Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MRCP > ID > Flashcards

ID Flashcards

1
Q

What is seen on CSF analysis in bacterial meningitis?

A

Cloudy appearance
Low glucose (50% plasma)
High protein
10-5000 PMNs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is seen on CSF analysis in viral meningitis?

A

Glucose 60-80% plasma
Normal/high protein
15-1000 lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is seen on CSF analysis in tuberculous meningitis?

A

Slightly cloudy, fibrin web
Low glucose (50% plasma)
High protein
30-300 lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the treatment of TB meningitis?

A

Usual therapy + prednisolone

12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the most common cause of viral meningitis?

A

Enterovirus e.g. Coxsackie

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which lobes does HSV-1 encephalitis affect?

A

Temporal and frontal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is HSV encephalitis diagnosed?

A

LP - viral CSF picture
PCR for HSV
CT: medial temporal and inferior frontal petechial haemorrhages
EEG: lateralised periodic discharges at 2Hz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the cause of Japanese encephalitis and how is it transmitted?

A

Flavivirus
Transmitted by culex mosquitos which breed in rice paddy fields
Reservoir hosts - aquatic birds
Amplification hosts - pigs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the symptoms of Japanese encephalitis that differentiate it from other forms of encephalitis?

A

Parkinsonian features

Acute flaccid paralysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type of virus is hepatitis B?

A

dsDNA hepadnavirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which is the first serological marker to appear in hepatitis B and indicates ongoing infection?

A

HBsAg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the characteristics of anti-HBs?

A

Implies immunity - exposure or immunisation

Negative in chronic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the characteristics of anti-HBc?

A

Present for around 6 months; implies previous or current infection
Negative if immunised (c=caught)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What hepatitis serology is expected to be seen in patients who have only been immunised against hepatitis B?

A

Anti-HBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the complications of hepatitis B?

A

Chronic hepatitis and fulminant liver failure
Glomerulonephritis
Polyarteritis nodosa
Cryoglobulinaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What level of anti-HBs shows adequate response to vaccination?

A

> 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the features of chronic hepatitis B?

A

Transaminitis
Ground glass appearance of liver
HBsAg and anti-HBc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the treatment of chronic hepatitis B?

A

48 weeks pegylated IFN-a

Synthetic thymidine nucleoside analogue e.g. tenofovir, entecavir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What type of virus is hepatitis C?

A

RNA flavivirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the serology of hepatitis C?

A

HCV RNA detected

anti-HCV antibodies (remain if patients clear the virus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What percentage of patients clear hepatitis C?

A

33%

66% develop chronic hepatitis C, 50% of these develop end stage liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the risk factors for developing chronic hepatitis C?

A

Asymptomatic in acute stage
Co-existing hepatic pathology
HIV
African American

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the complications of chronic hepatitis C?

A 
Arthritis
Sjogren's syndrome
Cirrhosis and HCC
Type 2 cryoglobulinaemia
PCT
Membranoproliferative GN
Autoimmune thyroid disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does management of hepatitis C depend on?

A

Viral genotype

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the treatment of hepatitis C?
2DAAS +/- ribavarin E.g. Harvoni (ledipasvir (NS5A inhibitor) and sofosbuvir (NS5B inhibitor)
26
What is HCC screening in hepatitis C?
6 monthly AFP, liver USS
27
In which patients does hepatitis E carry risk of significant mortality?
Pregnancy
28
What is the mechanism of action of rifampicin?
Inhibits bacterial DNA dependent RNA polymerase, preventing transcription of DNA into mRNA
29
What are the side effects of rifampicin?
Hepatitis Orange/pink secretions Flu like P450 inducer
30
What is the mechanism of action of isoniazid?
Inhibits mycolic acid synthesis
31
What are the side effects of isoniazid?
Peripheral neuropathy (prevent with pyridoxine) Hepatitis Agranulocytosis P450 inhibitor
32
What is the mechanism of action of pyrazinamide?
Converted into pyrazinoic acid which inhibits fatty acid synthase
33
What are the side effects of pyrazinamide?
Hyperuricaemia Arthralgia/myalgia Hepatitis
34
What is the mechanism of action of ethambutol?
Inhibits arabinosyl transferase which polymerises arabinose into arabian
35
What are the side effects of ethambutol?
Retrobulbar optic neuritis | Needs dose adjustment in renal impairment
36
Name 5 skin disorders associated with TB.
``` Lupus vulgaris Erythema nodosum Scarring alopecia Scrofuloderma Verrucosa cutis Gumma ```
37
What is the general treatment of HIV?
2NRTIs + PI/NRTI
38
Give some examples of NRTIs and their side effects.
Zidovudine: anaemia, myopathy, black nails Tenofovir: renal impairment, osteoporosis General: peripheral neuropathy
39
Give some examples of NNRTIs and their side effects.
Nevirapine, efavirenz | P450 induction, rashes
40
Give some examples of protease inhibitors and their side effects.
Ritonavir: P450 inhibitor Indinavir: renal stones, high bilirubin General: diabetes, hyperlipidaemia, buffalo hump and central obesity
41
Give some examples of integrase inhibitors.
Raltegravir, elvitegravir
42
What is the cause of progressive multifocal leukoencephalopathy?
Infection of oligodendrocytes by JC virus
43
What is seen on CT or MRI in PML?
Widespread demyelination, single/multiple lesions
44
What is seen on CT in cerebral toxoplasmosis?
Single or multiple ring enhancing lesions
45
What is the treatment of cerebral toxoplasmosis?
Sulfadiazine and pyrimethamine
46
Which virus is primary CNS lymphoma associated with?
EBV
47
Which imaging modality is positive in primary CNS lymphoma?
Thallium SPECT
48
How is cryptococcal meningitis diagnosed?
High opening pressure CSF, India ink test positive
49
What is the cause of AIDs dementia?
HIV virus itself
50
What is post exposure prophylaxis?
Combo PO antiretrovirals for 4 weeks Serological testing at 12 weeks post completion
51
What are the symptoms of HIV seroconversion illness?
Glandular fever type 1-4 weeks after infection Maculopapular rash Suggests the beginning of HIV antibody production
52
What is tested in suspected HIV seroconversion illness?
P24 antigen HIV PCR Antibodies negative up to 3 months
53
Which HIV patients should have prophylaxis against PCP pneumonia?
CD4 count <200
54
How is PCP pneumonia diagnosed?
CXR: bilateral interstitial pulmonary infiltrates BAL silver staining: cysts Sputum culture
55
What is the treatment of PCP pneumonia?
Co-trimaxazole | IV pentamidine if severe
56
If PCP patients are hypoxic <9.3kPa, what is added to treatment?
Steroids
57
What type of virus is HIV?
RNA retrovirus
58
Which cells does HIV virus infect?
CD4 T cells, macrophages, dendritic cells
59
How does HIV virus replicate?
After entering a cell, reverse transcriptase creates dsDNA from RNA for integration into the host cell's genome
60
Which vaccines are contraindicated in HIV?
Cholera Intranasal influenza Oral polio BCG
61
How is latent TB diagnosed, and when is a false negative likely?
Mantoux skin test --> if positive then IFN-gamma blood test used. Mantoux test false -ve: miliary TB, sarcoid, lymphoma, HIV, <6 months
62
How is active TB diagnosed?
3x sputum culture More sensitive than sputum smear with Ziehl-Neelson stain
63
What is the treatment of active TB?
Rifampicin and isoniazid for 6 months | Pyrazinamide and ethambutol for first 2 months
64
What is the treatment of latent TB?
3 months isoniazid and rifampicin, or 6 months isoniazid
65
What are the features of strep pneumonia CAP?
Rapid onset High fever Pleuritic chest pain Herpes labialis
66
What are the causes of infectious mononucleosis?
EBV or HH4
67
How is infectious mononucleosis diagnosed?
Atypical lymphocytes Transient rise in ALT Haemolytic anaemia secondary to cold agglutins (IgM) Maculopapular rash after amoxicillin
68
What is the cause of anthrax and how does it cause disease?
Bacillus anthracis (gram +ve rod) Produces tripartite protein toxin: protective factor, oedema factor (increased cAMP) and lethal factor (which is toxic to macrophages)
69
What are the features of anthrax?
Painless black eschar which can cause oedema, compartment syndrome, fever Necrotising fasciitis GI bleeding
70
What is the treatment of anthrax?
Ciprofloxacin
71
What is the reaction caused by release of endotoxins following bacterial death after first dose of antibiotics?
Jarisch-Herxheimer reaction
72
What is the treatment of lassa fever?
Ribavarin
73
How is dengue fever transmitted?
Aedes aegypti mosquito
74
What are the symptoms of dengue fever?
Retro-orbital headache Fever, myalgia Facial flushing and maculopapular rash
75
What may Dengue fever progress to?
Dengue haemorrhagic fever (form of DIC) --> dengue shock syndrome
76
What are the features of Chikungunya fever?
Rapid fever Debilitating joint pain Palmar/plantar rash
77
What are the features of Lassa fever?
Mucosal bleeding | Mastomys rodent
78
What are the features of Yellow fever?
5 day duration | Non specific symptoms
79
What are the features of leprosy?
Hypopigmented skin with sensory loss Lepromatous leprosy/multibacillary: extensive, symmetric nerve involvement Tuberculoid leprosy/paucibacillary: limited skin disease, asymmetric nerve involvement
80
What determines severity of leprosy?
Degree of cell mediated immunity
81
What is the treatment of leprosy?
Rifampicin, dapsone, clofazimine
82
How does the rabies virus cause disease?
Animal bite --> virus travels up nerve axons towards CNS
83
What are the features of rabies?
Prodromal headache/fever Hydrophobia and muscle spasms Hypersalivation
84
What is seen in infected neurons in rabies?
Negri bodies (cytoplasmic inclusion bodies)
85
What is the treatment of rabies?
2 further doses of vaccine | If not vaccinated, human rabies Ig with full vaccine course
86
What are the features of typhoid?
Relative bradycardia Abdo pain and distension Rose spots
87
How is typhoid diagnosed?
Large volume blood culture
88
What are the 3 serotypes of e coli?
O - lipopolysaccharide layer K - capsule H - flagellin
89
Which type of e.coli causes neonatal meningitis?
K1
90
Name some gram +ve bacteria.
Cocci - staph + strep | Bacilli - anthrax, listeria, diphtheria, clostridium
91
Name some gram -ve bacteria.
Cocci - neisseria, moraxella | Bacilli - e.coli, hib, pseudomonas, salmonella, shigella
92
What are the 7 live attenuated vaccines?
``` BCG MMR Intranasal influenza Oral rotavirus Oral polio Yellow fever Oral typhoid ```
93
What is the mechanism of action of aciclovir?
Guanosine analogue, phosphorylated by thymidine kinase which inhibits viral DNA polymerase
94
What is a side effect of aciclovir?
Crystalline nephropathy
95
What is the pathophysiology of botulism?
Clostridium botulinum produces botulinum toxin, a neurotoxin which irreversibly blocks the release of ACh
96
What are the features of botulism?
Fully conscious with no sensory disturbance Flaccid paralysis Bulbar palsy Dysarthria, diplopia, ataxia
97
What is the treatment of botulism?
Botulism antitoxin
98
What is Lemierre's syndrome?
Thrombophlebitis of the internal jugular vein secondary to peritonsillar abscess --> septic PE
99
What is the pathophysiology of diphtheria?
Corynebacterium diphtheria releases exotoxin encoded by b-prophage, which inhibits protein synthesis by catalysing ADP-ribosylation of elongation factor EF2
100
What are the features of diphtheria?
Diphtheric membrane on tonsils Cervical lymphad Neuritis Heart block
101
What is the treatment of diphtheria?
IM penicillin | Diphtheria antitoxin
102
What are the 2 reproductive cycles in falciparum malaria?
Exo-erythrocytic cycle in hepatocytes | Erythrocytic cycle in red blood cells
103
What are the features of falciparum malaria?
``` Schizonts on blood film Parasitaemia >2% Hypoglycaemia Acidosis Fever>39 Severe anaemia ```
104
What are schizonts on blood film?
Indicates imminent schizogony and consequentially significant rise in parasitaemia
105
What is Blackwater fever?
Acute renal failure secondary to large intravascular haemolysis Urine black/dark red (haemoglobinuria)
106
What is the treatment of falciparum malaria?
Uncomplicated: ACTs e.g. artesunate + mefloquine Complicated: IV artesunate
107
What is the treatment of severe parasitaemia >10% in falciparum malaria?
Exchange transfusion
108
What is the most common type of non falciparum malaria?
Vivax
109
What are the characteristics of knowlesi malaria?
Very fast erythrocytic cycle (24 hours) with end stage involves lysis of RBCs and release of additional parasites Therefore produces very high parasite counts in a short space of time
110
Which malaria is associated with nephrotic syndrome?
Malariae
111
What is the treatment of non falciparum malaria?
Chloroquine (unless resistant - ACT)
112
What medication is added in vivax/ovale malaria and why?
Primaquine | To destroy liver hypnozoites and prevent relapse
113
What is the cause and risk factor for melioidosis?
Gram -ve burkholderia pseudomallei in East Asia and Northern Australia RF: diabetes
114
What is the treatment of melioidosis?
10 days IV ceftazidime/carbapenem | Followed by 20 weeks oral maintenance phase
115
What is the cause of traveller's diarrhoea?
Enterotoxigenic e.coli
116
What are the features of amoebiasis?
Long incubation | RUQ pain - liver abscess with anchovy sauce aspirate
117
What is the treatment of amoebiasis?
Metronidazole and tinidazole, followed by luminal amoebicide (diloxanide furoate)
118
How is leptospirosis spread?
Infected rat urine
119
What are the early features of leptospirosis?
Fever, flu like, subconjunctival injection | Lasts a week
120
What are the features of second immune phase of leptospirosis (Weil's disease)?
AKI Hepatorenal syndrome Aseptic meningitis
121
What is the treatment of leptospirosis?
High dose ben pen or doxy
122
What is the cause of Q fever?
Coxiella burnetti
123
Rickettsia ricketsii causes which illness?
Rocky mountain spotted fever
124
What are the features of endemic typhus?
Rickettssi typhi Flea vector Central rash --> peripheral
125
What are the 2 forms of trypanosomiasis and what are they spread by?
African (sleeping sickness) --> tsetse fly American (Chagas disease) --> triatomine bug
126
What are the features of African trypanosomiasis?
Intermittent fever Trypanosoma chancre Posterior cervical lymphad Somnelence, reversal of sleep-wake cycle
127
What is the treatment of African trypanosomiasis?
IV pentamidine/suramin If CNS involvement: IV melarosprol
128
What is the Romana sign?
Chagoma and periorbital oedema seen in acute phase of American trypanosomiasis
129
What are the chronic features of Chagas' disease?
Myocarditis + dilated cardiomyopathy | Megaoesophagus and megacolon
130
What spreads leishmaniasis?
Sandfly bite
131
What are the 3 forms of leishmaniasis?
Cutaneous Mucocutaneous Visceral
132
What are the features of visceral leishmaniasis?
``` Caused by leishmania donovani Fevers, rigors Massive splenomegaly and hepatomegaly Weight loss Grey skin (kala-azar) Pancytopenia ```
133
How does toxoplasma gondii cause disease?
Oocysts release trophozoites which migrate around the body including to the eye, brain or muscle
134
What are the forms of toxoplasmosis?
Immunocompetent: asymptomatic/self limiting HIV: cerebral/chorioretinitis Congenital (transplacental spread): neuro and ophthalmic damage
135
What is the pathognomonic rash of strongyloidiasis?
Larvae currens
136
What is the treatment of strongyloidiasis?
Ivermectin
137
What is Katayama fever?
Acute schistosomiasis syndrome - fever, urticaria, arthralgia, cough, diarrhoea, eosinophilia
138
Which form of schistosoma causes terminal haematuria and is a risk factor for squamous cell bladder cancer?
Schistosoma haematobiu,
139
What do schistosoma mansoni and japonicum do?
Mature in the liver Travel through the portal system to inhabit the distal colon Cause hepatosplenomegaly, portal vein congestion, cor pulmonale
140
What is the commonest cause of visceral larva migrans?
Toxocara canis
141
Which tapeworm causes cysticercosis and what is the treatment?
Taenia solium | Niclosamide
142
What is the treatment of schistosomiasis?
Praziquantel
143
What is the cause of a painless ulcer (chancre)?
Syphilis | Treponema pallidum
144
What is the cause of a painful chancroid with ragged border?
Haemophilus ducreyi
145
What disease does chlamydia trachomatis cause?
Lymphogranuloma venereum
146
What are the stages of lymphogranuloma venereum?
Small painless ulcer Painful inguinal lymphad Proctocolitis
147
What is the treatment of LGV?
Doxycycline
148
What is the cause of granuloma inguinale?
Klebsiella granulomatis
149
What is the treatment of PID?
PO olfloxacin + PO metro OR IM ceftriaxone + PO doxy + PO metro
150
What is the treatment of chlamydia?
7 days doxycycline
151
What is the treatment of gonorrhoea?
IM ceftriaxone 1g

MRCP (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions