abdominal pain, diarrhea and cry cough
CXR shows bilateral diffuse patchy infiltrates

cytomegalovirus

35

CMV infection in post bone marrow transplant patients

upper and lower GI ulcers
bone marrow suppression
arthralgias
myalgias
esophagitis

36

rash starting on trunk and spreads to whole body including palms and soles

syphilis

37

initial testing for syphilis

RPR and VDRL

38

Tx syphilis

IM benzathine penicillin

39

jarisch herxheimer reaction

acute febrile illness with HA and myalgias after IM penicillin for syphillis

40

immunocompromixed patient with dense consolidation on CXR
CT shows halo signs around pulmonary nodules

aspergillosis

41

aspergillosis pulmonary. cXR finding and CT finding

cavitary lesion on CXR
CT- pulm nodules with halo sign or lesions with air crescent

42

marked eyelid swelling in newborn with produse purulent discharge

gonococcal conjunctivitis

43

Tx for gonococcal conjunctivitis

IN or IM ceftriaxone or cefotaxime

44

when does chlamydial conjunctivitis occur in newborn

5-14 days

45

Signs chlamydial conjunctivits

welling, chemosis,
watery or bloody or mucopurulent eye discharge

46

Tx chlamydial conjunctivitis

Oral erythromycin

47

why is topical eye ointment erythromycin given

to prevent gonococcal
has no activity on chlamydial

48

progression of bordetella pertussis in kids

1-2 weeks mild cough and rhinitis
2-6 weeks coughing with inspiratory whoop
vomiting after coughing spells
apnea and cyanosis in infants
weeks-months: resolve gradually

49

Tx bordetella pertussis

azithromycin, erythromycin, clarithromycin

50

labs in bordetella pertussis

marked lymphocytosis

51

Tx for PID

inpatient cefotetan and doxy
clinda or gentamicin IV

52

criteria for Dx PID

fever
leukocytosis
inc ESR
purulent cervical discharge
adenexal tenderness, cervical motion tenderness
lower abdominal tenderness

53

complications untreated PID

tubo ovarian abscesses, abscess rupture, pelvic peritonitis, sepsis

54

when to Tx someone with PId inpatient?

when high fever, failure to respond to antibiotics, nausea and vomiting, pregnancy and those at risk for noncompliance

55

Dx CMV diarrhea in AIDs patient

colonoscopy

56

findings on colonoscopy for CMV in AIDs

esosinophilic, intranuclear and basophilic intracytoplasmic inclusions

57

Tx for disseminated histoplasmosis

Itraconazole

58

What are the HACEK organisms

H aphrophilus
Aggregatibacter actinomycetemcomintans
Cardiobacterium hominis
E corrodens
Kingella kingae

59

when do you see Eikenella corrodens

poor dentition and periodontal infection

60

colonic neoplasia and endocarditis
likely pathogen causeing IE

strep gallolyticus
S bovis biotype I

61

endocarditis caused by enterococci is usually spread how

UTI

62

unilateral acute lymphadenitis in child

staph or strep pyogenes

63

bartonella henselase

cat scratch

64

bilateral acute lymphadenitis

adenovirus or EBV

65

patient with CF and recurrent sinopulmonary infections
most common pathogen

staph aureus

66

what antibiotic is prioritized in CF patient with Hx recurrent hospitalizations

IV vanc for MRSA

67

congenital syphilis

intermittent fever
osteitis
osteochondritis
mucocutaneous lesions, lymphadenopathy, hepatomegaly and persistent rhinitis

68

congenital rubella syndrome

microcephaly, microphthalmia and meningoencephalitis
sensorinueral deafness, cardiac anomalies, congenital glaucoma and cataracts

69

congenital herpes simplex

enecephalitis, chorioretinits, disseminated disease

70

congenital toxo

chorioretinitis, hydrocephalus and intracranial calcifications

71

large painful lymphadenopathy in inguinal area

chlamydia trachomatis

72

frothy green discharge

trich vaginalis

73

worsening croup, next step

racemic epinephrine before intubation

74

pteterm infant neonatal sepsis pathogen

E coli > GBS

75

Tx neonatal sepsis

ampicillin and gentamicin

76

prophylaxis for MAC in AIDs

CD4

77

clinical features blastomycosis

lung: acute or chronic pneumonia
skin: wartlike lesions with violaceous hue and skin ulcers
bones: osteomyelitis
GU: prostatitis and epididymo-orchitis
CNS can have meningitis or abscesses

78

Tx blasto

ampho B

79

tularemia

acute unilateral cervical lymphadenopathy with fever chills, HA and mailaise
zoonosis- after contact with rabbits, hamsters or blocc sucking arthropods

80

Tx for H flu type B meningitis

dexamethasone

81

on CT see a cyst with invaginated sclex

neurocysticcercosis

82

when do you give meningitis booster

age 16-21

83

what are the live attenuated vaccines

MMR
varicella
yellow fever
intranasal influenza

84

clinical presentatoin of rash in german measles (rubella)

spreads head down rapidly
maculopapular blanching
arthritis

85

rash in measles

higher fever with head to toe rash that spreads gradually
no arthritis

86

rocky mountain spotted fever rash

over wrists and ankles involving palms and oles
spreads centrally

87

what helps with measles

Vit A
T cell cytopenia and thrombocytopenia

88

herpes viral esophagitis

herpetic lesions wit round ovoid ulcers
have concurrent oral HSC

89

CMV esophagitis

deep linear ulcers
distal esophagus

90

which pills cause pill esophagitis

K Cl
tetracyclines
bisphosphonates
NSAIDs

91

Echinococcus granulosus

hyatid cyst causer
from close contact wiht dogs and from tapeworm

92

CT liver shows what for hyatdid cysts

eggshell calcification

93

Tx of hyatid cyst

surgical resection with albendazole

94

risk of aspirating hyatid cyst

anaphylactic shock

95

Febrile neutropenia

medical EM
start empitic abitibiotic with pseudomonas coverage like pip taz, cefepime or meropenem

96

what causes scarlet fever

GAS that produce erythrogenic exotoxins

97

rash of scarlet fever

sand paper like
punctate or finely papular

98

Tx scarlet fever

Penicillin V

99

Dx amebic liver abscess

trophozoites in stool
serology
liver imaging

100

Tx for amebic liver abscess

metonidazole

101

if aspirate amebicliver abscess

usually sterile

102

atypical lymphocytes

large basophilic cells with vacuolated appearance
CMV

103

Triad disseminated gonorrhea

tenosynovitis
dermatitis
migratory asymmetric polyarthalgia without purulent arthritis

104

Tx disseminated gonorrhea

IV ceftriaxone for 1-2 weeks
then PO cefixime when clinically imporved
Tx azithro or doxy for chlamydia

105

Dx disseminated gonorrhea

2 sets blood cultures
synovial fluid
urethral cervical cultures

106

recurrent disseminated gonorrhea

check terminal complement activity

107

Prevent toxo in HIV

TMP SMX

108

inflammation of superficial dermaitis, raised well demarcated red rash

erysipelas- cellulitis
Group A beta hemolytic strep (pyogenes)

109

Tx for PCP pnuemonia

TMP SMX IV for acutely ill

can do pentamidine Iv
atovaquone oral
TMP SMX and dapsone
clinda and primaquine

110

presentation trichenellosis

intestinal is within 1 week ingestion: ASx or abdominal pain, n/v/d
muscle stage (up to 4 weeks):
myositis, fevere, subungal splinter hemorrhages, periorbital edema, eosinophilia

111

areas of trichenella

Mexico, China, Thailand, Central Europe and argentina

112

what type of food has trichenella

undercooked or raw meat. usually pork

113

presentation dengue

fever, HA, retro orbital pain, rash and myalgia and arthralgias

114

typhoid fever

fever in first week then abdominal pain and salmon colored rash in 2nd week
HSM and abdominal complications like bleeding in 3rd week

115

rash in rubella

german measles
very fast spread of rash head to toe
also will ahve forscheimer spots with is patchy erythema on soft palate

116

rash in measles

more severe disease
rash is head to toe but very gradual and darker
and have high fever

117

Tx enterobiu vermicularis

pinworm
albendazole or pyrantel pamoate
Tx all household contacts

118

ivermectin used for

strongyloidiasis

119

presentaiton stronglyoides

urticaria, abdominal pain and respiratory problems
can have river blindness (ocular lesions)

120

Tx trichmoniasis

metro for patient and partner

121

Tx for cerebral toxo

sulfadiazine and pyrimethamine

122

Tx actinomycosis

penicillin

123

risk factors actinomycosis

dental caries, extractions
gingivitis
DM
malnutrition

124

presentation actinomycosis

chronic slowly progressive non tender indurated mass
extends through tissue planes and makes fistulas and sinus tracts
mandible is most common spot

125

yellow granular puss in infected tissue of mandible

actinomycosis
sulfur granules make color and consistency

126

Dx actinomycosis

gram stain showing Gram + branching bacilli

127

prosthetic joint infection within 3 months or surgery

staph aureus
gram - rods

128

prosthetic joint infection after 3 months since surgery

staph epidermidis
propionibacterium
enterococci

129

bacterial vaginosis

thin off white discharge with fishy odor
gardnerella
pH>4.5
clue cells

130

Tx bacterial vaginosis

metro or clinda

131

chlamydial cervicitis

mucopurulent discharge
erythematous friable cervix

132

Tx chlamydial cervicitis

azithro

133

thing green grey discharge, malorodours
strawberry cervix

trichomonas

134

Dx chlamydial cervicitis

nuclein acid amplicficaiton testing

135

Tx impetigo

topical mupirocin

136

Tx extensive impetigo

oral antibiotics like cephalexin and clindamycin

137

common causes of AIDs diarrhea

cryptosporidium, MAC, microsporidia, giardia and isospora belli

138

HIV patient with profuse non bloody diarrhea, next step

stool sample to check for ova and parasites

139

diarrhea from CMV

bloody

140

how to Dx pertussis

PCR

141

mumps

parotitis, otchitis

142

congenial syphilis

cutaneous lesions on palsm and soles
HSM
jaundice
anemia
rhinorrhea

143

what to do for child non vaccinated exposued to chicken pox

administer vaccine

144

Pertussis post exposure prophlyaxis

azithromycin for all close contacts

145

what causes herpangina

coxsackie A

146

herpetic gingivostomatitis

herpes simplex 1
clusters of small vesicles on the anterior oropharynx

147

what to give infant born to mom with active Hep B

Hep B Ig and vaccine

148

common pathogen for spinal pyogenic osteomyelitis

staph aureus

149

best image for spinal osteomyelitis

MRI

150

what causes acute rheumatic fever

strep pyogenes

151

syndenham chorea

acute rheumatic fever by strep pyogenes

152

which diarrheal illnesses last longer than 2 weeks

cryptosporidium
cystoisopora
microsporidia
cyclospora
giardia

153

diarrhea from entamoeba histolytica

abdominal pain and bloody

154

cavitary inflammatory upper lung lesion

reactivation TB

155

man from SE asia has lesion on left forearm that is hypopigmented and no pinprick sensation

do a skin Bx for leprosy
acid fast bacilli

156

post influenza pneumonia pathogen

staph aureus

157

Tx for cryptococcal meningoencephalitis

amphotericin plus flucytosine
then fluconazole PO

158

what is grisefulvin used for

dermatophytosis and onychomycosis

159

chemoproph for chloroquine resistant malaria

mefloquine

160

what areas have chloroquine Resistant P falciparum

sub saharan africa
souther and southeast asia

161

areas without P falciparum malaria

south america
mexico
korean peninsula

162

what to use for chemoproph malaria without P falciparum

primaquine

163

common cause nail pncture osteomyeltiis in adults

pseudmonase

164

rubeola

measles

165

koplik spots

measles

166

Tx measles

vit A and supportive care

167

how to Dx measles

PCR
acute and convalescent serology for anti measles IgM and IgG

168

acute HIV

mono like syndrome with generalized macular rash and GI symptoms

169

crystal induced nephopathy is a side effect of what HIV Rx

indinavir a protease inhibitor

170

side effect didanosine

pancreatitis

171

side effect abacavir

related HS syndrome

172

which HIV med causes lactic acidosis

NRTIs

173

which HIV meds cause steven johnsons syndrome

NNRTIs

174

nevirapine side effect

liver failure

175

bit by dog w/o rabies vaccination but dog seems healthy

confine dog for 10 days and observe
no post exposure prophylaxis

176

most common pneumonia in HIV patient

strep pneumo

177

liver shows smooth round big cyst with daughter cysts in it

Echinococcus- tapeworm
usually from sheep
Hyatid cyst

178

HIV patient with 6 mm PPD induration

Isoniazid and pyridoxine for 9 months

179

when are live vaccines CI in HIV patients

CD4

180

drug used for aspiration pneumonia

clinda

181

nocardia gram stain

gram + rod branching
partially acid fast
aerobic

182

lcinical features nocardia

systemic Sx
pneumonia like TB
CNS abscess
cutaneous

183

Tx nocardia

TMP SMX

184

keys for legionella pneumonia

recent travel on cruise or hotel

185

how does legionella p spread

water

186

signs legionella

high fever
bradycardia for high fever
neuro Sx of confusion
diarrhea
does not respond to beta lactam or aminoglycoside

187

labs in legionella

hyponatremia
hepatic dysfunction
hematuria and proteinura

188

hwo to Dx legionella

urinary Ag

189

give what with isoniazid

pyridoxine to prevent neuropathy

190

pregnant woman + syphilis.
allergic to penicillin
Tx?

first do skin testing to confirm tru allergy
penicillin desensitization

191

CSF analysis in herpes encephalitis

inc WBC (lymphocytes
normal glucose
increased protein

192

Tx herpes encephalitis

IV acyclovir

193

findings in CSF for viral meningitis

WBC 100-1000
glucose 40-70
protein

194

CSF in TB meningitis

WBC 5-1000
250 protein

195

what viruses cause meningitis

non polio enteroviruses
echo and coxsackie

196

most common pathogen for acute bacterial parotitis

staph aureus

197

most common pathogen causing croup

parainfluenza

198

Tx for bacterial vaginosis

metronidazole

199

clue cells

bacterial vaginosis

200

best screening for HIV

p24 Ag and HIV Ab

201

causes of impetigo

staph aureus
GAS
s pyogenes

202

complications of impetigo

post strep glomerulonephritis

203

step to confirm IE

bacterial blood cultures

204

Tx nocardia

TMP SMX

205

Tx to prevent HIV transmission in pregnany

triple therapy

206

widened prevertebral space in little kid drooling in resp distress

retropharyngeal abscess

207

cutaneous larva migrans

hookworm
sandboxes and beaches
severely pruritic elevated serpinginous reddish brown lesions on the skin

208

vaccines for post splenectomy

Meningo, H flu and PCV13 in 2 weeks

209

Tx candidal esophagitis

oral fluconazole

210

patient with PID from gonorrhea. should test for

syphilis. Tx for chlamydia

211

what are the strep viridans group

mitis, oralis, mutans and sobrinus and milleri and saguinis

212

patient confirmed with syphilis, do what other screening?

HIV with ELISA

213

patients with mono are at risk for what complication

autoimmune hemolytic anemia

214

how to confirm autoimmune hemolytic anemia from mono

IgM col agglutinin Ab "anti-i Ab"
coombs +

215

HIv patient with fevers, HA and signs of ICP (papilledema)

cryptococcal meningitis

216

most predisposing factor for acute bacterial sinusitis

Viral URI

217

bacillary angiomatosis

bartonella

218

risk of Bc bacillary angiomatosis

bleeding

219

Tx pinwrom

mebendazole

220

Tx for human bite

augmentin

221

Tx for dog bite

augmentin

222

best testing for HIV in infant under 18 mo old

PCR because passage of maternal Ab will confound Ab test

223

CSF meningitis

inc WB
inc protein
dec glucose

can have peteichiae and purpura

224

fever, fatigue, pharyngitis, polymorphous rash after taking amoxicillin or amplicillin

mono

225

most common cause meningitis in 18 month old

N meningitis

226

pneumonia vaccines

immunocompromised or special population receive PPSV23 once
then PCV13 followed by PPSV23 at age 65

227

rash in mycoplasma pneumonia

erythema multiforme

228

IV drug use, pulmonary symptoms and cavitary lesions in lung on CT

septic emboli from IE

229

common pathogen of septic emboli from IE

Staph aureus
lesions usually in lung periphery

230

Tx for healthy young male except he has syphliis and is allergic to penicillin

oral doxy

231

Tx to person with tertiary syphilis allergic to penicillin

ceftriaxone

232

what can cause subcutneous empysema

severe coughing paroxysms
pneumothorax
ruptured esophagus

order CXR to rule out pneumo

233

which patienets are at higher risk IE

drug IV users
those with MVP and regurg

234

septic arthritis pathogens in

staph
GBS
gram - bacilli

235

septic arthritis if child > 3 mo

staph
GAS
strep pneumo

236

first step after determining septic arthritis

arthrocentesis

237

doxycycline is contraindicated in

pregnant women and children

238

lymes Tx for 7 year old

amoxicillin or cefuroxamine

239

pathogens of cellulitis

beta hemolytic strep and staph aureus

240

Tx for cellulitis with systemic Sx of fever, rigors, chills, fatigue, confusion

nafcillin or cefazolin

241

Disseminated MAC infection

fever, cough,a bdominal pain, diarrhea, night sweats, weight loss
splenomegaly
elevated alk phos
CD4

242

first line Tx for disseminated MAC

azithromycin or clarithromycin

243

trypanosomiasis

East africa
acute febrile illness with chancre, myocarditis and progression to CNS involvement

244

babesiosis

endemic area with tick bite
ixodes tick
NE USu
causes hemolysis of RBC

245

Sx babesiosis

jaundice, hemoglobinuria, renal failure and death

246

babesiosis usually in what paptients

without a spleen or immunocomprmoised

247

how to Dx babesiosis

giemsa stained thick and thin blood smear

248

Tx babesiosis

quinine-clindamycin
atovaquone-azithromycin

249

erlichiosis

spotless rocky mountian spotted fever
fever, maliase, HA, n/v
leukopenia and thrombocytopenia

250

Q fever

zoonosis
coxiella burnetti
cattle, goat sheep
meat processing or vets
flu like syndrome and hepatitis or pneumonia like

251

condyloma acuminata

anogenital warts from HPV

252

leukocytoclastic vasculitis

can be from meds, infections, malignancy or inflammation
non blanching 1-3 mm violaceous papules in cluster or plaques

253

NF2

acoustic neuromas

254

most common cause pneumonia in nursing homes

strep pneumo

255

msot common cause CAP in adults

S pneumo

256

which UTI pathogen causes increased urine pH

proteus mirabilis from urease that increases ammonia to decrease free H+

257

struvite stones

proteus

258

urease producing bacteria

klebsiella, morganella morganii, pseudomonas, providencia, staph, ureaplasma urealyticum

259

Tx amebic abscess

metro

260

Tx for strep viridans IE native valve

aqueous penicillin G

261

pathogen of acute epididymitis in older patient

E coli because likely from UTI

262

pathoegn of acute epididiymitis in someone sexuallya ctive

C tach
N gonorrhea

263

when do you use amantadine and rimantadine

Influenza A

264

when to Tx influenza

within 48 hours onset with oseltamivir

265

signs Sx TSS

fever, diffus emyalgias, vomiting, profuse diarrhea hypotension, diffuse macular erythroderma like sunburn

266

management TSS

supportive
broad spect anti staph antibiotics

267

progressive multifocal leukoencephalopathy

no mass effect
in cortical white matter
gradual onset
hemiparesis and distrubances in speech vision and gait

268

confirm PML encephalopathy

MRI- non enhancing lesions with no mass effects

269

when to screen for hep C

high risk needle stick exposure
IV drug use
received transfusions before 1992!!!

270

no Sx chalmydia but test is +
nuclemic amplification test gonorrhea is negative
Tx?

single dose azithromycin or 7 days doxy

271

labs in erlichiosis

leukopenia and thrombocytopenia
elevated LFTs and LDH

272

Dx erlichiosis

intracytoplasmic morulae in monocytes
PCR for E chaggeensis and E ewingii

273

where is erlichiosis

southwastern and south central US

274

is there a rash in erlichiosis

not usually

275

erythromycin kills what pneumonia-pathogens

legionella and mycoplasma

276

where is chikungunya

centra and south america, tropical africa
south asia

277

mosquito carryin chikungunya and dengue

aedes

278

clinical manifestations chikungunya

3-7 day incubation
high fevers, polyarthralgias
HA, myalgias, conjunctivitis, maculopapular rash
lymphopenia, thrombocytopenia, inc LFTs

279

Tx chikungunya

supportive

280

reactive arthritis

1-4 weeks most GI or GU infection with asymmetric oligoarthritis, conjunctivitis, and oral lesions

281

Tx legionella pneumo

fluoros or macrolides

282

when to Tx PPD >10 mm induration

recent immigrants
IV drug users
healthcare workers
lab personnel in mycobacterium lab
DM, immunsuppressed with corticosteroids, ESRD
children

283

penicillin to precent S penumonia until age 5

284

most common cause osteomyelitis in adults and children

staph aureus

285

patients with splenic abscess present

fevers, chills, LUQ pain and splenic effusion
fever, leukocytosis splenomgealy

286

risk factors for splenic abscess

infective endocarditis, immunosuppression
IV drug use, trauma
hemoglobinopathies

287

pathogens causing splenic abscess

staph, strep and salmonella

288

Tx splenic abscess

splenectomy

289

gram - coccobacilli

H flue nontypeable

290

most common pathogens for pneumonia in CF

staph- most common
pseudomonas
H flue
strep pneumo