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MID > Presentations - Diagnosis > Flashcards

Presentations - Diagnosis Flashcards

1
Q

Chronic, slowly progressive pulmonary disease, persistent fever, weight loss in immunocompetent patients with underlying lung disease, cystic fibrosis, or HIV

A

Mycobacterium Avium complex.

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2
Q

Slow-progressing symptoms, similar to TB

A

Mycobacterium Kansasisi

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3
Q

Nodular skin lesion following exposure to nonchlorinated water.

A

Mycobacterium Marinum

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4
Q

Small, pale skin lesions, bilateral ulnar neuropathy

A

Mycobacterium Leprae - Early stage.

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5
Q

Recurring episodes of fever, chills, conjunctival suffusion, petechiae, abdominal tenderness, hepatosplenomegaly.

A

Borellia - Relapsing fever, Tick-borne and lethal if it progresses to CNS hemorrhage and liver failure. Treat with tetracycline.

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6
Q

Annular rash a few weeks after camping in the northeast

A

Lyme disease. Vector is deer tick. Test serum with ELISA, western blot, or PCR. Treat with doxycyline.

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7
Q

Chronic UVEITIS (swelling in the center of the eye), abrupt fever with headache and myalgias lasting 4-7 days.

A

Leptospirosis - worldwide zoonitic from domestic and wild animals. Can progress to meningitis, N,V, conjunctival hemorrhage

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8
Q

Severe hemoptysis in an immunocompromised patient. CXR shows a distinct, round mass. Infection spreads to the rest of the lungs, sinuses, and goes systemic leading to infarctions in eyes, CNS, bone

A

Aspergilloma (fungal ball in lung cavity). Diagnosis via culture and biopsy. Treat with Amphotericin B, voriconazole, caspofungin.

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9
Q

Risk factor for aspergillus infection

A

Lack of neutrophils

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10
Q

Allergic, asthma-like fungal infection.

A

Bronchopulmonary Aspergillosis

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11
Q

White pseudomembrane lining the mouth and tongue

A

Candida albicans - thrush, Can spread to liver, spleen and kidneys hematogenously. Diagnose by culture. Treat with Fluconazole/Amphotericin B.

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12
Q

Yeast that causes pneumonia and meningitis in HIV patients, longterm steroid users, and lymphoma patients.

A

Cryptococcus - ubiquitous but only infective if you don’t have working T Cells

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13
Q

Rhinocerebral infection in diabetic with ketoacidosis or opporunistic infection of burns/trauma.

A

Zygomycoses. Treatment is amphotericin B and surgical debridement if necessary.

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14
Q

New onset pneumonia in AIDS patients with CD4 <200 - does not respond to antibiotics or Ergosterol-targeted antifungals.

A

Pneumocystis jirovecii (contains no ergosterol in cell membrane.)

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15
Q

Warty, vegetative cauliflower-like lesions of the skin.

A

Chromoblastomycosis - treatment is excision or cryosurgery

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16
Q

Symptomatic lung infection from inhaled spores that disseminates to bone, skin, CNS in AIDS patients, pregnant patients,

A

Coccidomycosis. Treat with fluconazole

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17
Q

Fever, chills, myalgias, Headache, dry cough, after exposure to bird or bat droppings

A

Histoplasmosis. Diagnose via biopsy or lung secretions

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18
Q

Skin nodules, pulmonary symptoms in gardeners/landscapers

A

Sporotrichosis. Diagnose via biopsy.

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19
Q

Chronic progressive granulomatous disease that starts pulmonary and spreads to the mouth and mucosa in a patient from Latin America.

A

Paracoccidiomycosis

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20
Q

Granulomas and open, draining sinuses in the oral cavity and intestines in a patient with poor oral hygiene or post-surgery.

A

Actinomyces (A. Isreali), a filamentous bacillus. Treatment is a long course of beta lactams.

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21
Q

Pulmonary disease, reservoir worldwide in the soil, outbreaks in hospitals, suppurative granuloma with partially acid-fast bacteria, can spread to CNS

A

Nocardia, a filamentous bacillus. Treat with minocycline and augmentin.

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22
Q

Edema and hemorrhage, maculopapular to petechial rash on palms and soles. Can become necrotic and gangrenous

A

Rocky Mountain Spotted Fever - Rickettsia, a disease of the vascular endothelium.

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23
Q

Dysentery, colitis, rectal prolapse. Tropics, Asia, and the rural southwest

A

Trichuris Trichiura, whipworm. Human fecal-oral transmission. Treat with oral antihelminthics for 3 days.

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24
Q

Iron deficiency anemia, eosinophilic pneumonitis with asthma-like symptoms, may progress to Abdominal pain, intestinal obstruction, biliary obstruction, pancreatitis. Latin America, Asia, especially Indonesia.

A

Ascaris lumbricoides - Roundworm, usually asymptomatic.

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25
Q

Perianal/Perineal pruritis, vaginitis, sleep disturbance

A

Enterobius vermicularis - pinworm. Diagnose via scotch tape test for eggs.

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26
Q

Chronic iron deficiency anemia leading to stunted growth, poor pregnancy outcomes. South America, Africa, China, India, Central Asia,

A

Necator Americanus - Hookworm, an intestinal nematode

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27
Q

Chronic iron deficiency anemia leading to stunted growth and poor pregnancy outcomes in military members, residents of the Florida Panhandle

A

Necator Americanus - Hookworm, an intestinal nematode

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28
Q

Larva currens, a rapidly developing, wide band of urticaria, found in Africa, Asia, South America, and the Appalachians. Can go pulmonary, leading to dyspnea and cough, or progress to hyperinfection, leading to eosinophilia, acute enteritis, and severe diarrhea.

A

Strongloides stercoralis - Note that in hyperinfection co-morbidity with bacteria can lead to sepsis and death if untreated.

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29
Q

Nausea, vomiting, myalgias, edema, eosinophilia after eating pork.

A

Trichinella spiralis. Diagnose via muscle biopsy, serology, and treat with steroids and antihelminthics

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30
Q

Asymptomatic to irreversible lymphedema, can lead to elephantiasis of the lower limbs, hydrocoele, scrotal elephantiasis. Found in Southeast Asia

A

Lymphatic Filariasis - mosquito transmitted. Diagnosis via serology/ ultrasound of lymph nodes. treatment is prolonged and repeated antihelminthics.

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31
Q

Sclerosing keratitis, puritis, dermatitis, subcutaneous nodules, lymphadenopathy, found in Africa.

A

Onchocerciasis - river blindness. Vector is the blackfly.

32
Q

Calabar swellings (angioedema over one eye), worms in eyes.

A

Loiasis - African eye worm. Vector is local flies.

33
Q

Painful, localized skin rash, secondary bacterial cellulitis, associated with fecal contamination of water

A

Dracunculiasis - guinea worm - “Fiery Red Serpent of the Isrealites” Spread is via guinea worm larvae living in water-dwelling copepods.

34
Q

Bladder infection, hematuria, urinary retention leading to obstructive nephropathy and renal failure, found in Africa and the Middle East

A

Schistosoma haematobium

35
Q

Rash, ketayama syndrome (fever, chills, cough, myalgia, abdominal pain) followed at 4-12 weeks by diarrhea, dysentary, hematuria, found in AFRICA, S. AMERICA, AND THE CARIBBEAN.

A

Schistosoma mansoni

36
Q

Rash, ketayama syndrome (fever, chills, cough, myalgia, abdominal pain, lymphadenopathy, hepatosplenomegaly) followed at 4-12 weeks by diarrhea, dysentary, hematuria, found in EAST ASIA

A

Schistosoma Japonicum

37
Q

Tapeworm found in beef

A

Taenia saginata - treat with praziquantel (PZQ)

38
Q

Tapeworm found in pork

A

Taenia solium- treat with praziquantel (PZQ)

39
Q

Vague abdominal pain, feeling of “something moving inside,” pernicious B12 deficient anemia, found in Alaska and Canada in native populations who eat a lot of fish

A

Diphyllobothrium latrum, fish tapeworm.

40
Q

Large, space-occupying cysts in multiple organs, found in someone with lots of animal contact

A

Echinococcus, a hyatid, dogs and farm animals are the main hosts. Can be fatal. Diagnose via X ray, CT, MIR and treat surgically (PAIR - puncture, aspirate, inject chemicals, re-aspirate)

41
Q

Seizures and convulsions, epilepsy in Hispanic children or immigrants. Headache and CSF hypertension are possible.

A

Neurocysticercosis - Leukocytosis, eosinophilia, CT/MRI is diagnostic. treat with praziquantel (PZQ) and treat the symptoms if necessary.

42
Q

loose, foul-smelling stools, cramping, bloating, N, V, steatorrhea, malabsorbtion of fat,

A

Giardiasis - treat with metronidazole

43
Q

watery diarrhea, dehydration, weight loss, abd pain, chronic in HIV+ CD4<200

A

Cryptosporidiosis. Treat with Nitazoxanide

44
Q

colitis with gradual onset of GI symptoms, diarrhea, fever, weight loss, heme pos stool. Can develop liver abcess. Found in Africa, Latin America, SE Asia, India.

A

Amoebiasis

45
Q

Fever, abdominal pain, hepatomegaly eosinophilia after eating uncooked fish in southeast or central Asia

A

Opsithorchis (liver trematode) - intermediate host is snails. Treat with praziquantel.

46
Q

Fever, abdominal pain, hepatomegaly eosinophilia after eating uncooked fish in China, Korea, or Vietnam

A

Clonorchis (liver trematode) Treat with praziquantel.

47
Q

Pleuropulmonary paragonimiasis, chest pain, hemoptysis, cough, pulmonary infiltrates after eating shellfish in China, or the Philippines

A

Pragonimiasis (lung trematode) Treat with praziquantel.

48
Q

Most prevalent parasitic infection of humans

A

Ascaris lumbricoides - Giant Roundworm

49
Q

Winterbottom’s Sign

A

Posterior Cervical Adenopathy - Found in early Human Africa Tryponosomiasis (sleeping sickness)

50
Q

Most common cause of bacterial endocarditis

A

Staph Aureus, especially in IVDU

51
Q

Most common cause of subacute bacterial endocarditis

A

Viridian Streptococci (from the oral flora)

52
Q

PPD of 5-10mm is positive in

A

HIV+, symptoms and xray suggestive of TB, recent contacts with active TB cases.

53
Q

PPD of 10-15mm is positive in

A

High risk populations - IVDU, long-term care, prisons, homeless, healthcare workers.

54
Q

PPD of >15mm is positive in

A

EVERYBODY

55
Q

Rash found in Africa, S. America, SE Asia. Starts with a raspberry-like bump, and then numerous irregular plaques appear in multiple location

A

Yaws (Treponema)

56
Q

Rash which changes from red to blue to white over time, especially on the elbows, found in Mexico, Central America.

A

Pinta (Treponema)

57
Q

Gummatous lesions on the oral mucosa, found in Africa and West Asia

A

Bejel (Treponema Pallidium)

58
Q

Black, necrotic ulcer with fever, chills, myalgias, headache, and photophobia, found in Mediterranean and Middle East

A

Fievre Boutonuese (Rickettsia Conoril), vector is local ticks.

59
Q

Vesicular rash, fever, headache, chills, found in urban homeless.

A

Rickettsia Akari - body lous is vector. ONLY RICKETTSIA WITH A VESICULAR RASH.

60
Q

severe fever, myalgias, maculopapular rash which starts centrally and spreads to periphery. Found in cold, dirty places, often associated with refugee camps. 40% mortality.

A

Rickettsia Prawazeki

61
Q

Abrupt onset of fever, chills, HA, associated with rats and fleas. Worldwide distribution.

A

Rickettsia Typhi

62
Q

Sudden fever, headache, myalgias, found in rural Asia.

A

Scrub Typhus (Orienta Tsutsugamushi)

63
Q

Acute fever in livestock worker, progressing to chronic osteomyelitis

A

Q Fever, Coxiella Burnetti - Worldwide, zoonitic, highly infectious (ID50 1-10)

64
Q

Maculopapular rash, fever, chills, headache, malaise, LUEKOPENIA, following tick bite

A

Erlichia Chaffeensis - Human Monocytic Erlichiosis

65
Q

Fever, Headache, Malaise, Nausea, LEUKOPENIA AND PERIPHERAL NEUROPATHY, elevated liver enzymes, following tick bite.

A

Human Granulocytic Anaplasmosis (Anaplasma Phagocyticum)

66
Q

Golf-ball sized cysts in liver and lungs on xray, exposure to dogs or farm animals.

A

Echinococcus

67
Q

Eosinophilic Pneumonitis and/or “surgical abdomen” in kids

A

Ascaris Lumbricoides

68
Q

Localized skin pigment changes without other symptoms

A

Superficial fungus infection - Exophala Werneckii, Trichosporan Beigelli, Malessezia Furfur

69
Q

Intermittent episodes of fever, posterior cervical lymphadenopathy (winterbottom’s sign) followed by Headaches, increasing somnolence, found in Africa.

A

Sleeping Sickness (Tryponosoma). Vector is the Tsetse Fly.

70
Q

Facial lesion, followed by dilated cardiomyopathy, megaesophagus, and/or megacolon. Found in Bolivia, Argentina, Paraguay.

A

Chagas disease (Trypanosoma)

71
Q

pruritis, papular, vesicular, pustular lesions, short, serpiginous burrows in hands/feet.

A

Scabies. Can be transmitted person to person

72
Q

Pruritis of scalp, sleep disturbance

A

Lice. Outbreaks in schools.

73
Q

Linear/clustered bites

A

Bedbugs. Killed by heat.

74
Q

Painful, intensely itching papule on foot with central black dot, found in Africa, S. America, Caribbean

A

Jiggers. Treatment is extraction.

75
Q

Furruncule with larvae that the patient can feel moving around, oozes discharge when squeezed, found in tropics.

A

Myiasis (botfly maggots, transferred into skin via mosquito bite)

MID (1 decks)

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