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137 Cards in this Set
- Front
- Back
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The most common causes fever of unknown origin |
are connective tissue disease, infection, malignancy, |
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The quickest and easiest way to confirm activepulmonary tuberculosis |
is sputum culture. |
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Human bite pathogens are eiknella corrodens, ahemolytic streptococci, Staphylococcus aureus, management includes |
local and irrigation no primary closurenecessary except for the face, antibiotics and tetanus booster. Augmentin. |
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PPSV 23 alone for people in the ages 19 to 64recommended if |
Chronic heart, lung or liver disease. Diabetessmokers and alcoholics |
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If patient is 19 to 64 they will require thePPSV 23 and PCV 13 if |
CSF leaks, cochlear implantsSickle cell disease, no spleen,immunocompromised, chronic kidney disease |
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Order of pcv 13 and ppsv23 in patients olderthan 65 |
1 dose of pcv13 followed by ppsv23 in 6-12months. |
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Fungal meningitis results are and treated with |
are elevated opening pressure greater than 250,mononuclear lymphocytic predominance with the leukocyte count is low elevatedprotein and low glucose, positive India ink preparation for cryptococcosis.Amphotericin b andflucytosine. |
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If the patient responds well to initial therapywith fluCytosine and amphotericin for cryptococcal meningitis they can bemodified to |
fluconazole |
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Recommendation for pre-exposure prophylaxis torabies |
Rabies vaccine on days zero, seven and 21 or 28 |
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Recommendations for postexposure prophylaxis inpreviously unvaccinated people |
Rabies vaccine on days zero, three, seven and14Rabbies immunoglobulin on day zero |
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Recommendations for postexposure prophylaxis inpreviously vaccinated people |
Rabies vaccine on day 03 |
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Patient with fever chills loss of appetite sorethroat dry cough and headache admitted and given penicillin G. She has exudate that are forming membranes and tender cervical lymphadenopathy. The labcalls back and says that she's positive for Corynebacterium diphtheria . patient started on |
. patient started on diff. Antitoxin.Complication of the treatment is, anaphylaxis |
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to prevent development of acute rheumatic feverafter streptococcal tonsil pharyngitis the treatment is |
A 10 day course of oral penicillin |
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Necrotizing fasciitis can because by |
by Streptococcus pyogenes group A, staffaureus, Clostridium perfringes, or polymicrobial |
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In order to diagnose intraabdominal abscessafter surgery the best test |
abdominal ultrasound |
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A patient with fever, Petechiae , history ofintravenous drug abuse and holosystolic murmur at the apex suggest infectiveendocarditis. The patient later developed headache, lethargy and neck stiffnessthis is a |
Subarachnoid hemorrhage secondary to therupture of a mycotic aneurysm. |
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Acute infection of hepatitis C can be diagnosedby |
a positive HCV RNA later followed by a positiveanti-HCV antibody within 12 weeks |
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Resolved hep c infection markers |
negative hep c rna and positive anti Hcvantibody |
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The guidelines and treatment and management ofHIV-positive patients recommends evaluation of CD4 count and HIV load every |
3 to 4 months |
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Pcp pneumonia treated with |
Bactrim |
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Steroid use is recommended in moderate tosevere PCP infections with the alveolar arterial oxygen gradient more of |
35 as well as an arterial oxygen tension of 70or less |
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The treatment for chlamydia |
Husband azithromycin 1 g single dose,wife with erythromycin 500 mg four times a day for seven days. Useerythromycin if female is pregnant, otherwise doxycycline 100mg PO bid for 7days. |
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HIV associated thrombocytopenia appears at anytime and thought to be due to be too immune dysfunction or viral destruction.HIV thrombocytopenia is rarely associated with bleeding. |
Antiretrovirals therapy improves condition |
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In general viral load in treatment naïvepatients initiated on antiretrovirals therapy is expected to decrease |
By 1 month less than 5000 copies 2 to 4 months less then 500 copies1 4+ months less than 50 copies |
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Recommended antibiotic and pregnancy |
nitrofurantoin, amoxicillin, Augmentin,cephalexin |
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Pyelonephritis and pregnant woman is treatedwith |
Ceftriaxone or ampicillin and gentamicin. Ifsevere zosyn and carbapenems |
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serum sickness like syndrome may develop in theprodromal phase of hep b infection. This manifests as |
as fever, rash and arthralgias andusually resolve with the onset of jaundice |
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Cat scratch disease manifest as a |
a papule scratch site, regional lad , fever ofunknown origin. Generally is self-limiting. Azithromycin maybe even indisseminated disease or for immunocompromised host |
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Lidocaine will not be effective in a patientwith cellulitis because |
Local anesthetics are basic compound which canbe neutralized an infectious acidic environment |
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Giardiasis treatment nor recommended forasymptomatic patients unless |
high risk children in day care,immunocompromised. Tx if needed with metronidazole, nitazoxanide, tinidazole |
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Vaccines for adult HIV |
hepatitis A hepatitis B, HPV, influenza,Meningococcus, pneumococcus, tdap
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Initial treatment of cat bites is |
is augmentin. More serious infection withunasyn |
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What is the prognosis of Lyme disease |
Prognosis is good. Most patients are cured byantibiotics and disease free after one year. Oral doxycycline or amoxicillin. |
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Toxic shock syndrome is likely produced by |
the staph areus exotoxins |
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Viral rash development in patients withinfectious mononucleosis is |
likely caused by circulating immune complexes |
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Antibiotics in pediatric sepsis for childrenless than 28 days/" |
Ampicillin plus gentamicin or cefotaxime. Mostcommon organisms E. coli and group b strep |
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Antibiotics in pediatric sepsis for childrenmore than 28 days |
Ceftriaxone or cefotaxime. Vanc for meningealinvolvement Most common organisms are Streptococcus pneumonia and Neisseriameningitis |
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Patients with Rocky Mountain spotted fever maypresent initially was nonspecific and misleading symptoms such as low-gradefever lethargy myalgias and headaches. A petechiael rash which usually beginson the ankles and wrists and then spreads to the palms and soles and thecentral body happens on the 3rd to 5th day of illness. Treatment should beinitiated for patients even if |
there is no confirmatory test |
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Hiv lipodystrophy is |
fat accumulation on the back of the neck andabdomen along with extremities and face. Insulin resistance and dyslipidemiaare closely related |
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If a patient with HIV has triglyceride levelsgreater than 500 then a, if greater? |
fibrate such as gemfibrozil should beused. If triglycerides are levels less than 500 Then, statin can be used |
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Salmonella enteriditis and should be treatedwith |
replacement electrolytes since thegastroenteritis is self-limited. |
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Viral meningitis or encephalitis in thepediatric population is usually related to |
to enteroviruses or arboviruses, such aseastern esquine encephalitis, western equine encephalitis, St. Louisencephalitis, Colorado tick fever, California encephalitis |
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HIV patient with multiple small papules withcentral umbilication over the trunk and upper thighs with hemorrhagic crust |
Cutaneous cryptococcosis Dx by biopsy |
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Early neurosyphillis presents wit |
headache, nausea vomiting, stiff neck,posterior uveitis, decreased visual acuity |
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Late Syphilis presents with |
progressive dementia, pupillary defect, diffuseneurological signs, tabes dorsalis |
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Center criteria; |
tonsil liar exudates, tender anterior cervicallad, fever, absence of cough. 3 of these has a 50% predictive value. |
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IV pentamidine was associated with a number of metabolicand electrolyte disturbances including |
hyperkalemia, hypokalemia, hypocalcemia,hypoglycemia and hyperglycemia |
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Tuberculosis treatment even in pregnancy womenincludes |
includes isoniazid, rifampin, ethambutol for 9 months |
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Antibiotics for meningococcal prophylactics are |
rifampin , ceftriaxone, ciprofloxacin |
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Herpes zoster is treated with |
acyclovir , patients need to be isolated untilthe lesions are crusted. |
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Patients with IUD who are found to haveactinomycetes infection, guidelines recommend |
continue iud there is a small risk ofinfection. However they need to be seen if they develop pelvic infectionsymptoms |
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A pregnant woman who is HIV-positive and onantiretrovirals therapy, she should |
continue the therapy throughout her pregnancy.Patients on antiretrovirals therapy with undetectable viral load can have avaginal delivery however the infant should be formula fed and notbreakfast |
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In a child with a normal appearing tympanicmembrane with decreased mobility of pneumatic otoscopy suggests |
effusion in the middle ear. Effusions canpersist up to three months after an acute episode of otitis media. If no othersymptoms are present watchful waiting is all that is necessary |
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Bowel and bladder dysfunction is an importantrisk factor for urinary tract infections in toddlers or toilet training.Children may develop abnormal illumination habits such as |
total withholding and incomplete defecation,which lead to functional constipation. Fecal retention can cause rectalextension and instructional bladder empty. |
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Erypselas is provoked by |
group a streptococcus |
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Immunocompetent children can receive allstandard immunizations regardless of |
regardless of the pregnancy status of householdcontacts |
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The most common causes of pneumonia in cysticfibrosis in children are staph aureus and pseudomonas, treatment is |
Staph aureus-vanc Pseudomonas-zosyn, ceftazidime , ticarcillinclavulanate, cefepime. Meropenem imipenem |
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Which cd4 and rpr Titers would put someone athigher risk of neurosyphillis |
Cd4 less than 350 and rpr> 1:32 |
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Treatment for primary or secondary and earlyless than 12 months of infection of syphilis |
Penicillin G one single dose intramuscularly |
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Syphilis more than 12 months of infections orunknown duration or with cardiovascular syphilis |
treatment is penicillin g, for 3 weeks weeklyintramuscularly |
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Treatment of congenital syphilis is |
Aqueous penicillin G IV every 8 to 12 hours for10 daysSyphilis treatment isAqueous penicillin IV every four hours for 14days |
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What is one potential complication of treatmentof syphilis |
Acute febrile reaction within 24 hours which isreferred to as jarisch her herxheimer reaction |
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Invasive aspergillosis is common in bone marrowtransplant recipients. Typically involves the |
respiratory tract including the lungs and thesinuses along with fever |
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Schistosomiasis may suspected in patients with |
Hematuria, from Africa and urinay frequencywith anemia Dx is by stool with parasites or urine |
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The most common complication of cat scratchdisease is |
suppuration of lymph nodes |
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A 04 yo girl with a rash that started on herface and forehead and spread to the trunk and extremities. She has runny noseand poor appetite the rash is present throughout her body except the palms andsoles. There is patchy erythema on her soft palate. what is the most likely |
diagnosisRubella |
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The treatment options for latent tuberculosis are |
The treatment options for latent curriculumsare |
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Neonatal chlamydia Walker's transmission bye |
Direct vaginal contact |
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Chlamydia children 5 to 14 days present as |
Thickened injected conjuctivae, waterymucopurulent or bloodstained discharge, eyelid swelling, conjunctiva pseudo membrane |
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Tx of chlamydia in |
children, erythromycin for 14 days |
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Coxsackie virus can cause |
herpangina as well as vesicles in the palms,soles buttocks and genitalia |
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atient with giant ulcers with no virus found onbiopsy suggest |
suggest apthhous ulcers which is treated withprednisone when patients develop esophagitis |
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Patients with Candida endophthalmitis who haveChoreo retinitis need |
Vitrectomy and systemic amphotericin b |
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Physical exam and imaging of PCP shows |
Bilateral scattered rhonchi and wheezing. Chestx-ray with diffuse bilateral groundglass opacity |
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The number one cause of dilated cardiomyopathyin Mexico and Central America is |
Chagas disease. Apical aneurysm withoutcoronary disease should raise suspicion of chagas. Complete heart block andventricular tachycardia are also features |
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Influenza a management is |
Acetaminophen and symptomatic treatmenttreatment with oseltamivir Can be considered in patients older than 65,pregnant, or those at risk of pulmonary or cardiac disease, patientshospitalized. |
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Therapy duration for infants and children withtuberculosis meningitis, military tuberculosis and tuberculous osteomyelitis is |
12 months of anti tuberculous therapy |
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Which antibiotic is likely responsible foryellow plaques scatter over the sigmoid mucosa |
Ciprofloxacin . This is a known cause ofC. difficile |
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Who receives a tetanus toxoid booster |
Individuals with dirty wounds who have receivedbooster more than five years ago and individuals with clean wounds ones whohave received booster mora than 10 years ago |
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Tetanus immunoglobulin should be given to |
Anyone with a dirty wound and an unclear orinsufficient immunization history |
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The most common complication of having acuteotitis media is having |
another episode of acute otitis media with adifferent bacteria |
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Lime disease during pregnancy carries |
no risk of transmission to the fetus if treatedappropriately |
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Vaccinations for a new born to a mother withchronic hepatitis B, immunizations are |
Hepatitis B immunoglobulin and hepatitis Bvaccine 12 hours after birth.Second vaccination between 1 to 2 monthsThird dose at six monthsSerology controls must be done in 3 to 4 monthsafter the third dose or between nine and 15 months old |
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Chlamydia pneumonia in children features |
Absence of fever, staccato cough, history ofconcurrent conjunctivitis, auscultation and radiologic findings are out of proportion to the healthy appearance of the child |
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In patients with positive Elisaanti-HCV antibodies the diagnosis should be confirmed by |
HCV RNA |
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The most common infectious complication of tickis |
local infection |
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Progressive multifocal leuko encephalopathyfeatures |
Rapidly progressive neurological deficitwithout evidence of increased intracranial pressure. Antiretroviral therapyseems to be the only way to reverse the process |
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HbV vaccine is universally recommendedfor |
Newborns, school-age children, people withmultiple sexual partners, homosexuals, bisexual males, IV drug users,healthcare workers, patients requiring hemodialysis or repeat bloodtransfusions and household contacts of hepatitis B carriers |
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Clinical features of acute rheumatic fever |
Joint painEndocarditisSubcutaneous nodulesErythema margintumSydenham chorea |
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hronic prostatitis manifests clinically as |
lower urinary tract infection treatment isBactrim but preferably Cipro or Levo. |
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Patients with anal abscesses are a great riskof developing |
Fistula |
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The markers for acute hepatitis b infection are |
Hbsag, hbeag (high infectivity marker) and Igmantihbc |
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Markers of chronic hep b are' |
Hbeag with antihbc and igg antihbc |
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Patients risk to develop chronic hep b afteracute hep b is |
5% |
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To confirm Gonoccocal arthritis cultures shouldbe obtained from |
Joint fluid, rectum, urethra and oral cavity |
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Gonoccocal arthritis besides systemic symptomspresents with painful tendons along ankle and |
toe joints |
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Pear-shaped multi organisms are characteristicof |
of trichomonas vaginalis. Treatment should beoral metronidazole for the patient and his partner. |
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The best treatment for severe pelvicinflammatory disease is |
Cefoxitin and intravenous doxycycline |
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Tuberculosis is positive if induration or 5 mmor more in the setting of |
Patient with recent close contact withtuberculosis patientPatients with fibrotic changes on chest x-rayPatients with HIVOrgan transplant recipientPatients on chronic steroid therapy or otherimmunocompromised disease |
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Tuberculosis is positive with an integration of10 mm or more in the setting of |
Persons from Countries with high prevalence oftuberculosis residing in the US for the last five yearsIV drug usersHomeless personPrison workers healthcare facility workersPatients with medical disorder like diabetes,chronic renal failure, silicosis, malignancy children less than four years ofage |
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Which form of tuberculosis has to be reportedto the authorities |
Active tuberculosis. Latent tuberculosis is notreportable |
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At preschool age children with focal lungfindings with suspicion of pneumonia treatment |
High-dose amoxicillin most likely strep pneumo |
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Older child, more than preschool age, hemay be well appearing with bilateral lung findings treatment |
Azithromycin which may likely be duemycoplasma pneumo. |
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A person with no known risk factors fortuberculosis induration is positive for |
15 mm |
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Bacterial vaginosis features |
Thin, of white discharge with issue order withno inflammation. PH more than 4.5, with positive whiff in a positive with testKOH. |
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Treatment of bacterial vaginosis by gardnerellavaginalis is |
Metronidazole or clindamycin |
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Trichomoniasis features |
Thin, yellow green stinky frothy dischargevaginal inflammation. PH above 4.5 |
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Treatment of trichomoniasis is |
Metronidazole for both parties |
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Candida vaginitis features |
Perfect cottage cheese discharge with vaginalinflammation. PH below 4.5 with pseudo hyphae |
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Treatment of candida vaginits is |
Fluconazole |
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Postexposure prophylaxis to HIV includes |
2 nucleoside reverse transcriptase inhibitorsfor four weeks. Addition of a protease inhibitor in cases where the sourcepatient has a high viral load (tenofovir, emtricitabine, raltegravir) |
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If a patient who is immigrant has positivetuberculin test received tb treatment and then patient is still positive aftertreatment but no symptoms or radiologic findings then |
Reassurance with no further treatment. |
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Patients with dka may develop foul smellingnasal discharge with pain in paranasal area. Nasal mucosa inflammation with blackdiscoloration in the Antero inferior aspect. This is |
Rhinocerebral mucormycosis treted withamphotericin b. |
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Staff aureus, bacillus cereus noro viruses areall associated with |
Vomiting vomiting |
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Clostridium, enter toxic E. coli, entericviruses, Cryptosporidium, cyclospora, intestinal tapeworms are associated with |
Watery diarrhea |
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Salmonella, Campylobacter, Shiga toxinproducing E. coli, shigella, Enterobacter, vibrio, yersenia , are allassociated with |
Inflammatory diarrhea |
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Associated with deli meats and soft cheesecausing watery diarrhea, fever nausea and vomiting may also present withnon-gastrointestinal symptoms such as myalgia |
Listeria monocytogenes |
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Epiglotitisis caused by |
Haemophilus influenza type B. |
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Three month old. Weight corresponds to the 55thpercentile and head circumference is below the 7th percentile. What explainshis condition |
Maternal undercooked lamb meatconsumption during pregnancy. Associated with congenital toxoplasmosis |
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Congenital toxoplasmosis can manifest as |
Hydrocephalus, mental retardation, deafness,seizures.torch. |
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Body fluids where standard precautions havebeen recommended to prevent HIV transmission transmission art |
Semen, vaginal secretions, cerebrospinal,peritoneal, pleural, pericardial, synovial fluid any other body fluid withvisible blood. Urine without blood falling on an Open wound doesn't countto take precautions |
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Community acquired pneumonia is most likelycaused by |
Streptococcus pneumonia the classical symptomsinclude acute onset, purulent sputum, |
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Woman with positive hbsag. Nurse getting bloodfrom this patient gets poked. Nurse received 3 HbV vaccines one year ago andtiter found to be less than 10. What to do |
Give hep b immunoglobulin and initiaterevaccination. Based on the results of the patient this is active infection ofhepatitis B. A tighter more than 10 is protective against the virus and doesnot require postexposure prophylaxis. Postexposure prophylaxis for exposepatients who have either not been vaccinated or who did not appropriatelyrespond to vaccination involves both hepatitis B immunoglobulin as well asvaccination within 12 hours of exposure |
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A woman with fever, breast pain, focalinflammation and history of poor latch is classic for |
Lactational mastitis. The antibiotics of choiceinclude dicloxacillin and cephalexin which are safe during breast-feeding. Mostcommon organism to staff aureus. Revise breastfeeding technique and position.Ultrasound is the gold standard modality to differentiate for an abscessformation. |
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Acute otitis media can be caused by |
Streptococcus pneumoniaNontypeable Haemophilus influenzaMoraxella catarrhalis |
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Clinical features of acute otitis media |
Middle ear effusion, bulging tympanicmembrane |
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What is the treatment of acute tightest media |
First-line amoxicillinAugmentin 2nd line when first line failed |
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A woman in the intensive care unit intubated.Patient develops a well circumscribed erythematous patch on the lower abdomen.The next day she developed a hemorrhagic bullet in the center of the patch andwithin hours the bulla turns into a black necrotic ulcer. The ulcer exudes ayellow-green, purulent fluid sticky to the touch. Gram stain of the fluid ispositive for gram-negative rods. What is it |
Ecthyma gangrenous, likely due topseudomonas |
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What is the test for infectious mononucleosis |
Mono spot which screens for heterophileantibody |
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Patient with infectious mononucleosis becameseverely short of breath in the recumbent position he has pharyngeal edema andswelling of the soft tissues of the neck. what is the best treatment |
Admit and start IV steroids |
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Cdiff with WBC less than 15,000 and creatinineless than 1.5 times greater than baseline what is it what is the treatment |
Mild moderate C diff treated with oralmetronidazole |
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Clostridium difficile colitis with WBC morethan 15,000, creatinine greater than 1.5 times baseline with a serum albuminless than 2.5 what is this |
Severe c. difficile colitis treated with oralvancomycin |
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What is the next step if the patient has severec diff colitis and developed an illeus |
Add IV metronidazole and switched to rectalvancomycin |
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What if severe Clostridium difficile colitiswhat are the options |
Subtotal colectomy, diverting loop ileostomywith colonic lavage |
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What is the therapy of C diff for the firstrecurrence |
Metronidazole for non-severe illnessVancomycin for severe illness |
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What is the treatment of second recurrence ofClostridium difficile |
Pulse tapering oral vancomycin for 6 to 7 weeks |
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What is the treatment of subsequent relapses ofClostridium difficile |
Fidaxomicin Fecal microbiota transplant |
