Infectious Onlinemeded

Front 1

HIV, fever, FND,

Back 1

Toxoplasmosis

Prophylaxis: TMP-SMX

Hint 1

Front 2

Cytomegalovirus prophylaxis

Back 2

Ganciclovir dia

Front 3

Diabetic foot infection comes from ??

Back 3

Osteomyelitis due to contiguous spread from Polymicrobial wounds

Front 4

Herpangia ( 5 years , fever, oropharyngeal vesicles and uclers on the posterior soft palate, tonsils, uvula) caused by

Back 4

Coxsackie virus

Front 5

Echinococcus granulosus features

Back 5

Dog tapeworm, hydatid cyst( liver , lung ..) ,

Dx: imagining shows cyst inside cyst. IgG E serology

Rx: Albendazole

Front 6

Pertussis treatment and post exposure prophylaxis

Back 6

< 1 month : azithromycin (5 days)

> 1 month: azithromycin or clarithromycin or erythromycin

Front 7

Pertussis prophylaxis

Back 7

Macrolides for all close contacts

Front 8

Patient with infective endocarditis with infection of streptococcus gallolyticus ( S bovis biotype 1 ) should undergo??

Back 8

Colonoscopy to look for neoplasms

Front 9

Echinococcus granulosus features

Back 9

Dog tapeworm, hydatid cyst( liver , lung ..) ,

Dx: imagining shows cyst inside cyst. IgG E serology

Rx: Albendazole

Front 10

Congenital CMV features

Back 10

Mother exposure to saliva

Microcephaly , periventricular calcification, hepatosplenomegaly, .....

Dx: PCR

Rx: valganciclovir

Front 11

Acute bacterial rhinosinusitis

Back 11

> 10 days of persistent nasal discharge and cough, fever

Nontpeable H. Influenza, strep pneumoniae , Moraxella

Rx: amoxicillin +/- clavulanate

Front 12

Acute bacterial parotitis complication organism and prophylaxis in post operative patient?

Back 12

Staph aureus

Fluid hydration and oral hygiene

Front 13

Rubella virus in maternity features

Back 13

During the first semester

Sensorineural hearing loss, cardiac defects, cataracts

Front 14

Congenital varicella syndrome

Back 14

Limb hypoplasia , cataracts, skin lesions

Front 15

Skin lesions in AIDS patient is ??

Back 15

Kaposi sarcoma ( herpesvirus 8)

Front 16

Front (Term)

Back 16

Condyloma acuminata ( warts ) due to papillomavirus

Front 17

Front (Term)

Back 17

Leukocytoclastic vasculitis

Front 18

Front (Term)

Back 18

Malignant melanoma

Front 19

Front (Term)

Back 19

Neurofibromatosis type 1

Front 20

Pertussis treatment and post exposure prophylaxis

Back 20

< 1 month : azithromycin (5 days)

> 1 month: azithromycin or clarithromycin or erythromycin

Front 21

Pertussis prophylaxis

Back 21

Macrolides for all close contacts

Front 22

Patient with infective endocarditis with infection of streptococcus gallolyticus ( S bovis biotype 1 ) should undergo??

Back 22

Colonoscopy to look for neoplasms

Front 23

Fatigue, arthralgia , porphyria cutanea tarda( vesicles on the back hand and forearm) ??

Back 23

Chronic hepatitis C virus

Front 24

Skin lesions in AIDS patient is ??

Back 24

Kaposi sarcoma ( herpesvirus 8)

Front 25

Front (Term)

Back 25

Condyloma acuminata ( warts ) due to papillomavirus

Front 26

Front (Term)

Back 26

Leukocytoclastic vasculitis

Front 27

Front (Term)

Back 27

Malignant melanoma

Front 28

Front (Term)

Back 28

Neurofibromatosis type 1

Front 29

Infective endocarditis organism in AIDS patient who do intravenous drug users ??

Back 29

Staph aureus ( tricuspid more common)

On CT : nodal infiltrate with cavitation

Front 30

Chancroid (painful penile ulcer ) cause ?

Back 30

Haemophilus ducreyi infection

Front 31

Infective endocarditis with Eikenella corrodens etiology ??

Back 31

Poor dentition ( periodontal infection )

Front 32

PCP in HIV patient, CD4< 200 with ( PaO2 < 70 mm Hg or A-a gradient > 35 mm Hg ) RX

Back 32

TMP-SMX with corticosteroids

Front 33

Hepatitis C virus Dx steps

Back 33

2- step process: positive serologic antibodies and confirmatory molecular test for Hep C virus RNA.

Front 34

HIV Male patient, having sex with males, has recommended vaccinations including the Hep B vaccine should take which vaccine ?

Back 34

Hepatitis A vaccine

Front 35

Patient in the ICU or having central venous catheter, blood culture shows budding yeast ???

Back 35

Candidemia from Central venous catheter

It isn’t considered contaminant

Front 36

Orbital cellulitis features

Back 36

Pain with extraocular movement, visual changes , ophthalmoplegia

It’s severe infection

Front 37

Unvaccinated child with high fever, diffuse rash following cough, coryza ???

Back 37

Measles treated with supportive and Vit A

Front 38

Atypical community acquired pneumonia, confusion, GI symptoms, hyponatremia , mild hepatitis???

Back 38

Legionnaires’ disease

Dx : urine antigen testing

Rx: macrolide or fluoroquinolone

Front 39

Community acquired pneumonia with, arthralgia , valley fever , erythema nodosum, symptoms last for weeks???

Back 39

Coccidioides fungus ( no treatment is required unless immunosuppression give conazole)

Front 40

Front (Term)

Back 40

Miliary tuberculosis

Front 41

Patient with pyelonephitis who doesn’t improve within 72 hours of antibiotics use should undergo?

Back 41

CT scan of the abdomen and pelvis, if pregnant do ultrasound not CT

Front 42

Cryptococcal meningitis features

Back 42

In aids patients, very high opening pressure of CSF,

Rx: amphotericin B, serial LP , after 2 weeks start antiretroviral

Front 43

Lyme disease management

Back 43

Localized ( erythema migrans rash ) treated with doxycycline( > 8 years , not pregnant) .

Early and late disseminated treated with ceftriaxone

Front 44

Blastomycosis features

Back 44

Great lakes, rivers

Skin and bone lesion( lytic lesions) , pulmonary manifestation ( like TB).

Dx: broad - based yeast grown from sputum

Rx: itraconazole, amphotericin

Front 45

malaise headache, non tender rash , tick bite , Dx, Rx in < 8 years boy

Back 45

Erythema migrans ( early localized lyme )

Rx : amoxicillin in children < 8 or pregnant women

Front 46

Fever, cough, foul smelling sputum , after upper or GI procedure ???

Back 46

Anaerobic lung infection ( aspiration pneumonia)

Rx: amoxicillin-clavulanate , clindamycin

Front 47

Patient diagnosed with sarcoidosis who deteriorates after corticosteroids therapy ???

Back 47

Histoplasmosis

Front 48

Infective endocarditis with strep Rx

Back 48

IV penicillin G, or IV ceftiaxone for 4 weeks

Front 49

Infant with Unimmunized mothers, umbilical stump infection, , spasms, hypertonia inability to nurse( trismus ) ???

Back 49

Neonatal tetanus

Rx: Abx and tetanus immune globulin

Front 50

Infective endocarditis organism in AIDS patient who do intravenous drug users ??

Back 50

Staph aureus ( tricuspid more common)

On CT : nodal infiltrate with cavitation

Front 51

Chancroid (painful penile ulcer ) cause ?

Back 51

Haemophilus ducreyi infection

Front 52

Infective endocarditis with Eikenella corrodens etiology ??

Back 52

Poor dentition ( periodontal infection )

Front 53

PCP in HIV patient, CD4< 200 with ( PaO2 < 70 mm Hg or A-a gradient > 35 mm Hg ) RX

Back 53

TMP-SMX with corticosteroids

Front 54

Hepatitis C virus Dx steps

Back 54

2- step process: positive serologic antibodies and confirmatory molecular test for Hep C virus RNA.

Front 55

HIV Male patient, having sex with males, has recommended vaccinations including the Hep B vaccine should take which vaccine ?

Back 55

Hepatitis A vaccine

Front 56

Patient in the ICU or having central venous catheter, blood culture shows budding yeast ???

Back 56

Candidemia from Central venous catheter

It isn’t considered contaminant

Front 57

Orbital cellulitis features

Back 57

Pain with extraocular movement, visual changes , ophthalmoplegia

It’s severe infection

Front 58

Unvaccinated child with high fever, diffuse rash following cough, coryza ???

Back 58

Measles treated with supportive and Vit A

Front 59

Atypical community acquired pneumonia, confusion, GI symptoms, hyponatremia , mild hepatitis???

Back 59

Legionnaires’ disease

Dx : urine antigen testing

Rx: macrolide or fluoroquinolone

Front 60

Community acquired pneumonia with, arthralgia , valley fever , erythema nodosum, symptoms last for weeks???

Back 60

Coccidioides fungus ( no treatment is required unless immunosuppression give conazole)

Front 61

Front (Term)

Back 61

Miliary tuberculosis

Front 62

Patient with pyelonephitis who doesn’t improve within 72 hours of antibiotics use should undergo?

Back 62

CT scan of the abdomen and pelvis, if pregnant do ultrasound not CT

Front 63

Cryptococcal meningitis features

Back 63

In aids patients, very high opening pressure of CSF,

Rx: amphotericin B, serial LP , after 2 weeks start antiretroviral

Front 64

Lyme disease management

Back 64

Localized ( erythema migrans rash ) treated with doxycycline( > 8 years , not pregnant) .

Early and late disseminated treated with ceftriaxone

Front 65

Blastomycosis features

Back 65

Great lakes, rivers

Skin and bone lesion( lytic lesions) , pulmonary manifestation ( like TB).

Dx: broad - based yeast grown from sputum

Rx: itraconazole, amphotericin

Front 66

malaise headache, non tender rash , tick bite , Dx, Rx in < 8 years boy

Back 66

Erythema migrans ( early localized lyme )

Rx : amoxicillin in children < 8 or pregnant women

Front 67

Fever, cough, foul smelling sputum , after upper or GI procedure ???

Back 67

Anaerobic lung infection ( aspiration pneumonia)

Rx: amoxicillin-clavulanate , clindamycin

Front 68

Patient diagnosed with sarcoidosis who deteriorates after corticosteroids therapy ???

Back 68

Histoplasmosis

Front 69

Infective endocarditis with strep Rx

Back 69

IV penicillin G, or IV ceftiaxone for 4 weeks

Front 70

Infant with Unimmunized mothers, umbilical stump infection, , spasms, hypertonia inability to nurse( trismus ) ???

Back 70

Neonatal tetanus

Rx: Abx and tetanus immune globulin

Front 71

Infective endocarditis organism in AIDS patient who do intravenous drug users ??

Back 71

Staph aureus ( tricuspid more common)

On CT : nodal infiltrate with cavitation

Hint 71

Front 72

Front (Term)

Back 72

Miliary tuberculosis

Front 73

Infective endocarditis with Eikenella corrodens etiology ??

Back 73

Poor dentition ( periodontal infection )

Front 74

PCP in HIV patient, CD4< 200 with ( PaO2 < 70 mm Hg or A-a gradient > 35 mm Hg ) RX

Back 74

TMP-SMX with corticosteroids

Front 75

Hepatitis C virus Dx steps

Back 75

2- step process: positive serologic antibodies and confirmatory molecular test for Hep C virus RNA.

Front 76

malaise headache, non tender rash , tick bite , Dx, Rx in < 8 years boy

Back 76

Erythema migrans ( early localized lyme )

Rx : amoxicillin in children < 8 or pregnant women

Front 77

Patient in the ICU or having central venous catheter, blood culture shows budding yeast ???

Back 77

Candidemia from Central venous catheter

It isn’t considered contaminant

Front 78

Orbital cellulitis features

Back 78

Pain with extraocular movement, visual changes , ophthalmoplegia

It’s severe infection

Front 79

Unvaccinated child with high fever, diffuse rash following cough, coryza ???

Back 79

Measles treated with supportive and Vit A

Front 80

Atypical community acquired pneumonia, confusion, GI symptoms, hyponatremia , mild hepatitis???

Back 80

Legionnaires’ disease

Dx : urine antigen testing

Rx: macrolide or fluoroquinolone

Front 81

Community acquired pneumonia with, arthralgia , valley fever , erythema nodosum, symptoms last for weeks???

Back 81

Coccidioides fungus ( no treatment is required unless immunosuppression give conazole)

Front 82

Front (Term)

Back 82

Miliary tuberculosis

Front 83

Patient with pyelonephitis who doesn’t improve within 72 hours of antibiotics use should undergo?

Back 83

CT scan of the abdomen and pelvis, if pregnant do ultrasound not CT

Front 84

Cryptococcal meningitis features

Back 84

In aids patients, very high opening pressure of CSF,

Rx: amphotericin B, serial LP , after 2 weeks start antiretroviral

Front 85

Lyme disease management

Back 85

Localized ( erythema migrans rash ) treated with doxycycline( > 8 years , not pregnant) .

Early and late disseminated treated with ceftriaxone

Front 86

Blastomycosis features

Back 86

Great lakes, rivers

Skin and bone lesion( lytic lesions) , pulmonary manifestation ( like TB).

Dx: broad - based yeast grown from sputum

Rx: itraconazole, amphotericin

Front 87

malaise headache, non tender rash , tick bite , Dx, Rx in < 8 years boy

Back 87

Erythema migrans ( early localized lyme )

Rx : amoxicillin in children < 8 or pregnant women

Front 88

Fever, cough, foul smelling sputum , after upper or GI procedure ???

Back 88

Anaerobic lung infection ( aspiration pneumonia)

Rx: amoxicillin-clavulanate , clindamycin

Front 89

Patient diagnosed with sarcoidosis who deteriorates after corticosteroids therapy ???

Back 89

Histoplasmosis

Front 90

Infective endocarditis with strep Rx

Back 90

IV penicillin G, or IV ceftiaxone for 4 weeks

Front 91

Infant with Unimmunized mothers, umbilical stump infection, , spasms, hypertonia inability to nurse( trismus ) ???

Back 91

Neonatal tetanus

Rx: Abx and tetanus immune globulin

Front 92

Child , Severe cough, posttussive emesis, facial petechiae ..?

Back 92

Bordetella pertussis

Rx: macrolide

Front 93

18 months patient, Fever lethargy, Brudzinski sign, petechial rash ???

Back 93

Meningococcal meningitis ( fatal)

Front 94

Meningitis in children according to age ??

Back 94

< 1 month: group B strep, E-coli, Listeria, HSV.

> 1 month: strep pneumoniae, Neisseria .

Front 95

Successive crops , pruritic vesicles , fever, malaise, rash on trunk, face extremity ( maculopapular ) ???

Back 95

Varicella ( chickenpox)

Front 96

Cough, coryza, conjunctivitis, maculopapular rash ??

Back 96

Measles which transmitted by airborne route.

Percussions ( N95 face mask , negative pressure room)

Front 97

Congenital rubella syndrome

Back 97

Cataracts or glaucoma, hearing loss, heart disease( PDA)

Dx: IgM, PCR

Prevention: maternal immunization prior to conception

Front 98

Child with sore throat, Fever, tonsillar exudates , anterior cervical lymphadenopathy , no viral symptoms ( cough , congestion,rhinorrhea ) ??

Back 98

Group A strep pharyngitis

Dx: rapid strep antigen test or throat culture .

Rx: PCN, Amoxicillin

Front 99

Patient( injection drug use ) with low back pain Not relieved by rest , tenderness to gentle percussion??

Back 99

Vertebral osteomyelitis

Front 100

Ill patient with febrile paroxysms , traveled to tropical region , watery diarrhea, chills??

Back 100

Malaria

Dx: thick and thin blood smears

Sickle cell trait confers some protection from severe complications

Front 101

Malaria pathogens

Back 101

Plasmodium (falciparum, vivax, ovale ) parasites from infected Anopheles mosquito

Front 102

Malaria chart page 268

Back 102

Back (Definition)

Front 103

Neonatal sepsis management

Back 103

Temperature instability, feeding problems, lethargy

Rx: bacterial culture and abx

Front 104

Successive crops , pruritic vesicles , fever, malaise, rash on trunk, face extremity ( maculopapular ) ???

Back 104

Varicella ( chickenpox)

Hint 104

Front 105

Rapid development of Necrotizing fasciitis, Marine environmental, raw oysters, wound contaminated ???

Back 105

Vibrio vulnificus ( especially in patient with liver disease)

Front 106

Fever , vomiting, nausea, , abdominal pain, jaundice, pruritus, tender hepatomegaly , significant elevation in ALt, Ast, alkaline phosphatase???

Back 106

Hepatitis A virus, most patient recover in 3-6 weeks

Front 107

Human bite wound empiric therapy?

Back 107

Amoxicillin- clavulanate ( aerobic and anaerobic)

Front 108

Hospitalization, advanced age, antibiotics use , watery diarrhea, abdominal pain ..etc ?

Back 108

Clostridium difficile

Dx: stool toxin studies ( PCR)

Rx: metro

Front 109

Travelers diarrhea, watery, profuse, prolonged???

Back 109

Parasites ( cryptosporidium parvum)

Front 110

Prosthetic joint infection organisms according to time

Back 110

Within the first 3 months: staph aureus and pseudomonas.

More than 3 months ( 6 months) : less virulent organisms (staph epidermidis )

Front 111

Malaria chart page 268

Back 111

Back (Definition)

Front 112

Sexually active man with Mucoid discharge , dysuria ??

Back 112

Chlamydia

Rx: azithromycin

Prophylaxis: treat the partner

Front 113

Infective endocarditis following dental procedure caused by ??

Back 113

Viridans group ( mutans ) strep

Front 114

Recommended vaccines for chronic liver disease

Back 114

Tdap, influenza, pneumococcal ( first PPSV23 then PCV13 and PPSV23 at age 65 ),hep (A, B)

Front 115

Malaria prophylaxis in endemic areas ( outside Canada)

Back 115

Atovaquone, doxycycline or meftoquine

Front 116

P vivax malaria RX

Back 116

Primaquine

Front 117

Superficial Skin infection with demarcated edges , high fever, rash ???

Back 117

Erysipelas ( group A strep)

Front 118

AIDS patient , CD4< 80, fatigue, pulmonary symptoms, cutaneous lesion, pancytopenia, reticulonodular infiltrate ???

Back 118

Disseminated histoplasmosis

Dx: urine histoplasma antigen

Rx: amphotericin B

Front 119

Child , seizures, high fever, abdominal pain , large watery diarrhea containing mucus or blood ???

Back 119

Shigella gastroenteritis

Front 120

HIV patient with chest and upper abdominal rash ??

Back 120

Varicella zoster reactivation

Rx: valacyclovir, acyclovir

Front 121

Immunosuppressant patient with Pneumonia similar to tuberculosis, filamentous gram-positive acid fast rods ???

Back 121

Nocardia

Rx: TMP-SMX

Front 122

Adult Teacher, joints pain , GI symptoms, skin symptoms??

Back 122

Parvovirus B19

Dx: anti- parvovirus B19 IgM

Rx: spontaneous

Front 123

Fatigue, joints pain, fingertips pain ( Osler nodes), low grade fever, shortness of breath, dark urine , elevated ESR..?

Back 123

Subacute Infective endocarditis

Front 124

Preseptal vs orbital cellulitis

Back 124

Preseptal : eyelid erythema, chemosis , Rx: oral abx

Orbital cellulitis: same preseptal manifestations plus pain with extra ocular move, Rx: IV abx.

Front 125

Cat bites management ( Pasteurella multocida )

Back 125

Cleaning, prophylactic amoxicillin/clavulanate, tetanus booster ( if the last vaccine >5 years ago),no closure

Front 126

Great lakes , low grade fever, pneumonia, violaceous wartlike lesions, skin ulcers, osteomyelitis, prostatitis ??

Back 126

Blastomycosis

Rx: mild to moderate ( oral itraconazole ) , severe ( IV amphotericin B)

Front 127

Nail peds( splinter hemorrhage) , valve regurgitation..etc ?

Back 127

Infective endocarditis

Dx: blood culture then abx then TEE

Front 128

Infective endocarditis following dental procedure caused by ??

Back 128

Viridans group ( mutans ) strep

Front 129

Recommended vaccines for chronic liver disease

Back 129

Tdap, influenza, pneumococcal ( first PPSV23 then PCV13 and PPSV23 at age 65 ),hep (A, B)

Front 130

Malaria prophylaxis in endemic areas ( outside Canada)

Back 130

Atovaquone, doxycycline or meftoquine

Front 131

P vivax malaria RX

Back 131

Primaquine

Front 132

Superficial Skin infection with demarcated edges , high fever, rash ???

Back 132

Erysipelas ( group A strep)

Front 133

AIDS patient , CD4< 80, fatigue, pulmonary symptoms, cutaneous lesion, pancytopenia, reticulonodular infiltrate ???

Back 133

Disseminated histoplasmosis

Dx: urine histoplasma antigen

Rx: amphotericin B

Front 134

Child , seizures, high fever, abdominal pain , large watery diarrhea containing mucus or blood ???

Back 134

Shigella gastroenteritis

Front 135

HIV patient with chest and upper abdominal rash ??

Back 135

Varicella zoster reactivation

Rx: valacyclovir, acyclovir

Front 136

Immunosuppressant patient with Pneumonia similar to tuberculosis, filamentous gram-positive acid fast rods ???

Back 136

Nocardia

Rx: TMP-SMX

Front 137

Adult Teacher, joints pain , GI symptoms, skin symptoms??

Back 137

Parvovirus B19

Dx: anti- parvovirus B19 IgM

Rx: spontaneous

Front 138

Fatigue, joints pain, fingertips pain ( Osler nodes), low grade fever, shortness of breath, dark urine , elevated ESR..?

Back 138

Subacute Infective endocarditis

Front 139

Preseptal vs orbital cellulitis

Back 139

Preseptal : eyelid erythema, chemosis , Rx: oral abx

Orbital cellulitis: same preseptal manifestations plus pain with extra ocular move, Rx: IV abx.

Front 140

Cat bites management ( Pasteurella multocida )

Back 140

Cleaning, prophylactic amoxicillin/clavulanate, tetanus booster ( if the last vaccine >5 years ago),no closure

Front 141

Great lakes , low grade fever, pneumonia, violaceous wartlike lesions, skin ulcers, osteomyelitis, prostatitis ??

Back 141

Blastomycosis

Rx: mild to moderate ( oral itraconazole ) , severe ( IV amphotericin B)

Front 142

Nail peds( splinter hemorrhage) , valve regurgitation..etc ?

Back 142

Infective endocarditis

Dx: blood culture then abx then TEE

Front 143

Fever, focal bony pain ??

Back 143

Osteomyelitis caused by Staph

Front 144

Osteomyelitis in neonates organisms?

Back 144

E-coli, strep B( agalactiae)

Front 145

Osteomyelitis in foot puncture or Iv drug abuse organism ??

Back 145

Pseudomonas

Front 146

Osteomyelitis in sickle cell patient organism?

Back 146

Salmonella

Front 147

Osteomyelitis in patient with indwelling vascular catheter organism??

Back 147

Staph epidermidis

Front 148

Patient contacts with dogs , Hepatic cyst with eggshell calcification ??

Back 148

Hydatid cysts(Echinococcus)

Front 149

Sexually active, urethral discharge, absence of identifiable bacteria on culture??

Back 149

Chlamydia

Dx: NAAT ( nucleic acid amplification test )

Front 150

Hiv with CD4 < 50 prophylaxis

Back 150

TMP-SMX, azithromycin

Front 151

Violet papules in AIDS patient ?

Back 151

Kaposi sarcoma due to herpes virus 8

Front 152

Diabetic patient, poorly controlled DM, rhino-orbital mucormycosis ??

Back 152

Mucormycosis

Rx: surgical debridement, amphotericin B

Front 153

Patient with central line , fever, post operation, blood culture growth in >2 bottles

Back 153

Coagulase -negative staph

Front 154

Miliary tuberculosis features

Back 154

Subacute , Fever, weight loss, fatigue, pulmonary symptoms

Cxr: diffuse reticulonodular ,

Front 155

Most common risk factor of miliary tuberculosis?

Back 155

Substance abuse

Front 156

HIV patient with CD4 > 200 likely has which pneumonia?

Back 156

Community acquired pneumonia caused by strep pneumoniae

Front 157

Hiv with CD4 < 50 prophylaxis

Back 157

TMP-SMX, azithromycin

Front 158

Violet papules in AIDS patient ?

Back 158

Kaposi sarcoma due to herpes virus 8

Front 159

Diabetic patient, poorly controlled DM, rhino-orbital mucormycosis ??

Back 159

Mucormycosis

Rx: surgical debridement, amphotericin B

Front 160

Patient with central line , fever, post operation, blood culture growth in >2 bottles

Back 160

Coagulase -negative staph

Front 161

Miliary tuberculosis features

Back 161

Subacute , Fever, weight loss, fatigue, pulmonary symptoms

Cxr: diffuse reticulonodular ,

Front 162

Most common risk factor of miliary tuberculosis?

Back 162

Substance abuse

Front 163

HIV patient with CD4 > 200 likely has which pneumonia?

Back 163

Community acquired pneumonia caused by strep pneumoniae

Front 164

Acute , unilateral, cervical lymphadenitis in children caused by ??

Back 164

Staph aureus

Front 165

human Rabies transmission most commonly due to bite of ??

Back 165

Bats( ascending flaccid paralysis, copious drool , facial grimacing

Rx: immunoglobulin

Front 166

Child, Acute onset of fever and joint pain , elevated WBCs, CRP, ESR ???

Back 166

Septic arthritis

Dx: arthrocentesis and culture then empiric therapy

Front 167

Septic arthritis manga according to age

Back 167

< 3 months ( staph, group B strep , gram negative bacilli) : vancomycin and cefotaxime

>3 months ( staph, group A strep, strep pneumoniae) : nafcillin, clinda, van

Front 168

HIV patient with upper lobe Cavitation, 2 months of cough ??

Back 168

Tuberculosis reactivation

Front 169

HIV patient with upper lobe Cavitation, 2 months of cough ??

Back 169

Tuberculosis reactivation

Front 170

Child( 6 months-3 years), rhinorrhea, Fever, harsh, stridor , barky cough ??

Back 170

Crop ( parainfluenza virus )

Front 171

Perinatal Hepatitis B virus management

Back 171

HBV vaccine and Hepatitis B immunoglobulin

Front 172

Babesiosis features

Back 172

Protozoal , flu like, anemia, thrombocytopenia

Dx: peripheral blood smear

Front 173

Scarlet fever

Back 173

Child, Strep pyogenes , fever, pharyngitis, tonsillar erythema, sandpaper rash with desquamation , strawberry tongue , cervical lymphadenopathy

Dx: rapid strep antigen test

Rx: amoxicillin

Front 174

Infant with bilateral eye swelling and discharge for a STDs mother ??

Back 174

Gonococcal conjunctivitis

Rx: topical ophthalmic erythromycin

Front 175

Acute , unilateral, cervical lymphadenitis in children caused by ??

Back 175

Staph aureus

Front 176

human Rabies transmission most commonly due to bite of ??

Back 176

Bats( ascending flaccid paralysis, copious drool , facial grimacing

Rx: immunoglobulin

Front 177

Child, Acute onset of fever and joint pain , elevated WBCs, CRP, ESR ???

Back 177

Septic arthritis

Dx: arthrocentesis and culture then empiric therapy

Front 178

Septic arthritis manga according to age

Back 178

< 3 months ( staph, group B strep , gram negative bacilli) : vancomycin and cefotaxime

>3 months ( staph, group A strep, strep pneumoniae) : nafcillin, clinda, van

Front 179

HIV patient with upper lobe Cavitation, 2 months of cough ??

Back 179

Tuberculosis reactivation

Front 180

HIV patient with upper lobe Cavitation, 2 months of cough ??

Back 180

Tuberculosis reactivation

Front 181

Child( 6 months-3 years), rhinorrhea, Fever, harsh, stridor , barky cough ??

Back 181

Crop ( parainfluenza virus )

Front 182

Perinatal Hepatitis B virus management

Back 182

HBV vaccine and Hepatitis B immunoglobulin

Front 183

Babesiosis features

Back 183

Protozoal , flu like, anemia, thrombocytopenia

Dx: peripheral blood smear

Front 184

Scarlet fever

Back 184

Child, Strep pyogenes , fever, pharyngitis, tonsillar erythema, sandpaper rash with desquamation , strawberry tongue , cervical lymphadenopathy

Dx: rapid strep antigen test

Rx: amoxicillin

Front 185

Infant with bilateral eye swelling and discharge for a STDs mother ??

Back 185

Gonococcal conjunctivitis

Rx: topical ophthalmic erythromycin

Front 186

Acute , unilateral, cervical lymphadenitis in children caused by ??

Back 186

Staph aureus

Front 187

human Rabies transmission most commonly due to bite of ??

Back 187

Bats( ascending flaccid paralysis, copious drool , facial grimacing

Rx: immunoglobulin

Front 188

Child, Acute onset of fever and joint pain , elevated WBCs, CRP, ESR ???

Back 188

Septic arthritis

Dx: arthrocentesis and culture then empiric therapy

Front 189

Septic arthritis manga according to age

Back 189

< 3 months ( staph, group B strep , gram negative bacilli) : vancomycin and cefotaxime

>3 months ( staph, group A strep, strep pneumoniae) : nafcillin, clinda, van

Front 190

HIV patient with upper lobe Cavitation, 2 months of cough ??

Back 190

Tuberculosis reactivation

Front 191

HIV patient with upper lobe Cavitation, 2 months of cough ??

Back 191

Tuberculosis reactivation

Front 192

Child( 6 months-3 years), rhinorrhea, Fever, harsh, stridor , barky cough ??

Back 192

Crop ( parainfluenza virus )

Front 193

Perinatal Hepatitis B virus management

Back 193

HBV vaccine and Hepatitis B immunoglobulin

Front 194

Babesiosis features

Back 194

Protozoal , flu like, anemia, thrombocytopenia

Dx: peripheral blood smear

Front 195

Scarlet fever

Back 195

Child, Strep pyogenes , fever, pharyngitis, tonsillar erythema, sandpaper rash with desquamation , strawberry tongue , cervical lymphadenopathy

Dx: rapid strep antigen test

Rx: amoxicillin

Front 196

Infant with bilateral eye swelling and discharge for a STDs mother ??

Back 196

Gonococcal conjunctivitis

Rx: topical ophthalmic erythromycin

Front 197

Jarisch-Herxheimer reaction features

Back 197

In early syphilis , febrile reaction( rapid destruction of spirochetes) < 12 h of the initial treatment

Fever, headache, myalgia, rigors .

Rx: spontaneous

Front 198

Fever, sore throat, not able to swallow, pooled secretions in the oropharynx ??

Back 198

Epiglottitis due to H. Influenza B

Life threatening illness

Risk can be reduced by vaccine

Front 199

Odynophagia and dysphagia in HIV patient approach?

Back 199

White plaques: candida ( fluconazole )

Linear ulcers: CMV ( ganciclovir)

Vesicles, round ulcers: acyclovir

Aphthous ulcer : symptomatic therapy

Front 200

Management of patient with influenza ( fever, malaise..) in the absence of risk factors ( age> 65, chronic medical conditions.) ?

Back 200

Symptomatic treatment only

Don’t give influenza vaccine unless they get better

Front 201

Prophylaxis criteria of Lyme disease page 527

Back 201

Back (Definition)

Front 202

Catheter-associated UTI reduced by ??

Back 202

Clean intermittent catheterization

Front 203

Post exposure prophylaxis in newborn for a mother had varicella zoster prior to delivery??

Back 203

Administration of varicella specific immunoglobulin to the infant

Front 204

Prophylaxis criteria of Lyme disease page 527

Back 204

Back (Definition)

Front 205

Antibiotics prophylaxis for Lyme disease is not required if the tick attached for ??

Back 205

< 36 h

Front 206

Fever, cough, coryza, non purulent conjunctivitis, Koplik spots on mucosa, rash begins on face and spread ???

Back 206

Measles

Front 207

Erythema infectiosum ( fifth disease)

Back 207

Parvovirus B19, child with slapped cheek rash

Front 208

Pneumococcus vaccines criteria

Back 208

> 65 or < 65 with very high risk conditions ( CSF leak, sickle cell disease, HIV, Malignancy,chronic kidney disease) : 13 - valent pneumococcal followed later by 23-valent pneumococcal.

Age < 65 with mild conditions ( smoking, heart, lung, liver chronic diseases ) : 23-valent pneumococcal alone.

Front 209

Traveler, Right upper quadrant pain , fever , hepatomegaly , single , low density lesion in right lobe on ultrasound???

Back 209

Entamoeba histolytica protozoal

Dx: serology( stool ova )

Rx: metronidazole

Front 210

Young women sexually active with 2 partners , sore throat, fever, lower abdominal pain ??

Back 210

Gonococcal( neisseria gonorrhoeae) pharyngitis with pelvic inflammatory disease

Front 211

Infective endocarditis with tooth extraction??

Back 211

Strep viridans

Front 212

Immunocompromised patient ( diabetic..) with fever, nasal congestion, necrosis of the turbinate ???

Back 212

Mucormycosis caused by Rhizopus

Front 213

Infant with meningococcal infection died???

Back 213

Waterhouse-Friderichsen syndrome : vasomotor collapse , skin rash due to adrenal hemorrhage

Front 214

Persistent fever, malaise, absolute lymphocytosis on CBC ??

Back 214

CMV

Dx:,serology IgM is positive, heterophite antibody is negative

Front 215

Patient with symptoms like infective endocarditis but has eosinophilia , periorbital edema, myositis , GI symptoms ???

Back 215

Trichinellosis

Front 216

Necrotizing surgical infection ( after surgery)

Back 216

Intense pain , decreased sensitivity at the edges of the wound , cloudy-gray discharge, crepitus

Rx: surgical exploration , iV abx

Front 217

Aids patient with water diarrhea calcification according to CD4

Back 217

Cryptosporidium < 180

Microsporidium < 100

Mycobacterium avium complex( high fevers > 39 ) and CMV ( hematochezia) < 50 .

Front 218

Live vaccines ( MMR, zoster, varicella) are contraindicated in AIDS patient if the CD4 ??

Back 218

< 200

Front 219

Young Meningitis symptoms with petechial rash , CSF ( high protein, very high neutrophils > 1000) ??

Back 219

Meningococcal meningitis ( Neisseria)

Rx: ceftriaxone and Vancomycin

Front 220

Postoperative Fever chart according to time

Back 220

First 2 hours : trauma, blood products , malignant hyperthermia

>24 h and < week: nosocomial infection, group A strep, DVT

>1 week and < month: catheter site infection, C. difficile, drug

> month: viral infection, indolent organisms ( coagulase - negative staph)

Front 221

HIV patients should receive all the recommended vaccine plus ?

Back 221

Hepatitis B, strep pneumoniae vaccines

Front 222

CSF analysis for meningitis chart

Back 222

Back (Definition)

Front 223

Patient with multiple sex male , respiratory symptoms

Back 223

Pneumocystis pneumonia

Rx: TMP-SMX, corticosteroids if ( oximetry < 92%, A-a gradient > 35 )

Front 224

CSF analysis for meningitis chart

Back 224

Back (Definition)

Front 225

Patient with multiple sex male , respiratory symptoms

Back 225

Pneumocystis pneumonia

Rx: TMP-SMX, corticosteroids if ( oximetry < 92%, A-a gradient > 35 )

Front 226

TB patient using rifampin and isoniazid only, having neurologic symptoms???

Back 226

Isoniazid toxicity ( B6 deficiency)

Front 227

Toxoplasmosis

Back 227

Risk: undercooked meat, cat feces

Clinical: macrocephaly, diffuse intracranial calcification, infection signs

Dx: serology ( infant IgM, IgA)

Rx: pyrimethamine, sulfadiazine, folate

Front 228

Foodbore illnes chart

Back 228

Quick onset and vomiting: enterotoxin ingested ( staph)

Delayed onset and diarrhea: enterotoxin made in intestine( C. Perfringens, cholera)

Variable onset and fever : bacterial epithelial invasion ( campylobacter jejuni, listeria)

Front 229

Eat rice , rapid onset vomiting, normal fever ??

Back 229

Bacillus cereus preformed enterotoxin

Front 230

Live vaccines ( MMR, zoster, varicella) are contraindicated in AIDS patient if the CD4 ??

Back 230

< 200

Front 231

Young Meningitis symptoms with petechial rash , CSF ( high protein, very high neutrophils > 1000) ??

Back 231

Meningococcal meningitis ( Neisseria)

Rx: ceftriaxone and Vancomycin

Front 232

Postoperative Fever chart according to time

Back 232

First 2 hours : trauma, blood products , malignant hyperthermia

>24 h and < week: nosocomial infection, group A strep, DVT

>1 week and < month: catheter site infection, C. difficile, drug

> month: viral infection, indolent organisms ( coagulase - negative staph)

Front 233

HIV patients should receive all the recommended vaccine plus ?

Back 233

Hepatitis B, strep pneumoniae vaccines

Front 234

CSF analysis for meningitis chart

Back 234

Back (Definition)

Front 235

Patient with multiple sex male , respiratory symptoms

Back 235

Pneumocystis pneumonia

Rx: TMP-SMX, corticosteroids if ( oximetry < 92%, A-a gradient > 35 )

Front 236

CSF analysis for meningitis chart

Back 236

Back (Definition)

Front 237

Patient with multiple sex male , respiratory symptoms

Back 237

Pneumocystis pneumonia

Rx: TMP-SMX, corticosteroids if ( oximetry < 92%, A-a gradient > 35 )

Front 238

TB patient using rifampin and isoniazid only, having neurologic symptoms???

Back 238

Isoniazid toxicity ( B6 deficiency)

Front 239

Toxoplasmosis

Back 239

Risk: undercooked meat, cat feces

Clinical: macrocephaly, diffuse intracranial calcification, infection signs

Dx: serology ( infant IgM, IgA)

Rx: pyrimethamine, sulfadiazine, folate

Front 240

Foodbore illnes chart

Back 240

Quick onset and vomiting: enterotoxin ingested ( staph)

Delayed onset and diarrhea: enterotoxin made in intestine( C. Perfringens, cholera)

Variable onset and fever : bacterial epithelial invasion ( campylobacter jejuni, listeria)

Front 241

Eat rice , rapid onset vomiting, normal fever ??

Back 241

Bacillus cereus preformed enterotoxin

Front 242

Trip to Caribbean, high fever, polyarthralgias, lymphopenia , thrombocytopenia, rash ???

Back 242

Chikungunya fever ( mosquito - viral illness)

Front 243

Child , headache, fever, FND, seizure ?

Back 243

Brain abscess

Congenital heart disease is a risk factor of brain abscess

Front 244

Old patient > 65 , recent influenza, productive cough, fever,

Back 244

Bacterial pneumonia ( staph)

Front 245

Aspiration pneumonia ( alcoholism) caused by ?

Back 245

Klebsiella, anaerobes

Front 246

Pneumonia with GI symptoms??

Back 246

Legionella

Front 247

Child, painful non-itchy pustules, honey -crusted lesions around the mouth nose, hand ?

Back 247

Non- bullous impetigo ( staph, hemolytic strep )

Rx: topical abx( mupirocin)

Complication: post strep glomerulonephritis

Front 248

AIDS patient with positive tuberculin skin test ( > 5 mm) management??

Back 248

Latent TB

Rx: isoniazid and pyridoxine for 9 months

Front 249

Meningococcal vaccine recommendations

Back 249

All adolescents 11-12 , then a booster at age 16

Front 250

Live- attenuated vaccines( yellow fever...) is contraindicated in ??

Back 250

Allergies ( eggs )

AIDS ( CD4 < 200)

Immunodeficiency patients ( thymus) , immunosuppressive ( TNF antagonist, high dose of corticosteroids)

Front 251

Post exposure prophylaxis of HIV

Back 251

Immediate start of 2+1 antiretroviral therapy for 4 weeks

Front 252

Trip to Caribbean, high fever, polyarthralgias, lymphopenia , thrombocytopenia, rash ???

Back 252

Chikungunya fever ( mosquito - viral illness)

Front 253

Child , headache, fever, FND, seizure ?

Back 253

Brain abscess

Congenital heart disease is a risk factor of brain abscess

Front 254

Old patient > 65 , recent influenza, productive cough, fever,

Back 254

Bacterial pneumonia ( staph)

Front 255

Aspiration pneumonia ( alcoholism) caused by ?

Back 255

Klebsiella, anaerobes

Front 256

Pneumonia with GI symptoms??

Back 256

Legionella

Front 257

Child, painful non-itchy pustules, honey -crusted lesions around the mouth nose, hand ?

Back 257

Non- bullous impetigo ( staph, hemolytic strep )

Rx: topical abx( mupirocin)

Complication: post strep glomerulonephritis

Front 258

AIDS patient with positive tuberculin skin test ( > 5 mm) management??

Back 258

Latent TB

Rx: isoniazid and pyridoxine for 9 months

Front 259

Meningococcal vaccine recommendations

Back 259

All adolescents 11-12 , then a booster at age 16

Front 260

Live- attenuated vaccines( yellow fever...) is contraindicated in ??

Back 260

Allergies ( eggs )

AIDS ( CD4 < 200)

Immunodeficiency patients ( thymus) , immunosuppressive ( TNF antagonist, high dose of corticosteroids)

Front 261

Post exposure prophylaxis of HIV

Back 261

Immediate start of 2+1 antiretroviral therapy for 4 weeks

Front 262

Early Lyme disease features

Back 262

Spirochete infection, endemic areas, Ixodes scapularis

Erythema migrans, systemic symptoms ( cardiac, neurologic...)

Dx: clinical ( erythema migrans) , B burgdorferi serology ( cardiac/ neurologic)

Rx: oral ( doxycycline), IV ( ceftriaxone)

Front 263

Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration???

Back 263

Pneumocystis pneumonia ( jirovecii)

Front 264

Foodborne disease chart page 710

Back 264

Back (Definition)

Front 265

Headache, fever, nuchal rigidity which organism?

Back 265

Pneumococcal pneumonia ( strep pneumonia)

Front 266

19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion???

Back 266

Atypical pneumonia ( mycoplasma)

Rx: empiric azithromycin

Front 267

Menstruation, nasal packing, post surgery infection

High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??

Back 267

Toxic shock syndrome ( staph)

Front 268

Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms???

Back 268

Legionella pneumonia

Rx: macrolide or fluoroquinolones ( levofloxacin )

Front 269

Tetanus vaccine recommendation

Back 269

Patient with wound who haven’t received revaccination for 5 years ( give vaccine only )

Patient with dirty wound who have uncertain vaccine status ( give vaccine and Immune globulin)

Front 270

Prophylaxis of Lyme disease during traveling ?

Back 270

Tick repellent, protective clothing, tick checks

Front 271

Patient without specific symptoms, High fever, neutropenia??

Back 271

Febrile neutropenia

Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam )

Front 272

HIV, bright red firm exophytic nodules??

Back 272

Bacillary angiomatosis

Front 273

Most common cardiac effect of Lyme disease??

Back 273

AV block

Front 274

Post exposure prophylaxis of hepatitis A ?

Back 274

Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts

Front 275

Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ??

Back 275

Osteomyelitis

Dx: bone biopsy and culture of affected bone

Front 276

Varicella post exposure prophylaxis recommendation

Back 276

Yes Prior infection or 2 doses of vaccine: reassurance

No prior....etc: give vaccine alone( normal patient), immune globulin and vaccine(immunocompromised)

Front 277

Foodborne disease chart page 710

Back 277

Back (Definition)

Front 278

Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ???

Back 278

Staph aureus foodborne illness

Front 279

Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ???

Back 279

Infectious mononucleosis ( Epstein- Barr virus)

Front 280

Patient with osteomyelitis from plantar puncture wound???

Back 280

Pseudomonas aeruginosa

Front 281

HIV, bright red firm exophytic nodules??

Back 281

Bacillary angiomatosis

Front 282

Child, nocturnal perianal pruritus??

Back 282

Pinworm( enterobius vennicularis )

Dx: tape test ( eggs)

Rx : pyrantel pamoate, albendazole for all contacts

Front 283

Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ???

Back 283

EBV ( infectious mononucleosis

Dx: heterophile antibody( monospot) , Atypical lymphocytosis

Rx: avoid sports > 4 weeks ( risk splenic rupture)

Front 284

Painless bump, VDRL and HIV is negative???

Back 284

Primary syphilis

Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology

Front 285

Early Lyme disease features

Back 285

Spirochete infection, endemic areas, Ixodes scapularis

Erythema migrans, systemic symptoms ( cardiac, neurologic...)

Dx: clinical ( erythema migrans) , B burgdorferi serology ( cardiac/ neurologic)

Rx: oral ( doxycycline), IV ( ceftriaxone)

Front 286

Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration???

Back 286

Pneumocystis pneumonia ( jirovecii)

Front 287

Foodborne disease chart page 710

Back 287

Back (Definition)

Front 288

Headache, fever, nuchal rigidity which organism?

Back 288

Pneumococcal pneumonia ( strep pneumonia)

Front 289

19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion???

Back 289

Atypical pneumonia ( mycoplasma)

Rx: empiric azithromycin

Front 290

Menstruation, nasal packing, post surgery infection

High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??

Back 290

Toxic shock syndrome ( staph)

Front 291

Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms???

Back 291

Legionella pneumonia

Rx: macrolide or fluoroquinolones ( levofloxacin )

Front 292

Tetanus vaccine recommendation

Back 292

Patient with wound who haven’t received revaccination for 5 years ( give vaccine only )

Patient with dirty wound who have uncertain vaccine status ( give vaccine and Immune globulin)

Front 293

Prophylaxis of Lyme disease during traveling ?

Back 293

Tick repellent, protective clothing, tick checks

Front 294

Patient without specific symptoms, High fever, neutropenia??

Back 294

Febrile neutropenia

Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam )

Front 295

HIV, bright red firm exophytic nodules??

Back 295

Bacillary angiomatosis

Front 296

Most common cardiac effect of Lyme disease??

Back 296

AV block

Front 297

Post exposure prophylaxis of hepatitis A ?

Back 297

Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts

Front 298

Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ??

Back 298

Osteomyelitis

Dx: bone biopsy and culture of affected bone

Front 299

Varicella post exposure prophylaxis recommendation

Back 299

Yes Prior infection or 2 doses of vaccine: reassurance

No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised)

Front 300

Foodborne disease chart page 710

Back 300

Back (Definition)

Front 301

Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ???

Back 301

Staph aureus foodborne illness

Front 302

Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ???

Back 302

Infectious mononucleosis ( Epstein- Barr virus)

Front 303

Patient with osteomyelitis from plantar puncture wound???

Back 303

Pseudomonas aeruginosa

Front 304

HIV, bright red firm exophytic nodules??

Back 304

Bacillary angiomatosis

Front 305

Child, nocturnal perianal pruritus??

Back 305

Pinworm( enterobius vennicularis )

Dx: tape test ( eggs)

Rx : pyrantel pamoate, albendazole for all contacts

Front 306

Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ???

Back 306

EBV ( infectious mononucleosis

Dx: heterophile antibody( monospot) , Atypical lymphocytosis

Rx: avoid sports > 4 weeks ( risk splenic rupture)

Front 307

Painless bump, VDRL and HIV is negative???

Back 307

Primary syphilis

Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology

Front 308

Early Lyme disease features

Back 308

Spirochete infection, endemic areas, Ixodes scapularis

Erythema migrans, systemic symptoms ( cardiac, neurologic...)

Dx: clinical ( erythema migrans) , B burgdorferi serology ( cardiac/ neurologic)

Rx: oral ( doxycycline), IV ( ceftriaxone)

Front 309

Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration???

Back 309

Pneumocystis pneumonia ( jirovecii)

Front 310

Patient immunocompromised, has TB symptoms, temporal abscess, grow in gram stain positive acid -fast rods ???

Back 310

Nocardia

Rx: TMP-SMX

Front 311

Headache, fever, nuchal rigidity which organism?

Back 311

Pneumococcal pneumonia ( strep pneumonia)

Front 312

19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion???

Back 312

Atypical pneumonia ( mycoplasma)

Rx: empiric azithromycin

Front 313

Menstruation, nasal packing, post surgery infection

High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??

Back 313

Toxic shock syndrome ( staph)

Front 314

Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms???

Back 314

Legionella pneumonia

Rx: macrolide or fluoroquinolones ( levofloxacin )

Front 315

Tetanus vaccine recommendation

Back 315

Patient with wound who haven’t received revaccination for 5 years ( give vaccine only )

Patient with dirty wound who have uncertain vaccine status ( give vaccine and Immune globulin)

Front 316

Prophylaxis of Lyme disease during traveling ?

Back 316

Tick repellent, protective clothing, tick checks

Front 317

Patient without specific symptoms, High fever, neutropenia??

Back 317

Febrile neutropenia

Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam )

Front 318

HIV, bright red firm exophytic nodules??

Back 318

Bacillary angiomatosis

Front 319

Most common cardiac effect of Lyme disease??

Back 319

AV block

Front 320

Post exposure prophylaxis of hepatitis A ?

Back 320

Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts

Front 321

Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ??

Back 321

Osteomyelitis

Dx: bone biopsy and culture of affected bone

Front 322

Varicella post exposure prophylaxis recommendation

Back 322

Yes Prior infection or 2 doses of vaccine: reassurance

No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised)

Front 323

Foodborne disease chart page 710

Back 323

Back (Definition)

Front 324

Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ???

Back 324

Staph aureus foodborne illness

Front 325

Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ???

Back 325

Infectious mononucleosis ( Epstein- Barr virus)

Front 326

Patient with osteomyelitis from plantar puncture wound???

Back 326

Pseudomonas aeruginosa

Front 327

diabetic patient having osteomyelitis???

Back 327

Staph coagulase negative ( epidermidis) , B- hemolytic strep

Front 328

Child, nocturnal perianal pruritus??

Back 328

Pinworm( enterobius vennicularis )

Dx: tape test ( eggs)

Rx : pyrantel pamoate, albendazole for all contacts

Front 329

Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ???

Back 329

EBV ( infectious mononucleosis

Dx: heterophile antibody( monospot) , Atypical lymphocytosis

Rx: avoid sports > 4 weeks ( risk splenic rupture)

Front 330

Painless bump, VDRL and HIV is negative???

Back 330

Primary syphilis

Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology

Front 331

Early Lyme disease features

Back 331

Spirochete infection, endemic areas, Ixodes scapularis

Erythema migrans, systemic symptoms ( cardiac, neurologic...)

Dx: clinical ( erythema migrans) , B burgdorferi serology ( cardiac/ neurologic)

Rx: oral ( doxycycline), IV ( ceftriaxone)

Front 332

Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration???

Back 332

Pneumocystis pneumonia ( jirovecii)

Front 333

Patient immunocompromised, has TB symptoms, temporal abscess, grow in gram stain positive acid -fast rods ???

Back 333

Nocardia

Rx: TMP-SMX

Front 334

Headache, fever, nuchal rigidity which organism?

Back 334

Pneumococcal pneumonia ( strep pneumonia)

Front 335

19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion???

Back 335

Atypical pneumonia ( mycoplasma)

Rx: empiric azithromycin

Front 336

Menstruation, nasal packing, post surgery infection

High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??

Back 336

Toxic shock syndrome ( staph)

Front 337

Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms???

Back 337

Legionella pneumonia

Rx: macrolide or fluoroquinolones ( levofloxacin )

Front 338

Tetanus vaccine recommendation

Back 338

Patient with wound who haven’t received revaccination for 5 years ( give vaccine only )

Patient with dirty wound who have uncertain vaccine status ( give vaccine and Immune globulin)

Front 339

Prophylaxis of Lyme disease during traveling ?

Back 339

Tick repellent, protective clothing, tick checks

Front 340

Patient without specific symptoms, High fever, neutropenia??

Back 340

Febrile neutropenia

Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam )

Front 341

HIV, bright red firm exophytic nodules??

Back 341

Bacillary angiomatosis

Front 342

Most common cardiac effect of Lyme disease??

Back 342

AV block

Front 343

Post exposure prophylaxis of hepatitis A ?

Back 343

Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts

Front 344

Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ??

Back 344

Osteomyelitis

Dx: bone biopsy and culture of affected bone

Front 345

Varicella post exposure prophylaxis recommendation

Back 345

Yes Prior infection or 2 doses of vaccine: reassurance

No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised)

Front 346

Foodborne disease chart page 710

Back 346

Back (Definition)

Front 347

Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ???

Back 347

Staph aureus foodborne illness

Front 348

Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ???

Back 348

Infectious mononucleosis ( Epstein- Barr virus)

Front 349

Patient with osteomyelitis from plantar puncture wound???

Back 349

Pseudomonas aeruginosa

Front 350

diabetic patient having osteomyelitis???

Back 350

Staph coagulase negative ( epidermidis) , B- hemolytic strep

Front 351

Child, nocturnal perianal pruritus??

Back 351

Pinworm( enterobius vennicularis )

Dx: tape test ( eggs)

Rx : pyrantel pamoate, albendazole for all contacts

Front 352

Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ???

Back 352

EBV ( infectious mononucleosis

Dx: heterophile antibody( monospot) , Atypical lymphocytosis

Rx: avoid sports > 4 weeks ( risk splenic rupture)

Front 353

Painless bump, VDRL and HIV is negative???

Back 353

Primary syphilis

Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology

Front 354

Early Lyme disease features

Back 354

Spirochete infection, endemic areas, Ixodes scapularis

Erythema migrans, systemic symptoms ( cardiac, neurologic...)

Dx: clinical ( erythema migrans) , B burgdorferi serology ( cardiac/ neurologic)

Rx: oral ( doxycycline), IV ( ceftriaxone)

Front 355

Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration???

Back 355

Pneumocystis pneumonia ( jirovecii)

Front 356

Foodborne disease chart page 710

Back 356

Back (Definition)

Front 357

Headache, fever, nuchal rigidity which organism?

Back 357

Pneumococcal pneumonia ( strep pneumonia)

Front 358

19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion???

Back 358

Atypical pneumonia ( mycoplasma)

Rx: empiric azithromycin

Front 359

Menstruation, nasal packing, post surgery infection

High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??

Back 359

Toxic shock syndrome ( staph)

Front 360

Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms???

Back 360

Legionella pneumonia

Rx: macrolide or fluoroquinolones ( levofloxacin )

Front 361

Tetanus vaccine recommendation

Back 361

Patient with wound who haven’t received revaccination for 5 years ( give vaccine only )

Patient with dirty wound who have uncertain vaccine status ( give vaccine and Immune globulin)

Front 362

Prophylaxis of Lyme disease during traveling ?

Back 362

Tick repellent, protective clothing, tick checks

Front 363

Patient without specific symptoms, High fever, neutropenia??

Back 363

Febrile neutropenia

Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam )

Front 364

HIV, bright red firm exophytic nodules??

Back 364

Bacillary angiomatosis

Front 365

Most common cardiac effect of Lyme disease??

Back 365

AV block

Front 366

Post exposure prophylaxis of hepatitis A ?

Back 366

Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts

Front 367

Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ??

Back 367

Osteomyelitis

Dx: bone biopsy and culture of affected bone

Front 368

Varicella post exposure prophylaxis recommendation

Back 368

Yes Prior infection or 2 doses of vaccine: reassurance

No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised)

Front 369

Pneumonia with cystic fibrosis according to age organisms ?

Back 369

Infants and young children: staph aureus

Adults : pseudomonas aeruginosa

Front 370

Patient with penicillin allergy , has chancre ?

Back 370

Primary syphilis

Rx: doxycycline for 14 days ( because it’s allergic to penicillin)

Front 371

Indication of success in treatment of syphilis??

Back 371

4- fold decrease in antibodies titters( RPR) at 6-12 months

Front 372

Patient with Positive HBsAg and HBeAg management??

Back 372

HB vaccine and HB immune globulin

Front 373

HIV, bright red firm exophytic nodules??

Back 373

Bacillary angiomatosis

Front 374

Child, Fever, unilateral red tender neck swelling ??

Back 374

Lymphadenitis ( staph, strep )

Front 375

Patient with symptoms of acute UTI infection, unrinary alkalosis ( PH> 8 ) , organism?

Back 375

Proteus mirabilis ( urease -productive )

Complication: ammonium magnesium calculi

Front 376

Foodborne disease chart page 710

Back 376

Back (Definition)

Front 377

Infectious mononucleosis RX

Back 377

Avoid sports ( splenic rupture)

Front 378

Disseminated gonococcal infection features

Back 378

Sexually active, Tenosynovitis , dermatitis ( pustular rash ) , polyarthralgias

Dx: NAAT

Rx: IV ceftriaxone

Front 379

Predisposing factor of the bacterial sinusitis??

Back 379

Viral upper respiratory infection

Front 380

Most common valvular defect in infective endocarditis??

Back 380

Mitral regurgitation

Front 381

Fever, acute joint pain, inability to walk , very high leukocytosis and elevated ESR ??

Back 381

Septic arthritis by staph( joint destruction)

Rx: empiric vancomycin, Emergency surgical drainage.

Front 382

Bacterial causes of diarrhea chart page 840

Back 382

Back (Definition)

Front 383

Bacterial cases of diarrhea

Back 383

Bacillus( rice), staph( vomiting, rapid onset), clostridium Difficile ( antibiotics use), clostridium perifringes ( unrefrigerated food) , salmonella ( poultry, eggs ), vibrio vulnificus ( shellfish, invasive ),E-coli( watery then bloody ), shigella ( contaminated water, bloody),

Campylobacter ( raw meat, bloody)

Front 384

Patient with E-coli bloody diarrhea should avoid??

Back 384

Empiric antibiotic ( hemolytic uremic syndrome)

Front 385

Most following opportunistic infection after renal transplant?

Back 385

CMV ( colitis, bloody diarrhea, ulcers on colonoscopy,atypical lymphocytes)

Dx: biopsy

Front 386

Erythema, swelling, pain out of proportion, crepitus??

Back 386

Necrotizing fasciitis ( group A strep , staph)

Front 387

Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ???

Back 387

Staph aureus foodborne illness

Front 388

landscaper Patient with skin papule that ulcerate with nonpurulent , odorless drainage, proximal lesions??

Back 388

Sporothrix dimorphic fungus ( sporotrichosis ) found in decaying vegetation

Dx: culture

Rx: itraconazole (3-6 months)

Front 389

Bacterial causes of diarrhea chart page 840

Back 389

Back (Definition)

Front 390

Patient with osteomyelitis from plantar puncture wound???

Back 390

Pseudomonas aeruginosa

Front 391

diabetic patient having osteomyelitis???

Back 391

Staph coagulase negative ( epidermidis) , B- hemolytic strep

Front 392

Child, nocturnal perianal pruritus??

Back 392

Pinworm( enterobius vennicularis )

Dx: tape test ( eggs)

Rx : pyrantel pamoate, albendazole for all contacts

Front 393

Erythema, swelling, pain out of proportion, crepitus??

Back 393

Necrotizing fasciitis ( group A strep , staph)

Front 394

Painless bump, VDRL and HIV is negative???

Back 394

Primary syphilis

Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology

Front 395

Early Lyme disease features

Back 395

Spirochete infection, endemic areas, Ixodes scapularis

Erythema migrans, systemic symptoms ( cardiac, neurologic...)

Dx: clinical ( erythema migrans) , B burgdorferi serology ( cardiac/ neurologic)

Rx: oral ( doxycycline), IV ( ceftriaxone)

Front 396

Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration???

Back 396

Pneumocystis pneumonia ( jirovecii)

Front 397

Patient immunocompromised, has TB symptoms, temporal abscess, grow in gram stain positive acid -fast rods ???

Back 397

Nocardia

Rx: TMP-SMX

Front 398

Headache, fever, nuchal rigidity which organism?

Back 398

Pneumococcal pneumonia ( strep pneumonia)

Front 399

19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion???

Back 399

Atypical pneumonia ( mycoplasma)

Rx: empiric azithromycin

Front 400

Menstruation, nasal packing, post surgery infection

High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??

Back 400

Toxic shock syndrome ( staph)

Front 401

Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms???

Back 401

Legionella pneumonia

Rx: macrolide or fluoroquinolones ( levofloxacin )

Front 402

Tetanus vaccine recommendation

Back 402

Patient with wound who haven’t received revaccination for 5 years ( give vaccine only )

Patient with dirty wound who have uncertain vaccine status ( give vaccine and Immune globulin)

Front 403

Prophylaxis of Lyme disease during traveling ?

Back 403

Tick repellent, protective clothing, tick checks

Front 404

Patient without specific symptoms, High fever, neutropenia??

Back 404

Febrile neutropenia

Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam )

Front 405

HIV, bright red firm exophytic nodules??

Back 405

Bacillary angiomatosis

Front 406

Most common cardiac effect of Lyme disease??

Back 406

AV block

Front 407

Post exposure prophylaxis of hepatitis A ?

Back 407

Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts

Front 408

Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ??

Back 408

Osteomyelitis

Dx: bone biopsy and culture of affected bone

Front 409

Varicella post exposure prophylaxis recommendation

Back 409

Yes Prior infection or 2 doses of vaccine: reassurance

No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised)

Front 410

Pneumonia with cystic fibrosis according to age organisms ?

Back 410

Infants and young children: staph aureus

Adults : pseudomonas aeruginosa

Front 411

Patient with penicillin allergy , has chancre ?

Back 411

Primary syphilis

Rx: doxycycline for 14 days ( because it’s allergic to penicillin)

Front 412

Indication of success in treatment of syphilis??

Back 412

4- fold decrease in antibodies titters( RPR) at 6-12 months

Front 413

Patient with Positive HBsAg and HBeAg management??

Back 413

HB vaccine and HB immune globulin

Front 414

Acute cervical adenitis in children

Back 414

Unilateral: staph, strep pyogenes

Bilateral: adenovirus, EBV/ CMV

Front 415

Child, Fever, unilateral red tender neck swelling ??

Back 415

Lymphadenitis ( staph, strep )

Front 416

Patient with symptoms of acute UTI infection, unrinary alkalosis ( PH> 8 ) , organism?

Back 416

Proteus mirabilis ( urease -productive )

Complication: ammonium magnesium calculi

Front 417

Foodborne disease chart page 710

Back 417

Back (Definition)

Front 418

Infectious mononucleosis RX

Back 418

Avoid sports ( splenic rupture)

Front 419

Disseminated gonococcal infection features

Back 419

Sexually active, Tenosynovitis , dermatitis ( pustular rash ) , polyarthralgias

Dx: NAAT

Rx: IV ceftriaxone

Front 420

Predisposing factor of the bacterial sinusitis??

Back 420

Viral upper respiratory infection

Front 421

Most common valvular defect in infective endocarditis??

Back 421

Mitral regurgitation

Front 422

Fever, acute joint pain, inability to walk , very high leukocytosis and elevated ESR ??

Back 422

Septic arthritis by staph( joint destruction)

Rx: empiric vancomycin, Emergency surgical drainage.

Front 423

Bacterial causes of diarrhea chart page 840

Back 423

Back (Definition)

Front 424

Bacterial cases of diarrhea

Back 424

Bacillus( rice), staph( vomiting, rapid onset), clostridium Difficile ( antibiotics use), clostridium perifringes ( unrefrigerated food) , salmonella ( poultry, eggs ), vibrio vulnificus ( shellfish, invasive ),E-coli( watery then bloody ), shigella ( contaminated water, bloody),

Campylobacter ( raw meat, bloody)

Front 425

Patient with E-coli bloody diarrhea should avoid??

Back 425

Empiric antibiotic ( hemolytic uremic syndrome)

Front 426

Most following opportunistic infection after renal transplant?

Back 426

CMV ( colitis, bloody diarrhea, ulcers on colonoscopy,atypical lymphocytes)

Dx: biopsy

Front 427

Erythema, swelling, pain out of proportion, crepitus??

Back 427

Necrotizing fasciitis ( group A strep , staph)

Front 428

Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ???

Back 428

Staph aureus foodborne illness

Front 429

landscaper Patient with skin papule that ulcerate with nonpurulent , odorless drainage, proximal lesions??

Back 429

Sporothrix dimorphic fungus ( sporotrichosis ) found in decaying vegetation

Dx: culture

Rx: itraconazole (3-6 months)

Front 430

Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ???

Back 430

Infectious mononucleosis ( Epstein- Barr virus)

Front 431

Patient with osteomyelitis from plantar puncture wound???

Back 431

Pseudomonas aeruginosa

Front 432

diabetic patient having osteomyelitis???

Back 432

Staph coagulase negative ( epidermidis) , B- hemolytic strep

Front 433

Child, nocturnal perianal pruritus??

Back 433

Pinworm( enterobius vennicularis )

Dx: tape test ( eggs)

Rx : pyrantel pamoate, albendazole for all contacts

Front 434

Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ???

Back 434

EBV ( infectious mononucleosis

Dx: heterophile antibody( monospot) , Atypical lymphocytosis

Rx: avoid sports > 4 weeks ( risk splenic rupture)

Front 435

Painless bump, VDRL and HIV is negative???

Back 435

Primary syphilis

Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology

Front 436

Early Lyme disease features

Back 436

Spirochete infection, endemic areas, Ixodes scapularis

Erythema migrans, systemic symptoms ( cardiac, neurologic...)

Dx: clinical ( erythema migrans) , B burgdorferi serology ( cardiac/ neurologic)

Rx: oral ( doxycycline), IV ( ceftriaxone)

Front 437

Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration???

Back 437

Pneumocystis pneumonia ( jirovecii)

Front 438

Patient immunocompromised, has TB symptoms, temporal abscess, grow in gram stain positive acid -fast rods ???

Back 438

Nocardia

Rx: TMP-SMX

Front 439

Headache, fever, nuchal rigidity which organism?

Back 439

Pneumococcal pneumonia ( strep pneumonia)

Front 440

19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion???

Back 440

Atypical pneumonia ( mycoplasma)

Rx: empiric azithromycin

Front 441

Menstruation, nasal packing, post surgery infection

High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??

Back 441

Toxic shock syndrome ( staph)

Front 442

Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms???

Back 442

Legionella pneumonia

Rx: macrolide or fluoroquinolones ( levofloxacin )

Front 443

Tetanus vaccine recommendation

Back 443

Patient with wound who haven’t received revaccination for 5 years ( give vaccine only )

Patient with dirty wound who have uncertain vaccine status ( give vaccine and Immune globulin)

Front 444

Prophylaxis of Lyme disease during traveling ?

Back 444

Tick repellent, protective clothing, tick checks

Front 445

Patient without specific symptoms, High fever, neutropenia??

Back 445

Febrile neutropenia

Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam )

Front 446

HIV, bright red firm exophytic nodules??

Back 446

Bacillary angiomatosis

Front 447

Most common cardiac effect of Lyme disease??

Back 447

AV block

Front 448

Post exposure prophylaxis of hepatitis A ?

Back 448

Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts

Front 449

Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ??

Back 449

Osteomyelitis

Dx: bone biopsy and culture of affected bone

Front 450

Varicella post exposure prophylaxis recommendation

Back 450

Yes Prior infection or 2 doses of vaccine: reassurance

No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised)

Front 451

Pneumonia with cystic fibrosis according to age organisms ?

Back 451

Infants and young children: staph aureus

Adults : pseudomonas aeruginosa

Front 452

Patient with penicillin allergy , has chancre ?

Back 452

Primary syphilis

Rx: doxycycline for 14 days ( because it’s allergic to penicillin)

Front 453

Indication of success in treatment of syphilis??

Back 453

4- fold decrease in antibodies titters( RPR) at 6-12 months

Front 454

Patient with Positive HBsAg and HBeAg management??

Back 454

HB vaccine and HB immune globulin

Front 455

Acute cervical adenitis in children

Back 455

Unilateral: staph, strep pyogenes

Bilateral: adenovirus, EBV/ CMV

Front 456

Child, Fever, unilateral red tender neck swelling ??

Back 456

Lymphadenitis ( staph, strep )

Front 457

Patient with symptoms of acute UTI infection, unrinary alkalosis ( PH> 8 ) , organism?

Back 457

Proteus mirabilis ( urease -productive )

Complication: ammonium magnesium calculi

Front 458

Foodborne disease chart page 710

Back 458

Back (Definition)

Front 459

Infectious mononucleosis RX

Back 459

Avoid sports ( splenic rupture)

Front 460

Disseminated gonococcal infection features

Back 460

Sexually active, Tenosynovitis , dermatitis ( pustular rash ) , polyarthralgias

Dx: NAAT

Rx: IV ceftriaxone

Front 461

Predisposing factor of the bacterial sinusitis??

Back 461

Viral upper respiratory infection

Front 462

Most common valvular defect in infective endocarditis??

Back 462

Mitral regurgitation

Front 463

Fever, acute joint pain, inability to walk , very high leukocytosis and elevated ESR ??

Back 463

Septic arthritis by staph( joint destruction)

Rx: empiric vancomycin, Emergency surgical drainage.

Front 464

Bacterial causes of diarrhea chart page 840

Back 464

Back (Definition)

Front 465

Bacterial cases of diarrhea

Back 465

Bacillus( rice), staph( vomiting, rapid onset), clostridium Difficile ( antibiotics use), clostridium perifringes ( unrefrigerated food) , salmonella ( poultry, eggs ), vibrio vulnificus ( shellfish, invasive ),E-coli( watery then bloody ), shigella ( contaminated water, bloody),

Campylobacter ( raw meat, bloody)

Front 466

Patient with E-coli bloody diarrhea should avoid??

Back 466

Empiric antibiotic ( hemolytic uremic syndrome)

Front 467

Most following opportunistic infection after renal transplant?

Back 467

CMV ( colitis, bloody diarrhea, ulcers on colonoscopy,atypical lymphocytes)

Dx: biopsy

Front 468

Erythema, swelling, pain out of proportion, crepitus??

Back 468

Necrotizing fasciitis ( group A strep , staph)

Front 469

Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ???

Back 469

Staph aureus foodborne illness

Front 470

landscaper Patient with skin papule that ulcerate with nonpurulent , odorless drainage, proximal lesions??

Back 470

Sporothrix dimorphic fungus ( sporotrichosis ) found in decaying vegetation

Dx: culture

Rx: itraconazole (3-6 months)

Front 471

Treatment with isoniazid effect on liver ??

Back 471

Mild LFTs elevation( self-limited)

Front 472

Mumps complication?

Back 472

Orchitis, deafness

Front 473

Mononucleosis-like syndrome, fever, night sweats, lymphadenopathy??

Back 473

Acute HIV , the patient should be tested for HIV

Dx: viral load( early stage) , HIV antibodies may be negative pneumocystis

Front 474

Pneumocystis pneumonia suggests?

Back 474

Selection loss of CD4

Front 475

Sickle cell disease patient with fever and severe pain in the left tibia ???

Back 475

Osteomyelitis caused by salmonella, staph

Front 476

Neonatal sepsis, hypothermia, lethargy, low WBCs ???

Back 476

Meningitis caused by Group B strep

Front 477

Old patient who had a surgery, intubated, fever and right lung infiltration?

Back 477

Ventilator-associated pneumonia ( > 48 hours after intubation)

Follow up: gram stain and culture of respiratory secretions and empiric abx

Front 478

Old, fever, malaise, focal lower back pain , recent UTI infection???

Back 478

Vertebral osteomyelitis

Dx: blood culture, ESR, CRP, MRI then CT-guided bone biopsy

Front 479

Fever, sore throat, malaise, difficult swallow, posterior or diffuse cervical lymphadenopathy??

Back 479

Infectious mononucleosis( EBV)

Complications: acute airway obstruction, anemia, splenic rupture.

Dx: heterophile antibody ( Monospot test )

Rx: corticosteroids

Front 480

Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ???

Back 480

Infectious mononucleosis ( Epstein- Barr virus)

Front 481

AIDS patient, CD4 500, should be given varicella vaccine??

Back 481

Yes

If the CD4 < 200 then no

Front 482

9-year girl, uncontrolled writhing of arms and hands , face grimacing, heart symptoms , previous sore throat and fever ??

Back 482

Acute rheumatic fever caused by ( strep A pyogenes )

Front 483

Acute rheumatic fever criteria

Back 483

Erythema marginatum , subcutaneous nodules, migratory arthritis, carditis , chorea

Front 484

Annual vaccine of 60 years old patient??

Back 484

Influenza ( inactivated)

Front 485

Respiratory symptoms, bilateral diffuse infiltration, had liver transplant 7 months ago ???

Back 485

PCP

Dx: induced sputum or bronchoalveoalar lavage

Front 486

17 , no symptoms, has non tender, mobile posterior cervical lymph nodes ( < 2 cm ) , management??pers

Back 486

Observation

Front 487

Persistent right upper quadrant pain, low grade fever, had bloody diarrhea,

Back 487

Abscess from entamoeba histolytica

Rx: metronidazole( abscess) and luminal agent ( eradicate intestinal colonization)

Don’t drain the abscess

Front 488

> 65 , fever, headache, sore throat, runny nose , severe body aches< one week ??

Back 488

Influenza virus

Front 489

Girl, fever, painful swelling papule on the anterior thigh, lymphadenopathy,the family has cat, dog, turtle??

Back 489

Cat scratch disease ( Bartonella henselae)

Front 490

Woman, fatigue, headache, vomiting, HIV positive, papilledema???

Back 490

Cryptococcal meningoencephalitis

Dx: CSF cryptococcal antigen

Rx: amphotericin then fluconazole

Front 491

Patient with osteomyelitis from plantar puncture wound???

Back 491

Pseudomonas aeruginosa

Front 492

HIV man, frequent bloody diarrhea, abdominal pain weight loss, CD4 28 ???

Back 492

Cytomegalovirus ( bloody), not Mycobacterium avium complex ( watery)

Dx: colonoscopy with biopsy

Complications:,retinitis

Front 493

Girl, low grade fever, rash the spread quickly ( cephalocaudal ), auricular and occipital , arthralgia lymphadenopathy??

Back 493

Rubella

Front 494

Infectious mononucleosis diagnosis??

Back 494

Atypical lymphocytes

Heterophile antibodies ( negative in early illness)

Front 495

Sickle cell disease with fever, hypotension, asplenia , hypotension, anemia??

Back 495

Strep pneumoniae ( encapsulated)

Follow up: penicillin prophylaxis

Front 496

AIDS, tuberculosis symptoms, CD4 <50 ??

Back 496

Mycobacterium avium complex

Rx: azithromycin

Front 497

Man, intense pruritic lesion on foot

Back 497

Cutaneous larva migrans

Epidemiology : hookworm dog ( ancylostoma) or cat( braziliense), barefoot with sand or soil

Rx: antihelmintic ( ivermectin)

Front 498

Mononucleosis symptoms in sexually multiple patient, rash all over the body( involves palms and soles) , grey mucus patches in the mouth???

Back 498

Secondary syphilis

Front 499

Healthy patient wants to be sure he doesn’t have STDs ??

Back 499

HIV screen p24 antigen and antibody testing

Front 500

HIV screening indications chart page 984

Back 500

Back (Definition)

Front 501

Tooth removal, slow-growing non tender mass ( mandibular) , sulfur granules ??

Back 501

Cervicofacial Actinomyces ( gram positive)

Rx: penicillin

Front 502

diabetic patient having osteomyelitis???

Back 502

Staph coagulase negative ( epidermidis) , B- hemolytic strep

Front 503

HIV, headache, fever, FND, altered mental status, CD4 < 100, MRI shows ring- enhancing lesions ??

Back 503

Toxoplasma encephalitis

Rx: sulfadiazine and pyrimethamine.

Prophylaxis: TMP-SMX

Front 504

HIV, acute onset watery diarrhea, CD4 unknown , management??

Back 504

Stool examination included ova and parasites

Front 505

Newborn, rhinorrhea, desquamating ( bullous) rash?

Back 505

Syphilis

Front 506

Newborn, peri ventricular calcification??

Back 506

Cytomegalovirus

Front 507

Newborn, diffuse intracerebral calcifications , choriorenitis ??

Back 507

Toxoplasmosis

Front 508

Newborn, cataracts, PDA ???

Back 508

Rubella

Front 509

HIV, fever, FND,

Back 509

Toxoplasmosis

Prophylaxis: TMP-SMX

Front 510

Man, tick bite, high fever, headache, altered mental status, leukopenia , thrombocytopenia, elevated aminotrasferas ??

Back 510

Ehrlichiosis

Rx: doxycycline

Front 511

Woman, high fever,had cellulitis, holosystolic murmur??

Back 511

Infective endocarditis ( IVDU)

Rx: vancomycin

Front 512

Fever, leukocytosis , left upper quadrant abdominal pain , pleural effusion, systolic murmur ???

Back 512

Splenic abscess due to IE

Front 513

Child, nocturnal perianal pruritus??

Back 513

Pinworm( enterobius vennicularis )

Dx: tape test ( eggs)

Rx : pyrantel pamoate, albendazole for all contacts

Front 514

HIV, FND, CT( white matter lesions with no enhancement/ edema ) , CD4 < 200 ??

Back 514

Progressive multifocal leukoencephalopathy caused by JC virus reactivation

Front 515

Tuberculin skin test < 15 in healthy patient management??

Back 515

No more interventions

Front 516

Seizure like epilepsy, ICH, Travel, MRI( hypodense, enhancement /edema cysts )??

Back 516

Neurocysticerosis ( pork tapeworm) eggs

Rx: albendazole

Front 517

Bite from neighbor’s dog management?

Back 517

Observe the dog for 10 days for rabies, no immediate prophylaxis foe the patient

Front 518

child, Fever, odynophagia , neck pain with extension, muffled voice, lateral neck x-ray ( widened prevertebral space ) ???

Back 518

Retropharyngeal abscess

Front 519

Epiglottis symptoms but the swelling is submandibular , crepitus??

Back 519

Ludwig angina ( cellulitis from infected molar

Front 520

Patient had transplant, pulmonary symptoms, GI symptoms, hepatitis ???

Back 520

CMV

Front 521

Young Patient got influenza treatment and improved then got worse, high fever, necrotizing pneumonia, productive cough with blood, cavity infiltration???

Back 521

Secondary bacterial pneumonia ( methicillin-resistant staph)

Front 522

HIV, CD4 <50, tuberculosis symptoms, purple pedunculated lesions on face and extremity, CT( hyposense liver lesions) ??

Back 522

Bartonella ( bacillary angiomatosis )

Dx: biopsy

Rx: doxycycline or erythromycin

Front 523

Anesthetic hypopigmented lesions with peripheral nerve involvement ( ulnar) , painful nerve deformity??

Back 523

Leprosy

Dx: biopsy from the edge of lesion

Front 524

Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ???

Back 524

EBV ( infectious mononucleosis

Dx: heterophile antibody( monospot) , Atypical lymphocytosis

Rx: avoid sports > 4 weeks ( risk splenic rupture)

Front 525

Child, rash , painful pustules, golden yellow crust ??

Back 525

Impetigo

Rx: localized( non-bullous) : mupirocin

generalized( bullous) : cephalexin , clindamycin

Front 526

Child, 2 weeks rhinorrhea then dry cough causing vomiting??

Back 526

Pertussis

Dx: PCR

Rx: macrolide

Front 527

Painless bump, VDRL and HIV is negative???

Back 527

Primary syphilis

Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology

Front 528

Early Lyme disease features

Back 528

Spirochete infection, endemic areas, Ixodes scapularis

Erythema migrans, systemic symptoms ( cardiac, neurologic...)

Dx: clinical ( erythema migrans) , B burgdorferi serology ( cardiac/ neurologic)

Rx: oral ( doxycycline), IV ( ceftriaxone)

Front 529

Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration???

Back 529

Pneumocystis pneumonia ( jirovecii)

Front 530

Patient immunocompromised, has TB symptoms, temporal abscess, grow in gram stain positive acid -fast rods ???

Back 530

Nocardia

Rx: TMP-SMX

Front 531

Headache, fever, nuchal rigidity which organism?

Back 531

Pneumococcal pneumonia ( strep pneumonia)

Front 532

19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion???

Back 532

Atypical pneumonia ( mycoplasma)

Rx: empiric azithromycin

Front 533

Menstruation, nasal packing, post surgery infection

High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??

Back 533

Toxic shock syndrome ( staph)

Front 534

Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms???

Back 534

Legionella pneumonia

Rx: macrolide or fluoroquinolones ( levofloxacin )

Front 535

Tetanus vaccine recommendation

Back 535

Patient with wound who haven’t received revaccination for 5 years ( give vaccine only )

Patient with dirty wound who have uncertain vaccine status ( give vaccine and Immune globulin)

Front 536

Prophylaxis of Lyme disease during traveling ?

Back 536

Tick repellent, protective clothing, tick checks

Front 537

Patient without specific symptoms, High fever, neutropenia??

Back 537

Febrile neutropenia

Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam )

Front 538

HIV, bright red firm exophytic nodules??

Back 538

Bacillary angiomatosis

Front 539

Most common cardiac effect of Lyme disease??

Back 539

AV block

Front 540

Post exposure prophylaxis of hepatitis A ?

Back 540

Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts

Front 541

Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ??

Back 541

Osteomyelitis

Dx: bone biopsy and culture of affected bone

Front 542

Varicella post exposure prophylaxis recommendation

Back 542

Yes Prior infection or 2 doses of vaccine: reassurance

No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised)

Front 543

Pneumonia with cystic fibrosis according to age organisms ?

Back 543

Infants and young children: staph aureus

Adults : pseudomonas aeruginosa

Front 544

Patient with penicillin allergy , has chancre ?

Back 544

Primary syphilis

Rx: doxycycline for 14 days ( because it’s allergic to penicillin)

Front 545

Indication of success in treatment of syphilis??

Back 545

4- fold decrease in antibodies titters( RPR) at 6-12 months

Front 546

Patient with Positive HBsAg and HBeAg management??

Back 546

HB vaccine and HB immune globulin

Front 547

Acute cervical adenitis in children

Back 547

Unilateral: staph, strep pyogenes

Bilateral: adenovirus, EBV/ CMV

Front 548

Child, Fever, unilateral red tender neck swelling ??

Back 548

Lymphadenitis ( staph, strep )

Front 549

Patient with symptoms of acute UTI infection, unrinary alkalosis ( PH> 8 ) , organism?

Back 549

Proteus mirabilis ( urease -productive )

Complication: ammonium magnesium calculi

Front 550

Foodborne disease chart page 710

Back 550

Back (Definition)

Front 551

Infectious mononucleosis RX

Back 551

Avoid sports ( splenic rupture)

Front 552

Disseminated gonococcal infection features

Back 552

Sexually active, Tenosynovitis , dermatitis ( pustular rash ) , polyarthralgias

Dx: NAAT

Rx: IV ceftriaxone

Front 553

Predisposing factor of the bacterial sinusitis??

Back 553

Viral upper respiratory infection

Front 554

Most common valvular defect in infective endocarditis??

Back 554

Mitral regurgitation

Front 555

Fever, acute joint pain, inability to walk , very high leukocytosis and elevated ESR ??

Back 555

Septic arthritis by staph( joint destruction)

Rx: empiric vancomycin, Emergency surgical drainage.

Front 556

Bacterial causes of diarrhea chart page 840

Back 556

Back (Definition)

Front 557

Bacterial cases of diarrhea

Back 557

Bacillus( rice), staph( vomiting, rapid onset), clostridium Difficile ( antibiotics use), clostridium perifringes ( unrefrigerated food) , salmonella ( poultry, eggs ), vibrio vulnificus ( shellfish, invasive ),E-coli( watery then bloody ), shigella ( contaminated water, bloody),

Campylobacter ( raw meat, bloody)

Front 558

Patient with E-coli bloody diarrhea should avoid??

Back 558

Empiric antibiotic ( hemolytic uremic syndrome)

Front 559

Most following opportunistic infection after renal transplant?

Back 559

CMV ( colitis, bloody diarrhea, ulcers on colonoscopy,atypical lymphocytes)

Dx: biopsy

Front 560

Erythema, swelling, pain out of proportion, crepitus??

Back 560

Necrotizing fasciitis ( group A strep , staph)

Front 561

Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ???

Back 561

Staph aureus foodborne illness

Front 562

landscaper Patient with skin papule that ulcerate with nonpurulent , odorless drainage, proximal lesions??

Back 562

Sporothrix dimorphic fungus ( sporotrichosis ) found in decaying vegetation

Dx: culture

Rx: itraconazole (3-6 months)

Front 563

Treatment with isoniazid effect on liver ??

Back 563

Mild LFTs elevation( self-limited)

Front 564

Mumps complication?

Back 564

Orchitis, deafness

Front 565

Mononucleosis-like syndrome, fever, night sweats, lymphadenopathy??

Back 565

Acute HIV , the patient should be tested for HIV

Dx: viral load( early stage) , HIV antibodies may be negative pneumocystis

Front 566

Pneumocystis pneumonia suggests?

Back 566

Selection loss of CD4

Front 567

Sickle cell disease patient with fever and severe pain in the left tibia ???

Back 567

Osteomyelitis caused by salmonella, staph

Front 568

Neonatal sepsis, hypothermia, lethargy, low WBCs ???

Back 568

Meningitis caused by Group B strep

Front 569

Old patient who had a surgery, intubated, fever and right lung infiltration?

Back 569

Ventilator-associated pneumonia ( > 48 hours after intubation)

Follow up: gram stain and culture of respiratory secretions and empiric abx

Front 570

Old, fever, malaise, focal lower back pain , recent UTI infection???

Back 570

Vertebral osteomyelitis

Dx: blood culture, ESR, CRP, MRI then CT-guided bone biopsy

Front 571

Fever, sore throat, malaise, difficult swallow, posterior or diffuse cervical lymphadenopathy??

Back 571

Infectious mononucleosis( EBV)

Complications: acute airway obstruction, anemia, splenic rupture.

Dx: heterophile antibody ( Monospot test )

Rx: corticosteroids

Front 572

Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ???

Back 572

Infectious mononucleosis ( Epstein- Barr virus)

Front 573

AIDS patient, CD4 500, should be given varicella vaccine??

Back 573

Yes

If the CD4 < 200 then no

Front 574

9-year girl, uncontrolled writhing of arms and hands , face grimacing, heart symptoms , previous sore throat and fever ??

Back 574

Acute rheumatic fever caused by ( strep A pyogenes )

Front 575

Acute rheumatic fever criteria

Back 575

Erythema marginatum , subcutaneous nodules, migratory arthritis, carditis , chorea

Front 576

Annual vaccine of 60 years old patient??

Back 576

Influenza ( inactivated)

Front 577

Respiratory symptoms, bilateral diffuse infiltration, had liver transplant 7 months ago ???

Back 577

PCP

Dx: induced sputum or bronchoalveoalar lavage

Front 578

17 , no symptoms, has non tender, mobile posterior cervical lymph nodes ( < 2 cm ) , management??pers

Back 578

Observation

Front 579

Persistent right upper quadrant pain, low grade fever, had bloody diarrhea,

Back 579

Abscess from entamoeba histolytica

Rx: metronidazole( abscess) and luminal agent ( eradicate intestinal colonization)

Don’t drain the abscess

Front 580

> 65 , fever, headache, sore throat, runny nose , severe body aches< one week ??

Back 580

Influenza virus

Front 581

Girl, fever, painful swelling papule on the anterior thigh, lymphadenopathy,the family has cat, dog, turtle??

Back 581

Cat scratch disease ( Bartonella henselae)

Front 582

Woman, fatigue, headache, vomiting, HIV positive, papilledema???

Back 582

Cryptococcal meningoencephalitis

Dx: CSF cryptococcal antigen

Rx: amphotericin then fluconazole

Front 583

Patient with osteomyelitis from plantar puncture wound???

Back 583

Pseudomonas aeruginosa

Front 584

HIV man, frequent bloody diarrhea, abdominal pain weight loss, CD4 28 ???

Back 584

Cytomegalovirus ( bloody), not Mycobacterium avium complex ( watery)

Dx: colonoscopy with biopsy

Complications:,retinitis

Front 585

Girl, low grade fever, rash the spread quickly ( cephalocaudal ), auricular and occipital , arthralgia lymphadenopathy??

Back 585

Rubella

Front 586

Infectious mononucleosis diagnosis??

Back 586

Atypical lymphocytes

Heterophile antibodies ( negative in early illness)

Front 587

Sickle cell disease with fever, hypotension, asplenia , hypotension, anemia??

Back 587

Strep pneumoniae ( encapsulated)

Follow up: penicillin prophylaxis

Front 588

AIDS, tuberculosis symptoms, CD4 <50 ??

Back 588

Mycobacterium avium complex

Rx: azithromycin

Front 589

Man, intense pruritic lesion on foot

Back 589

Cutaneous larva migrans

Epidemiology : hookworm dog ( ancylostoma) or cat( braziliense), barefoot with sand or soil

Rx: antihelmintic ( ivermectin)

Front 590

Mononucleosis symptoms in sexually multiple patient, rash all over the body( involves palms and soles) , grey mucus patches in the mouth???

Back 590

Secondary syphilis

Front 591

Healthy patient wants to be sure he doesn’t have STDs ??

Back 591

HIV screen p24 antigen and antibody testing

Front 592

HIV screening indications chart page 984

Back 592

Back (Definition)

Front 593

Tooth removal, slow-growing non tender mass ( mandibular) , sulfur granules ??

Back 593

Cervicofacial Actinomyces ( gram positive)

Rx: penicillin

Front 594

diabetic patient having osteomyelitis???

Back 594

Staph coagulase negative ( epidermidis) , B- hemolytic strep

Front 595

HIV, headache, fever, FND, altered mental status, CD4 < 100, MRI shows ring- enhancing lesions ??

Back 595

Toxoplasma encephalitis

Rx: sulfadiazine and pyrimethamine.

Prophylaxis: TMP-SMX

Front 596

HIV, acute onset watery diarrhea, CD4 unknown , management??

Back 596

Stool examination included ova and parasites

Front 597

Newborn, rhinorrhea, desquamating ( bullous) rash?

Back 597

Syphilis

Front 598

Newborn, peri ventricular calcification??

Back 598

Cytomegalovirus

Front 599

Newborn, diffuse intracerebral calcifications , choriorenitis ??

Back 599

Toxoplasmosis

Front 600

Newborn, cataracts, PDA ???

Back 600

Rubella

Front 601

HIV, fever, FND,

Back 601

Toxoplasmosis

Prophylaxis: TMP-SMX

Front 602

Man, tick bite, high fever, headache, altered mental status, leukopenia , thrombocytopenia, elevated aminotrasferas ??

Back 602

Ehrlichiosis

Rx: doxycycline

Front 603

Woman, high fever,had cellulitis, holosystolic murmur??

Back 603

Infective endocarditis ( IVDU)

Rx: vancomycin

Front 604

Fever, leukocytosis , left upper quadrant abdominal pain , pleural effusion, systolic murmur ???

Back 604

Splenic abscess due to IE

Front 605

Child, nocturnal perianal pruritus??

Back 605

Pinworm( enterobius vennicularis )

Dx: tape test ( eggs)

Rx : pyrantel pamoate, albendazole for all contacts

Front 606

HIV, FND, CT( white matter lesions with no enhancement/ edema ) , CD4 < 200 ??

Back 606

Progressive multifocal leukoencephalopathy caused by JC virus reactivation

Front 607

Tuberculin skin test < 15 in healthy patient management??

Back 607

No more interventions

Front 608

Seizure like epilepsy, ICH, Travel, MRI( hypodense, enhancement /edema cysts )??

Back 608

Neurocysticerosis ( pork tapeworm) eggs

Rx: albendazole

Front 609

Bite from neighbor’s dog management?

Back 609

Observe the dog for 10 days for rabies, no immediate prophylaxis foe the patient

Front 610

child, Fever, odynophagia , neck pain with extension, muffled voice, lateral neck x-ray ( widened prevertebral space ) ???

Back 610

Retropharyngeal abscess

Front 611

Epiglottis symptoms but the swelling is submandibular , crepitus??

Back 611

Ludwig angina ( cellulitis from infected molar

Front 612

Patient had transplant, pulmonary symptoms, GI symptoms, hepatitis ???

Back 612

CMV

Front 613

Young Patient got influenza treatment and improved then got worse, high fever, necrotizing pneumonia, productive cough with blood, cavity infiltration???

Back 613

Secondary bacterial pneumonia ( methicillin-resistant staph)

Front 614

HIV, CD4 <50, tuberculosis symptoms, purple pedunculated lesions on face and extremity, CT( hyposense liver lesions) ??

Back 614

Bartonella ( bacillary angiomatosis )

Dx: biopsy

Rx: doxycycline or erythromycin

Front 615

Anesthetic hypopigmented lesions with peripheral nerve involvement ( ulnar) , painful nerve deformity??

Back 615

Leprosy

Dx: biopsy from the edge of lesion

Front 616

Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ???

Back 616

EBV ( infectious mononucleosis

Dx: heterophile antibody( monospot) , Atypical lymphocytosis

Rx: avoid sports > 4 weeks ( risk splenic rupture)

Front 617

Child, rash , painful pustules, golden yellow crust ??

Back 617

Impetigo

Rx: localized( non-bullous) : mupirocin

generalized( bullous) : cephalexin , clindamycin

Front 618

Child, 2 weeks rhinorrhea then dry cough causing vomiting??

Back 618

Pertussis

Dx: PCR

Rx: macrolide

Front 619

Painless bump, VDRL and HIV is negative???

Back 619

Primary syphilis

Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology

Front 620

Early Lyme disease features

Back 620

Spirochete infection, endemic areas, Ixodes scapularis

Erythema migrans, systemic symptoms ( cardiac, neurologic...)

Dx: clinical ( erythema migrans) , B burgdorferi serology ( cardiac/ neurologic)

Rx: oral ( doxycycline), IV ( ceftriaxone)

Front 621

Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration???

Back 621

Pneumocystis pneumonia ( jirovecii)

Front 622

Patient immunocompromised, has TB symptoms, temporal abscess, grow in gram stain positive acid -fast rods ???

Back 622

Nocardia

Rx: TMP-SMX

Front 623

Headache, fever, nuchal rigidity which organism?

Back 623

Pneumococcal pneumonia ( strep pneumonia)

Front 624

19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion???

Back 624

Atypical pneumonia ( mycoplasma)

Rx: empiric azithromycin

Front 625

Menstruation, nasal packing, post surgery infection

High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??

Back 625

Toxic shock syndrome ( staph)

Front 626

Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms???

Back 626

Legionella pneumonia

Rx: macrolide or fluoroquinolones ( levofloxacin )

Front 627

Tetanus vaccine recommendation

Back 627

Patient with wound who haven’t received revaccination for 5 years ( give vaccine only )

Patient with dirty wound who have uncertain vaccine status ( give vaccine and Immune globulin)

Front 628

Prophylaxis of Lyme disease during traveling ?

Back 628

Tick repellent, protective clothing, tick checks

Front 629

Patient without specific symptoms, High fever, neutropenia??

Back 629

Febrile neutropenia

Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam )

Front 630

HIV, bright red firm exophytic nodules??

Back 630

Bacillary angiomatosis

Front 631

Most common cardiac effect of Lyme disease??

Back 631

AV block

Front 632

Post exposure prophylaxis of hepatitis A ?

Back 632

Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts

Front 633

Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ??

Back 633

Osteomyelitis

Dx: bone biopsy and culture of affected bone

Front 634

Varicella post exposure prophylaxis recommendation

Back 634

Yes Prior infection or 2 doses of vaccine: reassurance

No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised)

Front 635

Pneumonia with cystic fibrosis according to age organisms ?

Back 635

Infants and young children: staph aureus

Adults : pseudomonas aeruginosa

Front 636

Patient with penicillin allergy , has chancre ?

Back 636

Primary syphilis

Rx: doxycycline for 14 days ( because it’s allergic to penicillin)

Front 637

Indication of success in treatment of syphilis??

Back 637

4- fold decrease in antibodies titters( RPR) at 6-12 months

Front 638

Patient with Positive HBsAg and HBeAg management??

Back 638

HB vaccine and HB immune globulin

Front 639

Acute cervical adenitis in children

Back 639

Unilateral: staph, strep pyogenes

Bilateral: adenovirus, EBV/ CMV

Front 640

Child, Fever, unilateral red tender neck swelling ??

Back 640

Lymphadenitis ( staph, strep )

Front 641

Patient with symptoms of acute UTI infection, unrinary alkalosis ( PH> 8 ) , organism?

Back 641

Proteus mirabilis ( urease -productive )

Complication: ammonium magnesium calculi

Front 642

Foodborne disease chart page 710

Back 642

Back (Definition)

Front 643

Infectious mononucleosis RX

Back 643

Avoid sports ( splenic rupture)

Front 644

Disseminated gonococcal infection features

Back 644

Sexually active, Tenosynovitis , dermatitis ( pustular rash ) , polyarthralgias

Dx: NAAT

Rx: IV ceftriaxone

Front 645

Predisposing factor of the bacterial sinusitis??

Back 645

Viral upper respiratory infection

Front 646

Most common valvular defect in infective endocarditis??

Back 646

Mitral regurgitation

Front 647

Fever, acute joint pain, inability to walk , very high leukocytosis and elevated ESR ??

Back 647

Septic arthritis by staph( joint destruction)

Rx: empiric vancomycin, Emergency surgical drainage.

Front 648

Bacterial causes of diarrhea chart page 840

Back 648

Back (Definition)

Front 649

Bacterial cases of diarrhea

Back 649

Bacillus( rice), staph( vomiting, rapid onset), clostridium Difficile ( antibiotics use), clostridium perifringes ( unrefrigerated food) , salmonella ( poultry, eggs ), vibrio vulnificus ( shellfish, invasive ),E-coli( watery then bloody ), shigella ( contaminated water, bloody),

Campylobacter ( raw meat, bloody)

Front 650

Patient with E-coli bloody diarrhea should avoid??

Back 650

Empiric antibiotic ( hemolytic uremic syndrome)

Front 651

Most following opportunistic infection after renal transplant?

Back 651

CMV ( colitis, bloody diarrhea, ulcers on colonoscopy,atypical lymphocytes)

Dx: biopsy

Front 652

Erythema, swelling, pain out of proportion, crepitus??

Back 652

Necrotizing fasciitis ( group A strep , staph)

Front 653

Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ???

Back 653

Staph aureus foodborne illness

Front 654

landscaper Patient with skin papule that ulcerate with nonpurulent , odorless drainage, proximal lesions??

Back 654

Sporothrix dimorphic fungus ( sporotrichosis ) found in decaying vegetation

Dx: culture

Rx: itraconazole (3-6 months)

Front 655

Treatment with isoniazid effect on liver ??

Back 655

Mild LFTs elevation( self-limited)

Front 656

Mumps complication?

Back 656

Orchitis, deafness

Front 657

Mononucleosis-like syndrome, fever, night sweats, lymphadenopathy??

Back 657

Acute HIV , the patient should be tested for HIV

Dx: viral load( early stage) , HIV antibodies may be negative pneumocystis

Front 658

Pneumocystis pneumonia suggests?

Back 658

Selection loss of CD4

Front 659

Sickle cell disease patient with fever and severe pain in the left tibia ???

Back 659

Osteomyelitis caused by salmonella, staph

Front 660

Neonatal sepsis, hypothermia, lethargy, low WBCs ???

Back 660

Meningitis caused by Group B strep

Front 661

Old patient who had a surgery, intubated, fever and right lung infiltration?

Back 661

Ventilator-associated pneumonia ( > 48 hours after intubation)

Follow up: gram stain and culture of respiratory secretions and empiric abx

Front 662

Old, fever, malaise, focal lower back pain , recent UTI infection???

Back 662

Vertebral osteomyelitis

Dx: blood culture, ESR, CRP, MRI then CT-guided bone biopsy

Front 663

Fever, sore throat, malaise, difficult swallow, posterior or diffuse cervical lymphadenopathy??

Back 663

Infectious mononucleosis( EBV)

Complications: acute airway obstruction, anemia, splenic rupture.

Dx: heterophile antibody ( Monospot test )

Rx: corticosteroids

Front 664

Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ???

Back 664

Infectious mononucleosis ( Epstein- Barr virus)

Front 665

AIDS patient, CD4 500, should be given varicella vaccine??

Back 665

Yes

If the CD4 < 200 then no

Front 666

9-year girl, uncontrolled writhing of arms and hands , face grimacing, heart symptoms , previous sore throat and fever ??

Back 666

Acute rheumatic fever caused by ( strep A pyogenes )

Front 667

Acute rheumatic fever criteria

Back 667

Erythema marginatum , subcutaneous nodules, migratory arthritis, carditis , chorea

Front 668

Annual vaccine of 60 years old patient??

Back 668

Influenza ( inactivated)

Front 669

Respiratory symptoms, bilateral diffuse infiltration, had liver transplant 7 months ago ???

Back 669

PCP

Dx: induced sputum or bronchoalveoalar lavage

Front 670

17 , no symptoms, has non tender, mobile posterior cervical lymph nodes ( < 2 cm ) , management??pers

Back 670

Observation

Front 671

Persistent right upper quadrant pain, low grade fever, had bloody diarrhea,

Back 671

Abscess from entamoeba histolytica

Rx: metronidazole( abscess) and luminal agent ( eradicate intestinal colonization)

Don’t drain the abscess

Front 672

> 65 , fever, headache, sore throat, runny nose , severe body aches< one week ??

Back 672

Influenza virus

Front 673

Girl, fever, painful swelling papule on the anterior thigh, lymphadenopathy,the family has cat, dog, turtle??

Back 673

Cat scratch disease ( Bartonella henselae)

Front 674

Woman, fatigue, headache, vomiting, HIV positive, papilledema???

Back 674

Cryptococcal meningoencephalitis

Dx: CSF cryptococcal antigen

Rx: amphotericin then fluconazole

Front 675

Patient with osteomyelitis from plantar puncture wound???

Back 675

Pseudomonas aeruginosa

Front 676

HIV man, frequent bloody diarrhea, abdominal pain weight loss, CD4 28 ???

Back 676

Cytomegalovirus ( bloody), not Mycobacterium avium complex ( watery)

Dx: colonoscopy with biopsy

Complications:,retinitis

Front 677

Girl, low grade fever, rash the spread quickly ( cephalocaudal ), auricular and occipital , arthralgia lymphadenopathy??

Back 677

Rubella

Front 678

Infectious mononucleosis diagnosis??

Back 678

Atypical lymphocytes

Heterophile antibodies ( negative in early illness)

Front 679

Sickle cell disease with fever, hypotension, asplenia , hypotension, anemia??

Back 679

Strep pneumoniae ( encapsulated)

Follow up: penicillin prophylaxis

Front 680

AIDS, tuberculosis symptoms, CD4 <50 ??

Back 680

Mycobacterium avium complex

Rx: azithromycin

Front 681

Man, intense pruritic lesion on foot

Back 681

Cutaneous larva migrans

Epidemiology : hookworm dog ( ancylostoma) or cat( braziliense), barefoot with sand or soil

Rx: antihelmintic ( ivermectin)

Front 682

Mononucleosis symptoms in sexually multiple patient, rash all over the body( involves palms and soles) , grey mucus patches in the mouth???

Back 682

Secondary syphilis

Front 683

Healthy patient wants to be sure he doesn’t have STDs ??

Back 683

HIV screen p24 antigen and antibody testing

Front 684

HIV screening indications chart page 984

Back 684

Back (Definition)

Front 685

Tooth removal, slow-growing non tender mass ( mandibular) , sulfur granules ??

Back 685

Cervicofacial Actinomyces ( gram positive)

Rx: penicillin

Front 686

diabetic patient having osteomyelitis???

Back 686

Staph coagulase negative ( epidermidis) , B- hemolytic strep

Front 687

HIV, headache, fever, FND, altered mental status, CD4 < 100, MRI shows ring- enhancing lesions ??

Back 687

Toxoplasma encephalitis

Rx: sulfadiazine and pyrimethamine.

Prophylaxis: TMP-SMX

Front 688

HIV, acute onset watery diarrhea, CD4 unknown , management??

Back 688

Stool examination included ova and parasites

Front 689

Newborn, rhinorrhea, desquamating ( bullous) rash?

Back 689

Syphilis

Front 690

Newborn, peri ventricular calcification??

Back 690

Cytomegalovirus

Front 691

Newborn, diffuse intracerebral calcifications , choriorenitis ??

Back 691

Toxoplasmosis

Front 692

Newborn, cataracts, PDA ???

Back 692

Rubella

Front 693

HIV, fever, FND,

Back 693

Toxoplasmosis

Prophylaxis: TMP-SMX

Front 694

Man, tick bite, high fever, headache, altered mental status, leukopenia , thrombocytopenia, elevated aminotrasferas ??

Back 694

Ehrlichiosis

Rx: doxycycline

Front 695

Woman, high fever,had cellulitis, holosystolic murmur??

Back 695

Infective endocarditis ( IVDU)

Rx: vancomycin

Front 696

HIV, fever, FND,

Back 696

Toxoplasmosis

Prophylaxis: TMP-SMX

Front 697

Child, nocturnal perianal pruritus??

Back 697

Pinworm( enterobius vennicularis )

Dx: tape test ( eggs)

Rx : pyrantel pamoate, albendazole for all contacts

Front 698

HIV, FND, CT( white matter lesions with no enhancement/ edema ) , CD4 < 200 ??

Back 698

Progressive multifocal leukoencephalopathy caused by JC virus reactivation

Front 699

Tuberculin skin test < 15 in healthy patient management??

Back 699

No more interventions

Front 700

Seizure like epilepsy, ICH, Travel, MRI( hypodense, enhancement /edema cysts )??

Back 700

Neurocysticerosis ( pork tapeworm) eggs

Rx: albendazole

Front 701

Bite from neighbor’s dog management?

Back 701

Observe the dog for 10 days for rabies, no immediate prophylaxis foe the patient

Front 702

child, Fever, odynophagia , neck pain with extension, muffled voice, lateral neck x-ray ( widened prevertebral space ) ???

Back 702

Retropharyngeal abscess

Front 703

Epiglottis symptoms but the swelling is submandibular , crepitus??

Back 703

Ludwig angina ( cellulitis from infected molar

Front 704

Patient had transplant, pulmonary symptoms, GI symptoms, hepatitis ???

Back 704

CMV

Front 705

Young Patient got influenza treatment and improved then got worse, high fever, necrotizing pneumonia, productive cough with blood, cavity infiltration???

Back 705

Secondary bacterial pneumonia ( methicillin-resistant staph)

Front 706

HIV, CD4 <50, tuberculosis symptoms, purple pedunculated lesions on face and extremity, CT( hyposense liver lesions) ??

Back 706

Bartonella ( bacillary angiomatosis )

Dx: biopsy

Rx: doxycycline or erythromycin

Front 707

Anesthetic hypopigmented lesions with peripheral nerve involvement ( ulnar) , painful nerve deformity??

Back 707

Leprosy

Dx: biopsy from the edge of lesion

Front 708

Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ???

Back 708

EBV ( infectious mononucleosis

Dx: heterophile antibody( monospot) , Atypical lymphocytosis

Rx: avoid sports > 4 weeks ( risk splenic rupture)

Front 709

Child, rash , painful pustules, golden yellow crust ??

Back 709

Impetigo

Rx: localized( non-bullous) : mupirocin

generalized( bullous) : cephalexin , clindamycin

Front 710

Child, 2 weeks rhinorrhea then dry cough causing vomiting??

Back 710

Pertussis

Dx: PCR

Rx: macrolide

Front 711

Painless bump, VDRL and HIV is negative???

Back 711

Primary syphilis

Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology