Infection

Question 1

genital herpes

Answer 1

painful genital ulceration
dysuria and pruritus
tender inguinal lymphadenopathy

Question 2

Cellulitis (near the eyes or nose)

Answer 2

co-amoxiclav

Question 3

Man returns from trip abroad with maculopapular rash and flu-like illness

Answer 3

think HIV seroconversion

Question 4

Bilateral conjunctivitis, bilateral calf pains and high fevers in a sewage worker suggests

Answer 4

leptospirosis

Question 5

alternative to metronidazole for patients with bacterial vaginosis

Answer 5

Topical clindamycin

Question 6

Red man syndrome

Answer 6

rapid intravenous infusion vancomycin

Typical symptoms include redness, pruritus and a burning sensation, predominantly in the upper body (face, neck and upper chest). Severe cases can be associated with hypotension and chest pain.

The management of red man syndrome involves cessation of the infusion, and when symptoms have resolved, recommencement at a slower rate.

Question 7

subconjunctival suffusion (redness)/haemorrhage

Answer 7

leptospirosis

Question 8

Hepatitis E is spread by

Answer 8

the faecal-oral route and is most commonly spread by undercooked pork

Question 9

treat Chlamydia in pregnancy

Answer 9

Azithromycin, erythromycin or amoxicillin

Question 10

most common cause of type 2 necrotising fasciitis

Answer 10

Streptococcus pyogenes

Question 11

EBV associated malignancies

Answer 11

Burkitt’s lymphoma
Hodgkin’s lymphoma
nasopharyngeal carcinoma

Question 12

toxoplasmosis Tx

Answer 12

immunocompetent –> no treatment
immunocompromised –> pyrimethamine and sulphadiazine

Question 13

patient found to be MRSA positive on screening

Answer 13

decolonisation regimen- nasal mupirocin and chlorhexidine for the skin

Question 14

causes of false-negative Mantoux test

Answer 14

immunosuppression (miliary TB, AIDS, steroid therapy)
sarcoidosis
lymphoma
extremes of age
fever
hypoalbuminaemia, anaemia

Question 15

investigation of choice in genital herpes

Answer 15

Nucleic acid amplification tests (NAAT)

Question 16

Disseminated gonococcal infection triad =

Answer 16

tenosynovitis, migratory polyarthritis, dermatitis

Question 17

False positive VDRL/RPR (non-treponemal tests)

Answer 17

‘SomeTimes Mistakes Happen’ (SLE, TB, malaria, HIV)

Question 18

treponema specific tests

Answer 18

TP-EIA, TPHA

Question 19

diagnosis and screening of HIV

Answer 19

Combination tests - HIV p24 antigen and HIV antibody

Question 20

Patients with hyposplenism should be vaccinated against

Answer 20

pneumococcal, Haemophilus type B and meningococcus type C (NHS)

Question 21

Yellow fever typically presents with

Answer 21

flu like illness → brief remission→ followed by jaundice and haematemesis

Question 22

Fever, facial spasms, dysphagia in an intravenous drug user →

Answer 22

tetanus

Question 23

Mycoplasma pneumoniae- diagnostic Ix

Answer 23

serology

Question 24

Negative non-treponemal test + positive treponemal test is consistent with

Answer 24

successfully treated syphilis

Question 25

Pneumonia, peripheral blood smear showing red blood cell agglutination, CXR shows bilateral consolidation →

Answer 25

Mycoplasma pneumoniae

Question 26

first line treatment in amoebiasis

Answer 26

metronidazole

Question 27

Genital wart treatment multiple, non-keratinised warts: solitary, keratinised warts:

Answer 27

multiple, non-keratinised warts: topical podophyllum solitary, keratinised warts: cryotherapy

Question 28

invasive diarrhoea (causing bloody diarrhoea and fever) treatment (e.g. salmonella)

Answer 28

ciprofloxacin

Question 29

Severe cellulitis should be treated with

Answer 29

co-amoxiclav, cefuroxime, clindamycin or ceftriaxone

Question 30

when is dexamethasone in meningitis contraindicated

Answer 30

meningococcal septicaemia (a non-blanching purpuric rash) septic shock, recently out of surgery immunocompromised

Question 31

Lyme disease diagnosis

Answer 31

antibody titres for Borrelia burgdorferi

Question 32

genital warts caused by

Answer 32

HPV 6 and 11

Question 33

HSV 1 vs HSV 2

Answer 33

HSV1: oral lesions HSV2: genital lesions

Question 34

Hepatitis A presents with

Answer 34

flu-like symptoms, RUQ pain, tender hepatomegaly and deranged LFTs

Question 35

HIV, neuro symptoms, single brain lesions with homogenous enhancement

Answer 35

CNS lymphoma