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ID - Awesome
Random ID questions
| Question | Answer |
|---|---|
| If bacterial meningitis pt is PCN resistant, what should you use ? | Rifampin |
| R sided endocarditis with septic emboli | Daptomycin |
| Ixodes scapularis | tick that causes ehrlichiosis, Lyme (borrelia Burgdorferi), and babesia |
| how to treat HSV encephalitis | IV acyclovir |
| how to treat extensively drug-resistant Pseudomonas aeruginosa infection | IV colistin |
| burns and skin grafts - what organism? | pseudomonas |
| side effect of polymixin E (collision) | high rates of nephrotoxicity |
| nonspecific prodromal flu-like syndrome and widening of the mediastinum | inhalation anthrax |
| dormant in soil, can be inhaled to cause infection | anthrax |
| why widened mediastinum in anthrax? | migration of inhaled spores to the mediastinal lymph nodes leads to tissue destruction and hemorrhage, resulting in the classic widening of the mediastinum and occasional bloody pleural effusions |
| how to dx anthrax? | PCR or blood cx |
| cutaneous infection from occupational exposure to contaminated meat or fish | Erysipelothrix rhusiopathiae |
| immunocompromised, baby or old person, unpasteurized milk products. what are the patient's symptoms? | Listeria monocytogenes. diarrhea or meningitis |
| bilateral T2 FLAIR hyper intensities on MRI involving the pulvinar thalamic nuclei (in thalamus) | Creutzfeldt-Jakob disease |
| rapidly progressive dementia and myoclonus, bland cerebrospinal fluid findings, and nondiagnostic neuroimaging studies | Creutzfeldt-Jakob disease |
| how to dx Creutzfeldt-Jakob disease | spongiform changes on pathologic examination of brain tissue |
| woman in community no comorbidities with viral syndrome that seems to be improving and then suddenly worsens with blood tinged sputum and cavitary infiltrate on CXR. What do you have to cover for and what abx ? | Community-associated methicillin-resistant Staphylococcus aureus pneumonia can occur following an influenza-like illness and requires initial empiric antibiotics with (ceftriaxone or cefotaxime) and (azithromycin or doxycycline) plus vancomycin |
| classic triad of symmetric, descending flaccid paralysis with prominent bulbar palsies (diplopia, dysarthria, dysphonia, and dysphagia) | botulinum |
| bulbar signs - 4 d's | Bulbar signs include the “4 Ds”: Diplopia, Dysarthria, Dysphonia, and Dysphagia |
| how to dx botulinum | detection of toxin in serum, stool, gastric aspirate, or suspect foods |
| how to tx botulinum | Treatment is mainly supportive and consists of passive immunization using trivalent equine antitoxin (A, B, and E) |
| gastroenteritis from Campylobacter infection, ascending paralysis, and paresthesias, oculomotor dysfunction | Guillain-Barré syndrome |
| ascending paralysis | GBS, Dermacentor ticks from the Pacific Northwest, tetrodotoxin toxin from puffer fish |
| ascending paralysis, predominantly affecting proximal large muscles who vacationed in Oregon | Dermacentor ticks |
| how to tx inhalation anthrax | IV cipro or doxy tx for 60 days, protect defense personnel with vaccines |
| post inhalation exposure to anthrax PPX | cipro or doxy |
| what bug associated with Bell's palsy? How to treat? | HSV1, tx with prednisone |
| how to treat immunocompromised patients with invasive pulmonary aspergillosis | voriconazole |
| “halo sign,” which is an area of low attenuation surrounding a nodule, reflecting hemorrhage into the tissue | invasive pulmonary aspergillosis |
| galactomannan antigen immunoassay | diagnosing invasive aspergillosis - It has good sensitivity in detecting invasive aspergillosis in patients with hematologic malignancy |
| where do you see polyoma BK virus | Polyoma BK virus is an increasingly recognized cause of graft nephropathy. Although infection is asymptomatic in most persons, it often causes clinical disease in immunosuppressed patients. |
| how to treat polymer BK virus? | Ifirst, decreased immunosuppression -->fluoroquinolones, leflunomide, and cidofovir (off-label use). Most common antiviral agents, including ganciclovir and acyclovir, appear to have little activity against this virus. |
| before starting treatment for osteomyelitis, what should you do? | bone biopsy first (superficial wound cultures not reliably the same organism) |
| what do you use a technetium-99m-labeled bone scan for? When would it be unreliable? | Use it to detect osteomyelitis, but would be unreliable if s/p recent ortho surgery |
| treat febrile neutropenia with what empiric treatment | pip-tazo |
| initiation of antiretroviral therapy for patients with HIV when? | AIDS-defining opportunistic infection or malignancy, have symptoms, a CD4< 500, active CVD, HIV-associated nephropathy, active co-infection with hepatitis B or C, and pregnancy (to prevent perinatal transmission) |
| treatment, suppression, and prevention of cytomegalovirus infections - what drug? | valganciclovir |
| side effect of valganciclovir | myelosuppression |
| treatment of acyclovir-resistant herpesvirus infection | Cidofovir and foscarnet |
Created by:
christinapham
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