infection

Question 1

genital herpes vs genital warts

Answer 1

herpes - ulcerated and painful

warts - fleshy and protruding

Question 2

mx of genital warts

Answer 2

multiple: topical podophyllum
single: cryotherapy

Question 3

travellers’ diarrhoea: what points to Giardiasis over E.coli

Answer 3

nature of symptoms - bloating and watery diarrhoea

length of illness - Giardiasis has an incubation period of >7 days; E. coli is 12-48 h

Question 4

features of Chlamydia

Answer 4

women: cervicitis (discharge, bleeding), dysuria
men: urethral discharge, dysuria
more common than Gonorrhoea

Question 5

mx of Chlamydia

Answer 5

7 days Doxycycline

Question 6

HIV with CD4<200

Answer 6

provide prophylaxis against PJP - Co-Trimoxazole

Question 7

which infections is a person susceptible to following splenectomy

Answer 7

Haemophilus influenzae

Meningococcus

Question 8

HIV + homogenous enhancing lesion on CT

Answer 8

primary CNS lymphoma

Question 9

HIV + ring enhancing lesion on CT

Answer 9

toxoplasmosis

Question 10

motile trophozoites on vaginal swab

Answer 10

Trichomonas vaginalis

Question 11

mx of Gonorrhoea

Answer 11

IM Ceftriaxone

Oral Cefixime + oral Azithromycin if patient refuses Ceftriaxone

Question 12

pelvic inflammatory disease mx

Answer 12

DMC

Doxycycline + Metronidazole + Ceftriaxone

Question 13

features of typhoid (Salmonella typhi)

Answer 13

abdo pain and distension
constipation
rose spots
relative bradycardia

Question 14

common causative organism of chronic wound infections

Answer 14

Pseudomonas aeruginosa

especially if patients have any degree of immunosuppression

Question 15

adverse effects of Trimethoprim

Answer 15

myelosuppression

tubular dysfunction leading to hyperkalaemia and increased serum creatinine

Question 16

Chancroid vs genital herpes

Answer 16

Chancroid - single painful deep ulcer with painful lymphadenopathy
genital herpes - multiple painful ulcers with painful lymphadenopathy

Question 17

UTI in pregnancy mx

Answer 17

treat even if asymptomatic
avoid Trimethoprim - use Nitrofurantoin
avoid Nitrofurantoin if near term - use Amoxicillin or Cefalexin

Question 18

mx of Chlamydia in pregnancy

Answer 18

Azithromycin or Erythromycin or Amoxicillin

Question 19

CSF findings in meningitis: bacterial vs viral vs TB

Answer 19

bacterial and TB have low glucose and high protein
viral has high glucose and normal/raised protein
TB has raised lymphocytes (30-300)

Question 20

most common organism found in central line infections

Answer 20

Staph epidermidis

Question 21

mx of Legionella pneumonia

Answer 21

Clarithromycin

Question 22

ix for genital herpes

Answer 22

NAAT (nucleic acid amplification tests)

Question 23

complications of gonorrhoea

Answer 23

urethral strictures, epididymitis, salpingitis (hence infertility)
disseminated infection

Question 24

mx of infective exacerbation of COPD

Answer 24

Amoxicillin or Doxycycline or Clarithromycin

Question 25

mx of cellulitis

Answer 25

Flucloxacillin

If penicillin allergic - Clarithromycin, Erythromycin (best for pregnancy) or Doxycycline

Question 26

HIV + non-enhancing lesions on CT

Answer 26

progressive multifocal leukoencephalopathy due to JC virus

Question 27

causative organism of meningitis that stains with India ink

Answer 27

Cryptococcus neoformans

Question 28

which causative organisms of gastroenteritis have shortest incubation periods?

Answer 28

Staph aureus

Bacillus cereus

Question 29

mx for MRSA infections

Answer 29

Vancomycin or Teicoplanin or Linezolid

Question 30

mx for sinusitis if ABX are indicated

Answer 30

phenoxymethylpenicillin

Question 31

mx of genital herpes in pregnancy

Answer 31

oral aciclovir

elective C-section if >28 weeks gestation

Question 32

when is PipTaz used for pneumonia?

Answer 32

hospital acquired pneumonia acquired >5 days after admission

Question 33

features of hep A

Answer 33

flu-like symptoms
RUQ pain
tender hepatomegaly
cholestatic LFTs

Question 34

pneumonia that desaturates on exertion

Answer 34

PJP

Question 35

most common causative organism of pyelonephritis

Answer 35

E. coli

Question 36

baseline tests needed before starting anti-TB medications

Answer 36

U&Es
LFTs
Vision testing
FBC

Question 37

genital warts: syphilis vs herpes

Answer 37

Symphysis is silent - no pain

Herpes is heard - pain

Question 38

ABX used for prophylaxis for contacts of meningococcal meningitis

Answer 38

Ciprofloxacin or Rifampicin

Question 39

mx of asymptomatic bacteruria in pregnant woman

Answer 39

urine culture at first antenatal visit
immediate 7 days ABX - Nitrofurantoin (avoid at term), Amoxicillin or Cefalexin
urine culture as test of cure

Question 40

features of lymphogranuloma venereum

Answer 40

painless ulcer

painful lymphadenopathy

Question 41

most common causative organism of tonsillitis

Answer 41

Streptococcus pyogenes

Question 42

features of infectious mononucleosis (glandular fever)

Answer 42

sore throat, pyrexia and lymphadenopathy - classic triad
palatal petechiae
splenomegaly

Question 43

live attenuated vaccines

MOOBY

Answer 43

MMR
Oral typhoid
Oral polio
BCG
Yellow fever

Question 44

features of cholera

Answer 44

diarrhoea (‘rice’ water)
hypoglycaemia
dehydration

Question 45

mx of contacts of confirmed Chlamydia cases

Answer 45

offer treatment prior to results of investigations

Question 46

what can happen if a child with sickle cell is infected with Parvovirus B19

Answer 46

aplastic anaemia with low reticulocyte count

Question 47

mx of toxoplasmosis in immunocompetent and immunosuppressed patients

Answer 47

immunocompetent - no treatment

immunosuppressed - pyrimethamine and sulphadiazine

Question 48

mx of prostatitis

Answer 48

14 days Ciprofloxacin BD