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Q Set B Flashcards

(68 cards)

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1
Q

M184V

A

Emtricitabine

-also abacavir

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2
Q

West Nile Virus

A
  • late summer, early fall; continental US; transmitted by mosquitoes
  • fever, HA, malaise, can have faint rash
  • neuroinvasive dz: meningoencephalitis, flaccid paralysis
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3
Q

Complications of Intravesical BCG

A
  • local - prostatitis, epididymitis, penile inf, ureteral obstruction
  • systemic - sepsis, granulomatous hepatitis, nodular or interstitial pneumonitis, osteomyelitis
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4
Q

Coccidiomycosis

A
  • C immitis, posadasii
  • Valley Fever
  • arthralgia, erythema nodosum
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5
Q

Granuloma inguinale

A
  • Klebsiella granulomatis
  • aka donovanosis
  • painless, slowly progressing ulcer (NO adenopathy)
  • kissing lesions
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6
Q

Lymphogranuloma venereum (LGV)

A
  • Chlamydia trachomatis

- painless ulcer, unilateral adenopathy

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7
Q

Chancroid

A
  • Haemophilus ducreyi
  • painful ulcer, purulent exudate, painful inguinal lymphadenopathy
  • “kissing ulcers”
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8
Q

Painless genital ulcers

A

Syphilis
LGV (Chlamydia trachomatis)
Granuloma inguinale (Klebsiella granulomatis)

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9
Q

Painful genital ulcers

A

HSV

Chancroid (Haemophilus ducreyi)

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10
Q

Y143

A

raltegravir

-but often needs a second mutation for resistance (N155, Q148)

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11
Q

I50L

A

-atazanavir

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12
Q

Maraviroc

A

-use only for patients with R5 co-receptor

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13
Q

Acute Streptococcal disease Antibody tests

A
  • ASO titer
  • Streptozyme test measure 5 Abs (ASO, hyaluronidase, streptokinase, NAD, DNAse B)- pharyngitis>skin
  • skin infection: only anti-DNAse B, anti-hyaluronidase
  • pharyngeal infection: ASO, DNAse B, NAD, hyaluronidase
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14
Q

K103N

A

Efavirenz

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15
Q

K65R

A

Tenofovir

the ONLY nucleoside analog still susceptible: zidovudine, but lots of side effects

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16
Q

Q148R

A

INSTI

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17
Q

N155H

A

INSTI

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18
Q

Cyclosporine + Tacrolimus toxicity

A

-azotemia, HA, tremor, seizures, mutism, HTN

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19
Q

Voriconazole + cyclosporine

A

-need to REDUCE cyclosporine dose when starting vori

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20
Q

Scombroid

A
  • histamine: rapid onset rash HA, D, abd cramping

- prevention: refrigeration of fish during all stages b/t catching and consumption

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21
Q

Mollaret meningitis

A
  • type of benign recurrent LYMPHOCYTIC meningitis
  • MCC: HSV-2
  • genital lesions often absent
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22
Q

Treatment for Listeria if PCN-allergic

A

TMP-SMX

otherwise, first line is Ampicillin

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23
Q

Aerobic GPRs

A
  • Bacillus (anthracis…)
  • Erysipelothrix
  • Rhodococcus
  • Corynebacterium (diphtheriae…)
  • Arcanobacterium
  • Listeria
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24
Q

TNF-alpha inhibitors put patients at risk for…

A

-TB, PJP, Histo, Listeria

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25
Raspberries
Cyclospora
26
ART in pregnancy
- TDF/FTC or ABC/3TC | - darunavir/ritonavir or DTG or RAL
27
Dapsone adverse effects
- hemolysis in pts with G6PD | - methemoglobinemia (tx: methylene blue)
28
Parinaud's syndrome
conjunctivitis + localized adenopathy (cervical, submandibular, pre-auricular) - fever - ddx: Bartonella, Adenovirus, Tularemia
29
Familial Mediterranean Fever
- recurrent episodes of fever and localized inflammation - Jewish, Turkish, Arab - 2 days of symptoms - colchicine
30
TRAPS (TNF-Receptor Associated Periodic Syndrome)
- recurrent episodes of F, abd pain, localized myalgia or cramp, tender rash, conjunctivitis - symptoms resolve after about 5 days - Scottish, Irish - steroids
31
Smallpox
- airborne precautions - quaratine at home until scabs have separated + vaccinate household contacts - eczema is a relative (not absolute) contraindication to smallpox vaccine
32
Anthrax
- biphasic: flu-like then rapidly progressive F, cough, SOB | - necrotic mediastinal and hilar LAD, bloody pleural effusions
33
Rubella
- infants with congenital rubella can shed x 1 year | - MMR is a live vaccine
34
Coxiella
- Q fever - asx, flu-like, pna, hepatitis > meningitis, endocarditis - inhalation of Coxiella burnetii from soil contaminated with urine/feces/parurition from cattle, goats, sheep - mild leukopenia, thrombocytopenia
35
Illnesses from Bartonella
- cat scratch fever (acute infection with LAD) - endocarditis - trench fever - bacillary angiomatosis - purple skin lesions - hepatic peliosis - cystic blood-filled liver lesions in HIV pts - Carrion's disease - South America, fever
36
Bacillary angiomatosis
- Bartonella henselae, CATS - purple vascular lesions - HIV or immunosuppressed
37
Granulomatosis with polyangiitis (GPA)
- autoimmune; LUNG + RENAL - c-ANCA - F, sinusitis, saddle nose deformity, hematuria, pulm infiltrates + cavities, arthralgias/myalgias, laryngeal and bronchial masses
38
Tick paralysis
- multiple kinds of ticks - fatigue + parasthesias --> weakness (asym or sym, ascending or descending) - normal CSF, no flu like symptoms - cure: tick removal
39
Botulism
- descending weakness | - cranial neuropathies
40
organophosphate intoxication
- agricultural pesticides | - cholinergic excess --> salivation, tearing, weakness, convulsions
41
Pufferfish
- tetrodotoxin - one of the deadliest nautural toxins! - weakness, dizzy, paresthesias, hypotension, general paralysis, resp failure
42
Mycoplasma genitalium
moxi 10-14 days
43
Eosinophilic Meningitis
1. Angiostrongylus - rat lungworm, eating snails/slugs or crab/shrimp; SE Asia, Hawaii, Caribbean 2. Baylisascaris - racoons, kids in sandbox or homeless 3. Gnathostoma: FW fish/frogs/reptiles; Asia
44
Ciguatera
- dinoflagellate toxin; fish related foodborne outbreak - GI sx + later neuro sx: parasthesis, painful teeth, hot/cold temp reversal, blurred vision, nerve palsies - Caribbean, Miami, South Pacific
45
Statins & ART
- ok to use atorva at low dose | - simva + lova impacted by CYP inhibitors (ex. boosted darunavir)
46
Rickettsia parkeri
- multiple eschars --> then fever, rash | - mid/south atlanic, south central, gulf coast, S american
47
Babesia tx
azithro + atovaquone
48
Voriconazole & ART
-avoid with boosters and efavirenz (reduces vori level)
49
Burkholderia pseudomallei
GN, endemic in SE Asia and N Australia - tsunamis, near drownings - skin lesions, pna, abscesses; any organ - imipenem or ceftaz then 3 mo orals - difficult to identify or misidentified on automated systems
50
Orf
pox virus, goat/sheep/reindeer papule --> pustule --> weeping nodules -last several weeks then resolves, no tx needed
51
Rickettisa africae
eschar, leukopenia, rash | -travelers going to S Africa
52
Scrub typhus
Orientia tsutsugamushi - Asia - doxy - eschar, F, HA, cough then rash
53
screening test for terminal complement disorder
CH50 | screens total hemolytic complement level
54
Rat bite fever
Streptobacillus moniliformis - filamentous GNR | -F, C, V, HA, myalgias, septic arthritis, rash
55
Dental ppx
-only for high risk: prosthetic heart valve, prior endocarditis, CHD with unrepaired cyanotic defect or 6 mo post repair, CHD with residual defect or prosthesis, heart transplant recipient with valvulopathy
56
Clostridium sordellii
toxic shock syndrome after abortion
57
Colorado Tick Fever
- recurring/biphasic fever + leukopenia, thrombocytopenia, +/- splenomeganly - Dermacentor tick - Western US + canada
58
Airborne precautions
TB, varicella, measles
59
Pertussis
-droplet precautions until on treatment x 5 days
60
Kikuchi disease
- young women, F, cervical LAD, necrotizing histiocytic infiltrate - no treatment needed - unknown cause
61
Tularemia
- Francisella tularensis - wild game or their ticks, handling/cleaning, muskrats, beavers, rabbits, squirrels - tick juice --> direct inoculation of eye - one cause of Parinaud's oculoglandular syndrome (conjunc + preauricular LAD)
62
Trichinellosis
- muslce pain/tenderness, splinter & conjunctivial hemorrhages, periorbital edema, ocular pain, eosinophilia - pork, wild board, bear - tx: albendazole/mebendazole
63
Q151M
-resistance to ALL NRTIS except tenofovir
64
Anthrax
- Bacillus anthracis (GPR) - exposure: ppx with cipro or doxy (even in kids of pregnant women) - no need for nasal swab for presumed exposed people - naturally occurring inhalational from hides for drums; standard precautions
65
Ludwig's angina
- infection spreading from periapical abscess around a molar tooth and extending into the sublingual space - usually bilateral - amp-sulbactam
66
Hypertriglyceridemia
1st line - fenofibrate | 2nd line - niacin
67
I50L
-atazanavir resistance
68
Neutropenic fever
-continue abx in high risk patients throughout the neutropenic period

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