14

Question 1

presentation c.diff

Answer 1

mild diarrhoea -> severe colitis

• diarrhoea
• fever
• loss of appetite
• nausea
• abdo pain
• dehydration

Question 2

brucellosis

Answer 2

used to be an occupational hazard of farmers, vets etc.

organisms were excreted in milk, placenta and aborted foetus

Question 3

presentation Zika virus

Answer 3

- typically asymptomatic 
or 
- headache 
- rash
- fever
- malaise
- conjunctivitis 
- joint pains 

• can cause microcephaly in unborn children

Question 4

presentation carbuncles

Answer 4

located @ back of neck/ posterior trunk/ thigh
multiseptated abscesses
purulent material
constitutional symptoms common

Question 5

if a traveller returned with hepatomegaly consider

Answer 5

• hepatitis
• malaria
• typhoid
• amoebic abscess

Question 6

most common organism erysipelas

Answer 6

strep pyogenes (2/3)
and
staph aureus (1/3)

Question 7

describe erysipelas

Answer 7

infection of upper dermis

Question 8

management crypotoccus and cryptococcosis infections

Answer 8

AmB and flucytosine

Question 9

management cryptococcal meningitis

Answer 9

AmB + flucytosine
followed by
fluconazole maintenance

Question 10

predisposing factors pyomyositis

Answer 10

• diabetes
• HIV/ immunosuppressed
• PWIDs
• rheumatological disease
• malignancy
• liver cirrhosis

Question 11

brucellosis investigation precautions

Answer 11

warn lab sample is coming because can spread in lab

Question 12

commonest pyomyositis organism

Answer 12

staph aureus

Question 13

what happens in acute disease phase of schistosomiasis infection

Answer 13

• 6-8 weeks

- egg deposited in bowel or bladder

Question 14

gram positive cocci that form grape-like clusters on a gram stain

Answer 14

staph aureus

Question 15

is a farmer with fever and protracted flu-like symptoms more likely to have leptospirosis or brucellosis

Answer 15

leptospirosis

Question 16

predisposing conditions necrotising fasciitis

Answer 16

• DM
• surgery
• trauma
• Peripheral vascular disease

Question 17

management pymomyositis

Answer 17

drainage of abscess with antibiotic cover (normally flucloxacillin or vancomycin)

Question 18

presentation pyomyositis

Answer 18

• high spiky fever

- pain

Question 19

sepsis presentation

Answer 19

• fever >38
• hypothermia <36
• tachpnoea
• tachycardia
• riggers/ chills
• N+V
• disturbed consciousness
• low urine output
• hypovolaemic
• leucopenia
• high CRP
• high procalcitonin
• arterial hypotension
• raised creatinine
• coagulation abnormalities
• peristalsis stoops
• hyperbilirubinaemia
• high lactate
• reduced cap refill
• arterial hypoxaemia

Question 20

presentation necrotising fasciitis

Answer 20

RAPID ONSET
- suddenly what appears like cellulitis but they're in extreme pain - need opiates
- redness comes in a few hours
- patient unwell, fever, tachycardia
- haemorrhage bullae
- skin necrosis 
- crepitus
- fever
- hypotension
- tachycardia
- delirium
- multiorgan failure
sequential development of:
- erythema
- extensive oedema
- severe unremitting pain

anaesthesia @ site of infection

Question 21

current again influenza outbreak strains

Answer 21

Egypt - H7N9

China - H5N1

Question 22

when do HEV symptoms occur

Answer 22

> 40 days incubation