Notes from Lectures

Question 1

Relative Risk

Answer 1

incidence in exposed / incidence in unexposed

Question 2

Odds Ratio

Answer 2

Probability that dz developed / probability that it did not develop

Question 3

AR

Answer 3

incidence in exposed - incidence in nonexposed

Question 4

NNT

Answer 4

1 / (rate in untreated - rate in treated)

Question 5

Sensitivity

Answer 5

TP/ (TP +FN)

Question 6

Specificity

Answer 6

TN / (TN + FP)

Question 7

Sens + Spec are ___ of prevalence

Answer 7

independent

vs NPV & PPV are dependent on prevalence

Question 8

Herpes B virus ppx

Answer 8

valacyclovir

macaques

Question 9

West Nile virus dx

Answer 9

CSF IgM (PCR low sensitivity)
(flaccid paralysis)

Question 10

St Louis Encephalitis

Answer 10

• mosquitos

- urinary sx early, SIADH

Question 11

ADEM

Answer 11

• post infectious or post immunization
• 2-4 wks after trigger
• b/l asym T2 hyperintensity in white matter

Question 12

Highest risk for SCT

Answer 12

D-R+

Question 13

Highest risk for SOT

Answer 13

D+R-

Question 14

PJP ppx

Answer 14

1st line - tmp-smx (covers toxo + nocardia)
2nd - atovaquone (expensive, poorly tolerated), dapsone (check G6PD, methemoglobinemia, doesn’t cover toxo), IV pentamidine (doesn’t cover toxo)

Question 15

Fluc resistant Candida

Answer 15

C krusei

Question 16

Septated hyphae

Answer 16

Aspergillus

Question 17

Non-septated hyphae

Answer 17

Mucor/zygo

Question 18

Pseudohyphae

Answer 18

yeast

Question 19

Nocardia - 4 B’s

Answer 19

Beaded, Branching, Brain (+lung), Bactrim

Question 20

Rhodococcus

Answer 20

Short GPR, cavitary pna, salmon pink colonies, advanced HIV/SOT, horse/manure exposure

Question 21

Bacteria with Safety Pin appearance

Answer 21

Yersinia
Vibrio
Burkholderia
H ducreyi (chancroid)
K granulomatis (granuloma inguinale)

Question 22

Meliodosis

Answer 22

• Burkholderia
• SE Asia, soil/water exposure (post tsunami), pna + severe sepsis, safety pin GNR
• can be yrs after exposure

Question 23

Actinomyces

Answer 23

• sulfur granules
• dental work or IUD
• erosive mass
• filamentous anaerobe

Question 24

Ehrlichia

Answer 24

• summertime F + cyotpenia, LFTs
• morulae in MONOCYTES (HME)
• lonestar tick / Ambylomma

Question 25

Anaplasma

Answer 25

- Ixodes | - morulae in GRANULOCYTES (HGA)

Question 26

Babesia

Answer 26

- Ixodes - presents like malaria - morulae in RBCs - atovaquone + azithro (AA)

Question 27

Tick borne relapsing fever

Answer 27

Borrelia (soft tick) | -spirochete (bacteremia) on bloodsmear

Question 28

Loeffler's syndrome

Answer 28

eosinophilic pneumonitis | -Ascaris

Question 29

Hookworms

Answer 29

Ancylostoma, Necator - Alabama, rural - cutaneous larva migrans, anemia, protein loss

Question 30

Whipworm

Answer 30

Trichuris - 2 polar plugs, football shaped egg - D, frank blood sometimes

Question 31

Pinworm

Answer 31

Enterobius - eggs have flatish one side - dx: pinworm paddle test

Question 32

Wuchereria

Answer 32

lymphatic filariasis

Question 33

Loa loa

Answer 33

eye worm, filariae

Question 34

Onchocerciasis

Answer 34

river blindness, nodules

Question 35

Trichienella

Answer 35

- cysts in wild pig or boar meat | - Abd pain, D, muscle pain, high CK, edema, eosinophilia

Question 36

Acid Fast Bacteria

Answer 36

``` Mycobacteria Rhodococcus Nocardia Legionella micdadei +lesser known others ```

Question 37

UL97

Answer 37

CMV resistance to ganciclovir

Question 38

UL54

Answer 38

CMV resistance to gan, cidofovir, & foscarnet

Question 39

ESBL tx

Answer 39

carbapenems (erta - no pseudomonas activity) (hint to ESBL: R to ctx)

Question 40

AmpC tx

Answer 40

Cefepime | or ceftolozane-tazo

Question 41

AmpC organisms

Answer 41

SPICE-M | Serratia, Providencia, (Idole positve) Proteus, Citrobacter, **Enterobacter**, Morganella

Question 42

KPC tx

Answer 42

mero-vaborbactam ceftaz-avibactam imi-cilastin-relebactam

Question 43

Carbapenem gaps

Answer 43

MRSA, Steno, Acineto, E faecium

Question 44

Metallo-carbapenemases (VIM, New Dehli, IMP) tx

Answer 44

ceftaz-avi + aztrenoam | cefiderocol

Question 45

oxa-type carbapenemase tx

Answer 45

ceftaz-avi

Question 46

Only FQ with MRSA coverage

Answer 46

delafloxacin

Question 47

Donut granuloma

Answer 47

Coxiella (Q fever) | Less commonly - EBV, CMV

Question 48

Janeway lesion

Answer 48

NONtender

Question 49

Osler node

Answer 49

tender

Question 50

Clenched fist bathroom brawl

Answer 50

Eikenella (GNR anaerobe)

Question 51

Recurrent sinopulm inf, chronic enteric inf, occ severe meningitis, low Igs and low response to vaccines

Answer 51

CVID

Question 52

Albinism, silvery sheen to hair, periph neuropathy, recurrent skin + sino pulm inf, dx: giant blue granules

Answer 52

Chediak Higashi Syndrome

Question 53

Recurrent Staph, Nocardia, Aspergillus (Burkholderia, Salmonella, BCG) inf

Answer 53

CGD | dx: DHR 123 or Nitroblue tetrazolium

Question 54

No neutrophils at site of infection, delayed umbilical stump separation, gingivitis

Answer 54

Leukocyte Adhesion Deficiency | dx: flow for CD18

Question 55

facies, ezema, boils, pna, baby teeth, pulm cysts, mucor, coronary aneurysms, recurrent sinopulm inf

Answer 55

Hyper IgE syndrome (Job's) | STAT3 mutation

Question 56

recurrent NTM infections

Answer 56

HIV or interferon gamma receptor deficiency

Question 57

HPV, disseminated NTM, pancytopenia, hypocellular marrow

Answer 57

GATA2 deficiency

Question 58

Prairie dogs exposure + pustular rash

Answer 58

Monkeypox | no pustular rash --> plague

Question 59

T pallidum pertenue

Answer 59

Yaws | ulcerating lesion

Question 60

When to give steroids for PJP

Answer 60

pO2 <70 on RA or | A-a gradient >35

Question 61

Lyme disease tx in pregnancy

Answer 61

Amoxicillin