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Block 3 POM Exam -- Infectious Disease (Random facts)


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Almost all giant cell arteritis pts. are above what age?
50 y.o.
One of the most common disseminated infections to show up at FUO is?
Disseminated Tb
The most common causative pathogen for bacterial meningitis is...
Strep pneumoniae
The most specific sign for establishing dx of sinusitis is?
Maxillary opacity on transillumination
What therapy covers the usual causes of sinusitis?
What are the most common pathogens for nosocomial, secondary infections (2)?
Staph Aureus
Pseudomonas aeruginosa
Top three causes for community acquired pneumonia
Strep pneumo
Haemophilus influenzae
Mycoplasma pneumoniae
Top two causes for community acquired UTI
E. Coli
Staph saprophyticus
Indwelling lines are RFs for what pathogens (3)?
Gram-negative rods
Bacteria that have beta-lactamases that are induced by cephalosporins

Top 3 causes for HIV-associated FUO
3 most common causes of meningitis in 3 mo - 18 y.o pts.
Strep pneumo
H. Influenzae
N. meningitides
Treatment for meningitis in 3 mo - 18 y.o. pt.
Cef3 + vancomycin
4m ost common causes of meningitis in > 50 y.o. pts.
Strep pneumo
N. meningitides
L. monocytogenes
Aerobic GNRs
Treatment for meningitis in > 50 y.o. pts.
Cef3 + vancomycin + ampicillin
Two most common causes for community acquired sinusitis
Strep pneumo
H. Influenzae
Most specific sign for community-acquired sinusitis
Maxillary toothache
What type of cold is caused by influenza C?
Afebrile, common colds
Non-pulmonary complications of influenza include (3)
Reye's syndrome
What is Reye's syndrome?
Fatty liver, w/ an encephalopathy

NOTE: this can be a complication of influenza
CNS side effects are most common w/ which anti-flu drug?
Which has more side effects in treating flu?

NA inhibitors or M2 inhibitors
M2 inhibitors
Pneumonia in the elderly or COPD pts. if often assoc. w/ which pathogen?
M. Catarrhalis
Pneumonia w/ necrosis w/ cavitation suggests which pathogens (3)?
Staph aureus
K. pneumoniae
S. pneumoniae
Bilateral, diffuse infiltrate in pneumonia suggests what etiology?
How is Hep A transmitted?
Fecal-oral route
Which hepatitis is the only one that causes spiking fevers?
Hep A
What is usually the first symptom of Hep A?
Dark urine
How is Hep B transmitted?
Blood, sexual contact
What is the incubation for Hep B?
3 - 6 months
What is the incubation of Hep A?
2 - 7 weeks
What is used in chronic Hep B therapy (3)?
What is the incubation period for Hep C?
~7 weeks
How is Hep C transmitted?
Blood, sexual contact
Which genotype of Hep C is assoc. w/ a poor response to therapy?
Genotype 1
Which anti-microbials are used against peritonitis in CAPD (2)?
Aminoglycoside + Vancomycin
This vulvovaginal infection maintains normal pH
Vulvovaginal Candidiasis
Hallmark cell type of Bacterial Vaginosis
Clue cell
What is the mainstay of treatment for bacterial vaginosis?
What replaces the lactobacilli in bacterial vaginosis?
Gardnerella vaginali
Large numbers of PMNs in a bacterial vaginosis case may indicate what?
A coincident vaginal process

BV discharge usually contains very few PMN
Involvement of what differentiates candidiasis from tinea infection?
The scrotum

Candidiasis frequently involves the scrotum
Tinea does not
How is trichomoniasis treated?
Types of HPV assoc. w/ genital warts
6 and 11
Preferred treatment for chancroid (3)?
New macrolides
What anti-microbial should syphilis pts. NOT be treated w/?
Below what level of CD4 is AIDS defined?
< 200
Advanced AIDS is below what level of CD4?
< 50
Average rate of decline in CD4 count in AIDS
50 per year
What 4 interventions have been proven to prolong survivial in AIDS?
Anti-retroviral therapy
Pneumocystis Jiroveci pneumonia prophylaxis
MAC prophylaxis
Care by HIV-experienced provider
What is the HIV serology often at during Acute Retroviral syndrome?
What is the prophylactic therapy for PCP?

When is it given to AIDS pts.?
TMP/SX 3x/week

At CD4 levels < 200
What is the prophylactic treatment for Tb?
INH for 9 months
What is the prophylactic treatment for Toxoplasmosis?

When is it given to AIDS pts.?

When CD4 levels are < 100
What is the prophylactic treatment for MAC?

When is it given to AIDS pts.?
Clarithromycin daily OR Azithromycin weekly

When CD4 levels are < 50
For what CD4 levels, would you treat an asymptomatic AIDS pt.?
CD4 200 - 350

> 350, treatment is often deferred
What is a side effect that is common to all PIs in the treatment of AIDS?
Can alter lipids to a variable degree

Raises concern of accelerated atherogenesis
What is almost always elevated in PCP infection in AIDS?
Serum LDH
What is the most common meningeal process complicating AIDS?
Cryptococcal meningitis

NOTE: CSF protein is elevated, and glucose is decreased
What is the triad of HIV encephalitis?
Cognitive, motor and behavioral dysfunction

NOTE: this is often afebrile
NOTE: CSF is often normal
What is the most common focal CNS process in AIDS?

NOTE: often presents as multiple lesions on CT
What is the most common cause of FUO in AIDS pts. w/ CD4 < 100?

NOTE: antiretroviral therapy can cause fever and myopathy
Common cause of chronic diarrhea in AIDS pts.
Pathogens assoc. w/ hematologic spread osteomyo in infants (3)
Staph aureus
Group B strep
E. Coli
Pathogens assoc. w/ hematologic spread osteomyo in children > 1 y.o. (3)
Staph aureus
Group A strep
H. influenzae
Pathogen assoc. w/ osteomyo assoc. w/ punctures through athlethic shoes
Pseudomonas aeruginosa
Tertian or quartan fever pattern suggests what diagnosis?
Pulse-temperature deficit is a classic finding in what?
Typhoid fever
A diseease that begins a week or more after a traveler leaves is NOT what?
Dengue fever

Dengue has a short incubation period of 5 - 7 days
Majority of cases of non-inflammatory diarrhea are caused by what?
What types of agents are contraindicated in bacterial dysentery?
Anti-motility agents
What pathogens are assoc. w/ bacterial dysentery (6)?
Entamoeba histolytica
What is the recommended treatment in amoebic colitis?
Prolonged diarrhea of more than two weeks duration raises the possibility of what?
Greater than this induration of a Tb test is considered positive for anyone
> 15 mm
Who gets treated for a Tb reaction of > 5mm?
HIV positive pts.
Recent close contact cases
4 indications for baseline LFTs in Tb situation
Liver disease
What is the most common form of extrapulmonary Tb?
Tb lymphadenitis
Tb lymphadenitis most often involves which nodes?

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