Harrisons Reviewer 2

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INFECTIOUS DISEASES MOST most common cause of FUO infections (then, neoplasms) most frequent cause of FUO in the elderly multisystem disease (giant-cell arteritis being the leading etiologic entity most common infection causing FUO in the elderly TB most common reason for visits to primary care providers URTI most common cause of URI rhinovirus most commonly involved sinus in sinusitis maxillary sinus (ethmoid, frontal, sphenoid) most common pathogens in sinusitis S. pneumoniae and nontypable H. influenzae most often involved in tooth pain in sinusitis upper molars most common pathogen in perichondritis P. aeruginosa and S. aureus most common pathogen in otitis externa P. aeruginosa and S. aureus most common cause of chronic otitis externa primarily by repeated local irritation, most commonly arising from persistent drainage from chronic middle-ear infection most common causative viruses in otitis media RSV, influenza virus, rhinovirus, enterovirus most important bacterial cause S. pneumoniae most common presenting symptom of oropharyngeal infections sore throat most frequent reasons for ambulatory care visits by adults and sore throat children most important source of concern in acute pharyngitis infection with group A beta-hemolytic strep (S. pyogenes) most common identifiable cause of acute pharyngitis respiratory viruses (rhinoviruses and coronaviruses) most commonly involved in infection of the oral cavity HSV or Candida species most commonly affected teeth in Ludwig's angina (fulminant lower second and third molars cellulitis) most common cause of death in Ludwig's angina asphyxiation most common cause of epiglottitis group A streptococcus most common consequence of extension of infection acute pharyngitis most common pathogens in deep infections group A beta hemolytic strep and S. aureus most common sites of entry mucosal surfaces (respiratory, alimentary, urogenital tracts) and the skin most common isolate in asplenic patients with bacterial sepsis S. pneumoniae (50-70%) (also H. influenzae and N. meningitidis) most commonly transmits Babesia Ixodes scapularis (also transmits Borrelia burgdorferi - Lyme disease; and Ehrlichia) most common cause of necrotizing fasciitis group A streptococci alone and a mixed facultative and anaerobic flora most common infectious disease emergencies involving CNS bacterial meningitis most common location of spinal epidural abscesses thoracic or lumbar spine most common etiologic agents of spinal epidural abscesses staphylococci most cost effective health intervention available vaccine most common extraneous allergen egg protein derived fro the growth of measles, mumps,
HarrisonsReviewer(17thEd.)partIIbyAlricV.Mondragon,M.D&KarenAnjelaM.Montevirgen
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most most most most
common vaccine-preventable infection in travelers important determinant of risk for GI illnesses in travelling frequently identified pathogens causing travelers' diarrhea frequent causes of persistent diarrhea after travel
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most common diagnoses in patients who require emergency department evaluation for symptoms occurring during airline flights most common medical problems encountered by travelers after their return home most common skin conditions affecting travelers after their return home IE most commonly involves
influenza, and yellow fever viruses in embryonated eggs influenza destination toxigenic E. coli, and enteroaggregative E. coli postinfectious sequelae such as lactose intolerance or irritable bowel syndrome chronic obstructive pulmonary disease
diarrhea, fever, respiratory illness and skin disease pyoderma, sunburn, insect bite, skin ulcers, cutaneous larva migrans heart valves, but may also occur on the low-pressure side of the ventricular septum at the site of a defect, on the mural endocardium where it is damaged by aberrant jets of blood or foreign bodies, or on intracardiac devices themselves mitral regurgitation, aortic stenosis, aortic regurgitation, VSD, complex congenital heart disease extension dental treatments immunosuppressed individuals and elderly patients children 2-5 years of age Staph aureus infants and elderly adults when person steps on a nail among hospitalized, immunocompromised hosts fish and domestic swine and causes cellulitis primarily in bone renderers and fishmongers Clostridium septicum
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cardiac conditions most commonly resulting in NBTE most common with aortic valve infection most widely accepted to predispose to endocarditis most commonly affected by herpes zoster most commonly affected by streptococcal lesions most common cause of localized folliculitis most commonly affected by erysipelas most common way by which P. aeruginosa is introduced into the deep tissues most commonly affected by gram-negative bacillary cellulitis due to P. aeruginosa gram-positive aerobic rod Erysipelothrix rhusiopathiae is most often associated with most commonly involved in spontaneous nontraumatic gangrene among patints with neutropenia, GI malignancy, diverticulosis, or recent radiation therapy to the abdomen most common cause of osteomyelitis most common site of infection(osteomyelitis) in older adults and IV drug users most commonly involed in tuberculous spondylitis (Pott's) Primary bacterial peritonitis most commonly occurs in conjunction with most common manifestation of PBP
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pyogenic bacteria and mycobacteria spine (vertebrae as most common site of hematogenous osteomyelitis) thoracic spine cirrhosis of the liver (frequently the result of alcoholism) fever
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most common organisms in PBP most common reason for discontinuation of continuous ambulatory peritoneal dialysis most common organism in CAPD peritonitis most common pathogen in overt exit-site infections in CAPD peritonitis anaerobe most frequently isolated from intraabdominal infections, especially prominent in abscesses most common anaerobic bloodstream isolate most often cause of intraperitoneal abscesses result from organ most subject to the development of abscesses most common source of liver abscess most common presenting sign of liver abscess single most reliable laboratory finding in liver abscess most reliable methods for diagnosing liver abscesses most frequently isolated in liver abscesses most common associated infection in splenic abscesses most sensitive diagnostic tool in splenic infections most common bacterial isolates from splenic abscesses most important factor in successful treatment of splenic abscesses most common etiology of perinephric and renal abscesses most important risk factor in perinephric abscesses most frequently encountered organisms in perinephric and renal abscesses most useful diagnostic modalities in perinephric and renal abscesses most likely to be isolated when psoas abscess arises from hematogenous spread or a contiguous focus of osteomyelitis most likely etiology of psoas abscess when it has an intraabdominal or pelvic source most useful diagnostic technique in psoas abscesses most common disease worldwide most common travel-related illness most common isolates from persons with the classic secretory traveler's diarrhea syndrome most common AGE among children <2
E.coli peritonitis Staph spp. Staph aureus B. fragilis B. fragilis fecal spillage from a colonic source, such as an inflamed appendix liver disease of the biliary tract (previously ruptured appendix) fever elevated serum concentration of alkaline phosphatase imaging studies, include US,CT, indium-labeled WBC or gallium scan, and MRI B. fragilis bacterial endocarditis CT scan of the abdomen Streptococcal spp., then S. aureus early diagnosis now UTI, previously hematogenous in origin usually complicating prolonged bacteremia with S. aureus concomitant nephrolithiasis obstructing urinary flow E. coli, Proteus spp, Klebsiella spp, renal ultrasonography and abdominal CT S. aureus mixed enteric flora CT acute upper respiratory illnesses (second: acute gastrointestinal illnesses traveler's diarrhea enterotoxigenic and enteroaggregative E. coli rotavirus
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one of the most common manifestations of nosocomial infections most common pathogens isolated from visibly bloody stools most commonly diagnosed diarrheal illness acquired in the hospital CDAD most frequently occurs in most common manifestation caused by C. difficile most sensitive test for CDAD most common sexually transmitted pathogen in US most frequent cause of acute epdidymitis in sexually active men under 35 most common manifestation of serious bacterial infections in women most often cause of Pelvic Inflammatory Disease most common cause of genital ulceration in most developing countries most useful when ulcers are painful and purulent, especially if inguinal lymphadenopathy with fluctuance or overlying erythema is noted most common cause of perianal ulcers and inguinal lymphadenopathy most often etiology of sexually acquired proctocolitis CANNOT ACCESS CANNOT ACCESS most common aminoglycoside resistance mechanism most common mechanism for resistance to beta-lactams most common mechanism of tetracycline resistance in G(-) bacteria most prevalent mechanism of resistance to trimethoprim and the sulfonamides in both G(+) and G(-) bacteria
diarrhea E. coli O157:H7 Clostridium difficile associated disease (CDAD) hospitals and nursing homes Diarrhea stool culture for C. difficile genital HPV C. trachomatis and less commonly N. gonorrhoeae mucopurulent cervicitis N. gonorrhoeae genital herpes demonstration of H. ducreyi by culture or by PCR test
HSV Campylobacter or Shigella spp.
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most often mechanism of resistance to chloramphenicol most common mechanism for resistance to macrolides, ketolides, lincosamides, and streptogramins most common mechanism of resistance to quinolones
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most important factor in choosing initial therapy for an infection in which the susceptibility of the specific pathogen(s) is not
inactivation of antibiotic destruction of the drug by beta-lactamases plasmid-encoded active-efflux pump that is inserted into the cytoplasmic membrane and extrudes antibiotic from the cell acquisition of plasmid-encoded genes that produce a new, druginsensitive target-specifically an insensitive dihydrofolate reductase for trimethoprim and an altered dihydropteroate synthetase for sulfonamides plasmid-encoded enzyme, chloramphenicol acetyltransferase, inactivates the compound by acetylation plasmid-encoded enzyme that methylates ribosomal RNA, interfering with binding of antibiotics to their target development of one or more mutations in target DNA gyrase and topoisomerase IV that prevent the antibacterial agent from interfering with the enzymes' activity information on local resistance rates
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known most important interaction involving tetracyclines
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most affected age group by invasive pneumococcal disease in absence of vaccination most common cause of pneumococcal bacteremia in adults most common respiratory tract infection by Strep. pneumo most common CNS infection by Strep. pneumo most common cardiac infection by strep. pneumo most common soft tissue/skeletal infection by Strep. pneumo (other) most common infections by Strep. pneumo most common isolate in otitis media and sinusitis most commonly affected by Pneumococcal pneumonia most common cause of CAP most common complication of pneumococcal pneumonia most common cause of bacterial meningitis in adults most often affected by Cellulitis most common diagnosis leading to an antibiotic prescription in the US most common cause of surgical wound infections second most common cause of primary bacteremia most common cause of bacteremia most frequent site of human colonization of S. aureus most human S. aureus infection are due to most often location of carbuncles most common cause of bone infections most often involved in hematogenous osteomyelitis in children most often seen in patients with endocarditis, those undergoing hemodialysis, diabetics, and injection drug users most common cause of epidural abscess most common cause of septic arthritis in native joints most commonly involved joints in septic arthritis most common precedent of community-acquired respiratory tract infections due to S. aureus most common cause of viral infections that precede S. aureus infections most often seen in injection drug users most common endocarditis caused by S. aureus most common causes of food-borne outbreaks of infection in
reduced absorption when these drugs are coadministered with divalent and trivalent cations, such as antacids, iron compounds, or dairy products children <2 years old pneumonia otitis media, acute sinusitis, tracheobronchitis, pneumonia, empyema meningitis, brain abscess endocarditis, pericarditis septic arthritis, osteomyelitis, cellulitis peritonitis, endometritis, primary bacteremia S. pneumoniae (or second to nontypable H. influenzae extremes of age S. pneumoniae empyema S. pneumoniae people with CTD or HIV infection acute otitis media S. aureus S. aureus CoNS anterior nares (also skin, vagina, axilla, perineum, oropharynx) capsular types 5 and 8 lower neck S. aureus long bones vertebral bone infections S. aureus S. aureus knees, shoulders, hips and phalanges viral infections or septic pulmonary emboli Influenza acute right-sided tricuspid valvular S. aureus endocarditis nosocomial endocarditis S. aureus
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the US most often affected by SSSS most common cause of prosthetic-device infections most common human pathogen overall in CoNS most abundant bacterial species on the skin that is part of normal flora most common cause of bacterial endocarditis most sensitive and specific means of definitive diagnosis most often cause of erysipelas most common associated infection with streptococcal TSS most common manifestation of late-onset infection most common manifestation of GBS infection in pregnancy and parturition most common form of human infection with S. suis most frequently cause pharyngeal diphtheria most commonly cause cutaneous disease (diphtheria) most often location of pseudomembranous lesion of diphtheria most often characterization of cutaneous diphtheria most common site affected by cutaneous diphtheria most commonly causes (Rhodococcus equi) most common manifestation of R. equi most important determinant of the pathogenesis of Listeria monocytogenes most common clinical syndromes of Listeria infections most often affected by granulomatosis infantiseptica most common form of tetanus elaborates the most potent bacterial toxin known most common form of botulism most clinically important species of Clostridium most abundant species of Clostridium most common of the clostridial species isolated from tissue infections and bacteremias 2nd or 3rd most common cause of food poisoning in the US most commonly isolated Clostridium species in intraabdominal infections most often affected by emphysematous cholecystitis most commonly affected by spreading cellulitis and fasciitis due to Clostrium most often site Clostridia are cultured
newborns and children Coagulase-negative staphylococcal infections (CoNS) S. epidermidis S. epidermidis Viridans streptococci culture of a throat specimen beta-hemolytic streptococci soft tissue infection (necrotizing fasciitis, myositis, cellulitis) meningitis peripartum fever cellulitis of the hand toxigenic strains nontoxigenic strains tonsillopharyngeal region punched-out ulcerative lesions with necrotic sloughing or pseudomembrane formation extremities pulmonary infections nodular cavitary pneumonia of the upper lobes (similar to TB or nocardiosis) beta-hemolysin, listeriolysin O (LLO) meningitis and septicemia skin, liver, spleen generalized tetanus Clostridium botulinum intestinal botulism in infants (infant botulism) C. perfringens C. ramosum (next, C. perfringens) C. perfringens C. perfringens, type A C. ramosum, C. perfringens, C. bifermentans diabetic patients patients with carcinoma, esp. sigmoid or the cecum wounds in the absence of clinical signs of sepsis
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most most most most
common cause of gas gangrene commonly affected by transient clostridial bacteremia common species in rapidly fatal clostridial sepsis important factors in the treatment of gas gangrene
most common cause of sporadic disease of meningococcal disease perhaps the most rapidly lethal form of septic shock experienced by humans most distinctive feature of meningococcemia most useful clinical finding in meningococcal disease most common clinical manifestation of gonorrhea in males most common form of gonorrhea in neonates most common manifestation of systemic infection or DGI in newborn most common manifestation of gonococcal infection in children beyond infancy third most common bacterial isolate from middle-ear fluid of children with otitis media most commonly isolated species of Moraxella most clinically relevant strain of H. influenzae most serious manifestation of infection with Hib most common features at presentation of Hib infection most common complication of Hib most common location of cellulitis in Hib infection 3 most common causes of childhood otitis media most reliable method for establishing diagnosis of Hib infection most common Haemophilus species isolated from cases of HACEK endocarditis most frequently affected by Cardiobacterium hominis most frequent site affected by Eikenella corrodens 3rd most common cause of septic arthritis in children <24 months most often affected by Pasteurella infections most often affected by Agrobacterium radiobacter most commonly affected by Plesiomonas shigelloides most commonly implicated Legionella serogroups in human infections most common Legionella species
C. perfringens predisposing focus in the GI tract, biliary tract, or uterus C. septicum expert surgical and medical management and control of complications serogroup B fulminant meningococcemia rash petechial or purpuric rash acute urethritis ophthalmia neonatorum septic arthritis gonococcal vulvovaginitis M. catarrhalis M. nonliquefaciens (ears, nose, throat) and M. osloensis (blood), M. urethralis (urine) type b and nontypable strains meningitis fever and altered CNS function subdural effusion head or neck nontypable H. influenzae, S. pneumoniae, Moraxella catarrhalis recovery of organism in culture H. aphrophilus and H. parainfluenzae aortic valve sites of infection in conjunction with other bacterial species Kingella kingae skin and soft tissue (mostly caused by cats) immunocompromised hosts, esp. individuals with malignancy or HIV infection immunocompromised hosts serogroups 1,4,6 L. pneumophila, L. micdadei, L. bozemanii, L. dumoffii, L.
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most common symptomes of Pontiac fever most common neurologic abnormalities most common extrapulmonary site of legionellosis most sensitive option for visualization of Legionella organism in tissues most consistent and prominent feature of Pertussis most important Bordetella species causing human disease most important virulence factor of B. pertussis
longbeachae malaise, fatigue, myalgia (in 97%) confusion or changes in mental status heart DFA stain violent cough Bordetella pertussis pertussis toxin, composed of B oligomer-binding subunit and an enzymatically active A protomer that ADP-ribosylates a guanine nucleotide-binding regulatory protein (G protein) in target cells GNB E. coli, (Klebsiella, Proteus) carbapenems E. coli urinary tract E. coli uncomplicated cystitis (dysuria, frequency, and suprapubic pain) abdomen/pelvis GNB E. coli E. coli and Staph aureus urinary tract ground beef (contaminated during processing) O157:H7 ETEC screening for E. coli strains that do not ferment sorbitol K. pneumoniae Pneumonia, UTI, abdominal infection, surgical site infection, soft tissue infection, bacteremia devitalized tissue and immunocompromised hosts urinary tract lactose negative, produce H2S, with swarming motility E. cloacae and E. aerogenes Pneumonia, UTI (particularly catheter-related), IV device
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most common cause of septic shock (?) accounts for most extraintestinal infections due to GNB and are the most virulent pathogens most reliable active beta lactam agent against ESBL-expressing strains most common enteric gram (-) species to cause extraintestinal infection in ambulatory, LTCF, and hospital setting most frequently infected by ExPEC single most common pathogen for all UTI syndrome/host group combinations most common acute UTI syndrome second most common site of extraintestinal infection due to E. coli most common cause of HAP most commonly isolated GNB in HAP most common blood isolates of clinical significance most common source of E. coli bacteremia most common food source of STEC/EHEC strains 4th most commonly reported cause of bacterial diarrhea most common agent of traveler's diarrhea most common method currently used to detect STEC/EHEC most important Klebsiella species from a medical standpoint most common clinical syndromes with Klebsiella most frequently affected by Klebsiella cellulitis or soft tissue infection most common site of Proteus infection most strains of Proteus are responsible for most Enterobacter infections most common syndromes in Enterobacter infections
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most strains of enterobacter are most common spread of Serratia infection most common sites of Serratia infection and source of bacteremia most common species causing Citrobacter infections most common sources of Morganella and Providencia infection most common symptom of Edwardsiella infection most common extraintestinal infection in Edwardsiella infection responsible for most Acinetobacter infections most common source of bacteremia in Acinetobacter infection most convenient biopsy-based test for H. pylori infection most specific (but may be insensitive) for H. pylori most consistently accurate test for H. pylori 2 most important factors in successful H. pylori treatment most common cause of G(-) bacteremia in neutropenic patients most common contributing factor to respiratory failure in CF and responsible for majority of deaths among CF most important factor in disease causation in Pseudomonas aeruginosa most common of all infections by P. aeruginosa 1st or 2nd most common cause of VAP most common types of eye disease in P. aeruginosa and often associated with contact lenses most devastating of P. aeruginosa eye infections most serious form of pseudomonas infection affecting ear most common type of P. Aeruginosa infection in AIDS patients most virulent among pseudomonads most commonly diagnosed form of melioidosis most prominent symptom of enteric fever most common period when GI bleeding and intestinal perforation occurs most common transmission of salmonellosis
infection, surgical site infection, abdominal infection lactose positive and indole negative sporadic infection respiratory tract, GU tract, IV devices, surgical wounds C. freundii and C. koseri surgical sites and soft tissue self-limiting watery diarrhea (severe colitis also occurs) wound infection due to direct inoculation (often freshwater, marine, snake related injuries) A. baumannii-calcoaceticus complex respiratory tract and IV devices biopsy urease test microbiologic culture urea breath test patient's close compliance with the regimen and the use of drugs to which H. pylori has not acquired resistance Pseudomonas aeruginosa infection Pseudomonas aeruginosa infection inflammatory response to many products of P. aeruginosa respiratory infections Pseudomonas aeruginosa Keratitis and corneal ulcers P. aeruginosa endophthalmitis secondary to bacteremia malignant otitis externa and necrotizing otitis externa pneumonia with/without bacteremia Burkholderia pseudomallei acute pulmonary infections prolonged fever third and fourth week of illness animal food products, especially eggs, poultry, undercooked ground meat, dairy products, and fresh produce contaminated with animal waste point mutations in the DNA gyrase genes gyrA and gyrB bacteremia and metastatic infection femur, tibia, humerus, lumbar vertebrae
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most common cause of resistance of Salmonella to nalidixic acid and fluoroquinolones most common with S. choleraesuis and S. Dublin most commonly affected sites with Salmonella osteomyelitis
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most frequently affected by reactive arthritis (Reiter's syndrome) following NTS gastroenteritis most common transmission of Shigella most efficient form of rehydration most common mode of acquisition of C. jejuni most common among compromised hosts most common enteric pathogen most common signs and symptoms of intestinal phase most prominent symptom in C. jejuni infection most common natural habitat of Vibrio species most common means of acquisition of V. cholerae most common environmental isolate and predominant cause of clinical cholera in areas in which it appeared most important of noncholera vibrio most common cause of severe vibrio infections in the US most often affected by primary sepsis by V. vulnificus most salt-tolerant of the vibrios most frequently implicated sources of Brucellosis most frequently targeted by Brucella infection most common focal features in Brucellosis most most most most commonly affected by osteomyelitis in Brucellosis common individual joints affected by Brucellosis effective combination for Brucellosis common clinical syndrome in Tularemia infection
persons with HLA-B27 histocompatibility antigen person to person (most efficiently by fecal-oral route) oral rehydration therapy ingestion of contaminated poultry that has not been sufficiently cooked systemic infections due to C. fetus C. jejuni diarrhea, abdominal pain, fever abdominal pain tidal rivers and bays under conditions of moderate salinity ingestion of water contaminated by human feces O139 Bengal; in SE Asia V. Cholerae O1 remains dominant V. parahaemolyticus and V. vulnificus V. vulnificus patients with cirrhosis or hemochromatosis V. alginolyticus dairy products, especially soft cheeses, unpasteurized milk and ice cream reticuloendothelial system, musculoskeletal tissues, genitourinary system musculoskeletal pain and physical findings in the peripheral and axial skeleton lumbar and low thoracic vertebrae knee, hip, sacroiliac, shoulder, sternoclavicular joints Streptomycin and Tetracycline ulcerative lesion at site of inoculation, with regional lymphadenopathy and lymphadenitis tabanid flies skin or mucous membranes either directly-through the bite of ticks, other arthropods or other animals; or via inapparent abrasions inguinal/femoral lymphadenopathy agglutination testing microagglutination and tube agglutination flea bite and direct contact with infected animal, especially exposure to an infected domestic cat femoral and inguinal nodes (next, axillary and cervical nodes) pneumonic plague
most common vectors of Francisella tularensis most common portal of entry for human infection with Tularemia most common form of tularemia in adults most frequent method of confirming tularemia most commonly used methods to detect antibody to F. tularensis most common mode of transmission of plague most commonly involved in bubonic plague most life-threatening form of plague
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most frequent acute clinical manifestations of Yersinia infection most common mode of identifying pathogenic Y. enterocolitica isolates most commonly affected by mesenteric adenitis and terminal ileitis most commonly affected by nonsuppurative sequelae of yersiniosis most commonly affected area by intestinal inflammation most common presentation of Yersinia enterocolitica infection most commonly affected in reactive arthritis from Yersinia enterocolitica infection most common clinical presentation of Y. pseudotuberculosis infection most commonly used tests to support diagnosis of yersiniosis most specific diagnosis test in Yersinia infection most often involved in disseminated disease of Bartonella infection most common manifestation of Bartonella infections in HIVinfected persons most often presentation of bacillary angiomatosis most often used test to diagnose urban trench fever most common extragenital manifestation of donovanosis most common presentation of nocardiosis most commonly isolated from clinical material and associated with invasive disease most common form of nocardial disease in respiratory tract most common site of dissemination of nocardiosis most common isolate in transcutaneous inoculation most misdiagnosed disease most common species causing Actinomycosis most frequent site of Actinomycosis most common association of Actinomycosis involvement of the pelvis most common symptoms of pelvic involvement of actinomycosis most common CNS involvement in actinomycosis most commonly affected in disseminated actinomycosis most commonly used for diagnosis of actinomycosis
enteritis or ileitis; mesenteric adenitis and terminal ileitis biotyping based on biochemical profiles and serotyping according to somatic O and H antigens older children and young adults adults distal ileum and less commonly ascending colon acute diarrhea from enteritis or enterocolitis knees and ankles fever and abdominal pain caused by mesenteric adenitis agglutination tests or ELISAs isolation of pathogenic Yersinia strain from feces nervous system, visceral organs, bone bacillary angiomatosis painless cutaneous lesions serologic studies or by isolating B. quintana oral donovanosis, presents as pain or bleeding in the mouth, lesions on the lips, or extensive swelling of the gums and palate pneumonia and disseminated disease Nocardia asteroides pneumonia brain (skin, supporting structures, kidneys, bone, muscle N. brasiliensis (N. asteroides in cooler climates) Actinomycosis A. israelii, (A. naeslundii, A. odontolyticus, A. viscosus, A. meyeri, A. gerencseriae, Propionibacterium propionicum) oral, cervical, facial site, usually as a soft tissue swelling, abscess, or mass lesion IUCD fever, weight loss, abdominal pain, abnormal vaginal bleeding or discharge single or multiple brain abscesses lungs and liver microscopic identification of sulfur granules
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most common anaerobic infections of the CNS most frequently isolated from infections with mixed anaerobic organisms most important clinical isolate in mixed infections most frequent isolates in female genital tract infections most extensively studied virulence factor of the nonsporulating anaerobes most commonly isolated from intraabdominal infections and bacteremia most commonly precedes necrotizing ulcerative gingivitis most common metastasis of Lemierre's syndrome (acute oropharyngeal infection) most common isolates in aspiration pneumonia
brain abscess and subdural empyema B. fragilis group B. fragilis organisms normally colonizing the vagina capsular polysaccharide complex of B. fragilis B. fragilis debilitating illness or affects severely malnourished children lung pigmented and nonpigmented Prevotella spp, Peptostreptococcus spp, Bacteroides spp, Fusobacterium spp. and anaerobic cocci E. coli and B. fragilis sites prone to contamination with feces or with upper airway secretions Bacteroides spp, Peptostreptococci, enterococci, clostridia, Proteus spp. actinomycosis (also, bacteroides spp, Fusobacterium spp., Clostridium spp bone biopsy Fusobacterium B. fragilis M. tuberculosis droplet crowding in poorly ventilated rooms HIV co-infection middle and lower lung zones mild anemia and leukocytosis lymph nodes, pleura, genitourinary tract, bones and joints, meninges, peritoneum, and pericardium LN disease posterior cervical and supraclavicular sites (scrofula) Spine (40%), Hips (13%), knees (10%); weight-bearing joints upper thoracic spine terminal ileum and cecum TB
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most common isolates of intraabdominal infections most frequent sites of injury to skin, bone, soft tissue, by trauma, ischemia, or surgery most frequently isolated organism in soft tissue or skin infection most common cause of anaerobic infections in bone most reliable culture specimen in patients with osteomyelitis most common isolates of anaerobic septic arthritis single most common anaerobic isolate from bloodstream most common and important agent of human disease among the pathogenic species of M. tuberculosis complex most common path of transmission of M. tuberculosis one of the most important factors in the transmission of tubercle bacilli most potent risk factor for TB among infected individuals most commonly involved in primary TB most common hematologic findings in TB most common extrapulmonary site of involvement in TB most common presentation of extrapulmonary TB most common site of LN TB most commonly affect in skeletal TB most common site of spinal TB in children most commonly involved in GI TB one of the most common diseases among HIV-infected persons
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worldwide most common form of extrapulmonary TB in HIV-infected persons most widely used screening for latent TB infection most important impediment to cure in TB most common adverse reaction of significance in TB treatment most common drug resistance in North America and Europe most commonly affected by most severe form lepromatous form of leprosy most affected nerves in leprosy most common form of leprosy most commonly affected nerve trunk in leprosy
lymphatic, disseminated, pleural, pericardial PPD or tuberculin skin test lack of adherence to treatment hepatitis Isoniazid resistance twice as common in men than women ulnar, posterior auricular, peroneal, posterior tibial nerves tuberculous leprosy (in India and Africa); Borderline Tuberculous (in SE Asia) ulnar nerve at the elbow (results in clawing of the 4th and 5th fingers, loss of dorsal interosseous musculature in affected hand and loss of sensation) footdrop, when the peroneal nerve is involved edema crops of painful erythematous papules that resolve spontaneously in a few days to a week but may recur; malaise; and fever plantar ulceration ulnar characteristic skin lesions and skin histopathology M. abscessus, fortuitum, chelonae, marinum, ulcerans MAC organisms (esp. M. intracellulare) M. avium and M. kansasii M. kansasii disseminated cutaneous disease pulmonary infection Rifampin GI upset hepatotoxicity and peripheral neuropathy retrobulbar optic neuritis missense mutations in embB gene ototoxicity and renal failure Rifabutin GI (dose-related)
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most dramatic manifestation of nerve affectation most characteristic microscopic feature of type 1 lepra lesions most common features of erythema nodosum leprosum
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most frequent complication of leprous neuropathy most common site of nerve abscesses in leprosy (ENL) most common presentation of leprosy most commonly involved species in cutaneous disease of nontuberculous mycobacterial infection most common cause of pulmonary disease most commonly isolated in disseminated disease second most common cause of lung disease due to NTM in the US most common clinical manifestation with infection with M. abscessus, chelonae, fortuitum next most common manifestation with infection with M. abscessus, chelonae, fortuitum most important and potent anti TB agent most common adverse event of Rifampin 2 most important adverse effects of isoniazid therapy most serious adverse effect of Ethambutol most common cause of ethambutol resistance in M. tuberculosis most common and most serious adverse effects of streptomycin most useful in prophylaxis of disseminated MAC infection most common adverse effects of rifabutin
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most active quinolones against M. tuberculosis most useful in treatment of multidrug-resistant TB most active agent for treatment of leprosy second most active drug in leprosy treatment 2 most common causes of NTM pulmonary infection most common side effects of Azithromycin most important for patients with syphilis of <1 yr duration most common types of tertiary disease of syphilis most most most most most important factor in increased mortality in syphilis common presentation of meningovascular syphilis frequently involved bones in skeletal gumma common clinical problem in congenital syphilis common early manifestation in congenital syphilis
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most most most most most most most most most most
widely used nontreponemal antibody tests for syphilis widely used agent for treatment of early syphilis sensitive index of response to treatment in neurosyphilis benign of the treponemal infections often location of initial papule important reservoir of leptospirosis important known pathogenic properties of leptospires common finding on PE of leptospirosis infection severe form of leptospirosis common radiographic finding in leptospirosis
most often affected lobes in leptospirosis (Weil's syndrome) most common cause of TBRF in sub-Saharan Africa most common vector-borne infection in the US and Europe most common abnormality in early infection: stage 2 (disseminated infection) of Lyme disease most common form of chronic CNS involvement in Lyme disease most common form of peripheral neuropathy in Lyme disease most common infectious agents that cause facial palsy most common symptoms during the first 3 days of Rocky Mountain Spotted Fever most important epidemiologic factor in RMSF
Levofloxacin and moxifloxacin ethionamide rifampin dapsone MAC organisms and M. kansasii GI symptoms and reversible hearing loss identification and examination of sexual contacts gumma, cardiovascular syphilis, symptomatic neurosyphilis (tabes dorsalis and paresis) cardiovascular syphilis stroke syndrome involving MCA of a relatively young adult long bones healthy appearing baby born to mother with (+) serologic test bone changes (61%), hepatosplenomegaly (50%), lymphadenopathy (32%), anemia (34%), jaundice (30%), thrombocytopenia, leukocytosis RPR and VDRL tests Pen G benzathine CSF pleocytosis Pinta (caused by T. carateum) extremities or face and is pruritic rodents, especially rats adhesion to cell surfaces and cellular toxicity fever with conjunctival suffusion Weil's syndrome patchy alveolar pattern that corresponds to scattered alveolar hemorrhage lower lobes in the periphery of the lung fields Borrelia duttoni Lyme disease fluctuating degree of AV block (1st, Wenckebach, or complete subtle encephalopathy affecting memory, mood, or sleep axonal polyneuropathy HSV1 and VZV fever, headache, malaise, myalgia, nausea, vomiting, anorexia history of exposure to a potentially tick-infested environment within 12 days preceding disease onset during a season of possible tick activity indirect immunofluorescence assay
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most common serologic test for confirmation of the diagnosis
14
167 167 167 167 168 168 169 169 169 169 169 169 169 169 169 170 171 171 171 171 171 171 171 171 171 172 172
most frequently imported rickettsiosis in Europe and North America most common pulmonary sign of murine typhus most commonly used diagnostic tool in Coxiella burnetti infection (Q fever) most prevalent genital mycoplasmas most firmly implicated in the etiology of Nongonococcal urethritis most common bacterial STI in the US foremost cause of epididymitis in sexually active heterosexual men <35 years of age most common cause of epididymitis in men over 35 most commonly isolated pathogen from college women with dysuria, frequency, and pyuria most common presentation of LGV in heterosexual men most sensitive and specific chlamydial diagnostic methods available, most expensive as well most commonly infected with Psittaci infections most common mode of transmission of Psittacosis most effective cell line for isolation of C. pneumoniae most common viral infections are spread by most frequently encountered toxicities with orally administered oseltamivir most widespread use of acyclovir most common mechanism of resistance to acyclovir most frequently encountered form of toxicity with acyclovir most commonly employed dosage for initial IV therapy most common initial dosage of foscarnet most common hematologic abnormality with foscarnet most common IFN monotherapy regimen most effective regimen for treatment of chronic hepatitis C most commonly used assays in HSV most persons acquire HSV1 infection before most common clinical manifestations of 1st episode of HSV1 infection
African tick-bite fever bibasilar rales serology M. hominis, U. urealyticum, U. parvum chlamydia trachomatis Chlamydia trachomatis Chlamydia trachomatis coliform bacteria and Pseudomonas aeruginosa Chlamydia trachomatis (in the absence of infection with uropathogens such as coliforms and S. saprophyticus) inguinal syndrome, characterized by painful inguinal lymphadenopathy beginning 2-6wks after presumed exposure NAATs (nucleic acid amplification tests) using PCR, ligase chain reaction, TMA, and other techniques Psittacine birds (parrots, parakeets, budgerigars) respiratory route HL cells direct contact, by ingestion of contaminated water or food, or by inhalation of aerosolized particles nausea, GI discomfort, vomiting treatment of genital HSV infections deficiency of the virus-induced thymidine kinase renal dysfunction 5mg/kg q12 for 14-21 days, followed by IV maintenance dose of 5mg/kg/day or 5x per week 60mg/kg q8 for 14-21days followed by maintenance dose of 90120mg/kg once a day anemia IFN alpha2b or alpha2a at 3million units 2x/week for 1218months combination of SC pegylated IFN and oral ribavirin those that measure antibodies to glycoprotein G to HSV1 (gG1) and HSV2 (gG2) third decade gingivostomatitis and pharyngitis
15
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most common clinical manifestation of reactivation of HSV1 most common age group affected by HSV pharyngitis and gingivostomatitis most common infections in patients with AIDS most common cause of corneal blindness in the US most commonly identified cause of recurrent lymphocytic meningitis (Mollaret's meningitis) most commonly involved with HSV infection of visceral organs most sensitive lab technique for HSV diagnosis most frequently used for treatment of HSV infections most common period of reactivation of latent VZV most commonly affected by chickenpox most common extracutaneous site of involvement in children with varicella most common infectious complication of varicella most serious complication following chickenpox infection most frequently involved dermatomes in Herpes zoster most debilitating complication of herpes zoster most frequently employed serologic tools for assessing host response (VZV)
recurrent herpes labialis children and young adults persistent ulcerative HSV infections HSV infection of eye HSV distal esophagus HSV DNA detection by PCR Acyclovir sixth decade of life children 5-9 yrs old CNS secondary bacterial superinfection of the skin (usually S. pyogenes or S. aureus) Varicella pneumonia T3-L3 pain associated with acute neuritis and postherpetic neuralgia immunofluorescent detection of antibodies to VZV membrane antigens, the fluorescent antibody to membrane antigen (FAMA) test, immune adherence hemagglutination, and enzyme-linked immunosorbent assay (ELISA). FAMA and ELISA early childhood, with second peak during late adolescence fever usually low-grade lymphadenopathy and pharyngitis posterior cervical nodes, but may be generalized macular rash CNS complications, splenic rupture, upper airway obstruction, or bacterial superinfection IgM antibody to VCA CMV petechiae, hepatosplenomegaly, jaundice heterophile antibody-negative mononucleosis syndrome CMV molluscum contangiosum young children
173 173 174 174 174 174 174 174 174 174 175 175 175 176 177
most most most most most most most
sensitive tests for VZV commonly affected by EBV infection common in the 1st 2 weeks of illness of EBV prominent during 1st 2 weeks of EBV often location of lymphadenopathy patients treated with ampicillin develop often cause of deaths in infectious mononucleosis
most useful for the diagnosis of acute infectious mononucleosis most common cause of heterophile-negative mononucleosis most common presentation of congenital CMV infection most common clinical manifestation of CMV infection in normal hosts beyond neonatal period most common and important viral pathogen complicating organ transplantation most common human disease resulting from poxvirus infection NONE most often affected population by common warts (verruca
16
178 178 178 178 178 178 178 179 179 179 179 179 179 179 180 180 180 180 180 180
vulgaris) most often affected by plantar warts (verruca plantaris) (one of the) most common sexually transmitted diseases in the US most common transmission of anogenital HPV infections most commonly affected by flat warts (verruca plana) most common site affected by anogenital warts in circumcised men most sensitive and specific methods of virologic diagnosis most common clinical manifestation of rhinovirus infection most commonly affected in SARS (seen on CXR) most commonly associated with HRSV infection in adults most common symptoms of HRSV Most common for Adenovirus most common clinical syndrome of Adenovirus most common types of Adenovirus causing epidemic keratoconjunctivitis most extensively studied of the orthomyxoviridae most extensive and severe outbreaks are caused by most frequent populations affected by Influenza B outbreaks most serious complication of influenza B infection most prominent high-risk conditions in influenza most important mediators of immunity most frequent characterization of influenza
adolescents and young adults anogenital warts (condyloma acuminatum) direct contact with infectious lesions children occurring on face, neck, chest, and flexor surfaces of forearms, and legs penile shaft PCR or hybrid capture assay common cold peripheral and lower lung fields or interstitial infiltrates common cold-like syndrome common cold, with rhinorrhea, sore throat, and cough infants and children, mostly from fall to spring acute upper respiratory tract infection type 8, 19, 37 Influenzae A and B Influenza A viruses schools and military camps (also institutions for elderly) Reye's syndrome chronic cardiac and pulmonary diseases and old age antibodies to hemagglutinin abrupt onset of systemic symptoms (headache, feverishness, chills, myalgia, malaise) and respiratory tract signs (cough and sore throat) legs and lumbosacral area patients >64 years old and those with certain chronic disorders, including cardiac or pulmonary disease, DM, hemoglobinopathies, renal dysfunction, and immunosuppression pneumonia: "primary" influenza viral pneumonia, secondary bacterial pneumonia, or mixed Strep. pneumo, S. aureus, and H. influenzae high-risk individuals with chronic pulmonary and cardiac disease and in elderly mixed features of viral and bacterial pneumonia legs human T cell lymphotropic virus (HTLV) type I
180 180
most commonly involved in myalgias from influenza most frequently affected by complications of influenza
180 180 180 180 180 180
most significant complication of influenza most common bacterial pathogen in pneumonia secondary to influenza most frequently affected by secondary bacterial pneumonia most common pneumonic complications during outbreaks of influenza most commonly affected by acute myositis in influenza infection most important Oncovirinae in humans
17
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most important Lentivirinae in humans most common outcome of HTLV-I infection most infected cells express (HTLV) most HTLV-I transformed cell lines are most common transmission of HTLV most likely etiologic cause of epidemic most common cause of HIV disease throughout the world most likely source of original human infection responsible for most of the HIV-1 infections in the world HIV-1 O group (outlier) is most closely related to most common form (or subtype) worldwide accounts for most infections in south and southeast asia most common mode of infection of HIV worldwide most common period of maternal transmission to the fetus most influential factor in (improvement in morbidity/mortality) most common opportunistic infection in HIV-infected individuals most consistent and potent inducers of HIV expression most dramatic example of a genetic factor influencing HIV infection and/or pathogenesis most potent agonist of CCR5 and HIV-suppressive chemokine for R5 strains of HIV-1 one of the most potent chemokines that attracts and activates mononuclear phagocytes most commonly used confirmatory test in HIV most common patterns of cross-reactivity 2 most commonly used techniques in HIV most severe cases occur in (HIV) most commonly involved in sinusitis related to HIV one of the most frequent complications of HIV infection most common manifestation of pulmonary disease in HIV most common cause of pneumonia single most common cause of pneumonia in patients with HIV infeciton in the US most common finding on chest x-ray for PCP most common age group affected by active TB in HIV patients most commonly affected by IRIS
HIV latent carriage of randomly integrated provirus in CD4+ T cells no viral gene products result of infection of a normal host T cell in vitro perinatally sexual contact and blood or blood products HIV-1 Pan troglodytes troglodytes species of chimpanzees group M (major) viruses found in Cameroonian gorillas subtype C viruses of the M group CRF01_AE heterosexual transmission during perinatal period increased use of potent ARV drugs, mycobacterium tuberculosis proinflammatory cytokines TNF-alpha, IL1beta, IL6 HIV cellular co-receptor CCR5 CCL3L1 gene that encodes MIP-1alphaP CCL2 Western blot antibodies that react with p24 and/or p55 RT-PCR assay and the bDNA assay patients with lower CD4+ T cell counts maxillary sinuses pulmonary disease pneumonia bacterial infections and the unicellular fungus P. jiroveci infection Pneumocystic pneumonia either normal film, if suspected early; or a faint bilateral interstitial infiltrate 25-44 years old in patients initiating ARV or anti-TB therapy at the same time, occurs several weeks following initiation of therapy, seen more frequently in patients with advanced HIV disease M. avium or M intracellulare species - MAC
182
most common atypical mycobacterial infection in HIV
18
182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182 182
most common most common most common HIV most common occurs in most common
presentation of MAC infection pattern of CXR in MAC presenting signs of Rhodococcus equi infection in pulmonary manifestation of histoplasmosis clinically significant finding in HIV (CVS-wise)
disseminated disease with fever, weight loss, night sweats bilateral, lower lobe infiltrate suggestive of miliary spread fever and cough in the setting of disseminated disease, presumably due to reactivation dilated cardiomyopathy associated with CHF, referred to as HIVassociated cardiomyopathy due to secondary infections soft palate C. jejuni Cryptosporidia, microsporidia, and Isospora belli C. immitis and Histoplasma capsulatum pancreatic injury indinavir-associated renal calculi condylomata lata, a form of secondary syphilis gemfibrozil and atorvastatin with nucleoside analogue reverse transcriptase inhibitors drug allergies patients starting therapy with CD4+ T cell counts <50cells/microliter who have a precipitous drop in HIV RNA levels following the initiation of HAART anemia patients with severely advanced HIV disease and in patients receiving any of a number of potentially myelosuppresive therapies use of HAART folliculitis AIDS dementia complex or HIV encephalopathy cerebral mass lesions (from toxoplasmosis, Lymphoma, then cryptococcal meningitis) toxoplasmosis, progressive multifocal leukoencephalopathy, CNS lymphoma toxoplasmosis Caribbean and France
most frequent cause of oropharyngeal and GI disease in HIV most common location of thrush of oral candidiasis most frequently isolated in diarrhea in HIV most common opportunistic protozoa that infect the GI tract and cause diarrhea in HIV most likely to involve the liver in HIV (among fungal opportunistic infections) most commonly a consequence of drug toxicity, notably secondary to pentamidine or dideoxynucleosides one of the most common drug-induced renal complications most common presentation of syphilis in HIV most commonly used in managing lipid abnormalities in HIV most common occurrence of lactic acidosis associated with ARV therapy in HIV most significant allergic reactions occuring in HIV-infected patients most commonly affected by IRIS
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most common hematologic abnormality in HIV-infected patients most frequently affected by neutropenia
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most most most most
effective medical approach to HIV prevalent dermatologic disorder in HIV patients severe form of neurologic problem in HIV common cause of seizure in HIV
most common cause of focal neurologic deficits in HIV patients one of the most common causes of secondary CNS infections in patients with AIDS most common areas with toxoplasmosis
19
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most common clinical presentation of cerebral toxoplasmosis in HIV most common peripheral neuropathy in HIV most common abnormal findings on fundoscopic examination in HIV one of the most devastating consequences of HIV infection most common presentation in HIV patients of Histoplasmosis third most common AIDS-defining illness in Thailand, following TB and Cryptococcosis most common appearance of Kaposi Sarcoma lesions most commonly affected by KS aside from skin single most important determinant of response appears to be most frequently affected by Small noncleaved cell lymphoma (Burkitt's lymphoma) most common extranodal site for lymphoma locations most commonly involved in CNS lymphoma most common HPV genotypes in the general population most common toxicity of Didanosine most common side effects of Maraviroc most effective way for sexually active uninfected individuals to avoid contracting HIV infection and for infected individuals to avoid spreading infection most condom failures result from most effective way to prevent transmission of HIV infection among IDUs most common infectious agents of mild gastroenteritis in the community and affect all age groups most common agent among older children and adults causing gastroenteritis most common age group affected with severe disease of rotavirus infection most common Astrovirus type most common age group infected by enterovirus infection most frequent shedders of enteroviruses and usually the index case in family outbreaks most common transmission of enteroviruses most common presentation of poliovirus most common site of weakness in poliovirus infection most common cause of aseptic meningitis and nonspecific
fever, headache, focal neurologic deficits distal sensory polyneuropathy, may be a direct consequence of HIV infection or a side effect of dideoxynucleoside therapy cotton-wool spots CMV retinitis disseminated disease presumably due to reactivation Penicillium marneffei raised macules lymph nodes, GI tract, lung the CD4+ T cell count patients age 10-19 CNS deep in the white matter HPV 16 and 18 painful sensory peripheral neuropathy dizziness due to postural hypotension, cough, fever, colds rash, muscle and joint pain, and stomach pain practice of "safer sex"
182 182 182 183 183 183 183 184 184 184 184 184
breakage or improper usage to stop use of injectable drugs Noroviruses Noroviruses young children with 1st or 2nd infection type 1 infants and young children young children fecal-oral route asymptomatic legs enteroviruses
20
184 184 184 184 184 184 184 184 184 185 185 185 186 186 186 187 187 188 188 188 188 189 189 189 189 190 191 191 191
febrile illness in neonates most common clinical manifestations of enterovirus infection most serious enterovirus infections in infants develop during most common pathogen in patients developing neurologic disease while receiving gamma globulin replacement most cases of enteroviral myocarditis affects most common cause of rubelliform rash most common cause of hand-foot-and-mouth disease most accurate method for antibody determination in enterovirus infections most infections of reoviruses are most common complication of measles infection most common secondary bacterial infection in measles most often documented pneumonia in immunocompromised and malnourished patients with measles most frequently involved in arthritis of rubella most important factor in the pathogenicity of rubella virus for the fetus most commonly used test in rubella most distinctive feature of Mumps most common manifestation of mumps among postpubertal males aside from parotitis most often manifestation of rabies after a prodromal phase most characteristic pathologic finding in rabies most commonly affected by Negri bodies (eosinophilic cytoplasmic inclusions) most distinguished presentation of Rabies encephalitis most common presentation of Colorado Tick Fever most important form of HF most common cause of HF with renal syndrome in Europe most important agent of hantavirus pulmonary syndrome I US NONE most common general anatomic categories of fungal infections most common general epidemiological categories of fungal infections most commonly used stains to identify fungi most reliable tests for deep organ fungal infections
nonspecific febrile illness first week of life echoviruses newborns, adolescents, or young adults echovirus 9 coxsackie A16 or enterovirus 71 measurement of neutralizing titers asymptomatic or cause very mild disease otitis media streptococci, pneumococci, or staphylococci Primary giant-cell (Hecht's) pneumonia fingers, wrists, and/or knees gestational age at the time of infection ELISA for IgG and IgM antibodies swelling of one or both parotid glands orchitis encephalitis Negri body Purkinje cells of the cerebellum and in pyramidal cells in the hippocampus early brainstem involvement, resulting in classic symptoms of hydrophobia and aerophobia fever and myalgia HF with renal syndrome Infections with Puumala virus Sin Nombre virus mucocutaneous and deep organ infeciton endemic and opportunistic periodic acid-Schiff and Gomori methenamine silver detection of antibody of Coccidioides immitis and Histoplasma capsulatum in serum and CSF, detection of cryptococcal polysaccharide antigen in serum and CSF, detection of Histoplasma antigen in urine or serum
21
191 191 192 192 193 193 193 194 194 194 195 196 196 196 196 196 197 197 197 197 197
most frequently recovered fungal organism from blood most prevalent endemic mycosis in North America most commonly involved in progressive disseminated histoplasmosis (PDH) principal drugs now used to treat most cases of coccidioidomycosis most patients with focal primary pulmonary coccidioidomycosis require most cases of disseminated coccidioidomycosis require most commonly mimicked by chronic pulmonary blastomycosis most common radiologic finding in Blastomycosis most common extrapulmonary manifestation of blastomycosis most important prognostic factor in cryptococcosis 4th most common isolate from the blood of hospitalized patients most important defense mechanism against hematogenously disseminated candidiasis most important component of innate immunity to Candida most frequently reported cause of chronic mucocutaneous candidiasis most commonly infected in deeply invasive candidiases most common pathogen responsible for invasive aspergillosis, chronic aspergillosis, allergic syndrome most common areas of growth of Aspergillus most common clinical features of Aspergillosis most most multi most common features of invasive sinusitis due to aspergillosis often site of dissemination of Aspergillus, from lungs to organs, in most severely immunocompromised hosts common features of disseminated aspergillosis
Candida Histoplasmosis bone marrow, spleen, liver, adrenal glands, and mucocutaneous membranes Triazole antifungals no therapy prolonged antifungal therapy malignancy or tuberculosis alveolar infiltrates with or without cavitation, mass lesions that mimic bronchogenic CA and fibronodular infiltrates skin disease extent and duration of the underlying immunologic deficits that predisposed them to develop the disease candida species innate immunity neutrophil failure of T lymphocytes to proliferate or to stimulate cytokines in response to stimulation by Candida antigens in vitro brain, chorioretina, heart and kidneys A. fumigatus decomposing plant material and in bedding asymptomatic, fever, cough, nondescript chest discomfort, trivial hemoptysis, shortness of breath fever, nasal or facial discomfort, blocked nose, nasal discharge most often brain (also skin, thyroid, bone, kidney, liver, GI, eye, heart valve) cutaneous lesions, gradual clinical deterioration in 1-3 days, low-grade fever, features of mild sepsis, multiple nonspecific abnormalities in lab tests hemorrhagic infarction MRI prosthetic valve infections culture-negative endocarditis with large vegetations life-threatening hemoptysis (could be presenting symptom) ethmoid and sphenoid sinuses local debridement and local application of antifungal agents
197 197 197 197 197 197 197
most typical of acute disease in cerebral aspergillosis most useful immediate investigation in cerebral aspergillosis most affected by aspergillus endocarditis most common presentation of aspergillus endocarditis most significant complication of aspergilloma most commonly affected sinus in chronic invasive sinusitis by aspergillus most common approach to otitis externa by aspergillus
22
197 197 198 199 199 199 199 199 199 199 199 199 199 199 199 200 201 202 202 202 202 202 202 202 202 202 202 203 203 203 203 204 204 204
most common most common Mucormycosis most common most frequent most common most common most common most common
cause of halo sign on HR thoracic CT scan genus recovered from patients with superficial skin infection site of malassezia infection dermatophytic infection cause of tinea pedis dermatophyte associated with tinea capitis presentation of sporotrichosis
Aspergillus spp. Rhizopus and Rhizomucor tinea versicolor (by malassezia) chest and midline of back tinea pedis tinea rubrum tinea tonsurans chronic cutaneous, lymphocutaneous, and/or subcutaneous disease hematogenous dissemination madurella mycetomatis Fonsecaea pedrosoi, F. compacta, Phialophora verrucosa, Rhinocladiella aquaspersa, Cladosporium carrionii exophiala jeanselmei, wangiella dermatitidis, bipolaris species Fusarium solani amphotericin B 95-140 kDa major surface glycoprotein (MSG) chemotherapy food-borne exposure E. histolytica (after schistosomiasis and malaria) asymptomatic cyst passage (most patients harbor E. dispar) liver febrile, RUQ pain which may be dull or pleuritic in nature and may radiate to shoulder pleuropulmonary involvement stool exam, serologic tests, noninvasive imaging of the liver alkaline phosphatase amebic vs pyogenic otherwise healthy children or young adults who often report recent swimming in lakes or heated swimming pools malaria asymptomatic Anopheles gambiae surface adhesin, variant protein PfEMP1 fever, fatigue, malaise, shaking chills, sweats, myalgia, and arthralgias asplenic patients ring forms zoonotic
most common among immunocompromised patients (mode of dissemination of S. schenckii) most common cause of eumycetoma worldwide most common etiologic agents of chromoblastomycosis most common etiologic agents of phaeohyphomycosis most common cause of fusariosis most frequent used therapeutic agent in algal infections most prominent antigen group in Pneumocystis single most effective means of controlling parasitic infections most prevalent transmission of Entamoeba histolytica 3rd most common cause of death from parasitic disease most common type of amebic infection most often extraintestinal infection by E. histolytica most often presentation of amebic liver abscess most most most most most most most most most most frequent complication of amebic liver abscess important procedures in the diagnosis of amebiasis often elevated lab finding in amebic liver abscess important differential diagnosis in liver abscess commonly infected with Naegleria important of the parasitic disease of humans malarial infections are effective mosquito vectors of malaria important antigen in Falciparum malaria common manifestations of B. microti infection
most often affected by Babesiosis, due to B. divergens most common form of Babesia most transmission cycles traditionally have been classified as
23
205 205 205 206 206 206 206 207 207 207 207 207 207 207 208 208 208 208 208 209 209 209 209 209 209 210 210 210 210
most prominent areas for skin lesions in Post-kala-azar dermal leishmaniasis (PKDL) most common side effects of therapy with Miltefosine most commonly affected by trypanosomiasis most important parasitic disease burden in Latin America most striking difference between West and East African trypanosomiases most common important adverse effect of suramin most important manifestations of Toxoplasmosis most critical factor that influence fetal outcome most probable source of recrudescent infection in immunocompromised individuals most likely stimulus for persistence of antibody titers in the immunocompetent host most common manifestation of acute toxoplasmosis most often involved areas in CNS Toxoplasmosis most ocular involvement in Toxoplasmosis is due to one of the most common parasitic diseases in both developed and developing countries worldwide most often species of Cryptosporidium causing human infections most commonly affected by microsporidiosis one of the most prevalent protozoal parasites in the US most sensitive means of detection of Trichomonas most commonly involved muscles in trichinella infection most commonly affected by visceral larva migrans (toxocara) most light infections of toxocara present as most commonly affected by Toxocara infection most common presenting symptoms of Toxocara infection most common cause of human eosinophilic meningitis most common cutaneous manifestation of strongyloidiasis among the most common and striking problems in general medicine most common causes of vegetative and minimally conscious states most common herniations most extreme pupillary sign in coma
face that develop during or after therapy for visceral leishmaniasis GI symptoms and reversible elevations in creatinine and aminotransferase levels heart Chagas' disease East African trypanosomiasis follow a more acute course renal damage congenital infection and encephalitis from reactivation of latent infection in the brains of immunosuppressed persons gestational age at time of infection bradyzoite cyst degeneration and rupture within the CNS bradyzoite cyst degeneration and rupture within the CNS cervical lymphadenopathy brainstem, basal ganglia, pituitary gland, and corticomedullary junction congenital infection giardiasis C. hominis and C. parvum patients with AIDS Trichomonas vaginalis culture of the parasite extraocular muscles, biceps, and muscles of the jaw, neck, lower back, and diaphragm children who habitually eat dirt asymptomatic posterior pole of the retina unilateral visual disturbances, strabismus, eye pain Angiostrongylus cantonensis (rat lungworm) recurrent urticaria, often involving the buttocks and wrists coma cardiac arrest with cerebral hypoperfusion and head injuries supratentorial to the infratentorial compartments through tentorial opening hence, transtentorial bilaterally dilated and unreactive pupils
24
210 210
most useful in diagnosis of coma most common categories of cerebrovascular diseases
210 210 211 211 211 211 211 212 212 212 212 212 212 213 213 213 213 213 213
most common stroke most widely distributed human filarial parasite most common presentations of the lymphatic filariases most frequent manifestations of onchocerciasis most serious complication of onchocerciasis most common early finding in onchocerciasis most common cause of manifestations in chronic schistosomiasis 2nd most significant pathologic change in the liver with schistosomiasis most often cause of swimmers' itch most importantly affected by chronic schistosomiasis most common symptoms of lung involvement in schistosomiasis 2nd most common cause of epilepsy in endemic areas (e.g. Philippines) most commonly detected site of cysticerci most common manifestations of cysticerci most common sites of echinococcal cysts most often presentation of patients with hepatic echinococcus who are symptomatic most common of all cestode infections most common involvement in Coenurosis most frequently cited use of microbial pathogens as potential weapons of war or terrorism
chemical-toxicologic analysis of blood and urine, cranial CT or MRI, EEG, CSF examination basal ganglia and thamalmic hemorrhage; pontine hemorrhage; cerebellar hemorrhage; basilar artery thrombosis; subarachnoid hemorrhage infarction in the territory of the MCA Wuchereria bancrofti asymptomatic or subclinical microfilaremia, hydrocele, acute adenolymphangitis, chronic lymphatic disease pruritus and rash visual impairment conjunctivitis with photophobia due to eggs retained in host tissues fibrosis S. mansoni and S. japonicum lungs and CNS cough, fever, and dyspnea Jacksonian epilepsy due to S. japonicum brain, CSF, skeletal muscle, subcutaneous tissue or eye neurologic manifestations liver and lungs abdominal pain or palpable mass in RUQ Hymenolepis nana CNS involvement and subcutaneous tissue poisoning of water supplies in the 6th century BC with the fungus Claviceps purpurea (rye ergot) by the Assyrians; the hurling of the dead bodies of plague victims over the walls of the city of Kaffa by the Tartar Army in 1346, efforts by the British to spread smallpox via contaminated blankets to the native American population loyal to the French in 1767 inhalational anthrax rural areas where a variety of small mammals may serve as reservoir hunters, during the colder months (with direct contact with infected mammals) aerosol
214 214 214 214
form most likely to be responsible for death in the setting of a bioterrorist attack most common areas for infection with Tularemia most likely affected by Tularemia most likely mode of dissemination of Tularemia as a biologic
25
214 214 215
weapon most likely modes of transmission for bioterrorism for Botulism most likely agents to be used on a battlefied most commonly affected by sulfur mustard
215 215 215 215 215 216 216 216
most sensitive sites for erythema with sulfur mustard most sensitive organs to mustard vapor injury most severe damage with sulfur mustard most effective benzodiazepines in cases of nerve agent induced seizures most likely scenario of nuclear terror most effective time to take Potassium Iodide in preventing or reversing radionuclide interaction most valuable early indicator for radiation-exposed patient most common cancers with radiation exposure
ingestion of contaminated food or inhalation of aerosolized toxin sulfur mustard and organophosphorus nerve agents skin (with erythema and vesicles), eyes (ranging from mild conjunctivitis to severe eye damage), and airways (ranging from mild upper airway irritation to severe bronchiolar damage) warm moist locations and thin delicate skin such as perineum, external genitalia, axillae, antecubital fossae, and neck eyes liquid mustard midazolam detonation of a single low-yield device first hour after exposure and is still effective 6h after exposure absolute lymphocyte counts taken every 4-6h for 5-6 days leukemia, breast, brain, thyroid, and lung cancer
18 18 113 113 INFECTIOUS DISEASES grouped vesicles on erythematous base that may evolve into pustules pathognomonic for measles Koplik's spots (1-2mm white or bluish lesions with an erythematous halo on the buccal mucosa earliest specific antibody to appear in response to infection IgM pathognomonic skin manifestations target lesion of Erythema migrans (lyme disease); ecthyma gangrenosum (pseudomonas aeruginosa); and eschars (rickettsial disease) harbinger of critical illness in febrile patient visible agitation or anxiety Necrotizing fasciitis without treatment, pain decreases because of thrombosis of the small blood vessels and destruction of the peripheral nerves, an ominous sign Drug of choice for Malaria (Asia-incl. SE Asia) Mefloquine, Doxycycline, Atovaquone-proguanil (Malarone) leading cause of illness in traveler's diarrhea mainstay for prevention of Travelers' diarrhea food and water precautions mainstay for therapy for travelers' diarrhea rehydration definitive method for unusual or difficult-to-cultivate organisms 16s sequencing Hallmark of pleurodynia (coxsackievirus B), trichinellosis, and severe muscle pain bacterial infection definitive when there is drainage, open would, or obvious portal Gram's stain and culture of entry, diagnosis is provided for by Hallmark of primary herpes simplex virus
115 115
117 117 117 117 119 119 121
26
121 121 122 122 124 124 126 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127
hallmark of renal abscesses from Candida, by ascension from the bladder mainstay of therapy of liver abscesses leading cause of morbidity in children; also major cause of death mainstay of treatment for infectious diarrhea or bacterial food poisoning definitively identifies salpingitis leading cause of death in some developing countries definitive diagnosis of cholangitis in liver transplant recipients Drug of choice for Acute otitis media Drug of choice for Bacterial gastroenteritis Drug of choice for Acute bacterial exacerbations of chronic bronchitis Drug of choice for Aeromonas infections Drug of choice for brucellosis (with streptomycin) Drug of choice for CA-MRSA infections, leptospirosis, syphilis, actinomycosis in pen-allergic patient Drug of choice for Bacillary angiomatosis (Bartonella henselae) Drug of choice for Campylobacter Drug of choice for CAP Drug of choice for Abscess in lung, brain, or abdomen Drug of choice for Antibiotic-associated clostridium difficile disease Drug of choice for Bacterial vaginosis Drug of choice for Actinomycosis Drug of choice for Anthrax Drug of choice for Acinetobacter spp Drug of choice for Antibiotic-associated pseudomembranous colitis Drug of choice for Bacteremia, endocarditis, other serious infections due to MRSA Drug of choice for Chlamydial infections Drug of choice for Clostridial myonecrosis Drug of choice combined with penicillin for staph, enterococcal, or viridans strep endocarditis Drug of choice for community-acquired UTI Drug of choice for E. coli UTI
ureteral obstruction with large fungal balls drainage - either percutaneous or surgical acute diarrheal illnesses adequate rehydration laparoscopy HIV require documentation of bacteremia or demonstration of aggregated neutrophils in bile duct biopsy specimen ampicillin/amoxicillin Ciprofloxacin, Levofloxacin, Moxifloxacin Doxycycline, Minocycline Doxycycline, Minocycline Doxycycline, Minocycline Doxycycline, Minocycline erythromycin, clarithromycin, azithromycin erythromycin, clarithromycin, azithromycin erythromycin, clarithromycin, azithromycin, levofloxacin, moxifloxacin Metronidazole Metronidazole Metronidazole Penicillin G Penicillin G Polymyxin E (colistin) Vancomycin Vancomycin doxycycline Penicillin G Gentamycin, amikacin, tobramycin TMP-SMX Cefazolin
27
127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127
Drug of choice for Ehrlichiosis Drug of choice for Enterococcus faecalis UTI Drug of choice for erysipeloid (Erysipelothrix rhusiopathiae) Drug of choice for ESBL-producing G(-) bacilli Drug of choice for gastric infections due to H. pylori Drug of choice for glanders Drug of choice for Gonococcal infections Drug of choice for granuloma inguinale Drug of choice for Granulomatous skin infections due to M. marinum Drug of choice for Group A and B streptococcal infection; pneumococcal infections Drug of choice for group A streptococcal pharyngitis in penallergic patients Drug of choice for H. influenzae meningitis and epiglottitis Drug of choice for hospital-acquired G(-) enteric infections Drug of choice for hospital-acquired infection due to G(-) bacilli resistant to all other chemotherapy Drug of choice for Hospital-acquired infections (non-MRSA) Drug of choice for hospital-acquired infections caused by nonpseudomonal facultative G(-) enteric bacilli Drug of choice for Infections by mixed flora (aspiration pneumonia, diabetic ulcers) Drug of choice for infections by obligate anaerobes Drug of choice for infections by susceptible staphylococci Drug of choice for infections by Vibrio vulnificus Drug of choice for Infections caused by Enterobacter spp. Drug of choice for infections due to Stenotrophomonas Drug of choice for Intraabdominal infections (facultative enteric GNB + obligate anaerobes) Drug of choice for Legionella Drug of choice for Legionella pneumonia Drug of choice for Leprosy Drug of choice for Leptospirosis Drug of choice for Listeria monocytogenes meningitis Drug of choice for melioidosis Drug of choice for Meningococcal meningitis and meningococcemia Drug of choice for mild CAP, skin and soft tissue infections caused by G(+) cocci
Doxycycline, Minocycline ampicillin/amoxicillin Penicillin G Imipenem or Meropenem erythromycin, clarithromycin, azithromycin Doxycycline, Minocycline Ceftriaxone Doxycycline, Minocycline minocycline Penicillin G erythromycin, clarithromycin, azithromycin ampicillin/amoxicillin Ciprofloxacin, Levofloxacin, Moxifloxacin Polymyxin E (colistin) Imipenem or Meropenem Ceftriaxone; ceftazidime, cefepime; Aztreonam Piperacillin-Tazobactam Clindamycin Clindamycin Doxycycline, Minocycline Imipenem or Meropenem, fluoroquinolones minocycline, Polymyxin E (colistin) Piperacillin-Tazobactam, Cefoxitin, Cefotetan, Imipenem, Meropenem erythromycin, clarithromycin, azithromycin Rifampin Dapsone Penicillin G ampicillin/amoxicillin Doxycycline, Minocycline Penicillin G Doxycycline, Minocycline
28
127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 127 128
Drug of choice for MRSA bacteremia Drug of choice for Mycobacterium avium-intracellulare infections Drug of choice for Mycoplasma Drug of choice for nocardial infections Drug of choice for obligate anaerobic G(-) bacteria (Bacteroides spp) Drug of choice for Oral and periodontal infections Drug of choice for P aeruginosa Drug of choice for Pasteurella multocida infection Drug of choice for PID Drug of choice for Pneumococcal meningitis Drug of choice for Pseudomonas Drug of choice for pyelonephritis Drug of choice for Rat-bite fever Drug of choice for rickettsial infections Drug of choice for S. aureus (non-MRSA) bacteremia and endocarditis Drug of choice for S. aureus skin and soft tissue infections (CAMRSA) Drug of choice for Salmonellosis Drug of choice for severe, invasive grp A strep infections Drug of choice for spirochetal infections by Borrelia (Lyme disease and relapsing fever) Drug of choice for Staph foreign body infections, in combo with other anti-staph agents Drug of choice for Surgical prophylaxis Drug of choice for Syphilis Drug of choice for Tetanus Drug of choice for Topical application to nares to eradicate S. aureus carriage Drug of choice for toxoplasmosis Drug of choice for Tularemia Drug of choice for typhoid fever Drug of choice for UTI Drug of choice for viridans Streptococcal endocarditis Drug of choice for VRE Drug of choice with beta-lactam antibiotic for G(-) bacteremia Drug of choice for Yaws mainstay of therapy in H. influenzae infection (CNS?) cornerstone in therapy for serious pneumococcal infection
Daptomycin erythromycin, clarithromycin, azithromycin erythromycin, clarithromycin, azithromycin sulfonamides Metronidazole Penicillin G Polymxyin E (colistin) Penicillin G Cefoxitin, Cefotetan Ceftriaxone Ceftazidime, cefepime; Aztreonam, Ciprofloxacin, Levofloxacin Gentamycin, amikacin, tobramycin Penicillin G Doxycycline, Minocycline Nafcillin, oxacillin; Cefazolin TMP-SMX, Linezolid ampicillin/amoxicillin; ceftriaxone Clindamycin doxycycline Rifampin Cefazolin Penicillin G Penicillin G Mupirocin sulfadiazine Gentamicin, Doxycycline, Minocycline Ceftriaxone Ciprofloxacin, Levofloxacin, Moxifloxacin Penicillin G; ceftriaxone Linezolid, Quinupristin/dalfopristin, Daptomycin Gentamycin, amikacin, tobramycin Penicillin G beta-lactam drugs beta-lactam antibiotics
29
129 129 130 130 130
leading cause of nosocomial infections mainstay of therapy of TSS definitive diagnosis for GAS gold standard for diagnosis of pharyngitis due to Strep leading cause of bacterial sepsis and meningitis in newborns and a major cause of endometritis and fever n parturient women Drug of choice for Rhodococcus hallmark of L. monocytogenes model definitive diagnosis for botulism cornerstone in therapy of rapidly advancing fasciitis mainstay for gas gangrene therapy definitive diagnosis of Meningococcal meningitis Drug of choice for Gonorrhea mainstay of therapy for uncomplicated gonococcal infection of the urethra, cervix, rectum, or pharynx hallmark of H. influenzae definitive diagnosis of Legionella pneumophila definitive method for diagnosis of legionella infection Drug of choice for Pertussis heralding onset of convalescent phase of pertussis gold standard for diagnosis of pertusis hallmark of pertussis mainstay for pertussis prevention hallmark syndrome of grossly bloody diarrhea
S. aureus supportive therapy with reversal of hypotension culture of throat specimen that is properly collected and properly processed; a positive rapid diagnostic kit throat culture Group B streptococcus
131 132 134 135 135 136 137 137 139 141 141 142 142 142 142 142 143
143 145 145 145 145 146 146
mainstay of treatment for all diarrheal syndromes Drug of choice for P. aeruginosa pneumonia, bacteremia may herald underlying disease at another site (often pneumonia or sinusitis) gold standard for diagnosis of patients with ear infection due to P. aeruginosa mainstay for therapy of acute pneumonia due to P. aeruginosa definitive diagnosis of enteric fever Hallmark of enteric fever
vancomycin killed vaccines do not provide protective immunity demonstration of toxin in serum by bioassay in mice incision of affected area surgery recovering N. meningitidis, its antigens, or its DNA from normally sterile body fluids or from skin lesions Penicillin single-dose regimens of the 3rd generation cephalosporins Ceftriaxone (given IM) and Cefixime (given orally) airway inflammation Direct fluorescent antibody (DFA) test isolation of organism from respiratory secretion or other specimens macrolide coughing episodes become less frequent and less severe nasopharyngeal secretions paroxysmal cough active immunization colonic edema and an initial secretory diarrhea may develop into the STEC/EHEC (Shiga toxinproducing E. coli /enterohemorrhagic E. coli ) replacement of water and electrolytes Pip-Tazo or Imipenem or Meropenem + Amikacin bacteremia positive technetium-99 bone scan potent antipseudomonal beta-lactam isolation of S. Typhi or S. Paratyphi from blood, bone marrow, other sterile sites, rose spots, stool, or intestinal secretions prolonged fever and abdominal pain
30
147 148 150 150 150 150
gold standard for diagnosis of Shigella infection definitive diagnosis of inflammatory diarrhea (Campylobacter enteritis) definitive diagnosis of Brucella gold standard for treatment of brucellosis in adults mainstay for serologic diagnosis for Brucellosis mainstay for veterinary prevention
152 154 156 156 156 158 158 158 158
Drug of choice for plague Drug of choice for Donovanosis earliest stage of actinomycotic involvement of the pelvis hallmark of actinomycosis hallmark of actinomycosis cornerstone of diagnosis of TB meningitis definitive diagnosis of Genitourinary TB definitive diagnosis of Pericardial TB (tuberculous pericarditis) definitive diagnosis of TB
158 158 159 159 159 161 162 166 167 167 167 169
gold standard for Tuberculous meningitis and tuberculoma diagnosis pathognomonic of miliary tuberculosis in up to 30% mainstay for Leprosy therapy pathognomonic for leprosy pathognomonic for leprosy Drug of choice in tuberculosis earliest sign of congenital syphilis definitive diagnosis of Lyme Borreliosis definitive diagnosis of ricketssia Drug of choice for rickettsioses, rocky mountain spotted fever mainstay of laboratory diagnosis of scrub typhus in Chlamydial infections, icterus, the result of severe hepatic involvement is a rare and ominous finding
isolation and identification of pathogen from fecal material culture or demonstration of characteristic organisms on stained fecal smears isolation of brucellae from blood, CSF, bone marrow, or joint fluid or from tissue aspirate or biopsy sample IM streptomycin (0.75-1g daily for 14-21 days) + doxycycline (100mg BID for 6 wks) standard agglutination test (SAT) national commitment to testing and slaughter of infected herds/flocks, control of animal movement, and active immunization of animals streptomycin (also gentamicin), Doxycycline, Minocycline chloramphenicol endometritis chronic, indolent phase manifested by lesions that usually appear as single or multiple indurations risk of relapse Lumbar puncture culture of 3 morning urine specimens by pericardiocentesis under echocardiographic guidance isolation and identification of M. tuberculosis from a clinical specimen or identification of specific sequences of DNA in a nucleic acid amplification test culture of CSF choroidal tubercles sulfones (dapsone) invasion and destruction of nerves in the dermis by T cells actual granuloma formation within dermal nerves capreomycin, after streptomycin rhinitis or "snuffles", soon followed by other mucocutaneous lesions culture of B. burgdorferi in Barbour-Stoenner-Kelly (BSK) medium requires examination of paited serum samples after convalescence doxycycline serologic assays (IFA, indirect immunoperoxidase, and enzyme immunoassays)
31
169 170 172 172 172 173 173 174 175 179
pathognomonic for psittacosis hallmark of Hodgkin's disease gold standard for defining HSV encephalitis hallmark of HSV encephalitis mainstay of therapy for HSV (mucocutaneous infections) heralded by pain within the dermatome hallmark of chicken pox hallmark of Burkitt's lymphoma hallmark of Epstein-Barr virus infection definitive diagnosis of adenovirus infection
179 182 182 182
mainstay for Coronavirus management cornerstone of management of patients with HIV infection cornerstones of an HIV prevention strategy definitive diagnosis of PCP
182 182 182 182 182 182
definitive diagnosis of microsporidia (Enterocytozoon bieneusi) definitive diagnosis of HIV-associated nephropathy definitive diagnosis of cerebral Toxoplasmosis gold standard for a diagnosis of HIV infection Hallmark of HIV Hallmark of HIV
182 182 182 182 182 182
Hallmark of HIV Hallmark of AIDS (before the development of effective prophylactic regimens) Hallmark of HIV-associated nephropathy Histologic hallmark of zidovudine-induced myopathy leading cause of end-stage renal failure among African Americans aged 20-64 in the US mainstay of treatment and prevention for indinavir-associated renal calculi
(Levinthal-Coles-Lillie bodies) characteristic cytoplasmic inclusion bodies high-level LMP1 expression in Reed-Sternberg cells brain biopsy acute onset of fever and focal neurologic symptoms and signs, esp in temporal lobe acyclovir, famciclovir, valcyclovir onset of disease (VZV) skin lesions: maculopapules, vesicles, scabs enhance proliferation of B cells, increasing the likelihood of cmyc translocation appearance of atypical lymphocytes in the peripheral blood (activated CD8+ T lymphocytes) established by detection of virus in tissue culture (as evidenced by cytopathic changes) and by specific identification with immunofluorescence or other immunologic techniques supportive therapy combination antiretroviral therapy (ART) or HAART education, counseling, and behavior modification demonstration of organism in samples obtained from induced sputum, broncheoalveolar lavage, transbronchial biopsy or open lung biopsy depends on electron-microscopic examination of a stool specimen, intestinal aspirate, or intestinal biopsy specimen renal biopsy brain biopsy positive EIA with a confirmatory Western Blot reverse transcription of its genomic RNA to DNA by the enzyme reverse transcriptase profound immunodeficiency resulting primarily from a progressive quantitative and quali deficiency of the subset of T lymphocytes (helper T cells) chronic and persistent infection Pneumocystis pneumonia (PCP) proteinuria red ragged fibers HIV infection adequate hydration
32
183 184 185 185 185 185
leading cause of mortality among children in developing countries leading cause of exanthems in children in the summer and fall may herald a bacterial superinfection (measles) fifth leading cause of childhood mortality worldwide pathognomonic for measles pathognomonic for measles
acute infectious gastroenteritis enterovirus infection leukocytosis measles Koplik's spots, eruption on buccal mucous membranes multinucleated giant cells with inclusion bodies in nucleus and cytoplasm (Warthin-Finkeldey cells) in respiratory and lymphoid tissues muscle weakness management of shock, reliance on pressors, modest crystalloid infusion, IV use of human serum albumin, treatment of renal failure with prompt dialysis for the usual indications mononuclear phagocyte system requires histopathologic identification of the fungus invading tissue, accompanied by evidence of an inflammatory response Voriconazole fungal culture requires conversion to the yeast phase at 37 oC or, more commonly, the use of NAAT that detect mycelial-phase growth growth of organism from sputum, pus, or biopsy material elevated serum level of total IgE positive culture of a sample taken directly from an ordinarily sterile site or positive result of both histologic testing and culture of a sample taken from an affected organ one or more pulmonary cavities expanding over a period of months or years in assoc. with pulmonary symptoms and systemic manifestation such as fatigue and weight loss. local eosinophilia and the breakdown products of eosinophils, Charcot-Leyden crystals black eschar of the palate
188 189
cardinal features of encephalitic rabies mainstay of Hemorrhagic Fever with renal syndrome
190 191 191 192 194 194 197 197
earliest involvement seen with Ebola and Marburg viruses definitive diagnosis of any fungal infection Drug of choice for Aspergillosis gold standard for diagnosis of histoplasmosis definitive identification of blastomycosis definitive diagnosis of blastomycosis cardinal diagnostic tests for allergic bronchopulmonary aspergillosis definitive diagnosis of aspergillosis
197
hallmark of chronic cavitary pulmonary aspergillosis
197 198 198 199 199 199 199 200 200
histologic hallmark of allergic fungal sinusitis hallmark of rhinocerebral mucormycosis in Mucormycosis, cavernous sinus thrombosis is an ominous sign definitive diagnosis of mycoses and algal infections definitive diagnosis of sporotrichosis definitive diagnosis of Paracoccidioidomycosis definitive diagnosis of Penicillinosis Drug of choice for All forms of PcP, primary and secondary prophylaxis mainstay for diagnosis of Pneumocystis
microscopic examination and culture culture of S. schenckii on any of a variety of media culture of organism culture TMP-SMX fiberoptic bronchoscopy with BAL
33
202 202 202 202
definitive diagnosis of amebic colitis definitive diagnosis of E. dispar colonization Drug of choice for Amebic liver abscess earliest intestinal lesions with amebiasis
203 203 204 205 206 206 206 206 206 207 209 210 210 210 210 211 211 211
may herald the development of cerebral disease coma is a characteristic and ominous feature of falciparum malaria (cerebral malaria) pathognomonic for Babesia microti and other small Babesia species mainstay of therapy for leishmaniasis definitive diagnosis of Leishmaniasis definitive diagnosis of Human African Trypanosomiasis Drug of choice for East African Trypanosomiasis with CNS involvement Drug of choice for Trypanosomiasis pathognomonic for CNS involvement in Trypanosomiasis definitive means of detecting or ruling out Toxoplasma infection when CNS lesion is suspected definitive diagnosis of Trichinellosis cardinal symptom of Enterobius infection definitive diagnosis of Angiostrongyliasis mainstay of treatment in abdominal angiostrongyliasis pathognomonic for strongyloidiasis definitive diagnosis of Filariasis definitive diagnosis of Onchocerciasis definitive diagnosis of loaisis
demonstration of hematophagous trophozoites of E. histolytica specific antigen-detection tests Metronidazole microulcerations of the mucosa of the cecum, sigmoid colon, or rectum that release erythrocytes, inflammatory lcelles, and epithelial cells generalized seizures are specifically associated with falciparum malaria
tetrads or "Maltese" crosses in blood smears during infections sodium stilbogluconate and meglumine antimonate demonstration of parasite in specimens from infected sites, which typically relies on classic microbiologic methods detection of the parasite arsenical melarsoprol Benznidazole any CSF abnormality in patient in whom trypanosomes have been found at other sites single-photon emission CT (SPECT) surgical biopsy of at least 1g of involved muscle perianal pruritus surgically with partial bowel resection careful observation and surgical resection migrating larvae eliciting serpiginous eruption, larva currens detection of parasites detection of an adult worm in an excised nodule, or more commonly, of microfilariae in a skin snip detection of microfilariae in peripheral blood or isolation of an adult worm from th eye or from subcutaneous biopsy specimen from a site of swelling developing after treatment onchocerciasis sclerosing keratitis chemotherapy Praziquantel Praziquantel Triclabendazole
211 211 211 212 212 212
second leading cause of infectious blindness worldwide leading cause of onchocercal blindness in Africa mainstay for onchocerciasis treatment Drug of choice for Clonorchis sinensis, O. viverrini, O. felineus Drug of choice for F. buski, H. heterophyes Drug of choice for F. hepatica, F. gigantica
34
212 212 213 213 213 213
213 214
Drug of choice for Paragonimus westermani Drug of choice for Schistosomiasis definitive method of treatment of Echinococcosis definitive diagnosis and treatment of coenurosis mainstay for cysticercosis with hydrocephalus treatment mainstay for patients with diffuse cerebral edema and elevated intracranial pressure due to multiple inflamed lesions in patients with cysticercosis pathognomonic for Echinococcus granulosus infection earliest symptoms of Anthrax
Praziquantel praziquantel surgery surgical excision of the lesion emergent reduction of intracranial pressure glucocorticoids
214 215 215 e14 e17 e35 e37 e37
mainstay of prevention of full-blown disease in botulism earliest form of mustard skin injury earliest effects from mustard and perhaps the only effects from a low concentration gold standard for bacterial strain analysis mainstay of schistosomiasis leading cause of death from poisoning cornerstone of trypanosomicidal treatment gold standard for differentiation between allograft rejection and reactivation of Chagas' disease
daughter cysts within larger cyst (eggshell or mural calcification on CT) typically a viral-like prodrome with fever, malaise, and abdominal and/or chest symptoms that progress over the course of a few days to a moribund state early recognition of the clinical syndrome and use of appropriate equine antitoxin erythema involve the nose, sinuses, and pharynx pulse-field gel electrophoresis Praziquantel carbon monoxide nitrofurans and nitroimidazole derivatives (Nifurtimox and benznidazole) endomyocardial biopsy
18 18 18 18 18 18 18 52 52 53 53 53 most most most most most most most most most most most most HEMATOLOGY, ONCOLOGY, ALLERGY, RHEUMATOLOGY, AND DERMATOLOGY MOST commonly affected by Ecthyma gangrenosum axillary, groin, perianal regions common type of eruption centrally distributed rashes (primarily truncal) commonly affected by Exanthem subitum (roseola) children <3 years of age prominent areas for rashes peripherally or being in peripheral (acral) areas before spreading centripetally common cause of Hand-foot-and-mouth disease coxsackievirus A16 prominent affected areas of variola lesions face and extremities prominent affected areas of varicella trunk often used in the diagnosis of herpesvirus infections Tzanck smear common type of Irritant contact dermatitis chronic low-grade irritant dermatitis commonly involved are in ICD hands common irritants in ICD chronic wet work, soap, detergents common cause of allergic contact dermatitis exposure to plants (family Anacardiaceae includes genus
35
53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 53 54 54 54 54 54 54 54 54 54 54 54 54 54 54
most commonly affected by Nummular eczema most common location affected by seborrheic dermatitis one of the most common dermatologic diseases most often affected areas in pityriasis rosea most common variety of psoriasis most commonly involved parts in Psoriasis most commonly affected age groups in Guttate psoriasis most often found together with psoriasis with arthralgia most often cause of impetigo most common dermatophyte infection most common variant of infection of the nails, tinea unguium or onychomycosis most commonly affected areas of filiform warts most useful and convenient method for treating warts most common location for acne most often affect by acne rosacea most frequently used agents in PV most common papulosquamous diseases Pityriasis rosea-like drug eruptions are seen most commonly with most common systemic disease as etiology of erythroderma most common malignancy associated with erythroderma most common causes of nonscarring alopecia most common cause of figurate eruption most common pustular dermatoses most common locations for mat telangiectasia most common sites of hereditary hemorrhagic telangiectasia (Osler-Rendu-Weber) most common form of oculocutaneous albinism (OCA) most frequently associated disorders with vitiligo most common autoantibodies noted with thyroid gland disorder in vitiligo 4 most common systemic disease considered with patients with vitiligo most common locations of pigment loss in Vogt-Koyanagi-
Toxicodendron - Poison ivy, poison oak, poison sumac) men, middle age scalp psoriasis trunk plaque-type elbows, knees, gluteal cleft, scalp children and young adults fingernail involvement S. aureus tinea pedis distal-lateral variant face, neck, skin folds cryotherapy with liquid nitrogen face (also chest and back) Caucasians of Northern European background; adults, women (in men severe disease) azathioprine, mycophenolate mofetil, cyclophosphamide psoriasis, tinea, pityriasis rosea, and lichen planus beta-blockers, ACEi, gold, and metronidazole CTCL (Cutaneous T Cell Lymphoma) CTCL (Cutaneous T Cell Lymphoma) telogen effluvium, androgenic alopecia, alopecia areata, tinea capitis, and some cases of traumatic alopecia tinea, urticaria, erythema annulare centrifugum, and granuloma annulare acneiform eruption and folliculitis face, oral mucosa, and hands - peripheral sites that are prone to intermittent ischemia mucous membranes, face, and distal extremities, including under the nails mutations in the tyrosinase gene (type I) or the P gene (type II) diseases of the thyroid gland antithyroglobulin, antimicrosomal, and antithyroid-stimulating hormone receptor antibodies Vogt-Koyanagi-Harada syndrome, scleroderma, onchocerciasis, and melanoma-associated leukoderma face and scalp
36
54 54 54 54 54 54 54 54 54 54 54 54
Harada syndrome acanthosis nigricans can reflect internal malignancy, most commonly of the caf au lait macules (CALM) most commonly associated with most common autoimmune diseases associated with diffuse hyperpigmentation most common drugs associated with bullae formation as drug reaction most common drugs that cause TEN most common infectious agents that cause vesicles and bullae most common form of porphyria 2 most common presentations of exanthems most common group A beta-hemolytic streptococcus that causes scarlet fever most common cutaneous eruption in Kawasaki's disease most serious associated systemic finding in Kawasaki's disease most common systemic signs and symptoms of urticarial vasculitis most common cause of elevated calcium phosphate product most common form of xanthomas and are associated with hypertriglyceridemia (type I, III, IV, V) most frequently involved with tuberous xanthomas most frequently involved sites in normolipemic flat xanthomas most common setting for eruptive xanthomas most common location of multiple angiokeratoms seen in Fabry disease 2 most common etiologies of erythematous papules in a lymphocutaneous or sporotrichoid pattern most common location for nodules of erythema nodosum most common location for lesions of erythema induratum most commonly associated diseases with erythema nodosum
GI tract neurofibromatosis (NF) and McCune Albright syndrome biliary cirrhosis, scleroderma doxycycline, sulfonamides, thiazides, NSAIDS, and psoralens phenytoin, barbiturates, carbamazepines, sulfonamides, penicillins, and NSAIDs HSV, VZV, and S. aureus PCT erythematous macules and papules (morbilliform) and confluent blanching erythema (scarlatiniform) pharyngitis morbilliform and scarlatiniform coronary aneurysm secondary to arteritis arthralgias and/or arthritis, nephritis, and crampy abdominal pain, with asthma and chronic obstructive lung disease seen less often secondary hyperparathyroidism in the setting of renal failure eruptive xanthomas large joints or hand upper trunk or side of the neck uncontrolled DM lower trunk Sporothrix schenckii (sporotrichosis) and M. marinum (mycobacteria other than TB; atypical mycobacteria) shin calf streptococcal infections, upper respiratory viral infections, sarcoidosis, inflammatory bowel disease in addition to drugs (oral contraceptives, sulfonamides, penicillins, bromides, iodides face AML dorsum of the hand or foot or in the head and neck region
54 54 54 54 54 54 54 54 54 54
54 54 54
most common location of the waxy papules and plaques found in sarcoidosis most commonly associated malignancy in Sweet's syndrome most common location of blue nevi (moles)
37
54 54 54 54 54 54
most common location of angiosarcoma most common presentation of cutaneous metastases most often cause of cutaneous metastases most frequent causes of nonpalpable petechiae and purpura most commonly associated with palpable purpura most common cause of infectious emboli
54 54 55 55 55 55 55 56 56 56 56 56 56 56 56 56 56 57 57 57 57 58 59
most common location of pyoderma gangrenosum most common associated disorders in pyoderma gangrenosum most commonly associated with drug-induced pemphigus most commonly affected age group (dermatitis herpetiformis) most common manifestation of dermatomyositis most often autoantibody in subacute cutaneous lupus erythematosus most common of all drug-induced reactions most common cause of erythema multiforme most common drugs that cause SJS or TEN most frequent adverse reactions to drugs most frequent causes of IgE-dependent reactions to drugs, which require prior sensitization second most frequent type of cutaneous reaction to drugs most frequent dose-dependent side effects of chemotherapy most frequent adverse event in drug administration most frequent cutaneous reactions with anti-malarials most frequent cause of urticarial eruptions most common repetitive probes most rapidly increasing of all human malignancies most common malignancy arising in immunosuppressed solidorgan transplant recipients after sunburn, most common type of photosensitivity disease is most common type of human porphyria NONE most abundant receptor on the platelet surface
scalp and face of elderly patients or within areas of chronic lymphedema firm, skin-colored subcutaneous nodules or firm, red to redbrown papulonodules MEN: lung, colon, melanoma, oral cavity. WOMEN: breast, melanoma, lung primary cutaneous disorders such as trauma, solar (actinic) purpura, and capillaritis leukocytoclastic vasculitis (LCV) gram-negative cocci (meningococcus, gonococcus), gramnegative rods (enterobacteriaceae) and gram-positive cocci (Staphylococcus) lower extremities ulcerative colitis and Crohn's disease drugs containing thiol group in their chemical structure (penicillamine, captopril, enalapril) second to fourth decade purple-red discoloration of the upper eyelids, sometimes associated with scaling and periorbital edema anti-Ro autoantibodies morbilliform or maculopapular eruptions herpes simplex virus anti-infectious sulfonamides, nevirapine, allopurinol, lamotrigine, aromatic anticonvulsants, oxicam NSAIDs cutaneous Penicillins and myorelaxants used in GA urticaria stomatitis and alopecia injection-site reactions pruritus ACE inhibitors, aspirin, penicillin, blood products alpha-satellite DNA probes melanomas BCCs and SCCs polymorphous light eruption (PLE) porphyria cutanea tarda (PCT) platelet glycoprotein (Gp) IIb/IIIa complex
38
59 59 59 59 60 60 60 60 60
most important predictor of bleeding risk most common symptom in hereditary hemorrhagic telangiectasia and in boys with vWD most important point in a history related to venous thrombosis is most commonly used screening tests in thrombosis most common cause of benign lymphadenopathy most frequent site of regional adenopathy most causes of regional adenopathy of the neck are most common symptoms produced by diseases involving the spleen are most serious consequence of splenectomy
history of bleeding epistaxis whether thrombotic event was idiopathic or was a precipitated event PT, aPTT, and platelet (63% nonspecific or reactive etiology), remainder would be due to infectious mononucleosis, toxoplasmosis, tuberculosis neck benign - upper respiratory infections, oral and dental lesions, infectious mononucleosis, other viral illnesses pain and a heavy sensation in the LUQ increased susceptibility to bacterial infections, particularly those with capsules such as S. pneumoniae, H. influenzae, and some gram-negative enteric organisms lung, skin, and blood antibiotics such as sulfa-containing compounds, penicillins, and cephalosporins infection S. aureus and enteric gram-negative bacteria myeloperoxidase deficiency Loeffler's syndrome, tropical pulmonary eosinophilia, Loeffler's endocarditis, eosinophilic leukemia, idiopathic hypereosinophilic syndrome involves the heart and central nervous system age lung cancer lung cancer breast cancer invasive tissue biopsy TNM nausea, vomiting, febrile neutropenia, myelosuppression acute emesis, occurs within 24h ondansetron and granisetron infection, respiratory failure, hepatic failure, renal failure tobacco smoking sexual transmission of HPV
60 61 61 61 61 61
most common sites of infection in patients that underwent splenectomy most frequent causes of drug-induced neutropenia most most most most important acute cause of neutrophilia common bacteria in Leukocyte Adhesion Deficiency common neutrophil defect dramatic hypereosinophilic syndromes
61 77 77 77 77 77 77 77 77 77 77 78 78
most severe complications of idiopathic hypereosinophilic syndrome most significant risk factor for cancer overall most common cancer most common cause of cancer death second most common cancer diagnosis of cancer relies most heavily on most widely used system of staging of cancer most common side effects of cancer treatment most common variety of nausea from cancer chemotherapy most effective drugs against highly emetogenic agents most common causes of death in patients with cancer most modifiable risk factor for cardiovascular disease, pulmonary disease, and cancer most common etiologic factor for cervical cancer
39
78 78 79 80 80 81 81 81 81 81 81 81 81 81 82 82 82
82 82 82 82 82 83 83 83 83 83 83 83 83 83 83 83 83 83
most efficient interval for screening sigmoidoscopy most common prostate cancer screening modalities most autosomal dominant inherited cancer syndromes are due to most common genetic alternation found in human cancer most potent trophic angiogenic molecules secreted by tumors most effective means of treating cancer most commonly used form of radiation therapy forms of radiation most commonly used to treat cancer most radioresistant organ most sensitive organs to radiation therapy in radio-resistant organs, the most sensitive component is most feared complication of bleomycin treatment most broadly active antineoplastic agents for use in solid tumors most common side effect of chemotherapy administration most often cause of cellulitis most common location of vesicles in Sweet's syndrome most common in patients being treated for acute leukemia and usually presents symptomatically around the time the neutropenia resolves most often presentation of mass lesions of the brain most common cause of chemotherapy-induced lung disease most often associated with neutropenia in cancer patients most common organisms in invasive fungal infections most common finding on skin examination most common melanoma most common melanoma in Blacks, Asians, and Hispanics most common manifestation of nodular melanoma 5th most common cancer in men 6th most common cancer in women most susceptible to development of melanoma period that melanoma is most capable of being cured by surgical excision most frequent variant observed in white population most common site for melanoma in men most common site for melanoma in women most important prognostic factor in melanoma most melanomas are diagnosed in most important precursor for melanoma
unknown, but 5 years is recommended DRE and PSA mutations in tumor-suppressor genes acquired mutation in p53 VEGF surgery teletherapy x-rays and gamma rays bone male testis, female ovary, and bone marrow the vascular endothelium pulmonary fibrosis taxanes nausea with or without vomiting infection with group A streptococcus or S. aureus face, neck, arms hepatic candidiasis
headache with or without fever or neurologic abnormalities bleomycin fungal infections Candida, Aspergillus pigmented lesion superficial spreading melanoma acral lentiginous melanoma rapidly growing, often ulcerated or crusted black nodule melanoma melanoma are those with fair complexions, red or blond hair, blue eyes, and freckles, and who tan poorly and sunburn easily superficial (so-called radial) growth superficial spreading melanoma back back and lower leg (from knee to ankle) stage at time of presentation clinical stage I and II atypical mole
40
83 83 83 83 83
most common cancer in the US most significant factor in nonmelanoma skin cancer most common site of tumor development in nonmelanoma skin cancer most frequent metastasis of SCC most frequently employed treatment modalities for BCC
nonmelanoma skin cancer cumulative exposure to sunlight, principally UV-B spectrum sun-exposed areas of the head and neck regional draining lymph nodes electrodesiccation and curettage, excision, cryosurgery, radiation therapy, laser therapy, Mohs micrographic surgery, topical 5-FU, and topical immunomodulators electrodesiccation and curettage head and neck head and neck trunk eyelid face extremity head and neck head and neck alcohol and tobacco combined modality therapy including surgery, radiation and chemo concomitant chemotherapy and radiation therapy adenocarcinoma adenocarcinoma esophagitis etoposide plus cisplatin or carboplatin deterring children from taking up smoking and helping young adults stop GI tract epithelial malignancies of the breast tumor staging S-phase analysis using flow cytometry adjacent and supraclavicular LN, liver, lungs, pleura, and bone liver stomach anterior and posterior walls of the gastric fundus arise from adenomatous polyps aspirin and other NSAIDs liver (initial site of distant spread in 1/3 of recurring colorectal cancer)
83 83 83 83 83 83 83 83 83 83 84 84 84 85 85 85 85 85 86 86 86 87 87 87 87 87 87 87
most commonly employed method by dermatologists for BCC most common location of atypical fibroxanthoma most common location of merkel cell carcinoma most common location of dermatofibrosarcoma protuberans most common location of sebaceous carcinoma most common location of microcystic adnexal carcinoma most common location of porocarcinoma most common location of eccrine carcinoma most common location of angiosarcoma most common risk factors for head and neck cancer in the US most successful treatment in locally or regionally advanced disease most effective approach to locally or regionally advanced disease most frequent histologic subtype most common form of lung cancer arising in lifetime nonsmokers, women, young patients (<45) most common side effect of curative thoracic radiation most widely used chemotherapy combination for SCLC most effective lung cancer prevention 2nd most common noncutaneous site for cancer most common cause of cancer in women most important prognostic variables for breast cancer most accurate measure of tumor growth rate most common spread of esophageal cancer most common site for hematogenous spread of gastric tumor most frequent extranodal site for lymphoma most frequently involved in gastric sarcoma most common site of colorectal cancers most effective class of chemopreventive agents in colon cancer most frequent visceral site of mets of colon cancer
41
87 87 87 87 87 87 87 88 88 88
most most most most most most most most most most
frequent symptoms of benign tumors common benign tumors of GI tract common site of isolated hemangiomas in GI tract frequently occurring small-bowel malignancies common primary cancer of the small bowel commonly affected by anal cancers potent ubiquitous natural chemical carcinogen for HCC common symptom of HCC common physical sign common modes of patient presentation (HCC)
88 88 88 88 89 89 89
most typical presentation of cholangiocarcinoma most frequent site of mets for carcinoma of the ampulla of Vater most effective therapy for carcinoma of the ampulla of Vater 4th most common cancer in men, 13th most common in women feature almost unique to pancreatic cancer most widely used serum marker in pancreatic cancer most clinically relevant distinction to make
pain, obstruction, hemorrhage adenomas, leiomyomas, lipomas, angiomas jejunum adenocarcinomas, lymphomas, carcinoid tumors, leiosarcomas adenocarcinomas middle-aged persons, more frequent in women than men Aspergillus fungus product, aflatoxin B1 abdominal pain (in high-risk areas) hepatomegaly (50-90%) patient with known history of hepatitis, jaundice, or cirrhosis, with an abnormality on UTZ or CT, or rising AFP or DCP (PIVKA2); patient with abnormal liver function test as part of routine exam; radiologic workup for liver transplant for cirrhosis; symptoms of HCC including cachexia, abdominal pain, or fever painless jaundice, often with pruritus, or weight loss, and acholic stools liver pylorus-sparing pancreaticoduodenectomy bladder cancer combination of K-ras and CDKN2A mutations cancer-associated antigen 19-9 (CA 19-9) between patients with disease that may be resected with curative intent and those with advanced disease in whom treatment is palliative low-grade papillary lesions that grow on a central stalk bladder (also benign cystitis 22%, bladder cancer 15%) hematuria, then irritative symptoms painless gross hematuria epithelial ovarian CA (85%) the peripheral zone TRUS between the ages of 20-40 third decade of life necrotic debris serous or mucinous first 3 decades endometrial CA sixth and seventh decade of life; mostly stage I disease
90 90 90 90 90 91 91 92 92 92 93 93 93 93
most common among transitional cell tumors most common source of gross hematuria most common presentation of bladder cancer most common symptom of carcinoma of renal pelvis and ureter most common ovarian cancer most cancers develop in imaging technique most frequently used to assess the primary tumor most frequently affected by testicular cancer nonseminomatous GCTs are most frequent in most frequent finding in pure seminoma most common benign epithelial tumors most frequent occurrence of granulosa and theca cell stromal cell tumors most common female pelvic malignancy most often age of presentation of endometrial CA
42
93 93 94 94 94 94 94 94 94 94 94 94 94 94 94 94 95 96 96 96 96 96 96 97 97 97 97 98 98 98 98 98 98
most common cause of cancer death in women 5th most common cause of cancer death in children most common presentation of soft-tissue sarcoma most common site of mets of soft-tissue sarcoma most important prognostic factor of soft-tissue sarcoma most common malignant tumors of bone 4 most common malignant nonhematopoietic bone tumors most common site of involvement of osteosarcoma most common classification of osteosarcoma most sensitive test to assess response to pre-op chemotherapy in osteosarcoma most common descriptions for osteosarcoma most important prognostic factor for LT survival most chondrosarcomas are most common sites of bone mets most frequent symptom of bone mets most common paraneoplastic endocrine syndromes NONE most common in cancers of lung, head, neck, skin, esophagus, breast, GU tract, multiple myelomas and lymphoma most common cause of humoral hypercalcemia of malignancy most common cause of ectopic ACTH most common thrombotic conditions in patients with cancer most common cancers associated with thromboembolic episodes most important modulator of O2 affinity most types of paraneoplastic encephalitis and encephalomyelitis most SCLC patients do not have tumor most frequently involved in anti-Ri-associated syndromes in paraneoplastic visual syndromes, the most commonly associated tumor is most common anemias most common hypoproliferative anemias one of the most prevalent forms of malnutrition most convenient laboratory test to estimate iron stores most common causes of increased red cell protoporphyrin levels most common diagnostic problems encountered by clinicians
cervical carcinoma sarcomas asymptomatic mass pulmonary parenchyma histologic grade, relationship to fascial planes, size of primary tumor plasma cell tumors osteosarcoma, chondrosarcoma, Ewing's sarcoma, malignant fibrous histiocytoma distal femur, proximal tibia, and proximal humerus 75% are classic category (osteoblastic, chondroblastic, fibroblastic) angiography hypervascular; high-grade response to chemotherapy classic category; and resistant to chemotherapy vertebrae, proximal femur, pelvis, ribs, sternum, proximal humerus, skull pain hypercalcemia; (also hyponatremia and Cushing's syndrome) humoral hypercalcemia of malignancy overproduction of PTHrP SCLC DVT and PE lung, pancreatic, GI, breast, ovarian, and GU, lymphoma, brain tumor pH respond poorly to treatment detectable antineuronal antibodies breast cancer SCLC hypoproliferative anemias anemia associated with acute and chronic inflammation iron deficiency serum ferritin level absolute or relative iron deficiency and lead poisoning distinction between true iron-deficiency anemia and anemia
43
98 98
99 99 99 99 99 99 99 99 99 100
most prominent complication of oral iron therapy most distinguishing feature between true iron-deficiency anemia and the iron-deficient erythropoeisis associated with inflammation most common genetic disorder in the world most common structural hemoglobinopathy most common clinical manifestation of sickle cell anemia most frequent underlying or concomitant conditions in patients with acute chest syndrome most significant advance in the therapy of sickle cell anemia most common forms of beta-thalassemia arise from most common type of alpha-thalassemia in Asians 2 most important acquired hemoglobinopathies most abundant GPI most affected tissues with cobalamin and folate deficiencies
associated with chronic inflammation GI distress serum ferritin values
thalassemias Sickle cell disease painful crises pulmonary infarction and pneumonia introduction of hydroxyurea as a mainstay of therapy for patients with severe symptoms mutations that derange splicing of the mRNA precursor or prematurely terminate translation of the mRNA alpha-thalassemia-2 trait carbon monoxide poisoning and methemoglobinemia glycophorins and band 3 after the marrow, epithelial cell surfaces of the mouth, stomach, and small intestine; and the respiratory, urinary, and female genital tracts autosomally recessive disease called Imerslund syndrome methotrexate trimethoprim presence of bizarre poikilocytes with red cells that appear to have unevenly distributed hemoglobin (hemighosts) and red cells that appear to have had parts of them bitten away (bite cells or blister cells) development of acute renal failure malaria Shiga-toxin producing E. coli Autoimmune hemolytic anemia spleen and liver anemia idiopathic Chloramphenicol
100 100 100 101
most common cause of megaloblastic anemia due to cobalamin deficiency in infancy in Western countries most powerful action against DHF reductase most active against the bacterial enzyme that inhibit DHF reductase most typical feature of G6PD deficiency
101 101 101 101 101 101 101 102
most serious threat from acute HA in adults with G6PD deficiency most frequent infectious cause of hemolytic anemia in endemic areas most frequent cause, in other parts of the world for HA most common form of acquired hemolytic anemia (except where malaria is endemic) most often location of phagocytosis-mediated red cell destruction most consistent blood finding in PNH most common cause of aplastic anemia most infamous culprit of aplastic anemia
44
102 102 102 102 102 102
most most most most most
common preceding infection in aplastic anemia common type of Fanconi's anemia common early symptom of aplastic anemia common hematologic diseases important side effects of chronic cyclosporine treatment
102 103 103 103 103 103 103 104 104 104
most important factors weighing in the decision between transplant and immunosuppression in adults who have a matched family donor most important pretreatment prognostic information in AML most common of the chronic myeloproliferative disorders most common cytogenic abnormality in polycythemia vera most often Polycythemia vera is first recognized by most significant complication of polycythemia vera essential thrombocytosis is most often identified most dramatic neurologic problems in essential thrombocytosis most common in monocytic leukemia most commonly used CR induction regimens most important factors predicting response at relapse
hepatitis Type A bleeding pancytopenia nephrotoxicity, hypertension, seizures, opportunistic infections, especially Pneumocystis carinii increasing age and severity of neutropenia
104 104 104 104 104 105 105 105 105 105 105 105 105
most common physical finding in CML most important prognostic indicators in CML (Sokal index) most important prognostic indicators in Hasford system most common hematologic side effect with Imatinib most common translocations in myeloma most prevalent form of leukemia in western countries most aggressive lymphoid leukemia most common cancer in childhood precursor B cell lymphoblastic leukemia are most commonly of most common lymphoid leukemia when B cell CLL presents as lymphoma the most common abnormality is most common treatments for typical B cell CLL/small lymphocytic lymphoma most MALT lymphoma origin
chromosomal analysis of the leukemic cell Polycythemia vera JAK2 gene located on the short arm of chr 9 and loss of heterozygosity on chr 9p due to uniparental disomy incidental discovery of a high hemoglobin or hematocrit thrombosis due to erythrocytosis incidentally when a platelet count is obtained during the course of a routine medical evaluation migraine-related gum hypertrophy and skin infiltration or nodules consist of combination chemotherapy with cytarabine and an anthracycline length of previous CR, whether initial CR was achieved with 1 or 2 courses of chemothrapy and the type of postremission therapy minimal to moderate splenomegaly percentage of circulating blasts, spleen size, platelet count, age, and cytogenic clonal evolution percentage of circulating blasts, spleen size, platelet count, age, and percentage of eosinophils and basophils myelosuppression t(11;14)(q13;q32) and t(4;14)(p16;q32) CLL Burkitt's leukemia B cell ALL pre-B cell origin B cell CLL/small lymphocytic lymphoma asymptomatic lymphadenopathy chlorambucil or fludarabine, alone of in combination gastric in origin
45
105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 105 106 106 106 106 106 106 106 106 106
most common presentation of mantle cell lymphoma most common presentation for follicular lymphoma one of the malignancies most responsive to chemotherapy and radiotherapy frequently used treatment in follicular lymphoma most common type of non-Hodgkin's lymphoma most common sites of extranodal involvement in diffuse large B cell lymphoma most popular regimen for diffuse large B cell lymphoma in the US most rapidly progressive human tumor precursor T cell lymphoblastic lymphoma is most often found in tropical spastic paraparesis, a manifestation of HTLV-I infection is most common in most peripheral T cell lymphomas are extranodal T/NK cell lymphoma of nasal type/angiocentric lymphoma/lethal midline granuloma most frequently involve most useful to document remission of Hodgkin's disease most popular chemotherapy regimens used in Hodgkin's disease most serious late side effects of Hodgkin's disease most common condition that pathologists and clinicians might confuse with lymphoma is most common symptom in myeloma next most common clinical problem in patients with myeloma most common infections in myeloma patients most frequent pathogens in infections in myeloma patients most common cause of renal failure in myeloma most important differential diagnosis in patients with myeloma single most powerful predictor of survival and can substitute for staging for myeloma patients most widely used method of assessing prognosis in myeloma patients most distinctive symptom of Gamma Heavy Chain Disease (Franklin's Disease) second most important blood group system in pretransfusion testing
palapble lymphadenopathy, frequently accompanied by systemic symptoms new, painless lymphadenopathy follicular lymphoma single-agent chlorambucil or cyclophosphamide or combination chemotherapy with CVP or CHOP diffuse large B cell lymphoma GI tract and bone marrow CHOP plus rituximab Burkitt's lymphoma young men presenting with a large mediastinal mass and pleural effusions individuals who acquire the virus during adulthood from transfusion or sex CD4+ the upper airway PET and gallium scans doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) second malignancies and cardiac injury reactive, atypical lymphoid hyperplasia bone pain susceptibility to bacterial infections pneumonias and pyelonephritis Streptococcus pneumoniae, S. aureus, K. pneumoniae in the lungs and E. coli and other G(-) organisms in the urinary tract hypercalcemia monoclonal gammopathies of uncertain significance (MGUS) serum beta2-microglobulin ISS system palatal edema, resulting from involvement of nodes in Waldeyer's ring, and this may progress to produce respiratory compromise Rh system
106
46
107 107 107 107
108 108 109 109 109 109 109 109
most common cause of incompatibility during pretransfusion screening most frequent reaction associated with transfusion of cellular blood components most frequently recognized antigen in posttransfusion purpura most common in patients treated with total-body irradiation and those who receive glucocorticoid therapy posttransplant for treatment of GVHD most common cause of infection, during period from engraftment to 3months posttransplant most common cause of thrombocytopenia most common noniatrogenic cause of thrombocytopenia most frequent etiologic serotype causing HUS most often cause of thrombocytosis most common inherited bleeding disorder most common type of vWD most commonly affected by acquired vWD
antibodies to Lewis system carbohydraye antigens febrile nonhemolytic transfusion reaction (FNHTR) HPA-1a cataract
109 109 109 110 110 110 110 110 110 110
most commonly affected by major side effect of DDAVP (hyponatremia) most common site of senile purpura most common inherited factor deficiencies most common cause of prolonged aPTT most common isolated abnormal PT most common coagulation disorders (one of the) most common hemophilia A mutations are due to most common bleeding manifestations in the severe form of hemophilia most common causes of DIC most common findings in DIC
Gram positive bacteria, fungi (particularly Aspergillus) and viruses including CMV drug ingestion (nonprescription and herbal remedies) viral and bacterial infections resulting in thrombocytopenia E. coli O157:H7 iron deficiency, inflammation, cancer, or infection, or underlying myeloprolferative process von Willebrand disease type 1 disease patients with underlying lymphoproliferative disorders, including monoclonal gammopathies of undetermined significance (MGUS), multiple myeloma, Waldenstrom's macroglobulinemia very young and very old skin that has been previously damaged by sun exposure hemophilias, x-linked diseases (Hemophilia A or B) hemophilia or FXI deficiency FVII deficiency hemorrhagic diathesis of liver disease, DIC, Vit K deficiency inversion of the intron 22 sequence (40%) recurrent hemarthroses (affecting mainly knees, elbows, ankles, shoulders, hips) bacterial sepsis, malignant disorders (solid tumors of acute promyelocytic leukemia), OB causes bleeding ranging from oozing from venipuncture sites, petechiae, ecchymoses to severe hemorrhage from GI tract or lung or into CNS FDP level prolonged PT values treatment with FFP FVIII arterial thrombosis
110 110 110 110 110
most sensitive test for DIC most common and earliest finding in Vit. K deficient patients most effective way to correct hemostasis in patients with liver failure most common target of antibody formation most common cause of AMI, ischemic stroke, limb gangrene
47
111 111 111 112 112 112 112 112 112 270 270 270 270 270 270 270 270 270 270 270 270 270 270 270 270 270 270 270 270 270 270 270 270 270
2 most common genetic risk factors for venous thrombosis most attractive method for pulmonary embolism most widely applied regimen for pulmonary embolism most abundant receptor on the platelet surface most widely used antiplatelet agent worldwide most common side effects of ticlopidine most common side effect of heparin most specific diagnostic test in HIT likely to be the most important cause of invasive cervical cancer most significant chest radiographic finding in SVC syndrome most reliable view of mediastinal anatomy most patients with pericardial metastasis are most frequent PE in pericardial effusion/tamponade most helpful diagnostic test in pericardial effusion/tamponade most common symptom of intestinal obstruction in patients with advanced cancer most common symptom of urinary obstruction in patients with cancer most common metastatic tumors causing biliary obstruction most common cause of malignant spinal cord compression (MSCC) most common site of MSCC most frequent cancer causing multiple site involvement most common initial symptom in patients with SCC most useful for demonstration of intramedullary pathology cancers that most often metastasize to the brain most common causes of involvement of leptomeninges most common cause of seizures in patients with cancer most commonly affected by hyperleukocytosis or leukostasis most common cause of malignant upper airway obstruction most common paraneoplastic syndrome most common cause of hyponatremia among patients with cancer most often associated with treatment of Burkitt's lymphoma most important steps in management of Tumor lysis syndrome most common agent causing HUS most common types of cancer where HUS occurs most common serious complications of cancer therapy
Factor V Leiden and prothrombin 20210A multi-slice spiral CT of the chest recombinant tissue plasminogen activator r(tPA) GPIIb/IIIa aspirin gastrointestinal bleeding serotonin release assay human papillomavirus widening of superior mediastinum, most commonly right side CT scan asymptomatic pleural effusion, sinus tachycardia, jugular venous distension, hepatomegaly, peripheral edema, cyanosis echocardiography pain flank pain gastric, colon, breast, lung CA lung cancer (also breast, and prostate) thoracic spine (70%) breast and prostate CA localized back pain and tenderness due to involvement of vertebrae by tumor T2-weighted images lung, breast, melanoma melanoma, breast, lung CA, lymphoma, acute leukemia metastatic disease to CNS brain and lung invasion from adjacent primary tumor, most commonly lung cancer (esophageal, thyroid, mediastinal) hypercalcemia SIADH Tumor Lysis syndrome recognition of risk and prevention mitomycin gastric, colorectal, pancreatic, breast CA neutropenia and infection
48
308 309 309 309
310 310 310 310 311 311 311 311 311 312 313 313 313 313 313 313 313 313 313 313 313 313 313 314
most potent and effective APCs in the body most common KIR haplotype in Caucasians most frequent among patients with more severe, erosive disease most common cause of recurrent or chronic sinopulmonary infection, meningitis, and bacteremia in patients with defects in humoral immunity most frequent primary immunodeficiency next most common primary immunodeficiency most frequent clinical problem in patients with x-linked agammaglobulinemia most common pattern of vasculitis in SLE most cases of chronic urticaria are most common sites for urticaria most effective means of controlling allergic diseases most potent drugs available for the relief of established rhinitis, seasonal or perennial most frequent side effect of intranasal glucocorticoids most consistent association for susceptibility to autoimmune disease has been with most commonly affected joints in polyarthritis of SLE most common SLE rash most serious manifestation of SLE most common presentation of nephritis in SLE patients most common manifestation of diffuse CNS lupus most most most most common pulmonary manifestation of SLE frequent cardiac manifestation of SLE commonly affect valve in SLE frequent hematologic manifestation of SLE
dendritic cells contains one activating KIR and 6 inhibitory KIR genes DR4 positive RA-associated alleles pyogenic bacteria such as H. influenzae, S. pneumoniae, S. aureus isolated IgA deficiency common variable immunodeficiency sinopulmonary bacterial infections leukocytoplasmic vasculitis idiopathic extremities and face, with angioedema often being periorbital and in the lips avoidance of exposure to the offending allergen intranasal high-potency glucocorticoids local irritation, with Candida overgrowth being a rare occurrence particular alleles of the MHC hands, wrists, knees photosensitive, slightly raised erythema, occasionally scaly on the face (particularly cheeks and nose; "butterfly" rash) nephritis asymptomatic cognitive dysfunction, including difficulties with memory and reason (also, headache) pleuritis with or without pleural effusion pericarditis mitral or aortic valves, or to embolic events anemia, normochromic normocytic (reflects chronic illness) (also, leukopenia, almost always consists of lymphopenia) ANA (positive in >95%, usually at the onset of symptoms) young individuals with lupus nephritis schistocytes on PBS and elevated serum levels of LDH fourth and fifth decade (80% developing disease between 3550) pain in affected joints, aggravated by movement
most important autoantibodies to detect in SLE most commonly affected by microvascular thrombotic crisis (TTP, HUS) most useful lab test in microvascular thrombotic crisis most frequent onset of RA most common manifestation of established RA
49
314 314
most common antibodies in persons with aggressive disease, with a tendency for developing bone erosions most frequently affected by anti-CCP
presence of anti-CCP individuals with an RA associated HLA-beta1 allele, and in those who smoke cigarettes and may occur before the development of clinical manifestations of RA leflunomide, alone or with methotrexate RHD polyarthritis and fever mitral valve friction rub or small effusion on echo knees, ankles, hips, elbows ASO and anti-DNase B titers heart, lungs, kidneys, and intestinal tract nonspecific interstitial pneumonitis scalp, upper back, and chest the extensor surfaces of the proximal interphalangeal joints reductions in FVC or DLCO early in the course of the disease nonspecific interstitial pneumonitis scleroderma renal crisis (most commonly within 4 years of onset of disease) remain asymptomatic until heart failure or serious arrhythmias occur hands, where contractures at the proximal interphalangeal joints and wrist develop, sometimes accompanied by tendon friction rubs characterized by leathery crepitation that can be heard or palpated upon passive movement terminal phalanges, where it causes loss of the distal tufts (acro-osteolysis) mild normocytic or microcytic anemia due to chronic inflammation anticentromere or antitopoisomerase-I purpura, recurrent urticaria, skin ulcerations, glomerulonephritis, and mononeuritis multiplex Spinal Fracture lower cervical spine
314 314 315 315 315 315 315 316 316 316 316 316 316 316 316 316 316
most frequently employed immunosuppressive agent used to treat patients with RA most common cause of heart disease in children in developing countries most common clinical presentation of ARF most commonly affected valve in ARF most common effect of pericarditis most commonly affected by arthritis of ARF most common serologic tests for ARF obliterative vasculopathy in SSc is a late finding most prominent in the most common histologic pattern in SSc salt and pepper appearance in SSc is most common on breakdown of atrophic skin leads to slow-healing ulceration that are most common at most common abnormalities in SSc with pulmonary involvement in patients with SSc who develop significant ILD, the most rapid progression in lung disease occurs the most common pattern of ILD in SSc is most dreaded complication of SSc with renal involvement most patients with SSc with cardiac involvement would most commonly affected in SSC with joint mobility impairment
316 316 316 317 318 318
bone resorption, a frequent late complication, occurs most commonly in most common anemia in SSc most common SSc-specific autoantibodies most common clinical features of Sjogren's syndrome Ankylosing Spondylitis; most serious complication Ankylosing Spondylitis; most commonly involved spine
50
318 318 318 318 318 318 318 318 318 318 318 319 319 319 319 319 319 319 319
most common occurrence of pseudoarthrosis (fracture through diskovertebral junction and adjacent neural arch) Ank. Spon.; most common extraarticular manifestation Most common cause of back pain other than AS Ank. Spon.; most commonly used measure of disease activity most common indication for surgery in patients with AS most common age range in Reactive Arthritis Most common rheumatic diseases in Africans Most common sites of involvement in Reactive Arthritis Most common site of keratoderma blenorrhagica most common causes of enteropathic arthritis most commonly affected in sarcoidosis most widely accepted pathogenic mechanism of vasculitis most effective therapy for Wegener's granulomatosis second most common manifestation of Churg-Strauss most frequent cause of death in Churg-Strauss in PAN, renal involvement most commonly manifests as most frequently involved in giant cell arteritis Takayasu's arteritis is most prevalent in most commonly affected arteries in Takayasu's arteritis
thoracolumbar spine acute anterior uveitis primarily mechanical and degenerative Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) severe hip joint arthritis 18-40 years old Reactive Arthritis and other peripheral spondyloarthritides joints of lower Ext.; esp. knee, ankle, subtalar, metatarsophalangeal, and toe interphalangeal palms and soles reactive arthritis and IBD-associated arthritis, when etiopathogenically related lung deposition of immune complexes in vessel walls cyclophosphamide mononeuritis multiplex myocardial involvement hypertension, renal insufficiency, or hemorrhage due to microaneurysms temporal artery adolescent girls and young women subclavian, common carotid, abdominal aorta, renal, aortic arch or root, vertebral, celiac axis, superior mesenteric, iliac, pulmonary, coronary CHF, cerebrovascular events, myocardial infarction, aneurysm rupture, or renal failure buttocks and lower extremities IgA skin and joints, while initial complaints related to the guy are less common gastrointestinal involvement idiopathic cutaneous vasculitis postcapillary venules cutaneous vasculitis, arthritis, peripheral neuropathy, and glomerulonephritis arteriole leukocytoclastic venulitis
319 319 319 319 319 319 319 319 319 319
disease-related mortality in Takayasu's arteritis most often occurs from palpable purpura of HSP is most commonly distributed over the antibody class most often seen in the immune complexes of patients with HSP presenting symptoms in adults with HSP most frequently involve most common presenting symptom in children with HSP most commonly encountered vasculitis in clinical practice most commonly involved vessels in idiopathic cutaneous vasculitis most common clinical manifestations of essential mixed cryoglobulinemia most commonly involved vessel in isolated vasculitis of the CNS/primary angiitis of the CNS most common finding in vasculitis associated with malignancies
51
319 320 321 321 321 322 322 322 322 322 322 322 322 322 322 322 322 323
most common form of vasculitis in connective tissue diseases (SLE, RA, inflammatory myositis, relapsing polychondritis) most dreaded complication in Behcet's syndrome most frequent associated rheumatologic disorder with relapsing polychondritis most frequent presenting manifestation of relapsing polychondritis most often involved cranial nerves in relapsing polychondritis most likely etiology of sarcoidosis most most most most most most common presenting symptoms of sarcoidosis common constitutional symptom commonly used method for detecting lung disease sensitive test for an ILD common chronic form of sarcoidosis common ocular manifestation of sarcoidosis
small-vessel venulitis isolated to the skin eye involvement with scarring and bilateral panuveitis systemic vasculitis, RA, SLE, Sjogren's, or Ankylosing spondylitis auricular chondritis cranial nerves II, III, VI, and VII infectious or non-infectious environmental agent that triggers inflammatory response cough and dyspnea (next 2, cutaneous and ocular disease) fatigue chest roentgenogram diffusion of carbon monoxide (DLCO) maculopapular lesions anterior uveitis (next, inflammation at posterior of the eye including retinitis and pars planitis) elevation of alkaline phosphatase, consistent with obstructive pattern lymphopenia hypercalcemia chest roentgenogram FMF arthritis erysipelas-like erythema (most commonly dorsum of the foot, ankle, lower leg, alone or in combination with abdominal pain, pleurisy, or arthritis) renal or rectal biopsy conjunctivitis and/or periorbital edema NOMID (neonatal-onset mutisystem inflammatory disease) transthyretin, transport protein for thyroid hormone and retinol binding protein A-Beta (AB) clonal expansion of plasma cells in the bone marrow that secrete a clonal Ig LC AL amyloidosis Kidneys (80%) fatigue and weight loss
most common abnormality of liver function most common hematologic problem most likely cause of sarcoidosis-associated renal disease most commonly used tool to assess lung involvement in sarcoidosis most frequent among individuals homozygous for the M694V mutation most characteristics cutaneous manifestation of FMF (familial Mediterranean fever) most often used to establish diagnosis of FMF most often ocular inflammation in TNF Receptor-associated Periodic Syndrome (TRAPS) most severe among 3 hereditary febrile syndromes: FCAS, MWS, NOMID most common cause of familial amyloidosis (AF) most common form of localized amyloidosis most frequent cause of AL amyloidosis most common type of systemic amyloidosis in North America most frequently affected organ in amyloidosis common initial symptoms of amyloidosis
323 323 323 323 324 324 324 324 324
52
324 324 324 325 326 326 326 326 326 327 327 327 327
second most common presentation most common cause of nephrotic syndrome in patients with RA (in Finland) most common form of AF is caused by most most most most most most most most most most common form of malalignment in the knee common type of arthritis potent risk factor for OA common cause of chronic knee pain in persons >45 effective exercise regimens in OA popular drug to treat osteoarthritic pain often affected by gout frequent early manifestation of gout commonly used hypouricemic agent serious side effects of allopurinol
cardiac symptoms (40%) AA amyloidosis mutation of the abundant plasma protein transthyretin (TTR, also known as prealbumin) genu varum (bowlegs) or genu valgum (knock knees) osteoarthritis age OA aerobic and/or resistance training NSAIDs middle-aged to elderly men and postmenopausal women acute arthritis xanthine oxidase inhibitor skin rash with progression to life-threatening toxic epidermal necrolysis, systemic vasculitis, bone marrow suppression, granulomatous hepatitis, renal failure elderly elderly knee bursae and tendons in and/or around the knees, shoulders, hips, and fingers S. aureus; N. gonorrhoeae hematogenous N. gonorrhoeae S. aureus S. aureus single joint, mostly knee (also hip, shoulder, wrist, elbow) patients with RA syndrome of fever, chills, rash, articular symptoms chronic granulomatous monarthritis positive with granulomatous inflammation young men 30-50 depression, anxiety, somatization, hypochondriasis
327 327 327 327 328 328 328 328 328 328 328 328 328 328 328 329 329
most commonly affected by CPPD crystal deposition in articular tissues most commonly affected by spinal stenosis most frequently affected joint in CPPD arthropathy most common sites of apatite deposition most common causes of infectious arthritis most common route in all age groups for infectious arthritis most commonly implicated organism in inf. Arthritis in young adults and adolescents most common nongonococcal isolate in adults of all ages most common organism in infections after surgical or penetrating injuries most common presentation of nongonococcal bacterial arthritis most common population with polyarticular infection most common manifestation of disseminated Gonococcal infection most common presentation of mycobacterial arthritis most common result of synovial tissue culture in mycobacterial arthritis most commonly affected by Reiter's syndrome most patients present with fibromyalgia between the ages most common psychiatric diagnoses associated with fibromyalgia
53
330 330 330 330 330 330 330 330 330 330 330 330 330 330 330 330 330 330 330 330 330 331 331 331 331 e12 e12 e13 e13
most often affected by acromegaly most commonly affected by arthropathy of acromegaly most commonly affected by hemarthrosis of hemophilic arthropathy most commonly affected joints in sickle cell crisis most common isolate in osteomyelitis in sickle cell disease patients most likely mechanism for avascular necrosis most frequent cause of neuropathic joint disease most commonly affected in tabes dorsalis almost always a feature of Hypertrophic osteoarthropathy most common intrathoracic malignancies with hypertrophic osteoarthropathy most frequently affected joints in HOA most often involved in myofascial pain most common age of onset of pigmented villonodular synovitis most commonly affected joint in pigmented villonodular synovitis most commonly affected in synovial chondromatosis most commonly affected by hemangiomas most common occurrence of lipomas most most most most most most most commonly affected population in synovial sarcoma common site of synovial sarcoma common site of visceral metastasis in synovial sarcoma common form of bursitis often affected tendon among the rotator cuff tendons often affected tendon by calcific tendinitis often affected by lateral epicondylitis
middle-aged persons knees, shoulders, hips, hands knees, ankles, elbows, shoulders, hips knees and elbows Salmonella typhimurium bone infarction DM knees, hips, and ankles clubbing bronchogenic carcinoma and pleural tumors ankles, wrists, knees posterior neck, low back, shoulders, chest third decade knee (also, hips, ankles, calcaneocuboid joints, elbows, and small joints of the fingers and toes) knee (also hip, elbow, shoulder) knee knee (from subsynovial fat on either side of the patellar tendon) young adults, more common in men knee (foot, ankle, elbow, shoulder) lung subacromial bursitis supraspinatus tendon supraspinatus tendon activities like tennis, pulling weeds, carrying suitcases, using screwdriver activities like swinging a golf club, throwing a baseball; workrelated repetitive activities Thymoma (accounting for ~40% of all mediastinal masses) fifth and sixth decades growth hormone deficiency hypothyroidism, followed by Graves' disease, thyroiditis, and cancer
most often affected by medial epicondylitis most common cause of an anterior mediastinal mass in adults thymomas are most common in most common hormone deficiency (in cancers??) most common abnormality in patients who received radiation therapy to the neck
32 HEMATOLOGY, ONCOLOGY, ALLERGY, RHEUMATOLOGY, AND DERMATOLOGY pathognomonic for Wegener's granulomatosis strawberry gums, red-purplish, granular gingivitis
54
32 53 53 54 55 55 55 55 55 55 56 59 77 77 79 80 81 82 82 82 83 84 85
pathognomonic for erythema multiforme minor and major (SJS) hallmark of acne vulgaris mainstay for lichen planus treatment pathognomonic signs of the three major autoimmune connective tissue disease-LE, scleroderma, and dermatomyositis heralds development of distinct clinical lesions 12-24 hrs later Hallmark of pemphigoid gestationis (herpes gestationis) mainstay for Pemphigus vulgaris mainstay for bullous pemphigoid mainstay for Dermatitis herpetiformis pathognomonic for dermatomyositis mainstay for therapy of urticaria or angioedema hallmark of moderate and sever factor VIII and IX deficiency, clotting factor deficiencies second leading cause of death behind heart disease Drug of choice for Effusion in patients with cancer hallmark for the presence of a tumor-suppressor gene at a particular locus hallmark of cancer hallmark of apoptosis definitive diagnosis of brain mass gold standard for lung infection diagnostics hemoptysis as ominous sign in Aspergillus infection earliest metastases of melanomas definitive staging procedure in patients with head and neck masses cornerstone of symptomatic management of metastatic disease in disseminated Non small cell lung CA leading cause of cancer death in both men and women mainstay of treatment of Gallbladder CA fourth leading cause of cancer-related death definitive treatment of the bladder CA gold standard for treatment of prostate CA with mets second leading cause of cancer deaths in men pathognomonic for GCT of all histologic types pathognomonic for testicular malignancy
the "iris" or "target" lesion on the skin comedone (whitehead or blackhead) topical glucocorticoids periungual telangiectasias onset of local symptoms (pruritus) in dermatitis herpetiformis linear deposits of C3 in epidermal basement membrane systemic glucocorticoids systemic glucocorticoids dapsone Gottron's sign/papules; violaceous, flat-topped papules over the dorsal interphalangeal joints epinephrine (in severe cases) Spontaneous hemarthroses cancer Doxycycline Loss of heterozygosity in tumor DNA deregulation of molecular mechanisms controlling cell cycle progression DNA fragmentation biopsy open-lung biopsy often to inguinal lymph nodes endoscopic examination standard medical management, judicious use of pain medications, the appropriate use of radiotherapy, outpatient chemotherapy primary carcinoma of the lung surgical, either simple or radical cholecystectomy for stages I or II, respectively pancreatic cancer radical cystectomy or radiation therapy surgical orchiectomy prostate cancer isochromosome of short arm of chr.12 painless testicular mass
85 88 89 90 91 91 92 92
55
93 94 94 96 99 99 99 101 101 101 101 104 104 106
leading cause of death from gynecologic cancer in the US mainstay for Ewing's primitive neuroectodermal tumors mainstay for chondrosarcoma definitive treatment for eosinophilia mainstay for therapy for sickle cell anemia reduction in arterial oxygen saturation is ominous because it promotes sickling on a massive scale onset of heart failure in hemosiderosis is ominous, often presaging death within a year definitive diagnosis of Hereditary Spherocytosis definitive diagnosis of glycolytic enzymopathies gold standard for proving life span of red cells is reduced gold standard for definitive diagnosis of PNH cytogenic hallmark of Chronic myeloid leukemia leading cause of therapy-associated AML earliest manifestation of renal failure in multiple myeloma patients may herald life-threatening bleeding mainstay for treatment of ITP mainstay for treatment of type 1 vWD earliest finding in Vitamin K second leading cause of death in hemophilia patients exposed to older clotting factor concentrates; major cause of morbidity gold standard for DVT (classic gold standard) gold standard for pulmonary embolism (classic gold standard) mainstay for prevention and treatment of venous thromboembolism earliest radiologic finding of vertebral tumor often heralds autonomic failure in men and may precede other symptoms by years Hallmark of hematopoietic growth factor (type 1) receptor family Hallmark of hematopoietic growth factor (type 1) receptor family
epithelial ovarian cancer (among the three: germ cells, stromal cells and epithelial cells) chemotherapy; often before surgery surgical resection of primary and recurrent tumors, including pulmonary mets directed at the underlying malignancy hydroxyurea
109 109 109 110 110 111 111 112 270 270 308 308
molecular studies demonstrating mutation in one of the genes underlying HS demonstrating the deficiency of an individual enzyme by quantitative assays red cell survival study flow cytometry t(9;22)(q34;q11.2) Anticancer drugs adult Fanconi syndrome, a type 2 proximal RTA) with loss of glucose and amino acids, as well as defects in the ability of the kidney to acidify and concentrate urine wet purpura (blood blisters in the mouth) and retinal hemorrhages plasma exchange DDAVP or desmopressin prolongation of PT values Hepatitis C virus (HCV) infection contrast venography; now replaced by ultrasonography pulmonary angiography; now replaced by assessment of clinical probability, D-dimer; spiral CT of chest anticoagulants erosion of the pedicles ("winking owl" sign) impotence, although not specific for autonomic failure extracellular regions of each receptor contain two conserved motifs 1. located at the N terminus, rich in cysteine residues
56
308
Hallmark of hematopoietic growth factor (type 1) receptor family therapeutic cornerstone for antibody-deficient patients who have recurrent infections and who are deficient in IgG hallmark of anaphylactic reaction Hallmark of systemic autoimmune diseases herald a flare, particularly nephritis or vasculitis mainstay in patients with fatigue, pain and autoantibodies of SLE, but without major organ involvement, mainstay of treatment for any inflammatory life-threatening manifestations of SLE definitive diagnosis of Rheumatoid arthritis earliest lesions in rheumatoid sinovitis earliest event in RA
310 311 312 313 313 313
2. located at the C terminus proximal to the transmembrane region and comprises 5 amino acid residues, tryptophan-serineC-tryptophan-serine replacement therapy with human immunoglobulin onset of some manifestation within seconds to minutes after introduction of the antigen associated relevant autoimmune manifestations increase in quantities of anti-dsDNA analgesics and antimalarials systemic glucocorticoids (0.5-2mg/kg per day PO or 1000mg of methylprednisolone sodium succinate IV daily for 3 days followed by 0.5-1mg/kg of daily prednisone or equivalent predominantly on characteristic clinical features and the exclusion of other inflammatory processes microvascular injury and an increase in the number of synovial lining cells nonspecific inflammatory response initiated by an unknown stimulus and characterized by accumulation of macrophages and other mononuclear cells within the sublining layer of the synovium potential of the synovial inflammation to cause cartilage damage and bone erosions and changes in joint integrity aspirin Penicillin valvular damage primary prophylaxis secondary prevention vasculopathy, cellular and humoral immunity, and progressive visceral and vascular fibrosis in multiple organs autoimmunity and altered endothelial cell function widespread obliterative vasculopathy and failure to repair damaged vessels widespread obliterative vasculopathy of small arteries and arterioles and fibrosis in the skin and internal organs skin thickening pulmonary involvement sacroiliitis blurring of the cortical margins of the subchondral bone,
314 314 314
314 315 315 315 315 315 316 316 316 316 316 316 318 318
hallmark of rheumatoid arthritis Drug of choice for Arthritis, arthralgia, and fever in ARF Drug of choice for Acute Rheumatic fever, LT secondary prophylaxis hallmark of rheumatic carditis mainstay for primary prevention for ARF mainstay for controlling ARF and RHD cardinal features of systemic sclerosis earliest manifestations of systemic sclerosis hallmark of Systemic Sclerosis hallmark of Systemic Sclerosis Clinical hallmark of Systemic sclerosis leading cause of death of patients with systemic sclerosis earliest manifestations of AS earliest changes by standard radiography in AS
57
318 318 319 319
mainstay for pharmacologic therapy for Ankylosing Spondylitis pathognomonic for Whipple's disease definitive diagnosis of vasculitis earliest form of Wegener's granulomatosis
319
Hallmark of idiopathic cutaneous vasculitis
319 320 321 322 322 324 324 324 325
325 326 326 326 326 326 326 327 327 328
mainstay of treatment of Cogan's syndrome sine qua non for diagnosis of Behcets syndrome earliest abnormality of hyaline and elastic cartilage noted histologically Drug of choice for Sarcoidosis hallmark of sarcoidosis gold standard for diagnosis of ATTR and other AF mutation pathognomonic for AL amyloidosis pathognomonic for ATTR amyloidosis may herald a more serious condition that requires further evaluation or laboratory testing to establish a diagnosis or document the extent and nature of the pathologic process pathognomonic for amyloidosis cardinal elements of the treatment of OA earliest changes of OA occur in radiographic hallmark of osteoarthritis leading cause of disability in the elderly mainstay for treatment of OA sine qua non of OA definitive diagnosis of CPPD mainstay for treatment during acute attack of gout definitive diagnosis of an infectious process (arthritis)
followed by erosions and sclerosis NSAIDs oculomasticatory and oculofacial-skeletal myorhythmia, accompanied by supranuclear vertical gaze palsy biopsy of involved tissue renal involvement is characterized by focal and segmental glomerulitis that may evolve into a rapidly progressive crescentic glomerulonephritis predominance of skin involvement, palpable purpura, macules, papules, vesicles, bullae, subcutaneous nodules, ulcers, and recurrent or chronic urticaria glucocorticoids recurrent aphthous ulcerations focal or diffuse loss of basophilic staining indicating depletion of proteoglycan from the cartilage matrix Glucocorticoids granuloma DNA sequencing macroglossia, with an enlarged, indented, or immobile tongue vitreous opacities caused by amyloid deposits specific musculoskeletal symptoms or their persistence
definitive diagnosis of PNH
soft tissue findings of macroglossia and periorbital ecchymoses improve the functioning of muscles surrounding the joint cartilage osteophytes osteoarthritis altering loading across the painful joint and improving function of joint protectors hyaline articular cartilage loss, present in a focal and initially non-uniform manner demonstration of typical crystals in synovial fluid or articular tissue administration of anti-inflammatory drugs such as NSAIDs, colchicine, or glucocorticoids relies on identification of the pathogen in stained smears of synovial fluid, isolation of the pathogen from cultures of synovial fluid and blood, or detection of microbial nucleic acids and proteins by PCR-based assays and immunologic techniques based on demonstration that a substantial proportion of the
58
patient's red cells
59

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19 19 19 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 31 113 114 115 115 115 115 115 115 116

117 117 117 117 117

most most most most

117 117 117

119 120 120 120 121

124 124 124 125 126 127 127 127

HSV Campylobacter or Shigella spp.

127 127 127

known most important interaction involving tetracyclines

most most most most

141 141 141 141 141 142 142

146 146 146

151 151 151 151 152 152

156 157 157 157 157 157 157 157 157

158 158 158 158 158 158 159 159 159

159 159 159

most common serologic test for confirmation of the diagnosis

most most most most most most most

180 180 180 180 180 180

most common atypical mycobacterial infection in HIV

182 182 182 182 182 182 182

most most most most

197 197 197 197 197 197 197

most useful in diagnosis of coma most common categories of cerebrovascular diseases

214 214 214 214

214 214 215

215 215 215 215 215 216 216 216

117 117 117 117 119 119 121

129 129 130 130 130

143 145 145 145 145 146 146

147 148 150 150 150 150

152 154 156 156 156 158 158 158 158

179 182 182 182

182 182 182 182 182 182

182 182 182 182 182 182

183 184 185 185 185 185

190 191 191 192 194 194 197 197

hallmark of chronic cavitary pulmonary aspergillosis

197 198 198 199 199 199 199 200 200

202 202 202 202

211 211 211 212 212 212

212 212 213 213 213 213

214 215 215 e14 e17 e35 e37 e37

associated with chronic inflammation GI distress serum ferritin values

100 100 100 101

101 101 101 101 101 101 101 102

102 102 102 102 102 102

most most most most most

107 107 107 107

108 108 109 109 109 109 109 109

110 110 110 110 110

308 309 309 309

316 316 316 317 318 318

323 323 323 323 324 324 324 324 324

93 94 94 96 99 99 99 101 101 101 101 104 104 106

310 311 312 313 313 313

314 314 314

318 318 319 319

Hallmark of idiopathic cutaneous vasculitis

319 320 321 322 322 324 324 324 325

definitive diagnosis of PNH

patient's red cells

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