Micro 1-Liners Sexually Transmitted

Front 1

247. Genital chancre begins as a papule, ulcerates to form a single, painless, clean-based ulcer. TOW?

Back 1

1o syphilis

Front 2

248. Cause of genital chancre, begining as a papule, ulcerating to form a single, painless, clean-based ulcer.

Back 2

Treponema pallidum

Front 3

249. A pen-allergy, non-pregnant, female pt w/ fever, "copper penny" macular lesions on the palms or soles; RPR(+) should be treated with

Back 3

Doxycycline

Front 4

250. Management choice of tabes dorsalis (10-20yrs), iritis, uveitis, or Argyll-Robertson pupils of pen-allergy in a pregnant woman w/ pen allergy; RPR(+) is

Back 4

Desensitization

Front 5

251. Hx of painful clustered vesicles with an erythematous base; urinary retention in a promiscuous woman. TOW?

Back 5

HSV-2 >> 1

Front 6

252. Giemsa stain of fluid from a herpetic lesion should reveal

Back 6

Multinucleated giant cells

Front 7

253. Patient with genital herpes does not respond to acyclovir because pt is infected with

Back 7

thymidine kinase deficient HSV

Front 8

254. A pregnant woman with 1o symptomatic HSV-2 infection is at risk of her baby developing

Back 8

neonatal (congenital) herpes

Front 9

255. Cause of painful genital ulcers; purulent, grey base; painful inguinal adenitis, in a man with multiple sexual partners is

Back 9

Haemophilus ducreyi

Front 10

256. Fastidious organism in the infiltrate of the penile ulcer, co-localized with neutrophils and fibrin, in a pt w/ chancroid is

Back 10

Haemophilus ducreyi

Front 11

257. All sex partners of pt with chancroid, regardless of symptoms, should be examined and treated with

Back 11

Azythromycin > ceftriaxone

Front 12

258. Most common cause of mucopurulent endocervical exudate (Gram stain non revealing) in a sexually promiscuous woman

Back 12

Chlamydia trachomatis D-K

Front 13

259. Dx of mucopurulent urethral discharge, dysuria, penile pruritis is based on

Back 13

NAAT of urethral specimen or urine (+)

Front 14

260. DOC of most frequent cause of nongonococcal urethritis

Back 14

Azythromycin > doxycycline

Front 15

261. Cause of rare genital ulcers, inguinal lymphadenopathy [cytology(-) for multi-nucleated giant cells; RPR (-)] in men is

Back 15

Chlamydia trachomatis L1-L3

Front 16

262. Hx of systemic Sx/Sn w/ cervical motion tenderness in a woman with turbo-ovarian abscess. TOW?

Back 16

PID

Front 17

263. Cause of mucopurulent urethritis, dysuria, penile pruritis [Smear (+):Gram-negative diplococci co-populated w/ PMNs] is

Back 17

Neisseria gonorrhoeae

Front 18

264. Deficiency in serum factors in a female pt w/ frequent gonorrhea and DGIs is

Back 18

C6-C9

Front 19

265. Immune evasion of Neisseria gonorrhoeae in frequent mucosal infection is due to

Back 19

Antigenic variation of pili.

Front 20

266. Auxotrophic strains of N. gonorrhoeae with serum (complements) resistance are likely to cause

Back 20

Septic arthritis (aka: DGI)

Front 21

267. Most frequent complication of gonococcal (GC) infection in men

Back 21

Epididymitis

Front 22

268. Cause of "bull headed clap", urethral stricture, prostatitis is

Back 22

Neisseria gonorrhoeae

Front 23

269. Urethritis is treated with ceftriaxone + azythromycin because

Back 23

Concurrent GC + Chlamydia

Front 24

270. An older woman with PID and tubo-ovarian abscess receives ceftriaxone, azythromycin, and metronidazole because

Back 24

Polymicrobic (endogenous) infection

Front 25

271. Cause of anogenital warts w/ histology (+): koilocytes is

Back 25

HPV 6 and 11

Front 26

272. Cause of atypical squamous cells of undetermined significance (ASCUS) on pap smear w/ no clinical signs of infection is

Back 26

HPV 16 and 18

Front 27

273. Cause of koilocytotic cells and possible progression to squamous cell carcinoma

Back 27

HPV 16 and 18

Front 28

274. Next step to identify viral cause of ASCUS on pap smear w/ and further management in a woman of age > 29 years is

Back 28

Colposcopy > HPV DNA in bpsy

Front 29

275. Wet prep of vaginal discharge from a pt w/ vaginal pruritis; ectocervical erythema ("strawberry cervix") should reveal

Back 29

motile tissue flagellate

Front 30

276. Gram stain of vaginal discharge w/ fishy odor from a pt w/ vaginal pruritis but no erythema and normal cervix should reveal

Back 30

SECs stippled with Gram-variable organisms.

Front 31

277. Pathology of bacterial vagisnosis is overgrowth (in vagina) of anaerobic Mobiluncus species and

Back 31

Gardnerella vaginalis

Front 32

278. DOC of bacterial vaginosis is

Back 32

metronidazole

Front 33

279. Wet prep of curdy discharge (no odor), adhering to vaginal walls, from a pregnant woman w/ recent UTI, who now has severe vaginal pruritis; vulvovaginal area - erythematous should reveal

Back 33

budding yeasts with pseudohyphae

Front 34

280. Normal commensal of skin, GI & GU tracts; endogenous overgrowth of budding yeast, capable of >10 diseases. TOW?

Back 34

Candida albicans

Front 35

281. Mechanism of action of a po DOC of vulvovaginal candidiasis is

Back 35

blocks C14α-lanosterol demethylase

Front 36

282. Hx of flu-like illness, lymphadenopathy, maculopapular rash in a bisexual man. Lab: lymphopenia and transaminase elevations; monospot/all serology (-). TOW?

Back 36

Acute retroviral syndrome

Front 37

283. Time from infection (acquisition) to acute seroconversion detected by HIV serology (ELISA/ WBlot) is

Back 37

6-12 weeks.

Front 38

284. Hx of mononucleosis-like illness and lymphadenopathy in a man who has sex man. Serology (-). What is HIV viral load?

Back 38

>10,000 copies/ml

Front 39

285. Host-cell receptor for HIV-1 infection

Back 39

CD4

Front 40

286. Homozygous for deletions in what gene renders resistance to infection and some protection against progression.

Back 40

CCR5

Front 41

287. Host cells that trap HIV and mediate the efficient transinfection of CD4+ T cells are

Back 41

Dendritic cells

Front 42

288. A man, who practices “sex with another man”, has antibodies to HIV (ELISA and WB) but asymptomatic. TOW?

Back 42

Clinical latency

Front 43

289. What happens to HIV-1 virus when acute retroviral syndrome progresses to clinical latency?

Back 43

Virus continues to replicate low level.

Front 44

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is i. Candidiasis, esophageal, bronchi, trachea, or lungs

Back 44

CD4+ < 200/μL

Front 45

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is ii. Cervical cancer, invasive

Back 45

CD4+ < 200/μL

Front 46

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is iii. Coccidioidomycosis, extrapulmonary

Back 46

CD4+ < 200/μL

Front 47

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is iv. Cryptococcosis, extrapulmonary

Back 47

CD4+ < 200/μL

Front 48

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is v. Cryptosporidiosis, chronic intestinal

Back 48

CD4+ < 200/μL

Front 49

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is vi. Cytomegalovirus retinitis (with vision loss)

Back 49

CD4+ < 200/μL

Front 50

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is vii. Encephalopathy, HIV-related

Back 50

CD4+ < 200/μL

Front 51

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is viii. Herpes simplex - Chronic ulcers

Back 51

CD4+ < 200/μL

Front 52

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is ix. Histoplasmosis, disseminated or extrapulmonary

Back 52

CD4+ < 200/μL

Front 53

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is x. Isosporiasis, chronic intestinal (duration >1 mo)

Back 53

CD4+ < 200/μL

Front 54

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xi. Kaposi sarcoma

Back 54

CD4+ < 200/μL

Front 55

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xii. Lymphoma, Burkitt

Back 55

CD4+ < 200/μL

Front 56

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xiii. Lymphoma, primary, of the brain

Back 56

CD4+ < 200/μL

Front 57

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xiv. Mycobacterium avium complex or Mycobacterium kansasii infection, extrapulmonary

Back 57

CD4+ < 200/μL

Front 58

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xv. Mycobacterium tuberculosis infection, any site (pulmonary or extrapulmonary)

Back 58

CD4+ < 200/μL

Front 59

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xvi. Pneumocystis pneumonia

Back 59

CD4+ < 200/μL

Front 60

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xvii. Progressive multifocal leukoencephalopathy

Back 60

CD4+ < 200/μL

Front 61

290. A man who practices “sex with another man”, is now HIV-1 serology (+) and has dual symptomatic infections/cancer (any two from below). Expected CD4+ count is xviii. Wasting syndrome due to HIV infection

Back 61

CD4+ < 200/μL

Front 62

291. A man with HIV infection has chronic diarrhea, oral thrush + toxoplasma encephalitis. Most likely CD4+ count is

Back 62

< 50 cells/μL.

Front 63

292. Most common cause of HIV- associated peripheral skin or mucosal ulcers

Back 63

HSV-1 (>> Histo > CMV > VZV > Syphilis)

Front 64

293. Most common cause of HIV- associated nodules (neoplasia)?

Back 64

HHV-8 (aka KSHV)

Front 65

294. Hx of fatigue, nausea, abdominal pain, diarrhea, fever, chills, night sweats, dry persistent cough w/ SOB and weight loss in a man with AIDS. Lab: PPD (-); blood culture (+) for AFB. TOW?

Back 65

Mycobacterium avium-intracellulare (MAI) complex (aka: MAC)

Front 66

295. Common cause of retinitis, viral pneumonitis or esophagitis in AIDS

Back 66

CMV

Front 67

296. Cases of CMV disease occur with immunosuppression level

Back 67

CD4< 50

Front 68

297. cytopathology of CMV infected tissue is characterized by large cells with

Back 68

nuclear (Cowdry owl’s eye) and cytoplasmic inclusions

Front 69

298. Hx of progressive CNS dz in a pt w/ AIDS: hemiparesis, visual, ataxia, aphasia, cranial nerves, sensory. Head MRI: ring-enhancing lesions. Toxo antibody (-). TOW?

Back 69

JC virus

Front 70

299. Definitive indication for initial HAART is CD4+ count?

Back 70

350/mm3.

Front 71

300. Objective of ARV Tx is to reduce viremia to what level of genomic RNA/mL

Back 71

< 50 copies RNA/mL.

Front 72

301. Initial regimen of anti-retroviral therapy is

Back 72

Emtricitabine + Tenofovir + Efavirenz

Front 73

302. Abacavir, emtricitabine, lamivudine, zidovudine, tenofovir belong to what class of antiretrovirals?

Back 73

NRTIs

Front 74

303. Efavirenz, nevirapine belong to what class of antiretrovirals?

Back 74

NNRTIs

Front 75

304. Atazanavir, Lopinavir, Saquinavir belong to what class of antiretrovirals?

Back 75

Protease inhibitors

Front 76

305. This drug binds to gp41 and prevents conformational change required for viral fusion and entry into cells.

Back 76

enfuvirtide

Front 77

306. This drug inhibits integrase, responsible for insertion of HIV proviral DNA into the host genome.

Back 77

raltegravir

Front 78

307. A man has AIDS and CD4 <200cells/μL or thrush. Antibacterial prophylaxis needed besides HAART is

Back 78

TMP-SMX (for PCP)

Front 79

308. A man has AIDS and CD4 <100 + pos toxo IgG. Chemoprophylaxis needed besides HAART is

Back 79

TMP-SMX (for Toxoplasma encephalitis)