Infection

Question 1

C Diff

Answer 1

Gram + rod causes pseudomembranous colitis

Causes: Abx( most common second and third generation cephalosporins), PPI

Mild: normal WCC
Moderate: raised WCC
Severe: raised WCC+ fever
Life- threatening: toxic megacolon

Ix: C Diff toxin in stool

Mx: 1st line: ORAL vancomycin
2nd line: ORAL fidaxomicin
3rd line or life threatening: oral vancomycin + IV metronidazole

Question 2

Ulcer and STI

Answer 2

Painless ulcer+ painless lymphadenopathy: syphilis

Painless ulcer+ painful lymphadenopathy: Lymphogranuloma venereum(caused by chlamydia)

Painful ulcer+ painful lymphadenopathy: Chancroid caused by haemophilia ducreyi

Question 3

amoebiasis

Answer 3

caused by Entamoeba histolytica

often traveler from developing country, present with BLOODY diarrhoea, malaise and fever. most commonly LIVER ABSCESS (diagnosed on USS), treat with metronidazole

Question 4

Toxoplasmosis

Answer 4

Host is cats
caused by toxoplasma gondii

Acute infection is usually self-limited, flu like illness

UNLESS— HIV, immunocompromised— ongoing low grade symptoms

commonest manifestation in HIV patients is CNS involvement— haemiparesis +/- speech abnormalities, neuropsychiatric symptoms

Tx: First line (pyrimethamine+ sulphadiazine) for 6 weeks (“pirate” cat pic online)

Question 5

Schistosomiasis

Answer 5

Traveler exposed to fresh water then develop itchy skin, and then malarial like illness (fever, myalgia, lethargy)