Corrections Flashcards
How long should post-exposure prophylaxis for HIV be continued?
4 weeks
What is Q fever caused by?
Coxiella burnetti
Who is Q fever typically seen in?
Farmers (typically from sheep/cattle)
Features of Q fever?
1) Fever
2) Transaminitis (deranged LFTs)
3) Atypical pneumonia
4) Endocarditis (culture-negative)
Mx of Q fever?
Doxycycline
Mx of trichomonas vaginalis?
Metronidazole
Severe hepatitis in a pregnant woman?
Think hep E
In what 3 scenarios are prophylactic abx given for bites?
1) A human bite that has drawn blood or broken the skin in a high-risk individual
2) A cat bite that has drawn blood or appears to be deep
3) A dog bite that has caused considerable tissue damage or is contaminated
What is used for propyalxis of animal bites?
3d course of co-amoxiclav
What bacteria causes typhoid?
Salmonella typhi
Features of typhoid?
1) initially systemic upset: headache, fever, arthralgia
2) relative bradycardia
3) abdominal pain, distension
4) constipation: although Salmonella is a recognised cause of diarrhoea, constipation is more common in typhoid
5) rose spots: present on the trunk
Can legionella pneumonia cause deranged LFTs?
Yes
What can be used to treat Chlamydia in pregnancy?
Azithromycin, erythromycin or amoxicillin
Mx of tetanus?
1) supportive therapy including ventilatory support and muscle relaxants
2) IM human tetanus immunoglobulin for high-risk wounds
3) metronidazole is abx of choice
Mx of women with a suspected UTI if associated with visible or non-visible haematuria?
Abx plus send an MSU
Mx of rabies post-exposure?
give immunglobulin + vaccination
Mx of legionella?
Macrolides e.g. clarithromycin
Mx of mastitis?
1) Continue breastfeeding
2) Simple measures:
- analgesia
- warm compresses
3) Abx if no improvement (flucloxacillin)
Length of abx course in mastitis?
10-14d
Can breast feeding continue duriing abx treatment in mastitis?
Yes
What Abx are indicated in non-lactational mastitis?
Broad spectrum e.g. co-amoxiclav or erythromycin/clarithromycin + metronidazole
Most commonly implicated bacteria in breast abscess?
Staph. aureus
Can a breast abscess cause systemic features?
Yes e.g. fever, chills, tachycardia, malaise, fatigue
Though commonly seen in lactating women, abscesses can also present in non-lactating women.
What are some predisposing factors?
Nipple piercings, diabetes, immunosuppression
Diagnostic investigation for breast abscess?
Culture of needle aspirate (can help guide abx)
Give a key differential for a breast abscess?
Galactocele
1st line mx of a breast abscess?
1) Smaller abscess (<5cm) –> Needle aspiration of the abscess
2) Larger abscess –> Surgical incision & drainage w/ washout
3) Adjuvant abx treatment (flucloxacillin)
Which anti-TB drug is an indiciation for visual monitoring?
Ethambutol –> can cause optic neuritis
What feature of C. diff makes it particularly hard to kill?
Spore formation
C. difficile spores are resistant to many environmental stresses, including heat, disinfectants, and antibiotics, which makes them particularly difficult to eliminate. These spores can persist on surfaces for months, making them a significant source of transmission in healthcare settings.
What is leptospirosis?
Leptospirosis is caused by the spirochaete Leptospira interrogans, classically being spread by contact with infected rat urine.
Who is at risk of leptospirosis?
sewage workers, farmers, vets or people who work in an abattoir
1st line mx of erysipelas?
Flucloxacillin
What causative organism of meningitis stains with India ink?
Cryptococcus neoformans
Mx of a tetanus prone wound in patients with an uncertain tetanus vaccination history?
Booster vaccine + immunoglobulin
Which cause of pneumonia can cause immune-mediated neurological diseases?
Mycoplasma
Mx of patients who are immunosuppressed 2ary to long-term steroids or methotrexate if they are exposed to chickenpox and have no antibodies to varicella?
Test for varicella antibodies and give VZIG if no antibodies
What vaccines should patients with hyposplenism have?
1) pneumococcal
2) Hib
3) meningococcal type C
Discharge in gonorrhoea vs chlamydia?
Discharge from chlamydia is usually clear or milky, while discharge from gonorrhoea tends to be thicker and can be yellow, white, or green
Mx of immunocompromised patients with toxoplasmosis?
Pyrimethamine + sulphadiazine
What are 2 options for prophylaxis of meningococcal meningitis for contacts of patients?
Oral ciprofloxacin or oral rifampicin
When may oral rifampicin be used instead of ciprofloxacin in prophylaxis of meningococcal meningitis?
E.g. history of tendon rupture
Mx of human bites?
Co-amoxiclav (like animal bites)
Mx of pneumonia caused by atypical pathogens?
Clarithromycin
Mx of exacerbation of chronic bronchitis?
Amoxicillin or clarithromycin
