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3.1 questions Flashcards

1
Q

Normal Range for Fasting Glucose

A

3-5.4 mmol/L

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2
Q

Normal Range for random glucose

A

3-7.7 mmol/L

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3
Q

Normal HbA1c level

A

4.7-6.1%

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4
Q

Normal pulse in Adults

A

60-100 BPM

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5
Q

Normal Resp Rate in adults

A

14

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6
Q

Normal BP in adults

A

<130/85

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7
Q

Fever

A

Oral > 37.2

Rectal >37.7

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8
Q

DM diagonostic criteria

A

Random 1 reading if symptomatic

2 reading if asymptomatic >11.1 mmol/L

Fasting >7.0 mmol/L

or 2 values of oral GGT

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9
Q

Hypokalemia

A

< 3.5 mmol/L

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10
Q

Serum bilirubin in Jaundice

A

> 19 umol/L

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11
Q

Hyperkalemia

A

>5 mmol/L

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12
Q

Excessuve alcohol drinking

A

Males > 4 /day

Females > 2 /day

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13
Q

Anaemia - Hb

A

Males < 130 g/L

Females < 115 g/L

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14
Q

Classificaton of BMI

A

Normal = 20-25

Overweight > 25

Obesity > 30

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15
Q

Important General Questions in history

A

Fatigue, tiredness or malaise

Fever, sweating, shakes

Weight change esp loss

Pain or discomfort

Any unusual lumps or numps

Any unusual bleeding

Skin problem - rash or itching

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16
Q

Most common cause (bacterial) of traveller’s diarrhoea

A

Escherichia coli

Campylobacter species

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17
Q

Travel infections transmitted by mosquitoes

A

Malaria

Yellow fever

Rift valley fever

Japanese B encephalitis

Chikungunya

Dengue fever

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18
Q

Onset of travellers diarrhoea

A

6-12 hours afters infected food or water

most common cause = water or ice, unclean utensil and so on

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19
Q

Traveller’s Diarrhoea

A

6-12 hours after ingestion

Last 2-3 days

Symptoms = abdominal cramps, frequent diarrhoea with loose watery stoools and possible vomiting

Very severe with passing of blood or mucus = shigella sp . camplobacter sp and amoebiasis

otherwise think E.Coli, Campulobacter sp, Shingella sp and Slamonella

Treatment = Rehydration

with antimotility Ioperamide (Imodium) or antibiotics (if moderate-severe) like Norfloxaxine or azithromycin

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20
Q

Main 2 cause of presistent diarrhoea

A

Amoebiasis or giardiasis

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21
Q

Species that cause Malaria

A

Plamodium Vivax and Plasmodium Ovale

Plasmodium Falciparum = Malignant

Plasmodium Malariae

Plasmodium Kowlesi

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22
Q

Presentation of Malaria

A

Always think in any returned traveller

Fever + Chills + headache

  • High fevers
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23
Q

Malaria Prophylaxsis drugs

A

Chloroquinine - approved for pregnancy, aggravates psoriasis, causes retinopathy

Doxycycline - Photosensitivity reactions

Mefloquine - cause dizziness, fuzzy head, blurred vision and neuropsychiatric

Atovaquone + Proquanil - avoid in pregnancu, kidney impairement. Causes Gi upsetm headache, dizziness, myalgia

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24
Q

Compulsary two vaccination for visiting ‘high risk’ areas

A

Yellow Fever

Meningococcus

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25
Q

Yellow Fever

Symptoms, Diagnosis, treamtent

A

Viral infection spread by Aedes Mosquitoes

  • Symptoms - Fever + Bradycardia + Jaundice + bleeding
  • Flu like-symptoms with relative bradycardia (THINK YELLOW FEVER IN BRADYCARDIA) =
    • Bradycardia = Faget’s sign
  • Albuminuria also present
  • Bleeding = from the gums and haematemesis

Diagnosis = ELISA testing

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26
Q

Meningococcal infection

Risk

A

esp risk for trekking through nepal + Haj pilgrimage

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27
Q

Hepatitis A

Risk, prevention

A

Rural and developing area

Declining level of antibodies to Hep A and adults are at special risk

A blood test to Hep A antibodies

Hepatitis A = 2 injections vaccine (given with Hep B usually)

Avoid contaminated food

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28
Q

Which Hepatitis has a high mortality in pregnant women

A

Hepatitis E

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29
Q

Japanese B encephalitis

Symptoms, Diagnosis, treamtent

A

Mosquito-borne flavivirus infection

High mortality

Rice paddies and pig farm = high risk

Febrile illness + Vomiting + Stupor

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30
Q

Rabies

Symptoms, Diagnosis, treamtent

A

Vaccine recommended, can also be given after bite

Wash immediately with soap

Painful bite + paraesthesia + hydrophobia (pain with drinking)

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31
Q

Main causes of infection in returned traveller

A

Mostly present within 2 weeks (except HIV)

Common infection = malaria, dengue, giardiasis, hepatitis A and B, gonorrhoea or Chlamydia Trachomatis and Helminthic

Non-infectious = DVT and thromboembolism

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32
Q

Investigation on gastrointestinal system

A

Mild = microscopy and culture

moderate or prolonged (>3 wks) =

  • Stool examination (3 specimens) - microscopy, wet preparation and culture
  • Faecal multiplex PCR
  • Treat Pathogen
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33
Q

Abnorminal discomfort

A
  • Bloating, intestinal hurry and bornorygmi and often followed by diarrhoea
  • usually no pathogen in stool

Important Signs

  • Maculopapular - genue, HIV, typhus, syphillis, arbovirus infection, leptospirosis, Q fever
  • Petechiae - viral haemorrhagic fever, leptospirosis, dengue
  • Rose spot - Typhoid
  • Eschar - Typhus (tick and scrub), anthrax
  • Chancre - African Trypanosomiasis, syphillis
  • Fever - think malaria
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34
Q

Treatment for malaria

A
  • Admit to hospital with infecious disease - rule out G6PD deficiency
  • Fluid replacement
  • P. vivax, P. ovale, P. malariae - artemether + lumefantrine + primaquine
  • P. falciparum - Riamet or quinine + doxycycline / clindamycin
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35
Q

Typhoid fever

Symptoms, Diagnosis, treamtent

A

Incubation - 10-14 days

  • Headache predominates
  • Stepladder fever + Abdominal pain (w/ constipation) + relative bradycardia
  • Pea soup diarrhoes
  • Rose spot rash (later)

Diagonosis - Blood/stool culture, (serology not helpful)

Treatment - Azithromycin or Ciprofloxacin

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36
Q

Cholera

Symptoms, Diagnosis, treamtent

A

Incudates hours to 5 days

Clinical variable fever + abrupt onset ‘rice water’ diarrhoea

  • Causes - electrolyte depletion, intense thirst, oliguira, weakness, shrunken eyes

Diagnosis = Stool microscopy and culture (Vibrio Cholerae)

Treatment

  • Strict barrier nursing
  • IV fluid and electrolytes
  • Doxycycline
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37
Q

Dengue Fever

Symptoms, Diagnosis, treamtent

A
  • sout-east pacific and queensland
  • Myalgia and fever <39 dengue > malaria
  • Fever + severe aching + rash

Symptoms = abrupt fever, headache, nausea, pain behind eye, severe backache, prostration, sore throat, aching muscles and joing

  • subsides in 2 days and then returns
  • Maculopapular rubelliform rash on limb or petechial rask

Diagonsis - IgM serology (dengue specific, best on 5 days); PCR; FBE: leukopenia, thrombocytopenia in haemorrhagic form

Treatment - Rest, fluid, analgesics

AVOID antibiotics and corticosteriods

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38
Q

Differentials for fever in returned traveller

A

Malaria

Dengue (rash)

Chikungunya

Encepalitis (delium, convulsion, coma)

Melioidosis (pneumonia)

Chlorea (rice-water diarrhoea)

Typhoid (stepladder fever + bradycardia)

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39
Q

Clinical Features of uncontrolled diabetes

A
  • Polyuria
  • Polydipsia
  • Loss of weight (Type 1)
  • tiredness and Fatigue
  • Propensity for infection - skin and gential (vaginal thrush)
  • Vulvovaginitis (inflammation and irritation of vagina)
  • Pruritus Vulvae (itchy valva)
  • Balanitis (inflammation of head of penis)
  • nocturnal enuresis (type 1)
  • Blurred vision/visual changes
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40
Q

Secondary causes of diabetes

A

Endocrine disorder

  1. Cushing Syndrome
  2. Acromegly
  3. Phaeochromocytoma
  4. polycyctic ovarian syndrome

Pancreatic disorder

  1. Haemochromatosis
  2. Chronic pancreatitis

Drug induced

  1. Thiazide diuretics
  2. Oestrogen therapy (high dose)
  3. Corticosteriods

Other transient causes

  1. Gestational diabetes
  2. Medical or surgical stress
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41
Q

Symptoms of diabetes complications - may be the presenting complaint

A
  • Staphylococcal skin infections
  • Polyneuropathy (tingling or numbness in feet, pain)
  • Impotence
  • Arterial disease - myocardial ischaemia, peripheral vascular disease
42
Q

Examination of Diabetes

A
  1. General inspection - including skin
  2. BMI (weight/height)
  3. Waist circumference
  4. Visual acuity
  5. Blood pressure - standing and lying
  6. Peripheral neuropathy - tendon reflex, sensation (cotton wool, 10g monofilaments)
  7. Urinalysis - glucose, albumin, ketones, nitrites
43
Q

Screening for T2D

A
  • People with impaired fasting glucose/impaired glucose tolerance
  • Age > 40 years
  • Age > 30 with family history (first degree relative with type 2 diabetes), obesity, bmi > 30, hypertension
  • Age > 18 in ATSI, pacific islanders
  • Previous gestation diabetes or history of large babies
  • People with long term steriod use and atypical antipsychotics
  • Polycystic ovarian syndrome esp overweight
  • CVD and other risk factors

Screen every 3 years

44
Q

Diagonsis of T2D

A
  • If symptomatic (2 of polydipsia, polyuria, freq skin infection or freq thrush)
    • Fasting Blood glucose > 7.0 mmol/L on two occasions
    • Random Blood glucose (2hd prandial) > 11.1 mmol/L on two occasions
    • HbA1c >6.5%
  • If asymptomatic
    • at least two seperate values, either fasting or post prandial, or two OGTT
45
Q

Microvascular complications of T2D

A

Retinopathy

Nephropathy

Neuropathy

46
Q

Macrovascular complication of T2D

A

Ischaemia / coronary heart disease

Cerebrovascular disease

Peripheral Vascular disease

Organs effects KNIVES

Kideney

Nerves

Infection
Vessels

Eyes

Skin

47
Q

Name 4 Diabeteic metabolic complications

A
  1. Hypoglycaemia
  2. Diabetic ketoacidosis
  3. Hyperosmolar hyperglycaemia
  4. Lactic acidosis
48
Q

Clinical complications of T2D

A
  1. Cataracts
  2. Refractive error of eye
  3. Sleep apnoea
  4. Depression
  5. Musculoskeletal - neuropathic joint damage (Charcot type Arthropathy), tendon rupture
  6. Foot ulcer
49
Q

Metabolic syndrome/ Syndrome X/ Insulin Resistance

A

Upper truncal obesity (waist circumference) > 102 cm M, > 88 cm F

plus any 2 or more of the following

Increased triglycerides > 1.7 nmol/L

Decreased HDL cholesterol <1.0 M, <1.3 F

Fasting glucose > 5.5 mmol

BP > 130/85

50
Q

Goals for Diabetes

A
  • Diet - normal healthy
  • Body mass index 5-10% for overweight or obese
  • Physical activity - atleast 30 mins
  • Smoking - 0
  • Alcohol consumption <2 standard drink
  • BGL - 6-8 mmol/L fasting, 8-10 mmol/L postprandial
  • HbA1c <7%
  • Total cholestrol <4.0
  • HDL-C >1.0
  • LDL <2.0
  • TG <2.0
  • BP 130/80
  • Urinary albumin < 20
  • Vaccination - against influenza and pneumococccal disease and dTPa vaccine
51
Q

Descrine three Insulin regimens

A
  1. Pre-mixed two injection - biphasic system
    • Breakfast and evening
  2. 3 injection per day
    • Short acting before breakfast and lunch;
    • Intermediate or long-acting before evening
  3. 4 injections (basal-bolus) system
    • Short acting before breakfast, lunch and dinner (bolus)
    • Intermediate-acting or long-acting at bedtime (basal)
52
Q

What are some available types of insulin

A
  • Ultra-short acting (peak 1 hr, duration 3.5-4.5)
    • Insulin aspart - NovoRapid
  • Short acting (peak 2-5 hr, duration 6-8)
    • Neutral - Actrapid
  • Intermediate (duration 12-24 hr)
    • Isophane - Protaphane
  • Long-acting (analouges)
    • Insulin glargine - Lantus
  • Premixed (short and intermediate or long)
    • Novomix
53
Q

Sick days in Diabetes management during insulin

A

Never omit insulin dose

More top-up insulin

Maintain glucose

54
Q

Drugs for Diabetes

A
  • Biguanides
    • Metformin
    • Side effects - GIT disturbances (diarrhoe, n/v), avoid in hepatic, kidney and cardiac disease, lactic acidosis
  • Sulfonyureas
    • Gliclazide, Glipizide, Glibenclamide, Glimepride
    • Side effects - hypoglucemia (common), weight gain, rash and GIT
  • a-glucosidase inhibitor
    • Acarbose
    • Side effects Flatulence, skin rashes, diarrhoea, liver effects
  • Thiazolidnediones (glitazones)
    • pioglitazone
    • Side effects - caution heart failure, odema, weight gain, heart failure, hepatic effects, fracture risk
  • DPP-4 agonist (gliptins)
    • Sitagliptin, Vildagliptin
    • Side effects - rhinorrhoea, headache hypersensitivity e.g. uticaria, dizziness, fatigue
  • SGLT 2 inhibitor
    • Canagliflozin, Dapaliflozin
    • Side effect - type of diuretic (bewares kidney failure), genitourinary infection, dehydration, dizziness, hypoglycaemia
55
Q

Control of hypertension in Diabetes

A

<130/80 = Target

Use ACE-I, ARK and Ca channel blocker

56
Q

Controls of dyslipidaemia

A

Target

Total < 4 mmol/L

TG <1.5 mmol/L

HDL > 1 mmol/L

LDL <2 mmol/L

Use - HMG-CoA reductase inhibitor

Resin for hypercholestrolemia

fibrates and resins for dyslipidemia

57
Q

Hypoglycaemia in diabetes.

A

Blood glucose level < 3.0 mmol/L

More common in type 1 but can occur in type 2

In type 2 it can happen with Sulphonylureas

Classic warning - sweating, tremor, palpitation, hunger, peri-oral paraesthsia

Rx. Rule of 15

give 15 g of low GI carb (can be 0.5-1 mg of glucagon) - wait 15 mins and then high GI carb

58
Q

Complications in T2D

A

Ketoacidosis - anion gap –> metabolic acidosis

Hyperosmonal hyperglycemic state - no anion gap

Prescipitating factors - infection, non-compliant, undiagnosed, change in lifestyle, myocardial infarction, stroke, steriods

59
Q

Ketoacidosis in T2D

A
  • Preceding polyuria, polydipsia, drowsiness
  • Vomiting and abdominal pain
  • Hyperventilation (severe acidosis, acidotic breathing) - Kussmal breathing
  • Ketonuria

Management

  • Urgent hospital admission
  • Rapid-acting insuilin IM 10 units
  • IV normal saline

(comatose patient requires water, sodium (3L N saline), potassium (KCl) and insulin)

60
Q

Hyperosmonal hyperglycemia in T2D

A
  • Altered conscious with marked dehydration in absence of ketoacidosis
  • Rx - IV fluids, Saline slowly, Insulin lower doses to ketoacidosis
61
Q

Name the 4 CAGE questionaire suggesting a problem drinker

A

2 or more positive replies = positive test

  1. Have you ever felt you should CUT down on your drinking?
  2. Have people ANNOYED you by critising your drinking?
  3. Have you ever felt bad or GUILTY about your drinking?
  4. Have you ever had a drink first thing in the morning to steady your never or get rid of hangover? an EYE-OPENER
62
Q

Investigation important in indentification of excessive chronic alcohol intake

A
  • Blood alcohol
  • Serum GGT - elevated in chronic drinkers
  • MCV- > 96 fL

Other cahnges

  • Abnormal liver function test (other than GGT)
  • Carbohydrate deficient transferrin (specific)
  • HDL elevated
  • LDL lowered
  • serum uric acid elevated
63
Q

Symptoms of alcohol withdrawal

A

Hangover (acute)-

  • headache
  • nausea
  • irritability
  • mild tremor

Withdrawal (chronic)

  • agitation
  • prominent tremor
  • sweating
  • insomnia
  • seizures
    • delirium tremens (DTs)
64
Q

Mangement of alcohol withdrawal

A
  • Maintain fluids, electrolytes and nutrition
  • Add Vitamin B complex inc thiamine

Medications - Diazepam, Thaimine, Vitamin B

IF psychotic add haloperidol

65
Q

What is delirium tremens

A

Serious life-treatening withdrawal state.

Onset - 1-5 days from withdrawal (usually 3-4)

Symptoms - disorientation, agitation, clouding of consciousness, marked tremors, visual hallucination

Signs - sweating, tachycardia, pyrexia, signs of dehydration

Rx- Hospitalisation, correct fluids and electrolyte with IV treatment, treat systemic infection, Thiamine. Diazepam IV slowly

Add Haloperidol if psychotic features present

66
Q

What are the hormones released by the anterior pituitary

A
  • ACTH
  • FSH
  • LH
  • TSH
  • GH
  • Prolactin
67
Q

What are the hormones released by posterior pituitary

A
  • ADH
  • Oxytocin
68
Q

Antibodies raised in Hashimoto thyroiditis

A
  • Antimicrosomal or antithyroid peroxidase antibodies
69
Q

What are the antibodies raised in Graves

A
  • Antitithyroglobulin
  • Antithyroid peroxidase
  • TSH receptor
70
Q

Common organisms causing UTI

A

Escherichia coli and Staphylooccus saprohyticus

Less common- gram negatice (Klebsiella sp and Prosteus sp.), enterococci sp and gram positive cocci (Streptooccus faecalis and staphylococcus)

71
Q

Diagonisis/Investigations important in UTI

A

Mid stream urine collection with microscopy WBC > 10per mL

Dipstick positive for leucocytes (presence of infection) and nitrates (presence of bacteria)

Culture with cound > 10^5 cfu/ml

Other test = FBE, ESR/CRP, blood culture, consider U&E and PSA (in men)

72
Q

Causes of tremor

A
  1. Physiological
  2. Benign essential tremor
  3. Anxiety - hyperventilation
  4. Hyperthyroidism
  5. Toxicitiy - alcohol, liver failure, uraemia
  6. Drugs - lithium, narcotic withdrawal
  7. Parkinson disease
  8. Drug-induced parkinsons
  9. Cerebellar disease
  10. Alzheimer’s disease
  11. Wilson disease
  12. Cerebral tumour (frontal lobe)
73
Q

Causes of flapping tremor (metabolic tremor)

A
  1. Wilson’s syndrome
  2. Hepatic encephalopathy
  3. Uraemia
  4. Respiratory failure
  5. Lesion of red nucleeus of midbrain
74
Q

Basic Clinical features of Parkinson’s

A
  1. Stooped posture
  2. Failure to swin arm or arms
  3. Masked facies
  4. staring expression
  5. slow, monotonous speech
  6. pill-rolling tremor at rest
  7. slow and shiffling gait at rest
  8. turning by numbers
75
Q

Classic tetrad of PD

A
  1. Tremor at rest
  2. Rigidity
  3. bradykinsia (poverty of movement)
  4. Postural instability (loss of postural reflex)
76
Q

Differential Diagnosis for PD

A
  1. Depression
  2. Multiple system atropy
  3. Progressive supranuclear palsy
  4. Normal pressurue hydrocephalus - MRI ventricular enlargement
  5. Frontal lobe damage/dementia
  6. Lewy body dementia - lilliputia
  7. Huntington’s
  8. Wilson’s disease
  9. Drug induced - antipsychotics, anticonvulsants, amiodarone, lithium
  10. Toxin- CO poisioning, manganese toxicity
77
Q

Red flags in Parkinsons

A
  • Rapid progresion of gait impairment, need to use wheelchair, dementia, postural instability, falls, dysautonomia, bulbar dysfunction within 5 years onset
  • Inspiratory respiratory dysfinction
  • Recurrent falls (>1 a year)
  • Poor response to L-dopa or DA agonist
  • Symmetrical symptoms
  • Onset of other treament - antipsychotic
78
Q

Pharmacology in parkinsons

A
  • Levadopa (converted to dopamine)
  • Usually given with dopa decarboxylase
  • Dopamine agonist - bromocriptine, pramipexole, ropinirole
  • Can add MAO-B inhibitor (Selegilene)
  • Can add COMT inhibitor (Entacapone, Tolcapone)
79
Q

Signs of parkinsons

A
  • Pill rolling tremor
  • Increased rigidity - cogwheel
  • Akinesia/bradykinesia slow
    • micrography
  • Postural/gait changes
  • Congnitive decline
  • Olfactory loss
80
Q

Differentials for acute vision loss in non-inflammed eye

A
  1. Retinal Detachment
  2. Retinal artery or vein occlusion
  3. Migraine
  4. Hyperglycemia
  5. Amauroxis fugax
  6. Anterior ischemic optic neuropathy- temporal gaint cell arthritis
  7. Optic Neuritis - MS
81
Q

Differentials for chronic vision loss in white eye

A
  1. Macular degeneration
  2. Refractive errors
  3. Cataracts
  4. Diabetic retinopathy
  5. Open angle glaucoma
82
Q

Red flags in vision loss

A
  • Sudden vision loss
  • Vision loss with temporal arteritis symptoms - jaw claudication (pain with chewing), temporal tenderness
  • Raised intraocular pressure – ie pain with tender globe and hazy cornea, nausea and fixed dilated pupil
  • Pain on eye movement in younger patients 30-50 – optic neuritis
  • History of new flashes and floaters
83
Q

Examinations to be done in vision loss

A
  1. Visual acuity
  2. Visual fields
  3. Red reflex
  4. pupil reflex
  5. Fundoscopy
  6. Blood pressure
  7. BGL
84
Q

Differentials for painless red eye

A
  1. chalazion/stye
  2. subconjuctival haemorrhage
  3. pteyrium
  4. eyelid disorders
85
Q

Differentials of painful red eye

A
  1. Conjuctivitis (allergic, bacterial, viral)
  2. Keratitis
  3. Corneal trauma
  4. Keratoconucticitis sicca dry eyes
  5. episcleritis
  6. scleritis
  7. Acute angle closure glaucoma
  8. endophthalmitis
  9. uveitis
86
Q

Emergency conditions causing red eye

A
  1. Angle closure glaucoma
  2. Ketaritis
  3. Ruptured globe/penetrating eye injury
  4. Blunt trauma
  5. Corneal abrasion
  6. Gonococcal conjuctivitis
87
Q

What should your uncorrected vision in better eye be better than to drive

A

6/12

88
Q

What is true about visual field in regards to driving unconditionally

A

Binocular with a horizontal extent of at least 110 degrees within 10 degrees above or below the horizontal midline,

If there is significant field loss/ scotoma within a central radius of 20 degrees of foveal fixation

89
Q

Important questions in history of fever

A

Travel

Pets

Occupation

Immunosupression

Drugs - cocaine, antimicrobials, anticholinergic, amphetamine

Sexual history

90
Q

Investigations to differentiate between infectious, malignant and autoimmune causes

A

Malignant - Weight loss, lymph involvement, CT

Autoimmune- ESR in giant cell, RF in rheumatoid, ANA in SLE, antibodies

LFT to differential Cirrhosis and Hepatitis,

D-dimer for DVT

ACE levels for Sarcoidosis

91
Q

Name 10 infectious causes of fever

A
  1. UTI
  2. Pneumonia
  3. sinusitis
  4. Mengitis
  5. Bacteraemia
  6. Tuberculosis
  7. Abdominal abcess
  8. Endocarditis
  9. Osteomyelitis
  10. cytomegalovirus (CMV), Epstein-barr virus, influenza
92
Q

Name three malignant cases of fever

A

Chronic leukaemia

Lymphoma

Metastatic cancer

93
Q

Name four autoimmune causes of fever

A

Gaint cell arthritis

Inflammatory bowel disease - Chron’s, ulcerative colitis

Rheumatoid Arthriitis

Systemic lupus erythematosus

94
Q

Lyssavirus

Symptoms, Examination, Diagnosis

A

Symptoms - Disoriented, insomnia, ataxia, rapidly deteriorating speech, hallucination, coma

Examination - Hydrophobia and intermittently febrile

Diagnosis - Serology – saliva test for rabies PCR

95
Q

Brucellosis

Symptoms, Examination, Diagnosis

A

Symptoms- Remitting relapsing course of fever, Arthralgia, myalgia

Examination - none

Diagnosis - Serology = SAT (serum agglutination test).

96
Q

Leptospirosis

Symptoms, Examination, Diagnosis

A

Symptoms - Biphasic illness with septicaemic and immune phase, High fever, headache, myalgia and arthralgia, rash, meningism and vomiting = common

Examination - Meningism, Jaundice

Diagnosis - Serology MAT (microagglutionation testing) or ELISA

97
Q

Q fever

Symptoms, Examination, Diagnosis

A

Symptoms - Similar to leptospirosis and brucellosis

Non-specific influenza like illness

Acute fever-myalgia, severe headache

Arthralgia, anorexia and acute weight loss

Examination none

Diagnosis - Serology – repeat 1-2 weeks later because negative at start of fever – PCR

Antibody – 4 fold rise

Prevention - Vaccine in abattoirs

98
Q

Hydatid disease

Symptoms, Examination and Diagnosis

A

Symptoms - Right upper quadrant pain or epigastric pain, nausea vomiting

Examination - none

Diagnosis - Stool exam – eggs and proglottids in stool

Serum serology

FBC – moderate eosinophilia, megaloblastic perinicious anaemia

99
Q

Definition of sepsis

A

Infection either suspected or confirmed with systemic features of fever, tachycardia, tachypnoea, or elevated white cell count

100
Q
A
101
Q
A

3.1 cards (13 decks)

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