Step 2 ID

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Author:
matt.hoffman
ID:
14830
Filename:
Step 2 ID
Updated:
2010-04-21 17:16:43
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USMLE Step Infectious Disease
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prep for step 2
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  1. Gram - coccobacilli
    Haemophilus spp
  2. Gram - diplococci
    • Neisseria (gonorrhea, septic arthritis, meningitis) or
    • Moracella spp
  3. Mucoid appearing gram -
    Klebsiella
  4. Gram + rods that form spores
    • Clostridium or
    • Bacillus
  5. Pseudohyphae
    Candida
  6. Acid-fast organsism
    • Mycobacterium TB or
    • Nocardia
  7. woman with PID and an IUD gram stain shows Sulfur granules
    Actinomyces
  8. Silver staining
    pneumocystis jiroveci and cat scratch disease
  9. Positive India Ink prep
    Cryptococcus
  10. Spirochete on microscopy? on dark field?
    • Light: Borrelia
    • Dark: Treponema, Leptospira
  11. Pt stuck with thorn. Rx?
    • Sporothrix schenckii
    • Rx: itraconazole, fluconazole, or oral K iodide
  12. Aplastic crisis in sickle cell disease
    Parvo B19
  13. Sepsis after splenectomy
    S pneumo, H influ, N meningitidis
  14. Pt with PNA from SW US? Rx?
    • Dx: Coccidioides immitits
    • Rx: Itraconazole, Fluconazole, or amphotericin B
  15. PNA after cave exploring or seeing birds in Mississippi or Ohio rivers
    Histoplasmosis
  16. PNA after exposure to parrot or exotic bird
    Chlamydia Psittaci
  17. Fungus ball or hemoptysis after TB-induced cavitary disease
    Aspergillus
  18. PNA in pt with silicosis
    TB
  19. Rx for diarrhea from drinking from stream
    Metronidazole
  20. Pregnant woman with cats
    Toxoplasma gondii
  21. B12 deficiency and abd symptoms
    Diphyllobothrium latum
  22. Seizures with ring enhancing brain lesion on CT
    Taenia solium (cysticercosis)
  23. Squamous cell Bladder cancer in Middle east and Africa
    Schistosoma haematobium
  24. Pin worm organism
    Enterobius spp
  25. Fever, myalgias, eosinophilia, periorbital edema, sp eating raw meat
    Trichinella spiralis (trichinosis)
  26. Young child with gastroenteritis
    rotavirus
  27. Food poisoning after raw seafood
    Vibrio parahaemolyticus
  28. Diarrhea after mexico travel
    E coli
  29. Rx for pt with diarrhea some time after abx
    Oral metronidazole or vancomycin
  30. Genital lesions in child with no signs of abuse
    Mulloscum contagiosum
  31. Cellulitis after cat or dog bites? Rx?
    • Dx: Pasteurella multocida
    • Rx: Ampicillin prophylactically
  32. Slaughterhouse worker with fever?
    Brucella spp
  33. Rx for PNA from water source (AC, etc)
    Azithromycin and Flouroquinolone
  34. Burn wound infx with blue green color
    Pseudomonas
  35. What illnesses are caused by Staph? What is the Rx for staph?
    • Cellulitis
    • Endocarditis
    • Osteomyelitis
    • Septic Arthritis (S. aureus)

    Rx: Dicloxacillin, Methicillin (Vancomycin if resistant)
  36. What is the Rx for Bronchitis?
    Amoxicillin and Erythromycin
  37. What infections are caused by Strep? Rx for strep?
    • Cellulitis
    • Endocarditis
    • Sepsis
    • Meningitis, Pneumonia (S pneumo)

    • Rx: Dicloxacillin, Methicillin
    • (S pneumo = third gen cephalosporin)
  38. Rx for Gonococcal arthritis?
    • Ceftriaxone
    • Flouroquinolone
    • Spectinomycin
  39. Rx for UTI?
    • Trimethoprim-sulfamethoxazole
    • Nitrofurantoin
    • Amoxicillin
    • Quinilones
  40. Rx for atypical pna?
    • Macrolides (*thromycin)
    • Doxycycline
  41. Causes of PNA? In whom? Rx?
    • S pneumonia: older adults (3rd gen cephalosporins)
    • H influ: young children (amp or amox or 3rd gen ceph)
    • S aureus: nosocomial, CF, IV abuse, granulomatous disease (methicillin or dicloxacillin)
    • Pseudomonas (CF), Klebsiella (homeless), E coli (noso, aspiration): 3rd gen penicillin or ceph + aminoglycoside
    • Mycoplasma, Chlam: Young college adults (*thromycins)
    • Pneumocystis Jiroveci, CMV: HIV (trimethoprim-sulfamethoxazole prophylaxis if CD4 < 200)
  42. HIV pt says 2 days ago he had Macules that changed to papules that changed to vesicles that ruptured and crusted over. They started on his trunk but have spread.
    Tzank smear shows multinucleated giant cells.
    What is your next step?
    Give Vericella Ig because it has been less than 4 days.
  43. Child comes in with slapped looking cheeks for three days and two days ago devp maculopapular rash on his arms legs and trunk. What is the diagnosis and causing agent?
    • Erythema Infectiosum (fifth disease)
    • parvovirus B19
  44. 4 yo child comes in with high fever for 5 days; conjunctivitis; an erythematous rash that shows desquamation and some edema on her trunk; a strawberry tongue with cracked lips; Cervical lymphademopathy on physical exam. What is the diagnosis and next step?
    • Kawasaki's Syndrome
    • Treat with ASA and IV Ig for heart protection
  45. Patient reports starting a fever 4 days ago, yesterday white spots on buccal mucosa, this AM a maculopapular rash that started on her head and has spread to her body. What is the diagnosis?
    Measles (Rubeola)
  46. Pt returns from N Carolina a week ago; 4 days ago started having a high fever, severe headache, and ached all over really bad; this AM rash appeared on palms and soles and has spread to her body and her face. What is the diagnosis? Possible complications? Rx?
    • Rocky Mtn Spotted Fever (Rickettsia)
    • Complications: DIC / Delerium
    • Rx: Doxycycline or Chloramphenicol
  47. What causes Roseola?
    Human Herpes Virus 6
  48. Pt with low grade fever and malaise; faint maculopapular rash starts on face and spreads to body. Whats the diagnosis?
    Rubella
  49. Pt had bad sore throat 10 days ago then a few days ago developped sandpaper like rash on stomach and chest with a high fever. Fever has started getting better but her rash is starting to peel. On physical you notice circumoral pallor and a strawberry tongue. What is the Dx? Complication? and Rx?
    • Scarlet Fever
    • Can become Rheumatic Fever
    • Rx with Penicillin
  50. What are the intial steps in epiglottitis?
    • 1. Do not examine the throat.
    • 2. Be prepared to establish an airway.
    • 3. Treat with third gen cephalosporins.
  51. Greyish pseudomembranes on pharynx, tonsils, and uvula. Myocarditis is possible.
    Diptheria. Rx with abx and antitoxin
  52. What infections are caused by Strep Pyogens?
    • 1. Rheumatic Fever
    • 2. Scarlet Fever
    • 3. Post strep glomerulonephritis
    • 4. Imetigo
    • 5. Erysipelas
    • 6. Cellulitis
    • 7. Necrotizing Fasciitis
    • 8. Endometritis
  53. Which bug causes dental caries and subacute endocarditis?
    S. Viridans
  54. Rx for animal bite?
    Amoxicillin and Clavulanate

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