Pseudogout associations – correct answer hemochromatosis, hyperparathyroidism,
acromegaly, hypothyroidism
Gout crystals – correct answer negatively birefringent needles
Pseudogout crystals – correct answer positively birefringent needles
Vasculitis associated with chronic Hep B – correct answer polyarteritis nodosa
Vasculitis associated with chronic Hep C – correct answer cryoglobulinemia
Best blood test for polyarteritis nodosa – correct answer There is none. Get abdominal
angiography first, then biopsy of muscle, skin, or sural nerve.
Churg-Strauss – correct answer vasculitis + eosinophilia + asthma
Takayasu’s arteritis – correct answer young asian female with diminished pulses (usually
preceeded by fatigue, weight loss, arthralgia, anemia, elevated ESR)
Best test for Takayasu’s – correct answer aortic angiography or MRA
Bite cells on blood smear – correct answer G6PD
Burr/Spur cells on blood smear – correct answer liver disease
Acanthocytes on blood smear (looks like spur cell but with more rounded spurs) –
correct answer liver disease, hypothyroidism, alcoholism
Basophilic stippling on blood smear – correct answer lead poisoning
Schistocytes on blood smear – correct answer TTP-HUS, DIC, prosthetic heart valve,
malignant htn, sepsis
Target cells on blood smear – correct answer thalassemia, other hemoglobinopathies,
liver disease
5 causes of microcytic anemia – correct answer iron deficiency, lead poisoning, anemia
of chronic disease (but usually normocytic), thalassemia, sideroblastic anemia (can also
have high MCV
Antibody test for celiac disease – correct answer anti-endomysial, tissue
transglutaminase (small bowel bx is best though)
Antibiotics for MRSA – correct answer IV: vanc, linezolid, daptomycin, tigecycline;
if minor infection, can use oral: TMP/SMX, doxy, minocycline, or maybe clindamycin
(there is inducible resistance to clinda though)
Antibiotics for MSSA – correct answer Oxacillin/nafcillin, dicloxacillin (IV and oral),
cefazolin (IV), cephalexin (oral)
Can you use cephalosporins in pt allergic to PCN? – correct answer yes, if the rxn is
rash only; no if pt has true anaphylaxis
Antibiotics to use for Staph with PCN allergy – correct answer cephalosporins if rash
only; macrolides, clindamycin, vancomycin, linezolid, daptomycin, TMP/SMX
Antibiotics for strep – correct answer PCN, ampicillin, amoxicillin
Antibiotics for GNRs – correct answer Cephalosporins: cefepime, ceftazidime
PCNs: piperacillin, ticaricillin
Monobactam: Aztreonam
Quinolones: cipro, levo, gati, moxi
Aminoglycs: gentamicin, tobramycin, amikacin
Carbapenems: imipenem, mero, erta
Limitation of ertapenem – correct answer does NOT cover pseudomonas
Piperacillin and ticarcillin – correct answer GNRs
strep
anaerobes
Carbapenems – correct answer good anaerobic coverage
strep
MSSA
Tigecycline – correct answer MRSA
good GNR coverage
Anaerobes – correct answer -metronidazole is BEST for abdominal anaerobes
(carbapenems, piperacillin, and ticarcillin have equal efficacy)
-cefoxitin and cefotetan are the ONLY cephalosporins
-respiratory anaerobes: clindamycin
Abx with NO anaerobic coverage – correct answer aminoglycs, aztreonam,
fluoroquinolones, oxacillin/nafcillin, all cephalosporins EXCEPT cefoxitin and cefotetan
Red man syndrome – correct answer red, flushed skin from histamine release,
associated with rapid infusion of vancomycin (so slow down the infusion rate)
Osteomyelitis – correct answer -most common is staph: oxacillin or nafcillin IV for 4-6
wks for MSSA; vanc, linezolid or dapto for MRSA
-GNRs: salmonella or pseudomonas, can use orals, but must cx org. first and make
sure it is sensitive (BONE bx and cx)
Cellulitis tx – correct answer -minor infection: oral dicloxacillin or cephalexin
-severe: IV oxacillin, nafcillin or cefazolin
-PCN allergy: if rash, then cephalosporin; if anaphylaxis, then vanc, linezolid, dapto
(macrolides or clinda for minor infection)
Sequelae of strep infection – correct answer -throat: rheumatic fever AND
glomerulonephritis
-skin: ONLY glomerulonephritis
Gonorrhea tx – correct answer -ceftriaxone IM
-cefixime oral
-cefpodoxime oral
-ciprofloxacin oral (2d line)
-if pregnant, then ceftriaxone IM
-ALSO treat for chlamydia
Chlamydia tx – correct answer -azithromycin (single dose)
-doxycycline (for 1 wk)
-if pregnant, then azithro
-ALSO treat for gonorrhea
Recurrent gonorrhea associated with… – correct answer terminal complement deficiency
(predisposes to any Neisseria infection)
PID tx – correct answer -outpatient: ceftriaxone (IM) and oral doxy
-inpatient: cefoxitin or cefotetan IV + doxy + (maybe) metronidazole
Abx safe in pregnancy – correct answer -PCNs
-cephalosporins
-aztreonam
-erythromycin
-azithromycin
Epidydimo-orchitis tx – correct answer -if <35 yo, then ceftriaxone + doxy -if >35 yo, then fluoroquinolone
Chancroid – correct answer -PAINFUL ulcer caused by Hemophilus ducreyi
-swab for gram stain and culture (on Nairobi medium or Mueller-Hinton agar)