Random Flashcards
1
Q
HLH clues
A
EBV associated
Elevated ferritin
Cytopenias
2
Q
major criteria of stills disease
A
fever 39 greater than 1 week
arthralgia > 2 weeks
rash
WBC > 10m
3
Q
minor criteria of stills disease
A
sore throat
LAD
HSM
Abnormal LFTs
negative ana and RF
4
Q
bechet’s disease criteria
A
recurrent oral ulcers
recurrent genital ulcers
uveitis, retinitis, hypopyon
pathergy
5
Q
malignancy associated with sweet syndrome
A
AML
6
Q
pathology in sweets syndrome
A
neutrophilic infiltrate without vasculitis
7
Q
GCA age distribution
A
older adults> 50 years old
8
Q
clinical findings of GCA
A
fever
scalp or temporal artery tenderness
jaw claudication
amaurosis fugax/sudden vision loss
ESR > 100
9
Q
takayasu epidemiology
A
young women
asian ancestry
10
Q
clinical features of takayasu arteritis
A
fever, arthralgia
pain with palpation of carotid
decreased pulses
extremity claudication
TIAs
11
Q
diagnosis of takayasu arteritis
A
arteriography
12
Q
Lofgren syndrome
A
hilar LAD
acute arthritis
Erythema nodosum
13
Q
biopsy in sarcoid
A
non caveating granulomas
14
Q
CNS finding of sarcoid
A
aseptic meningitis with basilar enhancement
15
Q
NODOSUM pneumonic
A
no cause
drugs: sulfa, penicillins
OCPs
Sarcoid
UC or Crohn’s
Microbes: EBV, Hep B/C, strep, mycoplasma, bartonella, TB, endemic fungi
16
Q
kikuchi disease epidemiology
A
young women
17
Q
clinical features of kikuchi disease
A
fever
cervical LAD (posterior and unilateral)
rash
asceptic meningitis
uveitis
18
Q
pathology in kikuchi disease
A
necrotizing histiocytic infiltrate (no neutrophils) and fragments of nuclear debris
19
Q
lab finding in kikuchi
A
atypical lymphocytes (mono like syndrome)
20
Q
EGPA organs involved
A
lungs
skin
heart
GI tract
CNS
21
Q
clinical clue for EGPA
A
tapering off steroids unmasks disease
22
Q
ANCA in EGPA
A
p-ANCA
23
Q
clinical triad of EGPA
A
allergic rhinitis
asthma
peripheral and lung eosinophilia
24
Q
organ involvement in GPA
A
respiratory tract
eyes
lung
kidney
25
diagnosis of GPA
biopsy or p-ANCA
26
buzzwords for relapsing polychondritis
recurrent cellulitis/cartilage inflammation
saddle nose
cauliflower ear
sparing of ear lobe
parasternal joint involvement
27
contact precautions of flu
standard plus droplet
28
preferred diagnostic method for flu
PCR/NAAT
29
recommended flu medications for outpatients
osteltamivir, baloxivir, zanamivir and IV peramivir
30
recommended flu medication for inpatients
oseltamivir
31
cutoff window for hospitalized patients to get flu medication
none
32
oseltamivir safe in pregnancy?
yes
33
situation in which influenza PEP is indicated
nursing home outbreaks
34
adenovirus association with what mab
alemtuzumab
35
Hantavirus pulmonary syndrome labs in cardiopulmonary phase
thrombocytopenia
hemoconcentration
left shift with atypical lymphocytes
elevated PT
abnormal LFTs
36
pharyngitis and rash
HIV
secondary syphilis
37
pharyngitis after oral intercourse
gonorrhea
HSV-2
38
pharyngitis and conjunctivitis
adenovirus
39
Vincent's angina
acute necrotizing ulcerative gingivitis
painful, sloughing of gingiva
40
clinical feature of Ludwig's angina
woody induration of the neck
41
clinical feature of diptheria
bull neck
42
dose adjustments when using azoles with tac/cyclosporine/rapamycin
decrease tac dose by about 50%
will increase the tac levels
43
dose adjustements when using RIF and tacrolomus/cyclosporine/rapamycin
increase tac dose
decreases tac levels and can precipitate rejection
44
interaction between RIF and prednisone
increases prednisone level
45
management of Lyme carditis with heart block
don't need permanent pacemaker, will resolve within several days of antibiotics
46
do you need lab testing for erythema migraines
no
47
Lyme testing in early infection
EIA/Serology can be negative in first 2-3 weeks of infection
48
prophylaxis for Lyme
give within 72 hours of tick exposure, 1 dose of 200 mg doxycycline
49
erythema migrans treatment
doxycycline x 10 d
amoxicillin or cefuroxime x 14 d
50
Lyme arthritis diagnosis
serology in blood is 100% sensitive
usually only test you need
can also use the PCR 100% specificity on synovial fluid
51
treatment of neurological Lyme without parenchymal disease
CTX, Cefotaxime, Penicillin or PO Doxycycline
52
treatment of Lyme carditis outpatient
ok for PO doxycycline
53
preferred testing for Lyme arthritis
serum ab testing
54
treatment of Lyme arthritis
po for 28 days
55
vaccine recommendation for persons getting cochlear implant
PCV 15 then PPV23 or PCV 20 given two weeks before surgery
56
treatment of bartonella infection involving CNS
doxycycline + rifampin
57
HIV + with bartonella treatment
doxy or erythromycin + rifamycin for 3 months
58
two drugs that can cause pseudohyperaldosteronism
itraconazole and posaconazole
59
option for PO step down therapy for candida krusei candidemia
voriconzole
60
when should eye exam be performed in neutropenic patients with candidemia
within the first week after recovery from neutropenia
61
what is the preferred test for diagnosis of chlamydia psittacosis pneumonia
PCR
62
preferred treatment of chlamydia psittacosis
doxycycline
can use macrolides or FQ also
63
what is the benefit of culture for legionella
can detect all species, urine antigen only specific for l. pneumophilia but can cross react with other serogroups
64
tropical pulmonary eosinophilia can be seen with
wuchereria Bancroft or brugia Malay
65
helminths that can cause loffler's syndrome
ascaris
hookworms
strongyloides
66
diagnosis of Whipple's disease
duodenal biopsy PAS + stain
PCR - more common for culture negative IE
67
triad in Whipple's disease
weight loss, arthralgia, diarrhea
68
treatment of Whipple's disease
CTX or Mero plus co-trimixazole
HCQ + Doxycycline
1 year
69
timing of acute rheumatic fever
19 days after GAS infection
70
treatment of primary episode of ACR
IM benzathine penicillin x 1 or PO penicillin x 10d
71
secondary ppx of ACR with carditis and valvular disease
IM benzathine weekly for 10 years or age 40 (whatever comes first) sometimes life long
72
secondary ppx of ACR with carditis and no valvular disease
10 years or until age 21
73
secondary ppx of ACR without carditis or valvular disease
5 years or until age 21
74
flaccid paralysis involving cranial nerves with descending weakness
botulism
75
treatment of botulism
antitoxin plus supportive care
76
treatment of vibrio vulnificus
FQ plus 3rd generation cephalosporin
77
treatment of bordatella pertussis
macrolide if within 3 weeks of symptom onset
78
treatment time window of bordatella pertussis in infants or pregnant women
if within 6 weeks of symptoms
79
PEP for bordatella
if within 3 weeks of contact, treat all household and contacts with risk of severe infection
80
timing of SSPE
7 years after measles infection
81
PEP for measles
non immune persons should get either MMR (within 72 hours) OR immunoglobulin within 6 days of exposure
don't give both- will inactive each other
82
meningococcemia ppx for pregnant women
ceftriaxone
83
meningococcemia ppx
rifampin
ciprofloxacin
ceftriaxone
within 7d of exposure
84
gram stain of burkholderia pseudomallei
aerobic GNR
85
Chest imaging of melioidosis
diffuse military nodules that can cavitate
86
treatment of burkholderia pseudomallei
carbapenems
ceftazidime
TMP-SMX
87
duration of treatment for melioidosis
IV then transition to PO for 3 months
88
salmon pink colonies
rhodococcus
89
rhodococcus gram stain
gram positive coccobacillus
90
lung findings of rhodococcus
cavitary
nodule
effusion
abscess
91
m kansasii therapy
daily RIF/EMB/INH x 18 months
92
heartland virus is what type of virus
phlebovirus
93
treatment of erythema migraines in pregnancy
amoxicillin
94
most common cause of fungal pericarditis
histoplasmosis
95
major criteria for Acute Rheumatic Fever
Carditis
Polyarthritis
Syndeham Chorea
Erythema marginatum
Subcutaneous nodules
96
two complications of ZIKA
Guillan barre syndrome
fetal malformations
97
what is the only vector borne illness that can be transmitted sexually
zika
98
what type of virus is zika
flavivirus
99
treatment of malaria in pregnancy
quinine or chloroquine
100
3 side effects of mefloquine
vivid dreams
insomnia
dizziness
101
side effect of polymyxin B
bronchospasm, neuromuscular blockade, seizures
102
what is a significant DDI with imi-cilastatin-relebactam
valproid acid
103
side effect of all azoles
teratogenic
104
posaconazole side effect
pseudohyperaldosteronism
HTN, hypokalemia
105
what antibiotic is least likely to be effective against DTR PsA
meropenem-vaborbactam
106
what to consider for DTR PsA if they have gotten Ceftaz-Avi or Cef-Tazo prior
high chance of resistance, use different antibiotic
107
mechanism of resistance to cefiderocol
mutations in iron transport proteins
108
OXA-48 treatments
ceftaz-avi
cefiderocol
109
NDM treatment
Cefiderocol
Combination of Ceftaz-Avi plus aztreonam
110
KPC treatment
ceftaz-avi
mero-vabor
cefiderocol
imi-cil-rele
111
what drug can you not use with KPC
ceftolozone-tazobactam
112
CRAB therapy options
Unasyn in combination with
cefiderocol
minocycline/tigecycline
polymixins
113
fluconazole resistant candidas
krusei
auris
haemulonii
sometimes glabrata
114
what formulation of voriconzole to use in renal failure
PO, IV will accumulate in renal failure
115
use of ISA in candidemia?
none, inferior to caspofungin
116
false positive Crag can be seen with what three organisms
trichosporon
Rothia
Capnocytophaga
117
MOA of azoles
binds to 14 alpha demethylase which inhibits synthesis of ergosterol from lanosterol during cell membrane production
118
MOA of echinocandins
inhibits the synthesis of B 1,3 Glucan
119
what mutation happens first in GCV and VGCV
UL-97
120
if there is a UL-97 mutation with GCV or VGCV, then what drugs will still be sensitive
cidofovir and foscarnet
121
If there is resistance to UL-54 with GCV or VGCV, what drugs will be resistant also
cidofovir
122
what drug to give with cidofovir to prevent renal toxicity
probenecid
123
two side effects of foscarnet
electrolyte abnormalities (hypophos) with renal dysfunction
GU ulcerations
124
Letermovir given with what three drugs can increase their levels
Cyclosporine
Tacrolimus
Sirolimus
125
letermovir given with what drug can decrease its levels
voriconzole
126
mechanism of lamivudine resistance in HBV
YMDD motif in viral DNA polymerase
127
Neuraminidase inhibitor mechanism of resistance
if present, what drug to use?
H274Y
Baloxivir
128
precautions for influenza
standard plus droplet
129
preferred test for flu diagnosis
PCR/NAAT
130
additional testing site for IC hosts for flu
lower respiratory tract specimens
131
exception to time limit on flu therapies
hospitalized or severe, progressive disease.
can give regardless of duration of symptoms
132
recommended flu treatment for inpatients
ostelamivir
133
CI to flu therapies in pregnant women?
none
134
adenovirus in HSCT associated with what drug
alemtuzumab
135
