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Year 4 > ID > Flashcards

ID Flashcards

1
Q

notifyable diseases from this years knowledge

A
  • acute encephalitis
  • acute meningitis
  • cholera
  • food poisoning
  • HUS
  • infective bloody diarrhoea
  • meningococcal septicaemia
  • MMR
  • SARS
  • whooping cough
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2
Q

causes of candidaemia

A
  • translocation from gut into blood stream (sepsis, perforation, obstruction, necrosis of bowel)
  • central/Arterial lines
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3
Q

how to diagnose candidal infection

A
  • blood culture: appears like large gram pos cocci

- beta-D-glucagon (v senstivie but not specific)

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4
Q

types of herpes viruses

A
  • herpes simplex virus 1 and 2
  • Epstein Barr virus (glandular fever and burkitt’s lymphoma)
  • cytomegalovirus
  • varicella zoster virus
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5
Q

pathogens found in infective endocarditis (different groups)

A
  • streptococcus viridans (normal variant)
  • staphylococcus aureus (IVDU)
  • staphylococcus epidermis (prostetic valves)
  • streptococcus bovis (colorectal cancer)
  • streptococcus mitis (dental work)
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6
Q

investigations for meningitis

A
  • viral and bacterial troat swabs
  • blood culture
  • penumococcal urinary antigen
  • meningococcal PCR
  • lumbar puncture
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7
Q

viral skin pathogens

A 
herpes simplex 
papilomavirus 
molluscum 
orf
varicella
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8
Q

bacterial skin pathogens and syndrome

A
  • S aureus (impetigo, furunculosis, boils, toxic epidermal necrolysis, acute paronychia)
  • S pyrogenes (cellulitis, eryipelas, impetigo)
  • C diphteriae (cutaenous diphteria)
  • M tuberculosis (lupus vulgaris)
  • M marinum (chronic ulcerative disease)
  • M ulcerans (destructive ulcer)
  • pseudomonas aerinosa (colonises burns)
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9
Q

fungal skin pathogens

A

epidemophyton

  • microsporum
  • trichophyton
  • candida
  • malassezia furfur
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10
Q

causes of necrotizing fasciitis

A
  • group 1: mixed aerobic and anerobic bacteria

- group 2: group A streptococci

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11
Q

presentation of necrotizing fasciitis

A
  • pain at site of infection out of proportion with skin findings
  • fever, confusion, weakness, diarrhoea
  • shock
  • discoloured or infected area
  • erythema rapidly spreading
  • woody induration and crepitus
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12
Q

treatment of necrotizing fasciitis

A

EMERGENCY

  • antibiotics
  • surgical eploration, debriement and amputation if necessary)
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13
Q

def necrotizing fasciitis

A

rapidly spreading infection of deep fascia, with inflammation leading to necrosis of subcutaneous tissue planes

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14
Q

different types of necrotizing fasciitis

A

type 1:

  • 1+ anaerobic species AND enterobacteria
  • ususally associated with diabetes or peripheral vascular disease

type 2:

  • group 1 streptococcus (isolated alone or with otheer bacteria: staph aureus)
  • haemolytic streptococcal gangrene
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15
Q

differentials for necrotizing fasciitis

A

cellulitis
pyomyositis
gas gangrene

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16
Q

causes of cellulitis

A

S aureus
S pyrogenes
pasteurella multocida
Psudomonas aeruginosa

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17
Q

risk factors for cellulitis

A
  • venous status/lymphoedema
  • obesity
  • diabetes
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18
Q

differentials for cellulitis

A
  • DVT
  • lymphoedema
  • venous insufficiency
  • venous eczema
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19
Q

treatment of cellulitis

A

Uncomplicated:

  • flucloxacillin (first line)
  • co-amoxiclav (mammal bites)
  • piperacillin with tazobactam
  • clindamycin (if penicillin allergic)

MRSA:
- vancomycin

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20
Q

risk factors for MRSA

A
  • recent course of antibiotics
  • hospital admissions
  • open wounds
  • contact with someone with MRSA
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21
Q

different treatments available for MRSA

A
  • vancomycin
  • doxycycline
  • linezolid
  • teicoplanin
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22
Q

warts pathogen

A

HPV

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23
Q

def verrucae

A

plantar warts: direct contact under wet conditions

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24
Q

warts management

A
  • resolve spontaneously

consider treatment if: painful, consmetically unsightly, persisting wart

  • cryptotherapy
  • topical salicylic acid
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25
Q

cause of gas gangrene

A

costridium perfingens

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26
Q

symptoms of gas gangrene

A

infected would
foul discharge
tender on palpation
crepitus felt

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27
Q

management of gas gangrene

A

rapidly progressive and life threatening

  • surgical debriement
  • antibiotics
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28
Q

common causes of CAP

A
  • strep pneumonia
  • haemophilus influenza
  • myycoplasm pneumonia (atypical pneumonia)
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29
Q

def atypical pneumonia

A

inflammation of interstitium not alveoli: CXR will be clear

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30
Q

aspiration pneumonia features and pathogen associated

A

red current jelly

Klabsiella pneumonia

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31
Q

assessment in CAP

A
  • ABCDE
  • bloods: normal, clotting and glucose
  • CXR
  • Sepsis screen + VCURB65
  • sputum culture
  • throat swab for viral OCR
  • urine for pneumococcal and legionella
  • BBV screen
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32
Q

management of CAP

A

CURB 0-1: amoxicillin
CURB 2: amoxicillin and clarythromycin
CURB 3+: co-amoxiclav and doxy or clarythromycin

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33
Q

types of influenza and which is most common? most serious?

A

A, B and C
most common: A and B
most serious A>B

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34
Q

what classes of surface antigen do you find on influenza

A

H and N

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35
Q

symptoms of uncomplicated influenza

A

fever
coryza
headaches, malaise, myalgia, arthralgia
GI symptoms

36
Q

presentation of complicated influenza

A

requires hospital admission and/or
symptoms and signs of LRTI (primary viral pneumonia or bacteria pneumonia)
CNS involvement (encephalitis, myelitis, GBS, aseptic meningitis) or/and significant exacerbation of underlying medical condition

37
Q

how do you manage severe acute respiratory infections

A

discuss with infection specialist
side room with resp precautions
make sure hydration and oxygen levels are managed

38
Q

investigations for SARI

A
  • blood cultures (x2)
  • sputum culrues (bacterial and legionella)
  • legionella urine antigen
  • nasopharyngeal swab for viral PCR
  • chlamydiaphilia/mycoplasma PCR
  • bacterial throat swab
39
Q

common viral causes of SARI

A
  • influenza
  • adenovirus
  • parainfluenza virus
  • respiratory syncytial virus
  • SARS
  • MERS
  • COVID
40
Q

risk factors for SARI

A

??

41
Q

who is at increased risk for infective diarrhoea

A
  • recent travellers
  • immunosuppresed
  • care home/hospiral patients
42
Q

diarrhoea in immunocompromised patient

A
  • salmonella, campylobacter, C diff, shigella, mycobacterium tuberculosis, cytomegalovirus, fungal/parasitic infections, norovirus, gardia
43
Q

how does diarrhoea preseenation different in immunocompromised

A

more severe and longer course of infection

44
Q

investigations for diarrhoea in immunocompromised patient

A
  • normal bloods + clotting and lactate
  • blood cultures (if septic)
  • faecal sample CS&M: must tell lab patient immunocompromised
  • ABG
  • sigmoidoscopy
45
Q

management of immunocompromised patient with diarrhoea

A
  • in post transplant: must contact transplant team
  • fluids resucue (ORS or IV fluids)
  • consider empiric antibiotics
  • urgent sigmoidoscopy to exclude colitis
  • HIV test
46
Q

management of fungal infection (investigations and treatment)

A
  • serum fungal antigen test (beta-D-glucan)
  • IV antifungals (2 weeks)
  • remove lines and send for culture
  • fungal culture for urine
  • echo
47
Q

causes of glandular fever

A

EBV

CMV

48
Q

spread of glandular fever

A
  • not very contagious
  • spread through contact with saliva, sex, blood transfusions, organ tranplantations and intrauterine
  • during incubation time (4-7 weeks) and while symptoms are present
49
Q

lifelong effect of glandular fever infectopn

A
  • latent carrier state

- reactivation more likely in immunocompromised

50
Q

management of glandular fever

A
  • self limiting (2-4 weeks)
  • analgesia
  • encourage people to go about normal activities ASAP
  • advice to avoid heacy lifting/contact sport for the first month (splenic rupture)
  • advise on spread of disease
  • arrange hospital admission if serious complications suspected
51
Q

complications of glandular fever

A
  • upper airway obstruction
  • splenic rupture
  • neutropaenia
  • malignant disease (in immunocompromised)
52
Q

presentation of glandular fever

A

sore throat
pyrexia
lymphadenopathy

malaise, anorexia, headache
splenomegaly

53
Q

diagnosis of glandular fever

A

Monospot test (heterophil antibody test) in second week of illness

54
Q

different parasitic infections

A
  • schisctosomiasis
  • strongyloidiasis
  • filariasis
  • malaria
55
Q

risk factors for parasitic infections

A
  • HIV/immunocompromised
  • eating raw foods
  • walking barefoor in areas endemic for soil transmitted helminths
  • living in close proximity with animals
  • swimming in waters endemic areas
  • travel
56
Q

schistosomiasis def

A

parasitic flatworm infection present in bowels or bladder

57
Q

route of inf schitosomiasis

A

freshwater, penetrate through skin

58
Q

route inf of strongyloidiasis

A

soil

59
Q

presentation of malaria

A
  • fever
  • headache
  • chills/sweating
  • fatigue/pain
  • back pain
  • enlarged spleen
  • nausea and vomiting
60
Q

spread of giardiasis and what type of pathogen

A

faecal oral

flagellate protozoan

61
Q

features of giardiasis

A
  • often asymptomaticc
  • lethargy, bloating, abdo pain
  • flatulence
  • non bloody diarrhoea
62
Q

treatment for giardiasis

A

metronidazole

63
Q

what test to do if suspect parasitic gastroenteritis

A

stool microscopy for trophoite and cysts

64
Q

diagnosis of malaria

A

Blood smear
normochromic normocytic anaemia
- thrombocytopaaenia
- elevate lactated dehydrogenase (haemolysis)

65
Q

treatment of malarai

A
  • chemoprophylaxis

- post infection treatment

66
Q

amoebic liver abscess pathogens

A
  • entamoeba histolytica parasite
67
Q

amoebic liver abscess transmission route

A

feacal oral

68
Q

pathogenesis of amoebic liver abscess

A

colonises small intestine and invade colonic mucosa

spread to liver via portal circulation

69
Q

clinical features of amoebic liver abscess

A
  • R upper quadrant pain
  • fever
  • recent Hx of diarrhoea and dysentry
  • jaundice (rare)
70
Q

investigations for amoiebic liver abscess

A
  • bloods (not associated with oesinophilia unlike other parasitic infections)
  • abdominal ultrasound
  • aspiration: think, brown fluid (anchovy pasteà
  • BBV screen (if indicated)
71
Q

treatment of amoebic liver abscess

A
  • metronidazole for 7-10 dzyd
  • lumen actuve agent
  • abcess drainage if significant complications
72
Q

hepatitis B serology

A
  • acute: early rise in anti core IgM
  • HbAg neg, HBVab positive: previous infection
  • HbAg pos and HbAb pos: chronic infection
73
Q

hepatitis C serology

A
  • HCV ab pos and HCV RNA neg: prior exposure

- HCV Ab pos and HCV RNA pos: chronic infection

74
Q

hepatits B spread

A

blood (IVDU, medical)
sex
vertical

75
Q

hep C transmission

A

blood (IVDU, medical)

sexual, vertical

76
Q

treatment of hep B

A
  • immunisation
  • acute: none
  • chronic: antivirals and interferon
77
Q

treatment hep C

A
  • interferon
  • ribavirin
  • protease inhibitors
78
Q

complications of hepatitis

A
  • liver cirrhosis

- hepatocellular carcinoma

79
Q

indications for HIV testing

A
  • chronic unexplained diarrhoea
  • oral candiditis
  • TB, pneumocystis
  • cerebral taxoplasmosis, primary cerebral lymphoma, cryptococcal meningitis
  • Kaposi’s sarcoma
  • oral candidasis, hep B or C inf, salmonella, shigela or campylobacter inf
  • cervical cancer
  • chronic lympadenopathy, fever
80
Q

if pregnant woman has HIV managemenr

A

babies:
- test them at birth, 6, 12 weeks (HIV DNA PCR)
- test them 18 months w/ HIV ab

breast feeding:

  • small risk of infection
  • safety triangle: no virus (U), hppy tums (of baby) and healthy breast (of mums)
81
Q

BBV testing

A

HIV antibody
HBV: HBsAg, antiHBs
HBC antibody

82
Q

HIV treatment

A
  • HAART (highly active antiretroviral therapy)

IRIS: starting treatment can start Immune reconstitution inflammatory syndrome: pospone treatment in patient with serous opportunistic infections)

83
Q

side effects of HAART

A

D&V, nausea
headache
tiredness
rash

lessens with time

84
Q

HAART interactions

A
  • nasal sprays
    inhalors
    herbal remedies (johns wort)
    recreational drugs
85
Q

exposure to HIV manageemnt

A

Post exposure prophylaxis (PEP)

- start within 72h of exposure, take for 28 days

86
Q

pre- exposure prophylaxis (PrEP)

A

for high risk individuals (sex or IVDU: partner with HIV, sharing needles with HIV person, keep using PEP, wanting to get pregnant and partner has HIV)

Year 4 (13 decks)

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