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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
Q

What is the most common bacterial cause of cellulitis?

A

Staphylococcus aureus

26
Q

What is the first-line management of cellulitis?

A

Flucloxacillin

Clarithromycin if penicillin allergic

27
Q

Where in particular do we worry about the development of cellulitis?

A

Hands

  • > very small spaces which can cause neuromuscular compromise if swollen
  • > orthopaedic emergency which warrants admission for antibiotics and decompression/debridement
28
Q

What antibiotic is first line for the treatment of animal bites?

A

Co-amoxiclav

29
Q

What are the antibiotics of choice in MRSA?

A

Doxycycline in mild infections

Vancomycin in severe infections

30
Q

What is the treatment for necrotising fasciitis?

A

Surgical debridement

Supportive IV antibioticss

31
Q

What is the most common cause of secondary bacterial pneumonia following flu?

A

Staphylococcus aureus

32
Q

What are the differential diagnoses for a hypoechoic lesion on liver ultrasound?

A 
Hepatocellular carcinoma
Liver metastases
Pyogenic liver abscess 
Hyatid cyst
Amoebic liver abscess
33
Q

How are amoebic liver abscesses best treated?

A

Metronidazole

Drainage if complicated

34
Q

What are the symptoms of amoebic liver abscess?

A 
RUQ pain
Fever
(Jaundice is RARE)
May have recent diarrhoea
Travel to: India, America, Mexico, Central/South America

Disproportionately high ALP

35
Q

What is the most common cause of infective mononucleosis?

A

Epstein-Barr Virus

36
Q

What are the symptoms of mononucleosis?

A

Symptoms may last >1 month
Fever, malaise and fatigue
Lymphadenopathy, pharyngitis, tonsilitis, splenomegaly

37
Q

How is mononucleosis diagnosed?

A

Often a clinical diagnosis

Monospot test: detects EBV antibodies

38
Q

How is mononucleosis managed?

A

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
Q

What are potential complications of mononucleosis?

A 
GBS
Meningitis/encephalitis
CN7 palsy
Splenic rupture
Airway obstruction
Burkitt lymphoma
40
Q

Which HIV test results are always repeated?

A

Positive results are always repeated

Negatives are only repeated if <4 weeks from potential exposure

41
Q

When are babies of HIV positive mothers tested?

A

birth, 6 weeks, 12 weeks

18 months

42
Q

What is the advise regarding breastfeeding in HIV-positive mothers?

A

Generally advised to avoid

If adamant: viral load should be undetectable, no diarrhoea in either and no nipple lesions

43
Q

What are the three most common classes of HAART therapy?

A

Reverse transcriptase inhibitors
Integrase inhibitors
Protease inhibitors

44
Q

At what CD4 count should antibiotic prophylaxis against PJP be given?
What medication is used?

A

CD4 <200

Co-trimoxazole

45
Q

How long after a potential exposure can PEP be given?

A

< 72 hours

Use condoms until confident this has been effective and no infection

46
Q

What medication is used at PrEP in the UK?

A

Truvada

47
Q

How is PJP diagnosed?

A

Sputum/BAL PCR
CXR- diffuse pulmonary infiltrates
CT- diffuse ground-glass opacities
B-d-glucan testing

Finals Revision (23 decks)

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