ID

Question 1

Profuse watery diarrhoea in an HIV positive patient with low CD4?

Answer 1

Think cryptosporidium

Question 2

Fatigue, fever, hepatomegaly in a farmer?

Answer 2

Brucellosis

Question 3

Considerations in starting ART with a low CD4 and concurrent infection

Answer 3

Generally, start ASAP especially if <100
However, if <50 consider the risk of immune reconstitution syndrome

Question 4

Tropical travel history, genital ulcer with friable edges which UNLIKE syphilis is growing?

Answer 4

Granuloma inguanale (klebsiella granulomatis)

Question 5

Travel abroad, might mention trekking, malabsorption and eosinophilia?

Answer 5

Strongyloides

Question 6

Which vaccine do you never give to HIV patients

Answer 6

BCG

Question 7

Most common CNS infection in HIV patients with CD4 <200?
CT appearances?

Answer 7

Toxoplasmosis
RIng enhancing lesions with oedema

Question 8

Frothy vaginal discharge? Strawberry cervix? Swollen labia?

Answer 8

Trichomonas

Question 9

Trauma to the eye followed by an ulcerative lesion, mention of a feathery edge, satellite lesions? Organism if caused by plant matter?
(May be atraumatic in HIV patients)

Answer 9

Mycotic keratitis
Aspergillus

Question 10

Cheese and meningitis? What Abx to add

Answer 10

Listeria
Amox

Question 11

AIDS, bloody diarrhoea, recent sexual contact (often MSM)?

Answer 11

Shigella

Question 12

Most common cancer in HIV patients?

Answer 12

KS

Question 13

KS virus association?

Answer 13

HPV 8

Question 14

Violaceous lesions on the limbs of an HIV positive patient?

Answer 14

Think KS

Question 15

KS lesions only in the mouth?

Answer 15

Think respiratory KS

Question 16

Farmer with flu-like symptoms and conjuctivitis, potentially systemically unwell with pulmonary haemorrhage? May also present in a fisherman or someone on a fishing holiday (contact with rat urine)

Answer 16

Leptospirosis

Question 17

Children’s worker, flu-like illness, vesicular rash, grey-yellow mouth ulcers?

Answer 17

Hand foot mouth, coxsackie virus

Question 18

Comma-shaped gram-ve bacilli?

Answer 18

Cholera

Question 19

South American man previously quite well presents with sudden cardiac dysfunction/cardiomyopathy?

Answer 19

Chagas (Trypanosomiasis cruzei)

Question 20

A characteristic linear rash that is itchy and seems to move, often on the feet?

Answer 20

Hookworm
e.g. ancylostoma braziliense

Question 21

Rash in the mouth - red spots with a blue/white centre?

Answer 21

Koplik spots - measles

Question 22

Strongyloides treatment?

Answer 22

Albendazole / ivermectin

Question 23

Cat scratch pathogen?

Answer 23

Barsonella henselae

Question 24

African travel history, nasty genital ulcer and suppurative unilateral lymphadenopathy?

Answer 24

Chancroid