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1
Q

why are Abx not often given with EHEC?

A

Increase risk of HUS

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2
Q

EHEC management?

A

Rehydrate, supportive therapy, notify PH

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3
Q

commonest cause of HAIs?

A

Blood-stream infections
pneumonias including VAPs
UTIs
Surgical site infections
(S.AUREUS)

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4
Q

Student S. America returns 1 week before return, bloody, mucous diarrhoea, febrile, abdo pain - likely cause?

A

salmonella typhi

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5
Q

foul smelling discharge - BV - clue cells - Rx?
(Gardnerella vaginalis)

A

Metronidazole

PO>topical and stat. 400mg BD 7/7

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6
Q

Gonorrhoea Rx:

A

stat dose IM CRO

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7
Q

lower abdo pain, dyspareunia, PV discharge - chlamydia + - Rx?

A

7/7 doxycycline

azithro if preg, br feeding/allergy

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8
Q

CIs to LP in child suspected of bacterial meningitis:

A

Sx raised ICP
haemodynamic instability
Extensive/spreading purpura
multiple seizures - until stabilised
Plt <100
Infection at LP site
respiratory compromise
GCS <9 or drop grater than 3
relative bradycardia + HTN

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9
Q

Mastitis abx of choice in breastfeeding?

A

Flucloxacillin

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10
Q

Lyme (Borellia) Abx?

A

Doxycycline

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11
Q

?Meningococcal septicaemia abx of choice?

A

IM Benpen stat then get to ED

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12
Q

Dx rabies?

A

clinical or PCR

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13
Q

20M returns S America, headache, fever, rash, meningism, deafness - dx and key Ix?

A

Typhys (Rickettsia). Serology.

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14
Q

Schisto Ix?

A

Urine microscopy (…)

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15
Q

steroids for COPD and new dysphagia?

A

oropharyngeal candidiasis

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16
Q

change PV discharge, thin, fishy, clue cells -

A

BV

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17
Q

UTI men abx and length?

A

Nitro/trim = 7/7

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18
Q

B. Burgdorferi Ix?

A

Anti-Borrelia burgdorferi titre
hard to culture

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19
Q

which step in HIV converts viral RNA into DNA?

A

Reverse transcriptase

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20
Q

acute epiglottitis caused by?

A

Hib

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21
Q

Ringworm Rx?

A

Miconazole

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22
Q

ringworm rash - describe?

A

annular spreading appearance
also dermatophytosis

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23
Q

aims of ART:

A

VL<50
CD4>350
reduce transmission
improve QOL while reducing SFx

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24
Q

transmission and incubation HAV?

A

FOT
2-6 weeks

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25
Q

who should not receive oral aciclovir for shingles?

A

otherwise F+W children - self-limiting
pregnancy - low risk
IC - IV needed

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26
Q

STI intracellular diplococci?

A

N. Gonorrhoeae

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27
Q

Abx for giardia?

A

metronidazole

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28
Q

STI 1st line ix?

29
Q

ix giardiasis?

A

if <14 days - stool mc+s
if >14/7 - send 2-3 stools

30
Q

Ghana, painless rash on trunk, scaly, pale patches, 1-3cm diameter ?

A

Pityriasis Vesicolor
Malasezzia furfur - yeast. skin scrapings mc+s

31
Q

amox 2/7 ago, rash, lymphocytosis - dx?

32
Q

hand foot and mouth =

A

coxackie A virus
vesicles rash on hands and feet and grey ulcers on mucosa

33
Q

36F yellow-green d/c. swollen and erythematous vagina -

A

thrichomoniasis

strawberry cervix

34
Q

42M W Africa, 2/52 headaches, fever. intermittent diarrhoea, weight loss over last year. only abnormality is fever OE. dx?

A

fungal men (due to weight loss and diarrhoea…)
tbf, OP would be higher in TBM

35
Q

70M T2DM L swelling face, extending. facial nerve palsy. green purulent d/c ear. includes forehead - causative pathogen?

A

pseudomonas aeruginosa

(malignant otitis externa 2 to DM)

36
Q

Leigonella - micro, e- abnormality, abx?

A

G- rods
hyponatraemia
macrolides/quinalones

37
Q

herald patch few days before widespread itchy rash indicates?

A

Pityriasis Rosea
Viral - Herpes 6/7 viruses

38
Q

prophylaxis for meningitis contact?

A

ciprofloxacin

39
Q

commonest cause nosocomial skin infection?

A

hand hygiene (lack of)

40
Q

commonest cause of bacterial food poisoning in UK?

A

campylobacter jejuni
FOT
2-5 days inc

41
Q

bacillus cereus incubation?

A

2-12 hours

42
Q

commonest cause of vaginal ulceration UK/USA?

43
Q

chancroid caused by?

A

Haemophylus ducreyi

44
Q

important notifiable disease UK ?

45
Q

norovirus vs c.diff based on symptoms?

A

c.diff less likely to have nausea, vomiting, more severe diarrhoea

46
Q

offensive yellow frothy discharge from vagina, erythema of mucosa -

A

trichomonas vaginalis (flagellated protozoa) - strawberry cervix

47
Q

HIV commonest opportunistic diahhroeal cause?

A

cryptosporidium

48
Q

screening of latent TB in high risk groups - ix?

A

mantoux test

49
Q

sporozoites produced where?

A

in liver during exoerythrocytic cycle

50
Q

50M farmer tick bite 2 weeks ago
fever, flu-sx, dry cough, LZ creps, HSM
Dx?

A

Q fever - coxiella burnetti

51
Q

50M recurrent fevers, Saudi return, arthralgia, weight loss, epididymo-orchitis, sacroiliitis?

A

Brucellosis

52
Q

hepatitis returning from India, student, no sexual/IV ect. =

53
Q

CMV retinitis?

A

Pizza-pie appearance
large multiple cotton wool spots

54
Q

CMV leads to?

A

GI ulceration
Hepatitis
Retinitis
Pneumonitis
Encephalitis
Rx - galvanciclovir

55
Q

BV ix?

A

vaginal pH

56
Q

HBV - which serology test would be positive in vaccination?

57
Q

Weil’s disease?

A

severe acute leptospirosis

58
Q

EBV sx?

A

abnormal LFTs
sore throat
severe cervical LN

59
Q

rose spots and relative bradycardia =

A

salmonella sp - blood culture

60
Q

S. Africa, return, high swinging fever 5 days, RUQ tender - dx ix

A

liver abscess, USS, aspirate

61
Q

Vietnam return then generally unwell 2 weeks later - ix, dx

A

malaria, T&T

62
Q

abx tomnsilitis requiring abx?

A

penicillin

63
Q

abx post-splenectomy?

A

penicillin

64
Q

Abx Gas gangrene?

A

vancomycin

65
Q

Abx PMC colitis?

A

vancomycin
(PMC is caused by c.diff!!!)

66
Q

what is unusual about children presenting with UTIs?

A

diarrhoea common

67
Q

Hx N.Meningitidis, new meningitis sounding picture - likely overall deficiency?

A

MAC formation deficiency

MSRA (9 decks)

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