ID

Question 1

Treatment for Pneumocystis Jirovecii

Answer 1

Co-timoxazole

Question 2

Patient presents to GUM clinic with white urethral discharge and dysuria.
Microscopy shows Gram neg diplococci
1) What is the most likely cause
2) 2 Mx options

Answer 2

1) Gonorrhoea

2) Intramuscular cetriaxone or oral cipro

Question 3

What are the features and cause of hairy leukoplakia

Answer 3

White plaques on the sides of tongue

EBV

Question 4

What type and shape of microbe is TB.

How can it be stained for on microscopy

Answer 4

Mycobacterium

Acid fast - Zeihl-Neelson stain

Question 5

Name for granulomas found in lungs in TB infections

Answer 5

Gohn focus - formed by the accumulation of alveolar macrophages

Question 6

Causes of secondary tb infections

Answer 6

Immunosuppression
HIV, Lymphoma, CKD, DM.
Steroids
TNF alpha inhibitors

Question 7

Main symptoms of TB infection

Answer 7

Cough, haemoptysis
Fever + weight loss + Night sweats
Malaise

Question 8

1) Initial inx for TB suspected patients
2) Screening test for previous TB exposure immunisation
3) TB vaccine name and type of vaccine

Answer 8

1) CXR. Sputum pot sample
2) Mantoux test
3) BCG - live attenuated

Question 9

1) Management of latent TB

2) Management of active TB

Answer 9

1) Rifampicin + Isoniazid for 3 months. Rifampicin alone for another 3 months
2) Rifampicin, Isoniazid, Pyrazinamide, Ethanbutol

Question 10

Side effects of RIPE TB drugs

Answer 10

Rifampicin  - Orange secretions 
Isoniazid - Peripheral neuropathy 
Pyrazinamide - Increased Uraemia 
Ethanbutol - Colour blindness 
All are hepatotoxic

Question 11

1) 3 methods of transmission of HIV
2) Classification of AIDS
3) 4 Opportunistic infection in HIV
4) 3 complications of HIV infection
5) Complication of late stage management of HIV

Answer 11

1) Sexual. Blood products, organs. Vertical
2) CD4+ Lymphocyte count < 200
3) Jirovecii. Candida infection. TB. Cytomegalovirus
4) Kaposi sarcoma. Non-Hodgkins lymphoma. Cervical cancer
5) Immune Reconstitution Infection syndrome - when immune system boosts and fights opportunistic infection overly

Question 12

1) 2 symptoms of candida infection
2) Differentiation between candida, BV and trichomonas
3) Mx of candida

Answer 12

1) Itching. White discharge - odourless.
2) Candida < pH of 4.5 < BV Trochomonas
3) Topical clotrimazole. Oral fluconazole

Question 13

1) 5 symptoms of chlamydia
2) Inx and swab used for chlamydia cultures
3) Mx and mx in pregnancy

Answer 13

1) Dysuria. Discharge. Dyspareunia, Epidimo-orchitis, Reactive arthritis. Can be asymptotic in women
2) Nucleic acid amplification test. Charcoal swab
3) Doxy 100mg 7 days. Azithromycin 500mg 2 days

Question 14

1) non-gonorrhoea cause of urethritis

2) Management of the above

Answer 14

1) Mycobacterium genitalis

2) Doxycycline 100mg 7 days or Azithromycin

Question 15

1) What type of organism are thichomonas
2) What 2 diseases to the increase the risk of
3) Mx

Answer 15

1) Protozoa
2) HIV and cervical cancer
3) Metronidazole