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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
What would pizza haemorrahage on fundoscopy indicate in HIV pt and how would you treat
cytomegalovirus CD4 count <50 IV ganciclovir
25
Presentation of malaria
fever fatigue headache jaundice splenomegaly
26
Pattern of malaria fever based on organism
vivax/ovale - 48hrs malariae - 72hrs falciparum - variable
27
Signs & treatment of severe malaria
- falciparum schizonts on blood film >2% parasitaemia: IV artesunate >10% parasitaemia: plasma exchange
28
Treatment of non falciparum malaria
artemisinin based combination therapy (ART) or choroquine ovale/vivax: primaquine after cholorquine to destroy liver hypnozoites and prevent relapse
29
Diagnosis of malaria
thin blood film: species thick blood film: specific
30
Prophylaxis malaria
malarone: 1-2 days before, 7 days after doxy: 1-2 days before, 4 weeks after chloroquine: 1 week before, 4 weeks after
31
Causes of meningitis 0-3m
GpB strep, e, coli, listeria
32
Causes of meningitis 3m-6y
N meningitis, s pneumoniae, h influenzae
33
Causes of meningitis 6-60
N meningitis, s pneumonia
34
Causes meningitis >60
N meningits, s pneumoniae, Listeria
35
Cause of meningitis immunocomp
listeria
36
Reasons to delay LP in ?meningitis
severe sepsis, resp/cardio compromise, increased ICP
37
Management of meningitis
IV cef (+ amox if >50) IV amox (listeria)
38
When do you give prophylaxis in meningitis
bacterial + contact within 7 days of symptoms PO cipro or rifampicin
39
Diagnosis of chlamydia
NAAT
40
Management chlamydia
doxy 7/7 azithromycin if preg
41
diagnosis of genital herpes
NAAT HSV1 HSV2
42
Management of genital herpes
PO aciclovir ECS if 28/39
43
Management of genital warts
topical podophyllum or cyrotherapy
44
Organism gonorrhoea
gram -ve diplococcus
45
Management of gonorrhoea
IM ceftriaxone + PO cipro if sensitive
46
What can gonorrhoea progress to?
disseminated gonococcal infection -tenosynovitis -migratory polyarthritis -dermatitis
47
Diagnosis of mono
Monospot test
48
Cause of PID
chlamydia trachomatis, n. gonorrhoea
49
Management PID
PO met + PO ofloxacin or PO met + PO doxy + IM cef
50
Cause of syphilis
treponema pallidum
51
Presentation of syphilis
Primary: chancre Secondary: rash, fever, ulcer, genital warts Tertiary: skin/bone lesions, aortic aneurysm, argyll-robertson pupil
52
Management of syphliis
IM benzathine penicillin non-treponemal titres to monitor
53
Cause/Presentation/Mx of BV
gardnerella vaginalis fishy, thin white discharge Clue cells PO met
54
Cause/presentation/Mx of trichomonas
trichomonas vaginalis offensive green discharge strawberry cervix microscopy: wet mount PO met
55
Cause of acute epiglottitis
h. influenzae
56
on XR what would thumb sign and and steeple sign indicate
thumb: acute epiglottitis Steeple: Croup
57
Management of acute epiglottitis
senior support, o2 IV Abx
58
Management of croup
dex
59
Cause of croup
PIV
60
Dengue cause
RNA virus, aedes aegypti mosquito
61
Presentation of Dengue
fever headache myalgia pleuritic pain rash
62
Investigation and treatment of Dengue
NAAT symptomatic
63
Explain the types of TB
primary: Ghon focus+hilar lymph nodes = Ghon complex Secondary: reactivation due to immunosuppression (steroids, HIV, malnutrition)
64
Site of TB
Usually lung apex CNS Vertebral bodies
65
TB symptoms
Primary: fever, pleuritic pain Secondary: cough, weight loss, fatigue, night sweats
66
TB diagnosis
Latent: Mantoux test Active: CXR, sputum smear, sputum culture, NAAT
67
TB management
active 2/12: RIPE 4/12: RI Latent 3/12: RI or 6/12 I

MRCP (19 decks)

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