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MED 5 > ID > Flashcards

ID Flashcards

1
Q

Beta-lactams

A

Inhibit cell wall synthesis by blocking peptidoglycan crosslinking

penicillins, carbapenems, aztreonam, and cephalosporins

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2
Q

Glycopeptide

A

vancomycin

  • Inhibits cell wall synthesis
  • only gram +
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3
Q

Adverse effects of Vancomycin

-which other antibiotic group has these side effects

A

Nephrotoxicity
Ototoxicity/vestibular toxicity

Aminoglycosides

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4
Q

Aminoglycosides-MOA

A

gentamicin

Inhibits bacterial protein synthesis by binding to the 30S subunit of the bacterial ribosome

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5
Q

Aminoglycosides-SE

A

Nephrotoxicity
Ototoxicity and vestibulotoxicity (impaired hearing and balance)
Neuromuscular blockade

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6
Q

Doxycycline is a

A

Tetracycline group of Abx

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7
Q

Doxycycline-MOA

A

Inhibits bacterial protein synthesis

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8
Q

Adverse effects of doxycycline

A

1) Hepatotoxicity
2) Deposition in bones and teeth → discolouration of teeth and inhibition of bone growth in children
3) Damage to mucous membranes (e.g., esophagitis)
4) Photosensitivity: UV light is absorbed by the drug, which releases energy to the surrounding area and damages exposed areas

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9
Q

erythromycin, azithromycin and clarithromycin-MOA

A

Inhibits bacterial protein synthesis

They are marcolides

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10
Q

Side effects of Macrolides

A

Increased intestinal motility → GI discomfort

QT-interval prolongation

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11
Q

Anaerobes above the diaphragm it is

Anaerobes below the diaphragm it is

A

Clindamycin is indicated for anaerobes above the diaphragm and metronidazole treats anaerobes below it!

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12
Q

Ciprofloxacin

  • belongs to
  • MoA
A

Fluoroquinolones

Inhibition of prokaryotic topoisomerase II (DNA gyrase) and topoisomerase IV

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13
Q

Ciprofloxacin- 2 most common side effects

A

Muscle ache, tendinitis, tendon rupture (especially the Achilles tendon)
QT prolongation

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14
Q

cotrimoxazole (TMP/SMX) = trimethoprim (TMP) + sulfamethoxazole (SMX)

MoA

A

Inhibition of bacterial folic acid synthesis

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15
Q

Infectious mononucleosis is caused by

A

EBV

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16
Q

Infectious mononucleosis-clinical features

A

Splenomegaly (50% of cases), fever, fatigue, malaise

Pharyngitis and/or tonsillitis (reddened, enlarged tonsils covered in pus); palatal petechiae

Bilateral cervical lymphadenopathy (especially posterior) that may become generalized and can, in severe cases, lead to airway obstruction

Abdominal pain

Possibly hepatomegaly and JAUNDICE

Maculopapular rash (similar to measles): caused by the infection itself in about 5% of cases, but is generally associated with the administration of aminopenicillin (e.g., ampicillin or amoxicillin)

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17
Q

Diagnostic test for Infectious mononucleosis

A

Monospot test: detects heterophile antibodies

Laboratory analysis: elevated LDH and liver transaminases
Peripheral smear: lymphocytosis with > 10% atypical lymphocytes

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18
Q

IM patient has a rash after treatment with ampicillin

A

Tonsillitis is an important differential diagnosis for infectious monoclueosis that is often treated with aminopenicillins (e.g., ampicillin). However, if given to a patient with IM, the patient often develops a macular erythematous rash after 5–9 days!

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19
Q

Treatment for IM

A

1) Avoid physical activity that may trigger splenic rupture (e.g., contact sports) for at least 3 weeks after the onset of symptoms.
2) Fluids (IV administration if necessary)
3) Analgesics/antipyretics (e.g., acetaminophen)

20
Q

EBV associated malignancies

A

Burkitt lymphoma (BL), a non-Hodgkin lymphoma
Hodgkin lymphoma
Nasopharyngeal carcinoma

21
Q

C.difficle infection-treatment

A

Metronidazole

22
Q

Traveller’s diarrhoea

-caused by

A

Most commonly caused by enterotoxigenic Escherichia coli (ETEC)

23
Q

Think of M-CENTOR to remember the Modified Centor score criteria:

A 
M = Must be older than 3 years
C = Cough absent
E = Exudate on the tonsils
N = Node enlargement
T = Temperature elevation
OR = young OR old.
24
Q

DDX for sore throat/tonsilitis

A

Tonsillitis in infectious mononucleosis
Tonsillitis in diphtheria (diphtheritic croup)
Pharyngitis
Aphthous stomatitis
Herpangina
Herpetic pharyngotonsillitis/herpetic gingivostomatitis
Ludwig angina
Oral thrush (fungal tonsillitis

25
Q

State the Suppurative complications of acute tonsilitis

A 
Peritonsillar abscess
Parapharyngeal abscess
Otitis media
Sinusitis
Cervical lymphadenitis
Mastoiditis
26
Q

state the non-suppurative complications of acute tonsilitis

A

Rheumatic fever
Scarlet fever
Poststreptococcal glomerulonephritis

27
Q

Otoscopy: tympanic membrane (TM) evaluation in AOM

A

Early findings

1) Retracted and hypomobile
2) Loss of light reflex

Late findings
Cartwheel TM
Red bulging TM with loss of landmarks

Tuning fork test: conductive hearing loss

28
Q

Complications of AOM

A

1) Mastoiditis
2) Labyrinthitis–>Etiology: Inflammation spreads to the inner ear (labyrinth) through the round window
3) Peripheral facial palsy
4) Otogenic abscess

29
Q

Lepto triad

A

Triad- Fever, jaundice and hemorrhage( in Weil’s disease, not the first presentation)

However, in 10% of cases, the disease progresses rapidly to a severe form (icterohemorrhagic leptospirosis, or Weil disease), which typically presents with a triad of jaundice, bleeding manifestations, and acute kidney injury.

30
Q

Scabies worse at night?

A

A warm bed or bath intensifies the pruritus because the mite becomes more active. Because of the release of allergenic antigens on mite trails, pruritus occurs even in regions of the body without mites.

Intense pruritus at night

31
Q

ddx for scabies

A

Scabies may be mistaken for eczema, especially as the topical use of glucocorticoids initially alleviates symptoms!

32
Q

Treatment of choice for scabies

A

Drug of choice: permethrin 5% lotion

Oral ivermectin: especially indicated in large outbreaks or severe forms of scabies

General measures–> Wash all textiles (e.g., clothing and bedding)

33
Q

Complications of scabies

A

Bacterial superinfection

34
Q

Three tests you can do for dengue

A
  1. Serology Test - Dengue Antibodies IgM/IgG (to detect past infection, however not specific)
  2. Molecular Test - Dengue PCR/NAAT- Specific and allows to determine serotypes (DNA) however negative in past infection
  3. Protein Test - NS1 antigen test- Specific and sensitive however negative in past infection
    - NS1 antigen testing-PCR
    - Viral non-strctural protein(NS)
35
Q

Why is only paracetamol recommended in dengue fever

A

Avoid aspirin, ibuprofen or other anti-inflammatory drugs - they increase the chance of bleeding.

36
Q

Strep pneumonia- what antigen can be tested

A

Pneumococcal urinary antigen can also be used to presumptively confirm infection

37
Q

GABHS

- predisposes you to

A

Group A Beta hemolytic streptococcus

Skin sores and scabies

38
Q

Post streptococcal glomerulonephritis- 4 things

A

Haematuria
Edema
Proteinuria
Hypertension

Nephritic sydrome

39
Q

Scrub typhus- rickettsial disease

  • what is the latin name
  • what is the treament
A

Orientia tsutsugamushi

  • Both present with fever, headache, rash, there may be an eschar visible •Diagnosis is serlogical – Will need a convalescent serum sample.
  • Treatment is with doxycycline
40
Q

ID guy said which antibiotic to use

A

Doxycycline

don’t be afraid to use it

41
Q

Syphillis and pregnancy why?

A

Risk of transmission is least in first trimester and greatest in the third trimester.

That why we test it in each triemster

• Intrauterine death occurs in up to 25% of untreated infections.
» Most Are In The Third Trimester

42
Q

5 classical signs of dengue fever

A
  1. Headache
  2. fever
  3. arthralgia
  4. retro- orbital pain
  5. mild hepatitis
  6. thrombocytopenia

Rarely complicated by sudden hypotension due to massive fluid shifts or bleeding.

43
Q

Diagnosis of dengue by

A

Diagnosis by serology: NS1 antigen, Dengue IgM and IgG.

44
Q

Who gets Dengue hemorrhagic fever (DHF)

what is dengue shock sydrome(DSS)

A

Dengue hemorrhagic fever is more frequent in individuals who experience a repeat infection with a second serotype, especially serotype 2!

Temperature change: ranges from hypothermia to a second spike in fever
Abdominal pain, vomiting
Changes in mental status (e.g., confusion)
Hemorrhagic manifestations (e.g., petechiae, epistaxis, gingival bleeding)
Increased vascular permeability → signs of pleural effusion and/or ascites
Dengue shock syndrome (DSS): DHF + shock

45
Q

Dengue hemorrhagic fever(4 criteria)

A
  1. Fever, or recent history of acute fever
  2. Hemorrhagic manifestations
  3. Low platelet count (<100 x109/L)
  4. Objective evidence of “leaky capillaries:

–> Elevated hematocrit (plasma leakage)

–> Ascites, pleural & other effusions

–> low albumin.

46
Q

best confirming test for dengue is

A

Best test for confirming infection: serology (IgM, IgG)

47
Q

Risk factors for GBS

A 
• GBS colonisation in current pregnancy
• GBS bacteriuria in current pregnancy
• Preterm labour at less than 37+0
weeks
• Previous baby with EOGBSD
• ROM longer than 18 hours
• Maternal temperature 38 oC or higher
intrapartum or within 24 hours of birth

IAP is indicated

MED 5 (23 decks)

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