MTB

Question 0

Penicillin (G, VK, Benzathine)

Answer 0

Viridans, Strep pyogenes, oral anaerobes, syphilis, listeria

Question 1

Bacteria covered by amoxicillin

Answer 1

HELPS

H influenza, Ecoli, Listeria, Proteus, Salmonella

Question 2

Ampicillin and amoxicillin covers

Answer 2

Same as penicillin, as well as Ecoli, Lyme, and a few other gram - bacilli

Question 3

Pencillin is the best initial therapy for

Answer 3

Otits media, dental infection and endocarditis prophylaxis, Lyme disease limited to rash, joint, or seventh CN involvement, UTI in pregnant women, listeria, and enterococcal infections

Question 5

PRPs (oxacillin, clox sculpin, dicloxacillin, and nafcillin) treats

Answer 5

Skin infections (impetigo, erysipelas, and cellulitis)

Endocarditis, meningitis, and bacteremia from staph

Osteomyelitis and septic arthritis only when the organism is proven sensitive

Not active against MRSA or enterococcus

Question 6

fever, headache, nausea, vomiting, stiff neck, photophobia, meningismus

Answer 6

Meningitis

Question 7

fever, HA, N/V, confusion

Answer 7

Encephalitis

Question 8

fever, HA, N/V, focal neuro findings

Answer 8

Abscess

Question 9

When is a head CT the BEST initial test?

Answer 9

when any of the following is present: papilledema, seizures, focal neuro findings, and confusion interfering with neuro exam

Question 10

If there is a contraindication to IMMEDIATE LP, what should you do?

Answer 10

antibiotics

Question 11

When is a bacterial antigen test indicated?

Answer 11

when the patient has received antibiotics prior to LP and culture may be falsely negative

Question 12

Most accurate diagnostic test for TB?

Answer 12

acid fast stain and culture on 3 high volume lumbar punctures.

Question 13

Most accurate diagnostic test for Lyme/Rickettsia?

Answer 13

Serology, ELISA, Western blot, PCR

Question 14

Most accurate diagnostic test for Cryptococcus?

Answer 14

India ink is 60-70% sensitive. Crypto antigen is more than 95% sensitive and specific

Question 15

Best initial treatment for bacterial meningitis?

Answer 15

Ceftriaxone, Vanco, Steroids

Treatment is based on cell count.

Add ampicillin if immunocompromised for Listeria

Question 16

RF for Listeria?

Answer 16

Elderly, neonates, steroid use, HIV/AIDS, immunocompromised including alcoholics, Pregnant

Resistant to ALL cephalosporins, but sensitive to penicillins.

Question 17

Neisseria Meningitis Management?

Answer 17

Respiratory isolation

Rifampin, Cipro, Ceftriaxone to close contacts to decerase nasopharyngeal carriage

Question 18

What’s the most common neuro deficit of untreated bacterial meningitis?

Answer 18

CN 8 nerve deficit or deafness

Question 19

Most common cause of encephalitis?

Answer 19

Herpes Simplex

Question 20

Most accurate test of Herpes encephalitis?

Answer 20

PCR of CSF

Question 21

Initial test for patient presenting with encephalitis?

Answer 21

CT of head

Question 22

Treatment of Herpes encephalitis?

Answer 22

Acyclovir.

Foscarnet for acyclovir resistant herpes

Question 23

Most sensitive finding for Otitis Media?

Answer 23

Immobility

Question 24

Most accurate diagnostic test for otitis media?

Answer 24

Tympanocentesis for sample of fluid for culture

Choose this answer if there are MULTIPLE RECURRENCES or if there’s no response to antibiotics.

Question 25

Best initial therapy for Otitis Media?

Answer 25

Amoxicillin If no response to amox, give: Amox/Clavulanate Azithromycin, Clarithromycin Cefuroxime, Loracarbef Levofloxacin, Gemifloxacin, Moxifloxacin

Question 26

When to do a biopsy in sinusitis?

Answer 26

Infection frequently reoccurs | No response to different empiric therapies

Question 27

Findings of Pharyngitis?

Answer 27

``` Pain on swallowing enlarged LN in neck exudate in pharynx fever no cough and no hoarseness ```

Question 28

Best initial test for Pharyngitis?

Answer 28

Rapid strep test If negative, and patient presents with findings of pharyngitis, treat with antibiotics until culture comes back

Question 29

Treatment of Pharyngitis?

Answer 29

1. Penicillin or amoxicillin is the best initial therapy 2. Penicillin allergic treated with cephalexin if reaction is only a rash. if allergy is anaphylaxis, use clindamycin or macrolide.

Question 30

Treatment of Influenza?

Answer 30

< 48 hours of Sx: oseltamivir, zanamivir >48 hours of Sx: Symptomatic treatment only. Analgesics, rest, antipyretics, hydration.

Question 31

Causes of Blood and WBCS in stool?

Answer 31

Salmonella: poultry Camplyobacter: most common cause, a/w GBS Ecoli 0157 H7: HUS Shigella: 2nd most common, a/w HUS Vibrio parahemolyticus: shellfish and cruise ships Vibrio vulnificus: shellfish, hx of liver disease, skin lesions Yersinia: high affinity for iron, hemochromatosis, blood transfusions C. dif: WBC/RBC In stool

Question 32

Best initial test for infectious diarrhea?

Answer 32

Blood and/or fecal leukocytes

Question 33

Most accurate test for infectious diarrhea?

Answer 33

Stool culture

Question 34

Causes of infectious diarrhea without blood/wbc in stool?

Answer 34

Viral Giardia: camping/hiking and unfiltered fresh water Cryptosporidiosis: AIDS with less than 100 CD4; detect with modified acid fast stain Bacillus Cereus: vomiting Staph Aureus: vomiting

Question 35

Treatment for infectious diarrhea?

Answer 35

Mild: oral fluid replacement severe: oral fluid replacement + oral antibiotics such as ciprofloxacin

Question 36

What becomes abnormal first, after acquiring Hep B infection?

Answer 36

Surface antigen

Question 37

What is the most direct correlate with the amount, or quantity of active viral replication?

Answer 37

e Antigen- directly correlated with DNA polymerase

Question 38

What indicates that a patient is no longer a risk for transmitting infection to another person (active infection resolved)?

Answer 38

No surface antigen found

Question 39

What is the best indication of the need for treatment with anti-viral medication in chronic disease?

Answer 39

e Antigen

Question 40

Best indicator that a pregnant won an will transmit infection to her child?

Answer 40

e Antigen

Question 41

Acute Hep C treatment?

Answer 41

Interferon, Ribavarin, and either bocprevir or telaprevir

Question 42

Chronic Hep C treatment?

Answer 42

and ONE of the following: entecavir, adefovir, lamovudine, telbivudine, interferon, or tenofovir Interferon is not best first choice due to adverse effects

Question 43

A/E of interferon?

Answer 43

Arthralgias/Myalgias Leukopenia and thrombocytopenia Depression and flu-like Sx

Question 44

Goal of chronic hep therapy?

Answer 44

reduce DNA polymerase to undetectable levels | convert those patients with e-Antigen to having anti-hepatitis e antibody

Question 45

A/E of ribavarin?

Answer 45

Anemia