Ou Im Absolutes Set 5

Front 1

what kind of organism is N. meningitidis and how to treat it?

Back 1

gram - diplococci and treat with ceftriaxone

Front 2

pt presents with fever, headache, and rash on distal extremities with possible hx of tick bite. What is the cause and treatment and what should be ordered

Back 2

RMSF
tx with doxy
order acute and convalescent titers

Front 3

what bugs are you at risk for in asplenia

Back 3

encapsulated ones like pneumococcus, H flu, and N meningitidis

Front 4

What bug should be covered when a patient is neutropenic?

Back 4

pseudomonas

Front 5

what is the cause of erysipelas and treatment?

Back 5

strep pyogenes/ GABHS and treat with penicillin of macrolide

Front 6

1. what is bug and treatment if pt has cellulitis after fresh water exposure?
2. bug and tx after salt water exposure?

Back 6

1. aeromonas-cipro
2. vibrio vulnificus- cipro +doxy

Front 7

what is typical bug and tx for necrotizing fascitits?

Back 7

group A strep, surgery
PCN + clinda

Front 8

what is typical bug and tx for gas gangrene?

Back 8

clostridium perfringins and s. aureus
tx with PCN and clinda and debride

Front 9

when should patients receive Tdap?

Back 9

childhood
then 11-18 y/o
then again between 19-64 regardless of when Td was given

Front 10

C diff
1. what abx are most likely to cause it
2. what tests should be ordered
3. what are the potential complications
4. what is treatment

Back 10

1. quinolones and clinda
2. stool assay for toxin A and V or DNA stool test
3. leukemoid reaction and toxic megacolon
4. flagyl, if relapse twice then po vance

Front 11

pt presents with fever, desquamating rash on palms and soles, after period. (could also be after nasal packing or wound packing)
what is dx and tx?
what is cause?

Back 11

1. TSS and tx with nafcillin or cefazolin
2. exotoxins from s. aureus or group A strep

Front 12

What is tx for acute bacterial meningitis and what does CSF look like?

Back 12

tx with ceftriaxone plus vanc
have neutrophilic leukocytosis with increased protein, and low glucose

Front 13

tx for meningitis:
1. pneumococcal
2. herpes
3. listeria (seen in elderly and immunocompromised)
4. s. aureus

Back 13

1. pen G
2. acyclovir
3. ampicillin
4. nafcillin and vanc

Front 14

who should get herpes zoster vaccine?

Back 14

anyone over age 60 regardless of shingles outbreak previously

Front 15

mexican pt presents with seizures after a pork roast the previous night.
1.dx?
2.tx?
3.bug?
4.Ct finding?

Back 15

1. neurocysticercosis
2. albendazole or praziquantel
3. taenia solium
4. cysts seen on Ct

Front 16

what bugs that cause PNA have a urine antigen?

Back 16

strep pneumo and legionella

Front 17

who should get pneumovax?

Back 17

<65 that have asthma, smoke, or immune problems
everyone 65 years or older
if had it before 65 give when turn 65 or 5 years after first vaccination

Front 18

what are common extrapulmonary complications of TB?

Back 18

renal and pleuropericardial

Front 19

what labs to dx TB?
What is tx for TB?

Back 19

AFB and culture, and quanti-feron test
2. 4 drug regimen with rif, INH, pyrazinamide and eth (RIPE tx)

Front 20

what can cause a false positive AFB?

Back 20

nocardia

Front 21

how big should PPD be to be positive in the following?
1. HIV +, close contacts, or immunosupressed
2. immigrants from high risk places, prisoners, homeless
3. all others

Back 21

1. 5mm
2. 10mm
3. 15mm

Front 22

what is tx for postive ppd but asymptomatic?

Back 22

INH with B6 for 9 months

Front 23

spontaneous bacterial peritonitis
1. what are usual bugs in SBP?
2. tap shows how many PNMs
3. sx?
4. treatment

Back 23

1. e. coli
2. >250-500
3. ascites and fever
4. ceftriaxone

Front 24

what classic triad of sx is seen in ascending cholangitis and what is the common bug?

Back 24

charcots triad: fever, RUG pain, jaundice
caused by e. coli

Front 25

Epidiymitis
1. cause and tx in young men
2. cause and tx in elderly men

Back 25

1. N gonorrhea or C. trachmatis --> tx wtih rocephin and doxy
2. gram negatives--> tx with bactrim or cipro

Front 26

Syphillis
1. bug
2. sx of primary
3. sx of seconday
4. sx of tertiary
5. dx with what and then what confirms ut
6. tx?

Back 26

1. treponema pallidum spirochete
2. painless chancre
3. rash
4. cardio problems like arrythmias and gummatous liver and neuro problems
5. +RPR or VRDL adn then get FTA-ABS ( do LP if think tertiary)
6. PEN G or doxy but always PEN G in preg

Front 27

pt presents with malodorous frothy discharge and petechiae.
Dx?
tx?

Back 27

trichomonas an give flagyl to pt adn partner

Front 28

pt has cottage cheese discharge, puritis and +KOH smear
Dx?
tx?

Back 28

candidiasis
tx with fluconazole

Front 29

Tx of GC?
TX of chlamydia

Back 29

1. cipro or rocephin
2. azithro or doxy

Front 30

PID
1. what are complications?
2. dx?
3. tx?

Back 30

1. tubo-ovarian abscess, ectopic pregnancy and infertility
2. cervical motion tenderness (chandelier's sign) and 10WBC on smear
3. ceftriaxone and doxy

Front 31

aspergillus
1. what is treatment of allergic bronchopulmonary aspergillosis?
2. pt has hemoptysis and +aspergillus precipitans on skin test. dx?
3. What is treatment for invasive aspergillosis?

Back 31

1. steroids
2. pulmonary aspergilloma (fungus ball)
3. amphotericin

Front 32

what is the source of cryptococcus neoformans and what is tx?

Back 32

encapsulated yeast from pigeon crap
tx with ampho B +5-flucytosine and fluconazole

Front 33

what is treatment for histoplasmosis and what is the source?

Back 33

tx ith ampho B or itraconazole
from bird or bat crap in ohio and mississippi river valley

Front 34

how to tx blastomycosis?

Back 34

same as histo

broad based buds?? #54 ID

Front 35

what is treatment for coccidiomycosis and where is it aquired?

Back 35

tx same as histo (ampho B for sever and itraconazole for rest)

aquired in SW united states , aka "valley fever

Front 36

a farmer presents with lymphangitis in arm (could also be a rose handler)
what is dx and tx?

Back 36

sporotrichosis
tx with SSKI (super saturated K iodide) or itraconazole

Front 37

Lyme dz
1. bug?
2. where is it?
3. sx of stage 1
4. sx of stage 2
5. dx?
6. tx?

Back 37

1. borrelia burgdorferi spirochete
2. NE USA (mass and connecticut)
3. erythema migrans rash with central clearing
4. 7th nerve palsy, encephalitis, AV blocks, arthritis
5. clinical +acute and convalescent titers
6. doxy unless severe involvement and then need ceftriaxone

Front 38

hx of tick bite but no rash and has thrombocytopenia and could have elevated LFTs?

Back 38

ehrlichiosis
tx with doxy

Front 39

pt presents with swollen lymph nodes (bubos) and lymphadenitis after playing with a rabbit?
dx?
tx?
bug?

Back 39

tularemia
tx with streptomycin, gentamicin, doxy or cipro
gram negative francisella tularensis

DONT CULTURE- BIOHAZARD
could also be after tick bite

Front 40

pt presents with malaria like illness and hemolysis after a tick bite.
dx?
tx?
what is a common co-infection with this?

Back 40

Babesiosis
tx with atovaquone and azithromycin
commonly with lyme disease

Front 41

pt presents with fevers every 3 days, rigors, HA, and is dx with malaria.
1. what is the bug?
2. how to dx it?
3. what is treatment?

Back 41

1. plasmodium falciparum
2. giemsa stain
3. chloroquine or if from resistant area quinine plus doxy

Front 42

what is bug in cat scratch dz and what is treatment

Back 42

bartonella henselae
dx with pcr or serology
tx with azithromycin

Front 43

pt presents with icterus, multi organ failure, hemorrhagic pneumonia after contact with animal urine.
Dx?
bug?
tx?

Back 43

Weils disease
from leptospirosis
tx with pen G

Front 44

how is brucellosis acquired and what is treatment

Back 44

from contact with body fluids of livestock or from unpasteurized dairy
tx with doxy

Front 45

animal bites-- bug and tx?
1. human
2. dog
3. cat
4. monkey

Back 45

1. eikenella; augmentin
2. pasteurella; augmentin
3. pasteurella; augmentin
4. herpesvirus simiae; acyclovir

Front 46

what is treatment for septicemia with VRE?
and fo UTI with VRE?

Back 46

sept= linezolid
UTI= nitrofurantoin

Front 47

botulism
1. how is it acquired?
2. what kind of organism is it?
3. what are sx?

Back 47

1. improperly canned foods or honey
2. anaerobic Gram + bacillus
3. DESCENDING FLACCID PARALYSIS-- with diplopia, ptosis, skeletal mm paralysis but sensation intact

Front 48

what bug goes with what smell?
1. horse barn
2. fruity or citrus
3. gym socks
4. chocolate cake

Back 48

1. c. diff
2. pseudomonas
3. s. aureus
4. proteus

Front 49

HIv pt with CD4 less than 100 presents with wt loss, fevers, anemia, and elevated alk phos.
dx?
tX?

Back 49

M. avium complex
treat with macrolide

Front 50

What is treatment for pulmonary infection with M. kanasii?

Back 50

rif, ethambutol, INH

Front 51

Pt with HIV presents with delirium and is found to have multiple CNS lesions.
dx and tx?

Back 51

toxoplasma gondii
tx with sulfadiazine

Front 52

HiV pt with chronic diarrhea and in O&P study is found to have acid-fast parasite.
What is the cause?
tx?

Back 52

crytosporidiosis
tx with nitazoxanide

Front 53

HIV pt has diarrhea and biliary dz.
what is treatment and cause?

Back 53

micosporidiosis and tx is albendazole

Front 54

what is treatment of strongyloides?

Back 54

thiabendazole

Front 55

howt to dx HIV?

Back 55

ELISA then western blot to confirm

Front 56

what immunizations should HIV pts get?

Back 56

pneumococcal vaccine, hep A and hep B, influenza

Front 57

what are criteria for beginning antiretroviral therapy ?

Back 57

CD4 < 200
AIDs
chronic hepatitis
age over 50
if sexually active so can reduce transmission

Front 58

what are the common side effects with the follow drugs and what class do they all fall into.
1. didanosine
2. zidovudine
3. abacavir

Back 58

they are all NRTIs (nucleoside analog reverse transcriptase inhibitors)
1. pancreatitis
2. bone marrow supression
3. lactic acidosis (they all cause lactic acidosi)

Front 59

what are side effects of protease inhibitors for HIV?

Back 59

DM, increased lipids, lipoatrophy
idinavir is a drug in this class

Front 60

what combo of antiretrovirals would be used for agressive tx?
what is goal of therapy

Back 60

two NRTIs + one PI or NNRTI
goal is to have undetectable viral load

Front 61

when to start ppx for PCP and what are options of ppx?

Back 61

when CD4 <200
ppx with TMP/SMX, dapsone, atavaquone, or inhaled pentamidine

Front 62

when to start TB ppx? what to give?

Back 62

if PPD >5mm or recent contact.
give INH with B6 for 9 months

Front 63

when should antiretrovirals be started if pt is dx with TB?

Back 63

within 2-4 weeks of TB treatment

Front 64

what is ppx if you get a hollow needle stick from HIV pt?

Back 64

3 drug ART for 28 days

Front 65

what is ppx for toxoplasmosis in HIV pt? and when to start it?

Back 65

bactrim when CD4<100

Front 66

what is PPX for MAC?

Back 66

CD4 <50 give azithromycin weekly
can stop ppx when cd4 >200

Front 67

what is treatment for CMV retinitis?

Back 67

valganciclovir, ganciclovir (neutropenia), foscarnet (nephrotoxic)

Front 68

what is tx for HSV in HIV pt?

Back 68

acyclovir

Front 69

what virus is associated with hairly leukoplakia and CNS lymphomas

Back 69

EBV

Front 70

what virus is associated with Kaposi's sarcoma?

Back 70

HSV-8

Front 71

pt with HIV presents with aplastic anemia, and pure RBC APLASIA
what is cause and tx?

Back 71

parvovirus B19 and tx with IVIG

Front 72

pt with HIv preesnts with nodular purple skin and organ lesions.
what is dx?
cause?
tx?

Back 72

Bacillary angiomatosis
caused by bartonella henselae
tx is doxy

Front 73

fevers, night sweats, productive cough, lytic bone lesions, and well-circumscribed, verrucous crusted lesions in a pt that lives in wisconsin would be what?

Back 73

blastomycosis