Infectious Dz

Question 1

What could cause a false positive reading on the TB PPD test?

Answer 1

1. recent BCG vaccination

2. Anergy (sarcoid, HIV)

Question 2

Reactivation TB typically occurs in which lobes

Answer 2

upper

Question 3

What type of cough is found in pertussis ?

Answer 3

Whooping cough

Question 4

Treatment of choice for pertussis

Answer 4

Macrolides, Erythromycin

Question 5

Phases of pertussis

Answer 5

1) catarrhal phase: 1-2 weeks of URI like symptoms, this is when you are contagious and when ABX are effective
2) paroxysmal phase: whooping cough
3) convalescent

Question 6

What abx fall into the penicillin class

Answer 6

penicillins, MSSA drugs, unasyn, zosyn

• penicillins have good gram positive coverage
• amoxicillin and ampicillin have gram positive AND gram negative

**unasyn and zosyn add on anaerobes

Question 7

what class of antibiotic is the broadest

Answer 7

carbapenem

Question 8

Types of candidiasis and their treatments

Answer 8

1. esophagitis (MC) fluconazole
2. thrush; nystatin
3. vaginal; white curd-like discharge . miconazole, clotrimazole
4. Intertrigo; diaper rash, topical clotrimazole
5. Endocarditis; IV amphotercin B

Question 9

What is the most common cause of fungal encephalitis?

Answer 9

cryptococcous

Question 10

Treatment of cryptococcus

Answer 10

amphotercin B and flucytosine

Question 11

Treatment of histoplasmosis

Answer 11

Itraconazole

Question 12

Clinical distinguishing feature of pneumocystis

Answer 12

oxygen desaturation when ambulating, associated with high LDH levels

Question 13

What organism is most likely to cause septic arthritis?

Answer 13

Gonorrhea

Question 14

What organism is most likely to cause reactive arthritis

Answer 14

Chlamydia

Question 15

Treatment differences in chlamydia and ghonarrhea?

Answer 15

Chlamydia= azithromycin+doxy

Gonorrhea=ceftriaxone + doxy

Question 16

Presentation of diphtheria

Answer 16

friable grey/white pharynx that bleeds when scraped

*Bull neck

Question 17

Diptheria treatment

Answer 17

antitoxin (horse serum)
+
Erythromycin / Penicillin

Question 18

What is truisms?

Answer 18

Lock jaw that occurs with tetanus

Question 19

treatment for tetanus

Answer 19

antitoxin
+
metronidazole

Question 20

8 D’s of botulism

Answer 20

Diplopia, Dilated fixed pupils, dry mouth, dysphagia, dysarthria, dysphonia, descending decreased muscle strength

Question 21

3 stages of syphilis presentation

Answer 21

1) primary: painless chancre
2) secondary; (weeks to months later); macularpapular rash on palms and soles
3) tertiary; up to 20 years later
- GUMMA: noncancerous granulomas
- Neurosyphilis
- Argyl-Robertson pupil; small pupil that does not react to light
- Cardiovascular: Aortitis

Question 22

Screening tests for syphillis

Answer 22

RPR, VDRL

Question 23

Treatment for syphilis

Answer 23

Pen G

Question 24

Jarisch-Herxheimer reaction

Answer 24

Reaction to penicillin treatment.

Acute fever, myalgia, headaches due to rapid lysis of spirochetes

Question 25

How to diagnose Lyme dz

Answer 25

ELISA testing followed Western Blott

Question 26

PE of herpes

Answer 26

prodromal burning 24 hrs prior then painful vesicles on an erythematous base

Question 27

HSV treatment

Answer 27

Acyclovir

Question 28

Appearance of CMV on bx

Answer 28

Owls eye

Question 29

CMV treatment

Answer 29

Ganciclovir

Question 30

Manifestations of HSV

Answer 30

1. chicken pox 2. zoster 3. Herpes Opthalmicus; trigeminal nerve (V), hutchington's sign 4. Herpes Oticus; Ramsey hunt syndrome, CN VII, otalgia, lesions on ear and TM 5. Post herpetic neuralgia

Question 31

Presentation of rabies

Answer 31

prodromal burning and itching, CNS manifestations, respiratory muscle paralysis

Question 32

What is the treatment of choice for meningococcal meningitis?

Answer 32

Penicillin G

Question 33

Clinical manifestations of Lyme dz

Answer 33

- erythema migrans, expanding warm bulls eye lesions - Crainal nerve VII palsy - AV block - rheumatologic arthritis

Question 34

Treatment for lyme disease

Answer 34

Doxycycline if over 8 years old -amoxicillin if under 8 years old or pregnant

Question 35

What is the epstein-barr virus also known as?

Answer 35

Infectious Mononucleosis

Question 36

Clinical manifestations of EBV

Answer 36

1) fever 2) sore throat 3) posterior cervical lyphadenopathy * *if given penicillin 5% will break out in rash!!!!

Question 37

A CD4 count below what number defines AIDS?

Answer 37

Below 200, or an AIDS defining illness present

Question 38

opportunistic infection when CD4 count reaches <200

Answer 38

PCP

Question 39

opportunistic infection when CD4 count reaches <150

Answer 39

Histoplasmosis

Question 40

opportunistic infection when CD4 count reaches <100

Answer 40

Toxoplasmosis | Cryptococcus

Question 41

opportunistic infection when CD4 count reaches <50

Answer 41

MAC | CMV retinitis

Question 42

HIV treatment options

Answer 42

- NNRTI + 2 NRTIs - PI + 2 NRTIs - INSTI + 2 NRTIs * NNRTI= non-nucleoside reverse transcriptase inhibitor * NRTI= nucleoside reverse transcriptase inhibitor * PI= protease inhibitor * INSTI= integrase strand transfer inhibitor

Question 43

What is HIV?

Answer 43

Retrovirus that changes viral RNA to DNA via reverse transcriptase

Question 44

Shigella presentation

Answer 44

Explosive watery, mucoid, bloody diarrhea with punctate areas of ulceration on sigmoidoscopy

Question 45

Treatment of shigella

Answer 45

Fluids, Bactrim if severe

Question 46

Salmonella sources

Answer 46

Poultry (dairy, meat, eggs) exotic pets *High risk in patients with sickle cell disease

Question 47

Presentation of salmonella gastroenteritis

Answer 47

abdominal pain, fever, mucus + bloody diarrhea

Question 48

Presentation of typhoid (enteric) fever

Answer 48

* Salmonella typhi infection - headache, pharengytis, cough (cephalic phase) - Crampy abdominal pain with PEA SOUP STOOLS, intractable fever, bradycardia, ROSE SPOTS

Question 49

Salmonella treatment

Answer 49

fluids and floroquinolones if severe