Infectious Disease Flashcards
(211 cards)
1
Q
Pathogen responsible for nail-puncture wound through tennis shoe?
A
Pseudomonas
2
Q
Best treatment for Ecthyma Gangrenosum?
A
ABX
3
Q
Best treatment for Pyoderma Gangrenosum?
A
Corticosteroids for treatment of underlying Crohn’s Disease
4
Q
Lab result seen in Salmonella Typhi infection?
A
Leukopenia … (rather than leukocytosis)
5
Q
Clinical presentation of Salmonella Typhi infection?
A
Truncal rose spots that appear ~1 week after fever
6
Q
Etiology of non-typhoidal salmonella?
A
Consumption of chicken/eggs
7
Q
Complication of non-typhoidal salmonella infection?
A
Atherosclerotic aortic aneurysm
8
Q
Why should non-typhoidal salmonella NOT be treated with ABX?
A
Increased risk of carrier state
9
Q
Vector for yersinia?
A
Flea
10
Q
Reservoir of yersinia?
A
Rodents … (prairie dogs)
11
Q
Appearance of yersinia on Gram stain?
A
Safety pin appearance … bipolar staining
12
Q
2 DOC for yersinia infection?
A
Streptomycin, Tetracycline
13
Q
Best treatment for bartonells henselae?
A
Azithromycin
14
Q
Clinical presentation of Legionella infection?
A
PNA, diarrhea, hyponatremia, bradycardia
15
Q
Treatment of Legionella infection?
A
Macrolide
16
Q
Lab result seen in setting of Bordetella infection?
A
Lymphocytosis
17
Q
Lab result seen in setting of Rickettsii infection?
A
Hyponatremia
18
Q
Cardiac manifestation of Coxiella infection?
A
Signs of endocarditis
19
Q
Aspect of HX that predisposes patients to Coxiella infection?
A
HX of heart valve damage … (murmur)
20
Q
What is a rickettsial infection that is not caused by classic Rickettsia?
A
Coxiella
21
Q
Should you order serology test for patient with suspected Lyme Disease?
A
No … (takes too long, need to start doxycycline before then)
22
Q
If a patient discovers tick on body, know it has been there for > 48 hours – what is best management?
A
1 dose of doxycycline
23
Q
If a patient discovers tick on body, know it has been there for < 48 hours – what is best management?
A
Observation
24
Q
Clinical presentation of stage 2 Lyme disease?
A
Polyarthritis, Bell’s palsy, Cardiac conduction
25
Which Cardiac conduction abnormality is associated with stage 2 Lyme disease?
3rd degree heart block
26
Clinical presentation of stage 3 Lyme disease?
Polyarthritis, Encephalitis
27
Causative agent of Granuloma Inguinale?
Klebsiella
28
Appearance of Granuloma Inguinale on biopsy?
Donovan bodies
29
Description of Granuloma Inguinale?
Beefy red granulomatous ulcer
30
Appearance of lungs in Primary TB infection?
Calcified hilar LN
31
\_\_\_ refers to Calcified hilar LN seen in Primary TB infection?
Gohn Complex
32
At what level of PPD induration should patients be treated with isoniazid if they have had recent TB contacts?
\> 5mm induration
33
At what level of PPD induration should patients be treated with isoniazid if they have HIV?
\> 5mm induration
34
How long should latent TB patients be treated with Isoniazid?
9 months
35
32 yo Indian immigrant presents for PPD test that showed 11mm of induration; Reports HX of BCG vaccination in home country – next step?
CXR + sputum culture
36
At what level of PPD induration should patients be treated with isoniazid if they have HX of BCG vaccination?
\> 10mm induration
37
Next step of workup for patients with (+) PPD?
CXR + Sputum culture
38
Next step of workup for patients with (+) PPD; (-) CXR and (-) Sputum culture?
Isoniazid for 9 months
39
Next step of workup for patients with (+) PPD; (+) CXR and (+) Sputum culture?
RIPE therapy … 4 drugs for 2 months; 2 drugs for 4 months
40
What are the 2 TB drugs that should be given for 4 months?
Isoniazid + Rifampin
41
AEs of streptomycin?
Nephrotoxicity, Ototoxicity
42
Treatment of Coccidioidomycosis?
Amphotericin B
43
3 aspects of clinical presentation for Coccidioidomycosis?
Sarcoid-like … Pulmonary lesions + Arthralgias + Erythema nodosum
44
3 aspects of clinical presentation for Histoplasmosis?
Interstitial PNA, Splenomegaly, Pancytopenia
45
Appearance of spleen in Histoplasmosis?
Calcified
46
2 aspects of clinical presentation for Blastomycosis?
Skin + Bone involvement
47
Best treatment for aspergilloma (fungal ball)?
Surgical removal
48
Clinical presentation for aspergilloma (fungal ball)?
Massive hemoptysis
49
Aflatoxin (aspergillus flavus) is a risk factor for which type of CA?
Liver
50
Best treatment for allergic bronchopulmonary aspergillosis?
Steroids + Oral itraconazole
51
Which type of Aspergillus infection in most common in immunocompromised patients?
Invasive pulmonary aspergillosis
52
Clinical presentation of Schistosoma mansoni?
Cirrhosis, portal HTN, varices
53
Clinical presentation of Schistosoma hematobium?
Squamous cell bladder CA
54
Clinical presentation of Diphyllbothrium latum?
Megaloblastic anemia
55
Alternate name for Diphyllbothrium latum?
Fish tapeworm
56
Alternate name for Enterobius vermicularis?
Pinworm
57
50 yo male with AML presents with fever; Finished CTX 10 days ago; Indwelling catheter with no redness or discharge; Labs show PML = 250 – next step in workup?
Draw blood and start IV piperacillin/tazobactam + IV aminoglycoside … covering for Pseudomonas
58
50 yo male with AML presents with fever; Finished CTX 10 days ago; Indwelling catheter with no redness or discharge; Labs show PML = 250; Patient is started on IV piperacillin/tazobactam + IV aminoglycoside – fever does not resolve after 5-7 days … what is next step in management?
Add Amphotericin B
59
Which 4 pathogens are most likely to infect patients with humoral deficiency?
Encapsulated organisms … Strep pneumoniae, Haemophilus influenza, Neisseria meningitis, Giardia
60
2 bacteria that affect patients with T cell deficiency?
Listeria, Nocardia
61
2 fungi that affect patients with T cell deficiency?
Histoplasma, Cryptococcus
62
2 protozoa that affect patients with T cell deficiency?
Pneumocystis carinii, Toxoplasma, Strongyloides
63
2 viruses that affect patients with T cell deficiency?
CMV, Varicella, HSV
64
Best treatment for Gonococcal arthritis?
IV ceftriaxone for 7-10 days
65
Schedule for Hepatitis B vaccine?
Birth, 1-2 months, 6-18 months
66
Best treatment for infants born to mothers with (+) HBsAg?
Hep B IgG, Hepatitis B vaccine
67
What type of vaccine is Hepatitis B?
Inactivated
68
What type of vaccine is Rotavirus?
Live attenuated
69
Route of administration for Rotavirus?
Oral
70
Schedule for Rotavirus vaccine?
2 months, 4 months, 6 months
71
Rotavirus vaccination should not be started on infants older than the age of …
15 weeks
72
AE of Rotavirus vaccination?
Intussusception
73
Schedule for DTap vaccine?
2 months, 4 months, 6 months, 15-18 months, 4-6 years
74
AE of DTap vaccine?
Encephalopathy
75
Schedule for Haemophilus Influenzae vaccine?
2 months, 4 months, 6 months
76
When is Haemophilus Influenzae booster vaccine given?
12-15 months
77
Schedule for PCV13 pneumococcal vaccine?
2 months, 4 months, 6 months
78
When should PCV13 pneumococcal booster vaccine be administered?
12-15 months
79
Indication of PPSV23 pneumococcal vaccine?
Immunocompromised
80
Schedule for PPSV23 pneumococcal vaccine?
After completing PCV13 vaccine (2 yo), then 7 yo
81
Schedule of Polio vaccine?
2 months, 4 months, 6-18 months, 4-6 years
82
Schedule of MMR vaccine?
12-15 months, 4-6 years
83
What type of vaccine is MMR?
Live attenuated
84
Contraindication to MMR vaccine?
Immunodeficiency
85
Schedule of Varicella Zoster vaccine?
12-15 months, 4-6 years
86
Important consideration for patients 6 weeks after receiving VZV vaccine?
Avoid ASA … (risk for Reye Syndrome)
87
Schedule for Hepatitis A vaccine?
Given between 12-24 mo (with 6 months between doses)
88
When may intranasal flu vaccine be administered?
2+ yo
89
Important consideration for patients 6 weeks after receiving influenza vaccine?
Avoid ASA … (risk for Reye Syndrome)
90
When is Tdap virus first given?
11-12 yo
91
How often is Tdap given?
Every 10 years
92
Contraindication to Tdap vaccine?
HX of encephalopathy
93
Timing of first meningococcal vaccine?
11-12 yo
94
Timing of first meningococcal booster?
16 yo
95
Which group of patients should receive meningitis vaccine before 11 yo?
Travelling to endemic region, Asplenia, Complement deficiency
96
Medication that allows for patients should receive meningitis vaccine before 11 yo?
Eculizumab
97
MOA of Eculizumab?
C5 inhibitor
98
When should HPV vaccine be given?
11-12 yo (with 6 months between doses)
99
Coagulase (+) staphylococcus?
Staph aureus
100
Coagulase (-) staphylococcus?
Staph epidermidis, Staph saprophyticus
101
What type of toxin is TSST-1 in Toxic Shock Syndrome due to Staph aureus?
Exotoxin
102
Most common type of nosocomial infection?
UTI
103
What is best ABX for treatment of post-influenza Staph aureus PNA?
IV nafcillin … (this is MSSA)
104
3 outpatient treatments for MRSA?
Clindamycin, TMP-SMX, Doxycycline
105
Common pathogen responsible for post-partum endometritis?
GBS
106
Which virulence factor is responsible for Scarlet fever cause by Strep pyogenes?
Exotoxin A-B-C
107
Which virulence factor is responsible for Necrotizing Fasciitis cause by Strep pyogenes?
Exotoxin B
108
Which ABX is important to add to cases of Necrotizing Fasciitis?
Clindamycin
109
In a patient with Toxic Shock Syndrome (hypotension, desquamating rash, thrombocytopenia, prolonged PTT) – how can you tell between TSS due to Strep pyogenes vs. Staph aureus?
Strep pyogenes = (+) culture; Staph aureus = (-) blood culture
110
32 yo male develops dry cough for 2 days; No exudate, no fever, no LAD – next step?
Observe … strep pharyngitis = fever, no cough, LAD, exudate
111
Patient presents with mucopurulent urethral discharge, multiple sexual partners, absence of bacteria on UA – diagnosis?
Chlamydial urethritis
112
In addition to strep bovis, which bacteria is associated with colon CA?
Clostridium septicum
113
Most common pathogen responsible for subacute bacterial endocarditis in native valves in patients without drug use HX?
Streptococcus viridans
114
Strep pneumoniae is most common cause of which 2 conditions in adults?
Pneumonia, Meningitis
115
3 DOCs for treatment of bacterial meningitis?
vanComycin, Corticosteroids, Ceftriaxone
116
Leading cause of invasive bacterial respiratory disease in patients with HIV infection?
Strep pneumoniae … (not PCP)
117
Best treatment for suspected meningitis caused by Listeria (patient is on chronic steroids)?
Ampicillin + Ceftriaxone + Vancomycin
118
Best treatment for Cornyebacterium Diphtheria?
Erythromycin + Diphtheria toxin
119
Complication of Cornyebacterium Diphtheria infection?
Myocarditis
120
Clinical presentation of Cornyebacterium JK infection?
IV catheter infection in bone marrow transplant
121
Best treatment for Cornyebacterium JK infection?
Vancomycin
122
Toxin used by Clostridium perfringens in setting of necrotizing fasciitis?
Lecithinase … phopholipidase
123
Etiology of neonatal tetanus?
Umbilical stump infection
124
Does tetanus infection induce protective immunity?
No … need to give vaccine after tetanus infection
125
If patient is diagnosed with C. diff infection, but unable to take medications orally – what is DOC?
IV metronidazole
126
Cutaneous manifestation of Bacillus anthracis infection?
Painless black ulcers
127
Best treatment for Cutaneous Bacillus anthracis infection?
Ciprofloxacin
128
Pulmonary manifestation of Bacillus anthracis infection?
Hemorrhagic mediastinitis
129
Clinical presentation of Hemorrhagic mediastinitis in Bacillus anthracis infection?
Widened mediastinum
130
Best treatment for Pulmonary Bacillus anthracis infection?
Ciprofloxacin + Tetracycline
131
Route of transmission for Pulmonary Bacillus anthracis infection?
Spore inhalation … not person-to-person transmission like PNA
132
Best treatment for bacillus cereus gastroenteritis?
Supportive
133
Best treatment for bacillus cereus eye trauma?
Vancomycin
134
Oxygen requirement of Nocardia?
Aerobe
135
Oxygen requirement of Actinomyces?
Anaerobe
136
Which is acid-fast staining – Nocardia or Actinomyces?
Nocardia
137
In addition to dental procedures, what is another exposure that might lead to infection with Actinomyces?
IUD insertion
138
Clinical presentation of Nocardia infection?
Abscess in lungs + brain
139
Best treatment for Nocardia infection?
TMP
140
Most common infectious cause of blindness in developed world?
HSV-1 keratitis
141
Complication of HSV-1?
Encephalitis
142
Classic smell associated with HSV-1 encephalitis?
Smell of burning runner
143
Complication of HSV-2?
Meningitis
144
Structure of Sporotrichosis on tissue culture?
Cigar-shaped yeast
145
What should you NOT do in Franciscella infection?
Aspirate the LN
146
Patient presents with non-healing ulcer after working around fish tank – pathogen responsible?
M. marinum
147
Pathogen most likely to cause genital herpes?
HSV-2
148
Best treatment for pregnant female with genital lesions?
C-Section
149
AE of valacyclovir?
Nephrotoxicity
150
Complication of HHV-6 treated with ASA?
Reye Syndrome
151
Is hairy leukoplakia seen in patients with HIV infection pre-malignant?
No
152
How can you differentiate varicella (chickenpox) from smallpox?
Smallpox = same stage; Varicella chickenpox = all different stages
153
Which specific type of immunodeficiency results in Varicella-Zoster Virus reactivation?
T cell deficiency
154
Which branch of CN V1 accounts for Hutchinson sign in VZV reactivation?
Nasociliary
155
3 aspects of clinical presentation in Ramsay Hunt Syndrome?
Ear pain, ipsilateral facial weakness, Vesicular lesions on external ear
156
Ramsay Hunt Syndrome results from reactivation of VZV from within …
Geniculate ganglion
157
Appearance of Tzanck smear in VZV infection?
Multinucleated giant cells
158
2 DOC for post-herpetic neuralgia?
TCA, gabapentin
159
Value of treating herpes zoster infection with acyclovir?
Shortened course of illness, but does not decrease incidence of post-herpetic neuralgia
160
Which 2 medications can decrease the likelihood of post-herpetic neuralgia?
Famicyclovir, Valacyclovir
161
Which pathogen is most commonly responsible for ocular complications in HIV patients?
CMV
162
Ocular effect of CMV in HIV patients?
Chorioretinitis
163
AE of ganciclovir?
Granulocytopenia
164
Appearance of EBV infection on blood smear?
Atypical lymphocytes … indentation of cytoplasm (ballerina skirt)
165
3 malignancies associated with EVB infection?
Nasopharyngeal carcinoma, Burkitt lymphoma, Hodgkin Lymphoma
166
Flu vaccination decreases influenza mortality by about \_\_\_%
33
167
Amatidine is effective against Influenza A or Influenza B?
A
168
Oseltamivir is effective against Influenza A or Influenza B?
Both
169
MOA of Oseltamivir in treatment of Influenza A and B?
Neuraminidase inhibitor
170
Best treatment for patients in nursing home in which influenza infection is spreading?
Give oseltamivir to slow spread of infection … No point in giving influenza vaccination … Only effective in preventing spread of influenza on population basis
171
Antigenic ___ in influenza infection is responsible for minor spontaneous mutations of HA or NA
Drift
172
Antigenic ___ in influenza infection is responsible for major changes in viral RNA segments
Shift
173
Which is responsible for yearly flu endemic infections – drift or shift?
Drift
174
Which is responsible for yearly flu pandemic infections – drift or shift?
Shift
175
Which group of patients should receive pre-exposure rabies prophylaxis?
Veterinarians
176
Patient is attacked by animal (thinks it was a raccoon) – should you start with rabies IgG + vaccination?
Yes
177
Hint for West Nile infection?
Dead birds
178
Vector for West Nile infection?
Aedes mosquito
179
In addition to Parvovirus B19, what are 2 other causes of Red Cell Aplasia?
Diamond-Blackfan Anemia … Thymoma
180
Which cells are targeted by HIV?
CD4+ T cells
181
Acute retroviral syndrome in HIV infection mimics …
Infectious mononucleosis
182
Majority of HIV spread occurs in …
Heterosexual patients … but homosexual sexual behavior is higher risk
183
Is HIV or Hepatitis B more likely to be transferred via needle stick?
Hepatitis B … 1:3
184
Best management of needlestick from known HIV patient?
Begin HAART therapy for 1 month
185
Best test for diagnosis of HIV infection?
ELISA, confirm with Western Blot
186
4 infectious diseases that should be screened for in newly-diagnosed HIV patients?
Syphilis, toxoplasma, Hepatitis B + C
187
Which 3 vaccines are contraindicated in all HIV patients?
Polio, varicella, yellow fever
188
Which vaccine is contraindicated in HIV patients with CD4 \< 200?
MMR
189
Best management of pregnant HIV patient?
Begin zidovudine after 10-12 weeks (regardless of CD4 count) + IV zidovudine during delivery + Zidovudine for infant for 6 weeks
190
CD4 count associated with CD4 \< 200?
Pneumocystis jiroveci
191
Best prophylaxis for Pneumocystis jiroveci?
TMP-SMX
192
Best prophylaxis for Pneumocystis jiroveci in patient with TMP-SMX allergy?
Dapsone
193
CD4 count associated with CD4 \< 100?
Toxoplasma
194
Best prophylaxis for Toxoplasma?
TMP-SMX
195
Best prophylaxis for Toxoplasma in patient with TMP-SMX allergy?
Dapsone
196
CD4 count associated with CD4 \< 50?
Mycoplasma Avium Carinum (MAC)
197
Best prophylaxis for Pneumocystis jiroveci?
Macrolides
198
When should HAART therapy be started in HIV patient?
CD4 \< 500
199
3 AEs of AZT therapy?
3 M’s … macrocytic anemia, myelosuppression, myopathy
200
HAART drug associated with HSN reaction?
Abacavir
201
3 AEs of Protease inhibitors?
Lipodystrophy, Inhibition of P450, DM
202
Which HAART drug should be avoided in patients with TB?
Rifampin … use Rifabutin instead
203
2 examples of Protease inhibitors?
Indinavir, Ritonavir
204
AE associated with indinavir?
Nephrolithiasis
205
AE associated with ritonavir?
Lipodystrophy
206
Most common pathogen causing invasive pulmonary disease in HIV patients?
Strep pneumoniae
207
Which pathogen is associated with CNS lymphoma in AIDs?
EBV
208
AE of pentamidine used in treatment of Pneumocystis Jiroveci?
Atypical PNX
209
3 ring-enhancing lesions of brain in HIV patients?
Toxoplasmosis, CNS lymphoma, Brain abscess
210
Best treatment for Cryptococcal meningitis?
Amphotericin B until CSF is negative + Oral fluconazole indefinitely
211
Special stain for Cryptococcal meningitis?
India ink
