ID practice

Question 1

Which is matched incorrectly?
α = incomplete hemolysis
β = complete hemolysis due to bacterial exotoxin
γ = no hemolysis
All of the above are correct

Answer 1

All of the above are correct

Question 2

First-line treatment for streptococcal infections is what?
a) Amoxicillin-clauvinate
b) Penicillin
c) Cephalosporin
d) Azithromycin/ clindamycin

Answer 2

b) Penicillin

second line = cephalosporin if rxn to PCN is mild, otherwise azithromycin or clindamycin

Question 3

A pt had malaise, headache, cough, and a sore throat. They then began experiencing abdominal pain, distention, and pea soup diarrhea. Physical exam shows splenomegaly and a pink rash on their trunk. How would you diagnose this form of salmonella?
a) Clinically
b) Stool culture
c) Blood culture

Answer 3

c) Blood culture

(pt has Enteric (typhoid fever) so stool culture is unreliable)

Question 4

Sudden, severe, “rice water” (grey, turbid, not odorous) diarrhea is the classic presentation of?
a) Salmonella
b) Shigella
c) Diphtheria
d) Cholera

Answer 4

d) Cholera

Question 5

Coryza (inflammation of nasal mucous membranes) is a part of the catarrhal stage of what condition Morgan’s sister almost died from as an infant?
a) Diphtheria
b) Pertussis
c) Botulism
d) Influenza

Answer 5

b) Pertussis

Question 6

Impaired EOMs, __________ pupils, loss of accommodation, nerve palsies, dry mouth, dysphagia, nausea/vomiting, and potentially respiratory paralysis (death) are all Sxs of botulism
a) constricted
b) dilated

Answer 6

b) dilated

Question 7

Can a pt be cured of pulmonary anthrax if it’s reached the hemorrhagic pneumonia form?
a) Yes, it’s potentially curable
b) No, it’s always fatal

Answer 7

b) No, it’s always fatal

(pulmonary form at this stage is always fatal)

Question 8

Which cause anogenital warts? Select all that apply
a) 6
b) 11
c) 16
d) 18

Answer 8

a) 6
b) 11

(11 may also cause laryngeal warts)

Question 9

_____________ is transmitted via saliva, 85% of US affected
a) HSV-1
b) HSV-2
c) Both of the above

Answer 9

a) HSV-1

(HSV-2: transmits via sexual contact, 25% of US affected)

Question 10

Oseltamivir or zanamivir can be considered in low-risk patients with __________ 12 years or older
a) Human Papillomavirus
b) Herpes Simplex Virus
c) Influenza
d) Varicella-Zoster Virus

Answer 10

c) Influenza

Question 11

What should you NOT give to chickenpox pts due to Reye’s syndrome risk?
a) Tylenol
b) ASA
c) Antivirals
d) Analgesia

Answer 11

b) ASA

Question 12

Which can give you rabies? Select all that apply
a) Bats
b) Skunks
c) Raccoons
d) Foxes
e) Mice
f) Rats
g) Rabbits

Answer 12

a) Bats
b) Skunks
c) Raccoons
d) Foxes

Question 13

Intracytoplasmic inclusions (“owl’s eyes”) and hilar/mediastinal lymphadenopathy are indicative of?
a) Rhabdovirus
b) CMV
c) HIV
d) Candidiasis

Answer 13

B) CMV

Question 14

Which has a disseminated complication rate higher than 40% in pts who are very sick patients with indwelling catheters? (Hint: Tx = amphotericin B)
a) Rhabdovirus
b) CMV
c) HIV
d) Candidiasis

Answer 14

d) Candidiasis

Question 15

A pt who used to cave in structures with bird droppings presents w hilar/mediastinal lymphadenopathy, and GI ulcers. What is the Tx for less severe disease?
a) Oral itraconazole
b) Amphotericin B
c) Lifelong itraconazole after recovery for all pts

Answer 15

a) Oral itraconazole

(Histoplasmosis)

Question 16

A pt who keeps pigeons has had mental status change, visual abnormalities, and headache. CSF findings indicate lymphocytosis, low glucose, and increased protein. What is the best next step in Tx?
a) Oral itraconazole
b) Amphotericin B + suppressive therapy with fluconazole
c) Lifelong itraconazole after recovery for all pts

Answer 16

b) Amphotericin B + suppressive therapy with fluconazole

(pt has Cryptococcus)

Question 17

The most common opportunistic infection in AIDS patients presents with respiratory findings out of proportion to imaging findings and bilateral diffuse infiltrates. This is describing what?
a) Cryptococcus neoformans
b) Candidal fungemia
c) Histoplasma capsulatum
d) Entamoeba histolytica
e) Pneumocystis Jiroveci

Answer 17

e) Pneumocystis Jiroveci

Question 18

What is the first line Tx for Pneumoscystis Jiroveci pts?
a) Steroids only
b) Vancomycin + steroids
c) Amoxicillin-clavinate + steroids
d) TMP-SMX + steroids

Answer 18

d) TMP-SMX + steroids

Question 19

A pt has anchovy paste purulence, fever, painful hepatomegaly, and sweating. Stool specimen shows cysts and trophozoites. Liver enzymes and eosinophils are normal. Antibodies for Amebiasis are positive. The pt is given Metronidazole and iodoquinol, along with fluids, electrolytes, & opioids, but their hepatic symptoms are still the same 4 days later. What is the next step?
a) Try Paromycin along with Metronidazole
b) Add chloroquine
c) Add permethrin
d) Drain hepatic abscesses

Answer 19

d) Drain hepatic abscesses

(pt has hepatic amebiasis)
Then, confirm treatment success with colonoscopy or 3 stool examinations

Question 20

A pt who just visited Brazil presents with coughing, wheezing, and blood-tinged sputum. You note a site of erythematous dermatitis with maculopapular and vesicular eruption. Stool test notes eggs and occult blood. Which of the following is NOT an appropriate Tx?
a) Mebendazole
b) Albendazole
c) Pyrantel
d) Permethrin

Answer 20

d) Permethrin

(Pt has hookworms)

Question 21

Pinworms can be treated with all of the same things as hookworm, and presents with what primary symptom?
a) Perianal pruritus
b) Painless perianal ulcers
c) Gummatous lesions
d) Chills, then fever, then diaphoresis

Answer 21

a) Perianal pruritus

Question 22

Another pt who just visited Brazil says they just had chills, then fever, and now they have diaphoresis and hepatosplenomegaly with fatigue. Which is an appropriate Tx?
a) Try Paromycin along with Metronidazole
b) Chloroquine
c) Permethrin
d) Drain hepatic abscesses

Answer 22

b) Chloroquine

Question 23

Which are an appropriate combination of tests for syphilis? Select all that apply
a) VDRL + RPR
b) VDRL + FTA-ABS
c) RPR + FTA-ABS

Answer 23

b) VDRL + FTA-ABS
c) RPR + FTA-ABS

Question 24

Ceftriaxone treats which?
a) Gonorrhea
b) Chlamydia

Answer 24

a) Gonorrhea

Question 25

_____________ is caused by gram-negative intracellular diplococci, and _________ is caused by intracellular parasites a) Gonorrhea; chlamydia b) Chlamydia; gonorrhea

Answer 25

a) Gonorrhea; chlamydia

Question 26

What should you give for a pregnant chlamydia pt? a) Doxycycline b) Azithromycin c) Erythromycin d) Amoxicillin e) Any of the above

Answer 26

c) Erythromycin

Question 27

What should you give a pregnant lyme disease pt? a) Doxycycline b) Azithromycin c) Erythromycin d) Amoxicillin e) Any of the above

Answer 27

d) Amoxicillin (Doxy if not pregnant)

Question 28

A pt who went hiking about 10 days ago has a rash that started at the wrists and ankles, but has now spread centrally. IgGs are elevated. What is the best Tx? a) Doxycycline b) Azithromycin c) Erythromycin d) Amoxicillin e) Any of the above

Answer 28

a) Doxycycline (pt has Rocky Mountain Spotted Fever)

Question 29

How do you confirm an HIV Dx? a) Rapid HIV antibody b) CD4 count and viral load c) ELISA

Answer 29

c) ELISA

Question 30

A very sick patient with an indwelling catheter is now experiencing retinal lesions, dermatitis, and meningitis. What is the Tx? a) IV amphotericin B b) IV itraconazole c) PO Fluconazole d) Topical itraconazole

Answer 30

a) IV amphotericin B (pt has candidal fungemia)

Question 31

Which is an example of a third stage (late persistent infection) symptom of Lyme disease? a) Aseptic meningitis b) Bell palsy c) Encephalitis d) Headache e) Polyneuropathy f) Pericarditis

Answer 31

e) Polyneuropathy (other stage 3 Sxs = chronic memory/ mood issues, bladder dysfunction)