PAEA INTERNAL MEDICINE EOR STUDY GUIDE UPDATED
EXAM QUESTIONS AND ANSWERS GRADED A+
✔✔how do you collect sputum for a positive tb diagnosis - ✔✔need 3 samples of early
morning sputum
✔✔how do u treat latent tb - ✔✔INHx9 months
✔✔how do you treat tb in areas of low drug resistance - ✔✔2 months of INH, followed
by 4 months of INH and rifampin. pyrazinamide commonly added
✔✔what are some s/e of tb treatment - ✔✔hepatitis, hyperuricemia, thrombocytopenia
✔✔how do u know your tb treatment has failed? - ✔✔positive cultures after 3 months of
tx, or positive afb stains after 5 months
✔✔what is pyridoxine used for in tb treatment - ✔✔preventing peripheral neuropathy
that is caused by isoniazid therapy
✔✔what drug can reduce the effects of treatment for tb? - ✔✔oral contraceptives
✔✔at what cd4 count do u start to see immunocompromisation - ✔✔500 or less
✔✔what is a normal cd4 count - ✔✔600-1500
✔✔in hiv infection, what does lack of sputum production and elevated ldh usually point
towards - ✔✔pneumocystic pneumonia
✔✔at what point is an hiv infection considered progressed to aids - ✔✔cd4<200
✔✔at cd4 levels less than 500 what are hiv patients susceptible to? - ✔✔recurrent
pneumonia, tb, vaginal candidiasis, herpes zoster
✔✔at cd4 levels less than 200, hiv patients are more susceptible to infections like... -
✔✔pneumocystic jirovecii, toxoplasmosis, crytococcosis, histoplasmosis or
cryptosporidiosis
✔✔cd4 levels less than 50, hiv pts are more susceptible to... - ✔✔mycobacterium avium
intracellulare complex, CMV retinitis colitis esophagitis, or cns lymphoma
✔✔a giemsa or silver stain can be used to diagnose what condition for hiv pts -
✔✔pneumocystis pneumonia
, ✔✔what is the treatment for PCP - ✔✔tmp-smx
✔✔what is used as a prognostic tool for PCP in hiv patients - ✔✔arterial po2. po2<70 ,
pts need prednisone
✔✔what is the most common cns mass lesion in aids pts - ✔✔cerebral toxoplasmosis
✔✔why would you check for ebv DNA in a aids pt csf? - ✔✔if you are trying to diagnose
cns lymphoma in a pt without getting a brain biopsy. ebv is present in 90% of cases of
cns lymphoma
✔✔how do u treat cerebral toxoplasmosis - ✔✔sulfadiazine and pyrimethamine, lesion
should regress in two weeks or consider cns lymphoma
✔✔how does cryptococcal meningitis manifest? - ✔✔headaches, personality changes,
visual disturbances, will have increased ic pressures
✔✔how do u confirm a diagnosis of cryptococcal meningitis - ✔✔india ink stain, fungal
culture, measure level of cryptococcal antigen from csf.
✔✔which disease do HIV pts get at cd4 counts less than 50 and can cause necrotizing
adrenalitis, which causes clinical adrenal insufficiencY? - ✔✔CMV
✔✔how is MAC (mycobacterium avium) diagnosed? - ✔✔blood cultures of
mycobacteria
✔✔what do u use for ppx in pts with cd4 count less than 200 - ✔✔tmp-smx three times
per week
✔✔when cd4 count falls below 100, and pts have positive tooplasma serology, what do
u use for ppx - ✔✔daily dosing tmp-smx
✔✔if cd4 count is less than 50, what are u using for ppx and which disease are you
concerned about - ✔✔MAC ppx is clarithromycin 5oo mg daily or azithro 1200mg
weekly
✔✔in which disease seen in aids/hiv does the ICP increase? - ✔✔cryptococcal
meningitis.
✔✔which organism has hyphae and psuedohyphae - ✔✔candida albicans
✔✔how do u diagnose candidiasis - ✔✔local-KOH prep
systemic-blood/tissue cultures
EXAM QUESTIONS AND ANSWERS GRADED A+
✔✔how do you collect sputum for a positive tb diagnosis - ✔✔need 3 samples of early
morning sputum
✔✔how do u treat latent tb - ✔✔INHx9 months
✔✔how do you treat tb in areas of low drug resistance - ✔✔2 months of INH, followed
by 4 months of INH and rifampin. pyrazinamide commonly added
✔✔what are some s/e of tb treatment - ✔✔hepatitis, hyperuricemia, thrombocytopenia
✔✔how do u know your tb treatment has failed? - ✔✔positive cultures after 3 months of
tx, or positive afb stains after 5 months
✔✔what is pyridoxine used for in tb treatment - ✔✔preventing peripheral neuropathy
that is caused by isoniazid therapy
✔✔what drug can reduce the effects of treatment for tb? - ✔✔oral contraceptives
✔✔at what cd4 count do u start to see immunocompromisation - ✔✔500 or less
✔✔what is a normal cd4 count - ✔✔600-1500
✔✔in hiv infection, what does lack of sputum production and elevated ldh usually point
towards - ✔✔pneumocystic pneumonia
✔✔at what point is an hiv infection considered progressed to aids - ✔✔cd4<200
✔✔at cd4 levels less than 500 what are hiv patients susceptible to? - ✔✔recurrent
pneumonia, tb, vaginal candidiasis, herpes zoster
✔✔at cd4 levels less than 200, hiv patients are more susceptible to infections like... -
✔✔pneumocystic jirovecii, toxoplasmosis, crytococcosis, histoplasmosis or
cryptosporidiosis
✔✔cd4 levels less than 50, hiv pts are more susceptible to... - ✔✔mycobacterium avium
intracellulare complex, CMV retinitis colitis esophagitis, or cns lymphoma
✔✔a giemsa or silver stain can be used to diagnose what condition for hiv pts -
✔✔pneumocystis pneumonia
, ✔✔what is the treatment for PCP - ✔✔tmp-smx
✔✔what is used as a prognostic tool for PCP in hiv patients - ✔✔arterial po2. po2<70 ,
pts need prednisone
✔✔what is the most common cns mass lesion in aids pts - ✔✔cerebral toxoplasmosis
✔✔why would you check for ebv DNA in a aids pt csf? - ✔✔if you are trying to diagnose
cns lymphoma in a pt without getting a brain biopsy. ebv is present in 90% of cases of
cns lymphoma
✔✔how do u treat cerebral toxoplasmosis - ✔✔sulfadiazine and pyrimethamine, lesion
should regress in two weeks or consider cns lymphoma
✔✔how does cryptococcal meningitis manifest? - ✔✔headaches, personality changes,
visual disturbances, will have increased ic pressures
✔✔how do u confirm a diagnosis of cryptococcal meningitis - ✔✔india ink stain, fungal
culture, measure level of cryptococcal antigen from csf.
✔✔which disease do HIV pts get at cd4 counts less than 50 and can cause necrotizing
adrenalitis, which causes clinical adrenal insufficiencY? - ✔✔CMV
✔✔how is MAC (mycobacterium avium) diagnosed? - ✔✔blood cultures of
mycobacteria
✔✔what do u use for ppx in pts with cd4 count less than 200 - ✔✔tmp-smx three times
per week
✔✔when cd4 count falls below 100, and pts have positive tooplasma serology, what do
u use for ppx - ✔✔daily dosing tmp-smx
✔✔if cd4 count is less than 50, what are u using for ppx and which disease are you
concerned about - ✔✔MAC ppx is clarithromycin 5oo mg daily or azithro 1200mg
weekly
✔✔in which disease seen in aids/hiv does the ICP increase? - ✔✔cryptococcal
meningitis.
✔✔which organism has hyphae and psuedohyphae - ✔✔candida albicans
✔✔how do u diagnose candidiasis - ✔✔local-KOH prep
systemic-blood/tissue cultures
