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 to tx pseudomonas?
Quinoloes (cipro/levo) cure rate 70% - TMP-SMZ
Antipseudomonal penicillin (pipercillin) or cephalosporin (ceftazdidime/cefepime) and aminoglycoside (tobramycin/amikacin)
Mainly clinical - epidemiological and seasonal setting
Immunocompromised patient ? dec vision - weakness/tingling of extremities or other neurological symptoms - MRI nonenhancing lesion in parietooccipital region

2. What is tetanus - diptheria - pertusis recommendation?
N meningitidis colonize in nasopharynx; cause mucosal invasion - systemic bacterimia and seeding in the meninges
<500 copies/ml
Only vaccine. immunoglobuin not required. previously unvaccinated person will receive both.
Td every 10 years - tdap once before 65 and after 65

3. When to tx asymptomatic bacteriurea >100 -000?
Trimethoprime-sulphamethoxazole if intolerant give pentamidine (cause pancreatitis p for p)
Staph - GBS - proteus - pseudomona - e coli - candida - bacteroids; organisms isolated only from deep curettage of ulcer
Pregnacy - urologic procedure - hip arthoplastu
Vaccine titer >10mU/ml

4. which heart valve is closer to ventricular conduction system/
Fever - facial swelling - nasal discha - maxilary pain and tenderness - headache - present in DKA - caused by zygomycetes tx surgical debridement and intranasal amphotericin
Aortic valve; endocardiits of AR p/w AV block and LBBB
Bronchoalveolar washing and transbronchial biopsy
Staph - GBS - proteus - pseudomona - e coli - candida - bacteroids; organisms isolated only from deep curettage of ulcer

5. acute onset +rusty sputum
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
Trimethoprime-sulphamethoxazole if intolerant give pentamidine (cause pancreatitis p for p)
Reddish orange discoloration of urine - feces - sweat - tears - sputum

6. INH
Non pregnant premanopausal - elderly - dm - sci - chronic foley
Hepatotoxitcity incidence 2.6% - commonly seen in alcoholic - liver disease - >50
For mac - we give azithromycin - mac has a for azithromycin; cd4 <50; remember CML designates for <50 c-cmv; m- mac - L-cns lymphoma
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

7. When to give prophylaxis against MAC
Similar pathophysiology as ITP - tx zidovudine
Voriconazol. mycetoma-surgical removal
When cd4 count falls below 200. 2p in pcp =200
For mac - we give azithromycin - mac has a for azithromycin; cd4 <50; remember CML designates for <50 c-cmv; m- mac - L-cns lymphoma

8. worsening of TB after starting HAART in HIV
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
Td every 10 years - tdap once before 65 and after 65
Harrt ---rapid improvement of immune function---increased inflammatory reaction--worsening of clinical symptoms; self limiting....needs no tx
HIV viral load

9. dame that has already occurred
Gemfibrozil and other fibrate drugs; statin and niacin also work not as good as fibrate drugs like gemfibrozil
Chlamydia pcr - 88% sensitivity and 99% specificity; if negative think about MUT organims; mycoplasma - ureaplasma and trichomonas; tx MUT with metronidazole
Cd4 count
Most common; fibromuscular dysplasia - Rt renal artery more common - angiography string of beads

10. what parameters increases risk of neurosyphilis in HIV patient
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.
Do EBV antibody test
Start with amphotericin B and flucytosin for 2 weeks - if there is clinical improvement discontinue them and start with fluconazol
HBIG hep B immunoglobulin

11. how CMV presents in immunocompromised patients
Fever of unknown orign - esophagiti - retinitis - diarrhoea - encephalits
ELISA and western blot of synovial fluid.
At first 4 weeks - then 8-12weks; remeasusing every 2m until viral load is undetectatable. then every 3 months
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.

12. How often HIV postiive patients CD4 count needs to be evaluated?
Within 72hrs of unprotected sex with HIV pos person - give two nucleosidase inhibitors (eg. zidovudin - lamivudein - tenofovir -) X4w
Throat cx of positive of GAS means bacteria are colonized bur not infected in IM. tx with ampi can trigger maculopaular rash
Similar pathophysiology as ITP - tx zidovudine
Every 3-4 hours to determine appropritate time to start HAART

13. 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
Immunocompromised patient ? dec vision - weakness/tingling of extremities or other neurological symptoms - MRI nonenhancing lesion in parietooccipital region
Most common; fibromuscular dysplasia - Rt renal artery more common - angiography string of beads
Do EBV antibody test

14. when not to give INH therapy if ppd positive and patient asyptomatic
Ampicillin-sublactam; most bites contain eikenella
Pt who have been treated before for latent TB
HBIG hep B immunoglobulin
Within 72hrs of unprotected sex with HIV pos person - give two nucleosidase inhibitors (eg. zidovudin - lamivudein - tenofovir -) X4w

15. When to tx influenza with antiviral therapy?
<500 copies/ml
Similar pathophysiology as ITP - tx zidovudine
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
Every 3-4 hours to determine appropritate time to start HAART

16. reddish colored papules with central umbilication in HIV or immunocompromised patient
Tx with amoxicillin or ceftriaxone. 90% are disease free after one year after tx
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
HIV syndrome or anti-retroviral syndrome; 2-3w after virus exposure. similar to IM.
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.

17. what if monospot test is neg in IM?
Do EBV antibody test
<500 copies/ml
Bed rest - NSAID - avoid contact sports; if patient develop SOB due to pharyngeal edema - give corticosteroid
Reddish orange discoloration of urine - feces - sweat - tears - sputum

18. infiltrate in upper lobe of lung?
Oropharyngeal secretions; hence named as kissing disease
Either TB or aspergillosis
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.
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

19. How long we tx chronic prostatis?
2 weeks in neutropenic patients and 7-10 days after catheter removed/patient improved
6-12 weeks
<5000 copies/ml
If a sample is ELISA positive - it is tested fro western blot for confirmation

20. How to dx progressive multifocal leukoencephalopathy
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
Give nystatin suspension or clotrimazol with an oral antifungal eg. fluconazol
Harrt ---rapid improvement of immune function---increased inflammatory reaction--worsening of clinical symptoms; self limiting....needs no tx
Immunocompromised patient ? dec vision - weakness/tingling of extremities or other neurological symptoms - MRI nonenhancing lesion in parietooccipital region

21. 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

22. How to confirm chlamydia infection?
Trimethoprime-sulphamethoxazole if intolerant give pentamidine (cause pancreatitis p for p)
Hepatotoxitcity incidence 2.6% - commonly seen in alcoholic - liver disease - >50
Chlamydia pcr - 88% sensitivity and 99% specificity; if negative think about MUT organims; mycoplasma - ureaplasma and trichomonas; tx MUT with metronidazole
N meningitidis colonize in nasopharynx; cause mucosal invasion - systemic bacterimia and seeding in the meninges

23. when HIV patient develop pcp?
Quinoloes (cipro/levo) cure rate 70% - TMP-SMZ
Exacerbate by HAART; give statin - if triglyceride >500 - give a fibrate
When cd4 count falls below 200. 2p in pcp =200
Viral load and CD4 count

24. hypertriglyceridemia in HIV
Exacerbate by HAART; give statin - if triglyceride >500 - give a fibrate
Mainly clinical - epidemiological and seasonal setting
Immune mediated; circulating IgG and IgM to penicillin derivatives
ELISA; initial visit - 6 - 12 and 24 weeks;

25. acute febrile reaction develops after starting penicilin tx to syphilis patient
PML; focal neurological deficit like MM; no specific tx; regress with HAART
Monospot test which screen heteropile ab that agglutinate horse rbc
When cd4 count falls below 200. 2p in pcp =200
Jarish-Herxheimer reaction; immunologica reaction due to rupture of sprochetes

26. how im is transmitted?
HIV viral load
Oropharyngeal secretions; hence named as kissing disease
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
Acyclovir

27. what would be viral load after 2-4m of HAART?
HIV RNA PCR assay; there may be small amount of virus that are not detectable in ELISA.
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.
<500 copies/ml
Most common E coli; less common; klebsiella - enterobacter - proteus - staph - groupd d strep

28. causative organisms of uti
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
Most common E coli; less common; klebsiella - enterobacter - proteus - staph - groupd d strep
Petechial rash developed 3-5th days of illness begins ankle or wrist and spread to palm/soles
Within 72hrs of unprotected sex with HIV pos person - give two nucleosidase inhibitors (eg. zidovudin - lamivudein - tenofovir -) X4w

29. What is the Tx of STD uretheritis?
Only vaccine. immunoglobuin not required. previously unvaccinated person will receive both.
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
HBIG hep B immunoglobulin
HIV lipodystrophy; no correlation with viral load; p/w insulin resistance and dyslipidemia (inc cholesterol - dec HDL)

30. can HIV transmitted through human bite?
Immune mediated; circulating IgG and IgM to penicillin derivatives
Cd4 count
HIV present in very minimal quantities in human saliva. exposure/contact of saliva will never trasmit HIV
HIV syndrome or anti-retroviral syndrome; 2-3w after virus exposure. similar to IM.

31. What is used for prophylaxis against meningo..meningitis?
Rifampin600mg q12. or cipro
Doesn't exceed more than 15 mm and size significantly decreases after 15 years
HIV RNA PCR assay; there may be small amount of virus that are not detectable in ELISA.
Quinoloes (cipro/levo) cure rate 70% - TMP-SMZ

32. damae that is about to occur?
At first 4 weeks - then 8-12weks; remeasusing every 2m until viral load is undetectatable. then every 3 months
HIV viral load
Harrt ---rapid improvement of immune function---increased inflammatory reaction--worsening of clinical symptoms; self limiting....needs no tx
Blastomycosis

33. INH
Vitamin B6 antagonist - can cause peripheral neuropathy if not give with b6
Rifampin600mg q12. or cipro
Staph - GBS - proteus - pseudomona - e coli - candida - bacteroids; organisms isolated only from deep curettage of ulcer
Harrt ---rapid improvement of immune function---increased inflammatory reaction--worsening of clinical symptoms; self limiting....needs no tx

34. What is the criteria for Spontaneous bact peritonitis
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
250 neutrophil/mm3 in peritoneal fluid - tx empiric abx; if tremor or other neuro sign give lactulose
Leukocytosis >100 cells - dec glucose - inc protien - inc opening pressure; in viral there will be lymphocytosis - normal glucose (virus doesn't eat) -
Vitamin B6 antagonist - can cause peripheral neuropathy if not give with b6

35. How to dx IM?
250 neutrophil/mm3 in peritoneal fluid - tx empiric abx; if tremor or other neuro sign give lactulose
Pt who have been treated before for latent TB
Monospot test which screen heteropile ab that agglutinate horse rbc
Classic triad: fever - pharyngitis - postauricular lymaphdenopahty - caused by EBV

36. How to tx IM?
Bed rest - NSAID - avoid contact sports; if patient develop SOB due to pharyngeal edema - give corticosteroid
Most common; fibromuscular dysplasia - Rt renal artery more common - angiography string of beads
CTP subjective; MELD objective; meld uses serum billirubin - inr and serum creatinin. meld used to determine 90 day mortality of liver diease
HIV present in very minimal quantities in human saliva. exposure/contact of saliva will never trasmit HIV

37. pathophysiology of toxic shock syndrom?
Tampoon in nostril/vagina. think t for t - staph release exotoxin --activation of t cells directly--release of massive cytokines.
Only vaccine. immunoglobuin not required. previously unvaccinated person will receive both.
When cd4 count falls below 200. 2p in pcp =200
Within 72hrs of unprotected sex with HIV pos person - give two nucleosidase inhibitors (eg. zidovudin - lamivudein - tenofovir -) X4w

38. What is the indication of corticosteroid in pcp infection?
Acyclovir
N meningitidis colonize in nasopharynx; cause mucosal invasion - systemic bacterimia and seeding in the meninges
Start with amphotericin B and flucytosin for 2 weeks - if there is clinical improvement discontinue them and start with fluconazol
AA gradient >35 or Po2 <70

39. antibiotic with good prostate penetration?
HIV lipodystrophy; no correlation with viral load; p/w insulin resistance and dyslipidemia (inc cholesterol - dec HDL)
Exacerbate by HAART; give statin - if triglyceride >500 - give a fibrate
Quinoloes (cipro/levo) cure rate 70% - TMP-SMZ
2 weeks in neutropenic patients and 7-10 days after catheter removed/patient improved

40. foot infections in DM
Clostridium perfringens after penetrative injuries/wounds
Staph - GBS - proteus - pseudomona - e coli - candida - bacteroids; organisms isolated only from deep curettage of ulcer
Harrt ---rapid improvement of immune function---increased inflammatory reaction--worsening of clinical symptoms; self limiting....needs no tx
Bed rest - NSAID - avoid contact sports; if patient develop SOB due to pharyngeal edema - give corticosteroid

41. How to tx chronic hep B
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.
Others lesions are ring enhancing and have mass effect while PML don't
Pegylated interferon and lamivudine
When cd4 count falls below 200. 2p in pcp =200

42. Do we need to give vaccine or immunoglobulin for rabies exposure in previously vaccinated person?
Bronchoalveolar washing and transbronchial biopsy
Cd4 count
Only vaccine. immunoglobuin not required. previously unvaccinated person will receive both.
Blastomycosis

43. How to differentiat PML from toxoxplasmosis - cns lymphoma adn brain abscess

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

44. What are the subjective /objective measure of encephalopathy?
CTP subjective; MELD objective; meld uses serum billirubin - inr and serum creatinin. meld used to determine 90 day mortality of liver diease
Start with amphotericin B and flucytosin for 2 weeks - if there is clinical improvement discontinue them and start with fluconazol
Voriconazol. mycetoma-surgical removal
Doesn't exceed more than 15 mm and size significantly decreases after 15 years

45. How to dx lyme arthritis?
ELISA and western blot of synovial fluid.
Clostridium perfringens after penetrative injuries/wounds
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
2 weeks in neutropenic patients and 7-10 days after catheter removed/patient improved

46. low grade fever - maculopapular rash - lymphadenopathy
HIV syndrome or anti-retroviral syndrome; 2-3w after virus exposure. similar to IM.
ELISA and western blot of synovial fluid.
250 neutrophil/mm3 in peritoneal fluid - tx empiric abx; if tremor or other neuro sign give lactulose
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.

47. How to tx TSS?
Massive (even 20L/day) fluid resuscitaiton which may clear toxin
Most common E coli; less common; klebsiella - enterobacter - proteus - staph - groupd d strep
Markedly elevated csf pressure >200 - inc protein - low glucose ; tx amphotericin and flucytosine
For mac - we give azithromycin - mac has a for azithromycin; cd4 <50; remember CML designates for <50 c-cmv; m- mac - L-cns lymphoma

48. What is the classic signs of nec fasc?
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.
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
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
Immune mediated; circulating IgG and IgM to penicillin derivatives

49. aspergillosis
Only vaccine. immunoglobuin not required. previously unvaccinated person will receive both.
Voriconazol. mycetoma-surgical removal
Massive (even 20L/day) fluid resuscitaiton which may clear toxin
At first 4 weeks - then 8-12weks; remeasusing every 2m until viral load is undetectatable. then every 3 months

50. oligodendrocyte with intranuclear inclusion and demyelination in HIV patient
HIV viral load
Hepatotoxitcity incidence 2.6% - commonly seen in alcoholic - liver disease - >50
PML; focal neurological deficit like MM; no specific tx; regress with HAART
4 months; characterized by knee joint effusion-large amount - joint stiffness - pain

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