ID Flashcards
What is an effective way of reducing transmission of HIV from mother to baby when pregnant?
Postnatal administration of zidovudine to the baby
What is the most common bacterial infection of industrialised countries?
Campylobacter enteritis
What meat often gives campylobacter infection?
Chicken
What does the parasite entameoba histolytica cause
Intestinal sx (usually bloody diarrhoea)
extra intestinal manifestations (usually liver abscess)
Treatment of tapeworm
Niclosamide
What causes cholera
Vibrio cholerae
Presentation of cholera
Abrupt onset of voluminous watery diarrhoea
Hypoglycaemia
No blood in stool
Treatment of cholera
Rehydration
Doxycycline or co-trimoxazole
What foodstuffs can you get cholera
Shellfish
Presentation of salmonella enteritiis
Significant abdo pain
Blood and mucus in stool
Test for lymes disease
ELISA test
causative organism of lymes disease
Borrelia Burgdorferi
Which hepatitis virus relies on conceurrent hep B infection for replication?
Hep D
WHat does a positive HAV-IgM and positive HAV-IgG mean?
Acute hep A is likely
What does a positive HAV-IgG and negative HAV-IgM indicate?
Past Hep A or immunity from previous vaccination
WHat serological test rises in current Hep B infection?
HbsAg (surface antigen)
WHat indicates the progression to chronic hep B (serologically)
HBsAg, HBeAg, HBVDNA
What indicated Hep B infection in the last 6 months
IgM anti-HBc
What does IgG anti-Hbc indicate?
persists for life and indicates past infection
what does anti-HBs without anti-HBC indicate?
Immunisation
What serological test confirms exposure of Hep C
anti-HCV antibodies
What serological test confirms ongoing Hep C infection
HCV-PCR
WHat is granuloma inguinae and how does it present
Caused by Klebsiella granulomatis
Reproduces in neutrophils plasma cells and histocytes
Primary painless indurated nodule
Progresses to a healed up ulcer
WHat does granuloma inguinae contain
Donovan bodies
Treatment of granuloma inguinae
Doxycycline or co-trim
Serology of aspergillosis
Aspergillus RAST
IgE
Beta glucan
Galactomannan
What is on a CXR when you have histoplasmosis?
Diffuse reinonodular changes (no change in 40-50%)
Treatment of cryptococcal meningitis
Amphotericin B
investigation for gonnorhoea in women
Endocervical swabs and NAAT
Quinine in malaria and insulin
Quinine stimulates insulin release due to extreme catabolism of the burden of malaria infection
These two factors together when given IV quinine can cause severe hypoglycaemia
Treatment of toxoplasmosis in immunocompromised individuals
pyrimethamine with sulfadiazine and folinic acid
Presentation of leprosy
Nodular rash
Gradual scarring of peripheral nerves results in sensory loss
Initial treatment of leprosy
Rifampicin, dapsone and clodazimine
Skin biopsy of nodules in leprosy shows what?
AFB (acid fast bacilli)
What is the hallmark sign of systemic meningococcal disease?
haemorrhagic skin lesions
Features of plasmodium vivax and plasmodium ovale compared to other species of malaria
Have an additional life cycle stage during which hypnozoites form in the liver
Can reactivate months to years after infection
Treatment of plasmodium vivax and ovale
Artemther-lumefantrine or chloroquine
then
Primaquine (eradicates hypnozoite stage of disease)
Presentation of measles
Koplicks spots
Fever
Malaise
Conjunctivitis
Cough
Coryzal sx
Then maculopapular rash develops
spreading from behind ears to face and migrates caudally
Lymphadenopathy and high fever
Cough up to 3 weeks
What can indicate PCP / pneumocistis jiroverci
Elevated 1,3 beta-D glucan levels
What is potts disease
Those with TB
Spondyolitis (especially of lower thoracic spine)
Paraspinous TB abscesses
Psoas abscess
Cord compression
Marked acute phase response with lymphocytosis
How long is reommended treatment for patients with TB treatment to the bone
12 months
How long does mycobacterium tuberculosis take to multiply
18-24 hours
much slower than other organisms
What does bone marrow biopsy showed Hodgkins lymphoma
Reed Sternberg cells
What usually preceeds the rash in measles
Flu like symptoms
Conjunctivitis
How does NAC work in paracetomal overdose?
Conjugation with the toxic metabolite as an exogenous gluthione source
What is whipples disease
A rare chronic multisystem condition caused by the combination of
- infection with gram positive actinobacteria (tropheryma whipellei)
- abnormal response of cell mediated immunity
Presentation of whipples disease
GI Sx
- abdo pain
- diarrhoea
- abdo distension
- steatorrhoea
- anorexia
Lymphadenopathy
Arthropathy
Cough
Intermittent pyrexia
As condition progresses; may be
- cardiac, neurological or resp involvement
Treatment of whipples
Long term Abx therapy (1-2 years)
e.g. 14 days ceftriaxone or benpen
followed by a years maintenance therapy of TMP
Risk factors for whipples disease
Working in agricultural environment
Sewage plant workers
Diagnosis of whipples disease
Jejunal biopsy
- deposition of macrophages containing PAS-positive granules within the villi
What is visceral leishmaniasis caused by
protozoa of Leishmana species
Vectored by the sand fly
Presentation of visceral leishmaniasis
Prolonged chronic deterioration
fevers
night sweats
epistaxis
dry cough
proceeding to weight loss, and further decline
Hepatosplenomegaly
Lymphadenopathy
Diagnosis of visceral leishmaniasis
Microscopy and culture
- of either a lymph node aspirate, splenic biopsy or bone marrow aspirate
Skin manifestations of typhoid
Maculopapular rose spots which blanch on pressing
Presentation of typhoid
Diarrhoea or constipation at onset
Fever
Malaise
Headache
Cough
Anorexia
Maculopapular rose spots
Blood findings of typhoid
Raised transaminases
Neutropenia
Causative organism of typhoid
Salmonella typhi
Treatment of PJP
Co-trimoxazole
Presentation of leptospirosis
Fever
Maliase
Conjunctiviits
Flu like symptoms
Progresses to
- jaundice
- hepatomegaly
- AKI
- aseptic meningitis (Weils disease)
Treatment of leptospirosis
IV penicillin
Where do you commonly catch brucellosis
Middle east
Who is at risk of leptospirosis
Infected animal urine (usually rats) / contaminated water
Contact with animals
Sewage workers
Farmers
Canoeists/rowers
Treatment of strongylodiasis infection
Albendazole for 3 days, can be repeated after 3 weeks if required
Ivermectin
Treatment of giardiasis
Tinidazole
What is strongylodiasis
Parasitic roundworm
How is strongylodiasis caught
Contact between bare skin and soil
Presentation of strongylodiasis
Can be asymptomatic
Abdo pain
Intermittent diarrhoea
Malabsorption
Weight loss
Loffler syndrome - pneumonitis if the larve migrate to the lungs
What does strongylodiasis cause on blood tests
Marked eosinophilia
Which serological marker shows vaccination success after Hep B immunisation
Anti-HBs antibodies
Diarrhoea of cholera is often described as what
Rice water stools
What is rocky mountain spotted fever and where is it seen
USA and south america
Caused by Rickettsia rickettsii, spread by ticks
Presentation of rocky mountain spotted fever
Non generalised headaches
Fever
Distinctive erythematous macular rash on palms and soles that moves centripetaly and after days may become petechial
Treatment of rocky moutnain spotted fever
Doxycycline
If pregnant - chloramphenicol
What should all individuals be screened for before treatment with primaquine
G6PD
Which type of malaria causes the most severe form of the disease
Plasmodium falciparum
Diagnostic tests of malaria
Serial thick and thin malaria blood films
Treatment of uncomplicated falciiparum malaria
Artemesinin combination therapy for at least 3 days
Treatment of severe falciuparum malaria
IV artesunate
2nd line - 5 day course IV quinine followed by second agent (e.g. doxy) for 7 days
What is regarded as a positive mantoux test
> 5mm regardless of previous BCG
What HPV viruses are most assosiated with cervical cancers
HPV-16 and HPV-18
WHat is thrichomonas vaginalis
Sexually transmitted protozoal infection
Presentation of thrichomonas vaginalis
Frothy vaginal discharge
Strawberry cervix O/E
Treatment of trichomonas vaginals
Metronidazole
What is an argyll robertson pupil and where is this seen as a complication of
Accomodates but does not react
Tertirary syphillis
Stool specimen analysis in cholera
Comma-shaped gram negative bacilli
What skin manifestation is assosiated with mycoplasma pneumonia
Erythema multiforme
How is dengue fever transmitted
Female mosquitos
- Aedes ageypti
- adedes albopictus
Presentation of dengue fever
Fever
Headache
Pain behind the eyes
Muscle and joint pains
Nausea and vomiting
Swollen glands
Rash
Diagnosis of dengue fever
Serum RT-PCR
Serum NS1
Serum ELISA
What is seen on ELISA test in dengue fever
IgM detectable after 1 week up until 12 weeks
IgG indicative of past infection and can remain in blood for many years
Treatment of dengue fever
Symptomatic
What is hydatid disease
Caused by dog tapeworm Echinococcus granulosis
Immediate host agricultural animal e.g. sheep
Presentation of hydatid disease
Cysts form in liver and lungs - leading to compesssive symptoms (slow growing)
- haemoptysis
- abdominal pain
- hepatomegaly
WHat is toxic shock syndrome
Acute, severe, multisystem inflammatory response secondary to streptococcal and staphylococcal bacterial toxin release
Most common causes of toxic shock syndrome
Staph A
Strep pyogenes
Presentation of toxic shock syndrome
Viral type symptoms
Pyreixa
Shock (hypotension)
Rash with potential future desquamation
Circulatory collapse
Potential for organ failure
Common antibiotic regime of TSS
IV clinda + IV fluclox/vancomycin
Most common cayses of necrotising fascitis
- Strep pyogenes (group A)
- Klebsiella, Clostridium, E coli, Staph A
Chalymydia and staining
Chalymudia organisms too small to see on staining - cannot grow on any free media
Common cause of keratitis with dendritic ulceration of the cornea
HSV
Presentation of HSV keratitis
Acute onset of pain
Blurred vision
Conjunctival injection
Dendritic ulceration of the cornea
Is propphylaxis required for pneumonoccoal meningitis
No
What does infection with shigella cause
Shigellosis
Presentation of shigellosis
Dysentery
- inflammation of the colon resulting in severe abdo pain and diarrhoea
Transmission of shigellosis
Faecal oral
Sexual
What is the most common cause of dysentry in the UK
Shigella
Treatment of shigellosis
Usually self limiting and resolves in 3-7 days
More severe cases - penicillin and cephalospoirins, macrolides and quinololones
Diagnossis of EBV
Heterophile antibody test / monospot test
What infection is EBV most commonly assosiated with
Infectious mononucleosis
WHat other manifestiation can EBV cause
Splenomegaly
Treatment of infectious mononucleosis
Supportive
What should patients with EBV avoid
Contact sports - due to risk of splenic rupture
What commonly is assosiated with reactive arthritis
Chalymydia
Gonorrhoea
Campylobacter
Salmonella
Triad of reactive arthritis
Arthritis (often asymmetrical and of the lower limbs)
Urethritis
Conjunctivitis
HLA assosiation of reactive arthritis
HLA-B27
What is the most common CNS infection in HIV positive individuals with CD4 counts < 200
Cerebral toxoplasmosis (toxoplasma gondii)
CT scan of brain in cerebral toxoplasmosis
Ring enhancing lesions
- typically multiple but may be single
Surrounding oedema
Treatment of cerebral toxoplasmosis
Sulfadiazine and pyrimethamine
HIV patients with a CD4 < 200 should have prophylaxis to what with what?
PJP
Co-trim
What is present on examination on 50% of paitents with nec fasc
Subcutaneous gas or crepitations
Where do healthcare staff commonly transport MRSA
Nose
Investigation to dignose norcardia spp.
Paraffin bait
Test to screen for lymes disease
Borrelia IgG
What causes botulinism
Clostridium botulinum
How to catch botulinism
Food - improperly preserved or canned
Open wounds / IV drug users
Presentation of botulinism
Initial presentation - visual, speech or swallowing disutrbances
Descending flaccid paralysis involving motor and autonomic symptoms
No sensory change
No loss of consciousness
Treatment of botulinism and when should this be given
Botulinium antitoxin
Should be administered immediately on clinical suspecision - do not wait for laboratory confirmation
Presentation of tetanus
Trismus
Spasms
Rigidity
What causes epidemic typhus
Rickettsia Prowazekki
How is infection of epidemis typhus spread
Faeces of the human body louse - pediculus humanus humanus
Can spread rapidly in where people live in crowded conditions with poor hygiene
Presentation of epidemus typhus
Headache
Conjunctivitis
Orbital pain
Measles like eruption on 5th day after onset of symptoms
- get bigger until eventurally purpuric
At end of first week
- signs of meningoencephalitis/stupor/coma/extrapyramidal symptoms
Treatment of epidemic typhus
Doxycycline or azithromycin
What causes Q fever
Coxiella Burnetti
Skin manifestation of secondary syphillis
Condylomata
What are koplicks spots and what condition do you see them in
Rash in mouth - red spots with a blue/white centre
Measles
When does symptoms after infection with salmonella occur
12-48 hours after ingestion
Incubation period of staph A toxin
Very short - 1 - 6 hours
How do you catch Q fever (C burnetti)
Spread between domestic animals by ticks, transmission to humans if of inhalation of infected dust and aerosols, and drinking unpasturised milk
What organism in south america can burrow but not go any further than under the skin, and causes an intense itchy rash along the path of their travel
Ancylostoma braziliense (hookworm)
What is the most opportunistic eye disease in patients with HIV
CMV retinitis
(only when CD4 counts < 50)
Presentation of CMV retinitis
Unilaterally or bilaterally
Floaters
Blurred vision
Visual loss
Retinal appearance of CMV retinitis
Pizza pie or cottage cheese and ketchup fundus
Presentation of diffuse infiltrative lymphocytic syndrome
Presents like sjogrens syndrome but extra glandular manifestations are common
Hx of HIV
Peripheral motor neuropathy / weakness
Parotid gland involvement
Exertional dyspnoea
Aseptic meningitis
Cranial nerve palsies
Rare to have auto antibodies
What is the most serious complication of diffuse infiltrative lymphocytic syndrome
Lymphocytic interstitial pneumonitis
What is chancroid caused by
Haemophilus ducreyi
Presentation of chancroid
Tender ulcer with a ragged edge
Readily bleeds on contact
Multiple ulcers can occur
Lymphadenopathy
Treatment of chancroid
Azithromycin stat dose or
Ceftriaxone one dose IM or
cipro for 3 days or
erythromycin for 7 days
What does hantavirus cause
Haemorrhagic fever with renal syndrome
What is the medical term and organism that causes “jock itch”
Fungus T Rubrum
Tinea curis
Presentation of tinea curis / jock itch
Similar to ringworm
Scaley, erythematous border that gradually spreads down the inner thigh
Extremely itchy
Presentation of cutaenous leishmaniasis
Nodule 1-2 months post infection/sandfly bite
Gradually ulcerates
Thick fibrous crust over the surface
Presentation of Q fever
Atypical pnuemonia
Incubation 14-26 days
Flu like illness - headaches, malaise, fever, dry cough
Hepatosplenomegaly and transaminitis
Endocarditis
Investigation of Q fever
Serology testing for Coxiella
Treatment of Q fever
Doxycycline
What causes diptheria
Corynebacteriim diptheriae
Presentation of diptheria
Fever
Non specific prodrome
Followed by
- membraneous pharingitis with thick, grey membranes seen on examination
- cervical lymphadenopathy and oedema leading to the characteristic “bull neck”
Rarely
- myocarditis
- heart block
Treatment of diptheria
Diptheria anti-toxin
Antibiotics
Diptheria toxoid immunisation (following acute infection)
Where is diptheria common
Russia
How to quantify viral load in HIV
PCR
Testing for HIV
ELISA
Causative organism of malignant otitis externa
Pseudomonas aeruingosa
What does malignant otitis externa involve
Invasion of the temporal bone and base of the skill
Can be rapidly progressive and life threatning
Facial swelling
Facial nerve involvement
Who does malignant otitis extrna almost always occur in
Diabetic patients
What is topical sprue
A cause of chronic diarrhoea and malabsorption assosiated with travel to the tropics (including india and SE asia)
Exact aietology unclear
Can present months or years after travel
Presentation of topical sprue
Diarrhoea
Steatorrohoea
Weight loss
Malabsorption symptoms
What should HIV anti retroviral therapy consist of
two nucleoside reverse transcriptase inhibitors and one other agent
e.g.
efaivranez/emtirictabine/tenfovir
What organism is most likely to be found in the sputum of an HIV positive individual
Cryptococcus spp.
How does cryptococcus generally present
Meningitis in immunocompromised individuals
Though pulmonary and disseminated infections may occur
Treatment of cryptococcal meningitis
IV amphotericin B
in combination with flucytosine or fluconazole
What does mefloquine (malaria prophylaxis) toxicity present as
Acute psychosis
Presentation of infection with the nermatoid Loa Loa (african eye worm)
slow passage across eye - can be sensed by patient
skin lesions confined to extemeties i.e. arms and legs
Lesions knwon as calabar swellings
Can be asymptomatic
Severe itching
Myalgia
Arthralgia
Tiredness
Urticaria
What is medetiranian spotted fever caused by
Rickettsia conorrii
How do you establish medeterianian spotted fever from other vector borne infections
Skin lesions eschar
- blackened centre of tick bite
What is enteric fever and what causes them
The collective term for typhoid and paratyphoid fevers
Salmonella typhi or salmonella paratyphi
Presentation of enteric fever
High fever and flu like symptoms
Abdomainal pain / constipation / diarrhoea may be present
Relative bradycardia
Blanching rash (rose spots)
Splenomegaly
What is seen in blood cultures in enteric fever
gram neg rods (salmonella species)
Key feature of mumps
Parotitis
WHat happens in 10% of patients with mumps and the treatment
Viral meningitis
Resolves spontaenously
Orchitis
Specialist review
Is mumps a notifiable disease
Yes
Mechanism of action of vancomycin
Prevents synthesis of polymers for the bacterial cell wall
What is IRIS (immune reconstitution inflammatory syndrome) and how does it present
Seen in HIV positive patients after commencing antiretrovirals
Presents as a paradoxical worsening of other infections
Tends to occur in patients with a very low CD4 count
Which anti retroviral used in HIV is commonly assosiated with a rash
Nevirapine
What do the questions commonly use as an antibiotic for cellulitis if someone is allergic to penciillin
Clindamycin
What should be suspected in every case of fever in a returning traveller, despite prophyaxis
Malaria
What can occur in assosiated with P falciparum infection
Blackwater fever
Intravascular haemolysis
Characteristic dark urine
Treatment of severe / cerebral malaria
IV artesunate
IV quinine if above not available
PEP post needlestick injury from higher risk patient
3 anti retroviral agents for 1 month
What causes paragonimiasis
Trematode fluke - paragonimus westermani
(ingested from an infected crustacean)
Features of paragonimiasis
Penetrate gut wall, peritoneum and the lungs
Cellular reaction, eosinophilia and haemorrhage
Granulomatous response
Treatment of african tick typhus
Doxy
Is yellow fever a live vaccine
Yes
What causes a viral meningitis caused by the mumps virus
Paramyoxvirus
Treatment of schistosomiasis
Praziquantel
Treatment of Loa loa / loiasis
Diethylcarbamazine (DEC)
Treatment of diardiasis
Tinidazole
Key features of strongylodies infection
Urticarial rash
Abdominal symptoms
Peripheral blood oesinophilia
Treatment of storngylodies infection
Ivermetcin or albendazole
Which part of the life cycle occurs in P vivax but not P falciparum
Hypnozoites
What are hypnozoites
Represent the dormant liver stage of p vivax and ovale
can cause late relapses after treatment
Not in p falciparum
Common pathogens causing bacterial meningitis in the immunocompromised
Strep pneumoniae
Neiserria meningitis
Listeria monocytogenes
Aerobic gram neg bacilli
Which organism is most likely to cause a culture negative endocarditis
Coxiella burnetti (Q fever)
Causes of culture negative endocarditis
Prev antibiotic administration
Brucells
Bartonella
Corxiella burnetti
Fungal causes
Malignancy
SLE
Virus causing kapsois sarcoma
Human herpesvirus 8
Prophylaxis for meningococcal B
Cirpofloxacin
Treatment of CMV encephalitis in HIV patients
Ganciclovir
What transmits epidemic typhus
Human body louse
Commonest cause of epididymo-orthitis in < and > 35s
< - STIs
> - gram neg enteric bacteria
Treatment of epidiymo orchiritis if NOT suspecting an STI
Ofloxacin
What causes yellow fever
Flavivirus
Presentation of yellow fever
Can be mild
Severe flu like illness
Pyrexia up to 40C
Epigastric pain
Vomiting
Bradycardia (fagets sign) on 2nd day of the illness
Recovery phase
Severe fever again
Jaundiced
Hepatomegaly
Bleeding from gums / bruising / haematemesis / melena
Treatment of yellow fever
Supporitve
Investigation for group A strep
Anti-streptolysin O titre
WHat can a high eosinophil count indicate
Helminth infection
Treatment of decomp liver failure in the context of chronic hep B
Entecavir
When is delayed initiation of ART considered
When CD4 count < 50
50% of patients have what
Pleural effusion
WHat organism causes cat stratch disease
Bartonella Heneslae
Pathology of bacterial vaginosis
Healthy microbiota of female GU tract (lactobacillus, L crispatus, L jensii and Liners ) are replaced by predominantely anaerobic micro organisms, such as gardenerlla vaginalis or prevotella, peptosteptococcus and bacteriodes spp.
WHat type of mosquites vector all malaria
Anopheles
What type of diseases do the aedes mosquito vector
Dengue
Yellow fever
Zika
Which type of malaria has the shortest incubation
Falciparum
What is PML caused by
JC virus
Presentation of PML
Focal, progressive neurology due to white matter demhyelination
Occurs weeks to months
Guidelines for travel for patients with active TB
IF
- have evidence of drug susceptible disease or no signs of drug resistance AND
- Do not have a clinical or public health need for admission to hospital
Can travel two weeks after starting therapy
Different if HIV positive or immunosuppressed
Malaria types capable of true dormancy
Vivax and ovale
Where can you catch p. ovale
only in sub saharan africa
Fundoscopy of HSV keratitis
Cornea - dendritic ulcer
Ulcer with linear blanching pattern
Terminal bulbs
Swollen epithelial borders
Central ulceration through the basement membrane
What serological tests would indicate if someone had previously had Hep B but has now completely cleared the infection
Postivie for both core and surface antibodies
Negative surface antigen
WHat is the marker of infection serologically for Hep B
Surface Antigen
Organisms that cause bloody diarrhoea
Salmonella
Shigella
Enterohaemorrhagic E coli
Entamoeba histolytica (slower course of disease)
S/E ethambutol
Ocular complications / optic neutritis
S/E of isoniazid
Drug induced hepatitis
Peripheral neuropathy
S/E Pyrazinamide
hepatotoxic
S/E rifampicin
Pink/orange secretions
Drug induced hepatitis
Interacts with alot of other medications
Which anti-malarial agent is affective against liver hypnozoites
Primaquine
Is streptococcus gram negative or positive
positive
Is neisseria meningitidis gram negative or positive
negative
What is trachoma and what is it caused by
Chronic keratoconjunctivitis
Chlamydia trachomatis
Patients with advanced HIV infection and CD4 counts < 50 are at high risk of what
Disseminated mycobacterium avium complex (MAC) infection
In questions . sitting near a river might indicate what
Possibility of exposure to rats urine (leptospirosis)
Causative organism of prosthetic joint infections that are chronic
Staphlococcus epidermi
Is chicken pox a live vaccine
yeS
What kind of bacteria is legionella
gram negative rod
Treatment for leprosy and for how long
Dapsone, clofazimine, rifampicin
At least 2 years
What bacteria can you get consuming soft cheeses
Listeria
What is the concern after a bat bite in the UK
Rabies
Treatment of high risk exposure to rabies in a non immune patient
Both rabies immunoglobulin and vaccine
Treatment of low risk exposure to rabies / someone who has been previously vaccinated
Vaccine course only
What kind of bacteria is gonorrrhoea
Gram negative diplococci
What is an indium labelled leukocyte study for
Detecting occult abcesses in patients of PUO whos conventional scans have failed to detect a source of infection
When does the jarish Herxheimer (JH) typically occur
Sphirochete infections e.g. lymes disease
Syphillis
Leptospirosis
Symptoms follow the first dose of antibioticd
What should be avoided in a pregnant patient with HIV
Foetal blood sampling
Treatment of chronic hep C infection of genotypes 1 or 4, with or without compensated cirrhosis
Daclatasvir and sofosbuvir
Treatment of genital warts secondary to HPV
Topical podophyllotoxin
What virus causes kaposis sarcoma
HHV-8
What virus causes hand foot and mouth disease
Coxsackie virus
Presentation of HFM disease
incubation 3-5 days
Followed by flu like symptoms
Yellow grey ulcers in mouth
Vesicular rash on hands and feet
Episodes often self limiting but can have complications - myocarditis, meningitis, encephalitis
Treatment of HFM disease
Supportive
How does s. schnekkii infect humans
Lives on soil and plant matter
Enters skin through cut or scrape
Treatment of s. schnekki infections
Reddish, non tender, maculopapular lesion at the site of innoculation (10 weeks after)
Over next several weeks. similar nodules form along proximal lymphatic channels
These break down and form a row of ulcers
Diagnosis of s. schnekki infections
Culture of biopsy samples on Sabouraud dextrose agar
Treatment of s. schnekki infection
Itraconazole
More severe / immunocompromised - IV amphotericin B
Which adults should receive aciclovir for chicken pox
If rash < 72 hours of onset and
- immunocompromised or
- non truncal parts of body or
- mod - severe pain or
- severe rash
What renal problem can secondary syphilis cause
Acute glomerulonephritis
Bacteria that are gram positive cocci
Staph
Strep
Enterococci
Bacteria that are gram positive rods
Actinomyces
Bacillus
Clostridium
Diptheria
Listeria monocytogenes
Bacteria that are gram negative cocci
Neisseria
Moraxella
Brucella
Bacteria that are gram negative rods
Legionella
Campylobacter
E coli
Pseudomonas
Proteus
Salmonella
What is the procedure if someone has a needle stick injury from someone who is positive for Hep C
Hep C virus ribonucleic acid monthly surviellance
If signs of seroconversion - treatment with antivirals can be initiayed
What abdominal symptom does giardiasis present with whihc the mechanism of which is not fully understood
Malabsorptions symptoms
How to differentiate between the 3 causative organisms of asthelets foot
Trichophyton - multiple small microconidia
Microsporum - produce single microconidia or multiseptate macronconidia
Epidermophyton - do not produce conidia
What is the CD4
T-helper cell
Cancer assosiations of EBV
Gastric cancer
Nasopharyngeal carcinoma
Definition of treatment failure in TB
Positive cultures after 4 months of therapy
What causes chancroid
Haemophilus ducreyi
Presentation of chancroid
Incubation 4 - 7 days
Erythematous papule forms
Subsequently breaks down into a painful ulcer
Painful inguinal lymphadenopathy develops, unusually unilaterally, which can suppurate
Several ulcers can merge to form giant serpiginous lesions
Diagnosis of chancroid
Isolating the organism from swabs taken from the lesion and cultured on chocolate based media
Treatment of chancroid
Single dose azithromycin
IM cef
3 day course erythromycin
When should oropharyngeal anthrax be considered
Patients who present with fever, severe pharyngitis and neck oedema
Particularly if there is consumption of raw or undercooked meat
Which vaccine can HIV positive patients not have
BCG
WHat can be used to cover for listeria in meningitis in patients with a penicillin allergy
Co-trimoxazole (instead of amoxicillin)
Treatment of falciparum malaria
Artemether with lumefantrine
Who is oral hairy leukoplakia seen in
HIV positive patients
Causative organism of ora hairy leukoplakia
EBV (in HIV positive patients)
Presentation of oral hairy leukoplakia
Similar appearance to candida
Irregular white patches on tongue and oral mucosa
Covered in tiny hair like projections occuring along the folds
Cannot be dislodged with scraping
Treatment of oral hairy leukoplakia
Managing underlying cause
WHat CD4 count do you need to have to get a live vaccination with HIV
> 200
What causes impetigo
Staph aureus
Occassionally strep pyogenes
Treatment of impetigo
Topical fusidic acid
What causes schistocytes on a blood film
Acute haemolytic anaemia
Presentation of congenital varicella syndrome
LBW
Characteristic abnormalities of the skin arms, legs, hands and extremeties, brain and eyes
Symptoms may vary depedning on timing of infection
Which ART is known to cause renal stones in 10% of patients who take it
Indinavir
Usual firm line treatment for ESBL
Meropenem
Infection period of chickenpox
1-2 days before the rash until all of the lesions are crusted and dry
Statin lowering drug that is preferred in HIV patients
Pravastatin
What causes bacterial vaginosis
Garnderella vaginalis
What causes the weakness in botulism
Exotoxin release
What suggests lupus vulgaris
A chronic progressive irregular plaque like lesion with central scarring from an invidual from an endemic area
What is the lupus vulgaris the most common manifestiation of
cutaneous tuberculosis
Malaria prophylaxis in patients with epilepsy
Doxycycline
Atovaquone with proguanil hydrochloride (Malarone)
WHat does an increasing PR interval in a patient with IE indicate
Aortic root abscess / sign of uncontrolled infection
Commonest cause of encephalitis in the UK
HSV
Which ARVs have the S/Es of hyperlipidaemia
Ritonavir
Lopinavir
Mechanism of action of mebendazole
Inhibitor of tubulin polymerisation
What does poor HIV control and middle/lower third oesophageal ulcers indicate
CMV infection
Treament of CMV in HIV individuals
Valganciclovir
Causative organism of BV
Gardnerella vaginalis
What to do if a pregnant lady is exposed to chicken pox
- Varicella zoster antibody testing
- if positive - no further intervention required
- if negative - VARICELLA ZOSTER IMMUNE GLOBULIN
If develops symptoms (aciclovir within 24 hours of onset)
What is the fancy name of the worm seen in the UK
Enterobius vermicularis
Investigation of leptospirosis
Microscopic agglutination test
Treatment of C diff
- Vanc
- Metronidazole
Most common adverse effect of immunoglobulin infusions
Headache
Treatment of cellulitis in a DIABETIC patient
co-amoxiclav
What causative organism would you think of if someone has pharyngitis, and develops a non blanching maculopapular rash around 48 hours of commencement of antibiottics treatment
EBV
Treatment of syphillis in a penicillin allergic patient
Doxycycline
Treatment of UTI in a breastfeeding woman who is pen allergic
Cefixime
Ascitic / abdominal involement TB - treatment duration
6 months
Investigation of cutaneous leishmaniasis
Punch biopsy from edge of an ulcer
Prophylaxis of close contacts of patients diagnosed with meningococcal meningitis
Single dose of ciprofloxacin
Common cause of insect bites infection
Strep pyogenes
Susceptibility to PJP can be associated with high levels of what
IgM
