ID

Question 1

How is girdiasis treated and what complication can occur after treatment?

Answer 1

Metronidazole

Lactose intolerance

Question 2

CURB 65 scoring

Answer 2

Confusion
Urea >7
RR > 110
BP systolic <90 or diastolic <60 ??
Aged >65

0 or 1 - oral amox
2 – admit for oral amox + clari
3-5 – admit for iv co-amox

Question 3

How is aspiration pneumonia treated?

Answer 3

IV Cephalosporin + metronidazole

Question 4

What are symptoms of malaria?

Answer 4

Malaise
Myalgia
Headache
N+V

Question 5

What are signs of malaria?

Answer 5

Jaundice
Haemolytic anaemia
Low platelets
Hepatosplenomegaly

Question 6

How is malaria diagnosed?

Answer 6

Thick and thin blood films

Need at least 3 blood samples on 3 diff days to rule out

Question 7

What are complications of malaria?

Answer 7

Hypoglcyaemia
Cerebral malaria – seizures
ARDS
Acute renal failure
DIC

Question 8

How does amoebiasis present?

Answer 8

Amoebiasis can be asymptomatic, cause mild diarrhoea, or severe amoebic dysentry

Amoebic dysentry presents with profuse bloody diarrhoea

If amoebic liver abscess= Fever, RUQ pain

Can also cause colonic abscesses

Question 9

How is leprosy treated?

Answer 9

Triple therapy = rifampicin+dapsone+clofazimine

Question 10

How does leptospirosis present?

Answer 10

Farmers, sewage workers, ppl in water
Red eyes – conjunctivitis
AKI
Hepatitis
Fever

Question 11

What are late signs of Lyme disease?

Answer 11

Heart block
Pericarditis
Facial nerve palsy
Meningitis

Question 12

What are features of Legionella pneumonia?

Answer 12

Dry cough – atypical pneumonia
Deranged LFTs
Low lymphocytes
Low sodium

Question 13

How is Legionella diagnosed?

Answer 13

urinary antigen

Question 14

What is seen on LP in TB meningitis?

Answer 14

Raised protein
low glucose
raised lymph

Question 15

How long is HIV post-exposure prophylaxis given?

Answer 15

4 weeks

Question 16

Patient with HIV with ring enhancing lesions- what is it and how is it managed?

Answer 16

Toxoplasmosis

Treated with Pyrimethamine + Sulphadiazine

Question 17

Patient with HIV with a single lesion with solid enhancement (not ring)- what is it and how is it managed?

Answer 17

Primary CNS lymphoma

Management = commence anti-retroviral therapy and whole brain irridation

Question 18

How is CMV retinitis managed?

Answer 18

Intraocular Ganciclovir and PO Valganciclovir

Question 19

Profuse bloody diarrhoea + RUQ pain?

Answer 19

Amoebic liver abscess

Question 20

Giardiasis

Answer 20

x

Question 21

How is latent TB treated?

Answer 21

Isonaizid (with Pyridoxine) for 6 months

Question 22

What is LGV?

Answer 22

Caused by chlamydia trachoma’s
However majority of patients will be HIV positive
Stage 1 = small painless ulcer
Stage 2 = painful inguinal lymphadenopathy
Stage 3 = Proctocolitis = Bloody bowel movements, rectal bleeding, abode pain, rectal pain

Question 23

How to manage Jarisch-Herxheimer reaction?

Answer 23

Paracetamol

Question 24

What are options for malaria prophylaxis?

Answer 24

Doxycycline

Mefloquine

Question 25

What is schistosomiasis and how does it present? How is it managed?

Answer 25

Parasitic flatworm infection
Enters from water - from freshwater swimming

Initially presents with a swimmer’s itch
Can then lead to hepatosplenomegaly, RUQ pain
Chronic = haematuria + dysuria

Management = praziquantel

Question 26

Chancroid vs. Chancre vs. LGV

Answer 26

Chancroid = painless ulcer, painless lymphadenopathy

Chancre= painful ulcer, painful lymphadenopathy

LGV= painless ulcer, painful lymphadenopathy

Question 27

Chagas disease

Answer 27

x

Question 28

How is leptospirosis managed?

Answer 28

Benzylpenicillin or Doxycycline

Question 29

What is the incubation period of Salmonella and E.coli?

Answer 29

24-48 hrs

Question 30

Which causes of gastroenteritis have an incubation period of more than 7 days?

Answer 30

Giardiasis

Amoebiasis

Question 31

What is lymphogranuloma vereneum and how does it present?

Answer 31

Caused by chlamydia trachoma’s
However majority of patients will be HIV positive
Stage 1 = small painless ulcer
Stage 2 = painful inguinal lymphadenopathy
Stage 3 = Proctocolitis = Bloody bowel movements, rectal bleeding, abode pain, rectal pain

Question 32

How does tetanus present? How is it managed?

Answer 32

Prodrome of fever, lethargy and headache
Trismus (lock jaw)
Risus sardonicus - muscles look like patient is grinning
Spasms
Arched back+hyperextended neck

Management = Metronidazole + supportive therapy.

Question 33

How many tetanus doses are given in the UK vaccination schedule and when is the last one given?

Answer 33

5 doses, last one at around 13-18 years of age.

Question 34

Who needs a tetanus booster? Who needs a tetanus booster AND tetanus immunoglobulin?

Answer 34

If last dose <10 yrs = no management needed

Full course but last dose <10 years ago..
Tetanus prone = booster
High risk = booster + immunoglobulins

Vaccine history incomplete/unknown
Everyone = booster
Tetanus prone/high risk = booster + immunoglobulin

Question 35

What is dengue fever and how does it present?

Answer 35

Viral infection spread by mosquito

Retro-orbital headache
Fever
Maculopapualar rash
Fasting flushing
Myalgia

usually mild and self limiting.

Question 36

How can severe dengue fever present?

Answer 36

Can cause thrombocytopenia (low platelets)
Spontaneous Bleeding

Still treated supportively - blood transfusions and fluids

Question 37

What is typhoid fever and how does it present?

Answer 37

Bacterial infection caused by salmonella typhi - spread faeco-orally

Causes systemic upset
Relative bradycardia
Rose spot rash
Constipation is more common than diarrhoea in early stages

Question 38

How is typhoid fever managed?

Answer 38

Ciprofloxacin