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MRCP > ID > Flashcards

ID Flashcards

1
Q

Likely organism in animal and human bites

A

animal: pasteurella multicida
human: strep spp, staph aureus

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2
Q

Mx animal/human bites

A

co-amox

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3
Q

What is campylobacter

A

gram -ve bacillus

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4
Q

Symptoms of campylobacter

A

headache malaise -> bloody diarrhoea abdo pain

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5
Q

Management and complications of campylobacter

A

self limitin
Clari if immunocomp/severe
-GBS, reactive arthritis, sepsis

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6
Q

When would you admit cellulitis for IV Abx?

A

Eron class 3-4
deteriorating
immunocomp
lymphoedema
facial or periorbital

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7
Q

At risk group with hep E

A

pregnant women - 20% mortality due to fulminant hepatitis

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8
Q

Serology of active, previous and immunised HBV

A

active: HBeAg, HBs Ag, Anti HBV IgM
Previous: Anti HBV IgG, HBs Ab
Imms: HBsAb

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9
Q

Management of HBV

A

pegylated interferon alpha
telbivudine, tenofovir
Imms: routine, IVDU, occupation, CLD, CKD

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10
Q

Management of HBV in prengnancy

A

90% risk of neonate developing chronic hep so given HBV vaccine and anti hep B immunoglobulins

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11
Q

HCV serology

A

HCV RNA +Ve
If >6m = chronic HCV

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12
Q

Management of HCV

A

protease inhibs
- daclatasvir+sofobuvir ±ribavirin

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13
Q

Types of HDV

A

co-infection: same time as HBV
superinfection: after HBV , associated with fulminant hep, chronic hep, cirrhosis

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14
Q

Diagnosis and management of HDV

A

PCR hepatitis D RNA
interferon

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15
Q

Pathophysiology HIV

A

binds to CD4 and GP120 glycoprotein on T cells
RNA->DNA (transcriptase)
Viral DNA into host DNA (integrase)
host cell releases virons (protease) which infect further T cells

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16
Q

Examples of cells with CD4 receptors

A

Macrophages, monocytes, T cells

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17
Q

How is HIV diagnosed

A

HIV antibody and HIV Antigen

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18
Q

Symptoms based on time HIV

A

first 12 weeks - acute phase, flu like
following this symptoms based on CD4 count

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19
Q

Presentation if CD4 count 200-500

A

-oral thrush
-shingles
-hairy leukoplakia
-Karposi sarcoma

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20
Q

Presentation if CD4 count 100-200

A

*pneumocystic jirovecii pneumonia
cerebral toxoplasmosis
multifocal lymphadenopathy

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21
Q

Presentation if CD4 count 50-100

A

aspergillosis
oesophageal candidiasis
cyrptococcal meningitis
CNS lymphoma

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22
Q

Presentation CD4 count <50

A

cytomegalovirus retintitis
mycobacterium avium complex

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23
Q

Compare CT findings of cerebral toxoplasmosis and CNS lymphoma

A

Cerebral toxoplasmosis: multiple ring enhancing lesions
CNS lymphoma: one homogeneous enhancing lesion

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24
Q

Management of HIV

A

start on diagnosis
2 NRTI + PI or NNRTI

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24
Q

What would pizza haemorrahage on fundoscopy indicate in HIV pt and how would you treat

A

cytomegalovirus CD4 count <50
IV ganciclovir

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25
Q

Presentation of malaria

A

fever
fatigue
headache
jaundice
splenomegaly

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26
Q

Pattern of malaria fever based on organism

A

vivax/ovale - 48hrs
malariae - 72hrs
falciparum - variable

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27
Q

Signs & treatment of severe malaria

A
  • falciparum
    schizonts on blood film
    >2% parasitaemia: IV artesunate
    >10% parasitaemia: plasma exchange
28
Q

Treatment of non falciparum malaria

A

artemisinin based combination therapy (ART) or choroquine
ovale/vivax: primaquine after cholorquine to destroy liver hypnozoites and prevent relapse

29
Q

Diagnosis of malaria

A

thin blood film: species
thick blood film: specific

30
Q

Prophylaxis malaria

A

malarone: 1-2 days before, 7 days after
doxy: 1-2 days before, 4 weeks after
chloroquine: 1 week before, 4 weeks after

31
Q

Causes of meningitis 0-3m

A

GpB strep, e, coli, listeria

32
Q

Causes of meningitis 3m-6y

A

N meningitis, s pneumoniae, h influenzae

33
Q

Causes of meningitis 6-60

A

N meningitis, s pneumonia

34
Q

Causes meningitis >60

A

N meningits, s pneumoniae, Listeria

35
Q

Cause of meningitis immunocomp

A

listeria

36
Q

Reasons to delay LP in ?meningitis

A

severe sepsis, resp/cardio compromise, increased ICP

37
Q

Management of meningitis

A

IV cef (+ amox if >50)
IV amox (listeria)

38
Q

When do you give prophylaxis in meningitis

A

bacterial + contact within 7 days of symptoms
PO cipro or rifampicin

39
Q

Diagnosis of chlamydia

A

NAAT

40
Q

Management chlamydia

A

doxy 7/7
azithromycin if preg

41
Q

diagnosis of genital herpes

A

NAAT
HSV1 HSV2

42
Q

Management of genital herpes

A

PO aciclovir
ECS if 28/39

43
Q

Management of genital warts

A

topical podophyllum or cyrotherapy

44
Q

Organism gonorrhoea

A

gram -ve diplococcus

45
Q

Management of gonorrhoea

A

IM ceftriaxone + PO cipro if sensitive

46
Q

What can gonorrhoea progress to?

A

disseminated gonococcal infection
-tenosynovitis
-migratory polyarthritis
-dermatitis

47
Q

Diagnosis of mono

A

Monospot test

48
Q

Cause of PID

A

chlamydia trachomatis, n. gonorrhoea

49
Q

Management PID

A

PO met + PO ofloxacin
or
PO met + PO doxy + IM cef

50
Q

Cause of syphilis

A

treponema pallidum

51
Q

Presentation of syphilis

A

Primary: chancre
Secondary: rash, fever, ulcer, genital warts
Tertiary: skin/bone lesions, aortic aneurysm, argyll-robertson pupil

52
Q

Management of syphliis

A

IM benzathine penicillin
non-treponemal titres to monitor

53
Q

Cause/Presentation/Mx of BV

A

gardnerella vaginalis
fishy, thin white discharge
Clue cells
PO met

54
Q

Cause/presentation/Mx of trichomonas

A

trichomonas vaginalis
offensive green discharge
strawberry cervix
microscopy: wet mount
PO met

55
Q

Cause of acute epiglottitis

A

h. influenzae

56
Q

on XR what would thumb sign and and steeple sign indicate

A

thumb: acute epiglottitis
Steeple: Croup

57
Q

Management of acute epiglottitis

A

senior support, o2 IV Abx

58
Q

Management of croup

A

dex

59
Q

Cause of croup

A

PIV

60
Q

Dengue cause

A

RNA virus, aedes aegypti mosquito

61
Q

Presentation of Dengue

A

fever
headache
myalgia
pleuritic pain
rash

62
Q

Investigation and treatment of Dengue

A

NAAT
symptomatic

63
Q

Explain the types of TB

A

primary: Ghon focus+hilar lymph nodes = Ghon complex
Secondary: reactivation due to immunosuppression (steroids, HIV, malnutrition)

64
Q

Site of TB

A

Usually lung apex
CNS
Vertebral bodies

65
Q

TB symptoms

A

Primary: fever, pleuritic pain
Secondary: cough, weight loss, fatigue, night sweats

66
Q

TB diagnosis

A

Latent: Mantoux test
Active: CXR, sputum smear, sputum culture, NAAT

67
Q

TB management

A

active
2/12: RIPE
4/12: RI

Latent
3/12: RI
or 6/12 I

MRCP (19 decks)

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