Internal Medicine EOR_
Infectious Disease (Smarty
PANCE)
Exam
2026
Questions and Answers
(A+ Grade Guarantee)
, Paralytic illness caused by Clostridium botulinum toxin - blocks
acetylcholine release at neuromuscular junction causing flaccid paralysis
What is botulism?
What are the three main types of Foodborne (preformed toxin in contaminated food), infant (spore
botulism? ingestion), wound (spore contamination of wounds)
Home-canned foods, smoked/fermented fish, honey (in infants),
What foods are commonly improperly preserved foods
associated with foodborne botulism?
What is the classic triad of botulism Descending flaccid paralysis, bulbar symptoms (diplopia, dysarthria,
symptoms? dysphagia), absence of fever
What are the characteristic "4 D's" of Diplopia, Dysarthria, Dysphagia, Descending paralysis
botulism?
Clinical diagnosis confirmed by mouse bioassay or detection of toxin in
serum/stool/food, EMG shows decreased CMAP amplitude
How is botulism diagnosed?
Botulism antitoxin (equine heptavalent for adults, BabyBIG for infants),
What is the treatment for botulism? supportive care with mechanical ventilation if needed
What is the timeframe for botulism Most effective within 24 hours of symptom onset - does not reverse
antitoxin effectiveness? existing paralysis but halts progression
Fungal infection caused by Candida species (most commonly C. albicans)
What is candidiasis? - can be superficial or invasive/systemic
What are the major risk factors for Immunosuppression, broad-spectrum antibiotics, central venous catheters,
invasive candidiasis? TPN, chemotherapy, prolonged ICU stay
What is oropharyngeal candidiasis White plaques on oral mucosa/tongue that scrape off leaving
(thrush)? erythematous base - common in HIV, inhaled steroids, antibiotics
What are the first-line treatments for Clotrimazole troches or nystatin suspension for mild cases; fluconazole
oropharyngeal candidiasis? 100-200mg daily for moderate-severe
Candida infection of esophagus causing odynophagia, dysphagia,
What is esophageal candidiasis and
retrosternal pain - AIDS-defining illness if CD4 <100
its presentation?
Diagnosis: endoscopy with biopsy; Treatment: fluconazole 200-400mg
How is esophageal candidiasis
daily x 14-21 days (first-line)
diagnosed and treated?
Thick white "cottage cheese" discharge, vulvar pruritus, erythema,
What is vulvovaginal candidiasis
dyspareunia - NOT sexually transmitted
presentation?
Topical azoles (miconazole, clotrimazole) x 1-7 days OR single-dose
What is the treatment for fluconazole 150mg PO
uncomplicated vulvovaginal
candidiasis?
Candida species in blood cultures - treat with echinocandin (micafungin,
What defines candidemia and its
caspofungin) or fluconazole, remove central lines
treatment?
2026
, Obligate intracellular bacteria causing most common bacterial STI in US
What is Chlamydia trachomatis? - often asymptomatic (70% women, 50% men)
Often asymptomatic, mucopurulent cervicitis, urethritis, PID (pelvic
What are the clinical manifestations inflammatory disease), dysuria, intermenstrual bleeding
of chlamydia in women?
Urethritis (dysuria, urethral discharge), epididymitis, proctitis, reactive
What are the clinical manifestations arthritis
of chlamydia in men?
Nucleic acid amplification test (NAAT) - can use urine, urethral, cervical,
What is the gold standard diagnostic
or rectal swabs
test for chlamydia?
What is the first-line treatment for Doxycycline 100mg PO BID x 7 days (preferred) OR Azithromycin 1g
uncomplicated chlamydia? PO single dose
What is lymphogranuloma venereum Chlamydia trachomatis serovars L1-L3 causing painless genital ulcer →
(LGV)? painful inguinal lymphadenopathy → proctocolitis
What are the complications of Pelvic inflammatory disease (PID), ectopic pregnancy, tubal infertility,
untreated chlamydia in women? chronic pelvic pain, Fitz-Hugh-Curtis syndrome
Perihepatitis associated with PID (chlamydia or gonorrhea) causing right
What is Fitz-Hugh-Curtis syndrome? upper quadrant pain - "violin string" adhesions
Severe diarrheal illness caused by Vibrio cholerae toxin - transmitted via
What is cholera? contaminated water/food in endemic areas
What is the characteristic Profuse watery diarrhea ("rice-water stools"), vomiting, rapid
presentation of cholera? dehydration, hypovolemic shock, no fever
What is the mechanism of cholera Increases cAMP in intestinal epithelial cells causing massive secretion of
toxin? water and electrolytes into intestinal lumen
How much fluid can be lost in severe Up to 1 liter per hour - can lead to severe dehydration and death within
cholera? hours if untreated
What is the cornerstone of cholera Aggressive fluid repletion - oral rehydration solution (ORS) for mild-
treatment? moderate, IV fluids for severe cases
What antibiotics shorten cholera Doxycycline 300mg single dose OR Azithromycin 1g single dose -
duration? reduces duration and transmission
What electrolyte abnormalities are Hypokalemia, metabolic acidosis, hyponatremia from massive fluid and
common in cholera? electrolyte losses
Encapsulated yeast causing opportunistic infection - most common fungal
What is Cryptococcus neoformans? CNS infection in AIDS patients
What are the major risk factors for Advanced HIV/AIDS (CD4 <100), organ transplantation, chronic
cryptococcal infection? corticosteroid use, sarcoidosis, cirrhosis
Cryptococcal meningoencephalitis - subacute headache, fever, altered
What is the most common
mental status, minimal meningeal signs
presentation of cryptococcosis?
2026
Infectious Disease (Smarty
PANCE)
Exam
2026
Questions and Answers
(A+ Grade Guarantee)
, Paralytic illness caused by Clostridium botulinum toxin - blocks
acetylcholine release at neuromuscular junction causing flaccid paralysis
What is botulism?
What are the three main types of Foodborne (preformed toxin in contaminated food), infant (spore
botulism? ingestion), wound (spore contamination of wounds)
Home-canned foods, smoked/fermented fish, honey (in infants),
What foods are commonly improperly preserved foods
associated with foodborne botulism?
What is the classic triad of botulism Descending flaccid paralysis, bulbar symptoms (diplopia, dysarthria,
symptoms? dysphagia), absence of fever
What are the characteristic "4 D's" of Diplopia, Dysarthria, Dysphagia, Descending paralysis
botulism?
Clinical diagnosis confirmed by mouse bioassay or detection of toxin in
serum/stool/food, EMG shows decreased CMAP amplitude
How is botulism diagnosed?
Botulism antitoxin (equine heptavalent for adults, BabyBIG for infants),
What is the treatment for botulism? supportive care with mechanical ventilation if needed
What is the timeframe for botulism Most effective within 24 hours of symptom onset - does not reverse
antitoxin effectiveness? existing paralysis but halts progression
Fungal infection caused by Candida species (most commonly C. albicans)
What is candidiasis? - can be superficial or invasive/systemic
What are the major risk factors for Immunosuppression, broad-spectrum antibiotics, central venous catheters,
invasive candidiasis? TPN, chemotherapy, prolonged ICU stay
What is oropharyngeal candidiasis White plaques on oral mucosa/tongue that scrape off leaving
(thrush)? erythematous base - common in HIV, inhaled steroids, antibiotics
What are the first-line treatments for Clotrimazole troches or nystatin suspension for mild cases; fluconazole
oropharyngeal candidiasis? 100-200mg daily for moderate-severe
Candida infection of esophagus causing odynophagia, dysphagia,
What is esophageal candidiasis and
retrosternal pain - AIDS-defining illness if CD4 <100
its presentation?
Diagnosis: endoscopy with biopsy; Treatment: fluconazole 200-400mg
How is esophageal candidiasis
daily x 14-21 days (first-line)
diagnosed and treated?
Thick white "cottage cheese" discharge, vulvar pruritus, erythema,
What is vulvovaginal candidiasis
dyspareunia - NOT sexually transmitted
presentation?
Topical azoles (miconazole, clotrimazole) x 1-7 days OR single-dose
What is the treatment for fluconazole 150mg PO
uncomplicated vulvovaginal
candidiasis?
Candida species in blood cultures - treat with echinocandin (micafungin,
What defines candidemia and its
caspofungin) or fluconazole, remove central lines
treatment?
2026
, Obligate intracellular bacteria causing most common bacterial STI in US
What is Chlamydia trachomatis? - often asymptomatic (70% women, 50% men)
Often asymptomatic, mucopurulent cervicitis, urethritis, PID (pelvic
What are the clinical manifestations inflammatory disease), dysuria, intermenstrual bleeding
of chlamydia in women?
Urethritis (dysuria, urethral discharge), epididymitis, proctitis, reactive
What are the clinical manifestations arthritis
of chlamydia in men?
Nucleic acid amplification test (NAAT) - can use urine, urethral, cervical,
What is the gold standard diagnostic
or rectal swabs
test for chlamydia?
What is the first-line treatment for Doxycycline 100mg PO BID x 7 days (preferred) OR Azithromycin 1g
uncomplicated chlamydia? PO single dose
What is lymphogranuloma venereum Chlamydia trachomatis serovars L1-L3 causing painless genital ulcer →
(LGV)? painful inguinal lymphadenopathy → proctocolitis
What are the complications of Pelvic inflammatory disease (PID), ectopic pregnancy, tubal infertility,
untreated chlamydia in women? chronic pelvic pain, Fitz-Hugh-Curtis syndrome
Perihepatitis associated with PID (chlamydia or gonorrhea) causing right
What is Fitz-Hugh-Curtis syndrome? upper quadrant pain - "violin string" adhesions
Severe diarrheal illness caused by Vibrio cholerae toxin - transmitted via
What is cholera? contaminated water/food in endemic areas
What is the characteristic Profuse watery diarrhea ("rice-water stools"), vomiting, rapid
presentation of cholera? dehydration, hypovolemic shock, no fever
What is the mechanism of cholera Increases cAMP in intestinal epithelial cells causing massive secretion of
toxin? water and electrolytes into intestinal lumen
How much fluid can be lost in severe Up to 1 liter per hour - can lead to severe dehydration and death within
cholera? hours if untreated
What is the cornerstone of cholera Aggressive fluid repletion - oral rehydration solution (ORS) for mild-
treatment? moderate, IV fluids for severe cases
What antibiotics shorten cholera Doxycycline 300mg single dose OR Azithromycin 1g single dose -
duration? reduces duration and transmission
What electrolyte abnormalities are Hypokalemia, metabolic acidosis, hyponatremia from massive fluid and
common in cholera? electrolyte losses
Encapsulated yeast causing opportunistic infection - most common fungal
What is Cryptococcus neoformans? CNS infection in AIDS patients
What are the major risk factors for Advanced HIV/AIDS (CD4 <100), organ transplantation, chronic
cryptococcal infection? corticosteroid use, sarcoidosis, cirrhosis
Cryptococcal meningoencephalitis - subacute headache, fever, altered
What is the most common
mental status, minimal meningeal signs
presentation of cryptococcosis?
2026
