question

Genital chancre begins as papule, ulcerates to form a single, painless, clean based ulcer. TOW:

answer

primary syphillis

question

Cause of genital chancre, beginning as papule, ulcerating to form a single, painless, clean based ulcer:

answer

Treponema pallidum

question

History of penicillin allergy in non-pregnant woman, who has fever, "copper penny" macular lesions on palms and/or soles; RPR (+). DOC:

answer

Doxycycline

question

History of penicillin allergy in pregnant woman, who is RPR (+) and has tabes dorsalis (10-20 yrs), or iritis, uveitis, iridocyclitis, Argyll-Robertson pupils. Manage how:

answer

Desensitization

question

History of painful clustered vesicles with erythematous base; urinary retention in promiscuous woman. TOW:

answer

HSV-2 >>1

question

Giemsa stain of fluid from herpetic lesion should reveal:

answer

Multinucleated giant cells

question

Patient with genital herpes does not respond to acyclovir because patient is infected with:

answer

thymidine kinase deficient HSV

question

A pregnant woman with primary symptomatic HSV-2 ifnection is at risk of her baby developing:

answer

neonatal (congenital) herpes

question

Cause of painful genital ulcers (no induration); purulent, dirty grey base; painful inguinal adenitis (bubos), in a man with multiple sex partners:

answer

Haemophilus ducreyi

question

Fastidious organism found within granulocytic infiltrate of penile ulcer and co-localized with neutrophils and fibrin, in a patient with chancroid is:

answer

Haemophilus ducreyi

question

all sex partners of patient with chancroid, regardless of symptoms, should be examined and treated with:

answer

azithromycin > ceftriaxone

question

Most common cause of mucopurulent endocervical exudate (gram stain non-revealing) in sexually promiscuous woman:

answer

Chlamydia trachomatis D-K

question

Dx of mucopurullent urethral discharge, dysuria, penile pruritis is based on:

answer

NAAT of urethral specimen or urine (+)

question

DOC of most frequent cause of non-gonococcal urethritis:

answer

Azythromycin > doxycycline

question

Cause of rare genitla ulcers, inguinal lymphadenopathy (cytology - for multinucleated giant cells; RPR -) in men is:

answer

Chlamydia trachomatis L1-L3

question

Hx of systemic Sx/Sn with cervical motion tenderness in a woman with turbo-ovarian abscess. TOW:

answer

PID

question

Cause of mucopurulent urethritis, dysuria, penile pruritis (smear +; gram negative diplococci copopulated with PMNs) is:

answer

Neisseria gonorrhoeae

question

History of frequent gonorrhea and disseminated gonococcal infection in a woman is due to deficieny in serm factors:

answer

terminal complements

question

Immune evasion of Neisseria gonorrhoeae in frequent mucosal infection is due to:

answer

Antigenic variation of pili

question

Auxotrophic stains of N gonorrhoeae (needing arginine for growth) and also with serum (complements) resistance are likely to cause:

answer

Septic arthritis (aka: DGI)

question

Most frequent complication of gonococcal (GC) infection in men:

answer

Epididymitis

question

Cause of "bull headed clap", urethral stricture, prostatitis is:

answer

Neisseria gonorrhoeae

question

Urethritis is treated with ceftriaxone + azythromycin because:

answer

Concurrent GC + chlamydia

question

An older woman with PID and tubo-ovarian abscess receives cefttriaxone, azythromycin, and metronidazole because:

answer

polymicrobic (endogenous) infection

question

Cause of anogenital warts with histology (+): koilocytes is:

answer

HPV 6 and 11

question

Cause of atypical squamous cells of undetermined significance (ASCUS) on pap smear with no clinical signs of infection is:

answer

HPV 16 and 18

question

Cause of Koilocytic cells and possible progression to squamous cell carcinoma:

answer

HPV 16 and 18

question

Next step to identify viral cause of ASCUS on pap smear with and further management in woman of age >29 yrs is:

answer

colposcopy > HPV DNA in biopsy

question

Wet prep of vaginal discharge from sexually promiscuous woman with vaginal pruritis; ectocervical erythema (strawberry cervix) should reveal

answer

motile tissue flagellate

question

Gram stain of vaginla discharge with fishy odor from sexually promiscuous woman with vaginal pruritis but no erythema and normal cervis should reveal:

answer

SECs stippled with gram-variable organisms

question

DOC of bacterial vaginosis (BV) is:

answer

metronidazole

question

Disruption of normal vaginal flora and depletion of lactobacilli in patient with bacterial vaginosis cause overgrowth of anaerobic Mobiluncus species and:

answer

Gardnerella vaginalis

question

Wet prep of curdy discharge (no odor), adhering to vaginal walls, from pregnant woman with recent UTI, who now has severe vaginal pruritis; vulvovaginal area - erythematous should reveal:

answer

budding yeasts with pseudohyphae

question

Normal commensl of skin, GI, GU tracts; endogenous overgrowth of budding yeast, capable of >10 diseases. TOW:

answer

Candidia albicans

question

mechanism of action of a po DOC of vulvovaginal candidiasis is:

answer

blocks C14α-lanosterol demethylase

question

history of flu-like illness, lymphadenopathy, maculopapular rash in bisexual man. Lab: lymphopenia and transaminase elevations; monospot/all serology negative. TOW:

answer

acute retroviral syndrome

question

Time from infection (acquisition) to acute seroconversion detected by HIV serology (ELISA/WBlot) is:

answer

6-12 wks

question

History of mononucleosis-like illness and lymphadenopathy in man with MSM. serology negative. What is HIV viral load:

answer

>10,000 copies/ml

question

Host cell receptor for HIV-1 infection:

answer

CD4

question

Homozygous deletions in what gene renders resistance to infection and some protection against progression:

answer

CCR5

question

Host cells that trap HIV and mediate the efficent transinfection of CD4+ T cells are:

answer

dendritic cells

question

A man who practices "sex with men" has antibodies to HIV (ELISA and Wblot) but asymptomatic. TOW:

answer

clinical latency

question

What happens to HIV-1 virus when acute retrovial syndrome progresses to clinical latency:

answer

virus continues to replicate at low level

question

Homosexual man who is HIV-1 positive and has dual infections/cancer (any 2 from below). Expected CD4+ count is:
Candidiasis, esophageal, bronchi, trachea, or lungs
Cervical cancer, invasive
Coccidioidomycosis, extrapulmonary
Cryptococcosis, extrapulmonary
Cryptosporidiosis, chronic intestinal
Cytomegalovirus retinitis (with vision loss)
Encephalopathy, HIV-related
Herpes simplex - Chronic ulcers
Histoplasmosis, disseminated or extrapulmonary
Isosporiasis, chronic intestinal (duration >1 mo)
Kaposi sarcoma
Lymphoma, Burkitt
Lymphoma, primary, of the brain
Mycobacterium avium complex or Mycobacterium
kansasii infection, extrapulmonary
Mycobacterium tuberculosis infection, any site
(pulmonary or extrapulmonary)
Pneumocystis pneumonia
Progressive multifocal leukoencephalopathy
Toxoplasmosis of the brain
Wasting syndrome due to HIV infection

answer

CD4+ < 200 /microliters

question

A man with HIV infection has lymphadenopathy, chronic diarrhea, oral thrush + herpes lesions. Expected CD4+ count is:

answer

50 cells/microliter

question

Most common cause of HIV-associated peripheral skin or mucosal uclers:

answer

HSV-1 (>> Histo > CMV > VZV > Syphillis)

question

Most common cause of HIV-associated nodules (neoplasia):

answer

HHV-8 (aka KSHV)

question

History of fatigue, abdominal pain, diarrhea, fever, chills, night sweats, dry persistent cough with SOB and weight loss in AIDS patient. lab: PPD -, blood culture + for AFB. TOW:

answer

Mycobacterium avium-intracellulare complex

question

Common cause of retinitis, viral pneumonitis, or esophagitis in AIDS:

answer

CMV

question

History: progressive CNS disease in patient with AIDS: hemiparesis, visual, ataxia, aphasia, cranial nerves, sensory. MRI: ring-enhancing lesions. Toxo antibody (-). TOW:

answer

JC virus

question

Definitive indication for initial HAART (CD4 count) is:

answer

CD4+ 350/mm³

question

objective of ARV treatment is to reduce viremia to what level of genomic RNA/ml:

answer

<50 copies RNA/ml

question

Initial regimen of anti-retroviral therapy is:

answer

Emtricitabine + Tenofovir + Efavirenz

question

Emtricitabine, tenofovir, Abacavir, Lamivudine, zidovudine, belong to what class of antiretrovirals:

answer

NRTIs

question

Efavirenz, nevirapine belong to what class of antiretrovirals:

answer

NNRTIs

question

Atazanavir, Lopinavir, Saquinavir belong to what class of antiretrovirals:

answer

Protease inhibitors (PIs)

question

This drugs bind to gp41 and prevents conformational change required for viral fusion and entry into cells:

answer

Enfuvirtide

question

This drug inhibits integrase, responsible for insertion of HIV proviral DNA into host genome:

answer

Raltegravir

question

A man has AIDS and CD4<200 cells/microliter or thrush. Antibacterial prophylaxis needed besides HAART is:

answer

TMP-SMX (for PCP)

question

A man has AIDS and CD4 <100, positive toxo IgG. Chemoprophylaxis needed besides HAART is:

answer

TMP-SMX (for toxoplasma encephalitis)

question

A man has AIDS and CD4<100 and PPD >5 mm induration. Antibacterial prophylaxis needed besides HAART is:

answer

INH + pyridoxine

question

A man has AIDS and CD4 <50. Antibacterial prophylaxis needed besides HAART is:

answer

Azythromycin (for MAC)

question

History of fever, a pustule at a cat scratch site, adenopathy, hepatosplenomegaly in patient with AIDS. Warthin-Starry stain tissue (+). TOW: (clue: bacillary angiomatosis)

answer

Bartonella henselae

question

Mneumonic of leading causes of congenital infections:

answer

ToRCH3eS-List
To = Toxoplasma gondii
R = Rubella
C = CMV
H = HSV-2
H = HIV
H = HBV
S = Syphilis
List = Listeria monocytogenes

question

Cause of chorioretinitis, intracranial calcifications, and hydrocephalus in a neonate (mom at pregnancy had mono-like illness after eating raw meat) is:

answer

Toxoplasma gondii

question

History of deafness, cataracts, heart defects, microcephaly, or mentral retardation in child (of seronegative mom, exposed to "blueberry muffin baby" in a very poor neighborhood). TOW:

answer

congenital rubella syndrome

question

Microcephaly, seizures, sensorineural hearing loss, feeding difficulties, petechial rash, hepatosplenomegaly, or jaundice in a neonate. PCR of urine should yield:

answer

CMV

question

Hepatosplenomegaly, neurolpgic abnormalities, frequent infections in neonate with low CD4 counts. Woman before birthing should have recieved:

answer

Nevirapine

question

Cause of vesicular lesions + conjunctivitis in child (asymptomatic at birth):

answer

HSV-2

question

History of cutaneous lesions, hepatosplenomegaly, jaundice, saddle nose, saber shins. Hutchinson teeth, + CN8 deafness in neonate (mom is a hooker). TOW:

answer

tertiary syphillis

question

Neonatal septicemia or meningitis (mom had flu like symptoms and ate imported cheese during pregnancy). TOW:

answer

Listeria monocytogenes

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