ID Flashcards
Campylobacter mx
Usually self limiting
Clarithromycin in severe or immmunocompromised
Chlamydia mx
7 day doxycycline first line
Azithromycin if pregnant
Legionella mx
Erythomycin/ clarity,ycin
Herpes simplex virus features
primary infection: may present with a severe gingivostomatitis
cold sores HSV 1
painful genital ulceration HSV 2
Herpes simplex mx
gingivostomatitis: oral aciclovir, chlorhexidine mouthwash
cold sores: topical aciclovir although the evidence base for this is modest
genital herpes: oral aciclovir. Some patients with frequent exacerbations may benefit from longer term aciclovir
Herpes zoster opthal,icus mx
Oral antivirals
Urgent opth rv
Curb score criteria
CConfusion (abbreviated mental test score <= 8/10)
RRespiration rate >= 30/min
BBlood pressure: systolic <= 90 mmHg and/or diastolic <= 60 mmHg
65ged >= 65 years
Ix in grilling barre
Abnormal nerve conduction studies
Rise in wcc on lp
DIC typical bloods
↓ platelets
↓ fibrinogen
↑ PT & APTT
↑ fibrinogen degradation products
Ecoli features
Common amongst travellers
Watery stools
Abdominal cramps and nausea
Giardiasis Features
Prolonged, non-bloody diarrhoea
Cholera features
Profuse, watery diarrhoea
Severe dehydration resulting in weight loss
Not common amongst travellers
Shigella features
Bloody diarrhoea
Vomiting and abdominal pain
Campylobacter features
A flu-like prodrome is usually followed by crampy abdominal pains, fever and diarrhoea which may be bloody
May mimic appendicitis
Complications include Guillain-Barre syndrome
Amoebiasis features
Gradual onset bloody diarrhoea, abdominal pain and tenderness which may last for several weeks
Most common cause of pneumonia in alcohol dependence
Klebsiella pneumoniae
Which bacteria oresents as atypical (or ‘walking’) pneumonia with gradual onset of symptoms over several weeks
Mycoplasma
Which pneumonia is most common after an influenza infection?
Staph A
Characteristics of pneumococcal pneumonia
rapid onset
high fever
pleuritic chest pain
herpes labialis (cold sores)
Wounds and tetanus booster
Patient has had a full course of tetanus vaccines, with the last dose < 10 years ago
no vaccine nor tetanus immunoglobulin is required, regardless of the wound severity
Patient has had a full course of tetanus vaccines, with the last dose > 10 years ago
if tetanus prone wound: reinforcing dose of vaccine
high-risk wounds (e.g. compound fractures, delayed surgical intervention, significant degree of devitalised tissue): reinforcing dose of vaccine + tetanus immunoglobulin
If vaccination history is incomplete or unknown
reinforcing dose of vaccine, regardless of the wound severity
for tetanus prone and high-risk wounds: reinforcing dose of vaccine + tetanus immunoglobulin
ebv / infectious mononucleosis mx
rest during the early stages, drink plenty of fluid, avoid alcohol
simple analgesia for any aches or pains
consensus guidance in the UK is to avoid playing contact sports for 4 weeks after having glandular fever to reduce the risk of splenic rupture
Post exposure prophylaxis hep C
monthly PCR - if seroconversion then interferon +/- ribavirin
Post exposure prophylaxis HIv
Oral anti retrovirals ASAP for 4 weeks
12week test post exposure
Varicella zoster post exposure prophylaxis
VZIG for IgG negative pregnant women/immunosuppressed
Haemophilus influenza features
Community-acquired pneumonia
Most common cause of bronchiectasis exacerbations
Acute epiglottitis
Staph A Pnuemknia features
Pneumonia, particularly following influenza
Mycoplasmampneumojiae features
Atypical pneumonia
Flu-like symptoms classically precede a dry cough. Complications include haemolytic anaemia and erythema multiforme
Legionella oneumophilia features
Atypical pneumonia
Classically spread by air-conditioning systems, causes dry cough. Lymphopenia, deranged liver function tests and hyponatraemia may be seen
Pneumonitis jerovicci features
Common cause of pneumonia in HIV patients. Typically patients have few chest signs and develop exertional dyspnoea
Mx toxoplasmosis
No treatment is usually required unless the patient has a severe infection or is immunosuppressed
Kaposi sarcoma features
caused by HHV-8 (human herpes virus 8)
presents as purple papules or plaques on the skin or mucosa (e.g. gastrointestinal and respiratory tract)
skin lesions may later ulcerate
respiratory involvement may cause massive haemoptysis and pleural effusion
radiotherapy + resection
Trichomonas
features
Trichomonas vaginalisis a highly motile, flagellated protozoan parasite. Trichomoniasis is a sexually transmitted infection (STI).
Features
vaginal discharge: offensive, yellow/green, frothy
vulvovaginitis
strawberry cervix
pH > 4.5
in men is usually asymptomatic but may cause urethritis
Trichomonas
management
oral metronidazole for 5-7 days, although the BNF also supports the use of a one-off dose of 2g metronidazole
Different types of stye
external (hordeolum externum): infection (usually staphylococcal) of sebum producing or glands of sweat glands
internal (hordeolum internum): infection of the Meibomian glands. May leave a residual chalazion (Meibomian cyst)
management includes hot compresses and analgesia. CKS only recommend topical antibiotics if there is an associated conjunctivitis
What is a chalazion
retention cyst of the Meibomian gland. It presents as a firm painless lump in the eyelid. The majority of cases resolve spontaneously but some require surgical drainage
Enteric fever features
initially systemic upset as above
relative bradycardia
abdominal pain, distension
constipation: although Salmonella is a recognised cause of diarrhoea, constipation is more common in typhoid
rose spots
labs previous Hep B imms
anti-HBs positive, all others negative
labs previas Hep B infection >6month
not a carrier
anti-HBc positive, HBsAg negative
previous hepatitis B, now a carrier:
anti-HBc positive, HBsAg positive
