Test your basic knowledge |

USMLE Step3 Infectious Disease

Subjects : health-sciences, usmle-step-3

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. How long abx is given in pseudomonas infection?
2 weeks in neutropenic patients and 7-10 days after catheter removed/patient improved
ELISA; initial visit - 6 - 12 and 24 weeks;
Do EBV antibody test
Immune mediated; circulating IgG and IgM to penicillin derivatives

2. foot infections in DM
High risk 19-64; 1-2 dose - above 65; one dose
Staph - GBS - proteus - pseudomona - e coli - candida - bacteroids; organisms isolated only from deep curettage of ulcer
Upper lobes; any fibrosis in this area suggestive of latent TB
Tx with amoxicillin or ceftriaxone. 90% are disease free after one year after tx

3. What is the classic signs of nec fasc?
Every 3-4 hours to determine appropritate time to start HAART
No skin changes but pain out of proportion; infection spreads along fascial plane rapidly with blister - erythema - and bullae formation; marked tenderness on palpation - and CREPITUS
<500 copies/ml
Similar pathophysiology as ITP - tx zidovudine

4. How often HIV postiive patients CD4 count needs to be evaluated?
Every 3-4 hours to determine appropritate time to start HAART
Oropharyngeal secretions; hence named as kissing disease
Either TB or aspergillosis
Type 1: patient with dm and pvd; caused by staph/GAS/ e coli/bacteroids; type2 - no associated medical illness - caused by laceration - trauma - surgery - IV drug abuse - caused mainly by GAS

5. What is characteristic for dx of rocky mountain spotted fever?
ELISA and western blot of synovial fluid.
Massive (even 20L/day) fluid resuscitaiton which may clear toxin
Leukocytosis >100 cells - dec glucose - inc protien - inc opening pressure; in viral there will be lymphocytosis - normal glucose (virus doesn't eat) -
Petechial rash developed 3-5th days of illness begins ankle or wrist and spread to palm/soles

6. hypertension in children
Most common; fibromuscular dysplasia - Rt renal artery more common - angiography string of beads
Oropharyngeal secretions; hence named as kissing disease
6-12 weeks
Aspergillosis. common in bone marrow transplants. typically involves lungs and sinuses

7. systolic HTN in elderly
Trimethoprime-sulphamethoxazole if intolerant give pentamidine (cause pancreatitis p for p)
Blastomycosis
Due to decrease elasticity of arterial wall; only systolic - diastolic normal - wide pulse pressure
At first 4 weeks - then 8-12weks; remeasusing every 2m until viral load is undetectatable. then every 3 months

8. What is the mch of ampicillin induced rash in IM
Mainly clinical - epidemiological and seasonal setting
Immune mediated; circulating IgG and IgM to penicillin derivatives
Td every 10 years - tdap once before 65 and after 65
Leukocytosis >100 cells - dec glucose - inc protien - inc opening pressure; in viral there will be lymphocytosis - normal glucose (virus doesn't eat) -

9. if a patient received BCG vaccine - how big is his PPD induration

Warning: Invalid argument supplied for foreach() in /var/www/html/basicversity.com/show_quiz.php on line 183

10. where TB normally affects
HIV viral load
ELISA; initial visit - 6 - 12 and 24 weeks;
Upper lobes; any fibrosis in this area suggestive of latent TB
Mainly clinical - epidemiological and seasonal setting

11. after bone marrow transplant - patient develop headache - fever - cought and chest pain. What is dx?
<500 copies/ml
Chlamydia pcr - 88% sensitivity and 99% specificity; if negative think about MUT organims; mycoplasma - ureaplasma and trichomonas; tx MUT with metronidazole
Doesn't exceed more than 15 mm and size significantly decreases after 15 years
Aspergillosis. common in bone marrow transplants. typically involves lungs and sinuses

12. How to differentiate different types of necrotizing fascitis?
For mac - we give azithromycin - mac has a for azithromycin; cd4 <50; remember CML designates for <50 c-cmv; m- mac - L-cns lymphoma
Fever - facial swelling - nasal discha - maxilary pain and tenderness - headache - present in DKA - caused by zygomycetes tx surgical debridement and intranasal amphotericin
Leukocytosis >100 cells - dec glucose - inc protien - inc opening pressure; in viral there will be lymphocytosis - normal glucose (virus doesn't eat) -
Type 1: patient with dm and pvd; caused by staph/GAS/ e coli/bacteroids; type2 - no associated medical illness - caused by laceration - trauma - surgery - IV drug abuse - caused mainly by GAS

13. clinical manifestation of mucomycosis
S. pneumonie. differentitate this from atypical pneumonia and pcp which are gradual onset - non productive cough -
Staph - GBS - proteus - pseudomona - e coli - candida - bacteroids; organisms isolated only from deep curettage of ulcer
Fever - facial swelling - nasal discha - maxilary pain and tenderness - headache - present in DKA - caused by zygomycetes tx surgical debridement and intranasal amphotericin
Most common E coli; less common; klebsiella - enterobacter - proteus - staph - groupd d strep

14. What is tetanus - diptheria - pertusis recommendation?
Classic triad: fever - pharyngitis - postauricular lymaphdenopahty - caused by EBV
Think about cutaneous cryptococous; lesions looks like molluscus contagiousm. present in face/trunk/anywherer; dx biopsy of lesion which shows granulomatous inflammation with multinucleated giant cell
Td every 10 years - tdap once before 65 and after 65
Voriconazol. mycetoma-surgical removal

15. Do we need to give vaccine or immunoglobulin for rabies exposure in previously vaccinated person?
N meningitidis colonize in nasopharynx; cause mucosal invasion - systemic bacterimia and seeding in the meninges
Acyclovir
Only vaccine. immunoglobuin not required. previously unvaccinated person will receive both.
Pt who have been treated before for latent TB

16. What is difference between uti relapse versus recurrence?
HIV lipodystrophy; no correlation with viral load; p/w insulin resistance and dyslipidemia (inc cholesterol - dec HDL)
Relapse: infecting organism is same as original infecting organism within 2 weeks of tx completion; recurrence: if the infecting organism is different from that of the original organism
HIV syndrome or anti-retroviral syndrome; 2-3w after virus exposure. similar to IM.
Staph - GBS - proteus - pseudomona - e coli - candida - bacteroids; organisms isolated only from deep curettage of ulcer

17. How long we tx chronic prostatis?
Relapse: infecting organism is same as original infecting organism within 2 weeks of tx completion; recurrence: if the infecting organism is different from that of the original organism
Similar pathophysiology as ITP - tx zidovudine
Every 3-4 hours to determine appropritate time to start HAART
6-12 weeks

18. How to confirm chlamydia infection?
Chlamydia pcr - 88% sensitivity and 99% specificity; if negative think about MUT organims; mycoplasma - ureaplasma and trichomonas; tx MUT with metronidazole
Trimethoprime-sulphamethoxazole if intolerant give pentamidine (cause pancreatitis p for p)
When patient is older >65 - pregnant - cardiac of pulmonary disease; patient without above risks are treated when they come within 48 hours of symptom onset
Rifampin600mg q12. or cipro

19. wisconsin - missisipi - ohio
Gonococcal with purulent discharges and presence of multiple diplococi and neurotrophils in urethral swab; non gonoccal (chlamydia) are watery disch - swab abacterial - sometimes have intracellular organism
Pregnacy - urologic procedure - hip arthoplastu
Blastomycosis
Aspergillosis. common in bone marrow transplants. typically involves lungs and sinuses

20. what parameters increases risk of neurosyphilis in HIV patient
HBIG hep B immunoglobulin
Jarish-Herxheimer reaction; immunologica reaction due to rupture of sprochetes
CD4 less than 350 and RPR >1:32; HIV infected patient with syphilis >1 yr should have CSF exam before tx. if csf normal tx with benzathine penicillin weekly for 3 weeks.
No skin changes but pain out of proportion; infection spreads along fascial plane rapidly with blister - erythema - and bullae formation; marked tenderness on palpation - and CREPITUS

21. How to dx IM?
Massive (even 20L/day) fluid resuscitaiton which may clear toxin
Vaccine titer >10mU/ml
Clostridium perfringens after penetrative injuries/wounds
Classic triad: fever - pharyngitis - postauricular lymaphdenopahty - caused by EBV

22. What is fatal consequence of RMSF?
Aspergillosis. common in bone marrow transplants. typically involves lungs and sinuses
Petechial rash developed 3-5th days of illness begins ankle or wrist and spread to palm/soles
When cd4 count falls below 200. 2p in pcp =200
AMS - focal neurological signs - seizures - multiorgan dysfunction - death; tx; doxycycline; for pregnant give chloramphenicle

23. How to dx adequate response to HBV vaccine
6-12 weeks
Oropharyngeal secretions; hence named as kissing disease
Vaccine titer >10mU/ml
Non pregnant premanopausal - elderly - dm - sci - chronic foley

24. patient is taking inhaled corticosteroid for asthma - now p/w oral candidiasis
Do EBV antibody test
Pt who have been treated before for latent TB
Give nystatin suspension or clotrimazol with an oral antifungal eg. fluconazol
Postcoital voiding - increased intake of cranberry juice

25. What are the behavioral interventions decrease the risk of UTI
Pts with pseudomonas bacerimia have this. they have perivascular bacterial invasion of the media and adventitia of arteries and veins. then ishcemic necrosis; skin and mucous membrane have nodular patches wtih hemorrhage and ulceration
Start with amphotericin B and flucytosin for 2 weeks - if there is clinical improvement discontinue them and start with fluconazol
Postcoital voiding - increased intake of cranberry juice
Cd4 count

26. low grade fever - maculopapular rash - lymphadenopathy
HIV syndrome or anti-retroviral syndrome; 2-3w after virus exposure. similar to IM.
Start with amphotericin B and flucytosin for 2 weeks - if there is clinical improvement discontinue them and start with fluconazol
Exacerbate by HAART; give statin - if triglyceride >500 - give a fibrate
N meningitidis colonize in nasopharynx; cause mucosal invasion - systemic bacterimia and seeding in the meninges

27. causative organisms of uti
When patient is older >65 - pregnant - cardiac of pulmonary disease; patient without above risks are treated when they come within 48 hours of symptom onset
Most common E coli; less common; klebsiella - enterobacter - proteus - staph - groupd d strep
Within 72hrs of unprotected sex with HIV pos person - give two nucleosidase inhibitors (eg. zidovudin - lamivudein - tenofovir -) X4w
Fever - facial swelling - nasal discha - maxilary pain and tenderness - headache - present in DKA - caused by zygomycetes tx surgical debridement and intranasal amphotericin

28. How to tx IM?
Within 72hrs of unprotected sex with HIV pos person - give two nucleosidase inhibitors (eg. zidovudin - lamivudein - tenofovir -) X4w
Type 1: patient with dm and pvd; caused by staph/GAS/ e coli/bacteroids; type2 - no associated medical illness - caused by laceration - trauma - surgery - IV drug abuse - caused mainly by GAS
Only vaccine. immunoglobuin not required. previously unvaccinated person will receive both.
Bed rest - NSAID - avoid contact sports; if patient develop SOB due to pharyngeal edema - give corticosteroid

29. What is tx for herpes zoster
6-12 weeks
Acyclovir
Pt who have been treated before for latent TB
Jarish-Herxheimer reaction; immunologica reaction due to rupture of sprochetes

30. when we see echym gangrenosum?
Aortic valve; endocardiits of AR p/w AV block and LBBB
Pts with pseudomonas bacerimia have this. they have perivascular bacterial invasion of the media and adventitia of arteries and veins. then ishcemic necrosis; skin and mucous membrane have nodular patches wtih hemorrhage and ulceration
Pregnacy - urologic procedure - hip arthoplastu
Only vaccine. immunoglobuin not required. previously unvaccinated person will receive both.

31. How to dx?
Mainly clinical - epidemiological and seasonal setting
Most common E coli; less common; klebsiella - enterobacter - proteus - staph - groupd d strep
Need lumbar puncture to relieve pressure; they have high opening pressure >350
Immune mediated; circulating IgG and IgM to penicillin derivatives

32. How to tx chronic hep B
Pegylated interferon and lamivudine
Do EBV antibody test
Type 1: patient with dm and pvd; caused by staph/GAS/ e coli/bacteroids; type2 - no associated medical illness - caused by laceration - trauma - surgery - IV drug abuse - caused mainly by GAS
Vaccine titer >10mU/ml

33. hypertriglyceridemia in HIV
Most common; fibromuscular dysplasia - Rt renal artery more common - angiography string of beads
Fever - facial swelling - nasal discha - maxilary pain and tenderness - headache - present in DKA - caused by zygomycetes tx surgical debridement and intranasal amphotericin
Exacerbate by HAART; give statin - if triglyceride >500 - give a fibrate
Others lesions are ring enhancing and have mass effect while PML don't

34. can HIV transmitted through human bite?
ELISA; initial visit - 6 - 12 and 24 weeks;
Blastomycosis
HIV present in very minimal quantities in human saliva. exposure/contact of saliva will never trasmit HIV
Every 3-4 hours to determine appropritate time to start HAART

35. after recent exposure - negative ELISA - How to confirm?
Relapse: infecting organism is same as original infecting organism within 2 weeks of tx completion; recurrence: if the infecting organism is different from that of the original organism
Monospot test which screen heteropile ab that agglutinate horse rbc
Tampoon in nostril/vagina. think t for t - staph release exotoxin --activation of t cells directly--release of massive cytokines.
HIV RNA PCR assay; there may be small amount of virus that are not detectable in ELISA.

36. What are the subjective /objective measure of encephalopathy?
Tx emptirically both gonococcus and chlamydia; 30% gono have coexsiting chlamydial infection; single dose ceftriaxone for gono and Azithromycin for chlamydia. if no improvement give metronidazol for trichomonas infection
CTP subjective; MELD objective; meld uses serum billirubin - inr and serum creatinin. meld used to determine 90 day mortality of liver diease
Postcoital voiding - increased intake of cranberry juice
AA gradient >35 or Po2 <70

37. How to dx progressive multifocal leukoencephalopathy
Similar pathophysiology as ITP - tx zidovudine
Immunocompromised patient ? dec vision - weakness/tingling of extremities or other neurological symptoms - MRI nonenhancing lesion in parietooccipital region
For mac - we give azithromycin - mac has a for azithromycin; cd4 <50; remember CML designates for <50 c-cmv; m- mac - L-cns lymphoma
Jarish-Herxheimer reaction; immunologica reaction due to rupture of sprochetes

38. When to tx asymptomatic bacteriurea >100 -000?
S. pneumonie. differentitate this from atypical pneumonia and pcp which are gradual onset - non productive cough -
Every 3-4 hours to determine appropritate time to start HAART
Pregnacy - urologic procedure - hip arthoplastu
Gemfibrozil and other fibrate drugs; statin and niacin also work not as good as fibrate drugs like gemfibrozil

39. What is the indication of corticosteroid in pcp infection?
Tx with amoxicillin or ceftriaxone. 90% are disease free after one year after tx
<500 copies/ml
When cd4 count falls below 200. 2p in pcp =200
AA gradient >35 or Po2 <70

40. how HAART therapy affects HIV viral loads?
Immune mediated; circulating IgG and IgM to penicillin derivatives
ELISA; initial visit - 6 - 12 and 24 weeks;
Within 6 months viral load will be <50
4 months; characterized by knee joint effusion-large amount - joint stiffness - pain

41. how CMV presents in immunocompromised patients
Fever of unknown orign - esophagiti - retinitis - diarrhoea - encephalits
Throat cx of positive of GAS means bacteria are colonized bur not infected in IM. tx with ampi can trigger maculopaular rash
Most common E coli; less common; klebsiella - enterobacter - proteus - staph - groupd d strep
Pts with pseudomonas bacerimia have this. they have perivascular bacterial invasion of the media and adventitia of arteries and veins. then ishcemic necrosis; skin and mucous membrane have nodular patches wtih hemorrhage and ulceration

42. How to dx lyme arthritis?
Pregnacy - urologic procedure - hip arthoplastu
Voriconazol. mycetoma-surgical removal
ELISA and western blot of synovial fluid.
Type 1: patient with dm and pvd; caused by staph/GAS/ e coli/bacteroids; type2 - no associated medical illness - caused by laceration - trauma - surgery - IV drug abuse - caused mainly by GAS

43. pathophysiology of toxic shock syndrom?
Jarish-Herxheimer reaction; immunologica reaction due to rupture of sprochetes
6-12 weeks
Tampoon in nostril/vagina. think t for t - staph release exotoxin --activation of t cells directly--release of massive cytokines.
Oropharyngeal secretions; hence named as kissing disease

44. How often viral load is monitored after HAART?
At first 4 weeks - then 8-12weks; remeasusing every 2m until viral load is undetectatable. then every 3 months
When cd4 count falls below 200. 2p in pcp =200
Bronchoalveolar washing and transbronchial biopsy
4 months; characterized by knee joint effusion-large amount - joint stiffness - pain

45. What is lag time to develop lyme arthritis after exposure to vector
4 months; characterized by knee joint effusion-large amount - joint stiffness - pain
6-12 weeks
Gonococcal with purulent discharges and presence of multiple diplococi and neurotrophils in urethral swab; non gonoccal (chlamydia) are watery disch - swab abacterial - sometimes have intracellular organism
Pegylated interferon and lamivudine

46. How to differentiate gonococcal and nongonoccal urethritis?
Gonococcal with purulent discharges and presence of multiple diplococi and neurotrophils in urethral swab; non gonoccal (chlamydia) are watery disch - swab abacterial - sometimes have intracellular organism
Leukocytosis >100 cells - dec glucose - inc protien - inc opening pressure; in viral there will be lymphocytosis - normal glucose (virus doesn't eat) -
Give nystatin suspension or clotrimazol with an oral antifungal eg. fluconazol
ELISA; initial visit - 6 - 12 and 24 weeks;

47. How to tx pcp?
Trimethoprime-sulphamethoxazole if intolerant give pentamidine (cause pancreatitis p for p)
Oropharyngeal secretions; hence named as kissing disease
Relapse: infecting organism is same as original infecting organism within 2 weeks of tx completion; recurrence: if the infecting organism is different from that of the original organism
250 neutrophil/mm3 in peritoneal fluid - tx empiric abx; if tremor or other neuro sign give lactulose

48. when western blot is done for HIV testing
Exacerbate by HAART; give statin - if triglyceride >500 - give a fibrate
If a sample is ELISA positive - it is tested fro western blot for confirmation
Bronchoalveolar washing and transbronchial biopsy
Ampicillin-sublactam; most bites contain eikenella

49. aspergillosis
Voriconazol. mycetoma-surgical removal
Markedly elevated csf pressure >200 - inc protein - low glucose ; tx amphotericin and flucytosine
Cd4 count
Type 1: patient with dm and pvd; caused by staph/GAS/ e coli/bacteroids; type2 - no associated medical illness - caused by laceration - trauma - surgery - IV drug abuse - caused mainly by GAS

50. thrombocytopenia in HIV
At first 4 weeks - then 8-12weks; remeasusing every 2m until viral load is undetectatable. then every 3 months
Due to decrease elasticity of arterial wall; only systolic - diastolic normal - wide pulse pressure
Antipseudomonal penicillin (pipercillin) or cephalosporin (ceftazdidime/cefepime) and aminoglycoside (tobramycin/amikacin)
Similar pathophysiology as ITP - tx zidovudine

Sorry!:) No result found.

Can you answer 50 questions in 15 minutes?

Major Subjects
Tests & Exams AP CLEP DSST GRE SAT GMAT	Certifications CISSP go to https://www.isc2.org/ PMP ITIL RHCE MCTS More...	IT Skills Android Programming Data Modeling Objective C Programming Basic Python Programming Adobe Illustrator More...	Business Skills Advertising Techniques Business Accounting Basics Business Strategy Human Resource Management Marketing Basics More...
Soft Skills Body Language People Skills Public Speaking Persuasion Job Hunting And Resumes More...	Vocabulary GRE Vocab SAT Vocab TOEFL Essential Vocab Basic English Words For All Global Words You Should Know Business English More...	Languages AP German Vocab AP Latin Vocab SAT Subject Test: French Italian Survival Norwegian Survival More...	Engineering Audio Engineering Computer Science Engineering Aerospace Engineering Chemical Engineering Structural Engineering More...
Health Sciences Basic Nursing Skills Health Science Language Fundamentals Veterinary Technology Medical Language Cardiology Clinical Surgery More...	English Grammar Fundamentals Literary And Rhetorical Vocab Elements Of Style Vocab Introduction To English Major Complete Advanced Sentences Literature Homonyms More...	Math Algebra Formulas Basic Arithmetic: Measurements Metric Conversions Geometric Properties Important Math Facts Number Sense Vocab Business Math More...	Other Major Subjects Science Economics History Law Performing-arts Cooking Logic & Reasoning Trivia

Test your basic knowledge |

USMLE Step3 Infectious Disease

Sorry!:) No result found.

Can you answer 50 questions in 15 minutes?

Let me suggest you:

Browse all subjects

Browse all tests

Most popular tests

Major Subjects

Tests & Exams

Certifications

IT Skills

Business Skills

Soft Skills

Vocabulary

Languages

Engineering

Health Sciences

English

Math

Other Major Subjects

Browse all subjects

Browse all tests

Most popular tests