Id And Abx Tx

Front 1

Rubella vs measles

Back 1

Both erythematous and maculopapular start on face and go to trunk and extremities.

Differences:
Rubella- occipital and post. cervical lymphadenopathy. Adult women have arthritis.
Measles (rubeola)- cough, coryza, conjunctivitis, and koplik spots.

Front 2

Condylomata acuminata from HPV:
Tx

Back 2

3 treatment options:
1. chem: podophyllin (contraind in pregs), trichloracetic acid
2. immune therapy: imiquimod, alpha interferon
3. surgery: cryo, laser, excision

Front 3

pt. has endocarditis from strep bovis. what other test should be performed?

Back 3

colonoscopy - bc. strep bovis is assoc.d w/ colorectal CA or uper GI CA

Front 4

histoplasmosis, coccidiodo, and blasto geography

Back 4

histo- SE USA
Cocci- SW USA
blast - central

Front 5

PCP :
- CD4 value
-management if O2< 70mmHg or A-a > 35
- " " " " > "".

Back 5

- <200/microL
- TMP-SMX + prednisolone
- TMP-SMX

Front 6

MCC of osteomyelitis

Back 6

S aureus

Front 7

Babesiosis
-where found
- features
- definitive dx made w/
-Tx

Back 7

-NE USA
- no rash, hemolytic anemia and affects splenectomized pt.s, thrombocytopenia
-Giemsa-stained thick and thin blood smear
- quinine-clinda or atovaquone-azithro

Front 8

cryptococcus neoformans

Back 8

encapsulated yeast commonly causes meningitis in HIV pt.
Tx w/ IV Ampho + oral flucytosine.
once improvement then maintence therapy w/ fluconazole

Front 9

Tx of CAP (= <48 hours in hosp):
1. outpt.
2. In pt.

Back 9

1. previously healthy and no abx in past 3 mo.s: Mac or doxy
or
comorbidities or abx used in past 3 mo.s = respiratory fluoroquinolones ( levo or moxi)
2. azithro + ceftriaxone
or resp fluoro

Front 10

nocardia asteroides

Back 10

filamentous aerobic gram + soil bacterium that is partially acid-fast. -> lung cavitation in immunocompro pt.
-Tx : TMP-SMX

Front 11

Tx of HAP (>48 hrs in hosp)

Back 11

DON'T GIVE MAC!
Antipseud beta lactam:
Antispeudo pen: TCP+tazobactam/clavulinic acid
or
Antipseudo ceph= ceftazidime, or cefepime
or
carbepenem (imipenem (SE=seizures) meropenem, doripenem)

Front 12

acute bacterial parotitis :
-physical presentation
- who are prone to it
- infectious agent
-what can prevent this

Back 12

-painful swelling of parotid gland aggravated by chewing.
high fever, swollen parotid gland.
- dehydrated postop pt.s and elderly
-staph aureus
- fluid hydration and oral hygiene pre- and post-op

Front 13

Tx of VAP

Back 13

1. Antipseudo beta lactam (see HAP tx)
+
2. 2nd antipseudo agent:
aminogly (GNAT) or fluoroquinolone (cipro or levo)
+
3. MRSA agent:
Vanco or linezolid

Front 14

syphillis Tx if allergic to penicillin

Back 14

oral azithromycin or doxycycline

Front 15

Lung abscess Tx

Back 15

clinda or pen

Front 16

PCP PNA Tx:
1. best initial
2. if toxicity from #1
3. Prophylaxis

Back 16

1. TMP-SMX
2. -pentamidine
or
-Clinda + primaquine (unless G6PD def)
3.-TMP-SMX or
- Dapsone or Atovoquone

Front 17

-sinusitis dx
-most accurate test
-Tx

Back 17

-clinical dx
-sinus Bx or aspirate (don't do this unless recurrent infxn and not responding to abx)
-amoxicillin, doxy, or TMP-SMX + decongestant

Front 18

empiric Tx and cause of PNA in kids:
1. neonate
2. 1-4 mo.s
3. 4 mo.s - 4 yrs.
4. 5 - 15 yrs.

Back 18

1. Grp B strep > E coli, listeria, Chlam trach.
Tx. Amp + Gent ( +/- Vanc if MRSA is a concern. and for Chlam use erythro)
2. RSV, chlam trach, parainflu, bordetella, strep pneumo, staph. A
Tx. Mac +/- cefotaxime
3. RSV, other virus (rhino, influ, parainflu, adeno, corona)
Tx. Amox or Amp
4. strep pneu > myco, c. pneu, viruses
Tx.(1) Amox +clarithro (or erythro)
(2) Azithro
(3) amox + doxy

Front 19

Allergic bronchopulmonary aspergillosis (ABPA):
1. presentation
2. what do you see on CXR
3. main clue to make dx
4. most accurate dxic test
5. Tx

Back 19

1. similar to asthma with SOB, hemoptysis, cough, and wheezing
2. tram-track lines in bronchi (these are indicative of edema of bronchial wall and bronchiectasis)
3.elevated eosinphil count
4. elevated level of IgE, aspergillus precipitans in serum, and/or aspergillus-specific IgE and IgG
5. prednisone + itraconazole

Front 20

PCP PNA
1. CXR
2. who to suspect
3. indicative lab finding

Back 20

1. interstitial infiltrates
2. CD4 < 200 or severely immunocompromised (ex. chemo)
3. LDH > 220

Front 21

differential dx for ground glass opacities(diffuse hazy infiltrate) on CXR?

Back 21

-interstitial pna (ex PCP)
- Pulm edema
- pulm hemorrhage
- hypersensitivity pneumonitis

Front 22

1. Tx for Acute exacerbation of chronic bronchitis (AECB) (ie Acute bacteria exacerbation of COPD (ABEC))
2. Bronchiectasis
3. CF

Back 22

same causitive agents as sinusitus ( strep pneu, H. influ,
morax cat)
Same Tx for 1-3:
-Amox/clavulinic acid
or
-Macs
or
- 2nd or 3rd gen Cephs
- Respiratory fluoroquinolones

Front 23

A-a gradient = normally
pAO2=
paO2 normally
paCo2 normally
PaO2/FiO2 (ie FiO2 ratio)

Back 23

pAO2 - paO2 = 5-15 mmHg
pAO2=150 - (PaCO2/0.8)
paO2 = 90-100 mmHg
PaCO2 = 40 mmHg
PaO2/FiO2 (FiO2 is typically .21), <200 is ARDS, <300 = gas xchange deficit

Front 24

ARDS (ie shock lung)
1. cause of it
2. CXR will show
3. Dx?
4.Tx

Back 24

1. diffuse lung injury from sepsis, aspiration, trauma, pancreatitis!, or trauma ->diffuse capillary leak
2. bilat infiltrates (looks like CHF but pressures are normal)
3. presumptive dx. PaO2/FiO2 <200 and PCWP <18 mmHg
4. intubation, mech venti w/ FiO2 < 60% to maintain SaO2 >90%, and >PEEP

Front 25

Pharyngitis and tonsillar infxn Tx

Back 25

(only treat with (+) throat Cx in pharyngitis)
Amox (augmentin) or Pen
-if allergic w/ rash: cephalexin
-if anaphylaxis: clinda or Mac

Front 26

1.trichinellosis presentation 1st symptom followed by
2. triad
3. other clues

Back 26

1. GI complaints
2. periorbital edema, myositis, eosinophelia
3. subungual spinter hemorrhages + conjunctival retinal hemorrhage

Front 27

Pt. comes in w/ gono and chlam.
what are additional STDs should be screened for?

Back 27

HIV, syphilis, hep B, pap smear for cervical CA, and hep C (if Hx of drug use)

Front 28

UTI drugs:
1. recommended in pregs
2. contraindicated in pregs

Back 28

1. Nitrofurantoin, Amox, ceph
2. tetra, fluoro, TMP-SMX

Front 29

HIV w/ painful swallowing and substernal burning.
1. what is it?
2. MCC and Tx
3. if doesn't resolve after #2?
4. possible other causative agents?

Back 29

1. esophagitis
2. Candida - fluconazole
3. esophagoscopy w/ cytology, Bx, an Cx
4. HSV or CMV

Front 30

Pt.s dx.ed w/ HIV should be tested for

Back 30

1. HIV RNA levels
2. CD4 count
3. VDRL syph test
4. PPD skin test
5. Anti-Toxo Ab titer
6. Pneumococcal polysach vacc (unless CD4 <200)
7. Hep B and A (and vacc if negative)

Front 31

Life-threatening rxns assoc.d w/ HIV therapy:
1. didanosine
2. abacavir
3. any of the NRTIs
4. any of the NNRTIs
5. liver failure
6. indinavir

Back 31

1. pancreatitis
2. hypersensitivity syndrome
3. lactic acidosis
4. Stevens-Johnson
5. nevirapine
6. crystal-induced nephropathy (needle-shaped crystals)

Front 32

kid w/ unilateral inflamed fluctuant cervical lymph nodes
1. typical cause
2. Tx

Back 32

1. strep or staph infxn
2. incision and drainage + dicloxacillin (covers both)

Front 33

Injx drug user, HIV +, fever, scattered crackles

Back 33

pulmonary infxn in the setting of IV drug abuse suggests septic embolism from infective endocard involving tricuspid value. Staph. A.

Front 34

Histoplasmosis:
1. endemic area
2. CD 4
3. S&S
4. Dx test
5. labs:
6. Tx

Back 34

1. Ohio river valley
2. <100
3. fever, wt. loss, night sweats, N&V, and cough , and SOB
4. Antigen in urine or serum
5. pancytopenia (if bone marrow involved), elevated LFT, elevated ferritin
6. Itraconazole

Front 35

Person comes in w/ probable HSV encephalitis.
1. 1st step
2. next step

Back 35

1. IV acyclovir w/o delay
2. PCR of CSF looking for viral DNA

Front 36

Healthcare worker exposed to HIV (percutaneous needle injury)
1.what do you do?

Back 36

1. draw blood for HIV serology and start antiretroviral therapy with 3 drugs immediately

Front 37

how do you remove a tick?

Back 37

take the mouth parts by tweezers and slowly remove it

Front 38

pt.s w/ hemachromatosis are vulnerable to what iron-loving bacteria?

Back 38

Listeria mono, Yersinia entero, and Vibrio vuln

Front 39

malig otitis ext (MOE)
1. presentation
2. what is seen upon examining ear
3. risk factors
4. causitive org
5. complications
6. Tx

Back 39

1. ear discharge and severe pain. pain radiates to TMJ and exacerbated by chewing
2. granulation tissue in ext aud. meatus
3. immunosuppressive conditions (DM)
4. pseudomonas aeruginosa
5. osteomyelitis of temporal bone and deafness
6. ceftazadime