Rotations Uworld Im Id

Front 1

Histoplasmosis

1) What is the most sensitive test to dx disseminated histoplasmosis?

2) Histoplasmosis is a fungus that is most often found where?

3) You should be concerned for Histoplasmosis when an HIV pts CD4 count decreases below what?
a) HIV pts w/ Histoplasmosis usually present how?

4) Give some other possible PE findings in histoplasmosis?

5) Give the lab findings for Histoplasmosis?

Back 1

1) Histoplasmosis Ag in urine or serum

2) Soil of endemic areas, such as the Ohio River Valley

3) 200
a) Fever, wt loss, night sweats, n/v, cough, SOB

4) Diffuse lymphadenopathy and hepatosplenomegaly

5) Pancytopenia (if BM is involved);
Elevated LFTs;
Elevated Ferritin

Front 2

Histoplasmosis Tx

1) What is the preferred anti-Fungal tx for histoplasmosis?

Back 2

1)
Mild-to-Moderate Dz: Itraconazole
Severe Dz: IV Liposomal amphotericin B for 2wks --> Itraconazole for 1 year

Front 3

Diabetic Foot Ulcer --> Osteomyelitis

1) Why are diabetic pts prone to developing foot ulcers?
a) Explain why the immune system has a hard time combating infxn in the region surround a diabetic foot ulcers?
b) What is the pathogenic mechanism of osteomyelitis in pts w/ a diabetic foot ulcer?

Back 3

1) Combo of Arterial Insufficiency and Peripheral Neuropathy
a) BC we already said that diabetics have arterial insufficiency.
TF, if there's a decreased amt of blood getting to the ulcer site,
then there will be a decreased amt of immune factors getting to the ulcer site,
then there's going to be defective healing of the ulcer
b) Contiguous spread of bacteria from skin ulcer to bone

Front 4

Newly Diagnosed HIV

1) In a pt newly diagnosed w/ HIV, what are 6 tests he/she should receive to detect / combat other Infectious dz'es?

Back 4

1) VDRL for syphilis
PPD
Anti-Toxoplasma Ab Titer
Pneumococcal polysaccharide vaccine (Unless CD4 < 200 / cm3)
Hep A & B Serology
Hep A & B Vaccine (If seronegative)

Front 5

Catherization

1) What is the best way to reduce the risk of infxn from a urinary catheter in a pt w/ neurogenic bladder?

2) What is the mechanism by which bacteria can adhere to teh catheter wall and TF reach the bladder?

Back 5

1) Intermittent catherization

2) By forming a biofilm along the catheter wall

Front 6

Give the etiology of diarrhea / dysentery in the following situations:
1) Seafood?
2) Daycare centers or other institutional settings?
3) Improperly cooked ground beef?
4) Undercooked pork?
5) Poultry

Back 6

1) Vibrio parahaemolyticus
2) Shigella
3) E coli
4) Yersinia enterocolitica
5) Campylobacter jejuni

Front 7

Influenza
1) Etiology of Influenza?

2) Influenza is characterized by what sx?
a) What can be detected on PE for a pt w/ Influenza?
b) Some lab findings for a pt w/ influenza?

3) What time of year does influenza usually take place?

4) 1 sequelae of influenza to be conscious of?

5) What is the fastest way to confirm your clinical suspicion of influenza?

6) Give the pharmacological options for tx-ing Influenza?

Back 7

1) LOOK UP!!

2) Fever, Chills, Malaise, Myalgias, Cough, Coryza
a) Fever, Pulmonary Findings (Wheezes, Crackles, Coarse Breath Sounds)
b) Leukopenia, Proteinuria

3) Winter

4) Influenza pneumonia

5) Nasal swabs

6) Antivirals:
a) Neuraminidase Inhibs:
Oseltamivir, Zanamivir
b) Rx only effective against Influenza A:
Rimantadine, Amantadine

Front 8

Malaria Prophylaxis

1) Prophylaxis for Chloroquine sensitive malaria Plasmodium falciparum should be done w/ what drug?

2) Prophylaxis for malaria d/t Plasmodium vivax and ovale should be done w/ what drug?
a) What is something unique about Plasmodium vivax and ovale?

3) Chloroquine Resistant Plasmodium falciparum is very prevalent in what 2 places?
a) What is the drug of choice for malaria prophylaxis in a person going to these areas where Plasmodium falciparum is often Chloroquine-resistant?

Back 8

1) Chloroquine

2) Primaquine
a) They can remain dormant in the liver

3) Sub-Saharan Africa;
The Indian Subcontinent (India, Pakistan, Bangladesh)
a) Mefloquine

Front 9

Infective Endocarditis

1) When you suspect infective endocarditis, what do you do first?
a) Why in this specific order?

Back 9

1) FIRST: Draw Blood Cx
SECOND: Start empiric Abs
a) BC you must be able to determine sensitivity. If you start broad spec ABX first, your cx may come back negative

Front 10

Lyme Dz

1) Describe what Erythema Chronicum Migrans looks like in a pt w/ Lyme Dz?

2) If a person w/ a hx of tick bite presents w/ ECM Rash, what is the next best step?
a) Why not do an ELISA test followed by a fonrimational Western Blot?

Back 10

1) Erythemetous w/ a zone of central clearing ("Bull's Eye Rash")
OR
Uniformly Red

2) tx w/ Oral Doxycycline
a) BC ECM i pathognomonic for Lyme's Dz and TF you do not need to do serologic testing

Front 11

CNS Cryptococcal Infxn in AIDS pts

1) How to tx CNS Cryptococcal Infxn in AIDS pts?

Back 11

1) IV amphotericin + Flucytosine

Front 12

Meningitis

Print pages 225 & 226 of 1st AID and learn the chrts

1) What is the empiric tx of bacterial meningitis in a 65 y/o man? Why use these tx?

2) What 4 groups of ppl are @ risk for Listeria meningitis?

Back 12

1) VAC:
Vancomycin: Covers 3 MC agents: Strep pneumo, H. flu, N. meningitidis
Ceftriaxone: " "

Ampicillin: Covers Listeria



2) Pts older than 55;
I/C pts;
Pts w/ malignancies (lymphoma);
Pts taking steroids

Front 13

Ticks

1) If a pt who lives in an area endemic w/ ticks, finds a tick on himself, what shoujld you instruct him to do?
a) Describe how you should remove the tick?

Back 13

1) Remoe the tick w/ tweezers ASAP
a) Grab the tick w/ tweezers by its mouthparts, as close to the skin as possible, then remove using steaady pressure

Front 14

Give the Et of Infectious Endocarditis:

1) IV Drug Users:

2) Prosthetic heart valves:

3) UTIs in young women:

4) Colon CA:

5) Pre-existing vave dz:

Back 14

1) Staph aureus
(Makes sense bc they're injecting into their skin)

2) Staph epidermidis

3) Staph saprophyticus

4) Strep bovis

5) Colon CA

Front 15

PCP pneumonia in HIV + pt

1) What is the clinical picture of PCP pneumonia in an HIV pt?

2) Tx?

Back 15

1) CD4 < 200;
Diffuse BL interstitail infiltrates;
Fever, dry Cough, Exertional Dyspnea

2) TMP - SMX
AND
Add prednisolone if PaO2 < 70 mmHg

Front 16

Lyme Dz

1) Lyme dz has what typical rash?
a) What CN is MOST OFTEN effected by Lyme Dz?

Back 16

1) EMC
a) Facial Nerve

Front 17

IE and Murmurs

1) What is the MC valvular abnormality in pts w/ Ingective Endocarditis NOT related to drug use?

2) What is the MC valve abnormlaity related to pts who DO have a hx of drug abuse?

Back 17

1) Mitral Regurg

2) Mitral regurg

Front 18

HIV Pt w/ Esophageal Candidiasis

1) What is the first step in the mngmnt of pt w/ HIV associated esophageal candadiasis?
a) If pt doesn't improve w/ fluconazole,, what's the best next step?
b) 2 other causes of esophagitis in HIV infected pts?

Back 18

1) fluconazole
a) Cytology, Biopsy & Cx to determine the etiology
b) Herpex Simplex Virus (HSV)
CMV

Front 19

Liver Cysts

1) Pt w/ liver cysts = what infectious agent?
a) E. granulosus not only effects the liver, but what other organ?
b) What subset of ppl are @ an increased risk for infxn w/ E. granulosus?

2) Pig farmers are @ an increased risk of what infectious dz?

3) Commercial Sex Workers are @ a high risk for for what infectious dz'es?

Back 19

1) Echinococcus granulosus
a) LUNG
b) sheep breeders

2) neurocysticercosis

3) Perihepatitis from gonorrhea;
Other STDs

Front 20

TB in HIV

1) All PPD positive pts w/ HIV should receive prophylaxix. What is the prophylaxis for TB in a pt w/ HIV?
a) What is considered a positive PPD in a pt w/ HIV?

Back 20

1) Pyridoxine and Isoniazid for 9 months
a) Skin induration > 5mm

Front 21

NCC (Neurocysticercosis) from Taenia solium (Pork Tapeworm)

1) What is NCC?
a) Et of NCC?
b) How common is NCC?

Back 21

1) The formation of multiple, small, fluid-filled cysts in the brain parenchyma
a) Taenia solium (Pork Tapeworm)
b) MC parasitic infxn of brain

Front 22

Babesiosis

1) Et?

2) Vector for Babesia?
a) TF it is endemeic where?

3) Clinical manifestations of Babesiosis?
a) Pops @ risk for babesiosis?
b) Lab dx of Babesiosis?

4) Definitive dx of babesiosis?

5) 2 MCC drug regimens for babesiosis?

Back 22

1) Babesia

2) Ixodes tick
a) NE US

3) Hemolytic anemia --> Jaundice;
HGB-uria;
Renal failure;
Death
a) Age > 40 y/o;
Asplenic;
I/C
b) Intravascular hemolysis;
Anemia;
Thrombocytopenia;
Mild Leukopenia;
Atypical Lymphocytosis;
Elevated ESR;
Abnormal liver fnctn tests;
Dec serum complement

5) Quinine-Clindamycin;
Atavaquone-Azithromycin

4) Giemsa-stained thick and thin blood smear

Front 23

DM and Fungus

1) Diabetics are @ an increased risk for what fungal infxn?

2) Tx for mucormucosis (esp if pt has some necrosis)?

Back 23

1) Mucormycosis from the fungus Rhizopus

2) Surgical debrideent of necrotic tissue;
Amphotericin B

Front 24

DM and Malignant Otitis Externa

1) What are the typical symptoms of malignant otitis external?
a) Ear pain will be exacerbated by what?
b) What will you see in the external auditory meatus?
c) What are RF for the development of malignant otitis externa?

2) Which IA is the MCC of malignant otitis externa?

Back 24

1) Ear discharge;
Severe ear pain that radiates to TMJ
a) Chewing
b) Granulation tissue
c) DM and any other immunosuppressive dz

2) Pseudoonas aeruginosa

Front 25

CMV

1) What are the sx of CMV?

2) Lab analysis of pts w/ CMV?

Back 25

1) Mononcleosis Type Sx:
Fever, pharyngitis, fatigue, Cervical lymphadenopathy
EXCEPT in CMV infxn their will be NO pharyngitis or Cervical Lymphadenopathy

2) Negative heterophile Ab test (Monospot);
Atypical lymphocytes

Front 26

PID

1) PID is the result of infxn w/ what 2 IAs?
a) If gram stain IDs N. gonorrhea as the causative agent, how should the pt be treated?

3) Pts w/ PID should also be screened for what other cond'ns?

Back 26

1) Gonorrhea or Chlamydia
a) w/ Ceftriaxone (For gonorrhea)
AND
Azithromycin (for Chlamydia)
BC Chlamydia often co-infects w/ Gonorrhea,
and Gram stain cannot detect Chlamydia

3) HIV, Syphilis, Hep B, Cervical CA (pap)
+
Hep C if he/she has a history of IV drug use

Front 27

Febrile Neutropenia

1) What is the definition of Febrile Neutropenia?
a) How to calculate ANC?

2) Empiric tx for Febrile

Back 27

1) ANC < 1500
+
Single Temp > 100.9
OR
Temp > 100.4 for over 1 hr

a) WBC Ct X % Neutrophils

Front 28

Nocardia Asteroides

1) Give the microbiology of Nocardia Asteroides?

2) MC sx of Nocardiosis?

3) Who is @ risk for Nocardiosis?

4) Tx for Nocardiosis?

Back 28

1) Gram positive;
Partially acid-fast;
Filamentous aerobes

2) Wt loss, fever, night sweats, pulmonary involvement (cavitation)

3) I/C: Chronic CS use and Diabetics

4) TMP-SMX

Front 29

Malaria

1) 4 Ets of Malaria

2) Which types can cause relapses bc they remain dormant in the liver?

3) Which types most often cause death?

4) What is the hallmark feature of malaria?
a) The cyclical feature coincides w/ wat?
b) How often does fever occur?

5) 2 other common features of malaria?

Back 29

1) Plasmodium vivax & Ovale;
Plasmodium Falciparum;
Plasmodium malriae

2) Vivax and Ovale

3) P. falciparum

4) Cyclical fever
a) Lysis of RBCs
b) q 48 w/ vivax and ovale;
q 72 w/ malariae;
No periodicity w/ falciparum

5) Anemia & Splenomegaly

Front 30

Aspergillosis

1) MC'ly occurs in who?

2) CXR of person w/ aspergillosis shows what?

3) CT scan shows what?

Back 30

1) IC (Chemo pts, DM, Chronic corticosteroids)

2) Cavitary lesion

3) Pulmonary nodules w/ "Halo sign"

Front 31

Infectious Endocarditis

1) R. sided heart murmurs will increase w/ what?
a) L. sided heart murmurs will increase w/ what?

2) IVDU are @ increased risk for what?
a) With what IA?
b) Why does this make sense?

3) What is your Abx of choice for IVDU w/ TC Infective Endocarditis?

Back 31

1) Inspiration
(bc more blood drawn into Right side of heart)
a) Expiration

2) Vegetations and involvement of TC valve
a) Staph aureus
b) BC staph is on the skin. Neede penetrates skin and then enters blood -->
Staph in blood.
Staph then goes into venous circulation, and the 1st valve it hits is the TC!

3) Vancomycin

Front 32

HIV Associated Esophagitis

1) Name 3 causes of HIV associated esophagitis?

2) Describe the ulcers of HSV in HIV associated esophagitis?
a) Tx for HSV esophagitis?

3) Describe the ulcers when CMV is the cause of HIV-associated esophagitis?
a) Tx of ulcers related to CMV esophagitis?

Back 32

1) Candadiasis (MC);
HSV;
CMV

2) Multiple, small and well circumscribed w/ a "Volcano-like (small and deep)" appearance
a) Acyclovir

3) Large, shallow and superficial
a) Ganciclovir

Front 33

Colitis in HIV pts

1) Colitis in HIV is usually caused by what organism?
a) So to recap, CMV can cause what two GI "itises"?
b) What about HSV?

2) Give the clinical picture of Colitis in an HIV + Individual?

3) Give the entire Infectious differential for a pt w/ Hematochezia and Lower ABD cramps?

4) Tx for CMV colitis?
a) If Ganciclovir tx fails, what's the 2nd line tx?

Back 33

1) CMV
a) Esophagitis;
Colitis
b) Only causes esophagitis, not coliris

2) Bloody Diarrhea;
ABD pain;
Multiple ulcers and mucsal erosions on colonoscopy;
Biopsy --> Cytomegalic cells w/ inclusion bodies

3) CMV;
Clostridium dificile;
Shigella;
E. histolytica;
Campylobacter

4) Ganciclovir
a) Foscarnet

Front 34

Secondary Bacterial Pneumonia

1) What is secondary bacterial pneumonia?
a) Secondary bacterial pneumonia is usually caused by what organisms?
b) Which of the above pathogens, when causing a secondary bacterial pneumonia, can also cause an acute necrotizing pneumonia (blood streaked sputum and pneumatoceles)?

Back 34

1) A BACTERIAL pneumonia that complicates a VIRAL URI
a) Staph aureus;
Strep pneumo;
H. flu
b) staph aureus

Front 35

Shinges (from herpes / varicella zoster)

1) What is the Tx of Choice for Herpes Zoster?
a) Alternative?

2) How to prevent post-herpetic neuralgia?

Back 35

1) Valacyclovir
a) Acyclovir

2) TCAs
(Amitriptyline or Nortriptyline)
+
Acute Antiviral tx

Front 36

SE of TB Medications

1) What are the 4 major medications for TB?
a) Which of the previous can cause peripheral neuropathy -->
Tingling in the extremities, numbness and ataxia?
b) What is the medication to P-lax the peripheral neuropathy from INH?
c) What is the medication to Tx peripheral neuropathy that already exists?
d) What is an additional SE of INH?

Back 36

1) Rifampin,
Isoniazid,
Pyrazinamide,
Ethambutol
a) Isoniazid
b) Pyridoxine 10 mg/day
c) Pyridoxine 100 mg/day
d) Hepatitis

Front 37

Infectious Mononucleosis

**) Et of IM?

1) What is the classic presentation of IM?
a) What may be found on the soft pallate of pts?

2) People w/ IM are @ risk for what 2 blood complications?
a) Give pathophys of these complications?
b) What type of Ab are these?
c) TF what test will usually be postiive?

3) How is the dx of IM confirmed?

Back 37

**) EBV

1) Fever;
Pharyngitis;
Generalized lymphadenopathy;
Splenomegaly;
Malaise;
Jaundice
a) Pallatal petechiae

2) AI hemolytic anemia;
Thrombocytopenia
a) Formation of EBV induced AB against RBCs and PLTs
b) IgM cold-agglutinin Ab
c) Coombs test (direct of indirect?)

3) Presence of atypical lymphocytes (Downy cells)
+
anti-heterophile Ab (positive Monospot)

Front 38

Prophylaxis

1) An HIV infected man presents w/ fever and cough. The differential should include what?
a) An atypical mycobacterial infection is especially likely if the pts T-cell count is below what?
b) HIV infected pts w/ a CD4 count < 50 mm should receive what for prophylaxis against MAC?

Back 38

1) MAC;
MTB;
Disseminated CMV;
Non-Hodgkin's Lymphoma
a) CD4 < 50
b) Azithromycin

Front 39

Kaposi's Sarcoma

1) What pt populations are most susceptible to Kaposi's Sarcoma?
a) What is the Et of Kaposi's Sarcoma?

2) Describe the appearance of the lesions of Kaposi's Sarcoma?

Back 39

1) HIV pts
a) HHV-8

2) Papules --> Plaques & Nodules;
Light brown --> Violet

Front 40

Secondary Syphillis

***Look @ Case Files for notes on Syphillis***

1) Describe the rash of secondary syphillis?

Back 40

1) Diffuse maculo-papular rash involving the face, trunk, extremities, PALMS AND SOLES

Front 41

Mucormycosis

1) Mucormycosis often effects what 2 parts of the body?

2) What is the MC etiologic agent of Mucormycosis?

3) What cond'n will predispose to mucormycosis?

4) Sequelae of Mucormycosis
a) What will happen to the nasal turbinates involved in mucormycosis?

Back 41

1) Nose & Maxillary Sinus

2) Rhizopus

3) Poorly controlled diabetes

4) Sequelae of Mucormycosis
a) Necrotic nasal turbinates

Front 42

Toxoplasmosis in an HIV + pt

1) What collection of findings often occurs in pts w/ Toxoplasmosis?

2) The CD4 count in pts w/ Toxoplasmosis is usually what?

3) @ the time of dx of HIV, pts should be screened for what?
a) If a pt HAS Ab against toxoplasma gondii, what does that mean?
b) Those pts who DO NOT have toxoplasmosis should be prophylaxed against it using what?
c) TMP-SMX will help prevent what 2 things?

Back 42

1) Fever;
HA;
Confusion;
Ataxia;
RING-enhancing brain lesion on MRI

2) < 100 cells / microliter

3) Ab against Toxoplasma gondii
a) It means that the pt either HAS or previously HAD toxoplasmosis
b) TMP-SMX
c) Toxoplasmosis;
PCP

Front 43

Ehrlichiosis

1) Et of Ehrlichiosis?
a) What is the vector for Ehrlichiosis?

2) Where is Ehrlichiosis endemic?

3) What are the clinical features of Ehrlichiosis?
a) Does Ehrlichia have a rash?
TF it is often called what?

4) What are some common lab findings in Ehrlishiosis?

5) What is the drug of choice for ehrlichiosis and WHEN should it be administered?

Back 43

1) Look UP!!!!
a) Tick

2) Southeastern,
South-Central,
mid-Atlantic,
upper Midwest,
California

3) Fever;
Malaise;
Myalgias;
HA;
N/V
a) NO!
"Spotless Rocky Mountain spotted Fever"

4) Leukopenia;
Thrombocytopenia;
Elevated ALT & AST

5) Doxycycline;
As soon as Ehrlichiosis is suspected

Front 44

Osteomyelitis

1) What is the MCC of osteomyelitis in children and adults?

2) BUT, what will be the MCC of osteomyelitis in ppl w/ a Hx of Nail Puncture wound?

3) How long will it take for plain radiographs to show evidence of osteomyelitis?

4) What is the tx of osteomyelitis from pseudomonas?

Back 44

1) Staph aureus

2) Pseudomonas

3) 2 wks

4) FQ + Aggressive surgical debridement

Front 45

Lung Problems

1) IV drug use + Pulmonary Infxn = what cond'n and IA?

2) What is the MCC of bacteremia in both the community AND hospital setting?

3) What 3 pt pops are likley to have s. aureus bacteremia?

4) What is one pulmonary complication of R. sided Infective Endocarditis?
a) What IA is the MCC of R. sided IE?

Back 45

1) Pulmonary Infxn;
S. aureus

2) S. aureus

3) IVDU;
Pts w/ skin infxns;
Pts w/ an infected medical device (prosthetic valve, etc...)

4) Vegetation embolization to the lungs -->
Nodular infiltrate
a) S. aureus

Front 46

Erysipelas

1) What is Erysipelas?
a) What is the presentation of Erysipelas?

b) What is the ML'ly involved site for erysipelas?

c) What is the ML'ly causative organism for erysipelas?

Back 46

1) A specific type of cellulitis
a) Inflammation of superficial dermis -->
Prominent swelling that is:
Sharply demarcated,
erythematous,
edematous,
has raised borders,
and is tender

b) The legs

c) GAS
(AKA: beta-hemolytic strep;
AKA: S. pyogenes)

Front 47

UTI

1) Name 5 common causes of UTIs?
a) Which of the previous are the MC?
b) Which of the previous has urease which can split urea into NH3 + CO2 -> Alkaline urine?

c) What is another bug, which does NOT usually cause UTIs, that also has urease?

Back 47

1) E. coli;
Klebsiella;
Proteus;
Pseudomonas aeruginosa;
Candida
a) E. coli
b) Proteus

c) H. pylori

Front 48

HSV Encephalitis

1) HSV encephalitis MC'ly affects which lobes of the brain?
a) What are 2 effects of HSV in the temporal lobes of the brain?
b) Give the CSF findings for HSV encephalitis?

2) What is the dx-ic test of choice for HSV encephalitis?

3) Upon suspicion of HSV encephaltiis, what is the next best step?

Back 48

1) Temporal lobes
a) Bizarre behavior and hallucinations
b) Low glucose and pleocytosis

2) CSF PCR fro HSV DNA!

3) IV Acyclovir

Front 49

HIV Testing

1) What is the preferred screening test for HIV?
a) Why?

2) What is the best confirmatory test for HIV?
a) Why?

Back 49

1) ELISA
a) 99.9% sensitivity

2) Western Blot
a) 99.9% specificity

Front 50

Influenza

1) What are the 3 diff antigenic types of Influenza?

2) Most pts are treated how?

3) What is the role of anti-viral medications in pts w/ influenza?
a) Anti-viral meds for influenza are only effective if administered when?
b) Give the anti-virals that can be used for flu?

Back 50

1) Influenza A, B & C

2) Bed rest & analgesics (acetominophen)

3) Reduce the sx of influenza by 2-3 days
a) w/in 48 hrs of onset of illness
b) Influenza A:
Amantadine & Rimantadine

Influenza A & B:
Neuraminadase Inhibs -
Zanamivir & Oseltamivir

Front 51

Anogenital Warts

1) What kind of warts are caused by Syphillis?

2) What kind of warts are caused by HPV?
a) 3 tx for condloma acuminata?

3) Describe the diffs b/t condyloma lata and condyloma acuminatum?

Back 51

1) Condyloma latum

2) Condyloma acuminata
a)
-Chemical or Physical agents:
TCA, 5-FU, Podophyllin
-Immune Therapy:
Imiquimod,
IFN-alpha
-Surgery:
Cryosurgery,
Excisional procedures,
Laser tx

3) Condyloma Lata:
Flat and velvety

Condyloma Accuminata:
Verrucous;
Papilliform;
Skin colored or pink

Front 52

Blastomycosis

1) Where is blastomycosis endemic?

2) What organs does blastomycosis usually effect?

3) What 2 types of skin lesions can blastomycosis cause?
a) Describe verrucous lesions of blastomycosis?

Back 52

1) South-Central and North-Central US

2) lungs, skin, bones, joints, prostate

3) Verrucous or Ulcerative
a) Initially papulopustular -->
Crusted, heaped up and warty w/ a violaceous hue and sharp borders;
Surrounded by microabscesses

Front 53

HCAP

1) What is one of the MC IA in HCAP, especially in a person w/ is intubated?

2) List some medications that cover pseudomonas?

Back 53

1) P. aeruginosa

2)
4th gen cephalosporins (cefepime);
Aztreonam;
Ciprofloxacine;
Imipenem/Cilastatin;
Tobramycin;
Gentamicin;
Aikacin;
Piperacillin-Tazobactam

Front 54

Cat Scratch Disease

1) What is the IA of Cat Scratch Disease?

2) What is the pt presentation of Cat Scratch Disease?

3) Although self-limited, cat-scratch dz can be treated w/ what?

Back 54

1) Bartonella henselae

2) Localized, cutaneous and possibly suppurative lymphadenopathy @ the site of infxn
+
Skin Lesion that goes from
vesicular --> erthemetous --> papular
BUT can also be pustular or nodular

3) 5 days Azithromycin