Micro

Question 1

Pneumonia

Answer 1

Fatigue, cough, fever

Productive or not`

Question 2

Crackles

Answer 2

Pneumonia

Question 3

What do present with pneumonia

Answer 3

CXR

Question 4

Treat atypical

Answer 4

Macrolides..azithromycin and clarithromycin

Question 5

Treat ambulatory

Answer 5

Macrolides….doxycycline if cant tolerate

Question 6

Increased risk of drug resistance

Answer 6

Fluoroquinolones or macrolide and beta lactam

Question 7

Treat hospitalized

Answer 7

Fluoroquinolones

Question 8

Treat ICU

Answer 8

Fluoroquinolone and lactam

Add piperacillin or a PE EM for pseudomonas coverage

Question 9

Mycoplasma pneumonia and chlamydia pneumoniae atypical

Answer 9

Follow URI

Except chlamydia have hoarse voice

Question 10

Legionella pneum atypical

Answer 10

More severe

Question 11

Age of walking pneumona

Answer 11

Younger

Follow UIR\RI

Question 12

Procalcitonin

Answer 12

Precursor that becomes elevated in proinflammatory stimuli, espicially those bacterial in origin

Question 13

Curb

Answer 13

Confusion 1
BUN>20 1
RR>30 1
BP<90/60 1
Over 65 1

01-outpatient
2-short inpatient or supervise
3-5 ICU

Question 14

Legionella

Answer 14

Water loving aerobic flagellate gram negative bacillus

Question 15

Treat legionella

Answer 15

Levofloxacin

Question 16

Fast fermented OH KEE

Answer 16

Klebsiella, E. coli, enterobacter

Question 17

Slow fermenters

Answer 17

Citrobacter serratia

Question 18

Who gets pneumococcal van

Answer 18

Over 65
Asplenic
2-64 with risk factors

Question 19

Contraindications to pneumococcal vax

Answer 19

Allergic anaphylaxis

Question 20

Fever inflamed turbinates

Answer 20

Adenovirus

Question 21

Rales and altered mental status, coughing fit right hear border obscured coughing at dinner last night

Answer 21

Aspiration pneumonia…anaerobic more indolent clindamycin amoxicillin.

Question 22

S aureus

Answer 22

Follows the flu! Bad can just die…

Question 23

Burkholderia

Answer 23

G1 bacillus, cat positive, non lactose fermenter. BC agar. CF. On hospital equipment and irrigation systems. Hard to treat

Question 24

Leptospirosis

Answer 24

Spirochete. High fever…HA, aspetic meningitis, severe myalgia. Hepatitis with jaundice renal failure with nephritis, subconjunctical hemorrhage. Rodents cattle, horse, goats,

Question 25

Chlamydia psittacosis

Answer 25

Obligate intracellular gram neg, no cell wall Birds Epistaxis and splenomegaly...need good history

Question 26

Procalcitonin elevated in what

Answer 26

Bacteria

Question 27

Smokers

Answer 27

Moraxella, HI

Question 28

After influenza

Answer 28

S aureus

Question 29

Francisella tularensis

Answer 29

Hunters, rabbit exposure Gram negative aerobic abrupt onset of nonspecific Fever chills Ulceroglandulas dr-most common. Single lesion at a tick bite site with a central Escher with assx. Adenopathy. Pulmonary tularemia-pleural effusions pacification patterns Eat rabbit not cooked inhale..drink

Question 30

Salmon sputum

Answer 30

S aureus

Question 31

VAP

Answer 31

ET intubation with 2 of fever, leukocytosis or pursuant sputum New or progressive opacity on CXR

Question 32

HA

Answer 32

Hospital over 48 hours

Question 33

HCAP

Answer 33

Hospitalized for at least 2 days within 90 days or in last 30 daysL nursing home, dialysis or family member with MDR

Question 34

Treat hospital

Answer 34

Vancomycin, CMC CMP,

Question 35

MTB

Answer 35

Weakly g+, nonmotile, aerobic

Question 36

Primary TB

Answer 36

Aerosol droplets, low fever, hilar lymphadenopathy->can get pleural effusions Lobes-middle and lower, healing=calcification Healing fibrosis causes latency

Question 37

What if no healing

Answer 37

Primary progressive TB

Question 38

Military T

Answer 38

Spread wide and far

Question 39

Secondary T

Answer 39

Deactivation Most common Fever chilled, cough, weight loss night sweats Apical posterior , pulmonary cavitation

Question 40

What do when present with secondary T

Answer 40

CXR< PPD< morning sputum

Question 41

Over 5 mm

Answer 41

HIV, close contact with active infection CXR with fibrotic changes consistent with TB Immunosuppression (TNF a inhibitors)

Question 42

10

Answer 42

Silicosis, DM, chronic renal failure... under 4

Question 43

14

Answer 43

Healthy over 4

Question 44

What is in PPD

Answer 44

Purified protein of MTB

Question 45

BCG vaccine

Answer 45

M Boris False positive TST test

Question 46

PPD

Answer 46

Type IV related

Question 47

Auramine rhodamine

Answer 47

Sensitive initial

Question 48

Ziehl neelsen stain

Answer 48

Specific

Question 49

India ink

Answer 49

Capsule

Question 50

What do with patient

Answer 50

Negative pressure ventilation

Question 51

How treat latent

Answer 51

9 months INH

Question 52

Normal treat

Answer 52

6 months with monthly sputum samples

Question 53

T thoracentesis

Answer 53

Positive adenosine deaminase and IFN gamma

Question 54

TB spondylitis

Answer 54

Potts

Question 55

AIDS weak fever cough

Answer 55

MTB AFV-acid fast bacillus, aerobic slow growing, facultative intracellular, caseating granulomas, cord factor, sulfatides, siderphores

Question 56

Scrofula

Answer 56

Lymphadentis most common extra pulm

Question 57

Mycobacterium Kanasii

Answer 57

No person person like Tb Older with underlying lung disease or smokers Men Midwest, south west, Similar to TB , Older smokers-cavitary lesions apex Women with chronic cough bronchiectasis in mid lune 50% die if untreated 18 months on 4 drugs

Question 58

Invasive aspergillosis

Answer 58

Hemorrhagic infarction | Necrotizing bronchopneumonia

Question 59

Aspergillus TB

Answer 59

Live in cavity! With hemoptysis

Question 60

Picornavirus

Answer 60

Rhinovirus +SsRNA rhiniovirus Nonenveloped Destroyed by stomach acid

Question 61

Coronavirus

Answer 61

As+RNA Helical enveloped Common cold SARS MERS and SARS and zoonotic

Question 62

Stain BT

Answer 62

Carbofuscin red