ID Uworld Flashcards
(290 cards)
1
Q
what causes bacillary angiomatosis
A
bartonella gram neg bacillus
2
Q
tx for bacillary angiomatosis in HIV patient
A
oral erythromycin
3
Q
most common secondary bacterial pneumonia
A
Staph, strep, H flu
4
Q
blood streaked sputum with multiple midfield lung cavities on CXR
A
acute necrotizing pneumonia with secondary penumatoceles
5
Q
what pathogen causes post viral URI necrotizing pulmonary bronchopneumonia
A
Staphylococcus aureus
6
Q
severe watery diarrhea in AIDs patient with CD4
A
cryptosporidium
7
Q
watery diarrhea in AIDs patient with high fever and CD4
A
MAC
8
Q
small volume frequent diarrha
with hematochezia and abdominal pain in AIDs patient with CD4
A
CMV
9
Q
what antibiotics can you use for UTI in pregnancy
A
nitrofurantoin
amoxicillin
augmentin
cephaexin
10
Q
differene of preseptal and orbital cellulitis
A
preseptal there is no paint with eye movement or vision impairment
11
Q
+HbsAg
+HbeAg
+antiHbcAg IgG
A
chronic hep B
12
Q
Tx chronic hep B
A
entecavir and tenofovir
13
Q
rubella
A
german measles
14
Q
congenital rubella
A
sensorineural hearing loss
intellectual disability
cardiac anoamlies
cataracts, glaucoma (leukocoria)
15
Q
congenital CMV
A
unilateral deafness, blindness from chorioretinitis
HSM purpura and jaundice
16
Q
congenital toxo
A
chorioretinits, hydrocephalus, intracranial calcifications
17
Q
empiric Tx for meningitis in immunocompromised
A
vanco, ampicillin cefepime
18
Q
Tx meninigitis 2-50 years old
A
vanco and third generation cephalosporin
19
Q
14 day old infant with spasms of whole body
poor suckling
no antenatal care
swollen and erythematous umbilical cord
A
tetanus
20
Q
tx cat bites
A
augmentin
21
Q
pathogen in cat bites
A
pasteurella multocida
22
Q
complication meningococcemia
A
waterhouse friederichsens syndrome
23
Q
what is waterhouse friederichsen syndrome
A
sudden vasomotor collapse and skin rash due to adrenal hemorrhage
24
Q
most common ventilator associated pneumonias
A
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
