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End of unit Flashcards

1
Q

CD4 count below 200 what opportunistic infections could occur in hiv

A

candidiasis - white coating on tongue and pain on swelling

penumocytisi penumonia - pneumocystisi hireovecii

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2
Q

CD4 count below 100 what opportunistic infections could occur in hiv

A

Cryptococcal meningitis:

Headache, fever, fatigue, LP has a high opening pressure

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3
Q

CD4 count below 50 what opportunistic infections could occur in hiv

A

Progressive multifocal leukoencephalopathy (PML)
Cognitive impairment, focal neurological signs, MRI shows hyperdense lesions

Cerebral toxoplasmosis : Headache, fever, confusion, focal neurological signs, seizures, imaging shows multiple ring enhancing lesions

Disseminated MAC: fever, night sweats, weight loss, diarrhoea, abdo pain, hepatosplenomegaly

CMV retinitis: floaters, visual field defects, painless visual loss, pizza pie fundus

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4
Q

CD4 count below 500 what opportunistic infections could occur in hiv- anything

A

TB:

Fever, chills, night sweats, weight loss, haemoptysis, lymphadenopathy, CXR- consolidation/cavities/nodules

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5
Q

HIV pneumonia causative organism

A

Pneumocystis carnii (jirovecii)

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6
Q

CAP causative organism

A

strep pneumoniae

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7
Q

HAP causative organism

A

staph

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8
Q

COPD pneumonia

A

haemophiliac influenzae

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9
Q

CF or ventilated patents causative organism for pneumonia

A

pseudomonas

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10
Q

immunocomprimsed pneumonia

A

aspergillus

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11
Q

post operative pneumonia causative organism

A

e.coli

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12
Q

Aids defining malignancies

A

Kaposi’s sarcoma- purple nodular lesions on back
High grade B cell non-Hodgkin’s lymphoma
Invasive cervical cancer

Non-AIDS defining malignancies include Hodgkin’s lymphoma and HIV related anal cancer

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13
Q

what is the difference between candida ( under cd4 200) and oral hairy leukoplakia ( under 500)

A

candid you can scape off tongue leading it to be red

. white patches on leukoplakia does not come off

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14
Q

what to treat candida

A

oral fluconazole

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15
Q

what to treat hair leukoplakia

A

self resolving maybe acyclovir

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16
Q

PCP - pneumocystis jiroveci
symptoms
treatment

A

dry cough, SOB, reduced effort tolerance and fever

trimethoprim , sulfamethoxazle with steroids if severe

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17
Q

what to treat mycobacterium tb

A

RIPE - rifampicin, isoniazid , pyrazinamide

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18
Q

symptoms of cryptococcal meningitis - below 100

A

headache fever and malice with neck stiffness , photophobia and fever and signs of raised ICP

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19
Q

treatment of cryptococcal meningitis

A

IV amphoctericin B + PO flu cytosine then fluconazole

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20
Q

cytomegalovirus symptoms and management

A

below 50
blind spots and visual floaters , peripheral field defects and painless visual loss
retinal haemorrhages and heard exudates

gancicclovir

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21
Q

difference between chlamydia and gonorrhoea

A

c - clear or white discharge and
G- green or yellow discharge

men in C need to have first catch urine sample and women vulvo-vaginal swab whereas in G men urethral swab and women endodermal-cervical swab

docyclicine for C
gonorrhoea - culture and ciprofloaxicn or cefratriaxone

22
Q

Herpes = blisters which form painful ulcers

treatment ?

A

oral acyclovir

23
Q

Lymphogranuloma venerum = painless ulcers + painful inguinal lymphadenopathy

treatment same as chlamydia

A

doxycycline - for 7 day

or one tablet of arthromycin

24
Q

Lymphogranuloma venerum = painless ulcers + painful inguinal lymphadenopathy

treatment same as chlamydia

A

doxycycline - for 7 day
or one tablet of arthromycin
\

Stage 1 Syphilis = painless ulcers
Treatment- HIV and HIV testing + referral

25
Q

thrush caused by what and what treatment

A

hrush (candida albicans)- present in normal flora (overgrowth is causes by stress, antibiotics or immunosuppression)
Cottage cheese like discharge, often sore. Give Canesten cream and/or fluconazole

26
Q

bacterial vaginosis - overgrowth of anaerobes like gardnerella
clue cells on microscopy ]]symptoms and treatment

A

smelly fishy discharge no pain

metronidazole

Genital psoriasis- dry and scaly skin. Often itchy.
Give steroid cream.

27
Q

common joints affected by RA

A

MCP and PIP

swan neck deformity -MCP flexion, PIP hyperextension, DIP hyperflexion).

Boutonniere finger deformity (PIP flexion, DIP hyperextension).
Ulnar deviation of proximal phalanges.
Z-shaped thumb.

28
Q

treatment for RA

A

NSAIDS and physiology
DMARDs - methotrexate and hydorxycloroquine ( continued through ores as contains folate)
biologics - anti-TNF

29
Q

antibodies seen for SLE

A

anti ds DNA , anti sm and ANA

get skin rashes plus small joints oh hands with weight change

30
Q

treatment for SLE

A

Hydroxychloroquine(all)+ prednisolone(sx relief)+ Methotrexate/Azithioprine if needed Cyclophosphamide as a rescue therapy

31
Q

OA is asymmetrical swelling on knees, hips and hands affecting DIP worsening with activity what findings

A

Serology negative, ESR and CRP normal

32
Q

UTI treat

A

Nitrofurantoin or Trimethoprim

33
Q

cellulitis

A

flucloacilin

34
Q

orbital cellulitis

A

co-amoxiccilin

35
Q

tonsilitis

A

1st line is pencillin - phenoxy

2nd line is erythromycin or clarithromycin

36
Q

CAP pneumonia antibiotics

A

amoxicillin and if atypical clarithromycin

37
Q

prostate drains to what nodes

A

iliac lymph nodes

38
Q

chicken pox
cause
symptoms and treat

A

varicella zoster
widespread papule that blister into vesicles and scab - parities and fever

treat with supportive fluids and if adults acyclovir
school exclusion until lesion have crusted over

39
Q

hand foot and mouth
cause
symtposm
treat

A

coxsackie virus A16

vescicale rash on hands and feet and painful oral ulcers and low grade fever

treat - supportive fluids and simple analgesics - oral lidocaine used for fluids

no exclusion from school

40
Q

impetigo

cause
symtposm

A

staph aureus

red sores, blisters round the mouth that burst and crust over forming Honey coloured crust

treat with 1st line topical hydrogen peroxide
2nd line fusidic acid and 3rd if spread flucloaxillin

school exclusion until lesion cursed and healed or 48hr after antibiotics commenced

41
Q

erythema infectious -slap cheek

cause
symtposm
treat

A

parvovirus B19

red cheeks and pink rash on limbs
aplastic anaemia

supportive analgesics - no exclusion from school

42
Q

scarlet fever
cause
symtposm
treat

A

group A strep

sore throat, fever and sick with GI upset
sandpaper like rash and tender cervical adenopathy and strawberry tongue with pharyngeal erythema

amoxicillin
return after 24 hr of antibiotics

43
Q

Kawasaki disease

cause
symtpom
treat

A
  • N/A acute vasculitis
    dever , sandpaper rash on palms and soles , tender lymphadenopathy and strawberry tongue

IV immunoglobulin and aspirin
no exclusion

44
Q

shingles
cause
symptoms
treat

A

varicella zoster
papules blister into vesicles and scab over into dermatomal distribution

acyclovir and analgesia - school exclusion until lesion have all crusted over

45
Q

in hiv what do you need to make sure during pregnancy

A

avoid breastfeeding

vertical transmission unlikely with undetectable viral load below 0.1 % - continue ART treatment and deliver via c section if viral load detectable - ART 4 weeks for baby

46
Q

treat for HIV

A

Treatment
Start ASAP
Backbone of two NRTI’s plus NNRTI or PI or INI
Post exposure prophylaxis= course of HIV therapy for 28 days.
Post-exposure prophylaxis
Should be given within 72 hours
Receptive anal sex – recommended regardless of HIV status
Everything in between
Oral sex without ejaculation- not recommended

47
Q

stages HIV

A

Stages
1 Seroconversion/ primary infection: triad of fever, rash and pharyngitis (only in 60% and usually mild)
2 Chronic/latent phase
3 AIDs (severe opportunistic infections and tumours)

48
Q

Ophthalmia neonatorum simply means infection of the newborn eye.

Responsible organisms include

A

Chlamydia trachomatis
Neisseria gonorrhoeae

Suspected ophthalmia neonatorum should be referred for same-day ophthalmology/paediatric assessment.

49
Q

what is subcostal plane

A

The subcostal plane is a transverse plane which bisects the body at the level of the 10th costal margin and the vertebral body L3.

50
Q 
Pylorus stomach
Left kidney hilum (L1- left one!)
Right hilum of the kidney (1.5cm lower than the left)
Fundus of the gallbladder
Neck of pancreas
Duodenojejunal flexure
Superior mesenteric artery
Portal vein
Left and right colic flexure
Root of the transverse mesocolon
2nd part of the duodenum
Upper part of conus medullaris
Spleen

are all at what level of the body

A

L1- transpyloric

51
Q

hairy leukopenia causes by what organism

A

EBV

52
Q

trimethoprim inhibits bacteria DHFR but methotrexate a chemotherapy agent inhibits

A

mammalian DHFR

Host defence (10 decks)

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