SAMI’s MCQ’S - ID - QUESTIONS

1. In cellulitis,all are true except:

a. staph and strept are the most common causes
b. gram negative bacilli should be covered in immunocompromised pts
c. 2nd generation cephalosporins are good choice for immunocompetent
adults
d. may be complicated by fascitis
e. NSAIDs may help symptoms resolution

2. All can be used to treat cellulitis in normal adults except:

a. clindamycin
b. cloxacillin
c. erythromycin
d. ceftazidime
e. vancomycin

3. In erysipelas,all are true except:

a. it is a type of cellulitis
b. caused by staph aureus
c. clearly-demarcated borders
d. classically involve the face
e. usually associated with leukocytosis

4. In necrotizing fascitis,all are false except:

a. can be treated by antibiotics only
b. usually requires extremity amputation
c. spread through muscles
d. rapidly progressive
e. commonly streptococcal pathology

5. All are risk factors for necrotizing fascitis except:

a. peripheral vascular disease
b. surgery
c. chickenpox
d. IVDU
e. Measles

6. Regarding cutaneous abscesses,all are true except:

a. usually caused by staph,strept
b. usually require I/D
c. requires antibiotics post I/D
d. swab for C/S is not needed
e. may require endocarditis prophylaxis for high risk population

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7. Regarding periorbital cellulitis,all are false except
a. usually secondary to dental infection
b. rarely spread to the orbit
c. needs admission for antibiotics
d. associated with restricted eye movements
e. needs antibiotics plus debridement

8. Regarding orbital cellulitis,all are true except:

a. usually secondary to sinusitis
b. associated with vision changes
c. needs CT for DX
d. usually needs debridement
e. high dose IV antibiotic is needed

9. Regarding cerebral malaria,all are false except:

a. focal findings rarely found
b. due to major arterial occlusion
c. CT then LP are required for DX
d. blood film usually gets the DX
e. high dose IV chloroquine is required

10. All are indications for admission for malaria except:

a. blackwater fever
b. falciparum species
c. parasitemia>2%
d. hypoxia
e. severe anemia

11. All are expected side effects of quinine except:

a. hypoglycemia
b. arrhythmia
c. ototoxicity
d. nephrotoxicity
e. AV block

12. Regarding TB,all are true except:

a. primary pulmonary TB is usually missed
b. reactivation pulmonary TB usually involves the ant segment of upper
lobe
c. military TB pts usually do not need isolation
d. HIV has to be ruled out
e. TB meningitis can mimic viral meningitis

13. All the following CXR findings can be associated with TB except:
a. hilar LN
b. alveolar infiltrate
c. millets picture
d. cavity

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 e. ground glass opacity

14. All the followings are complications of TB except:

a. pericarditis
b. pleural effusion
c. endocarditis
d. endophthalmitis
e. arthritis

15. Regarding miliary TB,all are true except:

a. presents with fever and weight loss
b. CXR is diagnostic
c. AFB in sputum is commonly found
d. can presents with unexplained pancytopenia
e. bronchoscopy may be needed for DX

16. Regarding TB cavity in CXR,all are true except:

a. AFB Is usually positive
b. may presents with massive hemoptysis
c. can be superinfected with aspergillus
d. can involve the superior segment of the lower lobe
e. usually needs surgical excision

17. Regarding typhoid fever,all are true except:

a. transmitted in a feco-oral pattern
b. common cause of fever post travel
c. may mimick malaria
d. widal serology may help in DX
e. IV vancomycin is needed for treatment

18. Regarding PCP pneumonia,all are false except:

a. presents with extrapulmonary symptoms
b. occurs in HIV only
c. can be treated by trimethoprim
d. steroids are needed in hypoxic pts
e. high LDH is 90% sensitive

19. All the followings may mimick PCP pneumonia except:

a. chlamydia pneumonia
b. TB cavity
c. viral pneumonia
d. mycoplasma pneumonia
e. BOOP

20. All the followings are expected in PCP pneumonia except:

a. high LDH
b. hypoxia
c. pneumothorax
d. pleural effusion

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 e. perihilar infiltrate

21. All the following antibiotics can be used alone in febrile neutropenia except:
a. ceftazidime
b. ceftriaxone
c. cefepime
d. cefuroxime
e. pipracillin/tazobactam

22. Regarding febrile neutropenia,all are false except:

a. the most common organism is staph aureus
b. vancomycin is the drug of choice
c. absolute neutrophilic count less that 1000
d. always needs admission
e. the highest risk if chemotherapy-related

23. Regarding disseminated gonococcemia,all are false except:

a. more common in males
b. triad of rash,arthitis and endocarditis
c. 2-4 weeks of IV ceftriaxone is needed
d. blood culture is usually positive
e. HIV is a major risk factor

24. Regarding urethral discharge in males,all are false except:

a. HIV has to be considered as a cause
b. caused by gonococci alone
c. usually sexually transmitted
d. 2-week cefuroxime course is needed
e. urethral swab is mandatory

25. Regarding PID treatment,all are false except:

a. always needs admission
b. always requires IV antibiotics
c. antibiotics used for outpatient management is different from ones used for
inpatient management
d. gonococci are penicillin sensitive
e. chlamydia can be covered by B-lactam Abs

26. Regarding antibiotics choice for output ttt of PID,none is recommended except:
a. amoxil+doxycycline
b. pen V + azithromycin
c. ofloxacin+doxycycline
d. cephalexin +azithromycin
e. cloxacillin+doxycycline

27. Regarding antibiotics choice for inpatient ttt of pelvic inflammatory disease are
false except:
a. clinda+gent IV then doxy for 2 weeks
b. vanco+gent IV then doxy for 2 weeks

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 c. amp+gent IV then doxy for 2 weeks
d. ceftriaxone IV then flagyl for 2 weeks
e. tazocin IV then cefuroxime for 2 weeks

28. All the followings are risk factors for pelvic inflammatory disease except:
a. IUD
b. multiple sexual partners
c. HIV
d. previous attack
e. instrumentation

29. All the followings can complicate pelvic inflammatory disease except:
a. septic shock
b. ovarian abscess
c. peritonitis
d. endometriosis
e. ectopic pregnancy

30. All are required for pelvic inflammatory disease DX except:

a. bilat adnexal tenderness
b. cervical motion tenderness
c. lower abd pain and tenderness
d. presence of at least one risk factor
e. absence of alternative DX

31. All the followings are STDs except:

a. gonococcal cervicitis
b. chlamydial prostatitis
c. trichomonas vaginitis
d. candidal vaginitis
e. gardenella vaginitis

32. Regarding tetanus treatment,all may be required except:

a. penicillin V
b. wound debridement
c. baclofen
d. lorazepam
e. phenytoin

33. All can be secondary to botulism except:

a. diplopia
b. spastic weakness
c. bulbar palsy
d. weak cry
e. resp failure

34. Which scenario suggests pulmonary anthrax:

a. lobar infiltrate alone
b. interstitial infiltrate alone

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 c. pleural effusion with miliary infiltrate
d. multi-lobar infiltrates with mediastinal LNs
e. bilat interstitial infiltrate with effusion

35. All the followings affect acetylcholine action at NMJ except:

a. botulinum toxin
b. black widow venom
c. pyrdiostigmine
d. tetanus
e. organohosphates

36. Regarding impetigo,all are false except:

a. exclusively caused by GABHS
b. should be treated by oral Abs
c. can be complicated by Glomerulonephritis
d. penV is usually recommended
e. always shows honey-crust appearance

37. All the following organisms usually cause URTI except:

a. GABHS
b. EBV
c. peptostreptococcus
d. strept pneumonia
e. neisseria gonorrhea

38. Regarding strept pharyngitis,all are false except:

a. caused by group D strept
b. usually preceded by coryza
c. it is a self-limited disease
d. usaually pen-resistant
e. more common in summer

39. Regarding infectious mono due to EBV,all are true except:

a. may mimick acute HIV seroconversion
b. can be complicated by splenic rupture
c. neutrophilia is common
d. amoxil adminstration causes rash
e. monospot test is positive

40. All the followings mimick acute HIV seroconversion except:

a. toxoplasmosis
b. CMV infection
c. viral hepatitis
d. infectious mononucleosis
e. shigellosis

41. Regarding HIV,all the followings are true except:

a. considered immunosuppressed if CD4 less than 500

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 b. PCP pneumonia is the most common opportunistic infection
c. needs droplet isolation
d. associated lymphocytopenia is common
e. a common cause of TB reactivation

42. HIV should be highly suspected in all the followings except:

a. CMV retinitis
b. esophageal candidiasis
c. kaposi sarcoma
d. oral thrush
e. primary CNS lymphoma

43. HIV pts with contrast-enhancing mass on CT head,all are false except:
a. always needs biopsy
b. LP is indicated
c. blood culture may show toxoplasma
d. lymphoma is a consideration
e. positive india ink stain on CSF

44. HIV with pulmonary symptoms,all are false except:

a. may need bronchoscopy for DX
b. kaposi sarcoma is the most common cause
c. PCP pneumonia rarely causes hypoxia
d. pneumococcal pneumonia is uncommon
e. gram negative pneumonia is common

45. All the followings could be transmitted by blood transfusion except:

a. HIV
b. malaria
c. TB
d. syphilis
e. HTLV

46. Regarding toxic shock syndrome,all are false except:

a. caused exclusively by staph aureus
b. requires positive blood culture for DX
c. the toxin is responsible for the syndrome
d. requires 5 organs to be dysfunctional for DX
e. Plasmapheresis may help resolution

47. All the followings can cause purpuric rash except:

a. gonococcemia
b. meningococcemia
c. rocky mountain spotted fever
d. lyme disease
e. leptospirosis

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48. Herpes simplex virus can cause all the followings except:
a. encephalitis
b. keratitis
c. peritonitis
d. whitlow
e. stomatitis

49. Regarding rabies,all are false except:

a. always fatal
b. can be transmitted by rats
c. spread to the brain by blood stream
d. IV acyclovir helps to decrease mortality
e. dogs are the most common source in USA

50. Regarding septic arthritis,all are false except:

a. staph epidermidis is a common cause
b. gonococci usually show up on gram stain of the synovial fluid
c. age and sexual history affects management
d. needs IV antibiotics only
e. staph aureus is a common cause in the neonate

51. Regarding overwhelming post-splenectomy infections,all are true except:

a. caused by encapsulated organisms
b. due to absence of opsins
c. IV ceftriaxone can be used
d. the most common organism is meningococcus
e. needs aggressive resuscitation

52. All the followings can be prevented by h.flu vaccine except:

a. epiglottitis
b. meningitis
c. pneumonia
d. cellulitis
e. osteomyelitis

53. All the following Abs are active against pen-resistant pneumococci except:
a. cefotaxime
b. ceftriaxone
c. vancomycin
d. ciprofloxacin
e. levofloxacin

54. Regarding peritonitis,all are false except:

a. if secondary to hollow bowel perforation, gram-negative bacilli is the sole
organism
b. if associated with chronic liver disease,usually polymicrobial
c. GNB is the organism mostly found with CAPD
d. xray is always needed to R/O perforation
e. vancomycin is a good antibiotic choice

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55. Regarding amebic liver abscess,all are false except:
a. always needs drainage
b. always needs biopsy
c. amebic serology rarely helps
d. can mimick bacterial liver abscess
e. CT is pathognomic

56. Pseudomonas is a common cause of all the followings except:

a. nosocomial pneumonia
b. keratitis in contact lens users
c. plantar puncture wounds through boots
d. meningitis in HIV
e. malignant otitis externa

57. IV ceftriaxone can be used alone to treat all except:

a. meningitis
b. pyelonephritis
c. Spontaneous bacterial peritonitis
d. Pneumonia
e. disseminated gonococcemia