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Infectious Disease
Internal Medicine
| Question | Answer |
|---|---|
| Most common cause of pneumonia: 1. adults age 18-40 2. adults age 40-65 | 1. mycoplasma 2. S pneumoniae |
| Treatment for otherwise young healthy patient with suspected community-acquired pneumonia. | macrolide (azythromycin) or doxycycline |
| Treatment for patient with suspected community-acquired pneumonia age > 65. | fluoroquinolone + azithromycin |
| What are the centor criteria for identifying streptococcal pharyngitis? | 1. fever 2. tonsillar exudate 3. tendor cervical lymphadenopathy 4. absence of cough |
| Patient with poorly controlled diabetes presenting with chronic sinusitis | mucormycosis |
| Patient with abrupt onset of fever, myalgias, cough. Treatment? | 1. Influenza 2. antivirals early in course (oseltamivir, zanamivir), analgesics and cough medicine |
| Common cause of postviral pneumonia. | S. aureus |
| 1. Oral medication for MRSA 2. IV medication for MRSA | 1. Linezolid 2. Vancomycin |
| Most common cause of meningitis for patients out of the neonatal period. | Streptococcus pneumoniae |
| Signs of meningitis with a petechial rash. | Nisseria |
| Best initial test for meningitis? | lumbar puncture |
| When do you need to get a CT before performing a lumbar puncture? | 1. papilledema 2. focal motor deficits 3. new onset seizures 4. mental status abnormalities |
| Empirical therapy for meningitis. What drug is added to cover Listeria in infants? | vancomycin + ceftriaxone + dexamethasone 1. vanc to cover resistance Strep pneumo 2. ceftriaxone for Neisseria 3. Ampicillin for Listeria |
| 1. Patient with fever, headache and altered mental status. 2. Most common cause 3. Treatment | 1. Encephalitis 2. HSV 3. acyclovir |
| 1. Best initial test for Cryptococcus neoformans 2. Treatment for Cryptococcus neoformans meningitis | 1. India ink 2. Amphotericin B initially followed by fluconazole |
| HIV patient with ring-enhancing lesion. 1. What are the two possible diagnoses? 2. What is the management. | 1. toxoplasmosis or lymphoma 2. treat with 10-14 days of pyrimethamine and sulfadiazine to see if patient responds |
| 1. Ear pain fever and decreased hearing 2. Most common organisms 3. Treatment | 1. otitis media 2. Strep pneumo, H. influenza, Moraxella 3. PO Amoxicillin |
| 1. Patient with facial pain, headache, postnasal drainage. 2. Most likely etiology 3. Treatment | 1. Sinusitus 2. usually viral 3. symptomatic with decongestants (i.e. pseudoephedrine oroxymetazoline); consider amoxicillin if not resolved in 7-10 days |
| 1. Diagnosis for suspected pharyngitis 2. Treatment. | 1. Rapid Streptococcal antigen 2. Penicillin V shortens symptom duration and decreases risk of rheumatic heart disease and glomerulonephritis |
| Cough with sputum production. No lung consolidation. | Bronchitis |
| Treatment for acute exacerbations of chronic bronchitis. | amoxicillin, doxycycline or TMP/SMX |
| Best intitial therapy for lung abscess. | Clindamycin |
| What score is used to predict need for hospitalization for pneumonia. | CURB-65 (1 pt each, 3-5 pts requires hospitalization) 1. confusion 2. uremia 3. respiratory distress 4. bp low 5. age >65 |
| Hospital-acquired pneumonia 1. Organisms 2. Treatment | 1. pseudomonas, Klebsiella, E.coli, MRSA 2. 3rd gen cephalosporins (ceftazidime) or carbapenems or piperacillin/tazobactam |
| Treatment for Pneumocystic jiroveci pneumonia. | TMP/SMX |
| Best initial test when suspecting tuberculosis from the H & P. | Chest X-ray |
| When apical lesion is found on CXR in suspected TB patient, what is the next step in management? | 1. sputum cluture and stain for acid-fast bacilli 3. if stain is positive, begin treatment and await culture for sensitivity |
| What is the 4 drug therapy for TB. how long are the drugs continued for? | 1. isoniazid, rifampin, pyrazinamide, ethambutol for 2 months 2. isoniazid and rifampin for another 4 months |
| During routine screen, patient has a positive PPD. What should be done? | 1. recheck PPD in 2 week 2. |
| Most important feature of any person presenting with possible food poisoning. | presence or absence of blood in the stool |
| 1. Most common cause of diarrhea in children 2. Gastroenteritis from raw shellfish associated with liver and skin lesions. | 1. Rotavirus 2. Vibrio vulnificus |
| Treatment for severe GI infections producing high fever, abdominal pain and hypotension. | 1. IV fluids 2. ciprofloxacin |
| What test can be used to: 1. Diagnose acute hepatitis C 2. Follow hepatitis C activity long-term | 1. IgM antibody 2. PCR-RNA viral load level |
| Test used to diagnose acute hepatitis B | hepatitis B surface antigen |
| Treatment for: 1. chronic hepatitis B 2. chronic hepatitis C | 1. interferon 2. interferon + ribavirin |
| Treatment for urethritis | cover neisseria and chlamydia with 1. ceftriaxone 2. azithromycin |
| 1st test to do in patient with painful ulcer on genitals. | darkfield looking for syphilis |
| 1. Patient with painful genital ulcer 2. treatment | 1. Chancroid from Haemophilus ducreyi 2. Azithromycin |
| 1. Unilaterally enlarged inguinal lymph nodes 2. Treatment | 1. Lymphogranuloma venereum 2. doxycycline |
| Painless, red, genital nodule that develops into a elevated mass. | Granuloma inguinale |
| 1. First tests diagnose a patient with secondary syphilis (rash covering hands and soles) 2. Confirmatory test | 1. VDRL and RPR 2. FTA-ABS |
| 1. Management of patient with multiple vesicles on the genitals 2. Management if vesicles have ulcerated and are unsure of diagnosis | 1. genital herpes, treat with acyclovir 2. Tzanck test |
| Treatment for: 1. uncomplicated cystitis 2. complicated cystitis 3. pyelonephritis 4. cystitis in pregnancy | 1. 3 days of TMP/SMX, nitrofurantoin, or any quinolone 2. 7 days of treatment of above 3. 10-14 days of fluroquinolone or ceftriaxone 4. 10-14 days of nitrofurantoin |
| What makes a UTI complicated | 1. stones 2. strictures 3. tumor 4. obstruction |
| 1. Patient with 2 weeks of persistent flank pain, fever pyuria with a negative urine culture. 2. Management | 1. perinephric abscess 2. ultrasound initially, need drainage and antibiotics for gram neg (zosyn, ceftriaxone) |
| 1. Can you get glomerulonephritis from Strep infections of the skin? 2. Can you get rheumatic fever from Strep infections of the skin? | 1. Yes 2. No |
| 1. First test in suspected osteomyelitis 2. confirmatory test | 1. X ray looking for periosteal 2. biopsy |
| What are the 3 types of osteomyelitis | 1. acute hematogenous 2. secondary to contiguous infection 3. vascular insufficiency (diabetes, PVD) |
| Most common cause of septic arthritis. | Neisseria gonorrhoeae |
| Treatment for gas gangrene. | surgical debridement |
| Most likely organism to cause endocarditis: 1. Native heart valve 2. Narcotic addicts 3. Prosthetic valve | 1. Streptococcus viridans 2. Staphylococcus aureus 3. Staphylococcus epidermidis |
| What are the 2 ways to diagnose endocarditis? | 1. positive blood cultures + abnormal echocardiogram 2. fever + risk + embolic phenomena if blood cultures are negative |
| Standard empirical treatment for endocarditis. | vancomycin + gentamicin |
| Treatment for Lyme disease with: 1. rash 2. heart block 3. joint pain 4. meningitis | 1. doxycycline 2. ceftriaxone 3. doxycycline 4. ceftriaxone |
| What 3 microorganisms need to be prophylaxed against in AIDs patients? What are the antibiotics and CD4 counts involved? | 1. Pneumocystis, TMP/SMX at <200/uL 2. Toxoplasmosis, TMP/SMX at <100/uL 3. MAC, Azithromycin at <50/uL |
| HIV drug causing: 1. kidney stones 2. hyperglycemia | 1. indinavir 2. protease inhibitors (-avir) |
Created by:
amichael@siumed.edu
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