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Infection Flashcards

1
Q

vaccinations at 8 weeks old

A
  1. 6 in 1 vaccine
  2. Men B
  3. rotavirus
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2
Q

infections protected against in 6 in 1 vaccine

A

diptheria
tetanus
pertussis
hep B
polio
h.influzena hype b

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3
Q

vaccinations at 12 weeks old

A
  1. 6 in 1
  2. rotavirus
  3. pneumococccal 13 conjugate
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4
Q

vaccinations at 16 weeks old

A
  1. 6 in 1
  2. Men B
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5
Q

vaccinations at 1 year old

A
  1. Men C and H. influenza B
  2. MMR
  3. pneumococcal conjugate 13
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6
Q

vaccinations at 3 years old

A
  1. diptheria, tetanus, pertussis, polio booster
  2. MMR
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7
Q

vaccinations at 12-13 y/o

A

HPV vaccine = against human papillomovirus 16 +18

se= bronchospasm

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8
Q

vaccinations at 14 y/o

A
  1. Men ACWY
  2. tetanus, diptheria and polio
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9
Q

examples of live vaccines

A

BCG
MMR
rotavirus
influenza
varicella
yellow fever
PO polio

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10
Q

contraindications to live vaccines

A
  • immunosuppression
  • DiGeorge
  • chemo/ radiotherapy in last 6 months
  • bone marrow trnasplant in last 6 months
  • immunoglobulins in last 3 months
  • anaphylaxis
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11
Q

inheritance of SCID

A

autosomal recessive

X link ADA deficiency in newborn boys

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12
Q

define SCID

A

absence of T and B cell function which causes lymphopene and hypogammaglobulinaemia

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13
Q

presentation of SCID

A

present around 6 months old with
- recurrent infections e.g pCP, influenza, bacetrial and fungal
- faltering growth
- persistent diarrhoea
- oral thrush / candidiasis
- BCG vaccine complications
- skin rashes

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14
Q

presentation of Omenn syndrome

A

first few weeks of life with..
- generalised erythematous rash
- chronic diarrhoea
- oedema
- lymphadenopathy

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14
Q

diagnosis of SCID

A
  • Lymphopenia
  • reduced IgG, IgA and IgM
  • reduced CD3 count
  • CXR - absent thymus shadow
  • purine nucleoside phoshorylase enzyme activity - test for underlying syndrome
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14
Q

cure for SCID

A

stem cell transplant

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15
Q

inheritance of hypogammaglobulinaemia

A

x linked

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16
Q

presentation of hypogammaglobulinaemia

A

present around 2 y/o …
- recurrent infection - sinusitis, strep pneumoniae
-persistent diarrhoea
- faltering growth
- recurrent herpes

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17
Q

diagnosis of hypogammaglobulinaemia

A
  • reduced IgG, IgM, IgA
  • PHA test normal - normal t cell function
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18
Q

presentation of chronic granulomatous disease

A

< 5 y/o…
- recurrent bacterial and fungal infections
e.g. burkholderia, pseudomonas
- abscesses
- chronic colitis
- lymphadenitis

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19
Q

diagnosis of chronic granulomatous disease

A
  1. dihydro-rhodamine neutrophil burst assay - absent
  2. nitroblue tetrazolium test -ve
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20
Q

cure for chronic granulomatous disease

A

stem cell transplant

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21
Q

presentation of IgE mediated allergic reaction

A

type 1 hypersensitivity reaction

anaphylaxis
angioedema
acute urticaria
vomiting
rhinorrhoea

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22
Q

diagnosis of IgE mediated reaction

A
  1. skin prick testing - wheal >2cm.
  2. serum IgE testing
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23
inheritance of hereditary angioedema
autosomal dominant
24
describe hereditary angioedema
type 1 - deficiency of C1INH on chromosome 11. deficiency of C1 esterase inhibitor causes increase bradykinin which causes leakage in post capillary venules
25
presentation of hereditary angioedema
episodic attacks of rash , abdo pain, oedema for 1-3 days not cured by adrenaline or anti histamines precipitated by stress, trauma, menstruation, ACE-I
26
diagnosis of hereditary angioedema
1. reduced C1 esterase inhibitor 2. C4 level reduced
27
complications of malaria
- resp distress, ARDS - anaemia - metabolic acidosis - hypoglycaemia - cerebral malaria - acute tubular necrosos - nephrotic syndrome - DIC
28
diagnosis of malaria
1. rapid antigen testing 2. thick and thin blood films ( 3 x neg films 12 hours apart excludes diagnosis) - thick = parasite detection - thin = species detection. >2% parasites = severe malaria, >10% = exchange transfusion
29
malaria prophylaxis
malarone
30
presentation of lyme disease
stage 1 = erythema migrans 'bulls eye rash' stage 2 = flu like, neurological disease, myocarditis, 1st degree heart block stage 3 = arthritis, acrodermatitis chronica atrophicans, polyneuropathy
31
diagnosis of lyme disease
ELISA test - if +ve, do immunoblot test
32
Treatment of lyme disease
doxycycline for 21 days (or if <12 y/o, amoxicillin)
33
presentation of EBV
fever sore throat cervical lymphadenopathy splenomegaly/ hepatomegaly malaise maculopapular rash (worse with amox)
34
complications of EBV
meningitis GBS splenic rupture chronic fatigue hepatitis
35
diagnosis of EBV
1. monospot test - heterophile abs +ve 2. film - atypical lymphocytosis 3. EBV antibody titre - IgM +ve
36
presentation of parvovirus B19 / slapped cheek
erythematous cheeks fever/ coryza/ headache maculopapular rash - lacy/ reticular trunk (not infectious when rash appears)
37
complications of parvovirus in pregnancy
hydrops fetalis death
38
complications of parvovirus
aplastic crises in haemolytic disease arthritis
39
presentation of measles
infectious 7 days after exposure fever Koplik spots - white on buccal mucosa macular rash - behind ears, spread to face, chest and back
40
complications of measles
1. otitis media 2. bronchopneumonia 3. subacute sclerosing pan -encephalitis ( 5-10 years after) 4. acute demyelinating encephalitis
41
presentation of subacute sclerosing panencephalitis
5 - 10 years after measles personality change seizures dyskinesia progressive unresponsiveness dementia
42
EEG of subacute sclerosing pan-encephalitis
periodic complexes, slow wave every 4-10 secs
43
presentation of mumps
fever malaise parotid swelling - b/l complications - orchitis , meningitis
44
presentation of typhoid fever
(salmonella typhi) - fever - bradycardia - rose spots - dehydration - epistaxis - intestinal haemorrhage
45
management of typhoid fever
IV cefotaxime or ciprofloxacin IVF
46
presentation of giardia
acute diarrhoea chronic diarrhoea -> malabsorption / partial villous atrophy
47
management of giardia
metronidazole
48
presentation of schistomiasis
swimming in dirty water unwell 4/52 after painless haematuria itchy rash
49
management of schistosimiasis
praziquantel
50
presentation of dengue fever
fever rash arthralgia haemorrhagic fever! - severe abdo pain and bloody vomits
51
presentation of cholera
rice water diarrhoea severe dehydration (50% die)
52
presentation of visceral leischmaniasis
ulcers with hyperpigmented scars splenomegaly hepatomegaly anaemia
53
presentation of leptospirosis
contact with contaminated water jaundice renal disease 'weils' flu like illness
54
presentation of brucellosis
middle east/ mediterranean from unpasteurised dairy products fever headache anorexia papular rash
55
complications of varicella
- secondary bacterial infection - thrombocytopenia - pneumonia - cerebellitis - one week after rash -> ataxia - encephalitis
56
who requires IV immunoglobulin in varicella zoster
- if immunocompromised and exposed - if babies born to mothers who have chicken pox 5 days before delivery and 2 days after delivery
57
who requires IV aciclovir in varicella zoser
- neonates - immunocompromised - if very unwell
58
describe chediak hagashi syndrome
defect in lysosomal trafficiking leading to giant granules in white blood cells
59
presentation of chediak hagashi syndrome
- silvery hair , light skin - recurrent infections - peripheral neuropathy
60
diagnosis of chediak hagashi syndrome
peroxidase stained blood film
61
presentation of hyper IgE syndrome
mild dysmorphism- coarse facies, prominent forehead eczema increased infections (s.aureus pneumonia) boils retained primary teeth autosomal dominant
62
diagnosis of Hyper igE syndrome
IgE >2000 eosinophilia
63
management of TB
1. 6 months rifampicin 2. 6 months isoniazid 3. 2 months pyrazinamide 4. 2 months ethambutol
64
side effects of rifampicin
orange/ red urine and tears hapetotoxicty pseudomembranous colitis
65
side effects of isoniazid
peripheral neuropathy
66
side effects of pyrazinamide
hepatotixicty arthritis increased uric acid
67
side effects of ethambutol
optic atrophy peripheral neuropathy
68
treatment of shigella (gram -ve)
ciprofloxacin

AKP (12 decks)

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