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MRCP Part 2 > ID > Flashcards

ID Flashcards

1
Q

Treatment regime in Isoniazod-resistant TB

A

2 months of RIPE

Then further 4 months of Rifampicin and Ethambutol (in place of RI)

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2
Q

Features of Strongyloides stercoralis infection (nematode worm)

A

Diarrhoea + abdo pain + bloating
Linear itchy rash (larva currens)
Pneumonitis if larvae migrate to lungs

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3
Q

Treatment of Strongyloidiasis

A

Ivermectin/albendazole

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4
Q

Features of Strongyloides Hyperinfection Syndrome (proliferation of larvae in immunosuppression)

A

Paralytic ileus
Sepsis due to gut bacteria translocation
Pulmonary infitrates

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5
Q

Suspect Lyme disease - erythema migrans is present

A

Treat: Doxycyline 14 - 21 days

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6
Q

Suspect Lyme disease - no erythema migrans.

A

ELISA for Borrelia burgdorferi antibodies

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7
Q

Suspect Lyme disease - (no erythema migrans) - Borrelia ELISA serology negative at <4wk since symptom onset

A

Repeat ELISA in 4-6wk

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8
Q

Suspect Lyme disease - (no erythema migrans) - Borrelia serology negative at >12wk since symptom onset

A

Immunoblot

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9
Q

Suspect Lyme disease - (no erythema migrans) - Borrelia ELISA positive

A

Immunoblot test

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10
Q

Suspect Lyme disease - (no erythema migrans) - Borrelia serology equivocal

A

Immunoblot

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11
Q

Management of early Lyme disease - in pregnancy

A

Amoxicillin (doxycycline CI in pregnancy)

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12
Q

Management of disseminated Lyme disease - in pregnancy

A

Ceftriaxone

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13
Q

Monitoring of HIV

A

Viral load every 6m

CD4 count annually

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14
Q

Clostridium botulinum - bacterial identification

A

Gram positive anaerobic bacillus

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15
Q

Management of botulism

A 
Botulism antitoxin (if early)
Supportive care
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16
Q

Features of leprosy

A

Hypopigmented patches
Anaesthetic nodules
May be symmetrical or asymmetrical nerve involvement
Alopecia

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17
Q

Diagnosis of leprosy

A

Skin biopsy

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18
Q

Management of leprosy

A

Triple therapy:

Rifampicin + dapsone + clofazimine

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19
Q

Features of Mycoplasma pneumonia

A 
Dry cough
Prolonged flu-like
Erythema multiforme
Hyponatraemia
Haemolytic anaemia (cold agglutinins)
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20
Q

Treatment of latent TB (asymptomatic TB, positive blood test, no imaging findings)

A

Dual therapy, either:

3 months of Isoniazid (+Pyridoxine) + Rifampicin

or

6 months of Isoniazid (+Pyridoxine)

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21
Q

Which drugs risk re-activation of TB

A

TNF inhibitors:
Etanercept
Infliximab

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22
Q

Tests used to diagnose latent TB

A

Quantiferon (IFN-g release assay)

Mantoux

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23
Q

Features of Dengue fever

A 
Fever
Severe bone/muscle aches
Retro-orbital headache
Maculopapular rash
Low WCC, low PLT
Haemorrhagic phase
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24
Q

Treatment of Dengue fever

A

Supportive

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25
Q

Features of Scrub typhus

A

Fever + muscle pain

Eschar at mite entry site

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26
Q

Features of Typhoid fever

A

Relative bradycardia
Abdo pain
Rose spots
Reactive athritis

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27
Q

Features of Chikungunya fever

A

Severe joint pain + swelling
High fevers
Lymphopenia
Thrombocytopenia

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28
Q

Ross River Virus - endemic in

A

Australia

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29
Q

Chikungunya fever - endemic in

A

Africa
Asia
Caribbean

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30
Q

Treatment for schistosomiasis

A

Praziquantel

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31
Q

Treatment for giardiasis

A

1 week Metronidazole
or
3g Tinidazole stat

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32
Q

Cryptococcus meningitis (fungal) - CSF findings

A

Raised opening pressure
Lymphocytosis
High protein
Low glucose

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33
Q

Management of Cryptococcus meningitis

A

Amphotericin B

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34
Q

Treatment for amoebic liver abscess

A

Metronidazole

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35
Q

Treatment of fungal liver abscesses

A

Amphotericin B

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36
Q

Treatment for intestinal amoeba (after treated the liver abscess)

A

Diloxanide furoate

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37
Q

Antibiotic for Legionnaire’s disease

A

Macrolide (clarithromycin/erythromycin) or quinolone (levofloxacin)

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38
Q

Antibiotic treatment of Listeria meningitis

A

IV amoxicillin/ampicillin + gentamicin

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39
Q

Antibiotic treatment of tetanus wound (after debridement and tetanus globulin)

A

Metronidazole IV

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40
Q

1st line management of Brucellosis

A

Oral doxycycline + rifampicin

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41
Q

Management of Brucellosis with neurological involvement

A

IV Ceftriaxone + doxycycline + rifampicin

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42
Q

Management of brucellosis with endocarditis

A

Gentamicin + doxycycline + rifampicin

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43
Q

Presentation of Yersinia enterocolitica

A

Pseudo-appendicitis
Reactive arthritis
Erythema nodosum

44
Q

Treatment of Yersinia

A

Aminoglycoside (gentamicin)

45
Q

Treatment of salmonella gastroenteritis (non typhoid)

A

Ciprofloxacin

46
Q

DIffuse macular/papular/nodular rash with discoloration, after treatment for visceral leishmaniasis

A

Post-kala-azar dermal leishmaniasis (PKDL)

47
Q

Visceral leishmaniasis “kala-azar” (spread by sand fly) - endemic in

A

Mediterannean, Middle East, Asia, Africa, S. America,

48
Q

Features of Giardiasis

A

Prolonged diarrhoea >10days
Bloating, abdo pain
Non-bloody

49
Q

Farmer, with fever, pneumonia, transaminitis, think…

A

Q fever (Coxiella burnetii)

50
Q

Treatment of Q fever (Coxiella)

A

Doxycycline

51
Q

Management of mild PCP

A

Co-trimoxazole

52
Q

Management of moderate/severe PCP

(eg diffuse shadowing on CXR/ low sats/ breathless at rest),

A

Co-trimoxazole + corticosteroids

53
Q

What does a positive IGRA (interferon-gamma release assay) indicate?

A

Active or latent TB

54
Q

What might positive Mantoux test (induration 6-15mm) indicate?

A 
Latent TB
Miliary TB
Sarcoidosis
HIV
Lymphoma
55
Q

Antibiotic used for Shigella (if needed)

A

CIprofloxacin

56
Q

Antibiotic used for Campylobacter (if needed)

A

Ciprofloxacin

57
Q

Antibiotic used for Cholera (if needed)

A

A tetracycline

58
Q

Features of Brucellosis

A

Fever, malaise
Sacroiliitis
Contact with sheep/goats
or animal products in Med/Middle East

59
Q

Features of malaria

A

Fever, myalgia
Jaundice
Hepatosplenomegaly

60
Q

Features of viral haemorrhagic fevers (Yellow fever, Dengue, Ebola, Lassa)

A

Prodrome
Anaemia, thrombocytopenia
Renal failure
DIC

61
Q

Treatment of uncomplicated Falciparum malaria

A

“ACT” Artemisinin-based combination therapy (eg artesunate plus mefloquine)

62
Q

Treatment of severe/complicated Falciparum malaria

A

IV artesunate

Exchange transfusion if parasite count >10%

63
Q

Who needs to be treated for non-typhoidal salmonella gastroenteritis?

A

> 50 years old and:
Immunocompromised
Valve disease
Endovascular abnormality

64
Q

Features of Yellow fever

A

Fever + malaise
Jaundice
Conjunctival injection
Relative bradycardia

65
Q

Councilman bodies in hepatocytes - seen in which disease

A

Yellow fever

66
Q

Antibiotics used to treat carbapenemase producing enterobacteriaceae (CPE)

A

Gentamicin (macrolide)
Tigecycline
Fosfomycin
Colistin

67
Q

Treatment of typhoid fever

A

Cefotaxime/ceftriaxone

68
Q

Features of Visceral Leishmaniasis (kala-azar)

A

Fevers
Hepatosplenomegaly
Pancytopenia
Grey skin

69
Q

Gold standard test for visceral leishmaniasis

A

Bone marrow or splenic aspirate (amastigote parasites)

70
Q

Confusion in returned traveller from Asia, think

A

Japanese encephalitis

71
Q

HIV positive with headache and neurological symptoms, think…

A

CNS cryptococcus

72
Q

Test for Cryptococcus

A

India ink

73
Q

Treatment of CNS cryptococcal infection

A

IV amphotericin B + flucytosine

74
Q

Treatment of staph aureus bactaraemia

A

At least 2 weeks of IV Flucloxacillin

75
Q

Features of acute schistosomiasis infection

A

Cough
Bloody diarrhoea
Eosinophilia
Splenomegaly

76
Q

Diagnosis of intestinal Cryptosporidium parvum (protozoan)

A

Cysts seen on acid-fast stain of stool culture

77
Q

Indication for varicella-zoster immunoglobulin (VZIG)

A

Should be given within 7 days of exposure to:
Immunosuppressed
Neonates
Pregnant without varicella antibodies

78
Q

Management of chickenpox in immunocompromised individuals (once developed chickenpox)

A

IV aciclovir

79
Q

Fever on alternate days - suggestive of

A

P. vivax or P. ovale malaria

80
Q

Treatment of plasmodium vivax malaria

A

Chloroquine + primaquine (for hyponozoites)

81
Q

Gold standard diagnostic test for strongyloidiasis

A

Stool microscopy

82
Q

Best test for strongyloidiasis eradication

A

Serological testing

83
Q

Management of low-severity community acquired pneumonia

A

Amoxicillin 5 days

84
Q

Management of low-severity community acquired pneumonia (pen-allergic)

A

Macrolide (clarithromycin) or tetracycline 5 days

85
Q

Management of moderate severity community acquired pneumonia

A

Amoxicillin + macrolide 7-10 days

86
Q

Management of high severity community acquired pneumonia

A

Co-amoxiclav (or ceftriaxone/tazocin) + macrolide

87
Q

CURB-65 score - 1 point for C if

A

AMTS <= 8/10

88
Q

CURB-65 score - 1 point for U if

A

Urea > 7

89
Q

CURB-65 score - 1 point for R if

A

RR >= 30

90
Q

CURB-65 score - 1 point for B if

A

Systolic <= 90 or diastolic <= 60

91
Q

Management of CURB-65 score 2+

A

Consider hospital admission

92
Q

Management of CURB-65 score 3+

A

Consider ITU

93
Q

Which HIV patients should receive PCP (pneumocystis carinii) prophylaxis

A

All those with CD4 count <200/mm

94
Q

Which non-HIV patients should receive PCP prophylaxis

A

Transplant recipients (solid organ or stem cell)

Taking steroids + another immunosuppressant for >1m

AI condition with lung involvement + high dose steroid >1m

95
Q

Diagnosis of PCP

A

Broncho-alveolar lavage - shows cysts with silver staining

96
Q

Initial empirical treatment for meningitis if <3 months old

A

IV cefotaxime + amoxillin/ampicillin)

97
Q

Initial empirical treatment for meningitis if 3 months - 50 years old

A

IV cefotaxime/ceftriaxone

98
Q

Initial empirical treatment for meningitis if >50 years old

A

IV cefotaxime/ceftriaxone + amoxicillin/ampicillin

99
Q

Treatment of meningococcal meningitis

A

IV benzylpenicillin
or
IV cefotaxime/ceftriaxone

100
Q

Treatment of pneumococcal meningitis

A

IV cefotaxime/ceftriaxone

101
Q

Treatment of meningitis caused by Haemophilus influenzae

A

IV cefotaxime/ceftriaxone

102
Q

Treatment of meningococcal meningitis (pen-allergic)

A

Chloramphenicol

103
Q

Treatment of meningitis caused by Haemophilus influenzae (pen-allergic)

A

Chloramphenicol

104
Q

Haemophilus influenzae appearance under microscope

A

Gram-negative coccobacilli

105
Q

Chlamydia trachomatis gram-stain

A

Gram-negative coccobacilli

106
Q

Management of close contacts of meningococcal meningitis (close contact within the 7 days before onset)

A

PO ciprofloxacin STAT
or PO Rifampicin BD 2 days
or IM ceftriaxone

Meningococcal vaccination when serotype availabe

MRCP Part 2 (15 decks)

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