Infectious Disease

Question 1

Empiric coverage for prosthetic valve endocarditis

Answer 1

Vancomycin
Rifampin
Gentamicin

Question 2

Empiric coverage native valve endocarditis

Answer 2

Vancomycin

Gentamicin

Question 3

Indications for surgical intervention for endocarditis

Answer 3

New onset CHF (most important)
Persistent bacteremia 
Recurrent emboli
Valve abscess
Large fungal vegetation 
Multi drug resistant organisms

Question 4

Clostridium septicum or strep bogus bacteremia

Answer 4

Colonoscopy

R/o malignancy

Question 5

Endocarditis ppx

Answer 5

All prosthetic valves
Prior history
Post-transplant heart with valvular disorder
CHD: unrelated cyanotic CHD, repairs within 6mo, repaired with prosthesis

Dental or respiratory procedures

Question 6

Antibiotic ppx for endocarditis

Answer 6

Amoxicillin 2g 1 hour prior

Question 7

Benign. Recurrent lymphocytic meningitis caused by HSV2

Monocytes in CSF

Answer 7

Mollaret’s meningitis

Question 8

Herpes encephalitis

Answer 8

HSV1

Question 9

Herpes meningitis

Answer 9

HSV2

Question 10

Neiseirria Meningitis precautions

Answer 10

Ppx for contacts
Ppx with rifampin 600mg BID x 2 days
Droplet precaution

Question 11

Management for acute prostatitis

Answer 11

Bactrim or Cipro x 4-6 weeks

Question 12

Management for chlamydia

Answer 12

Doxycycline + ceftriaxone (gonorrhea)
Treat partner
Repeat NAAT 3 weeks after treatment

Question 13

Yellow/green discharge
Strawberry crevix
pH> 5

Answer 13

Trichomonas

Question 14

Thin white/gray discharge
Fishy odor
Clue cells
pH > 5

Answer 14

Bacterial vaginosis

Question 15

Burning. Itchy
Vulvovaginal erythema
Thick white discharge
pH< 4.5

Answer 15

Candidiasis

Question 16

Painful genital ulcers
Gram neg bacillus
School of fish or box car appearance

Answer 16

H. Ducreyi

Question 17

Painless genital ulcer

Buboes

Answer 17

Lymphogranuloma venereum

Chlamydia trachomatis

Question 18

Painless ulcers
Looks like carcinoma of penis
Safety pin shaped intracytoplasmic inclusions

Answer 18

Granuloma inguinale
(Klebsiella granulomatis)

Doxycycline

Question 19

Tick bite

No rash

Answer 19

Erlichia/anaplasmosis

Inclusion bodies

Question 20

New England
Tick
Hemolytic anemia
Maltese cross or tetrad

Answer 20

Babesia

Question 21

Vesicular eruptions

Multinuclear giant cells

Answer 21

HSV

Question 22

Gulf coast
Cellulitis
Hemorrhagic bullae. Necrosis
LAD

Answer 22

Vibrio vulnificus

Question 23

Fish tank. Swim instructor.
Non healing skin ulcer.
AFB+

Answer 23

Mycobacterium marinum

Question 24

Florist. Gardner.
Tender papules
No LAD

Answer 24

Sporotrichosis

Itraconazole

Question 25

Neutropenia | Black lesion. Central ulceration

Answer 25

``` Ecthyma gangrenosum (Pseudomonas) ```

Question 26

Isolation for Herpes zoSter

Answer 26

1 dermatome: contact | > 2 dermatomes: contact + airborne

Question 27

Cat bite

Answer 27

Augmentin | Pasteurella

Question 28

Dog scratch Asplenic Shock

Answer 28

Capnocytophago canimorsus

Question 29

Cat scratch

Answer 29

Azithromycin | Bartonella

Question 30

Nodular lesions Modified silver stain Peliosis hepatis (cystic spaces with blood)

Answer 30

Bacillary angiomatosis | Batrtonella

Question 31

Dense core and rim of ground glass appearance

Answer 31

Aspergillosis

Question 32

+ serum galactomannan

Answer 32

Aspergillosis

Question 33

Post transplant | Ground glass intranuclear inculsions

Answer 33

BK virus

Question 34

Post transplant | Intracytoplasmic inclusion bodies

Answer 34

CMV

Question 35

Ulcers. Fevers | LAD

Answer 35

Tularemia

Question 36

Africa Fever Dysuria. Hematuria

Answer 36

Schistosoma

Question 37

Airborne precautions

Answer 37

HZV > 2 dermatomes Measles/varicella Covid MTB

Question 38

Droplet precautions

Answer 38

Neisseria Influenza Plague

Question 39

Narrow base budding

Answer 39

Cryptococcus

Question 40

HIV Opportunistic infection Tcell > 200

Answer 40

Strep pneumonia Kaposi sarcoma PPD + at 5mm

Question 41

HIV Opportunistic infection Tcell < 200

Answer 41

PJP | Candidiasis

Question 42

HIV Opportunistic infection Tcell < 100

Answer 42

Cryptococcal meningitis | Toxo

Question 43

HIV Opportunistic infection Tcell < 50

Answer 43

MAI

Question 44

HIV Opportunistic infection Tcell < 25

Answer 44

CMV retinitis | PML

Question 45

CT brain with multiple cystic lesions and calcifications. Mild hydrocephalus

Answer 45

Neurocysticercosis

Question 46

Side effect for protease inhibitors

Answer 46

Dyslipidemia

Question 47

Side effect for NRTI

Answer 47

Lactic acidosis