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Questions and Answers
What is the most common immunodeficiency in humans?
What is the most common immunodeficiency in humans?
Which symptom is most commonly associated with IgA deficiency?
Which symptom is most commonly associated with IgA deficiency?
In patients with suspected Celiac disease and IgA deficiency, what test might be unreliable?
In patients with suspected Celiac disease and IgA deficiency, what test might be unreliable?
What is the appropriate diagnosis for a 17-year-old with a history of autoimmune thyroiditis, type I diabetes, and childhood candidal infections?
What is the appropriate diagnosis for a 17-year-old with a history of autoimmune thyroiditis, type I diabetes, and childhood candidal infections?
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When should steroids be added to TMP/SMX treatment for PJP pneumonia?
When should steroids be added to TMP/SMX treatment for PJP pneumonia?
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What is the main treatment for otitis externa?
What is the main treatment for otitis externa?
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Which imaging technique is preferred in the management of malignant otitis externa?
Which imaging technique is preferred in the management of malignant otitis externa?
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What is the most common cause of otitis externa?
What is the most common cause of otitis externa?
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When should tympanostomy tubes be considered for a patient?
When should tympanostomy tubes be considered for a patient?
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What is the initial treatment for Strep pharyngitis?
What is the initial treatment for Strep pharyngitis?
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What is the most common cause of bronchiectasis in western countries?
What is the most common cause of bronchiectasis in western countries?
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What is the recommended antibiotic for aspiration pneumonia due to anaerobes above the diaphragm?
What is the recommended antibiotic for aspiration pneumonia due to anaerobes above the diaphragm?
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In a young child presenting with scant white sputum and linear opacity in the right-middle lobe on CXR, what is the likely diagnosis?
In a young child presenting with scant white sputum and linear opacity in the right-middle lobe on CXR, what is the likely diagnosis?
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What is the most common extra-renal location for cysts in ADPKD?
What is the most common extra-renal location for cysts in ADPKD?
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Which chromosome is associated with autosomal recessive polycystic kidney disease (ARPKD)?
Which chromosome is associated with autosomal recessive polycystic kidney disease (ARPKD)?
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In suspected meningitis, what is the current guideline regarding the order of lumbar puncture and antibiotic treatment?
In suspected meningitis, what is the current guideline regarding the order of lumbar puncture and antibiotic treatment?
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When screening for autosomal dominant polycystic kidney disease (ADPKD), which of the following tests is primarily indicated?
When screening for autosomal dominant polycystic kidney disease (ADPKD), which of the following tests is primarily indicated?
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At what age do symptoms typically begin to manifest in individuals with autosomal dominant polycystic kidney disease (ADPKD)?
At what age do symptoms typically begin to manifest in individuals with autosomal dominant polycystic kidney disease (ADPKD)?
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Which antibiotic combination is recommended for empiric therapy in suspected meningitis?
Which antibiotic combination is recommended for empiric therapy in suspected meningitis?
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What is the main reason for performing a CT head before lumbar puncture in suspected meningitis?
What is the main reason for performing a CT head before lumbar puncture in suspected meningitis?
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What complication is associated with ARPKD in pediatric patients?
What complication is associated with ARPKD in pediatric patients?
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Which statement best describes bronchiectasis associated with right middle lobe syndrome?
Which statement best describes bronchiectasis associated with right middle lobe syndrome?
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What is a notable feature of autosomal dominant polycystic kidney disease regarding cyst development?
What is a notable feature of autosomal dominant polycystic kidney disease regarding cyst development?
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What indicates a potential mass lesion in the context of neurologic examination?
What indicates a potential mass lesion in the context of neurologic examination?
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Which characteristic differentiates bacterial meningitis from aseptic meningitis?
Which characteristic differentiates bacterial meningitis from aseptic meningitis?
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In diagnosing fungal meningitis, what finding is primarily observed in the CSF?
In diagnosing fungal meningitis, what finding is primarily observed in the CSF?
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Which finding is most commonly associated with herpes encephalitis?
Which finding is most commonly associated with herpes encephalitis?
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What is the primary method for diagnosing Cryptococcal meningitis?
What is the primary method for diagnosing Cryptococcal meningitis?
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What is the first-line treatment for Cryptococcal meningitis?
What is the first-line treatment for Cryptococcal meningitis?
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What condition presents with confusion as a key symptom, differentiating it from meningitis?
What condition presents with confusion as a key symptom, differentiating it from meningitis?
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In an immunocompromised patient, a nodular density in the upper lobe is suggestive of what diagnosis?
In an immunocompromised patient, a nodular density in the upper lobe is suggestive of what diagnosis?
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What is the next best step in the management of aspergilloma in an immunocompromised patient?
What is the next best step in the management of aspergilloma in an immunocompromised patient?
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Which symptom is primarily associated with the diagnosis of bacterial pneumonias?
Which symptom is primarily associated with the diagnosis of bacterial pneumonias?
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What is the primary mechanism by which ciguatera toxicity affects the body?
What is the primary mechanism by which ciguatera toxicity affects the body?
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Which symptom is most likely to occur in a patient experiencing scombroid toxicity?
Which symptom is most likely to occur in a patient experiencing scombroid toxicity?
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If a patient develops an allergic-like reaction after eating shellfish, what is the most appropriate diagnosis?
If a patient develops an allergic-like reaction after eating shellfish, what is the most appropriate diagnosis?
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What is the primary cause of vomiting a few hours after eating meat?
What is the primary cause of vomiting a few hours after eating meat?
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What type of food is associated with S. aureus preformed heat-stable toxin causing vomiting?
What type of food is associated with S. aureus preformed heat-stable toxin causing vomiting?
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How long is the incubation period typically for gram-negative rods causing bloody diarrhea?
How long is the incubation period typically for gram-negative rods causing bloody diarrhea?
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Which genus of bacteria is NOT commonly associated with food poisoning?
Which genus of bacteria is NOT commonly associated with food poisoning?
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What is a key factor in diagnosing scombroid toxicity?
What is a key factor in diagnosing scombroid toxicity?
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What is the role of histidine decarboxylase in food poisoning scenarios?
What is the role of histidine decarboxylase in food poisoning scenarios?
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What is the likely diagnosis for a patient consuming aged fish and experiencing temperature dysesthesia?
What is the likely diagnosis for a patient consuming aged fish and experiencing temperature dysesthesia?
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Which finding is characteristic of bacterial meningitis when evaluating cerebrospinal fluid (CSF)?
Which finding is characteristic of bacterial meningitis when evaluating cerebrospinal fluid (CSF)?
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Which symptom is primarily indicative of encephalitis rather than meningitis?
Which symptom is primarily indicative of encephalitis rather than meningitis?
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What is the recommended first-line treatment for Cryptococcal meningitis?
What is the recommended first-line treatment for Cryptococcal meningitis?
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Which diagnostic test is traditionally used to identify Cryptococcal meningitis?
Which diagnostic test is traditionally used to identify Cryptococcal meningitis?
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In an immunocompromised patient with a nodular density in the upper lobe, what is the next best step in management?
In an immunocompromised patient with a nodular density in the upper lobe, what is the next best step in management?
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What can potentially result from IgA deficiency that complicates the diagnosis of Celiac disease?
What can potentially result from IgA deficiency that complicates the diagnosis of Celiac disease?
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Which autoimmune condition is closely associated with chronic mucocutaneous candidiasis in a patient with IgA deficiency?
Which autoimmune condition is closely associated with chronic mucocutaneous candidiasis in a patient with IgA deficiency?
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In the context of PJP pneumonia, what indicates the need for steroid treatment alongside TMP/SMX?
In the context of PJP pneumonia, what indicates the need for steroid treatment alongside TMP/SMX?
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Which factor may complicate the diagnosis of IgA deficiency when evaluating recurrent sinopulmonary infections?
Which factor may complicate the diagnosis of IgA deficiency when evaluating recurrent sinopulmonary infections?
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What is an important clinical consideration for a patient with a history of autoimmune conditions being evaluated for IgA deficiency?
What is an important clinical consideration for a patient with a history of autoimmune conditions being evaluated for IgA deficiency?
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What serious reaction is noteworthy in patients with IgA deficiency following blood transfusions?
What serious reaction is noteworthy in patients with IgA deficiency following blood transfusions?
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Which patient demographic is most likely to exhibit recurrent sinus infections due to IgA deficiency?
Which patient demographic is most likely to exhibit recurrent sinus infections due to IgA deficiency?
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What antibody test is likely to provide misleading results in individuals with IgA deficiency who are being assessed for gluten sensitivity?
What antibody test is likely to provide misleading results in individuals with IgA deficiency who are being assessed for gluten sensitivity?
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What is the most appropriate method for screening patients for autosomal dominant polycystic kidney disease (ADPKD)?
What is the most appropriate method for screening patients for autosomal dominant polycystic kidney disease (ADPKD)?
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Which chromosome is associated with autosomal dominant polycystic kidney disease (ADPKD)?
Which chromosome is associated with autosomal dominant polycystic kidney disease (ADPKD)?
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Which of the following is a significant complication associated with autosomal recessive polycystic kidney disease (ARPKD) in pediatric patients?
Which of the following is a significant complication associated with autosomal recessive polycystic kidney disease (ARPKD) in pediatric patients?
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When faced with suspected meningitis, what is the updated guideline regarding the initial procedure?
When faced with suspected meningitis, what is the updated guideline regarding the initial procedure?
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What condition is characterized by bronchiectasis due to right middle lobe syndrome?
What condition is characterized by bronchiectasis due to right middle lobe syndrome?
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Which of the following statements about cyst development in autosomal dominant polycystic kidney disease (ADPKD) is correct?
Which of the following statements about cyst development in autosomal dominant polycystic kidney disease (ADPKD) is correct?
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Which extra-renal location is most commonly affected by cysts in patients with polycystic kidney disease?
Which extra-renal location is most commonly affected by cysts in patients with polycystic kidney disease?
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What is the recommended combination of antibiotics for empirical therapy in suspected meningitis?
What is the recommended combination of antibiotics for empirical therapy in suspected meningitis?
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In suspected meningitis, under which circumstance would a CT scan be performed before a lumbar puncture?
In suspected meningitis, under which circumstance would a CT scan be performed before a lumbar puncture?
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What type of toxicity is primarily characterized by the sensation of 'hot feels cold' and 'cold feels hot'?
What type of toxicity is primarily characterized by the sensation of 'hot feels cold' and 'cold feels hot'?
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Which reaction occurs due to the consumption of decaying fish that converts histidine to histamine?
Which reaction occurs due to the consumption of decaying fish that converts histidine to histamine?
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What is the proper diagnosis for a patient who experiences an allergic-like reaction after consuming shellfish?
What is the proper diagnosis for a patient who experiences an allergic-like reaction after consuming shellfish?
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What toxin is associated with vomiting just a few hours after eating contaminated meat?
What toxin is associated with vomiting just a few hours after eating contaminated meat?
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What type of food consumption typically leads to symptoms like vomiting, bloody diarrhea, or unusual symptoms like severe abdominal pain in a short incubation period?
What type of food consumption typically leads to symptoms like vomiting, bloody diarrhea, or unusual symptoms like severe abdominal pain in a short incubation period?
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After how many hours do symptoms typically occur from food contamination related to Staphylococcus aureus toxins?
After how many hours do symptoms typically occur from food contamination related to Staphylococcus aureus toxins?
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Which situation is most likely associated with the development of scombroid toxicity?
Which situation is most likely associated with the development of scombroid toxicity?
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Which bacterium is known for causing gastrointestinal symptoms through heat-stable toxins when contaminated food is consumed?
Which bacterium is known for causing gastrointestinal symptoms through heat-stable toxins when contaminated food is consumed?
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What incubation period is typically observed for gram-negative rods causing bloody diarrhea?
What incubation period is typically observed for gram-negative rods causing bloody diarrhea?
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What type of allergic-like reaction may be misdiagnosed due to scombroid intoxication symptoms following fish consumption?
What type of allergic-like reaction may be misdiagnosed due to scombroid intoxication symptoms following fish consumption?
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Which antibiotic is most appropriate for the initial treatment of otitis media?
Which antibiotic is most appropriate for the initial treatment of otitis media?
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What is the primary purpose of using topical alcohol-acetic acid drops in otitis externa?
What is the primary purpose of using topical alcohol-acetic acid drops in otitis externa?
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In a patient with malignant otitis externa, what imaging technique is recommended to assess for fluid collection?
In a patient with malignant otitis externa, what imaging technique is recommended to assess for fluid collection?
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What clinical finding might indicate mastoiditis in a pediatric patient?
What clinical finding might indicate mastoiditis in a pediatric patient?
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Which organism is most commonly associated with otitis externa?
Which organism is most commonly associated with otitis externa?
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For a young child presenting with a history of scant white sputum and linear opacity in the right-middle lobe on CXR, what is the most likely diagnosis?
For a young child presenting with a history of scant white sputum and linear opacity in the right-middle lobe on CXR, what is the most likely diagnosis?
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What is the indication for performing a tympanostomy tube placement in children?
What is the indication for performing a tympanostomy tube placement in children?
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Which antibiotic should be prescribed for aspiration pneumonia caused by anaerobes above the diaphragm?
Which antibiotic should be prescribed for aspiration pneumonia caused by anaerobes above the diaphragm?
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In individuals with a risk of cerumen buildup, what is the appropriate treatment?
In individuals with a risk of cerumen buildup, what is the appropriate treatment?
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What complication might arise if fluid collection is not appropriately drained in a case of malignant otitis externa?
What complication might arise if fluid collection is not appropriately drained in a case of malignant otitis externa?
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Study Notes
USMLE Review Part II
- Hot/Cold Dysesthesia: Ciguatera toxicity; toxin blocks sodium channels; caused by consumption of reef fish.
- Scombroid: Reaction to decaying fish; histidine decarboxylase converts histidine to histamine.
- Shellfish Allergy: Reaction to shellfish, not scombroid.
- S. aureus: Preformed heat-stable toxin causes vomiting after eating contaminated food.
- Otitis Externa: Topical ciprofloxacin and hydrocortisone drops. Pseudomonas causing otitis externa.
- Malignant Otitis Externa: Otitis externa + mastoiditis; CT or MRI of temporal bone.
- Otitis Media: Amoxicillin (Augmentin frequently used for recurrent OM).
- Tympanostomy Tubes: 3+ OM in 6 months or 4+ in a year.
- Strep Pharyngitis: Amoxicillin or penicillin (not Augmentin).
- Aspiration Pneumonia/Abscess: Clindamycin for anaerobes.
- Bronchiectasis: Chronic foul-smelling sputum in COPD, TB or CF patients.
- Bronchiectasis (Young Kid): Right middle lobe syndrome (linear opacity in right-middle lobe on CXR).
- Polycystic Kidney Disease (AD): ADPKD → serial blood pressure checks, not MR angiograms (unless a family history of aneurysm).
- Polycystic Kidney Disease (AR): Affects the entire renal system (AR = 6; AD = 16 on the chromosome).
- Meningitis: Ceftriaxone and vancomycin (+/− steroids) in empiric treatment.
- Cryptococcal Meningitis: Latex agglutination or mucicarmine stain.
- Aspergilloma: Nodular density in immunocompromised pt (open lung biopsy).
- IgA Deficiency: Recurrent sinopulmonary infections.
- Chronic Mucocutaneous Candidiasis: 1-year hx of autoimmune thyroiditis + 2-year hx of type I DM + candidal infections since childhood.
- Autoimmune Conditions and Immunodeficiencies: Associate; CMC and IgA deficiency are examples.
- Pneumonia (PJP): TMP/SMX for treatment. Add steroids if PaO2 < 60 mm Hg or an A-a gradient >35.
- Fat Embolism: Long-bone fractures + petechiae on the chest.
- Hyperthyroidism/Hypothyroidism: Hashimoto's Thyroiditis + thyroid cancer.
- Type 1 Diabetes Mellitus: Hashimoto's Thyroiditis + thyroid cancer
- Multiple Endocrine Neoplasia (MEN): MEN1 (pituitary, pancreas, parathyroid). MEN2A (parathyroid, medullary thyroid carcinoma, pheochromocytoma). MEN2B (medullary thyroid carcinoma, pheochromocytoma, mucosal neuromas, Marfanoid body habitus).
- Burkitt Lymphoma: Abdominal mass + weight loss with lymphocytes + interspersed macrophages (also African boys with jaw lesions usually).
- Acute Lymphoblastic Leukemia (ALL): 40M + Hodgkin Lymphoma + renal condition (minimal change disease)
- Viral Infections: Cytomegalovirus (CMV), HSV, Group A Strep.
- Febrile Non-Hemolytic Transfusion Reaction: Most common; tx: acetaminophen.
- Transfusion Related Acute Lung Injury (TRALI): Blood transfusion + dyspnea + hypoxemia + bilateral pulmonary infiltrates as symptoms.
- Hot Tub Lung: Inflammation after prolonged exposure to hot tub vapors.
- Pulmonary Embolism (PE): V/Q scan, and if positive, spiral CT; heparin.
- Ischemic Stroke: tPA within 4.5 hours.
- Rhabdomyolysis: Alcoholic + increased creatine kinase; patient with increased creatine kinase + falls; positive urine dipstick for blood (negative microscopy).
- Anemia in Alcoholism: High MCV (non-megaloblastic macrocytic anemia).
- Acid-Base Disturbance in Asthma: Respiratory Alkalosis (low CO2, high pH).
- Acute Asthma: Albuterol, IV steroids, monitor O2 and CO2, and pH.
- Interstitial Cystitis: Chronic; anterior vaginal wall pain with no other findings in the absence of other symptoms for 6+ weeks .
- Stress Incontinence: Weakened pelvic floor muscles. Tx: Kegel exercises.
- Urge Incontinence: Hyperactive detrusor or detrusor instability.
- Overflow Incontinence: Obstruction, e.g., neurogenic bladder or BPH (benign prostatic hyperplasia); Tx: catheters.
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Description
This quiz covers essential topics in Infectious Diseases relevant for the USMLE Part II, including various types of dysesthesia, otitis, and treatment protocols. Test your knowledge on conditions like Scombroid, Otitis Externa, and aspiration pneumonia among others.
