ID Flashcards

1
Q

what is the management of HIV?

A

three drugs, typically two nucleoside reverse transcriptase inhibitors (NRTI) and either a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor (NNRTI)

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2
Q

if you get a needlestick injury from a HIV positive patient what should you do?

A

oral antiretroviral therapy should be started within 72 hours of exposure for 4 weeks

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3
Q

what are the features of gonorrhoea?

A

males: urethral discharge, dysuria
females: cervicitis leading to vaginal discharge

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4
Q

what is the management of gonorrhoea?

A

single dose of IM ceftriaxone 1g
if ceftriaxone is refused e.g. needle-phobic then oral cefixime 400mg (single dose) + oral azithromycin 2g (single dose) should be used

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5
Q

what is the treatment of bacterial vaginosis?

A

oral metronidazole for 5-7 days

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6
Q

what are the amsel’s criteria for diagnosis of bacterial vaginosis?

A

3 of the following 4 criteria should be present:
- thin white homogenous discharge
- clue cells on microscopy
- vaginal pH > 4.5
- positive whiff test (addition of potassium hydroxide results in fishy odour)

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7
Q

What should all people with TB be offered?

A

HIV test

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8
Q

What is lymphogranuloma venereum?

A

Caused by chlamydia thrachomatis
typically infection compromises three stages:
- stage 1: small painless pustule which later forms an ulcer
- stage 2: painless inguinal lymphadenopathy
- stage 3: proctocolitis

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9
Q

what are the risk factors for lymphogranuloma venereum?

A

men who have sex with men
the majority of patients who present in developed countries have HIB
historically was seen more in the tropics

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10
Q

What causes adrenal insufficiency in patients with HIV?

A

Commonly due to cytomegalovirus-related necrotising adrenalitis

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11
Q

According to British Infection Association guidelines, what should you do if you suspect bacterial meningitis?

A

LP should be performed within 1 hour of arrival at hospital provided it is safe to do so
treatment should be commenced immediately after the LP has been performed and within the first hour
If the LP cannot be performed within 1 hour treatment should be commenced immediately after blood cultures have been taken and LP performed as soon as possible after that

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12
Q

What is the incubation period for staph aureus and how does it present?

A

1-6 hrs,
severe vomiting
short incubation period

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13
Q

what is the incubation period of bacillus cereus and how does it present?

A

within 1-6 hrs
two types of illness are seen:
- vomiting within 6 hours, stereotypically due to rice
- diarrhoeal illness occurring after 6 hrs

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14
Q

what is the incubation period of e. coli and how does it present?

A

12-48 hrs,
commonest amongst travellers
watery stools
abdo cramps and nausea

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15
Q

what is the incubation period of shigella and how does it present?

A

48-72 hrs
bloody diarrhoea
vomiting and abdo pain

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16
Q

what is the incubation and presentation of campylobacter?

A

48-72 hrs incubation
a flu-like prodrome is usually followed by crampy abdo pains, fever and diarrhoea which may be bloody
may mimic appendicitis
complications include guillain-barre syndrome

17
Q

What are the early features of Lyme Disease?

A

early features - within 30 days:
- erythema migrans: bulls eye rash typically seen at the site of tick bite, typically develops 1-4 weeks after initial bite but may present sooner, usually painless, more than 5cm diameter and slowly increases in size
- systemic features: headache, lethargy, fever, arthralgia

18
Q

What is the Jarisch-Herxheimer reaction and what does it relate to?

A

treatment of syphilis:
- fever, rash, tachycardia after the first dose of antibiotic
- in contrast to anaphylaxis, there is no wheeze or hypotension
- it is thought to be due to release of exotoxins following bacterial death and typically occurs within a few hours of treatment
- no treatment is needed other than antipyretics if required

19
Q

What is the management of syphillis?

A

intramuscular benzathine penicillin is first-line management
alternatives: doxycycline

20
Q

what are the features of dengue fever?

A

fever
headache - retro-orbital
myalgia, bone pain, arthralgia
pleuritic pain
facial flushing
Maculopapular rash
Haemorrhagic manifestations - positive tourniquet test, petechiae, purpura/ecchymosis, epistaxis
warning signs include: abdominal pain, hepatomegaly, persistent vomiting, clinical fluid accumulation - ascites, pleural effusion

21
Q

what are the features of severe dengue?

A

haemorrhagic fever: form of DIC resulting in thrombocytopenia and spontaneous bleeding

22
Q

which vaccines are live attenuated vaccines?

A

BCG
MMR
influenza (intranasal)
oral rotavirus
oral polio
yellow fever
oral typhoid

23
Q

what is Kaposi’s sarcoma?

A

infection common in ppl with HIV
caused by human herpes virus 8
presents as purple papules or plaques on the skin or mucosa
skin lesions may later ulcerate
respiratory involvement may cause massive haemoptysis and pleural effusion
requires radiotherapy and resection

24
Q

what is cryptococcus?

A

most common fungal infection of CNS
presents with headache, fever, malaise, nausea/vomiting, seizures, focal neurological deficit
meningitis is typical presentation but may occasionally present with space-occupying lesion

25
Q

what is the treatment of neutropenic sepsis?

A

immediate broad spectrum antibiotics e.g. piperacillin with tazobactam (tazocin)

26
Q

what type of bacteria is chlamydia?

A

gram -ve bacteria, intracellular organism
most common sexually transmitted infection in the UK and a significant cause of infertility

27
Q

what is the national chlamydia screening programme?

A

programme set up by public health England which aims to screen every sexually active person under 25 for chlamydia annually or when they change their sexual partner - everyone that tests positive should have a re-test 3 months after treatment

28
Q

what are charcoal swabs used for and what can they confirm?

A

used for endocervical swabs and high vaginal swabs and they can confirm
BV
Candida
Gonorrhoea
Trichomonas
Group B strep

29
Q

what is NAAT testing used for?

A

used specifically for chlamydia and gonorrhoea

30
Q

what is cryptosporidiosis?

A

commonest protozoal cause of diarrhoea in the UK
common in immunocompromised (HIV) patients and in young children

31
Q

what antibiotics are commonly used to treat MRSA infections?

A

vancomycin
teicoplanin
linezolid

32
Q

What is the gold standard investigation for TB?

A

sputum culture

33
Q

what feature of c.dif makes it so difficult to destroy?

A

spore formation

34
Q

what cancers are linked to HPV infection?

A

over 99.7% are cervical cancers
around 85% are anal cancers
around 50% are vulval and vaginal cancers
around 20-30% of mouth and throat cancers