Case 17- Questions Flashcards
How are Leishmania parasites transmitted
They are transmitted by phlebotomine sandflies
Define stigma and health conditions particularly at risk of it
Stigma arises when an adverse social judgement is made about a group or person which leads to rejection, blame, social exclusion or devaluation:
1) HIV/Sexually transmitted diseases
2) Mental health disease
3) Learning disabilities
4) Physical/Visible disabilities
Two possible clinical features that could trigger screening for CMV in infants
1) Growth retardation
2) Encephalitis
3) Calcification on cranial ultrasound
4) Congenital cataracts
5) Failed neonatal hearing screen
6) Petechiae or purpura in the newborn
7) Hepatosplenomegaly
8) Prolonged jaundice
9) Unexplained thrombocytopaenia
10) Premature birth
Briefly explain the most common causes, types of infections and treatment of antibody immunodeficiency
Cause - bacterial infection (eg Pneumococcus & H. influenzae)
Types of infection - one from: Otitis, Pneumonia, Sinusitis, GI tract disturbances, Autoimmunity
Therapy: Immunoglobulin replacement
Function of Amphotericin B- antifungal agent
Puncture of the cell membrane by binding ergosterol
The best description of antigen presentation by MHC molecules
A MHC class 1 molecules binds with a peptide in the endoplasmic reticulum
What AIDs defining condition is associated with a CD4+ count of <100/mm^3
Disseminated Mycobacterium avium complex
What antibody class is able to cross the placenta and protect the newborn infant
IgG
What is the antiviral combination most commonly used across the world
Nucleoside/nucleotide reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors
What is the most common cause of fungal infection in the general population
Candida sp
Where do CD8 positive T cells recognise foreign sntigens
On the surface of any nucleated cell type
The organ responsible for the negative selection for self-recognising T lymphocytes.
Thymus
The protein that downregulates a T-cell mediated response (a checkpoint inhibitor), loss of which can lead to autoimmunity.
PD-1
A process involved in T cell independent B cell activation
It only occurs if B cell receptors have been crosslinked
A process involved in T cell independent B cell activation
It only occurs if B cell receptors have been crosslinked
How is antibody diversity generated
V, D and J gene segments are brought together by a somatic recombination process
How is antibody diversity generated
V, D and J gene segments are brought together by a somatic recombination process
What cell type is predominantly used against Helminths
IgE
What do non-nucleoside inhibitors target
Reverse transcription
The Nucleotide analog reverse-transcriptase inhibitor (NtRTI) that is a component of some PrEP candidates in clinical trials.
Tenofovir
What causes blood in urine
Malaria
What causes a maculopapular rash and fluid in the lungs
Dengue
What causes conjunctivitis
Zika virus
Initial managment of dengue
Initial fluid bolts over 10 to 15 minutes
Advice on how to reduce the risk of a communicable disease- malaria
1) Make sure all routine vaccinations are up-to-date
2) Explanation of need for travel insurance
3) Advise that the risk of contracting an infectious disease abroad depends upon context of visit: For example, region being visited, time of year/season, type of activity…urban or rural etc
Give an explanation about how a patients culture may influence their beliefs that pharmacological intervention is bad?
Religion = A belief that health is determined by a deity and thus this deity will heal them or that they are being punished and that here should be no intervention
Education = Pharmacological intervention is perceived to be harmful/drug companies out to exploit patients/conspiracy theories surounding use of pharmacotherapy etc
Friends/Family = Patient has been told of serious side effects of drugs/family member/friend bad experience of medication influences perception and beliefs of surrounding pharmacological intervention
Considering the cultural iceberg- state two cultural factors that influence patients behaviour
1) Religious beliefs
2) Life experience
3) Sexual orientation
4) Education
5) Values
6) Attitudes
What does OM stand for
Once daily in the morning
Type A reactions
Exaggerated effects of the medication when given at normal therapeutic doses. Can cause respiratory depression in excess
The antimalaria drug which is used to prevent relapse from Plasmodium vivax and Plasmodium ovale
Primaquine- effective against hypnozoites dormant in the liver
What are the Filarial nematodes and Trypansoma species transmitted
Filarial nematodes- transmitted by mosquitos
Trypanosoma- transmitted by Tsetse fly vectors
What information is legally required on the prescription
Prescriber address
Select the parasite that has gene cassettes of variable surface glycoproteins which continue to switch, enabling the organism to escape antibody detection and continue to replicate.
Trypanosome
What parisitic infection can be aquired by migration of larvae through bare feet
Hookworm infection
What is it when a patient follows the written instructions provided by their GP
Compliance- passive role where the patient is following instructions
What organism is most likely to cause haematuria- bathing in water
Schistoma Haematobium
Schistosoma Mansoni- causes disease of the bowel and liver. It does not typically cause urinary symptoms
The purpose of the BNF
Facilitates cost-effective, safe prescribing
The stage of the Plasmodium life cycle where they can infect Anopholes mosquito vectors
Gametocytes
