Fmed Quiz #2

Front 1

Tx of men with suspected lower UTI

Back 1

fluoroquinolone for 7-10 days

Front 2

men with pyelo

Back 2

outpt: fluoroquinolone for 14 days

inpt.: fluoroquinolone for 14-21 days

Front 3

when should an adult male undergo imaging (U/S or abd xray) to identify an anatomic abnormality or nephrolithiasis?

Back 3

after 2nd lower UTI

or

single episode of pyelo

Front 4

What Ab's are used to treat children with UTI's?

Back 4

TMP/SMX
amoxicillin/clavulanate
nitrofurantoin
3rd gen cephalosporin
(NOT fluoroquinolones)

Front 5

Who should be screened for asymptomatic bacteriuria?

Back 5

Pregnant women in their 1st trimester (12-16 weeks) by urine culture
AND
children with recurrent UTIs

Front 6

Std. Tx. of uncomplicated lower UTI

Back 6

3 days of TMP/SMX BID

(unless >20% resistance - then Cipro BID for 3 days

Front 7

Chlamydia trachomatis: what type of bacteria?

Back 7

obligatory intracellular

Front 8

Chlamydia: what cells does it predominately affect?

Back 8

columnar cells of genital tract; endocervix or the urethra
ALSO pneumonia and conjunctivitis

Front 9

Chlamydia: vaginitis or cervicitis?

Back 9

cervicitis

Front 10

Gold Std. Diagnostic test for chlamydia?

Back 10

Culture technique

Front 11

Newest nonculture technique for Chlamydia?

Back 11

Nucleic Acid Amplification Tests (NAAT)

Front 12

Recommended Tx. for uncomplicated genital Chlamydia

Back 12

Azithromycin 1g PO single dose

OR

Doxycycline 100mg PO BID X 7D

Front 13

Recommended Tx. for Chlamydia in preggers

Back 13

Erythromycin 500mg PO QID X 7D

OR

*Amoxicillin 500mg PO TID X 7D

Front 14

CDC recommends that women with Chlamydia infxs should be rescreened ...?

Back 14

3-4 mos. after antibiotic completion

Front 15

Typical presentation of Chlamydia pneumonia

Back 15

protracted onset of Sx.
staccato cough
no wheezing
no temp.

Front 16

Tx. of Chlamydia pneumonia or ophthalmia neonatorum

Back 16

erythromycin base of ethylsuccinate 50mg/kg/day orally divided into 4 doses per day for 14 days

Front 17

male to female ratio of Reactive Arthritis

Back 17

5:1

Front 18

Reactive Arthritis

Back 18

1-3 wks. after Chlamydial infx.
asymmetrical, multiple joints, LE
painless mucocutaneous lesions that tend to occur on the palms of hands and soles of feet

Front 19

Men with gonorrhea tend to be a/symptomatic

Back 19

symptomatic: dripping, burning discharge

Front 20

Which can affect the rectum, chlamydia or GC?

Back 20

GC - few, in any, symptoms

Front 21

ophthalmia neonatorum: Chlamydia v. GC

Back 21

GC = 2-5 days after birth
Chl = 5-12 days after birth

Front 22

Si/Sx of disseminated Gonococcal Infx.

Back 22

skin lesions
joint pain

Front 23

Skin lesions of disseminated GC

Back 23

few in number
only extremities
papules to pustules to hemorrhagic

Front 24

disseminated GC: blood work, skin lesion biopsies and aspiration of the joint?

Back 24

blood work and skin lesions: usually negative for GC

Joint fluid: gram stain shows GC, culture will be neg.

Front 25

Gold std. v. diagnostic test for GC

Back 25

Gold = culture
Usually = NAAT

Front 26

Gram stain of gonorrhea v. GC

Back 26

gonorrhea does not gram stain well but is gneg
GC is gneg

both are intracellular

Front 27

Tx. of GC should include tx. of ___?

Back 27

chlamydia

Front 28

ONLY CDC recommended tx.'s of pharyngeal gonococcal infx.'s

Back 28

ceftriaxone 125mg IM (single dose)
OR
cipro 500mg PO (single dose)

Front 29

Tx. of gonorrhea in children

Back 29

ceftriaxone 25-50 mg/kg IV or IM in single dose (should not >125mg ttl)

Front 30

Tx. of disseminated GC

Back 30

hospitalized.
endocarditis?
meningitis?
Ceftriaxone 1g IM or IV q 24h
parenteral Abx cont'd 24-48h after clinical improvement begins
then switch to oral for 7D

Front 31

GC + Preggers

If allergic?

Back 31

cephalosporin

if allergic, spectinomycin 2g IM

Front 32

Lab eval for PID

Back 32

- ESR
- C-reactive protein
- CBC
- test for presence of Chlam/GC

Front 33

PID in MRI or transvag U/S

Back 33

thickened, fluid filled tubes, with or without free pelvic fluid
OR
tubo-ovarian complex

Front 34

Two diagnostic tests for PID

Back 34

EMB
laproscopic exam

*both are invasive, reserved for lack of response to therapy or severely ill

Front 35

Drugs used in Tx. of PID

Back 35

fluoroquinolones
cephalosporins
metronidazole (Flagyl)

Front 36

MCC of respiratory complaints

Back 36

viruses

Front 37

clear nasal discharge that has persisted for several wks.

Back 37

suggesting allergy

Front 38

unilateral nasal discharge

Back 38

foreign body or necrotic tumor

Front 39

Si/Sx more suggestive of sinusitis

Back 39

maxillary toothache
purulent nasal discharge
poor sinus transillumination
lack of response to decongestants
"double sickening"

Front 40

"double sickening"

Back 40

possibly sinusitis
Started as Sx's of common cold but a few days they "got sicker"

Front 41

best way to differentiate a strep throat from pharyngitis assoc. with a cold

Back 41

rapid strep or throat culture

Front 42

What signs suggest pneumonia?

Back 42

presence of rales
localized decrease in breath

Front 43

Ill appearing pt. + no abnormal physical findings on lung exam =

Back 43

CXR

Front 44

bronchitis v. pneumonia: which is self limiting

Back 44

bronchitis

Front 45

most prevalent virus to cause URIs?

Back 45

Rhinovirus

Front 46

2nd MCC virus to cause URI?

Back 46

Coronavirus

Front 47

median duration of a cold

Back 47

1 week - most pts. improve by day 10 - lingering sx. may last up to 2 weeks

Front 48

When is URI/common cold most prevalent?

Back 48

Sept. - March

Front 49

When does the incidence of sinusitis peak?

Back 49

winter

Front 50

location of sinusitis in children v. adults

Back 50

children: posterior ethmoidal/sphenoid

adults: anterior ethmoid/maxillary

Front 51

Most prevalent bacterial etiologies of sinusitis

Back 51

S. pneumoniae
smokers - H. influenza

Front 52

Most acute sinusitis is caused by _____.

Back 52

Viral infection

Front 53

Facial pain and swelling have high/low sensitivity for acute sinusitis.

Back 53

LOW -- 50-60% of pats. with sinus sx. do not actually have sinusitis

Front 54

_______ should be considered in pts. with repetitive episodes of acute bronchitis.

Back 54

Asthma

Front 55

Peak incidence of of acute bronchiolitis is at what age?

Back 55

6 mos. of age

Front 56

MCC of bronchiolitis

Back 56

RSV

Front 57

Classic signs of bronchiolitis

Back 57

wheezing

hyperexpansion of lungs

Front 58

Recently, 80-90% of influenza related deaths occurred in what population?

Back 58

individuals > 65 years of age (5th leading cause of deathin >65y/o)

Front 59

Typical influenza infx.

Back 59

abrupt onset of:
fever
myalgia
sore throat
nonproductive cough

Front 60

Most prominent feature of bronchitis

Back 60

cough

Front 61

Abrupt onset of:
fever
myalgia
sore throat
nonproductive cough

Back 61

influenza infx.

Front 62

Key to diagnosing influenza

Back 62

being aware of influenza outbreaks in the community - extremely contagious

Front 63

The most consistent sign of pneumonia is?

Back 63

tachypnea

Front 64

Diagnostic std. for pneumonia

Back 64

CXR

Front 65

normal length of presentation of a URI

Back 65

1-2 weeks