Infectious Diesase

Question 1

PCP Prophylaxis

Answer 1

Trimethropim-Sulfamethoxazole (Cotrimoxazole) 160-800mg Until CD4 > 200 and Undetectable viral load, maintain for 3 monts

Question 2

PCP Prophylaxis alternatives

Answer 2

Dapsone 100mg daily

Question 3

Tigecycline

Answer 3

Binds 30S, inhibits bacterial protein synthesis.G(+) included MRSA, G(-) but not PSAE

Question 4

PCP Treatment alternatives

Answer 4

Primaquine + ClindamycinPentamidine

Question 5

Tenia Pedis risk factor

Answer 5

barefoot walking in public areas

Question 6

Tenia pedis features

Answer 6

interdigital type: prutirus erythema, erosionsMoccasin type: scales/fissures, extension onto the feetVesiculobullous type: painful bullae, erythema

Question 7

Tenia pedis diagnosis and treatment

Answer 7

Trycophyton Rubrumpotassium hydroxide microscopy of skin scapping, segmented hyphae1 line: Miconazole topical2 line: oral fluconazoleKeep feet dry and dispose old footwear

Question 8

Molluscum Contagiosum

Answer 8

Poxvirus

Question 9

Hydatid Cyst features

Answer 9

Echinococcus Granulosus

Eggshell cyst

Tte: abendazole + surgery

Question 10

Blunt Cardiac Injury features

Answer 10

Mechanism: shearing, compression, abrupt pressure change

Arrhythmias, MI, valve damage, cardiac contusion, septum/ventricular wall rupture, tamponade

EKG/TTUS

Question 11

Months of flu like illness, followed by monoarticular arthritis

Answer 11

Most commonly affected joint: Knee

Lyme Arthritis or Late Lyme Disease

Suspect if visiting Maine or the northease area

Question 12

Salmonella exposure risk

Answer 12

Inadequate refrigeration of the implicated food

Question 13

PPD interpretation

Answer 13

> 5mm: HIV, close TB contacts, CXR TB+.

> 10mm: homeless, developing nations, IV drug use, residents of health/correctional institutions, health care workers

> 15mm: everyone else

Question 14

TB Latent disease

Answer 14

+PPD without symptoms

Tte: INH x 9 months, INH x 6 months, rifampin x 4 months

Question 15

Dark Field Microscopy

Answer 15

Treponema pallidum, chancroid, sifilis

Question 16

HCV tte

Answer 16

IFN alpha

Question 17

Ecthyma Gangrenosum

Answer 17

Inmunocompromised patients

Rapidly progressive lesion from a small erythematous macule, to larger nodules with necrosis

Question 18

Viral Pericarditis

Answer 18

Hx of cough and sore throat

Question 19

Herpes simplex virus encephalitis

Answer 19

Compromises the frontotemporal lobes
CSF: lumphocytic pleocytosis, elevated proteins, elevated RBC, normal glucose

RBC in the CSF is due to the hemorrhagic destruction of the temporal lobes

Question 20

Shiga Toxins producing E. Coli (STEC)

Answer 20

Exposure to uncooked meats
Exposure to farm animals

Watery turns to bloody diarrhea by day 3, no fever

Supportive care, avoid ATB

HUS 1-2 weeks after diarrhea onset

Question 21

Blood in stools (inflammatory diarrhea)

Answer 21

Campylobacter
Shigella
Salmonella
Shiga producing E. Coli (STEC)

Question 22

Campylobacter Gasroenteritis

Answer 22

Transmitted most commonly via poultry

Fever, abd pain, diarrhea (mucos +/- blood)

pseudoappendicits (RLQ pain)

ATB: more than 7 days, high fever, pregnant

Question 23

Salmonella

Answer 23

Incubation 8 - 72 hrs

Duration 2 - 7 days

Question 24

Disseminated gonococcal infection

Answer 24

Migratory arthritis

Dermatitis

Tenosynovitis

Question 25

Peds: Severe accute otitis media

Answer 25

Significant ear pain Pain of more than 2 days Fever over 39 degrees

Question 26

Peds: OAM when to treat

Answer 26

Severe symptoms Infants under 6 m/o Bilateral OAM under 2 y/o Amoxicilin: 90 mg/kg/day BID

Question 27

Peds: OAM treatment

Answer 27

Amoxi/Clavunate Recurrent AOM (< 30 days) Otitis-Conjunctivitis syndrome (H. Flu) If failed: 3rd gen cephalosporin

Question 28

Centor Criteria (Adult Pharyingitis)

Answer 28

Fever Tender anterior cervical lymphadenopathy Tonsilar exudates No cough

Question 29

Peds: Neonate Bacterias Meningitis

Answer 29

Onset: Early < 3 days, late > 6 days Birth canal MO GBS 50% E. Coli 20-30%

Question 30

Peds: N. Meningitidis complications

Answer 30

Disseminated Intravascular Coagulation Adrenal Hemorrhage Shock

Question 31

Peds: Most common agent of acute gastroenteritis

Answer 31

Norovirus among most patients Rotovaris common un unvaccinated < 2 y/o

Question 32

Peds: Congenital Toxoplasmosis

Answer 32

Hydrocephalus Diffuse intracranial calcifications Chorioretinits

Question 33

Congenital Rubella

Answer 33

Patent Ductus Arteriosus Sensorineural hearing loss Cataracts

Question 34

Peds: VZV ages

Answer 34

1 and 4 y/o

Question 35

Peds: fever, headache and early morning vomiting

Answer 35

Brain Abscess Order CT scan

Question 36

Peds: Enterobius Vermicularis (Oxyuriasis) tte

Answer 36

Pyrantel Pamoate

Question 37

CF and PAE epidemiologu

Answer 37

After 10 y/o before that, staph

Question 38

Congenital HBV

Answer 38

90% transmission without prophylaxis Give vaccine and IVIG to the newborn

Question 39

congenital CMV

Answer 39

MOST COMMON CONGENITAL INFECTION transmited via bodily fluids ``` PERIVENTRICULAR calcifications Growth restriction Microcephaly Hepatosplenomegaly Thrombocytopenia ```

Question 40

Congenital Rubella

Answer 40

Maternal exposure Congenital sensorineural hearing loss, cataracts, patent ductus arteriosus (machine like murmur) Growth restriction

Question 41

Most common risk factor for pediatric acute bacterial rhinosinutisis

Answer 41

Viral URI

Question 42

N. Meningitidis prophylaxis

Answer 42

Transmission can occur 7 days before the symptoms begin Give to close contacts regardless of immunization status

Question 43

Pertussis Prophylaxis

Answer 43

Give macrolides for all household contacts regardless of vaccination status

Question 44

Peds: Pedyculosis treatment

Answer 44

Permethrine