Tick-Tok
Smear and far
The febrile journey
Rash decision
Where did the blood go?
100
The causative spirochete of Lyme disease may be transmitted when an infected Ixodes Scapularis tick attaches for at least _____ hours.
What is 36 hours?
100
What is the abnormality?
What is hypochromia?
(Occurs in conditions such as iron-deficiency anemia causing RBCs to contain less hemoglobin. )
100
Fever, petechiae, frontal headache, retro-orbital pain, and myalgias are features of this vector-borne illness
What is Dengue fever?
100
Name this rash
What is a heliotrope rash?
100
Name this physical exam finding and a disease it can indicate. 
What is conjunctival rim pallor and what is iron-deficiency anemia?
200
Hemolytic anemia is the hallmark of this tick-borne illness.
What is Babesiosis?
200
Name at least three diseases in which you would see schistocytes.
What is DIC, TTP-HUS, and HEELP?
200
Is doxycycline bacteriostatic or bacteriocidal?
What is bacteriostatic? MOA = inhibition of protein synthesis
200
Name this exam finding
What are Gottron papules?
See in dermatomyositis
200
Initial dose of oral vitamin B12 for supplementation used for most patients
What is 1000 -2000 micrograms/d?
300
What are two ways to diagnosis babesiosis?
What is direct visualization on a blood smear?
What is PCR testing?
300
What is the abnormality? 
Schistocytes
300
The most common travel-associated infection
What is traveler's diarrhea (caused by enterotoxigenic e.coli)?
300
Name three types of inflammatory myopathies
What is polymyositis, dermatomyositis, immune-mediated necrotizing myopathy, and inclusion body myositis?
300
Name three causes of hemolytic anemia
G6PD deficiency, sick cell disease, autoimmune hemolytic anemia, hereditary spherocytosis, PNH
400
Treatment (including dosing and duration) for early localized Lyme
What is doxycycline 100mg BID x 10 days?
400
A 74 year old male has a Hgb of 7.5 g/dL, WBC 2200, Plat 87,000. The smear shows a few nucleated erythrocytes and bone marrow shows hypolobulated neutrophils.
Diagnosis?
What is myelodysplastic syndrome?
400
Severe manifestations of malaria occur with this species (which has chloroquine resistance)
What is P.falciparum?
400
Name three dermatologic abnormalities associated with dermatomyositis
Gottron papules, heliotrope rash (violaceous rash on upper eyelids), and nailfold cappillary abnormalities. (also photodistrubuted poikiloderma including shawl sign)
400
What abnormality is seen here?
What are sickled cells
500
A 23-year-old woman is evaluated for a 4-day history of fever, headache, and myalgia. A rash appeared today. She completed a hike on the Appalachian Trail in North Carolina 12 days ago.
The rash is shown.
What is rocky mountain spotted fever?
500
Name at least five lab abnormalities seen with TTP
What is thrombocytopnia, elevated LDH, low haptoglobin, schistocytes on smear, decreased ADAMTS13 activit
500
39 y/o M, 8-weeks of intermittent fevers that began after returning Guyana 2 months ago. Also has fatigue, muscle and bone pain, and depression. He was adherent to malaria ppx. On exam, temp is 99.5F, with otherwise normal vitals. He has scattered LAN and a palpable liver edge. Labs notable for Hct 33%, WBC 3400, alk phos 167, ALT 71, AST 46. What is the most likely diagnosis?
Brucellosis
Coxiella infection (Q fever)
Histoplasmosis
Malaria
what is brucellosis
500
A 45-year-old man develops a generalized painful skin rash 4 weeks after starting allopurinol for recurrent gout. He is systemically ill with fever, malaise, and facial swelling.
The rash on his thigh is shown.
What is drug-induced hypersensitivity syndrome?
500
A 32-year-old woman is evaluated for dyspnea with exertion of 2 weeks' duration. Medical history is significant for systemic lupus erythematosus. Family history is unremarkable. Her only medication is hydroxychloroquine.
On physical examination, blood pressure is 98/60 mm Hg and pulse rate is 107/min; other vital signs are normal. Oxygen saturation is 98% breathing ambient air. Other than tachycardia, the physical examination is normal.
What is the most appropriate next step?
What is a DAT?