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ID Flashcards

1
Q

Treatment regime in Isoniazod-resistant TB

A

2 months of RIPE
Then further 4 months of Rifampicin and Ethambutol (in place of RI)

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2
Q

Features of Strongyloides stercoralis infection (nematode worm)

A

Diarrhoea + abdo pain + bloating
Linear itchy rash (larva currens)
Pneumonitis if larvae migrate to lungs

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3
Q

Treatment of Strongyloidiasis

A

Ivermectin/albendazole

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4
Q

Features of Strongyloides Hyperinfection Syndrome (proliferation of larvae in immunosuppression)

A

Paralytic ileus
Sepsis due to gut bacteria translocation
Pulmonary infitrates

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5
Q

Suspect Lyme disease - erythema migrans is present

A

Treat: Doxycyline 14 - 21 days

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6
Q

Suspect Lyme disease - no erythema migrans.

A

ELISA for Borrelia burgdorferi antibodies

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7
Q

Suspect Lyme disease - (no erythema migrans) - Borrelia ELISA serology negative at <4wk since symptom onset

A

Repeat ELISA in 4-6wk

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8
Q

Suspect Lyme disease - (no erythema migrans) - Borrelia serology negative at >12wk since symptom onset

A

Immunoblot

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9
Q

Suspect Lyme disease - (no erythema migrans) - Borrelia ELISA positive

A

Immunoblot test

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10
Q

Suspect Lyme disease - (no erythema migrans) - Borrelia serology equivocal

A

Immunoblot

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11
Q

Management of early Lyme disease - in pregnancy

A

Amoxicillin (doxycycline CI in pregnancy)

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12
Q

Management of disseminated Lyme disease - in pregnancy

A

Ceftriaxone

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13
Q

Monitoring of HIV

A

Viral load every 6m

CD4 count annually

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14
Q

Clostridium botulinum - bacterial identification

A

Gram positive anaerobic bacillus

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15
Q

Management of botulism

A

Botulism antitoxin (if early)
Supportive care

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16
Q

Features of leprosy

A

Hypopigmented patches
Anaesthetic nodules
May be symmetrical or asymmetrical nerve involvement
Alopecia

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17
Q

Diagnosis of leprosy

A

Skin biopsy

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18
Q

Management of leprosy

A

Triple therapy:
Rifampicin + dapsone + clofazimine

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19
Q

Features of Mycoplasma pneumonia

A

Dry cough
Prolonged flu-like
Erythema multiforme
Hyponatraemia
Haemolytic anaemia (cold agglutinins)

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20
Q

Treatment of latent TB (asymptomatic TB, positive blood test, no imaging findings)

A

Dual therapy, either:

3 months of Isoniazid (+Pyridoxine) + Rifampicin

or

6 months of Isoniazid (+Pyridoxine)

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21
Q

Which drugs risk re-activation of TB

A

TNF inhibitors:
Etanercept
Infliximab

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22
Q

Tests used to diagnose latent TB

A

Quantiferon (IFN-g release assay)
Mantoux

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23
Q

Features of Dengue fever

A

Fever
Severe bone/muscle aches
Retro-orbital headache
Maculopapular rash
Low WCC, low PLT
Haemorrhagic phase

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24
Q

Treatment of Dengue fever

A

Supportive

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25
Features of Scrub typhus
Fever + muscle pain Eschar at mite entry site
26
Features of Typhoid fever
Relative bradycardia Abdo pain Rose spots Reactive athritis
27
Features of Chikungunya fever
Severe joint pain + swelling High fevers Lymphopenia Thrombocytopenia
28
Ross River Virus - endemic in
Australia
29
Chikungunya fever - endemic in
Africa Asia Caribbean
30
Treatment for schistosomiasis
Praziquantel
31
Treatment for giardiasis
1 week Metronidazole or 3g Tinidazole stat
32
Cryptococcus meningitis (fungal) - CSF findings
Raised opening pressure Lymphocytosis High protein Low glucose
33
Management of Cryptococcus meningitis
Amphotericin B
34
Treatment for amoebic liver abscess
Metronidazole
35
Treatment of fungal liver abscesses
Amphotericin B
36
Treatment for intestinal amoeba (after treated the liver abscess)
Diloxanide furoate
37
Antibiotic for Legionnaire's disease
Macrolide (clarithromycin/erythromycin) or quinolone (levofloxacin)
38
Antibiotic treatment of Listeria meningitis
IV amoxicillin/ampicillin + gentamicin
39
Antibiotic treatment of tetanus wound (after debridement and tetanus globulin)
Metronidazole IV
40
1st line management of Brucellosis
Oral doxycycline + rifampicin
41
Management of Brucellosis with neurological involvement
IV Ceftriaxone + doxycycline + rifampicin
42
Management of brucellosis with endocarditis
Gentamicin + doxycycline + rifampicin
43
Presentation of Yersinia enterocolitica
Pseudo-appendicitis Reactive arthritis Erythema nodosum
44
Treatment of Yersinia
Aminoglycoside (gentamicin)
45
Treatment of salmonella gastroenteritis (non typhoid)
Ciprofloxacin
46
DIffuse macular/papular/nodular rash with discoloration, after treatment for visceral leishmaniasis
Post-kala-azar dermal leishmaniasis (PKDL)
47
Visceral leishmaniasis "kala-azar" (spread by sand fly) - endemic in
Mediterannean, Middle East, Asia, Africa, S. America,
48
Features of Giardiasis
Prolonged diarrhoea >10days Bloating, abdo pain Non-bloody
49
Farmer, with fever, pneumonia, transaminitis, think...
Q fever (Coxiella burnetii)
50
Treatment of Q fever (Coxiella)
Doxycycline
51
Management of mild PCP
Co-trimoxazole
52
Management of moderate/severe PCP (eg diffuse shadowing on CXR/ low sats/ breathless at rest),
Co-trimoxazole + corticosteroids
53
What does a positive IGRA (interferon-gamma release assay) indicate?
Active or latent TB
54
What might positive Mantoux test (induration 6-15mm) indicate?
Latent TB Miliary TB Sarcoidosis HIV Lymphoma
55
Antibiotic used for Shigella (if needed)
CIprofloxacin
56
Antibiotic used for Campylobacter (if needed)
Ciprofloxacin
57
Antibiotic used for Cholera (if needed)
A tetracycline
58
Features of Brucellosis
Fever, malaise Sacroiliitis Contact with sheep/goats or animal products in Med/Middle East
59
Features of malaria
Fever, myalgia Jaundice Hepatosplenomegaly
60
Features of viral haemorrhagic fevers (Yellow fever, Dengue, Ebola, Lassa)
Prodrome Anaemia, thrombocytopenia Renal failure DIC
61
Treatment of uncomplicated Falciparum malaria
"ACT" Artemisinin-based combination therapy (eg artesunate plus mefloquine)
62
Treatment of severe/complicated Falciparum malaria
IV artesunate Exchange transfusion if parasite count >10%
63
Who needs to be treated for non-typhoidal salmonella gastroenteritis?
>50 years old and: Immunocompromised Valve disease Endovascular abnormality
64
Features of Yellow fever
Fever + malaise Jaundice Conjunctival injection Relative bradycardia
65
Councilman bodies in hepatocytes - seen in which disease
Yellow fever
66
Antibiotics used to treat carbapenemase producing enterobacteriaceae (CPE)
Gentamicin (macrolide) Tigecycline Fosfomycin Colistin
67
Treatment of typhoid fever
Cefotaxime/ceftriaxone
68
Features of Visceral Leishmaniasis (kala-azar)
Fevers Hepatosplenomegaly Pancytopenia Grey skin
69
Gold standard test for visceral leishmaniasis
Bone marrow or splenic aspirate (amastigote parasites)
70
Confusion in returned traveller from Asia, think
Japanese encephalitis
71
HIV positive with headache and neurological symptoms, think...
CNS cryptococcus
72
Test for Cryptococcus
India ink
73
Treatment of CNS cryptococcal infection
IV amphotericin B + flucytosine
74
Treatment of staph aureus bactaraemia
At least 2 weeks of IV Flucloxacillin
75
Features of acute schistosomiasis infection
Cough Bloody diarrhoea Eosinophilia Splenomegaly
76
Diagnosis of intestinal Cryptosporidium parvum (protozoan)
Cysts seen on acid-fast stain of stool culture
77
Indication for varicella-zoster immunoglobulin (VZIG)
Should be given within 7 days of exposure to: Immunosuppressed Neonates Pregnant without varicella antibodies
78
Management of chickenpox in immunocompromised individuals (once developed chickenpox)
IV aciclovir
79
Fever on alternate days - suggestive of
P. vivax or P. ovale malaria
80
Treatment of plasmodium vivax malaria
Chloroquine + primaquine (for hyponozoites)
81
Gold standard diagnostic test for strongyloidiasis
Stool microscopy
82
Best test for strongyloidiasis eradication
Serological testing
83
Management of low-severity community acquired pneumonia
Amoxicillin 5 days
84
Management of low-severity community acquired pneumonia (pen-allergic)
Macrolide (clarithromycin) or tetracycline 5 days
85
Management of moderate severity community acquired pneumonia
Amoxicillin + macrolide 7-10 days
86
Management of high severity community acquired pneumonia
Co-amoxiclav (or ceftriaxone/tazocin) + macrolide
87
CURB-65 score - 1 point for C if
AMTS <= 8/10
88
CURB-65 score - 1 point for U if
Urea > 7
89
CURB-65 score - 1 point for R if
RR >= 30
90
CURB-65 score - 1 point for B if
Systolic <= 90 or diastolic <= 60
91
Management of CURB-65 score 2+
Consider hospital admission
92
Management of CURB-65 score 3+
Consider ITU
93
Which HIV patients should receive PCP (pneumocystis carinii) prophylaxis
All those with CD4 count <200/mm
94
Which non-HIV patients should receive PCP prophylaxis
Transplant recipients (solid organ or stem cell) Taking steroids + another immunosuppressant for >1m AI condition with lung involvement + high dose steroid >1m
95
Diagnosis of PCP
Broncho-alveolar lavage - shows cysts with silver staining
96
Initial empirical treatment for meningitis if <3 months old
IV cefotaxime + amoxillin/ampicillin)
97
Initial empirical treatment for meningitis if 3 months - 50 years old
IV cefotaxime/ceftriaxone
98
Initial empirical treatment for meningitis if >50 years old
IV cefotaxime/ceftriaxone + amoxicillin/ampicillin
99
Treatment of meningococcal meningitis
IV benzylpenicillin or IV cefotaxime/ceftriaxone
100
Treatment of pneumococcal meningitis
IV cefotaxime/ceftriaxone
101
Treatment of meningitis caused by Haemophilus influenzae
IV cefotaxime/ceftriaxone
102
Treatment of meningococcal meningitis (pen-allergic)
Chloramphenicol
103
Treatment of meningitis caused by Haemophilus influenzae (pen-allergic)
Chloramphenicol
104
Haemophilus influenzae appearance under microscope
Gram-negative coccobacilli
105
Chlamydia trachomatis gram-stain
Gram-negative coccobacilli
106
Management of close contacts of meningococcal meningitis (close contact within the 7 days before onset)
PO ciprofloxacin STAT or PO Rifampicin BD 2 days or IM ceftriaxone Meningococcal vaccination when serotype availabe

**Bank (74 decks)

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