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118 Cards in this Set
- Front
- Back
DISEASES CAUSED BY STAPHYLCOCCAL TOXINS?
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Toxic shock syndrome (TSST-1)
Scalded skin syndrome (exfoliative toxin) Food poisoning (enterotoxins A-E) – staphylococcal gastroenteritis |
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Group A Strep: aerobic, anaerobic, facultative anaerobe?
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Facultative anaerobe
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What are the non-suppurative diseases caused by group A strep?
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Rheumatic fever, post-strep glomerulonephritis
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Enterococci: aerobic, anaerobic, facultative anaerobic?
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Facultative anaerobic
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what important disease (that we vaccinate against) is caused by a corynebacterium?
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Diptheria
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DISEASES CAUSED BY LISTERIA MONOCYTOGENES
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Meningitis
Endocarditis Neonatal infection Infection in pregnant women |
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neiserria gonorrhea: lactose fermenter?
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NO: only glucose
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moraxella bears many similarities to...?
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neisseria
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Which animals are the following associated with: Bartonella
Pasturella Francisella Brucella |
Bartonella - cat
Pasturella – cat/dog Francisella - rabbit Brucella – cows/sheep/goats |
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Pseudomonas is important in what genetic disease?
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CF
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Which antibx is Widely used in surgical prophylaxis?
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first gen cephalosporin
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Tetracyclines are indicated when...?
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Pregnancy, age <8
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macrolides are prescribed in combo w/ what for the treatment of hospitalized patients with community acquired pneumonia?
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3rd gen cephalosporin
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Drug of choice for pertusis?
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Macrolides
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stevens-johnson syndrome - can be caused by which antibx?
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sulfa drugs
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Major uses of TMP-SMX?
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acute bronchitis, otitis media, lymphogranuloma venereum, PCP
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what is erysipelas? common cause?
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infection of the lymphatic system - cause is streptococcus
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When does Group A strep infection happen in relation to surgery? Staph aureus?
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6-48 hours post.
Several days to develop |
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Vibrio vulnificus?
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Raw Shellfish or traumatic wound exposed to salt water - skin infection
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necrotizing fasciitis: causes?
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type 1 or group A strep
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endocarditis: for each of the following situations, which bugs predominate?
Native valve IV drug abuser Prosthetic valve (early) Prosthetic valve (late) |
Native valve - S. aureus, Viridans
IV drug abuser - S. aureus Prosthetic valve (early) - Coag (-) staph Prosthetic valve (late) - viridans |
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Symptoms of endocarditis?
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Fever 75 – 85%
Chills 45 – 75% Arthralgias and myalgias 15 – 25% |
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What are some peripheral lesions of endocarditis?
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Osler nodes 0 – 23%
Splinter hemorrhages 5 – 50% Janeway lesions 0 – 10% Roth Spots 2 – 10% Petichiae 5 – 40% |
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duke criteria?
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Endocarditis: Major criteria
Major criteria (2) Microbiologic – positive blood culture in 2 of 2 sets Evidence of endocardial involvement – new murmur ie (2 major criteria, 1 major and 3 minor, or 5 minor) |
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Antibx for endocarditis?
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Penicillins/cephalosporings (sometimes in combo with gentamicin ie for coag neg staph)
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High risk factors for infective endocarditis?
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Prosthetic valve
History of IE History of complex cyanotic congenital heart disease – BLUE BABIES |
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Common causes of atypical pneumonia?
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Mycoplasma
Chlamydia Legionella |
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Which bug is responsible for most cases of uncomplicated UTI? Which bugs should be considered for complicated UTI?
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Uncomplicated - E coli
Complicated - Klebsiella, other enterobacteriaceae, Pseudomonas, serratia |
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Culture or no? Woman with typical UTI symptoms, pyuria, and no complicating factors?
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NO
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Uncomplicated cystitis; what tx?
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TMP/SMX
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Acute Otitis media - tx?
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Amoxicilin
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Severe sepsis is defined as..?
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Sepsis with 1 or more organ failures
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Most cases of sepsis now are caused by gram + or - organisms?
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Gram +
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Clinical manifestations of sepsis?
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Fever - early
Hypotension - early Tachycardia -early Tachypnea – sometimes earlyHypothermia - later lactic acidosis - later ARDS - later |
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Which antibx has an exclusively anaerobic bacterial spectrum?
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Metronidazole
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DIAGNOSIS OF C Dificile Associated Diarrhea RELIES ON...?
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DETECTION OF THE TOXIN BY IMMUNOASSAY ON STERILE STOOL FILTRATE, NOT CULTURE OF THE ORGANISM
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With coastal travel or seafood, which enteric bug do you suspect?
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Vibrios
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Traveler's diarrhea causes?
Empiric tx? |
ETEC, EIEC, Rotovirus, campylobacter.
Tx: quinalone, etc. |
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Salmonella bacteremia can cause which disease?
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Typhoid fever
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Nausea and Vomiting within 6 hours of suspicious meal: what bugs likely?
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S aureus and B cereus
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Abd cramps and diarrhea within 16 hours of suspicious meal - what bugs?
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C. perfringens and B cereus
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Fever, Abd cramps, and diarrhea within 48 hours of a suspicious meal - what bugs?
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Salmonella, Shigella, Campylobacter, Vibrio, E coli
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Most common of known foodborne pathogens?
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Noroviruses
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Listeria affects who...?
Food sources? |
Pregnant women, fetuses, immunocompromised. Processed cold meats and dairy products
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Diagnosing HSV infection..?
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Viral isolation
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Should be suspected as the causative agent of aseptic meningitis during the summer and fall seasons?
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Coxsackie B virus
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Which arboviruses have humans as the major vertebrate host?
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Dengue and yellow fever viruses?
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Dengue, St Louis, Yellow fever, and West nile are all what type of viruses?
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Flaviviruses - Arboviruses
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West nile should be considered in people who develop what syx after transfusion?
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WNV should be considered in persons who develop unexplained fever, meningitis, or encephalitis after transfusion
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Signs and symptoms of hospitalized patients with WNV
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Fever > 38oC 98.3%
Headache 57.9% Change in consciousness 46.8% Confusion 39.5% Vomiting 31.3% |
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antiviral eyedrops?
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triflurothymidine
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Which patients are likely to experience acyclovir resistance?
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Long term therapy immunocompromised patients (AIDS)
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Which drug is used for resistant Herpes or CMV? Problems with this drug?
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Foscarnet. Tons of toxicity
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main side effect of gancyclovir?
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hematologic toxicity
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what do zanamivir and oseltamivir do?
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inhibit neuraminidases of influenza A, B
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Ribavirin?
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for RSV bronchiolitis
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most common cause in the us of calcified granulomas in lung, liver, and spleen?
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acute histoplasmosis
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two antifungal drugs?
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ampho B, itraconazole
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Important opportunistic fungi?
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Candida, cryptococcus, aspergillus, zygomycetes
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oropharyngeal candidiasis aka?
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thrush
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tx for candida esophagitis?
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Fluconazole
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what is a key CSF finding in cryptococcal meningitis?
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Elevated opening pressure in majority of cases
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diabetic ketoacidosis is a risk factor for which fungus?
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mucormycosis
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Ampho B mechanism of action?
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Binds to ergosterol in cell membrane
Forms pores in membrane, permeability |
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nocardia drug of choice?
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tmp/smx
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INH mechanism of action?
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interferes with mycolic acid synthesis (cell wall)
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Rifampin mechanism of action
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Inhibits DNA-dependent RNA polymerase, interfering with transcription
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INH drug interactions?
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Increases phenytoin, valproate, carbamazepine concentrations
Monoamine oxidase inhibition |
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rifampin toxicities?
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Hepatitis (alkaline phos, bilirubin, transaminases) (milder than INH)
Hypersensitivity Flu-like illness with nephrotic syndrome and thrombocytopenia Cutaneous vasculitis Flushing, pruritus Orange body fluids |
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dapsone toxicity?
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dose-dependent anemia
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which drugs are curative of lyme's disease in early stages?
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doxycylcline or amoxicilin
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Describe Rock Mountain rash?
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petechial, with a PERIPHERAL distribution, first on hands/feet
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Characteristics of ehrlichia?
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gram -, obligate intracellular parasite,Ixodes vector, reservoir is white-tailed deer
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Ehrlichia early manifestations are similar to?
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Rocky Mountain
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tx of ehrlichiosis?
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doxycycline
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tx of chancroid?
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cephalosporin, azithro, cipro, etc...
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Antichlamydial tx?
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Doxy or erythromycin
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normal vaginal ecology - which important organism?
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Lactobacillus
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Things that disrupt normal vaginal ecology?
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antibx, douching, multiple sex partners, exposure to STD, defective lactobacilli
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vaginosis?
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non-inflammatory, discharge due to overgrowth of bacteria. absence of wbcs
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tx of bacterial vaginosis or trichomoniasis?
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metronidazole
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HIV ELISA From...?
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whole blood or oral swab
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indications for ART in AIDS?
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CD4 < 350, HIV viral load > 100,000 (very high), pregnancy, high risk exposure, any symptoms
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ART toxicities?
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mitochondrial: lactic acidosis, hepatic steatosis, lipoatrophy (wasting), etc.
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Abacavir toxicity?
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abacavir hypersensitivity reaction,
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didanosine toxicity?
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didanosine-induced pancreatitis
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nevirapine toxicities?
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hepatitis, hypersensitivity
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efavirenz toxicity?
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teratogenesis
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PCP prophylaxis?
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TMP-SMX
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which transplants have highest incidence of infection?
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heart lung
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Which types of infections predominate in solid organ transplants?
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Bacterial, CMV
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Early infections in post transplant?
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NOSOCOMIAL
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Infections during immunosuppressive period post organ transplant?
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Similar to AIDS
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Late stage (> 6 months post organ transplant) infection?
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VZV, EBV, community acquired viral infections (activation of latent state herpes virus infections)
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Anthrax diagnosis?
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Blood culture
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smallpox - what bug?
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orthopoxvirus - variola
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relative contraindications to smallpox vaccination?
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history of eczema, age < 1 y/o, pregnant, immunosuppressed, close contact with any of above
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smallpox case fatality rate?
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30%
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plague treatment?
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aminoglycosides - streptomycin
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staining of plague?
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bipolar
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pulse temp dissociation seen in...?
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tularemia
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undulant fevers?
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bartonella - trench fever
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NSIs in US per year?
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390,000
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post exposure control of: HBV? HIV? HCV?
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for unvacc: HBIG + vacc
HIV - PEP within 2 hours for 28 days HCV - no protection with PEP, acute therapy works |
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Loosened prosthesis - which bugs?
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Coag negative staph
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osteomyelitis diagnosis gold standard?
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BONE BIOPSY
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diabetic foot ulcer - bone involvement - which drug?
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clindamycin
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congenital cmv?
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microcephaly, jaundice, hepatosplenomegaly, purpuric rash,
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best method of diagnosing congenital cmv infection?
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viral isolation from infant's urine
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blueberry muffin rash?
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congenital rubella
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how is congenital syphilis diagnosed?
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serology, CSF eval, and long bone radiographs
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risk of vertical hiv transmission?
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25%
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toxoplasma exposure in the house from...? congenital tx?
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cat litter box.
pyimethamine/sulfadiazine |
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fever of unknown origin definition?
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Fever 38.3°C (101°F) or higher on several occasions.
Fever of more than 3 weeks’ duration. Diagnosis uncertain despite appropriate investigations, after at least three outpatient visits or at least 3 days in hospital. |
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Giant cell arteritis - diagnosing in FUO?
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Biopsy temporal artery
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Skin Eye Mucous Membrane (SEM)?
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Neonatal HSV
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what can mimic serious bacterial infection in the neonate?
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enterovirus and HSV
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which neonatal infection can present as a rash, encephalitis, or multisystem organ failure?
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HSV
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