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
