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711 Cards in this Set
- Front
- Back
- 3rd side (hint)
HIV, fever, FND, |
Toxoplasmosis Prophylaxis: TMP-SMX |
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Cytomegalovirus prophylaxis |
Ganciclovir dia |
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Diabetic foot infection comes from ?? |
Osteomyelitis due to contiguous spread from Polymicrobial wounds |
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Herpangia ( 5 years , fever, oropharyngeal vesicles and uclers on the posterior soft palate, tonsils, uvula) caused by |
Coxsackie virus |
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Echinococcus granulosus features |
Dog tapeworm, hydatid cyst( liver , lung ..) , Dx: imagining shows cyst inside cyst. IgG E serology Rx: Albendazole |
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Pertussis treatment and post exposure prophylaxis |
< 1 month : azithromycin (5 days) > 1 month: azithromycin or clarithromycin or erythromycin |
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Pertussis prophylaxis |
Macrolides for all close contacts |
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Patient with infective endocarditis with infection of streptococcus gallolyticus ( S bovis biotype 1 ) should undergo?? |
Colonoscopy to look for neoplasms |
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Echinococcus granulosus features |
Dog tapeworm, hydatid cyst( liver , lung ..) , Dx: imagining shows cyst inside cyst. IgG E serology Rx: Albendazole |
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Congenital CMV features |
Mother exposure to saliva Microcephaly , periventricular calcification, hepatosplenomegaly, ..... Dx: PCR Rx: valganciclovir |
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Acute bacterial rhinosinusitis |
> 10 days of persistent nasal discharge and cough, fever Nontpeable H. Influenza, strep pneumoniae , Moraxella Rx: amoxicillin +/- clavulanate |
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Acute bacterial parotitis complication organism and prophylaxis in post operative patient? |
Staph aureus Fluid hydration and oral hygiene |
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Rubella virus in maternity features |
During the first semester Sensorineural hearing loss, cardiac defects, cataracts |
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Congenital varicella syndrome |
Limb hypoplasia , cataracts, skin lesions |
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Skin lesions in AIDS patient is ?? |
Kaposi sarcoma ( herpesvirus 8) |
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Front (Term) |
Condyloma acuminata ( warts ) due to papillomavirus |
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Front (Term) |
Leukocytoclastic vasculitis |
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Front (Term) |
Malignant melanoma |
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Front (Term) |
Neurofibromatosis type 1 |
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Pertussis treatment and post exposure prophylaxis |
< 1 month : azithromycin (5 days) > 1 month: azithromycin or clarithromycin or erythromycin |
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Pertussis prophylaxis |
Macrolides for all close contacts |
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Patient with infective endocarditis with infection of streptococcus gallolyticus ( S bovis biotype 1 ) should undergo?? |
Colonoscopy to look for neoplasms |
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Fatigue, arthralgia , porphyria cutanea tarda( vesicles on the back hand and forearm) ?? |
Chronic hepatitis C virus |
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Skin lesions in AIDS patient is ?? |
Kaposi sarcoma ( herpesvirus 8) |
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Front (Term) |
Condyloma acuminata ( warts ) due to papillomavirus |
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Front (Term) |
Leukocytoclastic vasculitis |
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Front (Term) |
Malignant melanoma |
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Front (Term) |
Neurofibromatosis type 1 |
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Infective endocarditis organism in AIDS patient who do intravenous drug users ?? |
Staph aureus ( tricuspid more common) On CT : nodal infiltrate with cavitation |
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Chancroid (painful penile ulcer ) cause ? |
Haemophilus ducreyi infection |
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Infective endocarditis with Eikenella corrodens etiology ?? |
Poor dentition ( periodontal infection ) |
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PCP in HIV patient, CD4< 200 with ( PaO2 < 70 mm Hg or A-a gradient > 35 mm Hg ) RX |
TMP-SMX with corticosteroids |
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Hepatitis C virus Dx steps |
2- step process: positive serologic antibodies and confirmatory molecular test for Hep C virus RNA. |
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HIV Male patient, having sex with males, has recommended vaccinations including the Hep B vaccine should take which vaccine ? |
Hepatitis A vaccine |
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Patient in the ICU or having central venous catheter, blood culture shows budding yeast ??? |
Candidemia from Central venous catheter It isn’t considered contaminant |
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Orbital cellulitis features |
Pain with extraocular movement, visual changes , ophthalmoplegia It’s severe infection |
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Unvaccinated child with high fever, diffuse rash following cough, coryza ??? |
Measles treated with supportive and Vit A |
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Atypical community acquired pneumonia, confusion, GI symptoms, hyponatremia , mild hepatitis??? |
Legionnaires’ disease Dx : urine antigen testing Rx: macrolide or fluoroquinolone |
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Community acquired pneumonia with, arthralgia , valley fever , erythema nodosum, symptoms last for weeks??? |
Coccidioides fungus ( no treatment is required unless immunosuppression give conazole) |
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Front (Term) |
Miliary tuberculosis |
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Patient with pyelonephitis who doesn’t improve within 72 hours of antibiotics use should undergo? |
CT scan of the abdomen and pelvis, if pregnant do ultrasound not CT |
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Cryptococcal meningitis features |
In aids patients, very high opening pressure of CSF, Rx: amphotericin B, serial LP , after 2 weeks start antiretroviral |
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Lyme disease management |
Localized ( erythema migrans rash ) treated with doxycycline( > 8 years , not pregnant) . Early and late disseminated treated with ceftriaxone |
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Blastomycosis features |
Great lakes, rivers Skin and bone lesion( lytic lesions) , pulmonary manifestation ( like TB). Dx: broad - based yeast grown from sputum Rx: itraconazole, amphotericin |
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malaise headache, non tender rash , tick bite , Dx, Rx in < 8 years boy |
Erythema migrans ( early localized lyme ) Rx : amoxicillin in children < 8 or pregnant women |
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Fever, cough, foul smelling sputum , after upper or GI procedure ??? |
Anaerobic lung infection ( aspiration pneumonia) Rx: amoxicillin-clavulanate , clindamycin |
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Patient diagnosed with sarcoidosis who deteriorates after corticosteroids therapy ??? |
Histoplasmosis |
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Infective endocarditis with strep Rx |
IV penicillin G, or IV ceftiaxone for 4 weeks |
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Infant with Unimmunized mothers, umbilical stump infection, , spasms, hypertonia inability to nurse( trismus ) ??? |
Neonatal tetanus Rx: Abx and tetanus immune globulin |
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Infective endocarditis organism in AIDS patient who do intravenous drug users ?? |
Staph aureus ( tricuspid more common) On CT : nodal infiltrate with cavitation |
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|
Chancroid (painful penile ulcer ) cause ? |
Haemophilus ducreyi infection |
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|
Infective endocarditis with Eikenella corrodens etiology ?? |
Poor dentition ( periodontal infection ) |
|
|
PCP in HIV patient, CD4< 200 with ( PaO2 < 70 mm Hg or A-a gradient > 35 mm Hg ) RX |
TMP-SMX with corticosteroids |
|
|
Hepatitis C virus Dx steps |
2- step process: positive serologic antibodies and confirmatory molecular test for Hep C virus RNA. |
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|
HIV Male patient, having sex with males, has recommended vaccinations including the Hep B vaccine should take which vaccine ? |
Hepatitis A vaccine |
|
|
Patient in the ICU or having central venous catheter, blood culture shows budding yeast ??? |
Candidemia from Central venous catheter It isn’t considered contaminant |
|
|
Orbital cellulitis features |
Pain with extraocular movement, visual changes , ophthalmoplegia It’s severe infection |
|
|
Unvaccinated child with high fever, diffuse rash following cough, coryza ??? |
Measles treated with supportive and Vit A |
|
|
Atypical community acquired pneumonia, confusion, GI symptoms, hyponatremia , mild hepatitis??? |
Legionnaires’ disease Dx : urine antigen testing Rx: macrolide or fluoroquinolone |
|
|
Community acquired pneumonia with, arthralgia , valley fever , erythema nodosum, symptoms last for weeks??? |
Coccidioides fungus ( no treatment is required unless immunosuppression give conazole) |
|
|
Front (Term) |
Miliary tuberculosis |
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|
Patient with pyelonephitis who doesn’t improve within 72 hours of antibiotics use should undergo? |
CT scan of the abdomen and pelvis, if pregnant do ultrasound not CT |
|
|
Cryptococcal meningitis features |
In aids patients, very high opening pressure of CSF, Rx: amphotericin B, serial LP , after 2 weeks start antiretroviral |
|
|
Lyme disease management |
Localized ( erythema migrans rash ) treated with doxycycline( > 8 years , not pregnant) . Early and late disseminated treated with ceftriaxone |
|
|
Blastomycosis features |
Great lakes, rivers Skin and bone lesion( lytic lesions) , pulmonary manifestation ( like TB). Dx: broad - based yeast grown from sputum Rx: itraconazole, amphotericin |
|
|
malaise headache, non tender rash , tick bite , Dx, Rx in < 8 years boy |
Erythema migrans ( early localized lyme ) Rx : amoxicillin in children < 8 or pregnant women |
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|
Fever, cough, foul smelling sputum , after upper or GI procedure ??? |
Anaerobic lung infection ( aspiration pneumonia) Rx: amoxicillin-clavulanate , clindamycin |
|
|
Patient diagnosed with sarcoidosis who deteriorates after corticosteroids therapy ??? |
Histoplasmosis |
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|
Infective endocarditis with strep Rx |
IV penicillin G, or IV ceftiaxone for 4 weeks |
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Infant with Unimmunized mothers, umbilical stump infection, , spasms, hypertonia inability to nurse( trismus ) ??? |
Neonatal tetanus Rx: Abx and tetanus immune globulin |
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|
Infective endocarditis organism in AIDS patient who do intravenous drug users ?? |
Staph aureus ( tricuspid more common) On CT : nodal infiltrate with cavitation |
|
|
Front (Term) |
Miliary tuberculosis |
|
|
Infective endocarditis with Eikenella corrodens etiology ?? |
Poor dentition ( periodontal infection ) |
|
|
PCP in HIV patient, CD4< 200 with ( PaO2 < 70 mm Hg or A-a gradient > 35 mm Hg ) RX |
TMP-SMX with corticosteroids |
|
|
Hepatitis C virus Dx steps |
2- step process: positive serologic antibodies and confirmatory molecular test for Hep C virus RNA. |
|
|
malaise headache, non tender rash , tick bite , Dx, Rx in < 8 years boy |
Erythema migrans ( early localized lyme ) Rx : amoxicillin in children < 8 or pregnant women |
|
|
Patient in the ICU or having central venous catheter, blood culture shows budding yeast ??? |
Candidemia from Central venous catheter It isn’t considered contaminant |
|
|
Orbital cellulitis features |
Pain with extraocular movement, visual changes , ophthalmoplegia It’s severe infection |
|
|
Unvaccinated child with high fever, diffuse rash following cough, coryza ??? |
Measles treated with supportive and Vit A |
|
|
Atypical community acquired pneumonia, confusion, GI symptoms, hyponatremia , mild hepatitis??? |
Legionnaires’ disease Dx : urine antigen testing Rx: macrolide or fluoroquinolone |
|
|
Community acquired pneumonia with, arthralgia , valley fever , erythema nodosum, symptoms last for weeks??? |
Coccidioides fungus ( no treatment is required unless immunosuppression give conazole) |
|
|
Front (Term) |
Miliary tuberculosis |
|
|
Patient with pyelonephitis who doesn’t improve within 72 hours of antibiotics use should undergo? |
CT scan of the abdomen and pelvis, if pregnant do ultrasound not CT |
|
|
Cryptococcal meningitis features |
In aids patients, very high opening pressure of CSF, Rx: amphotericin B, serial LP , after 2 weeks start antiretroviral |
|
|
Lyme disease management |
Localized ( erythema migrans rash ) treated with doxycycline( > 8 years , not pregnant) . Early and late disseminated treated with ceftriaxone |
|
|
Blastomycosis features |
Great lakes, rivers Skin and bone lesion( lytic lesions) , pulmonary manifestation ( like TB). Dx: broad - based yeast grown from sputum Rx: itraconazole, amphotericin |
|
|
malaise headache, non tender rash , tick bite , Dx, Rx in < 8 years boy |
Erythema migrans ( early localized lyme ) Rx : amoxicillin in children < 8 or pregnant women |
|
|
Fever, cough, foul smelling sputum , after upper or GI procedure ??? |
Anaerobic lung infection ( aspiration pneumonia) Rx: amoxicillin-clavulanate , clindamycin |
|
|
Patient diagnosed with sarcoidosis who deteriorates after corticosteroids therapy ??? |
Histoplasmosis |
|
|
Infective endocarditis with strep Rx |
IV penicillin G, or IV ceftiaxone for 4 weeks |
|
|
Infant with Unimmunized mothers, umbilical stump infection, , spasms, hypertonia inability to nurse( trismus ) ??? |
Neonatal tetanus Rx: Abx and tetanus immune globulin |
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|
Child , Severe cough, posttussive emesis, facial petechiae ..? |
Bordetella pertussis Rx: macrolide |
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18 months patient, Fever lethargy, Brudzinski sign, petechial rash ??? |
Meningococcal meningitis ( fatal) |
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Meningitis in children according to age ?? |
< 1 month: group B strep, E-coli, Listeria, HSV. > 1 month: strep pneumoniae, Neisseria . |
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Successive crops , pruritic vesicles , fever, malaise, rash on trunk, face extremity ( maculopapular ) ??? |
Varicella ( chickenpox) |
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Cough, coryza, conjunctivitis, maculopapular rash ?? |
Measles which transmitted by airborne route. Percussions ( N95 face mask , negative pressure room) |
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Congenital rubella syndrome |
Cataracts or glaucoma, hearing loss, heart disease( PDA) Dx: IgM, PCR Prevention: maternal immunization prior to conception |
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Child with sore throat, Fever, tonsillar exudates , anterior cervical lymphadenopathy , no viral symptoms ( cough , congestion,rhinorrhea ) ?? |
Group A strep pharyngitis Dx: rapid strep antigen test or throat culture . Rx: PCN, Amoxicillin |
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Patient( injection drug use ) with low back pain Not relieved by rest , tenderness to gentle percussion?? |
Vertebral osteomyelitis |
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Ill patient with febrile paroxysms , traveled to tropical region , watery diarrhea, chills?? |
Malaria Dx: thick and thin blood smears Sickle cell trait confers some protection from severe complications |
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Malaria pathogens |
Plasmodium (falciparum, vivax, ovale ) parasites from infected Anopheles mosquito |
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Malaria chart page 268 |
Back (Definition) |
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Neonatal sepsis management |
Temperature instability, feeding problems, lethargy Rx: bacterial culture and abx |
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Successive crops , pruritic vesicles , fever, malaise, rash on trunk, face extremity ( maculopapular ) ??? |
Varicella ( chickenpox) |
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Rapid development of Necrotizing fasciitis, Marine environmental, raw oysters, wound contaminated ??? |
Vibrio vulnificus ( especially in patient with liver disease) |
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Fever , vomiting, nausea, , abdominal pain, jaundice, pruritus, tender hepatomegaly , significant elevation in ALt, Ast, alkaline phosphatase??? |
Hepatitis A virus, most patient recover in 3-6 weeks |
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Human bite wound empiric therapy? |
Amoxicillin- clavulanate ( aerobic and anaerobic) |
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Hospitalization, advanced age, antibiotics use , watery diarrhea, abdominal pain ..etc ? |
Clostridium difficile Dx: stool toxin studies ( PCR) Rx: metro |
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Travelers diarrhea, watery, profuse, prolonged??? |
Parasites ( cryptosporidium parvum) |
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Prosthetic joint infection organisms according to time |
Within the first 3 months: staph aureus and pseudomonas. More than 3 months ( 6 months) : less virulent organisms (staph epidermidis ) |
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Malaria chart page 268 |
Back (Definition) |
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Sexually active man with Mucoid discharge , dysuria ?? |
Chlamydia Rx: azithromycin Prophylaxis: treat the partner |
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Infective endocarditis following dental procedure caused by ?? |
Viridans group ( mutans ) strep |
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|
Recommended vaccines for chronic liver disease |
Tdap, influenza, pneumococcal ( first PPSV23 then PCV13 and PPSV23 at age 65 ),hep (A, B) |
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|
Malaria prophylaxis in endemic areas ( outside Canada) |
Atovaquone, doxycycline or meftoquine |
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|
P vivax malaria RX |
Primaquine |
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Superficial Skin infection with demarcated edges , high fever, rash ??? |
Erysipelas ( group A strep) |
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|
AIDS patient , CD4< 80, fatigue, pulmonary symptoms, cutaneous lesion, pancytopenia, reticulonodular infiltrate ??? |
Disseminated histoplasmosis Dx: urine histoplasma antigen Rx: amphotericin B |
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|
Child , seizures, high fever, abdominal pain , large watery diarrhea containing mucus or blood ??? |
Shigella gastroenteritis |
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|
HIV patient with chest and upper abdominal rash ?? |
Varicella zoster reactivation Rx: valacyclovir, acyclovir |
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Immunosuppressant patient with Pneumonia similar to tuberculosis, filamentous gram-positive acid fast rods ??? |
Nocardia Rx: TMP-SMX |
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|
Adult Teacher, joints pain , GI symptoms, skin symptoms?? |
Parvovirus B19 Dx: anti- parvovirus B19 IgM Rx: spontaneous |
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Fatigue, joints pain, fingertips pain ( Osler nodes), low grade fever, shortness of breath, dark urine , elevated ESR..? |
Subacute Infective endocarditis |
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|
Preseptal vs orbital cellulitis |
Preseptal : eyelid erythema, chemosis , Rx: oral abx Orbital cellulitis: same preseptal manifestations plus pain with extra ocular move, Rx: IV abx. |
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|
Cat bites management ( Pasteurella multocida ) |
Cleaning, prophylactic amoxicillin/clavulanate, tetanus booster ( if the last vaccine >5 years ago),no closure |
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|
Great lakes , low grade fever, pneumonia, violaceous wartlike lesions, skin ulcers, osteomyelitis, prostatitis ?? |
Blastomycosis Rx: mild to moderate ( oral itraconazole ) , severe ( IV amphotericin B) |
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|
Nail peds( splinter hemorrhage) , valve regurgitation..etc ? |
Infective endocarditis Dx: blood culture then abx then TEE |
|
|
Infective endocarditis following dental procedure caused by ?? |
Viridans group ( mutans ) strep |
|
|
Recommended vaccines for chronic liver disease |
Tdap, influenza, pneumococcal ( first PPSV23 then PCV13 and PPSV23 at age 65 ),hep (A, B) |
|
|
Malaria prophylaxis in endemic areas ( outside Canada) |
Atovaquone, doxycycline or meftoquine |
|
|
P vivax malaria RX |
Primaquine |
|
|
Superficial Skin infection with demarcated edges , high fever, rash ??? |
Erysipelas ( group A strep) |
|
|
AIDS patient , CD4< 80, fatigue, pulmonary symptoms, cutaneous lesion, pancytopenia, reticulonodular infiltrate ??? |
Disseminated histoplasmosis Dx: urine histoplasma antigen Rx: amphotericin B |
|
|
Child , seizures, high fever, abdominal pain , large watery diarrhea containing mucus or blood ??? |
Shigella gastroenteritis |
|
|
HIV patient with chest and upper abdominal rash ?? |
Varicella zoster reactivation Rx: valacyclovir, acyclovir |
|
|
Immunosuppressant patient with Pneumonia similar to tuberculosis, filamentous gram-positive acid fast rods ??? |
Nocardia Rx: TMP-SMX |
|
|
Adult Teacher, joints pain , GI symptoms, skin symptoms?? |
Parvovirus B19 Dx: anti- parvovirus B19 IgM Rx: spontaneous |
|
|
Fatigue, joints pain, fingertips pain ( Osler nodes), low grade fever, shortness of breath, dark urine , elevated ESR..? |
Subacute Infective endocarditis |
|
|
Preseptal vs orbital cellulitis |
Preseptal : eyelid erythema, chemosis , Rx: oral abx Orbital cellulitis: same preseptal manifestations plus pain with extra ocular move, Rx: IV abx. |
|
|
Cat bites management ( Pasteurella multocida ) |
Cleaning, prophylactic amoxicillin/clavulanate, tetanus booster ( if the last vaccine >5 years ago),no closure |
|
|
Great lakes , low grade fever, pneumonia, violaceous wartlike lesions, skin ulcers, osteomyelitis, prostatitis ?? |
Blastomycosis Rx: mild to moderate ( oral itraconazole ) , severe ( IV amphotericin B) |
|
|
Nail peds( splinter hemorrhage) , valve regurgitation..etc ? |
Infective endocarditis Dx: blood culture then abx then TEE |
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|
Fever, focal bony pain ?? |
Osteomyelitis caused by Staph |
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|
Osteomyelitis in neonates organisms? |
E-coli, strep B( agalactiae) |
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Osteomyelitis in foot puncture or Iv drug abuse organism ?? |
Pseudomonas |
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Osteomyelitis in sickle cell patient organism? |
Salmonella |
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Osteomyelitis in patient with indwelling vascular catheter organism?? |
Staph epidermidis |
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|
Patient contacts with dogs , Hepatic cyst with eggshell calcification ?? |
Hydatid cysts(Echinococcus) |
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|
Sexually active, urethral discharge, absence of identifiable bacteria on culture?? |
Chlamydia Dx: NAAT ( nucleic acid amplification test ) |
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|
Hiv with CD4 < 50 prophylaxis |
TMP-SMX, azithromycin |
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|
Violet papules in AIDS patient ? |
Kaposi sarcoma due to herpes virus 8 |
|
|
Diabetic patient, poorly controlled DM, rhino-orbital mucormycosis ?? |
Mucormycosis Rx: surgical debridement, amphotericin B |
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|
Patient with central line , fever, post operation, blood culture growth in >2 bottles |
Coagulase -negative staph |
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|
Miliary tuberculosis features |
Subacute , Fever, weight loss, fatigue, pulmonary symptoms Cxr: diffuse reticulonodular , |
|
|
Most common risk factor of miliary tuberculosis? |
Substance abuse |
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|
HIV patient with CD4 > 200 likely has which pneumonia? |
Community acquired pneumonia caused by strep pneumoniae |
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|
Hiv with CD4 < 50 prophylaxis |
TMP-SMX, azithromycin |
|
|
Violet papules in AIDS patient ? |
Kaposi sarcoma due to herpes virus 8 |
|
|
Diabetic patient, poorly controlled DM, rhino-orbital mucormycosis ?? |
Mucormycosis Rx: surgical debridement, amphotericin B |
|
|
Patient with central line , fever, post operation, blood culture growth in >2 bottles |
Coagulase -negative staph |
|
|
Miliary tuberculosis features |
Subacute , Fever, weight loss, fatigue, pulmonary symptoms Cxr: diffuse reticulonodular , |
|
|
Most common risk factor of miliary tuberculosis? |
Substance abuse |
|
|
HIV patient with CD4 > 200 likely has which pneumonia? |
Community acquired pneumonia caused by strep pneumoniae |
|
|
Acute , unilateral, cervical lymphadenitis in children caused by ?? |
Staph aureus |
|
|
human Rabies transmission most commonly due to bite of ?? |
Bats( ascending flaccid paralysis, copious drool , facial grimacing Rx: immunoglobulin |
|
|
Child, Acute onset of fever and joint pain , elevated WBCs, CRP, ESR ??? |
Septic arthritis Dx: arthrocentesis and culture then empiric therapy |
|
|
Septic arthritis manga according to age |
< 3 months ( staph, group B strep , gram negative bacilli) : vancomycin and cefotaxime >3 months ( staph, group A strep, strep pneumoniae) : nafcillin, clinda, van |
|
|
HIV patient with upper lobe Cavitation, 2 months of cough ?? |
Tuberculosis reactivation |
|
|
HIV patient with upper lobe Cavitation, 2 months of cough ?? |
Tuberculosis reactivation |
|
|
Child( 6 months-3 years), rhinorrhea, Fever, harsh, stridor , barky cough ?? |
Crop ( parainfluenza virus ) |
|
|
Perinatal Hepatitis B virus management |
HBV vaccine and Hepatitis B immunoglobulin |
|
|
Babesiosis features |
Protozoal , flu like, anemia, thrombocytopenia Dx: peripheral blood smear |
|
|
Scarlet fever |
Child, Strep pyogenes , fever, pharyngitis, tonsillar erythema, sandpaper rash with desquamation , strawberry tongue , cervical lymphadenopathy Dx: rapid strep antigen test Rx: amoxicillin |
|
|
Infant with bilateral eye swelling and discharge for a STDs mother ?? |
Gonococcal conjunctivitis Rx: topical ophthalmic erythromycin |
|
|
Acute , unilateral, cervical lymphadenitis in children caused by ?? |
Staph aureus |
|
|
human Rabies transmission most commonly due to bite of ?? |
Bats( ascending flaccid paralysis, copious drool , facial grimacing Rx: immunoglobulin |
|
|
Child, Acute onset of fever and joint pain , elevated WBCs, CRP, ESR ??? |
Septic arthritis Dx: arthrocentesis and culture then empiric therapy |
|
|
Septic arthritis manga according to age |
< 3 months ( staph, group B strep , gram negative bacilli) : vancomycin and cefotaxime >3 months ( staph, group A strep, strep pneumoniae) : nafcillin, clinda, van |
|
|
HIV patient with upper lobe Cavitation, 2 months of cough ?? |
Tuberculosis reactivation |
|
|
HIV patient with upper lobe Cavitation, 2 months of cough ?? |
Tuberculosis reactivation |
|
|
Child( 6 months-3 years), rhinorrhea, Fever, harsh, stridor , barky cough ?? |
Crop ( parainfluenza virus ) |
|
|
Perinatal Hepatitis B virus management |
HBV vaccine and Hepatitis B immunoglobulin |
|
|
Babesiosis features |
Protozoal , flu like, anemia, thrombocytopenia Dx: peripheral blood smear |
|
|
Scarlet fever |
Child, Strep pyogenes , fever, pharyngitis, tonsillar erythema, sandpaper rash with desquamation , strawberry tongue , cervical lymphadenopathy Dx: rapid strep antigen test Rx: amoxicillin |
|
|
Infant with bilateral eye swelling and discharge for a STDs mother ?? |
Gonococcal conjunctivitis Rx: topical ophthalmic erythromycin |
|
|
Acute , unilateral, cervical lymphadenitis in children caused by ?? |
Staph aureus |
|
|
human Rabies transmission most commonly due to bite of ?? |
Bats( ascending flaccid paralysis, copious drool , facial grimacing Rx: immunoglobulin |
|
|
Child, Acute onset of fever and joint pain , elevated WBCs, CRP, ESR ??? |
Septic arthritis Dx: arthrocentesis and culture then empiric therapy |
|
|
Septic arthritis manga according to age |
< 3 months ( staph, group B strep , gram negative bacilli) : vancomycin and cefotaxime >3 months ( staph, group A strep, strep pneumoniae) : nafcillin, clinda, van |
|
|
HIV patient with upper lobe Cavitation, 2 months of cough ?? |
Tuberculosis reactivation |
|
|
HIV patient with upper lobe Cavitation, 2 months of cough ?? |
Tuberculosis reactivation |
|
|
Child( 6 months-3 years), rhinorrhea, Fever, harsh, stridor , barky cough ?? |
Crop ( parainfluenza virus ) |
|
|
Perinatal Hepatitis B virus management |
HBV vaccine and Hepatitis B immunoglobulin |
|
|
Babesiosis features |
Protozoal , flu like, anemia, thrombocytopenia Dx: peripheral blood smear |
|
|
Scarlet fever |
Child, Strep pyogenes , fever, pharyngitis, tonsillar erythema, sandpaper rash with desquamation , strawberry tongue , cervical lymphadenopathy Dx: rapid strep antigen test Rx: amoxicillin |
|
|
Infant with bilateral eye swelling and discharge for a STDs mother ?? |
Gonococcal conjunctivitis Rx: topical ophthalmic erythromycin |
|
|
Jarisch-Herxheimer reaction features |
In early syphilis , febrile reaction( rapid destruction of spirochetes) < 12 h of the initial treatment Fever, headache, myalgia, rigors . Rx: spontaneous |
|
|
Fever, sore throat, not able to swallow, pooled secretions in the oropharynx ?? |
Epiglottitis due to H. Influenza B Life threatening illness Risk can be reduced by vaccine |
|
|
Odynophagia and dysphagia in HIV patient approach? |
White plaques: candida ( fluconazole ) Linear ulcers: CMV ( ganciclovir) Vesicles, round ulcers: acyclovir Aphthous ulcer : symptomatic therapy |
|
|
Management of patient with influenza ( fever, malaise..) in the absence of risk factors ( age> 65, chronic medical conditions.) ? |
Symptomatic treatment only Don’t give influenza vaccine unless they get better |
|
|
Prophylaxis criteria of Lyme disease page 527 |
Back (Definition) |
|
|
Catheter-associated UTI reduced by ?? |
Clean intermittent catheterization |
|
|
Post exposure prophylaxis in newborn for a mother had varicella zoster prior to delivery?? |
Administration of varicella specific immunoglobulin to the infant |
|
|
Prophylaxis criteria of Lyme disease page 527 |
Back (Definition) |
|
|
Antibiotics prophylaxis for Lyme disease is not required if the tick attached for ?? |
< 36 h |
|
|
Fever, cough, coryza, non purulent conjunctivitis, Koplik spots on mucosa, rash begins on face and spread ??? |
Measles |
|
|
Erythema infectiosum ( fifth disease) |
Parvovirus B19, child with slapped cheek rash |
|
|
Pneumococcus vaccines criteria |
> 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. |
|
|
Traveler, Right upper quadrant pain , fever , hepatomegaly , single , low density lesion in right lobe on ultrasound??? |
Entamoeba histolytica protozoal Dx: serology( stool ova ) Rx: metronidazole |
|
|
Young women sexually active with 2 partners , sore throat, fever, lower abdominal pain ?? |
Gonococcal( neisseria gonorrhoeae) pharyngitis with pelvic inflammatory disease |
|
|
Infective endocarditis with tooth extraction?? |
Strep viridans |
|
|
Immunocompromised patient ( diabetic..) with fever, nasal congestion, necrosis of the turbinate ??? |
Mucormycosis caused by Rhizopus |
|
|
Infant with meningococcal infection died??? |
Waterhouse-Friderichsen syndrome : vasomotor collapse , skin rash due to adrenal hemorrhage |
|
|
Persistent fever, malaise, absolute lymphocytosis on CBC ?? |
CMV Dx:,serology IgM is positive, heterophite antibody is negative |
|
|
Patient with symptoms like infective endocarditis but has eosinophilia , periorbital edema, myositis , GI symptoms ??? |
Trichinellosis |
|
|
Necrotizing surgical infection ( after surgery) |
Intense pain , decreased sensitivity at the edges of the wound , cloudy-gray discharge, crepitus Rx: surgical exploration , iV abx |
|
|
Aids patient with water diarrhea calcification according to CD4 |
Cryptosporidium < 180 Microsporidium < 100 Mycobacterium avium complex( high fevers > 39 ) and CMV ( hematochezia) < 50 . |
|
|
Live vaccines ( MMR, zoster, varicella) are contraindicated in AIDS patient if the CD4 ?? |
< 200 |
|
|
Young Meningitis symptoms with petechial rash , CSF ( high protein, very high neutrophils > 1000) ?? |
Meningococcal meningitis ( Neisseria) Rx: ceftriaxone and Vancomycin |
|
|
Postoperative Fever chart according to time |
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) |
|
|
HIV patients should receive all the recommended vaccine plus ? |
Hepatitis B, strep pneumoniae vaccines |
|
|
CSF analysis for meningitis chart |
Back (Definition) |
|
|
Patient with multiple sex male , respiratory symptoms |
Pneumocystis pneumonia Rx: TMP-SMX, corticosteroids if ( oximetry < 92%, A-a gradient > 35 ) |
|
|
CSF analysis for meningitis chart |
Back (Definition) |
|
|
Patient with multiple sex male , respiratory symptoms |
Pneumocystis pneumonia Rx: TMP-SMX, corticosteroids if ( oximetry < 92%, A-a gradient > 35 ) |
|
|
TB patient using rifampin and isoniazid only, having neurologic symptoms??? |
Isoniazid toxicity ( B6 deficiency) |
|
|
Toxoplasmosis |
Risk: undercooked meat, cat feces Clinical: macrocephaly, diffuse intracranial calcification, infection signs Dx: serology ( infant IgM, IgA) Rx: pyrimethamine, sulfadiazine, folate |
|
|
Foodbore illnes chart |
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) |
|
|
Eat rice , rapid onset vomiting, normal fever ?? |
Bacillus cereus preformed enterotoxin |
|
|
Live vaccines ( MMR, zoster, varicella) are contraindicated in AIDS patient if the CD4 ?? |
< 200 |
|
|
Young Meningitis symptoms with petechial rash , CSF ( high protein, very high neutrophils > 1000) ?? |
Meningococcal meningitis ( Neisseria) Rx: ceftriaxone and Vancomycin |
|
|
Postoperative Fever chart according to time |
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) |
|
|
HIV patients should receive all the recommended vaccine plus ? |
Hepatitis B, strep pneumoniae vaccines |
|
|
CSF analysis for meningitis chart |
Back (Definition) |
|
|
Patient with multiple sex male , respiratory symptoms |
Pneumocystis pneumonia Rx: TMP-SMX, corticosteroids if ( oximetry < 92%, A-a gradient > 35 ) |
|
|
CSF analysis for meningitis chart |
Back (Definition) |
|
|
Patient with multiple sex male , respiratory symptoms |
Pneumocystis pneumonia Rx: TMP-SMX, corticosteroids if ( oximetry < 92%, A-a gradient > 35 ) |
|
|
TB patient using rifampin and isoniazid only, having neurologic symptoms??? |
Isoniazid toxicity ( B6 deficiency) |
|
|
Toxoplasmosis |
Risk: undercooked meat, cat feces Clinical: macrocephaly, diffuse intracranial calcification, infection signs Dx: serology ( infant IgM, IgA) Rx: pyrimethamine, sulfadiazine, folate |
|
|
Foodbore illnes chart |
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) |
|
|
Eat rice , rapid onset vomiting, normal fever ?? |
Bacillus cereus preformed enterotoxin |
|
|
Trip to Caribbean, high fever, polyarthralgias, lymphopenia , thrombocytopenia, rash ??? |
Chikungunya fever ( mosquito - viral illness) |
|
|
Child , headache, fever, FND, seizure ? |
Brain abscess Congenital heart disease is a risk factor of brain abscess |
|
|
Old patient > 65 , recent influenza, productive cough, fever, |
Bacterial pneumonia ( staph) |
|
|
Aspiration pneumonia ( alcoholism) caused by ? |
Klebsiella, anaerobes |
|
|
Pneumonia with GI symptoms?? |
Legionella |
|
|
Child, painful non-itchy pustules, honey -crusted lesions around the mouth nose, hand ? |
Non- bullous impetigo ( staph, hemolytic strep ) Rx: topical abx( mupirocin) Complication: post strep glomerulonephritis |
|
|
AIDS patient with positive tuberculin skin test ( > 5 mm) management?? |
Latent TB Rx: isoniazid and pyridoxine for 9 months |
|
|
Meningococcal vaccine recommendations |
All adolescents 11-12 , then a booster at age 16 |
|
|
Live- attenuated vaccines( yellow fever...) is contraindicated in ?? |
Allergies ( eggs ) AIDS ( CD4 < 200) Immunodeficiency patients ( thymus) , immunosuppressive ( TNF antagonist, high dose of corticosteroids) |
|
|
Post exposure prophylaxis of HIV |
Immediate start of 2+1 antiretroviral therapy for 4 weeks |
|
|
Trip to Caribbean, high fever, polyarthralgias, lymphopenia , thrombocytopenia, rash ??? |
Chikungunya fever ( mosquito - viral illness) |
|
|
Child , headache, fever, FND, seizure ? |
Brain abscess Congenital heart disease is a risk factor of brain abscess |
|
|
Old patient > 65 , recent influenza, productive cough, fever, |
Bacterial pneumonia ( staph) |
|
|
Aspiration pneumonia ( alcoholism) caused by ? |
Klebsiella, anaerobes |
|
|
Pneumonia with GI symptoms?? |
Legionella |
|
|
Child, painful non-itchy pustules, honey -crusted lesions around the mouth nose, hand ? |
Non- bullous impetigo ( staph, hemolytic strep ) Rx: topical abx( mupirocin) Complication: post strep glomerulonephritis |
|
|
AIDS patient with positive tuberculin skin test ( > 5 mm) management?? |
Latent TB Rx: isoniazid and pyridoxine for 9 months |
|
|
Meningococcal vaccine recommendations |
All adolescents 11-12 , then a booster at age 16 |
|
|
Live- attenuated vaccines( yellow fever...) is contraindicated in ?? |
Allergies ( eggs ) AIDS ( CD4 < 200) Immunodeficiency patients ( thymus) , immunosuppressive ( TNF antagonist, high dose of corticosteroids) |
|
|
Post exposure prophylaxis of HIV |
Immediate start of 2+1 antiretroviral therapy for 4 weeks |
|
|
Early Lyme disease features |
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) |
|
|
Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration??? |
Pneumocystis pneumonia ( jirovecii) |
|
|
Foodborne disease chart page 710 |
Back (Definition) |
|
|
Headache, fever, nuchal rigidity which organism? |
Pneumococcal pneumonia ( strep pneumonia) |
|
|
19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion??? |
Atypical pneumonia ( mycoplasma) Rx: empiric azithromycin |
|
|
Menstruation, nasal packing, post surgery infection High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??
|
Toxic shock syndrome ( staph) |
|
|
Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms??? |
Legionella pneumonia Rx: macrolide or fluoroquinolones ( levofloxacin ) |
|
|
Tetanus vaccine recommendation |
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) |
|
|
Prophylaxis of Lyme disease during traveling ? |
Tick repellent, protective clothing, tick checks |
|
|
Patient without specific symptoms, High fever, neutropenia?? |
Febrile neutropenia Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam ) |
|
|
HIV, bright red firm exophytic nodules?? |
Bacillary angiomatosis |
|
|
Most common cardiac effect of Lyme disease?? |
AV block |
|
|
Post exposure prophylaxis of hepatitis A ? |
Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts |
|
|
Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ?? |
Osteomyelitis Dx: bone biopsy and culture of affected bone |
|
|
Varicella post exposure prophylaxis recommendation |
Yes Prior infection or 2 doses of vaccine: reassurance No prior....etc: give vaccine alone( normal patient), immune globulin and vaccine(immunocompromised) |
|
|
Foodborne disease chart page 710 |
Back (Definition) |
|
|
Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ??? |
Staph aureus foodborne illness |
|
|
Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ??? |
Infectious mononucleosis ( Epstein- Barr virus) |
|
|
Patient with osteomyelitis from plantar puncture wound??? |
Pseudomonas aeruginosa |
|
|
HIV, bright red firm exophytic nodules?? |
Bacillary angiomatosis |
|
|
Child, nocturnal perianal pruritus?? |
Pinworm( enterobius vennicularis ) Dx: tape test ( eggs) Rx : pyrantel pamoate, albendazole for all contacts |
|
|
Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ??? |
EBV ( infectious mononucleosis Dx: heterophile antibody( monospot) , Atypical lymphocytosis Rx: avoid sports > 4 weeks ( risk splenic rupture) |
|
|
Painless bump, VDRL and HIV is negative??? |
Primary syphilis Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology |
|
|
Early Lyme disease features |
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) |
|
|
Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration??? |
Pneumocystis pneumonia ( jirovecii) |
|
|
Foodborne disease chart page 710 |
Back (Definition) |
|
|
Headache, fever, nuchal rigidity which organism? |
Pneumococcal pneumonia ( strep pneumonia) |
|
|
19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion??? |
Atypical pneumonia ( mycoplasma) Rx: empiric azithromycin |
|
|
Menstruation, nasal packing, post surgery infection High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??
|
Toxic shock syndrome ( staph) |
|
|
Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms??? |
Legionella pneumonia Rx: macrolide or fluoroquinolones ( levofloxacin ) |
|
|
Tetanus vaccine recommendation |
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) |
|
|
Prophylaxis of Lyme disease during traveling ? |
Tick repellent, protective clothing, tick checks |
|
|
Patient without specific symptoms, High fever, neutropenia?? |
Febrile neutropenia Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam ) |
|
|
HIV, bright red firm exophytic nodules?? |
Bacillary angiomatosis |
|
|
Most common cardiac effect of Lyme disease?? |
AV block |
|
|
Post exposure prophylaxis of hepatitis A ? |
Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts |
|
|
Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ?? |
Osteomyelitis Dx: bone biopsy and culture of affected bone |
|
|
Varicella post exposure prophylaxis recommendation |
Yes Prior infection or 2 doses of vaccine: reassurance No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised) |
|
|
Foodborne disease chart page 710 |
Back (Definition) |
|
|
Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ??? |
Staph aureus foodborne illness |
|
|
Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ??? |
Infectious mononucleosis ( Epstein- Barr virus) |
|
|
Patient with osteomyelitis from plantar puncture wound??? |
Pseudomonas aeruginosa |
|
|
HIV, bright red firm exophytic nodules?? |
Bacillary angiomatosis |
|
|
Child, nocturnal perianal pruritus?? |
Pinworm( enterobius vennicularis ) Dx: tape test ( eggs) Rx : pyrantel pamoate, albendazole for all contacts |
|
|
Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ??? |
EBV ( infectious mononucleosis Dx: heterophile antibody( monospot) , Atypical lymphocytosis Rx: avoid sports > 4 weeks ( risk splenic rupture) |
|
|
Painless bump, VDRL and HIV is negative??? |
Primary syphilis Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology |
|
|
Early Lyme disease features |
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) |
|
|
Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration??? |
Pneumocystis pneumonia ( jirovecii) |
|
|
Patient immunocompromised, has TB symptoms, temporal abscess, grow in gram stain positive acid -fast rods ??? |
Nocardia Rx: TMP-SMX |
|
|
Headache, fever, nuchal rigidity which organism? |
Pneumococcal pneumonia ( strep pneumonia) |
|
|
19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion??? |
Atypical pneumonia ( mycoplasma) Rx: empiric azithromycin |
|
|
Menstruation, nasal packing, post surgery infection High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??
|
Toxic shock syndrome ( staph) |
|
|
Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms??? |
Legionella pneumonia Rx: macrolide or fluoroquinolones ( levofloxacin ) |
|
|
Tetanus vaccine recommendation |
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) |
|
|
Prophylaxis of Lyme disease during traveling ? |
Tick repellent, protective clothing, tick checks |
|
|
Patient without specific symptoms, High fever, neutropenia?? |
Febrile neutropenia Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam ) |
|
|
HIV, bright red firm exophytic nodules?? |
Bacillary angiomatosis |
|
|
Most common cardiac effect of Lyme disease?? |
AV block |
|
|
Post exposure prophylaxis of hepatitis A ? |
Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts |
|
|
Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ?? |
Osteomyelitis Dx: bone biopsy and culture of affected bone |
|
|
Varicella post exposure prophylaxis recommendation |
Yes Prior infection or 2 doses of vaccine: reassurance No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised) |
|
|
Foodborne disease chart page 710 |
Back (Definition) |
|
|
Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ??? |
Staph aureus foodborne illness |
|
|
Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ??? |
Infectious mononucleosis ( Epstein- Barr virus) |
|
|
Patient with osteomyelitis from plantar puncture wound??? |
Pseudomonas aeruginosa |
|
|
diabetic patient having osteomyelitis??? |
Staph coagulase negative ( epidermidis) , B- hemolytic strep |
|
|
Child, nocturnal perianal pruritus?? |
Pinworm( enterobius vennicularis ) Dx: tape test ( eggs) Rx : pyrantel pamoate, albendazole for all contacts |
|
|
Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ??? |
EBV ( infectious mononucleosis Dx: heterophile antibody( monospot) , Atypical lymphocytosis Rx: avoid sports > 4 weeks ( risk splenic rupture) |
|
|
Painless bump, VDRL and HIV is negative??? |
Primary syphilis Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology |
|
|
Early Lyme disease features |
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) |
|
|
Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration??? |
Pneumocystis pneumonia ( jirovecii) |
|
|
Patient immunocompromised, has TB symptoms, temporal abscess, grow in gram stain positive acid -fast rods ??? |
Nocardia Rx: TMP-SMX |
|
|
Headache, fever, nuchal rigidity which organism? |
Pneumococcal pneumonia ( strep pneumonia) |
|
|
19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion??? |
Atypical pneumonia ( mycoplasma) Rx: empiric azithromycin |
|
|
Menstruation, nasal packing, post surgery infection High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??
|
Toxic shock syndrome ( staph) |
|
|
Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms??? |
Legionella pneumonia Rx: macrolide or fluoroquinolones ( levofloxacin ) |
|
|
Tetanus vaccine recommendation |
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) |
|
|
Prophylaxis of Lyme disease during traveling ? |
Tick repellent, protective clothing, tick checks |
|
|
Patient without specific symptoms, High fever, neutropenia?? |
Febrile neutropenia Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam ) |
|
|
HIV, bright red firm exophytic nodules?? |
Bacillary angiomatosis |
|
|
Most common cardiac effect of Lyme disease?? |
AV block |
|
|
Post exposure prophylaxis of hepatitis A ? |
Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts |
|
|
Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ?? |
Osteomyelitis Dx: bone biopsy and culture of affected bone |
|
|
Varicella post exposure prophylaxis recommendation |
Yes Prior infection or 2 doses of vaccine: reassurance No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised) |
|
|
Foodborne disease chart page 710 |
Back (Definition) |
|
|
Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ??? |
Staph aureus foodborne illness |
|
|
Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ??? |
Infectious mononucleosis ( Epstein- Barr virus) |
|
|
Patient with osteomyelitis from plantar puncture wound??? |
Pseudomonas aeruginosa |
|
|
diabetic patient having osteomyelitis??? |
Staph coagulase negative ( epidermidis) , B- hemolytic strep |
|
|
Child, nocturnal perianal pruritus?? |
Pinworm( enterobius vennicularis ) Dx: tape test ( eggs) Rx : pyrantel pamoate, albendazole for all contacts |
|
|
Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ??? |
EBV ( infectious mononucleosis Dx: heterophile antibody( monospot) , Atypical lymphocytosis Rx: avoid sports > 4 weeks ( risk splenic rupture) |
|
|
Painless bump, VDRL and HIV is negative??? |
Primary syphilis Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology |
|
|
Early Lyme disease features |
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) |
|
|
Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration??? |
Pneumocystis pneumonia ( jirovecii) |
|
|
Foodborne disease chart page 710 |
Back (Definition) |
|
|
Headache, fever, nuchal rigidity which organism? |
Pneumococcal pneumonia ( strep pneumonia) |
|
|
19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion??? |
Atypical pneumonia ( mycoplasma) Rx: empiric azithromycin |
|
|
Menstruation, nasal packing, post surgery infection High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??
|
Toxic shock syndrome ( staph) |
|
|
Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms??? |
Legionella pneumonia Rx: macrolide or fluoroquinolones ( levofloxacin ) |
|
|
Tetanus vaccine recommendation |
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) |
|
|
Prophylaxis of Lyme disease during traveling ? |
Tick repellent, protective clothing, tick checks |
|
|
Patient without specific symptoms, High fever, neutropenia?? |
Febrile neutropenia Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam ) |
|
|
HIV, bright red firm exophytic nodules?? |
Bacillary angiomatosis |
|
|
Most common cardiac effect of Lyme disease?? |
AV block |
|
|
Post exposure prophylaxis of hepatitis A ? |
Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts |
|
|
Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ?? |
Osteomyelitis Dx: bone biopsy and culture of affected bone |
|
|
Varicella post exposure prophylaxis recommendation |
Yes Prior infection or 2 doses of vaccine: reassurance No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised) |
|
|
Pneumonia with cystic fibrosis according to age organisms ? |
Infants and young children: staph aureus Adults : pseudomonas aeruginosa |
|
|
Patient with penicillin allergy , has chancre ? |
Primary syphilis Rx: doxycycline for 14 days ( because it’s allergic to penicillin) |
|
|
Indication of success in treatment of syphilis?? |
4- fold decrease in antibodies titters( RPR) at 6-12 months |
|
|
Patient with Positive HBsAg and HBeAg management?? |
HB vaccine and HB immune globulin |
|
|
HIV, bright red firm exophytic nodules?? |
Bacillary angiomatosis |
|
|
Child, Fever, unilateral red tender neck swelling ?? |
Lymphadenitis ( staph, strep ) |
|
|
Patient with symptoms of acute UTI infection, unrinary alkalosis ( PH> 8 ) , organism? |
Proteus mirabilis ( urease -productive ) Complication: ammonium magnesium calculi |
|
|
Foodborne disease chart page 710 |
Back (Definition) |
|
|
Infectious mononucleosis RX |
Avoid sports ( splenic rupture) |
|
|
Disseminated gonococcal infection features |
Sexually active, Tenosynovitis , dermatitis ( pustular rash ) , polyarthralgias Dx: NAAT Rx: IV ceftriaxone |
|
|
Predisposing factor of the bacterial sinusitis?? |
Viral upper respiratory infection |
|
|
Most common valvular defect in infective endocarditis?? |
Mitral regurgitation |
|
|
Fever, acute joint pain, inability to walk , very high leukocytosis and elevated ESR ?? |
Septic arthritis by staph( joint destruction) Rx: empiric vancomycin, Emergency surgical drainage. |
|
|
Bacterial causes of diarrhea chart page 840 |
Back (Definition) |
|
|
Bacterial cases of diarrhea |
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) |
|
|
Patient with E-coli bloody diarrhea should avoid?? |
Empiric antibiotic ( hemolytic uremic syndrome) |
|
|
Most following opportunistic infection after renal transplant? |
CMV ( colitis, bloody diarrhea, ulcers on colonoscopy,atypical lymphocytes) Dx: biopsy |
|
|
Erythema, swelling, pain out of proportion, crepitus?? |
Necrotizing fasciitis ( group A strep , staph) |
|
|
Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ??? |
Staph aureus foodborne illness |
|
|
landscaper Patient with skin papule that ulcerate with nonpurulent , odorless drainage, proximal lesions?? |
Sporothrix dimorphic fungus ( sporotrichosis ) found in decaying vegetation Dx: culture Rx: itraconazole (3-6 months) |
|
|
Bacterial causes of diarrhea chart page 840 |
Back (Definition) |
|
|
Patient with osteomyelitis from plantar puncture wound??? |
Pseudomonas aeruginosa |
|
|
diabetic patient having osteomyelitis??? |
Staph coagulase negative ( epidermidis) , B- hemolytic strep |
|
|
Child, nocturnal perianal pruritus?? |
Pinworm( enterobius vennicularis ) Dx: tape test ( eggs) Rx : pyrantel pamoate, albendazole for all contacts |
|
|
Erythema, swelling, pain out of proportion, crepitus?? |
Necrotizing fasciitis ( group A strep , staph) |
|
|
Painless bump, VDRL and HIV is negative??? |
Primary syphilis Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology |
|
|
Early Lyme disease features |
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) |
|
|
Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration??? |
Pneumocystis pneumonia ( jirovecii) |
|
|
Patient immunocompromised, has TB symptoms, temporal abscess, grow in gram stain positive acid -fast rods ??? |
Nocardia Rx: TMP-SMX |
|
|
Headache, fever, nuchal rigidity which organism? |
Pneumococcal pneumonia ( strep pneumonia) |
|
|
19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion??? |
Atypical pneumonia ( mycoplasma) Rx: empiric azithromycin |
|
|
Menstruation, nasal packing, post surgery infection High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??
|
Toxic shock syndrome ( staph) |
|
|
Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms??? |
Legionella pneumonia Rx: macrolide or fluoroquinolones ( levofloxacin ) |
|
|
Tetanus vaccine recommendation |
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) |
|
|
Prophylaxis of Lyme disease during traveling ? |
Tick repellent, protective clothing, tick checks |
|
|
Patient without specific symptoms, High fever, neutropenia?? |
Febrile neutropenia Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam ) |
|
|
HIV, bright red firm exophytic nodules?? |
Bacillary angiomatosis |
|
|
Most common cardiac effect of Lyme disease?? |
AV block |
|
|
Post exposure prophylaxis of hepatitis A ? |
Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts |
|
|
Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ?? |
Osteomyelitis Dx: bone biopsy and culture of affected bone |
|
|
Varicella post exposure prophylaxis recommendation |
Yes Prior infection or 2 doses of vaccine: reassurance No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised) |
|
|
Pneumonia with cystic fibrosis according to age organisms ? |
Infants and young children: staph aureus Adults : pseudomonas aeruginosa |
|
|
Patient with penicillin allergy , has chancre ? |
Primary syphilis Rx: doxycycline for 14 days ( because it’s allergic to penicillin) |
|
|
Indication of success in treatment of syphilis?? |
4- fold decrease in antibodies titters( RPR) at 6-12 months |
|
|
Patient with Positive HBsAg and HBeAg management?? |
HB vaccine and HB immune globulin |
|
|
Acute cervical adenitis in children |
Unilateral: staph, strep pyogenes Bilateral: adenovirus, EBV/ CMV |
|
|
Child, Fever, unilateral red tender neck swelling ?? |
Lymphadenitis ( staph, strep ) |
|
|
Patient with symptoms of acute UTI infection, unrinary alkalosis ( PH> 8 ) , organism? |
Proteus mirabilis ( urease -productive ) Complication: ammonium magnesium calculi |
|
|
Foodborne disease chart page 710 |
Back (Definition) |
|
|
Infectious mononucleosis RX |
Avoid sports ( splenic rupture) |
|
|
Disseminated gonococcal infection features |
Sexually active, Tenosynovitis , dermatitis ( pustular rash ) , polyarthralgias Dx: NAAT Rx: IV ceftriaxone |
|
|
Predisposing factor of the bacterial sinusitis?? |
Viral upper respiratory infection |
|
|
Most common valvular defect in infective endocarditis?? |
Mitral regurgitation |
|
|
Fever, acute joint pain, inability to walk , very high leukocytosis and elevated ESR ?? |
Septic arthritis by staph( joint destruction) Rx: empiric vancomycin, Emergency surgical drainage. |
|
|
Bacterial causes of diarrhea chart page 840 |
Back (Definition) |
|
|
Bacterial cases of diarrhea |
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) |
|
|
Patient with E-coli bloody diarrhea should avoid?? |
Empiric antibiotic ( hemolytic uremic syndrome) |
|
|
Most following opportunistic infection after renal transplant? |
CMV ( colitis, bloody diarrhea, ulcers on colonoscopy,atypical lymphocytes) Dx: biopsy |
|
|
Erythema, swelling, pain out of proportion, crepitus?? |
Necrotizing fasciitis ( group A strep , staph) |
|
|
Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ??? |
Staph aureus foodborne illness |
|
|
landscaper Patient with skin papule that ulcerate with nonpurulent , odorless drainage, proximal lesions?? |
Sporothrix dimorphic fungus ( sporotrichosis ) found in decaying vegetation Dx: culture Rx: itraconazole (3-6 months) |
|
|
Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ??? |
Infectious mononucleosis ( Epstein- Barr virus) |
|
|
Patient with osteomyelitis from plantar puncture wound??? |
Pseudomonas aeruginosa |
|
|
diabetic patient having osteomyelitis??? |
Staph coagulase negative ( epidermidis) , B- hemolytic strep |
|
|
Child, nocturnal perianal pruritus?? |
Pinworm( enterobius vennicularis ) Dx: tape test ( eggs) Rx : pyrantel pamoate, albendazole for all contacts |
|
|
Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ??? |
EBV ( infectious mononucleosis Dx: heterophile antibody( monospot) , Atypical lymphocytosis Rx: avoid sports > 4 weeks ( risk splenic rupture) |
|
|
Painless bump, VDRL and HIV is negative??? |
Primary syphilis Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology |
|
|
Early Lyme disease features |
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) |
|
|
Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration??? |
Pneumocystis pneumonia ( jirovecii) |
|
|
Patient immunocompromised, has TB symptoms, temporal abscess, grow in gram stain positive acid -fast rods ??? |
Nocardia Rx: TMP-SMX |
|
|
Headache, fever, nuchal rigidity which organism? |
Pneumococcal pneumonia ( strep pneumonia) |
|
|
19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion??? |
Atypical pneumonia ( mycoplasma) Rx: empiric azithromycin |
|
|
Menstruation, nasal packing, post surgery infection High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??
|
Toxic shock syndrome ( staph) |
|
|
Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms??? |
Legionella pneumonia Rx: macrolide or fluoroquinolones ( levofloxacin ) |
|
|
Tetanus vaccine recommendation |
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) |
|
|
Prophylaxis of Lyme disease during traveling ? |
Tick repellent, protective clothing, tick checks |
|
|
Patient without specific symptoms, High fever, neutropenia?? |
Febrile neutropenia Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam ) |
|
|
HIV, bright red firm exophytic nodules?? |
Bacillary angiomatosis |
|
|
Most common cardiac effect of Lyme disease?? |
AV block |
|
|
Post exposure prophylaxis of hepatitis A ? |
Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts |
|
|
Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ?? |
Osteomyelitis Dx: bone biopsy and culture of affected bone |
|
|
Varicella post exposure prophylaxis recommendation |
Yes Prior infection or 2 doses of vaccine: reassurance No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised) |
|
|
Pneumonia with cystic fibrosis according to age organisms ? |
Infants and young children: staph aureus Adults : pseudomonas aeruginosa |
|
|
Patient with penicillin allergy , has chancre ? |
Primary syphilis Rx: doxycycline for 14 days ( because it’s allergic to penicillin) |
|
|
Indication of success in treatment of syphilis?? |
4- fold decrease in antibodies titters( RPR) at 6-12 months |
|
|
Patient with Positive HBsAg and HBeAg management?? |
HB vaccine and HB immune globulin |
|
|
Acute cervical adenitis in children |
Unilateral: staph, strep pyogenes Bilateral: adenovirus, EBV/ CMV |
|
|
Child, Fever, unilateral red tender neck swelling ?? |
Lymphadenitis ( staph, strep ) |
|
|
Patient with symptoms of acute UTI infection, unrinary alkalosis ( PH> 8 ) , organism? |
Proteus mirabilis ( urease -productive ) Complication: ammonium magnesium calculi |
|
|
Foodborne disease chart page 710 |
Back (Definition) |
|
|
Infectious mononucleosis RX |
Avoid sports ( splenic rupture) |
|
|
Disseminated gonococcal infection features |
Sexually active, Tenosynovitis , dermatitis ( pustular rash ) , polyarthralgias Dx: NAAT Rx: IV ceftriaxone |
|
|
Predisposing factor of the bacterial sinusitis?? |
Viral upper respiratory infection |
|
|
Most common valvular defect in infective endocarditis?? |
Mitral regurgitation |
|
|
Fever, acute joint pain, inability to walk , very high leukocytosis and elevated ESR ?? |
Septic arthritis by staph( joint destruction) Rx: empiric vancomycin, Emergency surgical drainage. |
|
|
Bacterial causes of diarrhea chart page 840 |
Back (Definition) |
|
|
Bacterial cases of diarrhea |
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) |
|
|
Patient with E-coli bloody diarrhea should avoid?? |
Empiric antibiotic ( hemolytic uremic syndrome) |
|
|
Most following opportunistic infection after renal transplant? |
CMV ( colitis, bloody diarrhea, ulcers on colonoscopy,atypical lymphocytes) Dx: biopsy |
|
|
Erythema, swelling, pain out of proportion, crepitus?? |
Necrotizing fasciitis ( group A strep , staph) |
|
|
Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ??? |
Staph aureus foodborne illness |
|
|
landscaper Patient with skin papule that ulcerate with nonpurulent , odorless drainage, proximal lesions?? |
Sporothrix dimorphic fungus ( sporotrichosis ) found in decaying vegetation Dx: culture Rx: itraconazole (3-6 months) |
|
|
Treatment with isoniazid effect on liver ?? |
Mild LFTs elevation( self-limited) |
|
|
Mumps complication? |
Orchitis, deafness |
|
|
Mononucleosis-like syndrome, fever, night sweats, lymphadenopathy?? |
Acute HIV , the patient should be tested for HIV Dx: viral load( early stage) , HIV antibodies may be negative pneumocystis |
|
|
Pneumocystis pneumonia suggests? |
Selection loss of CD4 |
|
|
Sickle cell disease patient with fever and severe pain in the left tibia ??? |
Osteomyelitis caused by salmonella, staph |
|
|
Neonatal sepsis, hypothermia, lethargy, low WBCs ??? |
Meningitis caused by Group B strep |
|
|
Old patient who had a surgery, intubated, fever and right lung infiltration? |
Ventilator-associated pneumonia ( > 48 hours after intubation) Follow up: gram stain and culture of respiratory secretions and empiric abx |
|
|
Old, fever, malaise, focal lower back pain , recent UTI infection??? |
Vertebral osteomyelitis Dx: blood culture, ESR, CRP, MRI then CT-guided bone biopsy |
|
|
Fever, sore throat, malaise, difficult swallow, posterior or diffuse cervical lymphadenopathy?? |
Infectious mononucleosis( EBV) Complications: acute airway obstruction, anemia, splenic rupture. Dx: heterophile antibody ( Monospot test ) Rx: corticosteroids |
|
|
Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ??? |
Infectious mononucleosis ( Epstein- Barr virus) |
|
|
AIDS patient, CD4 500, should be given varicella vaccine?? |
Yes If the CD4 < 200 then no |
|
|
9-year girl, uncontrolled writhing of arms and hands , face grimacing, heart symptoms , previous sore throat and fever ?? |
Acute rheumatic fever caused by ( strep A pyogenes ) |
|
|
Acute rheumatic fever criteria |
Erythema marginatum , subcutaneous nodules, migratory arthritis, carditis , chorea |
|
|
Annual vaccine of 60 years old patient?? |
Influenza ( inactivated) |
|
|
Respiratory symptoms, bilateral diffuse infiltration, had liver transplant 7 months ago ??? |
PCP Dx: induced sputum or bronchoalveoalar lavage |
|
|
17 , no symptoms, has non tender, mobile posterior cervical lymph nodes ( < 2 cm ) , management??pers |
Observation |
|
|
Persistent right upper quadrant pain, low grade fever, had bloody diarrhea, |
Abscess from entamoeba histolytica Rx: metronidazole( abscess) and luminal agent ( eradicate intestinal colonization) Don’t drain the abscess |
|
|
> 65 , fever, headache, sore throat, runny nose , severe body aches< one week ?? |
Influenza virus |
|
|
Girl, fever, painful swelling papule on the anterior thigh, lymphadenopathy,the family has cat, dog, turtle?? |
Cat scratch disease ( Bartonella henselae) |
|
|
Woman, fatigue, headache, vomiting, HIV positive, papilledema??? |
Cryptococcal meningoencephalitis Dx: CSF cryptococcal antigen Rx: amphotericin then fluconazole |
|
|
Patient with osteomyelitis from plantar puncture wound??? |
Pseudomonas aeruginosa |
|
|
HIV man, frequent bloody diarrhea, abdominal pain weight loss, CD4 28 ??? |
Cytomegalovirus ( bloody), not Mycobacterium avium complex ( watery) Dx: colonoscopy with biopsy Complications:,retinitis |
|
|
Girl, low grade fever, rash the spread quickly ( cephalocaudal ), auricular and occipital , arthralgia lymphadenopathy?? |
Rubella |
|
|
Infectious mononucleosis diagnosis?? |
Atypical lymphocytes Heterophile antibodies ( negative in early illness) |
|
|
Sickle cell disease with fever, hypotension, asplenia , hypotension, anemia?? |
Strep pneumoniae ( encapsulated) Follow up: penicillin prophylaxis |
|
|
AIDS, tuberculosis symptoms, CD4 <50 ?? |
Mycobacterium avium complex Rx: azithromycin |
|
|
Man, intense pruritic lesion on foot |
Cutaneous larva migrans Epidemiology : hookworm dog ( ancylostoma) or cat( braziliense), barefoot with sand or soil Rx: antihelmintic ( ivermectin) |
|
|
Mononucleosis symptoms in sexually multiple patient, rash all over the body( involves palms and soles) , grey mucus patches in the mouth??? |
Secondary syphilis |
|
|
Healthy patient wants to be sure he doesn’t have STDs ?? |
HIV screen p24 antigen and antibody testing |
|
|
HIV screening indications chart page 984 |
Back (Definition) |
|
|
Tooth removal, slow-growing non tender mass ( mandibular) , sulfur granules ?? |
Cervicofacial Actinomyces ( gram positive) Rx: penicillin |
|
|
diabetic patient having osteomyelitis??? |
Staph coagulase negative ( epidermidis) , B- hemolytic strep |
|
|
HIV, headache, fever, FND, altered mental status, CD4 < 100, MRI shows ring- enhancing lesions ?? |
Toxoplasma encephalitis Rx: sulfadiazine and pyrimethamine. Prophylaxis: TMP-SMX |
|
|
HIV, acute onset watery diarrhea, CD4 unknown , management?? |
Stool examination included ova and parasites |
|
|
Newborn, rhinorrhea, desquamating ( bullous) rash? |
Syphilis |
|
|
Newborn, peri ventricular calcification?? |
Cytomegalovirus |
|
|
Newborn, diffuse intracerebral calcifications , choriorenitis ?? |
Toxoplasmosis |
|
|
Newborn, cataracts, PDA ??? |
Rubella |
|
|
HIV, fever, FND, |
Toxoplasmosis Prophylaxis: TMP-SMX |
|
|
Man, tick bite, high fever, headache, altered mental status, leukopenia , thrombocytopenia, elevated aminotrasferas ?? |
Ehrlichiosis Rx: doxycycline |
|
|
Woman, high fever,had cellulitis, holosystolic murmur?? |
Infective endocarditis ( IVDU) Rx: vancomycin |
|
|
Fever, leukocytosis , left upper quadrant abdominal pain , pleural effusion, systolic murmur ??? |
Splenic abscess due to IE |
|
|
Child, nocturnal perianal pruritus?? |
Pinworm( enterobius vennicularis ) Dx: tape test ( eggs) Rx : pyrantel pamoate, albendazole for all contacts |
|
|
HIV, FND, CT( white matter lesions with no enhancement/ edema ) , CD4 < 200 ?? |
Progressive multifocal leukoencephalopathy caused by JC virus reactivation |
|
|
Tuberculin skin test < 15 in healthy patient management?? |
No more interventions |
|
|
Seizure like epilepsy, ICH, Travel, MRI( hypodense, enhancement /edema cysts )?? |
Neurocysticerosis ( pork tapeworm) eggs Rx: albendazole |
|
|
Bite from neighbor’s dog management? |
Observe the dog for 10 days for rabies, no immediate prophylaxis foe the patient |
|
|
child, Fever, odynophagia , neck pain with extension, muffled voice, lateral neck x-ray ( widened prevertebral space ) ??? |
Retropharyngeal abscess |
|
|
Epiglottis symptoms but the swelling is submandibular , crepitus?? |
Ludwig angina ( cellulitis from infected molar |
|
|
Patient had transplant, pulmonary symptoms, GI symptoms, hepatitis ??? |
CMV |
|
|
Young Patient got influenza treatment and improved then got worse, high fever, necrotizing pneumonia, productive cough with blood, cavity infiltration??? |
Secondary bacterial pneumonia ( methicillin-resistant staph) |
|
|
HIV, CD4 <50, tuberculosis symptoms, purple pedunculated lesions on face and extremity, CT( hyposense liver lesions) ?? |
Bartonella ( bacillary angiomatosis ) Dx: biopsy Rx: doxycycline or erythromycin |
|
|
Anesthetic hypopigmented lesions with peripheral nerve involvement ( ulnar) , painful nerve deformity?? |
Leprosy Dx: biopsy from the edge of lesion |
|
|
Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ??? |
EBV ( infectious mononucleosis Dx: heterophile antibody( monospot) , Atypical lymphocytosis Rx: avoid sports > 4 weeks ( risk splenic rupture) |
|
|
Child, rash , painful pustules, golden yellow crust ?? |
Impetigo Rx: localized( non-bullous) : mupirocin generalized( bullous) : cephalexin , clindamycin |
|
|
Child, 2 weeks rhinorrhea then dry cough causing vomiting?? |
Pertussis Dx: PCR Rx: macrolide |
|
|
Painless bump, VDRL and HIV is negative??? |
Primary syphilis Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology |
|
|
Early Lyme disease features |
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) |
|
|
Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration??? |
Pneumocystis pneumonia ( jirovecii) |
|
|
Patient immunocompromised, has TB symptoms, temporal abscess, grow in gram stain positive acid -fast rods ??? |
Nocardia Rx: TMP-SMX |
|
|
Headache, fever, nuchal rigidity which organism? |
Pneumococcal pneumonia ( strep pneumonia) |
|
|
19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion??? |
Atypical pneumonia ( mycoplasma) Rx: empiric azithromycin |
|
|
Menstruation, nasal packing, post surgery infection High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??
|
Toxic shock syndrome ( staph) |
|
|
Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms??? |
Legionella pneumonia Rx: macrolide or fluoroquinolones ( levofloxacin ) |
|
|
Tetanus vaccine recommendation |
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) |
|
|
Prophylaxis of Lyme disease during traveling ? |
Tick repellent, protective clothing, tick checks |
|
|
Patient without specific symptoms, High fever, neutropenia?? |
Febrile neutropenia Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam ) |
|
|
HIV, bright red firm exophytic nodules?? |
Bacillary angiomatosis |
|
|
Most common cardiac effect of Lyme disease?? |
AV block |
|
|
Post exposure prophylaxis of hepatitis A ? |
Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts |
|
|
Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ?? |
Osteomyelitis Dx: bone biopsy and culture of affected bone |
|
|
Varicella post exposure prophylaxis recommendation |
Yes Prior infection or 2 doses of vaccine: reassurance No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised) |
|
|
Pneumonia with cystic fibrosis according to age organisms ? |
Infants and young children: staph aureus Adults : pseudomonas aeruginosa |
|
|
Patient with penicillin allergy , has chancre ? |
Primary syphilis Rx: doxycycline for 14 days ( because it’s allergic to penicillin) |
|
|
Indication of success in treatment of syphilis?? |
4- fold decrease in antibodies titters( RPR) at 6-12 months |
|
|
Patient with Positive HBsAg and HBeAg management?? |
HB vaccine and HB immune globulin |
|
|
Acute cervical adenitis in children |
Unilateral: staph, strep pyogenes Bilateral: adenovirus, EBV/ CMV |
|
|
Child, Fever, unilateral red tender neck swelling ?? |
Lymphadenitis ( staph, strep ) |
|
|
Patient with symptoms of acute UTI infection, unrinary alkalosis ( PH> 8 ) , organism? |
Proteus mirabilis ( urease -productive ) Complication: ammonium magnesium calculi |
|
|
Foodborne disease chart page 710 |
Back (Definition) |
|
|
Infectious mononucleosis RX |
Avoid sports ( splenic rupture) |
|
|
Disseminated gonococcal infection features |
Sexually active, Tenosynovitis , dermatitis ( pustular rash ) , polyarthralgias Dx: NAAT Rx: IV ceftriaxone |
|
|
Predisposing factor of the bacterial sinusitis?? |
Viral upper respiratory infection |
|
|
Most common valvular defect in infective endocarditis?? |
Mitral regurgitation |
|
|
Fever, acute joint pain, inability to walk , very high leukocytosis and elevated ESR ?? |
Septic arthritis by staph( joint destruction) Rx: empiric vancomycin, Emergency surgical drainage. |
|
|
Bacterial causes of diarrhea chart page 840 |
Back (Definition) |
|
|
Bacterial cases of diarrhea |
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) |
|
|
Patient with E-coli bloody diarrhea should avoid?? |
Empiric antibiotic ( hemolytic uremic syndrome) |
|
|
Most following opportunistic infection after renal transplant? |
CMV ( colitis, bloody diarrhea, ulcers on colonoscopy,atypical lymphocytes) Dx: biopsy |
|
|
Erythema, swelling, pain out of proportion, crepitus?? |
Necrotizing fasciitis ( group A strep , staph) |
|
|
Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ??? |
Staph aureus foodborne illness |
|
|
landscaper Patient with skin papule that ulcerate with nonpurulent , odorless drainage, proximal lesions?? |
Sporothrix dimorphic fungus ( sporotrichosis ) found in decaying vegetation Dx: culture Rx: itraconazole (3-6 months) |
|
|
Treatment with isoniazid effect on liver ?? |
Mild LFTs elevation( self-limited) |
|
|
Mumps complication? |
Orchitis, deafness |
|
|
Mononucleosis-like syndrome, fever, night sweats, lymphadenopathy?? |
Acute HIV , the patient should be tested for HIV Dx: viral load( early stage) , HIV antibodies may be negative pneumocystis |
|
|
Pneumocystis pneumonia suggests? |
Selection loss of CD4 |
|
|
Sickle cell disease patient with fever and severe pain in the left tibia ??? |
Osteomyelitis caused by salmonella, staph |
|
|
Neonatal sepsis, hypothermia, lethargy, low WBCs ??? |
Meningitis caused by Group B strep |
|
|
Old patient who had a surgery, intubated, fever and right lung infiltration? |
Ventilator-associated pneumonia ( > 48 hours after intubation) Follow up: gram stain and culture of respiratory secretions and empiric abx |
|
|
Old, fever, malaise, focal lower back pain , recent UTI infection??? |
Vertebral osteomyelitis Dx: blood culture, ESR, CRP, MRI then CT-guided bone biopsy |
|
|
Fever, sore throat, malaise, difficult swallow, posterior or diffuse cervical lymphadenopathy?? |
Infectious mononucleosis( EBV) Complications: acute airway obstruction, anemia, splenic rupture. Dx: heterophile antibody ( Monospot test ) Rx: corticosteroids |
|
|
Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ??? |
Infectious mononucleosis ( Epstein- Barr virus) |
|
|
AIDS patient, CD4 500, should be given varicella vaccine?? |
Yes If the CD4 < 200 then no |
|
|
9-year girl, uncontrolled writhing of arms and hands , face grimacing, heart symptoms , previous sore throat and fever ?? |
Acute rheumatic fever caused by ( strep A pyogenes ) |
|
|
Acute rheumatic fever criteria |
Erythema marginatum , subcutaneous nodules, migratory arthritis, carditis , chorea |
|
|
Annual vaccine of 60 years old patient?? |
Influenza ( inactivated) |
|
|
Respiratory symptoms, bilateral diffuse infiltration, had liver transplant 7 months ago ??? |
PCP Dx: induced sputum or bronchoalveoalar lavage |
|
|
17 , no symptoms, has non tender, mobile posterior cervical lymph nodes ( < 2 cm ) , management??pers |
Observation |
|
|
Persistent right upper quadrant pain, low grade fever, had bloody diarrhea, |
Abscess from entamoeba histolytica Rx: metronidazole( abscess) and luminal agent ( eradicate intestinal colonization) Don’t drain the abscess |
|
|
> 65 , fever, headache, sore throat, runny nose , severe body aches< one week ?? |
Influenza virus |
|
|
Girl, fever, painful swelling papule on the anterior thigh, lymphadenopathy,the family has cat, dog, turtle?? |
Cat scratch disease ( Bartonella henselae) |
|
|
Woman, fatigue, headache, vomiting, HIV positive, papilledema??? |
Cryptococcal meningoencephalitis Dx: CSF cryptococcal antigen Rx: amphotericin then fluconazole |
|
|
Patient with osteomyelitis from plantar puncture wound??? |
Pseudomonas aeruginosa |
|
|
HIV man, frequent bloody diarrhea, abdominal pain weight loss, CD4 28 ??? |
Cytomegalovirus ( bloody), not Mycobacterium avium complex ( watery) Dx: colonoscopy with biopsy Complications:,retinitis |
|
|
Girl, low grade fever, rash the spread quickly ( cephalocaudal ), auricular and occipital , arthralgia lymphadenopathy?? |
Rubella |
|
|
Infectious mononucleosis diagnosis?? |
Atypical lymphocytes Heterophile antibodies ( negative in early illness) |
|
|
Sickle cell disease with fever, hypotension, asplenia , hypotension, anemia?? |
Strep pneumoniae ( encapsulated) Follow up: penicillin prophylaxis |
|
|
AIDS, tuberculosis symptoms, CD4 <50 ?? |
Mycobacterium avium complex Rx: azithromycin |
|
|
Man, intense pruritic lesion on foot |
Cutaneous larva migrans Epidemiology : hookworm dog ( ancylostoma) or cat( braziliense), barefoot with sand or soil Rx: antihelmintic ( ivermectin) |
|
|
Mononucleosis symptoms in sexually multiple patient, rash all over the body( involves palms and soles) , grey mucus patches in the mouth??? |
Secondary syphilis |
|
|
Healthy patient wants to be sure he doesn’t have STDs ?? |
HIV screen p24 antigen and antibody testing |
|
|
HIV screening indications chart page 984 |
Back (Definition) |
|
|
Tooth removal, slow-growing non tender mass ( mandibular) , sulfur granules ?? |
Cervicofacial Actinomyces ( gram positive) Rx: penicillin |
|
|
diabetic patient having osteomyelitis??? |
Staph coagulase negative ( epidermidis) , B- hemolytic strep |
|
|
HIV, headache, fever, FND, altered mental status, CD4 < 100, MRI shows ring- enhancing lesions ?? |
Toxoplasma encephalitis Rx: sulfadiazine and pyrimethamine. Prophylaxis: TMP-SMX |
|
|
HIV, acute onset watery diarrhea, CD4 unknown , management?? |
Stool examination included ova and parasites |
|
|
Newborn, rhinorrhea, desquamating ( bullous) rash? |
Syphilis |
|
|
Newborn, peri ventricular calcification?? |
Cytomegalovirus |
|
|
Newborn, diffuse intracerebral calcifications , choriorenitis ?? |
Toxoplasmosis |
|
|
Newborn, cataracts, PDA ??? |
Rubella |
|
|
HIV, fever, FND, |
Toxoplasmosis Prophylaxis: TMP-SMX |
|
|
Man, tick bite, high fever, headache, altered mental status, leukopenia , thrombocytopenia, elevated aminotrasferas ?? |
Ehrlichiosis Rx: doxycycline |
|
|
Woman, high fever,had cellulitis, holosystolic murmur?? |
Infective endocarditis ( IVDU) Rx: vancomycin |
|
|
Fever, leukocytosis , left upper quadrant abdominal pain , pleural effusion, systolic murmur ??? |
Splenic abscess due to IE |
|
|
Child, nocturnal perianal pruritus?? |
Pinworm( enterobius vennicularis ) Dx: tape test ( eggs) Rx : pyrantel pamoate, albendazole for all contacts |
|
|
HIV, FND, CT( white matter lesions with no enhancement/ edema ) , CD4 < 200 ?? |
Progressive multifocal leukoencephalopathy caused by JC virus reactivation |
|
|
Tuberculin skin test < 15 in healthy patient management?? |
No more interventions |
|
|
Seizure like epilepsy, ICH, Travel, MRI( hypodense, enhancement /edema cysts )?? |
Neurocysticerosis ( pork tapeworm) eggs Rx: albendazole |
|
|
Bite from neighbor’s dog management? |
Observe the dog for 10 days for rabies, no immediate prophylaxis foe the patient |
|
|
child, Fever, odynophagia , neck pain with extension, muffled voice, lateral neck x-ray ( widened prevertebral space ) ??? |
Retropharyngeal abscess |
|
|
Epiglottis symptoms but the swelling is submandibular , crepitus?? |
Ludwig angina ( cellulitis from infected molar |
|
|
Patient had transplant, pulmonary symptoms, GI symptoms, hepatitis ??? |
CMV |
|
|
Young Patient got influenza treatment and improved then got worse, high fever, necrotizing pneumonia, productive cough with blood, cavity infiltration??? |
Secondary bacterial pneumonia ( methicillin-resistant staph) |
|
|
HIV, CD4 <50, tuberculosis symptoms, purple pedunculated lesions on face and extremity, CT( hyposense liver lesions) ?? |
Bartonella ( bacillary angiomatosis ) Dx: biopsy Rx: doxycycline or erythromycin |
|
|
Anesthetic hypopigmented lesions with peripheral nerve involvement ( ulnar) , painful nerve deformity?? |
Leprosy Dx: biopsy from the edge of lesion |
|
|
Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ??? |
EBV ( infectious mononucleosis Dx: heterophile antibody( monospot) , Atypical lymphocytosis Rx: avoid sports > 4 weeks ( risk splenic rupture) |
|
|
Child, rash , painful pustules, golden yellow crust ?? |
Impetigo Rx: localized( non-bullous) : mupirocin generalized( bullous) : cephalexin , clindamycin |
|
|
Child, 2 weeks rhinorrhea then dry cough causing vomiting?? |
Pertussis Dx: PCR Rx: macrolide |
|
|
Painless bump, VDRL and HIV is negative??? |
Primary syphilis Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology |
|
|
Early Lyme disease features |
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) |
|
|
Pneumonia in immunocompromised, respiratory failure ( using accessory muscles) , fever, dry cough, diffuse interstitial infiltration??? |
Pneumocystis pneumonia ( jirovecii) |
|
|
Patient immunocompromised, has TB symptoms, temporal abscess, grow in gram stain positive acid -fast rods ??? |
Nocardia Rx: TMP-SMX |
|
|
Headache, fever, nuchal rigidity which organism? |
Pneumococcal pneumonia ( strep pneumonia) |
|
|
19, persistent dry cough, pharyngitis, normal leukocyte, macular rash , interstitial infiltration, small effusion??? |
Atypical pneumonia ( mycoplasma) Rx: empiric azithromycin |
|
|
Menstruation, nasal packing, post surgery infection High fever, hypotension, diffuse erythematous rash , multi-organ involvement, thrombocytopenia, bands??
|
Toxic shock syndrome ( staph) |
|
|
Travel, contaminated water , fever, GI symptoms, pulmonary symptoms, neurologic symptoms??? |
Legionella pneumonia Rx: macrolide or fluoroquinolones ( levofloxacin ) |
|
|
Tetanus vaccine recommendation |
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) |
|
|
Prophylaxis of Lyme disease during traveling ? |
Tick repellent, protective clothing, tick checks |
|
|
Patient without specific symptoms, High fever, neutropenia?? |
Febrile neutropenia Rx: empiric anti- pseudomonas( cefepime , meropenem, piperacillin - tazobactam ) |
|
|
HIV, bright red firm exophytic nodules?? |
Bacillary angiomatosis |
|
|
Most common cardiac effect of Lyme disease?? |
AV block |
|
|
Post exposure prophylaxis of hepatitis A ? |
Hepatitis A vaccine or hepatitis A immune globulin for ( sex , household ) contacts |
|
|
Chronic diabetic, foot ulcer does not heal, has odor , bone palpable ?? |
Osteomyelitis Dx: bone biopsy and culture of affected bone |
|
|
Varicella post exposure prophylaxis recommendation |
Yes Prior infection or 2 doses of vaccine: reassurance No prior....etc: give vaccine alone( normal patient), immune globulin alone (immunocompromised) |
|
|
Pneumonia with cystic fibrosis according to age organisms ? |
Infants and young children: staph aureus Adults : pseudomonas aeruginosa |
|
|
Patient with penicillin allergy , has chancre ? |
Primary syphilis Rx: doxycycline for 14 days ( because it’s allergic to penicillin) |
|
|
Indication of success in treatment of syphilis?? |
4- fold decrease in antibodies titters( RPR) at 6-12 months |
|
|
Patient with Positive HBsAg and HBeAg management?? |
HB vaccine and HB immune globulin |
|
|
Acute cervical adenitis in children |
Unilateral: staph, strep pyogenes Bilateral: adenovirus, EBV/ CMV |
|
|
Child, Fever, unilateral red tender neck swelling ?? |
Lymphadenitis ( staph, strep ) |
|
|
Patient with symptoms of acute UTI infection, unrinary alkalosis ( PH> 8 ) , organism? |
Proteus mirabilis ( urease -productive ) Complication: ammonium magnesium calculi |
|
|
Foodborne disease chart page 710 |
Back (Definition) |
|
|
Infectious mononucleosis RX |
Avoid sports ( splenic rupture) |
|
|
Disseminated gonococcal infection features |
Sexually active, Tenosynovitis , dermatitis ( pustular rash ) , polyarthralgias Dx: NAAT Rx: IV ceftriaxone |
|
|
Predisposing factor of the bacterial sinusitis?? |
Viral upper respiratory infection |
|
|
Most common valvular defect in infective endocarditis?? |
Mitral regurgitation |
|
|
Fever, acute joint pain, inability to walk , very high leukocytosis and elevated ESR ?? |
Septic arthritis by staph( joint destruction) Rx: empiric vancomycin, Emergency surgical drainage. |
|
|
Bacterial causes of diarrhea chart page 840 |
Back (Definition) |
|
|
Bacterial cases of diarrhea |
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) |
|
|
Patient with E-coli bloody diarrhea should avoid?? |
Empiric antibiotic ( hemolytic uremic syndrome) |
|
|
Most following opportunistic infection after renal transplant? |
CMV ( colitis, bloody diarrhea, ulcers on colonoscopy,atypical lymphocytes) Dx: biopsy |
|
|
Erythema, swelling, pain out of proportion, crepitus?? |
Necrotizing fasciitis ( group A strep , staph) |
|
|
Child , had lunch outside, acute onset of vomiting, cramps, no diarrhea ??? |
Staph aureus foodborne illness |
|
|
landscaper Patient with skin papule that ulcerate with nonpurulent , odorless drainage, proximal lesions?? |
Sporothrix dimorphic fungus ( sporotrichosis ) found in decaying vegetation Dx: culture Rx: itraconazole (3-6 months) |
|
|
Treatment with isoniazid effect on liver ?? |
Mild LFTs elevation( self-limited) |
|
|
Mumps complication? |
Orchitis, deafness |
|
|
Mononucleosis-like syndrome, fever, night sweats, lymphadenopathy?? |
Acute HIV , the patient should be tested for HIV Dx: viral load( early stage) , HIV antibodies may be negative pneumocystis |
|
|
Pneumocystis pneumonia suggests? |
Selection loss of CD4 |
|
|
Sickle cell disease patient with fever and severe pain in the left tibia ??? |
Osteomyelitis caused by salmonella, staph |
|
|
Neonatal sepsis, hypothermia, lethargy, low WBCs ??? |
Meningitis caused by Group B strep |
|
|
Old patient who had a surgery, intubated, fever and right lung infiltration? |
Ventilator-associated pneumonia ( > 48 hours after intubation) Follow up: gram stain and culture of respiratory secretions and empiric abx |
|
|
Old, fever, malaise, focal lower back pain , recent UTI infection??? |
Vertebral osteomyelitis Dx: blood culture, ESR, CRP, MRI then CT-guided bone biopsy |
|
|
Fever, sore throat, malaise, difficult swallow, posterior or diffuse cervical lymphadenopathy?? |
Infectious mononucleosis( EBV) Complications: acute airway obstruction, anemia, splenic rupture. Dx: heterophile antibody ( Monospot test ) Rx: corticosteroids |
|
|
Child, fatigue, fever, exudative pharyngitis, diffuse cervical lymphadenopathy, polymorphous rash( after administration of amoxicillin) ??? |
Infectious mononucleosis ( Epstein- Barr virus) |
|
|
AIDS patient, CD4 500, should be given varicella vaccine?? |
Yes If the CD4 < 200 then no |
|
|
9-year girl, uncontrolled writhing of arms and hands , face grimacing, heart symptoms , previous sore throat and fever ?? |
Acute rheumatic fever caused by ( strep A pyogenes ) |
|
|
Acute rheumatic fever criteria |
Erythema marginatum , subcutaneous nodules, migratory arthritis, carditis , chorea |
|
|
Annual vaccine of 60 years old patient?? |
Influenza ( inactivated) |
|
|
Respiratory symptoms, bilateral diffuse infiltration, had liver transplant 7 months ago ??? |
PCP Dx: induced sputum or bronchoalveoalar lavage |
|
|
17 , no symptoms, has non tender, mobile posterior cervical lymph nodes ( < 2 cm ) , management??pers |
Observation |
|
|
Persistent right upper quadrant pain, low grade fever, had bloody diarrhea, |
Abscess from entamoeba histolytica Rx: metronidazole( abscess) and luminal agent ( eradicate intestinal colonization) Don’t drain the abscess |
|
|
> 65 , fever, headache, sore throat, runny nose , severe body aches< one week ?? |
Influenza virus |
|
|
Girl, fever, painful swelling papule on the anterior thigh, lymphadenopathy,the family has cat, dog, turtle?? |
Cat scratch disease ( Bartonella henselae) |
|
|
Woman, fatigue, headache, vomiting, HIV positive, papilledema??? |
Cryptococcal meningoencephalitis Dx: CSF cryptococcal antigen Rx: amphotericin then fluconazole |
|
|
Patient with osteomyelitis from plantar puncture wound??? |
Pseudomonas aeruginosa |
|
|
HIV man, frequent bloody diarrhea, abdominal pain weight loss, CD4 28 ??? |
Cytomegalovirus ( bloody), not Mycobacterium avium complex ( watery) Dx: colonoscopy with biopsy Complications:,retinitis |
|
|
Girl, low grade fever, rash the spread quickly ( cephalocaudal ), auricular and occipital , arthralgia lymphadenopathy?? |
Rubella |
|
|
Infectious mononucleosis diagnosis?? |
Atypical lymphocytes Heterophile antibodies ( negative in early illness) |
|
|
Sickle cell disease with fever, hypotension, asplenia , hypotension, anemia?? |
Strep pneumoniae ( encapsulated) Follow up: penicillin prophylaxis |
|
|
AIDS, tuberculosis symptoms, CD4 <50 ?? |
Mycobacterium avium complex Rx: azithromycin |
|
|
Man, intense pruritic lesion on foot |
Cutaneous larva migrans Epidemiology : hookworm dog ( ancylostoma) or cat( braziliense), barefoot with sand or soil Rx: antihelmintic ( ivermectin) |
|
|
Mononucleosis symptoms in sexually multiple patient, rash all over the body( involves palms and soles) , grey mucus patches in the mouth??? |
Secondary syphilis |
|
|
Healthy patient wants to be sure he doesn’t have STDs ?? |
HIV screen p24 antigen and antibody testing |
|
|
HIV screening indications chart page 984 |
Back (Definition) |
|
|
Tooth removal, slow-growing non tender mass ( mandibular) , sulfur granules ?? |
Cervicofacial Actinomyces ( gram positive) Rx: penicillin |
|
|
diabetic patient having osteomyelitis??? |
Staph coagulase negative ( epidermidis) , B- hemolytic strep |
|
|
HIV, headache, fever, FND, altered mental status, CD4 < 100, MRI shows ring- enhancing lesions ?? |
Toxoplasma encephalitis Rx: sulfadiazine and pyrimethamine. Prophylaxis: TMP-SMX |
|
|
HIV, acute onset watery diarrhea, CD4 unknown , management?? |
Stool examination included ova and parasites |
|
|
Newborn, rhinorrhea, desquamating ( bullous) rash? |
Syphilis |
|
|
Newborn, peri ventricular calcification?? |
Cytomegalovirus |
|
|
Newborn, diffuse intracerebral calcifications , choriorenitis ?? |
Toxoplasmosis |
|
|
Newborn, cataracts, PDA ??? |
Rubella |
|
|
HIV, fever, FND, |
Toxoplasmosis Prophylaxis: TMP-SMX |
|
|
Man, tick bite, high fever, headache, altered mental status, leukopenia , thrombocytopenia, elevated aminotrasferas ?? |
Ehrlichiosis Rx: doxycycline |
|
|
Woman, high fever,had cellulitis, holosystolic murmur?? |
Infective endocarditis ( IVDU) Rx: vancomycin |
|
|
HIV, fever, FND, |
Toxoplasmosis Prophylaxis: TMP-SMX |
|
|
Child, nocturnal perianal pruritus?? |
Pinworm( enterobius vennicularis ) Dx: tape test ( eggs) Rx : pyrantel pamoate, albendazole for all contacts |
|
|
HIV, FND, CT( white matter lesions with no enhancement/ edema ) , CD4 < 200 ?? |
Progressive multifocal leukoencephalopathy caused by JC virus reactivation |
|
|
Tuberculin skin test < 15 in healthy patient management?? |
No more interventions |
|
|
Seizure like epilepsy, ICH, Travel, MRI( hypodense, enhancement /edema cysts )?? |
Neurocysticerosis ( pork tapeworm) eggs Rx: albendazole |
|
|
Bite from neighbor’s dog management? |
Observe the dog for 10 days for rabies, no immediate prophylaxis foe the patient |
|
|
child, Fever, odynophagia , neck pain with extension, muffled voice, lateral neck x-ray ( widened prevertebral space ) ??? |
Retropharyngeal abscess |
|
|
Epiglottis symptoms but the swelling is submandibular , crepitus?? |
Ludwig angina ( cellulitis from infected molar |
|
|
Patient had transplant, pulmonary symptoms, GI symptoms, hepatitis ??? |
CMV |
|
|
Young Patient got influenza treatment and improved then got worse, high fever, necrotizing pneumonia, productive cough with blood, cavity infiltration??? |
Secondary bacterial pneumonia ( methicillin-resistant staph) |
|
|
HIV, CD4 <50, tuberculosis symptoms, purple pedunculated lesions on face and extremity, CT( hyposense liver lesions) ?? |
Bartonella ( bacillary angiomatosis ) Dx: biopsy Rx: doxycycline or erythromycin |
|
|
Anesthetic hypopigmented lesions with peripheral nerve involvement ( ulnar) , painful nerve deformity?? |
Leprosy Dx: biopsy from the edge of lesion |
|
|
Patient with sore throat, malaise..etc for 2 weeks, exudative tonsils , enlarged tender mobile nodes along cervical, axilla, inguinal ( diffuse lymphadenopathy) ??? |
EBV ( infectious mononucleosis Dx: heterophile antibody( monospot) , Atypical lymphocytosis Rx: avoid sports > 4 weeks ( risk splenic rupture) |
|
|
Child, rash , painful pustules, golden yellow crust ?? |
Impetigo Rx: localized( non-bullous) : mupirocin generalized( bullous) : cephalexin , clindamycin |
|
|
Child, 2 weeks rhinorrhea then dry cough causing vomiting?? |
Pertussis Dx: PCR Rx: macrolide |
|
|
Painless bump, VDRL and HIV is negative??? |
Primary syphilis Dx: non treponemal and treponemal FTA-ABS ( 97% sensitive) serology |
|