ID Flashcards

1
Q

What are the potential complications of traveller’s diarrhoea?

A

Dehydration
Post-infective IBS
Reactive arthritis/uveitis/urethritis = Reiter’s syndrome
GBS

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2
Q

How does chicken pox usually present?

A

Prodrome of fever and lethargy

Itchy vesicular rash which starts on face & chest, then spreads throughout the body

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3
Q

What are the potential complications of chicken pox infection?

A
Infected skin lesions
Pneumonitis
Encephalitis
Myocarditis
Hepatitis

Increased risk of the above in the immunocompromised and pregnant populations

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4
Q

What should you do if a pregnant woman is exposed to chicken pox and is unsure of her immunity status?

A
  1. Test for VZV IgG
  2. If not immune, give VZIG if <10d of exposure
  3. If symptomatic, give oral acyclovir
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5
Q

How long should people with chicken pox avoid contact with others?

A

Until lesions have all crusted over (usually about 5 days after rash appears)

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6
Q

How does shingles usually present?

A

In those who have already been exposed to VZV (due to reactivation in dorsal root ganglia)
Usually painful/itchy prodrome
Painful vesicular rash in dermatomal distribution
No crossing of the midline of the body

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7
Q

How is shingles treated?

A

Oral acyclovir

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8
Q

How does measles usually present?

A

Prodrome of fever, malaise, conjunctivitis, cough
Development of koplik spots in the mouth
Development of rash: mobiliform maculopapular rash which starts on the face and moves down the body
Rash lesions can merge together and become confluent

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9
Q

What are potential complications of measles?

A

Otitis media
Diarrhoea

Bacterial Pneumonia
Acute encephalitis
Pregnancy complications

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10
Q

What are symptoms of primary HIV infection?

A
Pharyngitis
Lymphadenopathy
Headache
Mouth ulcers
Flu-like symptoms

May present like glandular fever or flu

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11
Q

Which type of herpes is involved with oral ulcers, cold sores, eye and URT symptoms?

A

HSV 1

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12
Q

Which type of herpes is responsible for genital ulceration?

A

HSV2

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13
Q

Which antibiotic can precipitate a rash in glandular fever?

A

Amoxicillin

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14
Q

What is the recommended chemoprophylaxis of malaria?

A

Doxycycline

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15
Q

What are the typical symptoms of malaria?

A
Fluctuating temperature 
Headache
Fever
Fatigue
Dry cough
N+V
Splenomegaly

Travel to endemic area

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16
Q

What is the treatment for threadworm?

A

Mebendazole

Whole family should be treated

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17
Q

What are symptoms of giardiasis?

A

Watery diarrhoea
Excessive flatulence

Generally picked up from contaminated water

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18
Q

What is the treatment for scabies?

A

Permethrin

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19
Q

What are symptoms of schistosomiasis?

A

Bloody diarrhoea
Haematuria

Hepatic fibrosis and portal hypertension
Pulmonary fibrosis
Space occupying lesion and seizures

20
Q

How would you diagnose and treat candidaemia?

A

May grow in standard blood culture bottle
Presence of B-d-glucan in the blood

MEDICAL EMERGENCY
RX micafungin treatment until 2 weeks after cultures become negative

21
Q

What are the most common bacterial causes of infective endocarditis?

A

Streptococcus viridans

Staphylococcus aureus in IVDUs

22
Q

How is infective endocarditis diagnosed?

A

Blood cultures from 3 different sites at different times

Echocardiogram = gold standard diagnostic test

23
Q

What tests should be ordered in suspected meningitis?

A
Blood cultures
LP: culture + sensitivity, microscopy, gram stain, PCR, cells/protein/glucose/pressures
Pneumococcal urinary antigen
Viral and bacterial throat swabs
Meningococcal PCR of blood or CSF
24
Q

What are the most common bacterial and viral causes of meningitis?

A

Bacterial: Staphylococcus pneumoniae, neisseria meningitidis

Viral: herpes viruses (HSV 2), enteroviruses e.g. coxsackie

25
What is the most common bacterial cause of cellulitis?
Staphylococcus aureus
26
What is the first-line management of cellulitis?
Flucloxacillin Clarithromycin if penicillin allergic
27
Where in particular do we worry about the development of cellulitis?
Hands - > very small spaces which can cause neuromuscular compromise if swollen - > orthopaedic emergency which warrants admission for antibiotics and decompression/debridement
28
What antibiotic is first line for the treatment of animal bites?
Co-amoxiclav
29
What are the antibiotics of choice in MRSA?
Doxycycline in mild infections | Vancomycin in severe infections
30
What is the treatment for necrotising fasciitis?
Surgical debridement | Supportive IV antibioticss
31
What is the most common cause of secondary bacterial pneumonia following flu?
Staphylococcus aureus
32
What are the differential diagnoses for a hypoechoic lesion on liver ultrasound?
``` Hepatocellular carcinoma Liver metastases Pyogenic liver abscess Hyatid cyst Amoebic liver abscess ```
33
How are amoebic liver abscesses best treated?
Metronidazole | Drainage if complicated
34
What are the symptoms of amoebic liver abscess?
``` RUQ pain Fever (Jaundice is RARE) May have recent diarrhoea Travel to: India, America, Mexico, Central/South America ``` Disproportionately high ALP
35
What is the most common cause of infective mononucleosis?
Epstein-Barr Virus
36
What are the symptoms of mononucleosis?
Symptoms may last >1 month Fever, malaise and fatigue Lymphadenopathy, pharyngitis, tonsilitis, splenomegaly
37
How is mononucleosis diagnosed?
Often a clinical diagnosis | Monospot test: detects EBV antibodies
38
How is mononucleosis managed?
Supportive care: analgesia, fluids, antipyretics No need to exclude from school/work but avoid sharing saliva Avoid contact sport due to risk of splenic rupture
39
What are potential complications of mononucleosis?
``` GBS Meningitis/encephalitis CN7 palsy Splenic rupture Airway obstruction Burkitt lymphoma ```
40
Which HIV test results are always repeated?
Positive results are always repeated | Negatives are only repeated if <4 weeks from potential exposure
41
When are babies of HIV positive mothers tested?
birth, 6 weeks, 12 weeks | 18 months
42
What is the advise regarding breastfeeding in HIV-positive mothers?
Generally advised to avoid | If adamant: viral load should be undetectable, no diarrhoea in either and no nipple lesions
43
What are the three most common classes of HAART therapy?
Reverse transcriptase inhibitors Integrase inhibitors Protease inhibitors
44
At what CD4 count should antibiotic prophylaxis against PJP be given? What medication is used?
CD4 <200 | Co-trimoxazole
45
How long after a potential exposure can PEP be given?
< 72 hours | Use condoms until confident this has been effective and no infection
46
What medication is used at PrEP in the UK?
Truvada
47
How is PJP diagnosed?
Sputum/BAL PCR CXR- diffuse pulmonary infiltrates CT- diffuse ground-glass opacities B-d-glucan testing