PANCE/PANRE

Question 1

This TB drug can cause hepatitis and peripheral neuropathy (which can be prevented by giving with B6)

Answer 1

Isoniazid

Question 2

This TB drug causes orange colored secretions as a SE

Answer 2

Rifampin

Question 3

Candida esophagitis DOC

Answer 3

Fluconazole

Question 4

Associated with intracellular RBC parasites seen on peripheral thin and thick smears

Answer 4

Malaria

Question 5

Associated with pathognomonic TETRAD inclusions** seen within RBCs

Answer 5

Babesiosis

Question 6

Rickettsia rickettsii
**fevers, chills, myalgia with a red maculopapular rash that starts at the wrists and ankles, spreading to the palms and soles as well as centrally

Answer 6

rocky mountain spotted fever

Question 7

Borrelia burgdorferi

*erythema migrants, arthritis, neurological and cardiac symptoms

Answer 7

Lyme disease

Question 8

A PPD of ____ mm is considered positive in an HIV patient, or pts with granulomas seen on XRay

Answer 8

5

induration only! NOT erythema

Question 9

A PPD of ___mm is needed for a positive in a pt with no risk factors

Answer 9

15

induration only!! not erythema!!

Question 10

A PPD of ___mm is needed for a positive result in a prisoner who is at risk for TB exposure

Answer 10

10

Question 11

A PPD of ___mm is a positive result for a health care worker

Answer 11

10

Question 12

Malaria DOC

Answer 12

Chloroquine

Question 13

Kaposi sarcoma (human herpesvirus 8) is seen in…

Answer 13

immunodeficient pts (ie AIDS)

Question 14

Administering macrolides too quickly can cause…

Answer 14

Red Man syndrome

Question 15

Darkfield microscopy is a direct method to diagnose…

Answer 15

syphilis

Question 16

Treponema pallidum is a spirochete and the causative agent of…

Answer 16

syphilis

Question 17

India ink is used in the diagnosis of…

Answer 17

Cryptococcus neoformans

can also use Cryptococcal antigen

Question 18

Isoniazid plus pyridoxine (B6) for duration of 9 months is the treatment for…

Answer 18

positive PPD with negative Xray

not active TB

Question 19

Pt with high fevers, HA, joint pain and CP.
ECG shows second degree heart block
Lumbar puncture consistent with lyme meningitis

DOC?

Answer 19

IV ceftriaxone

Question 20

43 yo male went camping where he hunted and ate rabbits. 5 days later he develops HA, fever and nausea. On his hand, there is an ulcerated papule with a central eschar and tender regional lymphadenopathy. There is also splenomegaly and diarrhea. What is likely the dx?

Answer 20

Tularemia

Question 21

Caused by Francisella tolerances, a gm negative coccobacilli

*transmitted via tick or inset bite or from handling rodent or rabbit tissues

Answer 21

Tularemia

Question 22

This CNS histologic finding is seen in a patient with rhabdovirus (rabies)

Answer 22

Negri bodies

Question 23

Leads to encephalitis

*definitive diagnosis is the presence of NEGRI BODIES** in the brain, especially in the hippocampus

Answer 23

Rhabdovirus (rabies)

Question 24

Eosinophilic inclusions in the cytoplasm of neurons

Answer 24

Negri bodies (seen in rabies)

Question 25

An 11 yo boy presents to the pediatric clinic with persistent temperatures. Exam shows significant lymphadenopathy, giving the child a "bull neck" appearance. There are gray/white membrane on the posterior pharynx that bleed when scraped. What is the management of choice?

Answer 25

Diphtheria antitoxin plus Penicillin

Question 26

Treatment for baby who develops botulism from eating honey

Answer 26

botulism antitoxin with respiratory support

Question 27

Infant who is vomiting and physical exam shows: flaccid paralysis, dry mouth, feeble cry, fixed dilated pupils. Dx?

Answer 27

Botulism

Question 28

65 yo female who spent 2 months on Martha's Vineyard presents to the urgent care with gradual onset of fever, chills and jaundice. No rash present. Labs show hemolytic anemia. Peripheral smear shows parasites within RBCs in a tetrad formation. Likely dx?

Answer 28

Babesiosis

Question 29

Parasitic infection see in the northeast US that infects RBCs **tetrad seen in RBCs!! hemolytic anemia

Answer 29

Babesiosis

Question 30

43 yo male presents to clinic with a 5 day hx of profound diarrhea. Describes bowel movements at grey, without odor, blood or pus. Tells you he just got back 2 days ago from New Orleans and he ate local crawfish and shellfish. No rash on exam. Vitals show high grade fever and a pulse rate of 128 bp. Likely dx?

Answer 30

Cholera

Question 31

Invasive diarrhea commonly associated with the development of bloody diarrhea. Often described as "pea soup" colored

Answer 31

Salmonella

Question 32

Cyrptococcal meningitis is the most common cause of...

Answer 32

fungal meningitis | seen in immunocompromised

Question 33

HIV pt comes in with HA and stiff neck. Labs show: decreased glucose, elevated WBCs with lymphocytes You're thinking maybe cryptococcal meningitis. What test can you do?

Answer 33

India ink! (or Cryptococcal antigen)

Question 34

Histoplasma capsulatum is associated with soil containing....

Answer 34

bat and bird droppings (esp in Mississippi and Ohio river valley areas)

Question 35

Bat and bird droppings..think?

Answer 35

Histoplasma

Question 36

Oral hairy leukoplakia is associated with what virus?

Answer 36

EBV

Question 37

Rifampin Isoniazid Pyrazinamide Ethambutol (RIPE)

Answer 37

tx for TB

Question 38

44 yo male with hx of longstanding HIV infection presents to the clinic with fever, body aches and HA for last 10 days. CT scan shows "ring enhancing lesions". What is the is most common predisposing factor?

Answer 38

Cat exposure (Toxoplasmosis)

Question 39

parasitic infection that is most commonly transmitted from soil, cat feces or undercooked meat * flu like symptoms if immunocompetent * encephalitis and chorioretinitis in immunosuppressed

Answer 39

Toxoplasmosis

Question 40

RING ENHANCING LESIONS!!

Answer 40

Toxoplasmosis

Question 41

Hemolytic uremic syndrome can be caused by enterohemorrhagic...

Answer 41

E.Coli

Question 42

Clarithromycin plus ethambutol is used for management of..

Answer 42

mycobacterium

Question 43

pain and prosthesis site of inoculation

Answer 43

Classic first sign of tetatanus infection

Question 44

Is adminsitering measles mumps rubella (MMR) vaccine contraindicated in pt with history of HIV and CD4 count of 100?

Answer 44

YES..this is contraindicated!!* | can only be given to HIV pts with levels above 200