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Infectious Disease Flashcards

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0
Q

What is most common viral pathogen to cause aseptic meningitis in both children and adults?

A

Entero virus

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1
Q

Which cancer is associated with HTLV2 infection?

A

Hairy cell leukemia

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2
Q

What is best diagnostic test for west Nile meningitis?

A

IgM antibody in CSF

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3
Q

What is most common pathogen for causing benign recurrent lymphocytic meningitis?

A

HSV 2

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4
Q

What age do you need to add ampicillin to abx coverage for meningitis for listeria coverage?

A

50 years old

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5
Q

Bacterial pathogens most common in meningitis associated with basilar skull fracture?

A

H. Influenza
S. Pneumoniae
GAS

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6
Q

Bacterial pathogens associated with meningitis and post neurosurgery/head trauma

A

Staphylococcus aureus
CONS
P. Aeruginosa

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7
Q

Common bacterial pathogens that cause meningitis with associated VPS or intraventricular catheters

A

S. Aureus
CONS
GNR esp. P. Aeruginosa
Diphtheroids (p. Acnes)

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8
Q

What time frame should LP be repeated in bacterial meningitis if there is failure to respond to IV abx and dexamethasone treatment?

A

36-48 hours

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9
Q

What is most common empiric treatment for brain abscess?

A

3rd generation cephalosporin
Metronidazole
Vancomycin

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10
Q

What size of brain abscess requires stereotactical aspiration?

A

> 2.5 cm

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11
Q

What is standard length of treatment for bacterial brain abscess?

A

6-8 weeks IV abx, maybe 3-4 weeks of surgically removed

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12
Q

What is the most common condition to predispose someone to a cranial subdural empyema?

A

Para nasal sinusitis

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13
Q

What is the most common pathogen that causes sinus epidural abscess?

A

S. Aureus

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14
Q

What is empiric abx coverage for spinal epidural abscess

A

Vancomycin

Anti pseudomonas cephalosporin or carbapenum

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15
Q

What are 2 most common pathogens that cause encephalitis in USA?

A

HSV

West Nile Virus

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16
Q

What type of paralysis is seen with west Nile viral encephalitis?

A

Acute flaccid paralysis - similar to polio

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17
Q

What is diagnostic test of choice for diagnosing west Nile neuro invasive disease?

A

Detection of west Nile IgM antibody in CSF

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18
Q

What are the hallmarks of creutzfeldt Jacob disease?

A

Rapidly Progressive dementia

Myoclonus

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19
Q

Which neural protein is elevated in CSF with creutzfeldt Jacob disease?

A

14-3-3 protein

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20
Q

What pathogen is associated with cellulitis and freshwater contact/brackish water?

A

Aeromonas hydrophilic

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21
Q

What organism is associated with cellulitis with areas of bullae and hemorrhage and recent salt water/seafood?

A

Vibrio vulnificus

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22
Q

What pathogen causes cellulitis usually of the hands or arms after handling saltwater marine life?

A

Erysipelthrix rhusiopathiae

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23
Q

What pathogen is associated with a cellulitis and contact primarily with dogs?

A

Capnocytophaga canimorsus - common in asplenia

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24
What organism is associated with a cellulitis with central eschars?
Bacillus anthracis
25
What organism is associated with a cellulitis with ulcerative lesions and central eschar and recent contact with infected animals (particularly cats)?
Francisella tularensis
26
What organism causes a cellulitis at a site of trauma and recent contact with fresh or salt water?
Mycobacterium marinum
27
What type of patient is at increase risk of vibrio vulnificans necrotizing fasciitis?
Immunocompromised pts with iron overload syndrome such as cirrhosis
28
What are the two bacteria that cause toxic shock syndrome?
Staphylococcus | Streptococcus (group A or b)
29
What are good prophylactic antibiotic regimens for animal bites?
Augmentin Or Doxycycline/fluoroquonolone plus clindamycin
30
What is antibiotic of choice for treatment of cat scratch disease?
Azithromycin
31
What organisms should be considered if there is a CAP with lung cavities?
``` CA-MRSA Oral anaerobes Fungal pathogens TB Atypical mycobacterium ```
32
What organism can cause CAP with exposure to bat or bird droppings?
Histoplasmosis
33
What organism can cause CAP with recent exposure to farm animals or cats?
Coxiella burnetti
34
What organism can cause CAP with recent travel to southeast or east Asia?
Burkholderia pseudomallei
35
What 2 antigen tests should be preformed on all ICU pts with CAP?
Urine legionella and pneumonococcal antigens
36
What are good beta lactam antibiotics for outpatient treatment of CAP?
Augmentin Cefpodoxime Cefuroxime
37
What is preferred abx treatment for legionella?
Fluoroquinolone, Azithromycin or doxycycline
38
What patients need a follow up chest X-ray 6-8 weeks after a pneumonia to evaluate for underlying mass?
>40 years old | Smoker
39
What geographic regions is Lyme disease most prevalent?
Northeast | North central
40
What geographic location is most common for ehrlichiosis?
Southeast South central Mid-Atlantic
41
What is best diagnostic test for Lyme disease if in early disseminated stage (3-6weeks)?
ELISA with confirmatory western blot
42
What forms of Lyme disease require IV antibiotic treatment?
Myocarditis with 2nd or 3rd degree heart block Meningitis Encephalitis
43
What joint is most commonly involved in Lyme arthritis?
Knee
44
What are antibiotic options for treating Lyme disease?
Doxycycline, amoxicillin or Cefuroxime of PO or IV Ceftriaxone
45
What is geographic location common for Babesiosis?
North east | North central
46
Which tick Bourne illness can present with hemolytic anemia, splenomegaly, hepatomegaly, DIC and multi organ failure?
Babesiosis
47
What is preferred diagnostic test for babesiosis?
PCR of serum
48
What is the treatment for Babesiosis?
Atorvaquone plus Azithromycin Or Quinine plus clindamycin
49
When do you do exchange transfusion for Babesiosis?
If > 10% parasitemia
50
What organism causes southern tick-associated rash illness (STARI)?
Amblyomma americanum
51
What geographic location is STARI common in?
South central Southeast Mid-Atlantic
52
What is treatment of STARI?
Empiric treatment of Eyrthema Migricans with doxycycline
53
What geographic location is anaplasmosis seen in?
Northeast | North central
54
What geographic location is ehrlichiosis seen in?
Southeast South central Mid-Atlantic
55
What is a characteristic pathology finding for ehrlichiosis or anaplasmosis?
Intraleukocytic clusters of bacteria (morulae) on buffy coat stain
56
What is treatment of ehrlichiosis or anaplasmosis?
Doxycycline for 7-14 days
57
What lab finding can help differentiate between anaplasmosis/ehrlichiosis and RMSF?
RMSF usually has normal white count and others have leukocytosis
58
When do you consider using post coital antibiotic prophylaxis for recurrent UTIs?
>2 UTI in 6 months or | >3 in 12 months
59
Which fluoroquinolone should not be used to treat acute pyelonephritis?
Moxifloxacin
60
What is the treatment of choice for acute prostatitis?
Bactrium (alt fluoroquinolone) x 4-6 weeks
61
What is a Ghon complex?
Localized pulmonary and lymph node scarring secondary to tuberculosis
62
What patients is a PPD of 5 mm considered positive?
HIV Recent contact with active TB CXR with possible PPD Organ transplant/immunocompromosed
63
What patients is a positive PPD > 10 mm?
``` Recent travel to high prevalence countries IVDU Resident jail/nursing home et Healthcare workers Children < age 4 ```
64
What is first choice antibiotic treatment for shigellosis?
Ciprofloxacin
65
What is first choice alternative for vancomycin for treatment of blood stream infections or endocarditis caused by MRSA?
Daptomycin
66
What is the preferred test for tuberculosis screening in children less than age 5?
PPD
67
What patients require post varicella exposure treatment?
Immunocompromised or pregnant patients Treat with VZIG or IVIG Treat within 96 hrs of exposure
68
What is the typical rash seen with smallpox?
Starts on buccal and pharyngeal mucosa, spreads to face and trunk and finally extremities (centrifugally) Starts as macules to papules to vesicles to bullae and finally crust over after which they are no longer infectious
69
What anti-rejection medication levels increase with addition of macrolid antibiotics or azoles?
Tacrolimus/sirolimus
70
What are two alternative treatment regimens for latent TB?
Directly observed rifapentine and isoniazid for 3 months | Rifampin daily x 4 months
71
What is typical length of treatment for tuberculosis meningitis?
9-12 months
72
What TB drug can cause an optic neuritis?
Ethambutol
73
What drugs is Multi-drug resistant TB resistant to?
Isoniazid | Rifampin
74
What drugs are Extensively drug-resistant (XDR) tuberculosis resistant to?
At least 1 of 2nd line drugs: kanamycin, capreomycin, or amikacin Fluoroquinolones
75
What type of TB disease is BCG vaccine most effective in preventing?
Disseminated TB and tuberculosis meningitis in children
76
What is Lady Windermere syndrome?
Mycobacterium about complex (MAC) pulmonary infection in middle aged or elderly women who smoke
77
What is "hot-tub lung"?
MAC hypersensitivity like pneumonitis due to inhaled aerosolsized water
78
At what CD4 count are MAC infections most likely to occur?
< 50
79
What is antibiotic treatment for MAC?
Macrolide (Azithromycin, clarithromycin), ethambutol and rifampin Add amikacin or streptomycin if severe disease
80
What is treatment of MAC lymphadenitis?
Excisional surgery alone
81
Where is mycobacterium kansasii most commonly found?
Urban municipal water supplies
82
When do you initiate anti retroviral therapy in HIV patients?
``` History of AIDS defining opportunistic infection or malignancy CD4 count <500 HIV nephropathy Presence of symptoms Pregnancy Co infection with hepatitis C/B Active cardiovascular disease ```
83
What extrapulmonary manifestations of TB should adjuvant prednisone be added to quadruple therapy?
Pericarditis | Meningitis
84
How long is treatment for mycobacterium kansasii?
18 months - sputum cultures must be negative for 12 months
85
What is primary risk factor for development of a rapidly growing mycobacterium (RGM) infections?
Often hospital acquired with exposure to colonized liquid or tap water
86
What is preferred treatment for candidiasis in a severely ill patient?
Echinocandin- capsofungin, micafungin, or anidulafungin
87
Which type of malaria has classic "banana shaped" gametocytes on blood smear?
Plasmodium flaciparum
88
Which TB medication can precipitate gout?
Pyrazinamide
89
What is length of treatment for candidemia?
14 days after clearance of cultures
90
What is treatment of choice for candidal pyelonephritis?
Flu comatose
91
What type of infection with candida should NOT be treated with echinocandins?
Meningitis | Endophthalmitis
92
What is the treatment for allergic bronchopulmonary asperguillosis?
Corticosteroids during exacerbation | Itraconazole
93
What is definitive therapy for pulmonary aspergilloma (fungal ball)?
Surgical resection
94
What is the galactomannan antigen immunoassay useful for detecting?
Detecting asperguillosis in the CSF, serum, or BAL
95
What is first line treatment for asperguillosis?
Voriconazole
96
What patient populations are at increased risk for development of mucormycosis?
Prolonged neutropenia Severe burns or trauma Poorly controlled diabetes mellitus Immunosuppressed
97
What fungus has characteristic broad, ribbon-like, irregular, aseptate hyphae with right angle branching?
Mucormycosis
98
What is treatment of mucormycosis?
Surgical debridement | Amphotericin B
99
What is primary treatment for non invasive cutaneous cryptococcosis?
Fluconazole
100
What is the primary treatment for disseminated cryptococcous, immunocompromised patient, meningoencephalitis?
2 weeks induction with amphoB and flucytosine (4 weeks if Not immunocompromised) followed by consolidation therapy with flu console x 8 weeks Maintenance therapy should be continued if HIV until CD >100 for at least 3 months and at least 1 year antifungal therapy
101
What fungus has single broad based yeast buds?
Blastomycosis
102
What is the treatment of mild acute pulmonary/extra pulmonary blastomycosis?
May not require treatment If moderate infection oral itraconazole 6-12 months Severe - amphotericin B 1-2 weeks followed by itraconazole 6-12 months
103
What is 2nd most common site of blastomycosis infection after pulmonary involvement?
Skin
104
What is the treatment of mild pulmonary histoplasmosis?
No treatment needed
105
What is first line treatment of for histoplasmosis?
Moderate infection - itraconazole | Severe - amphotericin B
106
What is length of treatment needed for coccidiomycosis infection?
3-6 months
107
What is treatment of coccidiomycosis meningitis?
Oral fluconazole for life
108
What is the presentation of Sporothrix schenckii infection?
Papule or infected lesion after gardening
109
What is treatment for sporotrichosis?
Itraconazole
110
What are common STD that cause proctitis?
Chlamydia Gonorrhea HSV Syphilis
111
Which partners should be screen if patient positive for chlamydia?
Any within the past 60 days or the last partner if >60 days
112
When do you need to hospitalize for PID?
1. Inability to exclude surgical emergency 2. Pregnancy 3. Failure to respond to outpt treatment 4. Inability to tolerate PO therapy 5. Signs of toxicity 6. Suspected tubo-ovarian abscess
113
What is the most common organism to cause epididymitis?
Chlamydia
114
What is IV abx choice for PID?
Cefotetan plus doxycycline Or Clindamycin plus gentamicin
115
When do you classify a patient as having early latent secondary syphilis?
Disease known to be < 1 year
116
When do you treat the partners of patient with syphilis?
All partners exposed within previous 3 months even if serologic results are negative
117
What illicit drug is associated with a higher rates of chancroid?
Crack cocaine
118
What is treatment of chancroid?
Azithromycin 1g PO x 1 Or Ceftriaxone 250mg IM x 1
119
What is treatment of lymphogranuloma venerum?
Doxycycline 100 mg PO BID x 21 days
120
What is typical presentation of lymphogranuloma venerum?
Proctitis or proctocolitis in men who have sex with men with perianal ulcers
121
What is the most common location of hematogenous osteomyelitis in adults?
Vertebral column
122
What imaging modality is preferred to diagnose osteomyelitis if MRI not possible?
CT
123
How many weeks must a patient have fevers in order to be consider for FUO?
``` 3 weeks (outpatient) 3 days (inpatient) ```
124
What are the two most common causes of FUO in HIV/AIDS patients?
1. Infections in particular mycobacterial infections | 2. Non Hodgkin's lymphoma
125
What organisms often cause FUO that turns out to be endocarditis?
``` HACEK organisms Hemophilus aphrophilus Actinobacillus actinomycetemcomitans Cardiobacterium hominis Eikenella corrodens Kingella kingae ```
126
Which FUO syndrome presents with sensorineural hearing loss, urticarial rash, fever, abdominal pain, and eventually amyloidosis?
Muckle Wells syndrome
127
Which autoimmune diseases are frequently associated with CVID?
Pernicious anemia IBD Rheumatoid arthritis Hemolytic anemias
128
What is diagnostic tests for CVID?
1st quantitative immunoglobulins Then Antibody response to vaccines (don't do if IgG < 200 because you already know they won't respond)
129
What type of infections do people get with complement deficiencies?
Encapsulated organisms
130
Which complement deficiencies lead to increased infections with particularly Neisseria infections?
C5, C6, C7 and C8 | Properdin deficiency
131
What type of paralysis is caused by botulism?
Descending flaccid paralysis
132
What is preferred treatment for tularemia?
Stretomycin or gentamicin
133
What is preferred treatment for anthrax or yersinia pestis?
Doxycycline or Ciprofloxacin
134
What organism has a distinct "box-car" shaped appearance, aerobic non motile bacillus?
Anthrax
135
How do you diagnose anthrax?
PCR of any fluid
136
What CXR or chest CT finding is concerning for pulmonary anthrax?
Mediastinal widening
137
What is length of treatment for anthrax?
10-14 days IV abx, total treatment 60 days
138
What is post exposure protocol for anthrax?
Treatment with Ciprofloxacin or doxycycline plus anthrax vaccine x 3 doses
139
What is serious eye complication that can occur from smallpox?
Blindness from keratitis or corneal ulceration
140
What characteristic differentiates smallpox rash from varicella?
Varicella has multiple stages of lesions while smallpox all lesions are at the same stage of maturation on any area of the body
141
When should post exposure vaccination be done if exposed to smallpox?
Any close contacts, given within 3 days of exposure
142
What are the common presentations o the plague?
1. Primary cutaneous (bubonic) with lymphadenitis 2. Septicemia plague 3. Primary pneumonic plague 4. Secondary pneumonic plague
143
What is characteristic shape of yersinia pestis?
Gram negative bacilli with bipolar staining and "safety pin" shape
144
What is length of treatment for the plague?
10 days
145
What is post exposure prophylaxis for the plague?
Doxycycline or fluorquinolone for 7 days
146
What is classic triad of botulism?
1. Descending flaccid paralysis with prominent bulbar signs 2. Normal body temperature 3. Normal mental status
147
What are the common presentations of tularemia?
1. Pneumonic 2. Typhoidal 3. Septicemic 4. Oropharyngeal
148
What is best diagnostic tool for tularemia?
PCR of any fluid
149
What is treatment for tularemia?
Streptomycin or gentamicin for 7-14 days
150
What is prophylaxis for tularemia exposure?
Doxycycline or Ciprofloxacin for 14 days
151
What are four viral hemorrhagic virus families that can be used in bioterrorism?
Flaviviridae Filoviridae Arenaviridae Bunyaviridae
152
What is fever cycle in malaria?
Every 48-72 hrs
153
What % parasitemia in malaria is associated with increased rates of altered mental status, DIC, hepatic failure, acute hemolysis?
5-10%
154
Which two malaria species have the highest disease severity?
P. flaciparum | P. knowlesi
155
Which malaria species have high rates of relapse?
P. vivax P. ovale P. malariae
156
Which malaria species is not found in Africa?
P. knowlesi because no macaque monkeys in Africa
157
What antimalarial prophylaxis can be given to pregnant women?
Chloroquine
158
How is dengue fever transmitted?
Mosquito
159
What is "saddleback" pattern mean for dengue fever?
2 febrile periods with a time in between afebrile
160
When is IVIG recommended for post exposure for hepatitis A?
< 12 months old Immunocompromised state Unvaccinated
161
What is the cause of endemic or murine typhus?
Rickettsia typhi
162
What is the treatment for Rickettsial typhus?
Doxycycline
163
How do people contract brucellosis?
Contaminated milk or meat Direct inoculation via skin wounds or mucous membranes Exposure to domestic animals giving birth
164
What is treatment of brucellosis?
Combo doxycycline, streptomycin and rifampin
165
What patients is penicillium marneffei a problem?
HIV
166
What bacteria is associated with diarrhea and exposure to a puppy or kitten with diarrhea?
Campylobacter
167
What bacteria is associated with diarrhea and chitterlings (pork intestines)?
Yersinia
168
Which bacteria is associated with diarrhea and cruise ship?
Norovirus
169
What organism can cause diarrhea associated with untreated fresh water or contaminated shellfish?
Aeromonas | Plesiomonas
170
What bacteria cause bloody stools?
``` Shigella Campylobacter STEC Salmonella Entamoeba ```
171
What bacteria can cause diarrhea with symptoms that mimic appendicitis?
Yersinia
172
What organisms commonly cause diarrhea associated with daycare centers?
Shigella Rotavirus Norovirus Giardia
173
Which diarrheal pathogen is associated with Guillain Barre syndrome?
Campylobacter
174
What is recommended treatment for campylobacter?
Only if severe | Azithromycin or erythromycin
175
What is treatment of Shigellosis?
ALL require 5 days fluoroquinolone - high rate of shedding
176
What is a known endovascular complication associated with Salmonella diarrhea?
Aortitis
177
When should antibiotics be given for Salmonella diarrhea?
1. Younger than 6 months old or older than 50 yo 2. Presence of prosthetic heart valves or joints 3. Co morbidities such as sickle cell, uremia, malignancy 4. Severe atherosclerotic disease 5. Impaired cellular immunity
178
How long is fecal shedding of salmonella?
5 weeks
179
What is treatment for salmonella?
Fluoroquinolone 5-7 days
180
Which vibrio species is associated with raw shellfish?
Vibrio parahaemolyticus
181
If patient unable to take PO abx, what IV medication should be given to treat C diff?
Flagyl - IV vanco does not penetrate the colon
182
Which patients are at increased risk for developing severe infection from Giardia?
Hypogammaglobulinemia
183
What is preferred diagnostic test for Giardia?
Stool antigen immunoassay
184
What biliary complication can be seen with HIV and cryptosporidium?
Acalculous cholecystitis
185
How do you diagnose cryptosporidium?
Acid fast stain of stool Or Serologic assay of stool
186
What is treatment of cryptosporidium?
If immunocompetent usually unnecessary | Nitrazoxanide if severe
187
What is treatment of amebiasis?
Metronidazole plus paromycin or iodoquinol
188
When is CMV infection most likely post transplant?
2 weeks - 4 months
189
What is the most common consequence of EBV infection in post transplant patients?
PTLD - more common in solid organ transplants
190
What complication does BK virus cause in kidney transplant?
Ureteral strictures and nephropathy
191
What complication is BK virus associated with in HSCT patients?
Hemorrhagic cystitis
192
What type of paralysis is seen with tick paralysis?
Ascending paralysis mostly affecting large muscles
193
What is typical presentation of paralytic shellfish poisoning?
Within a few hours of ingestion First tingling of the lips and mouth, then parasthesias of the fingers and toes, then loss of control of arms and legs and eventually can look control of trunk muscles/respiratory distress
194
What finding can be seen in the urine for a transplant patient with BK virus nephropathy?
Decoy cells in urine
195
What statin is usually used for HIV patients if needed?
Atorvastatin
196
What timeframe after transplant do patients tend to get pneumocystis jirovecii infection?
Usually late phase > 100 days
197
When do transplant patients tend to get CMV infections?
Middle period (30-100 days) or late phase >100 days
198
When do post transplant patients tend to get VZV infection?
Late phase > 100 days
199
When do past transplant patients tend to get HSV infections?
Early or post engraftment phase < 30 days
200
Which organisms is the most common cause of invasive fungal infection post transplant?
Asperguillosis
201
Which type of transplant is at risk for cryptococcous infection ?
Solid organ. Rare in HSCT
202
What timeframe do you start reimmunizing post HSCT patients?
6-12 months
203
What timeframe can you give live vaccines (VZV/MMR) to post HSCT patients?
After 24 months if no GVHD
204
How long after transplant is ganiciclovir or valganciclovir given for CMV prophylaxis?
3-4 months
205
How long after transplant is bactrim given for PCP prophylaxis?
12 months
206
How many CFU are required for diagnosis of CAUTI?
> 1000 (10^3) - single catheter urine specimen or midstream void of catheter removed
207
What is the timeframe after a surgery does an infection of the soft tissue around incision considered a surgical site infection/hospital acquired infection?
30 days | 1 year if implanted device
208
How long should you provide prophylactic antibiotics after surgery?
No longer than 24 hrs
209
Which type of antiseptic is preferred prior to surgery?
Chlorhexidine
210
How long should you treat VAP?
8 days
211
How often do you need change a transparent dressing to prevent a CLABSI?
7 days
212
What MIC for vancomycin should you consider alternative agents?
> 2 | Clindamycin or linezid is for PNA and daptomycin for bloodstream
213
If ESBL infection present when should tigecycline not be used as a mono therapy?
If bacteremia present
214
If actinobactor UTI multi drug resistance present, is tigecycline or minecycline preferred?
Minocycline - higher urinary concentrations
215
Which 4 heart conditions typically require antibiotic prophylaxis to prevent infective endocarditis?
1. Prosthetic cardiac valve 2. Previous history of infective endocarditis 3. Unrepaired Cyanotic heart disease including palliative shunts and conduit 4. Cardiac transplant patients with valvulopathy
216
What are primary antibiotic regimens for endocarditis prophylaxis?
1. Amoxicillin 2g or 50/kg 2. Cephalexin 2g or 50/kg 3. Clindamycin 600 mg or 20/kg 4. Azithromycin or clarithromycin 500mg or 15/kg IV - ampicillin, Ceftriaxone, cefazolin or clindamycin
217
Do patients need abx prophylaxis for endocarditis if undergoing EGD/colonoscopy?
No | Not for GU procedures either
218
What drug is approved for pre exposure prophylaxis of HIV in individuals with high risk sexual behavior?
Emtricitabine/tenofovir
219
How soon after HIV infection does acute retroviral syndrome occur?
2-4 weeks
220
What is best test for diagnosing acute retroviral syndrome?
Nucleic acid amplification test
221
At what CD4 count do you initiate bactrim prophylaxis for PCP in HIV patients?
<200 | Bactrim DS daily or three times per week
222
At what CD4 count do you begin to see toxoplasmosis infections in HIV patients?
<100 | Bactrim is prophylaxis
223
At what CD4 count do you initiate Azithromycin for MAC in HIV patients?
<50
224
What PPD size is positive in an HIV patient?
5 mm
225
Which HIV drugs are associated with higher rates of lipodystrophy?
Zidovidine | Stavudine
226
What timeframe do you see immune reconstitution inflammatory syndrome after initiation of ART in HIV patients?
Few weeks to a few monthsp
227
What is treatment of IRIS in HIV?
Continue ART Treat underlying infections Steroids
228
What CD4 count is cryptococcal infections most likely to occur in HIV patients?
<100
229
What PaO2 in ambient air should you start corticosteroids as adjuvant treatment for PCP pneumonia in AIDS?
35
230
What is treatment of toxoplasmosis?
Pyrimethamine plus sulfadiazine or clindamycin
231
What CD4 count do you start to have CMV infections in HIV?
<50
232
What is the most common manifestation of bartonella infection in AIDS patients?
Bacillary angiomatosis
233
Which drugs are non nucleoside reverse transcriptase inhibitors?
Efavirenz Etravirine Nevirapine Rilpivirine
234
What is preferred initial treatment for HIV?
Tenofovir (NRTI) Emtricitaine (NRTI) Efavirenz (NNRTI)
235
What HIV medication is associated with neural tube defects if given during pregnancy?
Efavirenz
236
What drug boosts the effect of protease inhibitors?
Ritonavir
237
Which HIV drugs are given in place of efavirenz?
Raltegravir (integrase inhibitor) | Atazanavir or darunavir (protease inhibitors)
238
Which HIV class of drug should not be given with lovastatin or simvastatin?
Protease inhibitors
239
Which HIV drug should not be given with PPI?
Atazanavir
240
What is referred treatment regimen for HIV pregnant women?
Lamivudine Lopinavir/ritonavir Zidovudine
241
Which influenza subtype do antigenic shifts occur?
A
242
How many outbreaks per year do you need before starting suppressive therapy for HSV?
> 6 or severe outbreaks or immunocompromised
243
What is a rare hematologist complication of valacyclovir in patients with AIDS?
TTP
244
How soon should acyclovir be started for treatment of VZV infections?
Within 24 hrs of the onset of lesions
245
Which carbapenum has lowest risk for causing seizures?
Doripenum
246
What is common complication of tigecycline?
Pancreatitis
247
What monitoring needs to be done for daptomycin use?
CK levels - can cause rhabdomyolysis
248
What is serious side effect of telavancin?
Nephrotoxicity
249
What neurological side effect can occur with linezolid?
Peripheral or optic neuropathy
250
What organism is doripenum more active against than imipenum and meripenum?
Pseudomonas
251
What type of infection could one use colistin?
MDR gram negative bacteria
252
What are major side effects of colistin?
Neurotoxicity | Nephrotoxicity
253
What are absolute contraindications to hyperbaric oxygen treatment?
Untreated pneumothorax | Recent chemo with doxorubicin or cisplatin
254
What is reservoir for schistomatosis?
Snails
255
What disease is thalidomide still used to treat?
Leprosy/Hansen disease
256
What gram negative cocci causes a pneumonia?
Moraxella
257
What pneumonia organism has salmon colored sputum and pneumatoceles?
Staph aureus
258
What is Loeffler syndrome?
Eosinophilic pneumonia due to helminth infection
259
``` What is cause of: Spontaneous pneumothorax Lytic bone lesions DI Young male smoker ```
Langerhans cell histiocytosis
260
``` What causes: Non smoking female Long bone pain Intermittent hemoptysis Clubbing Pain with palpation anterior shins ```
Adenocarcinoma with hypertrophic osteoarthropathy - treat cancer and use NSAIDS

Internal Medicine (12 decks)

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