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Infectious Disease

Internal Medicine

QuestionAnswer
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)