Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCP 2 > ID & GUM > Flashcards

ID & GUM Flashcards

1
Q

amoebiasis treatment

A

metronidazole to kill active parasites
diloxanide furoate to kill cysts
aspiration for large liver abscesses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

abx that disrupt folate synthesis

A

trimethoprim
sulfonamides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

abx that disrupt bacterial ribosome function

A

30S:
tetracyclines, aminoglycosides

50S:
macrolides, clindamycin, linezolid, chloramphenicol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

vanc and gent adverse effects

A

red man
ototoxic
nephrotoxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

macrolide adverse effects

A

P450 inhibition
cholestasis
thrombophlebitis
QTc prolongation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

abx c/i in myaesthenia gravis

A

gentamicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

galactomannan antigen is present in

A

aspergillosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ABPA hypersensitivity type

A

1 and 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

aspergillosis tests

A

invasive and chronic: serum galactomannan
ABPA: IgE, aspergillus specific IgE and IgG, eosinophilia
CPA: IgG

XR nodules, consolidation, infiltrates, cavities
HRCT: nodules, halo, air crescent
HRCT/MRI brain: focal lesions, SOL, abscesses, haemorrhagic lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

meningitis organisms

A

neisseria
strep pneumoniae
hib

in neonates: strep agalactiae, ecoli, strep pneumoniae, listeria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

meningitis treatment

A

benpen stat (300/600/1200mg)
IV ben pen/cefotaxime/chloramphenicol
add vanc if foreign travel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

meningitis prophylaxis

A

ciproflox stat
for contacts within 7 days prior to onset of illness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

normal vaginal pH

A

< 4.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

BV micro-organisms

A

gardnerellam atopobium
prevotella
mycoplasma hominis
mobiluncus

reduced lactobacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

brucellosis pathophysiology

A

invades nearby mucosa
lymphatic spread
> haematogenous spread
> reticuloendothelial system

re-infection can occur as immunity following infection is not adequate
incubation days to months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

brucellosis treatment

A

dual or triple therapy 6 weeks
notifiable disease
specialist involvement if pregnant or < 8y

PO doxy and IM strep
or
PO quinolone and rifampicin
or
PO doxy and rifampicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

diagnosing c diff

A

stool PCR and glutamate dehydrogenase immunoassay
50% of patients have plaques on colonoscopy/sigmoidoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

cellulitis microorganisms

A

strep pyogenes and staph aureus
pseudomonas aeruginosa (hot tubs, sponges)
vibrio vulnificus (saltwater)
aeromonas hydrophilia (freshwater)
erysipelothrix (butcher, vet)
mycobacteria marinum (aquarium)
pasteurella, capnocytophaga (dog/cat bite)
eikenella (human bite)
strep moniliformis (rodent bite)
strep pneumoniae, haemophilus, anaerobes (injury, burns, immunocompromised)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

abx for cellulitis with lymphoedema

A

amox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

avoiding sexual contact with chlamydia

A

additional 7 days after treatment with azithromycin
test after 3-6 months for re infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

chlamydia treatment if pregnant/breastfeeding

A

azithromycin
amox
erythromycin
test of cure after 3 weeks if pregnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

botulism

A

gram positive bacillus
flaccid paralysis
food born/wound/infant/inhalation bioterrorism
toxins A, B, E cleave SNARE proteins at NMJ
> inhibits release of ACh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

botulism presentation

A

blurred vision, diplopia, ptosis (CN III, IV, VI)
dysarthria, dysphagia (oculobulbar or CN IX, X, XII)
symmetrical descending flaccid paralysis
absent deep tendon reflexes
urinary retention, constipation, postural hypotension, dry mouth
GI symptoms if food borne or infantile
typically afebrile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

management of botulism

A

mechanical ventilation if upper airway compromise
horse heptavalent antitoxin for adults
IVIG for infants
surgical debridement for wound botulism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

cryptosporidiosis

A

most common cause of infectious diarrhoea in pt with HIV
contaminated water or food with oocysts
oocytes shed for 7 days
chronic infection in immunocompromised
dx: stool microscopy, stool antigens, stool PCR
tx: mostly supportive, nitazoxanide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

congenital CMV

A

sensorineural deafness
LD, developmental delay
sight problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

CMV transmission

A

blood, transplant
sexual contact
saliva
placental
latency sites: endothelial cells of arterial walls, T cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

CMV treatment

A

valganciclovir or ganciclovir 1 month for immunocompromised or congenital infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

dengue vaccine

A

should only be used in people previously infected due to increased risk of severe dengue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

diagnosing dengue

A

RT PCR
NSI
ELISA IgM and IgG (IgG indicates past infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

e coli virulence factorw

A

verotoxin (shiga like) > bloody diarrhoea, HUS
heat stable/labile enterotoxins > watery diarrhoea
p fimbriae > UTI
K1 capsular polysaccharide > neonatal meningitis, pneumonia
lipopolysaccharide > bacteraemia, septic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

e coli subtypes

A

EIEC (invasive) > dystentery
ETEC (toxigenic) > watery diarrhoea, heat labile and stable toxins
EPEC (no toxin) > diarrhoea
EHEC > HUS, bloody diarrhoea
EAEC (aggregative) > persistent diarrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

filariasis

A

mosquito borne (anopheles, culex)
dx: microfilariae on blood film, anti filarial IgG4
labs may be negative as lymphoedema can develop years after infection
preventative albendazole/ivermectin/DEC
tx: DEC
tropical pulmonary eosinophilia is a complication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

dermatophytes vs yeasts

A

Dermatophytes:
trichophyton rubrum/interdigitale
epidermophyton floccosum (tinea pedis/corporis/cruris/unguium)

yeasts:
candidiasis
pityrosporu, orbicularis (pityriasis versicolour)

cryptococcus and histioplasmosis are dimorphic

35
Q

cryptococcus presentation

A

immunocompromised host
subacute (1-2 weeks)
headache, fever, confusion

36
Q

histioplasmosis

A

found in soil containing bird/bat droppings
affects immunocompromised
spores turn into yeast cells at body temp
> macrophages ingest alveoli
> microconidia transform into yeasts
asymptomatic or flu like symptoms
dx:
CXR often normal or may show calcified granulomas
urine PCR and antigens
serum antibodies after 2-6 weeks

tx: amphoteracin B (need to monitor renal function

37
Q

when to refer/admit gonorrhoea

A

conjunctival
pregnant
unresponsive to treatment
ascending infection
admit: disseminated, PID

38
Q

treating diarrhoea in HIV

A

CMV: ganciclovir
microsporidium: albendazole
MAI: 12m anti TB
cyclo/isospora: cotrimox
salmonella/shigella: azithro
HAART side effect: loperamide
cryptosporidium: supportive

39
Q

HIV 1 vs 2

A

1 is worldwide
2 is endemic to west africa

40
Q

factors that increase risk of HIV transmission

A

concurrent STIs esp HSV-1 and other ulceratives
hep C coinfection
high viral load
advanced stage of disease

41
Q

seroconversion

A

development of persistent detectable antibody response to HIV

42
Q

stages of HIV infection

A

infection
clinical latency after seroconversion- progressive fall in CD4 and rise of viral load over 5-10y
early and late AIDS

43
Q

HIV diagnosis

A

serology for antibody- 3 month window between inoculation and seropositive
test for HIV RNA and p24 in window
also test for Hep B and C

44
Q

HAART drugs

A

NRTI- zidovudine, lamivudine
NNRTI- efavirenz, nevirapine
protease inhib- ritonavir, darunavir, saquinavir
integrase inhib- rategravir, elvitegravir

45
Q

hookworm

A

helminth, lives in small intestine of host
infects human host through skin as larvae in sand/soil contaminated with faeces
> migrates to lungs and gut
> cutaneous larvae migrans, GI symptoms incl bleeding, protein loss, SOB and wheeze
ancylostoma duodenale
necator americanus

46
Q

leprosy treatment

A

dapsone + rifampicin + clofazimine

47
Q

listeria treatment

A

generally supportive
amox or cotrimox if immunosuppressed or pregnant or > 60y
ampicillin + gent if meningitis or systemic infection

48
Q

lyme disease organism

A

europe- borellia garinii, afzelii
n america- borellia burgdorferi

49
Q

lyme disease presentation stages

A

1 (localised):
erythema migrans at bite site
1-4 weeks post bite
fever, headache, regional lymphadenopathy

2:
weeks to months post stage 1
myalgia, further rash, arthritis, neuro/cardiac

3 (chronic complications):
months to years later
oligoarthritis, neuro, acrodermatitis atrophicans

50
Q

diagnosing lyme disease

A

IgM and IgG serology
confirm positive ELISA with immunoblotting
inflam markers will be normal in stage 2 and 3
if ELISA negative within 4 weeks, repeat
if ELISA negative within 12 weeks, do immunoblot

51
Q

jarisch herxheimer reaction

A

self limiting reaction to abx in lyme disease
onset hours to days following start of abx

52
Q

falciparum malaria treatment

A

uncomplicated- artemesinin tablets
severe- IV artesunate or IV quinine then doxy

53
Q

malaria associated with severe anaemia, AKI, splenic rupture

A

p vivax

54
Q

causes of nec fasc

A

staph aureus
strep
clostridiu, perfringens

55
Q

types of nec fasc

A

1- polymicrobial
2- group a strep
3- marine organisms
4- fungal

56
Q

nec fasc risk factors

A

raised CRP, WBC
raised creat, glucose
low Hb, Na

57
Q

focal vs generalised neuro disease in AIDS

A

focal:
toxoplasmosis
TB meningitis

generalised:
cryptococcal meningitis
PML (JC virus)
CMV encephalitis

focal commonly presents w/ dysphagia, hemiparesis, seizures

58
Q

diagnosing cryptococcal meningitis

A

CSF india ink
serum cryptococcal antigen

59
Q

toxoplasmosis treatment

A

pyrimethamine + sulfadiazine
+ folinic acid to prevent BM suppression

60
Q

preventing peripheral neuropathy from isoniazid

A

pyridoxine

61
Q

PID treatment

A

ceft + doxy + metro
or
oflox + metro
or
moxiflox

62
Q

q fever

A

coxiella burnetti
zoonotic
> doxy
> cotrimox 5/52 if pregnant

63
Q

rocky mountain spotted fever

A

rickettsia rickettsii
wrists > trunk > extremities
may be eschar at bite site
> doxy or chloramphenicol

64
Q

qSOFA

A

quick sequential organ failure assessment
SBP< 100
RR > 22
GCS < 15

64
Q

schisto treatment

A

praziquantel
2 doses for haematobium, mansoni
TDS for japonicum
may need another dose a few weeks later

65
Q

contact tracing for syphilis

A

primary: 3/12
secondary: 2y
tertiary: > 2y

66
Q

patterns of immunodeficiency

A

neutrophil: recurrent bacterial or fungal skin infections

complement: often incidental, neisseria

B cell: sinopulmonary
T cell: opportunistic (PCP), invasive (CMV), intracellular (salmonella, mycobacteria)

67
Q

abx for endocarditis

A

native valve: amox + gent
prosthetic valve: vanc + gent + rifampicin
staph: fluclox
MRSA: vanc + rifamp
strep: benpen +/- gent
HACEK: amox + gent

68
Q

endocarditis indications for surgery

A

cardiac failure or haemodynamic compromise
extensive valve incompetence
large veg
emboli or abscess
fungal
abx resistant

69
Q

abx for TSS

A

IV clinda + fluclox/vanc

70
Q

typhoid fever

A

prolonged fever, abdo pain, rose spot rash
s typhi and s paratyphi

bacteria invade gut wall
> migrate into peyers patches of distal ileum
> spread throughout reticuloendothelial system
>liver, spleen, BM, bloodstream
asymptomatic until bacteraemic

71
Q

typhoid fever stages

A

week 1:
high fever, relative bradycardia
disturbed bowel habit (constipation more common)
nausea, prodromal

week 2:
persistent fever, rose spots
diarrhoea, abdo pain, splenomegaly

week 3:
hepatomegaly, bowel perf, GI bleed, meningitis, haemolytic anaemia, acute cholecystitis, renal failure, myocarditis

72
Q

diagnosing typhoid

A

blood cultures
stool cultures
bone marrow, rose spot cultures
Widals agglutination test antibodies

73
Q

typhoid fever treatment

A

confirmed: ciproflox

extensively resistant: meropenem + azithromycin

suspected: cephalosporin +/- azithromycin

dex for neuro complications

74
Q

toxoplasmosis treatment

A

pyrimethamine and sulfadiazine
folinic acid and weekly FBC
prophylaxis: trimethoprim + sulfamethoxazole
spiramycin to prevent vertical transmission

75
Q

features of severe malaria

A

Hb < 50
glucose < 2.2
pH < 7.3
lactate > 5

76
Q

falciparum malaria treatment

A

uncomplicated: artemesinin PO
severe: IV artesunate or IV quinine then doxy

77
Q

trypanosomiasis treatment

A

1st stage:
W African- pentamidine
E African- suramin

2nd stage:
W African- nifurtimox + eflornithine
E African- melarsoprol

chagas: benznidazole or nifurtimox

78
Q

trypanosomiasis

A

African- tsetse fly
W African: t brucei gambiense
E Africa: t brucei rhodesiense

S American- reduvid bugs
t cruzi
chagas disease develops after 10-20y

79
Q

TB treatment

A

R+I 6 months (12 months if CNS)
P+E 2 months

add steroids for meningitis
add 3 months if pyrazinamide is discontinued due to s/e

RIP- hepatitis, risk increases with age
E- optic neuritis, yellow vision
I- peripheral neuropathy (give with pyridoxine)
R= orange/red urine

80
Q

opportunistic mycobacterial disease

A

m kanasii, xenopi, malmoense, avium intracellulare

cause disease identical to TB, undistinguishable on smear
usually underlying COPD, bronchiectasis, previous TB

> rifampicin + ethambutol 9m-2y

81
Q

UTI treatment in pregnancy

A

nitro 7/7 (avoid if at term)
amox
cefalexin

82
Q
A

MRCP 2 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions