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ID 2 USMLE
ID USMLE2
| Question | Answer |
|---|---|
| TB treatment | RIPE-rifampin, INH, pyrazinamide, ethambutol + B6 w INH to prevent peripheral neuritis |
| cut-offs for PPD + | 5mm if HIV, close TB contacts, CXR evidence of TB; 10 indigent/homeless, IV drug, chronic illness, health care workers, inmates, residents of developing nations; 15 everyone else |
| complications assoc w TB meds | rifampin=body fluids orange; ethambutol=optic neuritis, red-green color blind; INH=peripheral neuritis and hepatitis |
| how active TB diagnosed | sputum acid fast stain (take 3 a.m. samples) |
| what is prophylactic TB therapy | INHx9mo (for PPD conversion w/o active symptoms, CXR suggests old TB) |
| what vaccine makes PPD+ | BCG vaccine |
| standard treatment for malaria | oral chloroquine--but increasing resistance, so now also add primaquine |
| how difft Strep and Staph | Strep catalase - chains, Staph catalase + clusters |
| how difft subtypes of Staph | all catalase +, coag +, b hemo = S Aureus; coag - novobiocin sensitive= S epidermis; coag - novobiocin resistant= S sapro |
| how difft subtypes of Strep | all catalase -, then subdivide by hemolysis: alpha=pneu, viridian; beta=GrpA (pyo), GrpB (aglact); gamma=Enterococc |
| what do alpha, beta, gamma hemolysis for strep mean in culture? | alpha=green partial hemolysis; beta=clear, complete hemo; gamma=no hemo |
| + Quellung test indicates what | S pneu (its capsule) |
| name some gram + rods | Clostridium (anaerobe, spore), Listeria (milk, meningitis in baby), bacillus (aerobe, spore) |
| beta hemo, Grp A Strep is which organism | S Pyo |
| how difft alpha hemo Streps? | optochin sensitive, bile soluble=S Pneu; optochin resistant, bile insoluble=viridians (no capsule) |
| name some gram - cocci/coccoid rdos | cocci=Neisseria, coccoid=H flu, Pasteurella, Brucella, Bordetella |
| gram - non cocci/non rods | spirochetes=H pylori, borrelia; comma=vibrio, Camp Jej; safety pin=yersinia; branch=Nocardia |
| gram - rods aerobic | Pseudo, Legionella, Bordetella, Brucella |
| gram - rods facult anaerobic | Enterobac, Pasteurella, H Flu, Vibrio |
| subdivide gram neg rods based on lactose ferment | lactose ferment [LEEK]=Klebsiella, E coli, Enterobac; non fermenter [SSPP]= Shigella, Salmonella, Proteus (oxidase -); Pseudo (oxidase +) |
| subdivide gram neg rod non lactose ferment | Shigella, Salmonella, Proteus (oxidase -); Pseudo (oxidase +) |
| obligate anaerobe bac | Clostridium, Actinomyces, Bacteroides |
| clinical presentation PCP | severe hypoxia with normal CXR or diffuse, bilateral interstitial infiltrates and dry cough **esp suspect in HIV w PNA |
| classic triad of Strep pharyngitis? Centor criteria (4)? | fever, exudative pharyngitis, cervical lymphadenopathy (w/o cough)--the Centor criteria includes 4: errhythematous and exudative pharyngitis, cervical lymphadenopathy, w/o cough |
| characteristics of rheum F | No rheum for SPECC: subQ nodules, polyarthritis, eythema marginatum, chorea, carditis |
| Strep B causes | PNA, meningitis, sepsis mainly in babies |
| lab test indicates recent Strep pyo infx | ASO titer |
| symptoms not indicating Strep pyo pharyngitis | cough, hoarseness, GI, conjunctivitis |
| characteristics of scarlet F | sandpaper-like rash on trunk, strawberry tongue; rash desquamates after few days |
| difft bw Janeway lesions and Osler nodes | Osler's painful and raised on finger pads, Janeway errhyth and on palm or sole--both endocarditis |
| adenovirus causes | pharyngitis, PNA, pink eye |
| besides adenovirus, what other organisms cause pharyngitis-like illnesses | Hflu=epiglottitis, parainflu=croup, C Diphth=pseudo mem pharyngitis, Strep pyo=pharyngitis and rheum F |
| parvo causes | slapped cheek (erythema infectosium), hydrops fetalis, plastic crisis in sickle cell |
| papilloma causes | HPV warts CIN, cervical cancer |
| poxvirus causes | small pox, molluscum (think HIV) |
| list various Herpes virus | HSV1,2, varicella, EBV, CMV, HHV6,8 |
| HSV1,2 cause | HSV1-oral, HSV2 genital |
| varicella causes | chicken pox, zoster, shingles |
| EBV causes | mono, Burkitt lymph |
| CMV causes | various dz in immunosuppresses |
| congenital CMV causes | petechial rash, periventricular Ca++, (MC congenital infxn) |
| HHV6 causes | roseola-very hi fever, stops and then rash |
| HHV8 causes | Kaposi's sarcoma in HIV |
| Tzanck smear is used to ID | HSV and VZV |
| tx CMV | ganciclovir |
| tx HSV | acyclovir (also for EBV tx) |
| name DNA viruses | adeno, parvo, papillo, pox, various Herpes |
| dog/cat bite assoc with infxn? | Pasteurella |
| cat assoc with infxn? | Toxo |
| cat scratch assoc with infxn | bartonella henslea |
| thorn assoc w infxn | sporothrix schenke |
| sheep assoc w infxn | anthrax |
| crypto assoc w environ causes | soil, pigeon droppings |
| Histo assoc w | bird/bat, Missi/Ohio, caves |
| Cocci assoc w | SW US/CA |
| Paracocci assoc w | S America |
| systemic mycoses (4) | Histo, Blasto, Cocci, Paracocci |
| tx for systemic mycoses | local infxn: flucanozole, ketoconazole; systemic: amphotericin B |
| opport infxns | candida, PCP, systemic mycoses, aspergill, crypto |
| describe mycoplasm PNA | walking PNA chest xray looks much worse than pt, incrsd cold agglutin (IgM) **don't give PCN bc no cell wall |
| pericarditis caused by | coxsackie A, B, TB |
| myocarditis caused by | coxsackie B, Lyme, Chagas, SLE |
| subacute endocarditis caused by | strep viridans |
| acute bac endocarditis caused by | Staph aureus |
| findings RMSF | rash starting on palms, decrsd plts, proteinuria, hematuria |
| list Rickettsi type dz | typhus, prowazeki, Ehrlichia, Q fever (Coxiella burnetti) |
| what organism for Q fever | coxielli burnetti |
| why Q fever unique | no rash, no fever, negative Weill Felix, not Rickettsi genus |
| what's Weill Felix rxn | Ab cross reacts with Proteus (which is an UTI bug in hospitals); all the Rickettsia bugs except Q fever are positive for this |
| which Rickettsi is fleas? Lice? | fleas=R typhi (endemic), lice=prowazeki (epidemic) |
| dzs passed by tick | Lyme (Borrelia burgdorfei), Ehrlichia, tularemia, plague (yersinia pestis), epidemic typhus (Ricket. Prowazeki) |
| what organism for Lyme dz | Borrelia burgdorfei |
| describe typhus rash | begins on trunk and spreads out (v RMSF) |
| what's 5th dz? Name, Symptoms and organism | erythema infectiosum (slapped-cheek--starts on cheek and proceeds to trunk and extremities) ((caused by parvovirus B19)) |
| scarlet fever | sandpaper-like rash on trunk, strawberry tongue; rash desquamates after few days |
| dzs can cause rash on palms, soles | RMSF, syphillis, coxsackie A (hand, foot, mouth dz), erythema multiforme |
| what are the dermatophytes? | microsporum, trichophyton, epidemiophyton |
| what dzs do dermatophytes cause? | tineas pedis and cruris (athlete's foot and jock's itch), tinea corporis, tinea capitis (ringworm, scalp caling) |
| how identify dermatophytes? | KOH preparation |
| what organism causes tinea versicolor? | pityrosporum orbiculare (yeast) |
| signs/symptoms rubeola | 3c's: cough, coryza, conjunctivitis, Koplik spots, rash head to toe spread |
| what are the paramyxo viruses? | (PRM) parainfluenza, rubeola (measles), RSV |
| what virus family are german measles under? | togavirus |
| signs/symptoms rubella | generally same as rubeola except more mild, also suboccip and postauricul nodes tneder, rash more faint head to toe and encephalitis also a potl complication |
| what are complications of rubeola | encephalitis and giant cell PNA |
| what's the tx for RSV | ribavirin |
| India ink prep on CSF from HIV pt would mean | Crypto |
| what Rx given at what CD4 count for HIV/AIDs | <500: HAART, <200: PCP Rx (bactrim, same Rx as for Toxo which at risk <100), <100: Mycobac (clarithromycin, erythromycin) |
| what Rx for PCP? If allergies? | trimethoprim-sulfamethoxazole (Bactrim); if allergy: dapsone and pentamidine |
| when is a person diagnosed w AIDs | if CD4<200, if opportunistic infxn |
| Ring enhancing cerebral lesions in HIV pt | usu Toxo, or primary brain lymphoma |
| yrly what should HIV pts get? Overall what vaccines? | PPD, Flu vaccine (+ other vaccines Pneu, Hep, inactive polio vaccine, MMR **only live vaccine they should get) |
| HIV pts at risk for what blood cancer | non hodgkins lymphoma |
| pregnant women w HIV | they and their babies should take AZT (zidovudine), mom's can't breast feed, positive HIV test on infant <6mo is unreliable (could be mom's Abs) |
| how detect PCP path | Silver (Wright-Giemsa or Giemsa) |
| retinitis in HIV due to? Treatment? | CMV, treatment ganciclovir/valganciclovir (back up is foscarnet) |
| at what CD4 count is pt at risk for Toxo? Myco? PCP? | Toxo <100, PCP<200, Myco <100 |
Created by:
ehstephns
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