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Potpourri
Potpourri
Potpourri
Potpourri
Potpourri
100
Treatment of choice for erythema migrans in a pregnant woman?
What is amoxicillin?
100
Causative agent of hot tub folliculitis?
What is Pseudomonas?
100
Name the most likely causative organism: 34y/o woman from Ohio on adalimumab for Crohns disease presents with fever and malaise x 2 weeks, elevated transaminases, and pancytopenia.
What is Histoplasma?
100
Most likely cause of this illness? A 35-year-old male visited Zimbabwe for 3 weeks to assess farm productivity. One day after his return to the United States, he developed fever, headache, diffuse myalgies and joint pains in his hands, elbows, shoulders, knees, and feet. He had a macular non-pruritic rash. His fingers and wrists were swollen but not erythematous. He relates that he took mefloquine weekly.
What is Chikungunya?
100
Which of the following would you administer for prophylaxis of a non-vaccinated pregnant woman (10 weeks) exposed to a child with chicken pox? A. Valtrex B. VariZig C. Varicella vaccine D. A&B
What is B?
200
A 56-year-old housewife living in rural Colorado is hospitalized for pneumonia. The husband says she is healthy. When he left that morning, she was well and was peering into the throat of the family cat which seemed to be sick, coughing or choking. She is febrile to 104.2, looks ill, coughing up bloody purulent sputum. WBC 29,500 with 70% segs and 15% bands; platelets 86,000. What is the most likely cause of her presentation?
What is Yersinia?
200
The causative agent of this syndrome: 31-year-old woman with n/v x 3 days, fever, double vision, and unsteady gait. Her husband noted upon wakening this AM that her eyes “weren’t looking in the same place.” An MRI of the head demonstrated inflammation of the pons and medulla.
What is Listeria?
200
Name 3 causes of nodular lymphangitis - defined by marching subcutaneous lesions, intervening normal skin, often without specific lymph node involvement
What are Sporothrix, Nocardia, and M.marinum?
200
A 40-year-old man from Ghana was visiting his daughter in the United States. She sought medical care for her father who has generalized pruritus. A 4 cm painless nodule was found on his right hip. Biopsy of the nodule reveals cross-sections of very thin nematodes. The most likely cause of the nodule is:
What is Onchocerca volvulus
200
The correct PrEP regimen for this patient is: A 37-year-old man presents asking about HIV PrEP. He is in a monogamous relationship with his HIV- husband of 7 years. He is HIV antibody negative on rapid testing and his creatinine clearance is calculated at >100 cc/min.
What is none.
300
Name the disease: A 28-year-old male comes in with 12 days of fevers, cough, and muscle aches. He recently returned from a community service mission in Vietnam. The last week there, he assisted with construction of a clinic in a rural area. On examination he has a fever of 103°F, and signs of consolidation in the lungs. His exam also shows multiple skin abscesses. A CT of the chest reveals cavitary pneumonia and a liver abscess. The abscess is aspirated and reveals many gram negative organisms which on culture were an aerobic, oxidase positive bacillus which the automated system was unable to identify.
What is meliodosis?
300
Initial management of a 37-year-old male lab tech who presents 60 minutes after exposure to a needlestick from an HIV+ man undergoing routine blood draw. The patient whose blood was being drawn takes abacavir/lamivudine + darunavir/ritonavir with his last HIV RNA 62 copies/ml and CD4 553.
What is tenofovir/emtricitabine + raltegravir X 4 weeks?
300
This is how many millimeters of induration considered "positive" in an HIV infected individual.
What is 5?
300
Name most likely causative organism: A 55-year-old man from Afghanistan was being evaluated for a complex cystic mass in his liver. While waiting for his next appointment, he rapidly develops shortness of breath 20 minutes after falling onto his abdomen while running to catch a train. In the emergency department, he is noted to be tachycardic, hypotensive, and diaphoretic. His tongue and lips are swollen, he has diffuse wheezing on pulmonary auscultation, and he has hives all over his body.
What is Echinococcus granulosus?
300
Which of the following is most likely to be affected by taking St. Johns Wort? raltegravir, darunavir,ritonavir, tenofovir, zidovudine, lamivudine.
What is darunavir?
400
Name the organism: 19y/o presents with left eye pain, watery discharge, redness of conjunctiva. Also with tender swelling in front of his left ear. He is a college student, is sexually active, has a kitten and a dog.
What is Bartonella?
400
Most likely infectious cause of progressive renal failure in a renal transplant recipient?
What is BK virus nephropathy?
400
Name the causative organism: A 23-year-old healthy female develops severe abdominal pain and vomiting several hours after eating sushi prepared from raw wild-caught Pacific salmon. Upper endoscopy revealed a 2 cm long nematode embedded in the gastric mucosa.
What is Anisakis simplex?
400
A 42-year-old woman with HIV that for the last month it has been difficult for her to climb stairs and get up from chairs, and she feels overall weak. She denies myalgias. Her strength was normal before starting medications. On exam, the strength in her hip flexors is markedly decreased (3+/5), and the sensory exam is normal including deep tendon reflexes. Her creatine kinase level is 550 (twice normal). Which medication is the likely cause of her symptoms?
What is zidovudine?
400
Most likely underlying problem leading to meningitis due to Streptococcus gallolyticus (S. bovis) in a woman who has two pet dogs and had lived in rural parts of Southeast Asia as a Peace Corp volunteer over a decade prior.
What is Strongyloidiasis?
500
Name the disease: A woman presents to the ER with a necrotic ulcer on her hand and a history of participating in a "drumming circle" event.
What is anthrax?
500
Most likely diagnosis of recurrent unexplained fevers that will last for several days x 10 years, abdominal pain, muscle cramping, and intermittent erythematous rash.
TNF-receptor associated periodic fever (TRAPS)
500
A 23-year-old monogamous man presents to clinic asking about the HPV vaccine. He states he has been in a monogamous relationship with the same man for three years. He has no allergies and has never received an HPV vaccine. True or False: He should receive the bi-valent vaccine?
What is False. The Bivalent vaccine is for cervical cancer, not for men. He should receive the 9 valent vaccine.
500
Treatment of choice for the following disease? A 55-year-old male from Westchester, New York has not traveled for 10 years outside of the East Coast. He was hospitalized because of chills and fever. Laboratory results: wbc 4500, plts 25K, Hct 25, bili 3.5, LDH >2500 U/L. Blood smear showed ring forms in 7% of RBC’s.
What is clindamycin and quinine?
500
Treatment of choice for a 55-year-old woman from rural Connecticut who reports a tick bite she had five days previously. She is quite convinced that the tick could not have been attached for more than 24 hours.
What is no treatment?