Infection Flashcards
How should severe malaria be treated?
Urgent intravenous artesunate is the most appropriate treatment. It is well tolerated and highly effective. If this cannot be obtained, then intravenous quinine should be used until artesunate is available.
Is malaria a notifiable disease?
Yes, all malaria is notifiable.
How should infectious diseases be diagnosed?
- Urine sample
- Stool sample
- Blood lactate
- HIV screen
- FBC
- Blood culture
- Blood film
What is purpura fulminans and what is it a sign of?
Purpura fulminans is an acute, often fatal, thrombotic disorder which manifests as blood spots, bruising and discolouration of the skin resulting from coagulation in small blood vessels within the skin and rapidly leads to skin necrosis and disseminated intravascular coagulation. Sign of sepsis.
How should the patient be treated with meningiococcal sepsis?
Ceftriaxone
What is PCP?
Pneumocystis pneumonia (PCP) is a serious infection caused by the fungus Pneumocystis jirovecii. Aids defining illness.
Most people who get PCP have a medical condition that weakens their immune system, like HIV/AIDS, or take medicines (such as corticosteroids) that lower the body’s ability to fight germs and sickness.
What are the symptoms of PCP?
What is the treatment for cellulitis?
Severity:
Class I: Patients lack systemic signs or symptoms.
Class II: Patients have comorbid conditions that affect recovery.
Class III: Patients have accompanying limb-threatening conditions or confusion,
tachycardia, or other unstable conditions.
Class IV: Patients have severe, life-threatening infection or sepsis
Treatment of cellulitis depends on its classification.
• Class I: oral antibiotics in an outpatient setting
• Class II: oral or I.V. antibiotics in an outpatient setting
• Class III: hospitalization for I.V. antibiotic therapy
• Class IV: urgent hospitalization for intensive multiple therapy and specialist consultation
MR has confirmed several ring enhancing mass lesions in the brain associated with oedema and mass effect. Which of the following may cause a ring-enhancing mass lesion on MR?
Toxoplasma gondii
What is HCV?
HCV is an RNA virus. There are 4 genotypes.
4-20 weeks incibation
It is endemic worldwide, with increased prevalence rates in Africa, Pacific Region and the Eastern Mediterranean. Parenteral spread (blood contact) accounts for the majority of cases through shared needles/syringes.
UK prevalence is as high as 40% in the UK in IVDUs. The majority of patients (60%) have acute asymptomatic infection. It can less commonly present with an acute icteric epidose, which typically has 2 phases: Phase 1: A prodromal ‘flu-like illness lasting 3-10 days.
Malaise, myalgia, sometimes with RUQ pain. Phase 2: Icteric illness lasting 1-3 weeks generally but has been seen to persist for over 12 weeks. Jaundice, itch, anorexia, nausea. Fever is not generally seen in this phase. The patient may report cholestatic symptoms of pale stools and dark urine. On examination the patient may be dehydrated, with liver enlargement/tenderness.
Acute liver failure is rare and occurs in less than 1% of cases. Up to 85% of patients will become chronic carriers of HCV which may develop into chronic liver disease and hepatic decompensation over time, as in this case.
What is the definition of AIDS?
the number of their CD4 cells falls below 200 cells per cubic millimeter of blood (200 cells/mm3). (In someone with a healthy immune system, CD4 counts are between 500 and 1,600 cells/mm3.) OR
they develop one or more opportunistic infections regardless of their CD4 count.
How is hepatitis A different from B and C?
- Spread through food and faecal oral route
- No chronic infection
- Average of 15 days incubation period vs 40-100 days
- A is RNA like C whereas B is a DNA virus
What is a rare infection caused by Aedes Egypti in Tanzania?
Chikungunya virus - it means doubled over in pain. It has spread to Asia and Oceania. Like Dengue but worse pain in joints and fever. Dengue causes problems when fever drops
How is gonnorhea treated?
ciprofloxacin used to be the treatment of choice. However, there is increased resistance to ciprofloxacin (around 36% in the UK) and therefore cephalosporins are now more widely used
there was a change in the 2019 British Society for Sexual Health and HIV (BASHH) guidelines. Previously the first-line treatment was IM ceftriaxone + oral azithromycin. The new first-line treatment is a single dose of IM ceftriaxone 1g (i.e. no longer add azithromycin). If sensitivities are known (and the organism is sensitive to ciprofloxacin) then a single dose of oral ciprofloxacin 500mg should be given
if ceftriaxone is refused (e.g. needle-phobic) then oral cefixime 400mg (single dose) + oral azithromycin 2g (single dose) should be used
What are some risk factors for clostridum difficile?
lindamycin is historically associated with causing Clostridium difficile but the aetiology has evolved significantly over the past 10 years. Second and third generation cephalosporins are now the leading cause of Clostridium difficile.
Other than antibiotics, risk factors include: proton pump inhibitors
