Infectious Disease and ABx

Question 1

Bright red firm friable exophytic nodules in patients with HIV

Answer 1

Bacillary AngioM

Question 2

Coxsackie Herpangia vs Gingivostomatitis

Answer 2

Coxsackie: gray vesicles on oropharyngeal area

Gingivostomatitis: becomes on anterior oral area (lips tongue bucca etc.)

Question 3

Maculopapular rash and fever days after MMR

Answer 3

Live Vx, causes a mild version of measles sometimes. All ok, but is mildly contagious (stay away from immunocomp). Don’t need airborne precaution though. No need to Tx

Question 4

Why does Tet of Fallot increase risk of cerebral abscess

Answer 4

Bac can transfer to systemic circ easily

Question 5

> = 5mm is the cut off for PPD in who

Answer 5

HIV, recent contact, organ transplant, immunosuppressive patient, previous Tb signs on Xray

Question 6

> = 10mm is the cut off for PPD in who

Answer 6

All my risky P

Immigrant for endemic, IVDU, prison environment, nursing home, homeless shelter, Tb lab 🥼, DM/Leuk/ESRD/Malab patient, <4yo

Question 7

Widening of the preveetbral space on lateral X-ray, is a sign of which URI

Answer 7

Retropharygneal abcess

Question 8

Dx this

Child with fever, dysphagia, muffled voice, no uvula deviation, widened pre vertebral space, Hx of URI prior . No stridor

Answer 8

Retropharyngeal abcess

Question 9

Why do we give penicillin in acute Rheum fever patients?

Answer 9

Essentially to decrease carriage and recurrent infx. Since reinfx can efff up a ARF patient a lot more

Question 10

Dx test for non typhoidal salmonella

Answer 10

Stool culture

Question 11

Salmonella in US

Answer 11

always non typhoidal

Question 12

Dx test of typhoidal salmonella

Answer 12

Blood culture

Question 13

Tx for non typhoidal salmonella

Answer 13

Self limited

Question 14

Tx for typhoidal salmonella

Answer 14

Ceftriaxone.

Question 15

Typhoidal Vx for what!

Answer 15

Only typhoidal salmonella (travelling patients)

Question 16

Trichinellosis overview

Answer 16

From undercooked meat in the third world. Have GI phase (not sever), then muscle stage:
Myositis, fever, subungual hemorhage, periorbital edema, eosinophilia

Question 17

Typhoid fever time frame

Answer 17

Progressive. 1st week of fever and illness. 2nd week if the rash and abdomen pain. 3rd week of abdominal complications and HS Meg

Question 18

Splenectomy patient… starts to get fever. What ABx prophlx

Answer 18

Amoxicillin clav. Or quinolone if penicillin allergy

Question 19

PCP presentations details

Answer 19

SOB, dry cough, fever, HYPOXIA, LDH high, diffuse bilateral reticulonodular infiltrates. Usually AIDS or immunosuppressed patients

Question 20

Dx if PCP

Answer 20

Get BAL or sputum. Not always revealing, need silver stain often

Question 21

PCP Tx? Why do we reinstate ART later

Answer 21

TMP SMX, CS to decrease inflam. ART needed anger to prevent sudden IS activation

Question 22

Two organisms post transplant that are high risk. For first 6mo at least

Answer 22

CMV and PCP

Question 23

Enterobius Tx

Answer 23

Pyrantel pamoate or albendazole for patient and all household

Question 24

IE blood cultures from where

Answer 24

3 different vein puncture sites

Question 25

What are the symptoms that point toward orbital cellulitis (compared to preseptal cellulitis)

Answer 25

Pain in EOM, opthalmoplegia, proptosis

Question 26

When is TMP SMX prophlx indicated in HIV

Answer 26

CD4 <100

Question 27

When is CMV prophlx indicated in HIV

Answer 27

Never. Only a transplant case would have prophylaxis

Question 28

Invx for entamoeba

Answer 28

Stool PCR best. But so serology if only liver abcess

Question 29

Tx for entaemaeba

Answer 29

Metro or tinidazole. Then do a paromomycin luminal agent. Only drain if above fails/imminent rupture

Question 30

Bartonella vs kaposi subtle differences

Answer 30

Bartonella more likely to have fever, and the lesions are Papuplar/plaques.

Question 31

Echinococcus symptoms

Answer 31

Usually assymp

Question 32

Go through the post exposure prophylaxis for varicella. People who have been vaccinated or had chickenpox as a child do not need it. But consider those who haven’t got that, and consider immuno a competent or immuno compromised

Answer 32

Immuno competent patients can have the vaccine within five days. Immuno compromised patients have Ig within 10 days (same for pregnant and newborns)