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MRCP 1 > ID > Flashcards

ID Flashcards

1
Q

Brodie’s abscess presentation and X-ray findings

A

Chronic osteomyelitis, insidious onset. Localised abscess often near the site of the metaphysis
Xray: Lytic lesion with sclerotic margins

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2
Q

“Honeycomb” appearance on limb xray

A

Osteomyelitis - thickened bone with irregular and patchy sclerosis

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3
Q

When are topical aminoglycosides c/i in otitis externa

A

If the TM is perforated

Note acetic acid can be used as 1st line treatment if there is no hearing impairment or discharge

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4
Q

Side effect of chloramphenicol ear drops

A

Contact dermatitis (10% of people)

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5
Q

Mechanisms of action of the 3 drugs in typical PEP for HIV?

A

2 nucleoside reverse transcriptase inhibitors plus either non nucleoside RT inhibitor, protease inhibitor or integrase inhibitor

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6
Q

1st line antibiotics for pyelonephritis in patient > 3months

A

Oral: cefalexin or co-amoxiclav

If IV required co-amoxiclav

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7
Q

NICE guidelines on UTI criteria for diagnosis of pyelonephritis?

A

Bacteriuria and fever 38C or higher

or fever less than 38 with loin pain/tenderness and bacteriuria

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8
Q

Onset of staph aureus food poisoning usually starts about 24hrs after ingestion of contaminated food T/F

A

F - onset is usually from 30 minutes to 8 hours post ingestion.

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9
Q

Diarrhoea with s aureus gastroenteritis is usually profuse and watery T/F

A

T - symptoms start with emesis and then diarrhoea a few hrs later, usually only symptomatic for one day

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10
Q

Vibrio vulnificus is classically associated with what food?

A

Oysters

Note: other seafood too. Symptoms vomiting, diarrhoea and fever about 24-48 hrs after ingestion

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11
Q

How long after ingestion of contaminated food does presentation with clostridium perfringens (welchii) or botulinum typically occur?

A

6-12 hours

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12
Q

What finding on a CBC is highly indicative of a helminth infection?

A

Eosinophilia

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13
Q

Antibiotics are routinely prescribed as part of the management of dental abscess T/F

A

F - only prescribed if the patient is systemically unwell

Mgmt is analgesia and dental referral

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14
Q

What is a kerion?

A

A large swelling that is a complication of tinea capitis, it is a hypersensitivity reaction

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15
Q

What is the treatment of a kerion?

A

Systemic antifungal +/- a short course of steroids

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16
Q

Herpes is a DS DNA virus T/F

A

True

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17
Q

Haemophilus ducreyi causes what STI?

A

Chancroid

Note: painful necrotising genital ulcer; it is a gram neg cocci

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18
Q

E coli is able to multiple in typical fridge temperatures of about 4degrees T/F

A

False - E coli can survive but not multiply.

Listeria monocytogenes can grow/multiple at temperatures of 0-4degrees C

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19
Q 
Prophylactic antibiotic(s) of choice for meningitis exposure
What should be used for a pregnant patient
A

Ciprofloxacin or Rifampicin

Pregnancy: ceftriaxone

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20
Q

Hepatosplenomegaly is common in which Reye’s syndrome, malaria, dengue or leptospirosis?

A

Malaria

Hepatomegaly is common in other diseases but splenomegaly is rare in the other disease

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21
Q

What is the incubation period of Dengue?

A

5-10 days

Note: incubation period for leptospirosis is 7-12 days

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22
Q

Patient’s with malaria may be hyper or hypoglycaemic at presentation T/F

A

F - hyper is usually earlier in disease and hypoglycaemia is in more severe disease or cerebral malaria

Other common findings in malaria - symptomatic haemolytic anaemia (systolic murmur) with hepatosplenomegaly and jaundice

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23
Q

Neisseria meningitidis morphology

A

Gram -ve coccus

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24
Q

Is psuedomonas aeruginosa gram + or -

A

Gram -ve

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25
Q

Is haemophilus influenzae gram + or -

A

Gram -ve

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26
Q

Morphology of e coli and klebsiella

A

Gram -ve bacillus

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27
Q

Morphology of listeria

A

Gram + bacillus

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28
Q

Morphology of strep

A

Gram + coccus in chains

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29
Q

What is the most common invasive fungal infection in children admitted to the ICU?

A

Invasive candida

Note: often associated with indwelling venous caterer

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30
Q

What is the tx of CNS aspergillosis?

A

IV voriconazole

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31
Q

What is the treatment of invasive mucormycosis?

A

Posaconazole

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32
Q

When a patient is on voriconazole the dose of cyclosporin needs to be increased T/F

A

F - azole antifungals limit the metabolism of cyclosporin and hence increase it’s serum levels and so dose of cyclosporin needs to be reduced

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33
Q

C/I to lumbar puncture in suspected meningitis?

A 
An evolving and rapidly progressive rash
Coag abnormalities
Shock
Resp insufficiency
Local superficial infection at LP site
Signs of increased ICP (reduced or fluctuating level of consciousness, relative bradycardia, HTN, focal neuro signs or abnormal posturing)
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34
Q

Incubation period for N meningitidis?

A

2-7 days

Note: droplet spread, gram -ve diplococci

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35
Q

Morph of staph

A

Gram + cocci in clusters

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36
Q

Most common cause in community acquired pneumonia in those < 5 yrs?

A

Strep pneumo

Note: > 5 mycoplasma pneumonia

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37
Q

Children with parvovirus infection are no longer contagious once the rash has appeared T/F

A

T

Note: incubation period is 4-20 days

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38
Q

Classic exam findings in congenital TB?

A

Hepatomegaly, splenomegaly and abdo distension

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39
Q

Clinical manifestations of congenital TB?

A

Poor feeding, irritability, failure to thrive and fever

Cough +/- resp distress

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40
Q

Incubation period of scarlet fever? How long is a person infectious?

A

Incubation 1-7 days

Infectious for 3 weeks

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41
Q

What is Lemiere’s disease?

A

Retropharygneal abscess followed by thrombophlebitis of the internal jugular vein and another abscess (commonly in the lungs)

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42
Q

Use of azithromycin is C/I in those with a renal tx T/F

A

F - it is not CI but if the pt is on tacrolimus these two drugs interact and hence will need careful monitoring of tacro levels

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43
Q

What age patient and where does tuberculosus arthritis often effect?

A

2- 5 yrs old
Hip

Note: early signs on ray - decrease in density of bone (rarefication), followed by fuzziness and narrowing of joint space

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44
Q

How many serotypes does the botulinum toxin have?

A

7

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45
Q

What antibiotic needs to be avoided in those on theophylline?

A

Ciprofloxacin

Note: it is an enzyme inhibitor and increases serum levels of theophylline

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46
Q

Tx of non TB mycobacterium lymphadenopathy?

A

Surgical excision

Can use azithromycin if excision is CI

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47
Q

Lab test for Wilson’s disease?

A

Serum ceruloplasmin - it is low

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48
Q

What is Menke’s disease?

A

Disease of Cu absorption leading to Cu deficiency

Features - kinky hair, FFT, neuro symptoms such as hypotonia

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49
Q

Features of leprospirosis?

A

Asymptomatic or flu like illness

Can progression to jaundice and renal impairment; conjunctival suffusion is characteristic but not always present

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50
Q

In the setting of Hep B was is AntiHBs indicative of?

A

Vaccination (hep B surface antibody)

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51
Q

Lab finding indicative of a person with Hep B being highly infectious?

A

Hep B envelop antigen

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52
Q

In the setting of Hep B what is IgM antiHBc indicative

A

Acute infection

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53
Q

HBsAg and Anti HBc what type of hep B infection?

A

Unable to tell, could be acute or chronic

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54
Q

Tx of neonatal chlam conjunctivitis

A

oral erythromycin

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55
Q

Tx of neonatal gon conjunctivitis

A

IV ceftriaxone or cefotaxime

Also saline irrigation

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56
Q

Which would be expected to present earlier, neontal conjunctivitis due to chlam or gon?

A

Gon - incubation is 2-5 days

Note: gon - serosanguious discharge which later becomes pustular.
Chlam incubation 5-14 days, inflammation of eyelids and purulent discharge

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57
Q

What percentage of infants with RSV require hospitalisation? When is the peak incidence?

A

1-3%

2-7 months

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58
Q

Leishman-Donovan bodies may be see in what disease?

A

Leishmaniasis

Can also be diagnosised using Giemsa stain

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59
Q

Main clue for diagnosis of visceral leishmaniasis

A

Dark skin, blackening of the skin (common name in India is black fever)

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60
Q

Tx of a <28 day old infant with chickenpox

A

IV acyclovir - cannot use PO in neonates as pharmacokinetics is unpredictable

Note: for prophylaxis use varicella zooster immunoglobulin

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61
Q

Hepatitis A incubation period is 1-7 days T/F

A

F

Incubation period is 14-28 days

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62
Q

Hepatitis A incubation period is 14-28 days T/F

A

T

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63
Q

A patient is vaccinated against varicella and then develops a rash. What is the likely aetiology?

A

A vesicular rash can occur due to vaccination - timing 15-42 days post vaccination
If the rash occurs less than 14 days or > 42 days it is likely due to wild type varicella

NB: samples should be taken from the lesions for diagnosis, to know if it is vaccine or wild type

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64
Q

How does salmonella typhi usually present?

A

Mild/mod diarrhoea + high fevers

Note: Yersinia enterocolitica can also present this was but tends to have more abdo pain

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65
Q

Prophylactic AEDs are indicated in the tx of HSV encephalitis T/F

A

F - there is insufficient evidence to rec this

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66
Q

What is the most common cause of community acquired pneumonia in those < 2 yrs?

A

Viral

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67
Q

Regarding the treatment of scabies when should all clothes and linens be washed?

A

At the end of treatment

Note: the permethrin cream also needs to be reapplied each time hands are washed as the cream needs to be on the skin for 8 - 10 hours

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68
Q

In children what is chronic bilateral parotid infection caused by?

A

It is pathognomonic of HIV

Presents with dry mouth, dry eyes and swelling of salivary glands and lymphadenopathy - similar to Sjogren’s but no autoantibodies

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69
Q

What type of virus is hepatitis B?

A

DNA virus

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70
Q

When are antibiotics required for the treatment of an AOM?

A

Symptoms for four days of more
Systemic upset (not only fever)
<2 yrs with bilateral infection
TM perforation or drainage in the ear canal

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71
Q

Acute hydrocephalus is a common feature of what type of meningitis?

A

TB meningitis

Note: clues to this un vaccinated child, lymphocyte predominance in CSF. Listeria would also cause a lymphocyte predominance but would not cause acute hydrocephalus

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72
Q

Features of chronic suppurative otitis media?

A

Recurrent discharge (> 2 weeks) which escapes through a perforated TM
Absence of an acute infection (no fever or pain)
Hx of previous AOM supports diagnosis

73
Q

Mgmt of chronic suppurative otitis media?

A

ENT referral

Do not swab or treat w/antibiotics
Complications: mastoiditis, facial nerve palsy and intracranial infection. Hearing loss from perforation is usually temporary

74
Q

In rheumatic fever who long are prophylactic antibiotics needed in those with carditis?

A

10 yrs or until the pt turns 21 (whichever is longer)

Note: need tx antibiotics for 10 days first

75
Q

High fevers for 3 days without an obvious source and when the fever subsides a red maculo-papular rash develops on centrally. Rash resolves within 48-72 hours. What virus?

A

HHV 6 (aka roseola)

Also children will commonly have a febrile seizure

Note: Contrast this to rubella when the rash and fever are present at the same time

76
Q

What life cycle stage is common is P vivax and ovale but not P falciparum?
What is the clinical significance of this?

A

Hypnozoites - a dormant liver stage

They can cause late relapses after treatment, hence to eradicate them (and precent relapse) a course of primaquine must be given following a course of chloroquine for vivax/ovale

77
Q

What is the treatment of schistosomiasis?

A

Praziquantel

Note: transmitted by freshwater snails

78
Q

Who long should a child with diarrhoea or emesis stay out of school until?

A

48 hours after last emesis or diraahoea

79
Q

Management of suspected Lyme disease?

A

1: Empiric treatment > 12 yr doxycycline, < 12 yrs amoxicillin
2: Acute and convalescent titres

Note: typical course is 21 days; if facial palsy 2 months; if arthritis 4 months

80
Q

Periventicular calcification are seen in what congenital infection?

A

CMV

Note: toxoplasma gondii will also have calcifications but they are diffuse

81
Q

Erythema chronic migrans is assoc with what infectious disease?

A

Lyme disease

82
Q

Patients with B19 are infectious for 5-7 days after the rash appears T/F

A

F - no longer infectious once rash appears

83
Q

An infant is born to a mother with active TB but has no signs of TB themselves. What is the mgmt?

A

Isoniazid for 3 months (or until develops signs of TB) then do a Mantoux if < 5mm can d.c med and give BCG

84
Q

What type of cells seen on LP in bacterial meningitis?

A

Lots of polymorphs
Few lymphocytes

Note: also up to 5g/L protein and glucose less than 2/3 of blood level

85
Q

CSF findings in TB meningitis?

A

High protein
Low glucose
Lymphocytosis

Also CSF may have a cobweb appearance on standing

Note: also have lymphocytes in viral meningitis but low protein

86
Q

In a child and neonate how many cell is normal in CSF

A

Child: 5 lymphocytes
Neonate: up to 15 cells of which 1-2 can be PMNs

Note: any PMNs in child is abnormal

87
Q

Bilateral parotitis is a red flag for what in children?

A

HIV infection

88
Q

Effective therapy can reduce maternal foetal transmission of HIV from 25% to 5% T/F

A

F - from 25% to 1%

89
Q

For how many days prior to onset of vesicular rash is a person with chicken pox infectious? How long is the incubation period?

A

2 days prior

Incubation period is 21 days

90
Q

What age group does roseola usually affect?

A

6 months to 2 yrs

Note: typical presentation, several days of fever and then as the fever breaks a rash

91
Q

What is the average total length of illness with acute otitis?

A

4 days

92
Q

What is the average total length of illness with acute pharyngitis/tonsillitis?

A

1 week

93
Q

What is the average total length of illness with the common cold?

A

1.5 weeks

94
Q

What is the average total length of illness with acute rhinosinusitis?

A

2.5 weeks

95
Q

What is the average total length of illness with acute cough?

A

3 weeks

96
Q

CSF investigation of choice in a partially treated meningitis?

A

CSF latex agglutination - with identify polysaccharide cell walls from killed bacteria

97
Q

Torula stain is for what pathogen?

A

Cryptococcus

98
Q

HIV and Hep B can be transmitted through breast milk T/F

A

F - only HIV

Other diseases that can be transmitted - GBS, gc, CMV

99
Q

A well appearing febrile infant of 2 months presents with urine dip concerning for a UTI what is the next step in mgmt?

A

Bloods - FBC, CRP, and blood culture; IV abx while awaiting results

Note: If < 1 month or ill appearing needs LP too

100
Q

There is an increased risk of nec fasciitis when a patient with chickenpox infection is given what medication?

A

NSAIDs

Consider nec fac if they have rapidly progressing pain and erythema (likely GAS)

101
Q

CBC findings in salmonella typhi?

A

Thrombocytopenia and neutropenia

102
Q

Presentation of salmonella typhi in an infant?

A

Prolonged fever without significant exam findings
Relative bradycardia
Thrombocytopenia and neutropenia

103
Q

What month is the peak of rotavirus?

A

March

104
Q

What is the presentation of tick born viral encephalitis?

A

Typically a biphasic course
Features: headache, ataxia and meningism are commonest. Can also have myelitis or meningoradiculoneuritis (can cause flaccid paralysis of a single limb)

Note: arboviruses are among the commonest causes of meningoencephalitis worldwide ; endemic to eastern europe

105
Q

Prior to starting a pt on primaquine what lab test need to be obtained?

A

G6PD

If pt is G6PD def primaquine will cause severe haemolytic anaemia

106
Q

What is the incubation period of glandular fever / EBV?

A

1-2 months

107
Q

What is the first and 2nd line oral antibiotics for impetigo?

A

1st : flucloxacillin

2nd: clarithromycin

108
Q

What is the classic triad for congenital toxo?

A

Hydrocephalus (NB for differentiating from other TORCH infections)
Retinochoroiditis
Intracerebral calcification (diffuse)

Note: this is uncommon presentation, 90% are asymptomatic in neonatal period.

109
Q

What is the most common mode of Hep C transmission worldwide?

A

Vertical

Note: vertical transmission rate is about 9%

110
Q

What is the most likely infectious pathogen in mastitis?

A

S aureus

111
Q

Leishmania infantum and donovani are endemic to much of the Mediterranean basin T/F

A

F - infantum is endemic to Mediterranean

Donovan is seen in east Africa and Asia

112
Q

What is the initial treatment for uncomplicated H pylori eradication?

What is the exception?

A

One week of amoxicillin, clarithromycin and omeprazole

Exception: if haematemesis still do abx for 1 week but PPI is for 4 weeks

Note: can sub clarithromycin for metronidazole

113
Q

What % of children with Kawaskai disease develop coronary artery aneurysm?

A

25% untreated

5% treated

114
Q

Neuro manifestation occur in less than 10% of patients with Lyme disease T/F

A

F - neuro manifestations in approx 15%

115
Q

Borrelia burgdorferi gram + or neg?

A

Neither - stains weakly

116
Q

When should a mother be treated for syphilis to reduce the risk of vertical transmission?

A

At least one mother prior to delivery

117
Q

What titre in syphilis correlate with disease activity and hence increased risk of transmission?

A

High VDRL titres

Note: this is only if the case has already been confirmed by TPPA screening tests, as there is a high rate of false positive with VDRL
Positive IgM titres also indicates a recent infection

118
Q

What are the 3 Kocher criteria and to what disease are they related?

A

Septic arthritis
NWB; WBC > 12 and ESR > 40

If all 3 present a 93% chance of septic arthritis

119
Q

What are the typical bacteria that cause CRMO?

A

None! Bacterial cultures are usually negative and inflammatory markers normal

They do however have fever

120
Q

What bones does CRMO typically affect

A

Long bones

121
Q

What are the physical exam findings in brucellosis?

A

Papular rash
Hepatosplenomegaly
Marked lymphadenopathy

Note: incubation is 1-5 weeks; from unpasteurised dairy or working with goats, sheep, pigs or cattle
Has an acute and chronic phase. Chronic phase included relapsing fevers, sweats, arthralgia, constipation, emotional disturbance.

122
Q

What class of antibiotics (and examples) should be used to treat whooping cough?

A

Macrolides - azithromycin, clarithromycin and erythromycin

123
Q

Bordetella pertussis gram + or -ve?

A

Negative

124
Q

What is the treatment of choice for malaria falciparum?

A

Malarone (proguanil and atovaquone)

NB WHO recommends that all malaria tx should be combo due to high rates of resistance. Only exception is quinine mono therapy can be given initially to patients presenting with severe malaria as it can be given IV

125
Q

What malaria medication can be given IV? when would this be needed?

A

Quinine - severe malaria; this is the only time mono therapy should be used

126
Q

What is the medication of choice for malaria prophylaxis?

A

If > 11kg Malarone (proguanil and atovaquone) - not actually licensed for use in children but rec by CDC and Public Health England for those over 11kg travelling to endemic areas.

If > 5 but less than 11kg mefloquine

127
Q

Foul smelling perspiration is a classic sign of what infection?

A

Brucellosis

128
Q

How to interpret a mantoux in a patient who has had BCG and not?

A

Positive if > 5mm if no hx BCG

Positive if > 10mm if hx BCG

129
Q

In a patient who is asymptomatic for TB but has a strongly positive mantoux what is the likely diagnosis latent or recovered from previous TB infection?

A

Latent TB

Note: in pt with a hx of TB but recovered would expect a negative or very weakly positive mantoux

130
Q

A patient with measles is infectious for how long?

A

5 days after rash onset, hence should be excluded from school for that long.

131
Q

When is a patient with parvovirus most infectious?

A

Most infectious prior to onset of rash

132
Q

Cough, coryza and conjunctivitis followed by a confluent rash that typically begins behind the ears?

A

Measles

133
Q

Treatment of choice in MRSA bacteraemia?

A

Need to use combo antibiotics and this combo should NOT include any beta lactams due to resistance possibility

Hence can use vancomycin + rifampicin or another duo (other options linezolid, tigecycline)

134
Q

3 classic features of pertussis infection

What is treatment?

A

Paroxysms of coughing
Subconjunctival haemorrhages from repeated coughing
Marked lymphocytosis

Treatment: supportive but azithromycin is given to limit infectivity of to other children

135
Q

Anorexia, abdo pain, megaloblastic anaemia and eosinophilia what infection?

A

Tapeworm (the anaemia is due to vitB12 def)

136
Q

What is the first line treatment of tapeworm infection

A

Praziquantel

137
Q

Meningococcal PCR is now a standard investigation in cases of suspected meningococcal septicaemia T/F

A

T - it gives a definitive diagnosis so should be prioritised

138
Q

What is the clinical significant of a rapidly spreading purpuric rash in a pt with suspected meningococcal infection?

A
  1. More likely to be septicaemia than meningitis (although the 2 can coexist)
  2. It is a C/I to LP due to concern for severe coag defects
139
Q

What is the standard treatment of Cryptosporidum related gastro?

A

Supportive care with oral rehydration

140
Q

When is treatment indicated in Cyrptosporidum related gastro?

A

Immunocompromised
Unusually severe features
Persistent (> 2 weeks)

Note: not great data for treatment but can try antiprotazoal agents such as albendazole, nitazoxanide or paromomycin

141
Q

What broad class of medication is mebendazole

A

Anthelminthic

142
Q

A feature about the presentation of eczema herpeticum that can help distinguish it from an eczema flare or superimposed bacterial infection?

A

Presentation of lesions at different stages - condition starts with a group of fluid filled lesions with further new lesions forming over 7 -10 days

143
Q

Indications for IV acyclovir in eczema herpeticum?

A

Severe infection
Rapid spread
Eye involvement

Note: otherwise can be treated outpatient with oral

144
Q

An eye infection with which pathogen would respond best to chloramphenicol eye drops? Chlamydia trachomatis, p aeruginosa, s aureus

A

S aureus would respond best

Chlamydia can be treated with chloramphenicol but responds better to a macrolide such as azithromycin

P aeruginosa is resistant

145
Q

In a patient with CF what is the commonest organism causing infection in the first year of life?

A

Staph aureus

Note: flucloxacillin prophylaxis can be used

146
Q

What is the typical presentation of dengue

A

Fever arthralgia and rash

Note: retro orbital pain and photophobia may also be prominent

147
Q

Treatment of group A strep pharyngitis?

A

Penicillin V for 10 days

Note: greater treatment failure has been shown with a 7 day course.

148
Q

Phases of yellow fever?

A

Acute febrile flu like phase, recovery phase and then ill again

149
Q

What is the main feature on presentation to differentiate bacterial tracheitis from croup?

A

Both will have a preceding coryzal illness, stridor, fever and barking cough but the patient with bacterial tracheitis will be more more ill appearing.

150
Q

Peripheral neuropathy is a side effect of what medication used to treat TB?

A

Isoniazid

151
Q

Which blood group antigen helps to protect those of West African descent from P vivid malaria?

A

Duffy

Note: high rates in that pop and extremely rare in other populations

152
Q

In a pt with bacterial meningitis when are steroids indicated?

A
  1. Must be > 3 months old PLUS
  2. i CSF frankly purulent or
    ii CSF WBC > 1000 or
    iii CSF WBC elevated with protein conc 1 g
    iv or > or bacteria on gram stain

NB different in TB meningitis mgmt

153
Q

Steroids may be indicated in the mgmt of meningococcal septicaemia T/F

A

F - NEVER

Sometimes indicated in bacterial meningitis

154
Q

When should vancomycin be added in the treatment empiric tx of bacterial meningitis?

A

If hx of recent foreign travel or prolonged use of antibiotics

155
Q

Empirical tx of bacterial meningitis

A
  1. < 3 months CTX/cefotaxime PLUS ampicillin (listeria coverage)
  2. > 3 months CTX

+/- vanc if hx of prolonged abx use or foreign travel

+/- steroids (> 3months only)

156
Q

Which TB medication can cause elevation of AST and ALT?

A

Isoniazid

Note: the drug undergoes acetylation in the liver

157
Q

Infant with chlam trachomatis eye infection what treatment?

A

Oral macrolide such as erythromycin

No role for any topical treatment

158
Q

What is the approx carriage rates of c diff in neonates? More common in breast or formula feed?

A

50% in neonates

More common in formula feed

159
Q

Morphology of C diff

A

Anaerobic gram + rod

160
Q

Classic side effect of quinine?

A

Tinnitus

161
Q

Exposure prophylaxis for VZV in an asymptomatic immunosuppressed child?

Treatment if child develops symptoms?

A

Asymptomatic: IM varicella zoster Ig
Symptomatic: IV normal immunoglobulin

Note: if it is an onc patient on chemo should only hold the chemo if child becomes systemically unwell/haemodynamically unstable.

162
Q

Post exposure measles prophylaxis for immunosuppressed pt?

A

IM normal immunoglobulin

The idea that normal immunoglobulin has contains antibodies against a range of infections including measles

163
Q

What is the most common cause of viral encephalitis in infants?

A

Enteroviruses

164
Q

The mortality rate of untreated HSV encephalitis is 50% T/F

A

F - 75%

165
Q

The mortality rate of untreated HSV encephalitis is 75% T/F

A

T

166
Q

In a mother with HIV IV zidovudine during labour has been shown to decrease the risk of HIV transmission to the neonate T/F

A

F - no evidence to support this.

Oral zidovudine from 28 weeks gestation onwards and for the infant until 6 weeks old are both shown to reduce risk

167
Q

Which eye infections caries an increased risk of corneal perforation chlam or gonorrhoea?

A

Gonorrhoea

168
Q

Trichomonias and BV both cause a fishy bacterial odor, what clinical way to differenciate?

A

BV: no vaginal pain or itching, not associated with sexual activity
Trich: associated with pain and itching, sexually transmitted

169
Q

The parotid swelling in mumps is bilateral > 90% of time T/F

A

F - up to 25% of the time the swelling is unilateral

170
Q

All children with HIV infection require PCP prophylaxis regardless of CD4 count T/F

A

T

Note: in a new diagnosis HIV start prophylaxis immediately and plan to start anti retrovirals when the results of drug susceptibility and Hep B status are available

171
Q

How long is the course of treatment for TB meningitis?

A

1 year

Note: steroids are used at the start of the treatment course.

172
Q

Empiric abx for suspected meningitis for 3 month to 18 yr old patient?

A

IV CTX or cefotaxime

173
Q

H pylori is a common cause of gastritis T/F

A

F - not a common cause

174
Q

H pylori infection is often asymptomatic T/F

A

T

Note: it is a gram neg bacillus

175
Q

H pylori can be associated with nosocomial transmission T/F

A

T - endoscopes not correctly clean are one mode of nosocomial transmission

176
Q

Listeria meningitis can be associated with a minimal rise in CRP T/F

A

T

177
Q

Necator Americans is also known as?

A

Hookworm

Note: Ancylostoma duodenale is another type of hookworm
Common cause of chronic GI bloodless worldwide

178
Q

Enterobius vermicularis is AKA?

A

Pinworm

Anal itch, esp at night is the most common symptom. Can also cause vulvovaginitis and abdominal pain. Stool is often negative for ova but adults worms are frequently seen at the anus

MRCP 1 (21 decks)

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