inf dise

Question 1

white discharge at urethral meatus, dysuria, + G negative DIPLOCOCCI
what is dx?

Answer 1

Gonorrhoea

• Mx with IM CEFTRIAXONE 1g
• if this is refused –> oral CEFIXIME 400mg (single dose) + oral AZITHROMYCIN 2g (single dose)

Question 2

before giving BCG vaccine what to do

Answer 2

tuberculin skin test

-to exclude past exposure to TB

Question 3

immunocompetent pt with low grade fever, generalised lymphadenopathy, prominent cervical LNs + malaise, EBV serology NEGATIVE, dx?

Answer 3

Acute toxoplasmosis can mimic acute EBV infection

-pregnant testing and counselling paramount due to risk of congenital toxo

Question 4

what is meningococcal chemoprophylaxis in both adults and children

Answer 4

single dose oral CIPROFLOXACIN (or rifampicin)

Question 5

pregnant W UTI symptomatic Mx

Answer 5

• a urine culture should be sent in ALL cases
• should be tx with an ABx for 1st-line: NITROFURANTOIN (should be avoided near term)
• 2nd-line: amoxicillin or cefalexin
• trimethoprim is teratogenic in the 1st trimester + should be avoided in pregn

Question 6

pregnant W UTI asymptomatic bacteriuria

Answer 6

• a urine culture should be performed routinely at the first antenatal visit
• CKS recommend an immediate ABx prescription of either NITROFURANTOIN (should be avoided near term), amoxicillin or cefalexin. This should be a 7-DAY course
• the rationale of tx asympt bacteriuria is the signif risk of progress to acute pyelonephritis
• a further urine culture should be sent following completion of treatment as a TOCure

Question 7

Retro-orbital headache, fever, facial flushing, rash, thrombocytopenia in returning traveller

Answer 7

dengue

-transm by mosquiots - Aedes aegypti

Question 8

mx UTI in catheterised pts

Answer 8

• do NOT treat asympt bacteria in catheterised pts

- if pt is symptomatic they should be treated with ABx (7 day course)

Question 9

what virus causes HIV pts to have worsening speech + behavioural problems + co-ord difficulties with multifocal non-enhancing lesions on MRI

Answer 9

JC Virus causing multifocal leukoencephalopathy

-sx = ataxia, weakness, visual changes, disturbed speech, cognitive disturbance

Question 10

aged 6-60Y what organism causes bact meningitis

Answer 10

Strep Pneumoniae

or N.meningitides

Question 11

genital wart tx

Answer 11

• multiple, non-keratinised warts: topical podophyllum

- solitary, keratinised warts: cryotherapy

Question 12

MSM offered imms against what

Answer 12

Hep A

Hep B

Question 13

hep A sx, disease course + prognosis

Answer 13

SYMPTOMS-flu-like symptoms, RUQ pain, tender hepatomegaly (85%) and cholestatic LFTs (ALT, ALP high)
DISEASE COURSE- prodrome 3-10days incl flu like sx, GI sx, + headache, cough, sore throat, constip, Diarrhoea, itch or utricaria
PROGNOSIS- 85% full recovery in 3m, and close to 100% full recovery in 6m
-does not cause CLD, no carrier state + results in lifelong immunity

Question 14

what does negative non-treponemal test + positive treponemal test mean

Answer 14

successfully treated syphilis
non-treponemal: VDRL or RPR NEGATIVE -after tx
treponemal: TPHA or TP-EIA POSITIVE - stays +

Question 15

BV what organism

Answer 15

Gardnerella Vaginalis

Question 16

Most comm org causing T2 Nec Fasc

Answer 16

strep pyogenes

Question 17

Preceding influenza and now pneumonia, likely organism?

Answer 17

Staph Aureus

Question 18

Returns from abroad, flu symptoms, RUQ pain, tender hepatomegaly, cholestatic LFTs

Answer 18

Hep A