Id Board Review 3

Front 1

Recurrent sinopulmonary pyogenic infections and chronic diarrhea suggest impairment of which type of immunity? What organisms?

Back 1

Humoral

Encapsulated organisms- strep pneumoniae, H influenzae, neisseria spp

Front 2

Recurrent skin, lung, liver come abscesses or granuloma, periodontal disease suggest what type of immune deficiency? What organisms?

Back 2

Impaired phagocytosis/ neutrophil function

Catalase positive organisms

S aureus, cons, viridans strep, enterococcus, E. coli, pseudomonas, k pneumoniae, enterobacter, citrobacter, aspergillus, fusarium

Front 3

Disseminated infections or unusual organisms raise concer for what type or immune deficiency?

Back 3

Cellular

Intercellular organisms

Herpes, adeno, rsv, flu, paraflu, listeria, hpv, nocardia, Tb, atypical mycobacteria, pjp, aspergillosis, crypto, endemic mycoses, toxo, strongyloides

Front 4

Clues for complement deficiency

Back 4

Recurrent meningococcal disease, non-B meningococcal disease, family history SLE

Front 5

Screening test for complement deficiency

Back 5

CH50, AH50

Front 6

Organisms associated with chronic granulomatous disease

Back 6

Catalase positive organisms

Staph aureus, serratia marcescens, burkholderia cepacia, nocardia spp, aspergillus spp, chromobacterium violaceum, granulibacter bethesdensis

Front 7

Diagnosis of CGD

Back 7

Measure superoxide production. Nitroblue tetrazolium reduction or dihydrorhodone oxidation

Front 8

Prophylaxis for CGD

Back 8

Bactrim, itraconazole

Interferon gamma

Front 9

Neutropenia for 3-5 days alternating every 2-5 weeks, skin infections, high frequency of clostridial infections

Back 9

Cyclic neutropenia

Front 10

Recurrent eczema, skin abscesses, lung infections, eosinophilia

Back 10

Hyper-IgE recurrent infection syndrome

Front 11

Prophylaxis for autosomal dominance hyper-IgE syndrome

Back 11

Bactrim

Front 12

Symptoms of CVID

Back 12

Recurrent sinopulmonary pyogenic infections. Chronic diarrhea, autoimmune illness, increased risk gastric cancer and lymphoma

Front 13

Symptoms of x-linked hyper-IgM syndrome

Back 13

Recurrent pyogenic infections and PJP pneumonia

Front 14

Common causes of cd4 lymphopenia

Back 14

Hiv, htlv, cmv, Tb, brucellosis, Q fever, medication, heme malignancy

If not found might be idiopathic

Front 15

Schuffners dots

Back 15

P vivax or ovale

Front 16

Malaria band form

Back 16

P malariae or knowlesi

Front 17

Banana shaped gametocyte

Back 17

P falciparum

Front 18

Malaria prophylaxis for Central America or Middle East

Back 18

Chloroquine weekly for 2 weeks prior to travel and 4 weeks after return

Front 19

Malaria prophylaxis with atovaquone proguanil

Back 19

1 tab daily 2 days before travel, then 7 days after return

Front 20

Malaria prophylaxis with doxycline

Back 20

1 tab BID starting on the day of exposure, then 4 weeks after return

Front 21

Malaria prophylaxis with mefloquine

Back 21

Don’t use for SE Asia

1 tab weekly for 2 weeks, then 4 weeks after return

Front 22

Treatment of uncomplicated p falciparum malaria

Back 22

Artemether/lumefantrine x3 days

Atovaquone/proguanil x3 days

2nd line: quinine x3 days plus doxy x7 days

Front 23

Treatment of severe p falciparum malaria

Back 23

Iv artesunate

Iv quinidine or quinine

Front 24

Treatment of p vivax malaria

Back 24

Chloroquine x3 days then primaquine x14 days (check g6pd first)

Front 25

Babesia treatment

Back 25

Clindamycin plus quinine

Front 26

Babesia transmission

Back 26

Ixodes tick

Blood transfusions

Front 27

Babesia transmission

Back 27

Ixodes tick

Blood transfusions

Front 28

Tx cutaneous leishmaniasis

Back 28

Local or observe if not severe and not L braziliensis.

Heat, cryotherapy

Po miltefosine, ketoconazole, fluconazole

Iv antimony, Lipo ampho B

Front 29

Treatment of mucosa leishmaniasis

Back 29

Iv antimony

Iv lipo ampho b

Po miltefosine

Front 30

Treatment of visceral leishmaniasis

Back 30

Lipo ampho b

Po miltefosine if L donovani

Front 31

Leishmaniasis vector

Back 31

Sand fly

Front 32

Trypanosomiasis vector

Back 32

Tse tse fly

Front 33

Trypanosomiasis that progresses over months

Back 33

West African, T brucei gambiense

Humans are reservoir

Front 34

Trypanosomiasis that progresses over weeks

Back 34

East African, T brucei rhodesiense

Cattle and game are reservoirs

Front 35

Treatment of trypanosomiasis

Back 35

Check CSF first. If >5 WBC then treat as late stage

Early: pentamidine or suramin

Late: eflornithine-nifurtimox or melarsoprol

Front 36

Vector for Chagas’ disease (T cruzi)

Back 36

Reduviid bug, blood transfusion, congenital

Front 37

Diagnosis of Chagas’ disease

Back 37

Acute: parasites in blood

Chronic: IgG antibody, check two tests to confirm diagnosis

Front 38

Treatment of Chagas’ disease

Back 38

Always read acute, sometimes young patients without cardiac disease

Benznidazole or nifurtimox

Front 39

Treatment of balantidium coli (protozoan, colitis and abdominal pain)

Back 39

Tetracycline or metronidazole

Front 40

Diagnosis of entamoeba histolytica

Back 40

Stool o&p only 50% sensitive

Stool antigen >90% sensitive for intestinal disease

Serology helpful for amebic lover abscess

Front 41

Treatment of entamoeba histolytica

Back 41

Tinidazole or metronidazole followed by intraluminal agent (paromomycin)

Front 42

Treatment of giardia

Back 42

Tinidazole, metronidazole, nitazoxanide, albendazole

Front 43

Most common cause of Brodie’s abscess

Back 43

S aureus

Front 44

Ddx suppurative lymph node

Back 44

Bartonella henselae

Tularemia

Chanchroid

Staphbaureus

Lgv

Front 45

Ddx community acquired ARDs

Back 45

Blasto

Hantavirus

Front 46

Itraconazole capsules require *** for absorption

Back 46

Gastric acid

Avoid taking with ppi or h2 blocker

Front 47

Galactomannan will cries react with

Back 47

Aspergillus

Histo

Penicillium

Front 48

Serum beta-D glucan will cross react with

Back 48

Aspergillus, candida, fusarium, pneumocystis

NOT mucorales or crypto

Front 49

Voriconazole is metabolized primary by *** and lesser extent by ***

Back 49

CYP2C19

CYP3A4, CYP2C9

Front 50

Voriconazole toxicity

Back 50

Encephalopathy, visual disturbance, photosensitivity, hepatitis, fluoride toxicity (periostitis with bone pain)

Front 51

Treatment or candiduria (if symptomatic, obstruction, stents, urologic procedure)

Back 51

Fluconazole

5-FC

Amphotericin bladder washing

Front 52

Candida resistant to fluconazole

Back 52

Glabrata (10-15%)

Krusei (intrinsic)

Auris

Front 53

Candida that can be resistant to amphotericin b

Back 53

Lusitaniae

Front 54

Yeast in the blood

Back 54

Candida, crypto, histo

Talaromyces, trichosporon, malassezia, saccharomyces

Front 55

Mould in the blood

Back 55

Fusarium

Acremonium, phialemonium

Front 56

Aspergillus resistant to ambisome

Back 56

Terreus

Front 57

Scedosporium is resistant to

Back 57

Ampho

Front 58

Fusarium is resistant to

Back 58

Ampho, fluc, candins

Front 59

Can get false positive crypto antigen in patients with

Back 59

Trychosporon asahii

Front 60

Risk factors for mucormycosis

Back 60

Iron overload (esp use deforoxamine), DKA, immune compromise, altered skin integrity

Front 61

Treatment of mucormycosis

Back 61

High dose ampho b

Isavuconazole, posaconazole

Front 62

Causes of mycetoma (Madura foot)

Back 62

Actino, nocardia

Scedosporium, pseudallescheria

Front 63

Treatment options for hbv

Back 63

Tdf or taf

Entecavir

Front 64

Pulmonary infection identical to PCP but all pneumocystis testing is negative

Back 64

Pulmonary toxoplasmosis (check PCR)

Front 65

Front (Term)

Back 65

A. Lone star tick (amblyoma americanum): ehrlichia, tularemia and stari

B. Ixodes scapularis: Lyme, babesia, anaplasma

C. American dog tick: rmsf

Front 66

Schuffners dots

Back 66

P vivax, p ovale

Front 67

Plasmodium band form

Back 67

P malariae and knowlesi

Front 68

Incubation period p falciparum and knowlesi

Back 68

8-25 days

Front 69

Incubation period of p vivax and ovale

Back 69

2 weeks

Front 70

Incubation period of p malariae

Back 70

3-4 weeks

Front 71

Common donor derived infections (test before transplant)

Back 71

CMV, ebv, toxo

Can give prophylaxis

Front 72

Uncommon donor derived infections

Back 72

Lcmv, rabies, chagas, wnv, acanthamoeba, balamuthia, visceral leishmaniasis, malaria, cocci