INFECTION Flashcards

1
Q

What is Pyrexia of unknown origin (PUO)?

A

Prolonged fever of > 38.3 on multiple occasions for at least 3 weeks

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2
Q

What are the causes of systemic inflammatory response (SIR)?

A
  • Infection
  • Malignancy
  • Inflammatory conditions
  • HIV
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3
Q

What are common symptoms associated with prolonged fever?

A
  • Increased heart rate (HR)
  • Increased respiratory rate (RR)
  • Increased CRP
  • Increased ESR
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4
Q

What basic investigations should be performed in cases of PUO?

A
  • Blood cultures (3 sets)
  • Urinalysis
  • U/E, LFT
  • Full blood count (FBC)
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5
Q

What is characteristic of Staphylococcus aureus?

A

Gram positive cocci in grape-like clusters

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6
Q

What conditions are commonly caused by Staphylococcus aureus?

A
  • Soft tissue infections
  • Recurrent abscesses
  • Staphylococcal toxic shock syndrome
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7
Q

What is the mechanism of Staphylococcal toxic shock syndrome?

A

Activation of T cells by superantigens, primarily TSST-1

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8
Q

What is the first-line treatment for Group A streptococcal sore throat?

A

Phenoxymethylpenicillin

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9
Q

What are the symptoms of Group A streptococcal tonsillitis?

A
  • Sore throat
  • Headache
  • Fever
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10
Q

What are the diagnostic tests for streptococcal infections?

A
  • Streptococcal antigen test
  • Culture
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11
Q

What are the key features of Staphylococcal toxic shock syndrome?

A
  • Fever > 38.9
  • Rash with diffuse macular erythroderma
  • Desquamation 1-2 days after rash onset
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12
Q

What is the treatment protocol for sepsis?

A
  • Administer IV antibiotics within 1 hour
  • IV fluids
  • Oxygen therapy
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13
Q

What is the CURB65 criteria used for?

A

Assessing the severity of pneumonia

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14
Q

What are the components of the CURB65 score?

A
  • Confusion
  • Urea nitrogen > 7mmol/L
  • Respiratory rate > 30
  • Blood pressure (systolic < 90 or diastolic < 60)
  • Age 65 or older
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15
Q

What is the incubation period for influenza?

A

1-4 days

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16
Q

What are the symptoms of influenza?

A
  • Fever
  • Myalgia
  • Headache
  • Severe cough
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17
Q

What are neuraminidase inhibitors used for?

A

Treating influenza by inhibiting viral replication

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18
Q

What are the common symptoms of Hepatitis B?

A
  • Constitutional symptoms
  • Right upper quadrant pain
  • Jaundice
  • Nausea and anorexia
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19
Q

What laboratory markers indicate acute Hepatitis B infection?

A
  • HBsAg (surface antigen)
  • IgM antibodies
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20
Q

What are the key features of viral meningitis?

A
  • Headache
  • Neck stiffness
  • Photophobia
  • Fever
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21
Q

What is the most common cause of viral meningitis in the UK?

A

Enterovirus

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22
Q

What are the key symptoms of bacterial meningitis?

A
  • Severe headache
  • Rapid onset of fever
  • Neck stiffness
  • Focal neurological signs
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23
Q

What is the treatment for bacterial meningitis?

A
  • IV ceftriaxone
  • IV amoxicillin (in age extremes)
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24
Q

What is the significance of a low CD4 count in HIV patients?

A

Increased risk of opportunistic infections

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25
Q

What is the first-line treatment for tuberculosis?

A

Isoniazid, Rifampicin, Ethambutol, Pyrazinamide (4 for 2 months, then 2 for 4 months)

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26
Q

What are the side effects of Isoniazid?

A

Peripheral neuropathy

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27
Q

What are common symptoms of leprosy?

A
  • Anaesthetic hypopigmented macules
  • Thickened peripheral nerves
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28
Q

What is the primary causative agent of syphilis?

A

Treponema pallidum

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29
Q

What is a key feature of the secondary stage of syphilis?

A

Symmetrical maculopapular rash

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30
Q

What is the treatment for syphilis?

A

Penicillin

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31
Q

What is the healing time for the perianal area?

A

3-8 weeks

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32
Q

What are the symptoms of secondary syphilis?

A
  • Symmetrical maculopapular rash (trunk, palms, soles, and face)
  • Mucosal ulcers
  • Lymphadenopathy
  • Malaise
  • Fever
  • Hepatitis
  • Glomerulonephritis
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33
Q

What percentage of untreated patients with syphilis will develop gummatous disease?

A

1 out of 3

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34
Q

What are the types of treponemal tests for syphilis?

A
  • Treponema pallidum haemagglutination assay
  • Treponemal enzyme immunoassay
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35
Q

What are non-treponemal tests for syphilis?

A
  • Rapid plasma regain (RPR)
  • Venereal disease reference laboratory (VDRL)
36
Q

What is the first-line treatment for primary and secondary syphilis?

A

Single dose of intramuscular penicillin G (benzathine benzylpenicillin)

37
Q

What is the treatment duration for tertiary and late syphilis?

A

2-3 weeks of IM penicillin G

38
Q

What is the treatment for neurosyphilis?

A

IV penicillin G for 10-14 days

39
Q

What is the first-line treatment for patients allergic to penicillin?

A

Doxycycline or tetracycline

40
Q

What is rheumatic fever associated with?

A

Group A beta-haemolytic streptococcus infection (scarlet fever)

41
Q

What is a major criterion for diagnosing rheumatic fever?

A
  • Arthritis
  • Pericarditis
  • Valvulitis
  • Sydenham’s chorea
42
Q

What is the treatment for carditis in rheumatic fever?

A

Prednisolone

43
Q

What is Lyme disease caused by?

A

Borrelia burgdorferi carried by ticks

44
Q

What is the characteristic rash of early Lyme disease?

A

Erythema migrans (bull’s eye rash)

45
Q

What are the early symptoms of Lyme disease?

A
  • Flu-like symptoms
  • Fever
  • Chills
  • Headache
  • Fatigue
  • Muscle and joint aches
46
Q

What is the first-line treatment for Lyme disease?

A

Doxycycline

47
Q

What are the two forms of rabies?

A
  • Furious (70%)
  • Paralytic (30%)
48
Q

What is the incubation period for rabies?

A

1-3 months

49
Q

What virus causes measles?

A

RNA paramyxovirus

50
Q

What are Koplik spots?

A

Small areas of grey discolouration in the mouth associated with measles

51
Q

What is the most common cause of viral infectious gastroenteritis?

52
Q

What is the first-line treatment for cholera?

A

Rehydration with Na+/K+ with osmotic effect

53
Q

What are the symptoms of typhoid fever?

A
  • Rose coloured spots
  • Fever
  • Abdominal pain
  • GI symptoms
  • Bradycardia
54
Q

What is the first-line treatment for uncomplicated malaria?

A

Oral doxycycline for 21 days or 28

55
Q

What is the causative agent of schistosomiasis?

A

Freshwater snails

56
Q

What is the first-line treatment for schistosomiasis?

A

Praziquantel

57
Q

What type of bacteria causes C. difficile infections?

A

Clostridium difficile

58
Q

What is the first-line treatment for a non-severe C. difficile infection?

A

Oral metronidazole

59
Q

What is the most common cause of bacterial food poisoning in the UK?

A

Campylobacter jejuni

60
Q

What is the characteristic stool appearance in cholera?

A

Rice-water stools

61
Q

What is the treatment for severe or complicated malaria?

A

IV artesunate or IV quinine + doxycycline or clindamycin (oral)

62
Q

What is the incubation period for malaria?

A

1 year, especially 3 months after traveling

63
Q

What type of rash is associated with dengue fever?

A

Macular rash

64
Q

What is a common complication of mumps?

A

Orchitis (epididymis-orchitis)

65
Q

What is the most common cause of infantile gastroenteritis?

66
Q

What vaccine were children under 5 vaccinated against in 2013?

A

Norovirus

Norovirus is the most common cause of viral infectious gastroenteritis.

67
Q

What is the most common cause of viral infectious gastroenteritis?

A

Norovirus

Norovirus outbreaks often occur in hospitals and care homes.

68
Q

How is Norovirus transmitted?

A

Faecal-oral route or airborne transmission

Norovirus is highly contagious with a low infecting dose.

69
Q

What are the common symptoms of Norovirus infection?

A

Non-bloody diarrhoea and vomiting

70
Q

What type of testing is used for Norovirus?

A

Viral PCR / Antigen testing

71
Q

What is Giardia lamblia?

A

A parasite

Giardia lamblia is associated with contaminated water supplies.

72
Q

What test is used to diagnose parasitic infections?

A

Stool microscopy

73
Q

What is Entamoeba histolytica?

A

A parasite

It is transmitted through foreign travel and poor hygiene.

74
Q

What is Candida Albicans commonly associated with?

A

Oral thrush

Oral thrush presents as white spots on the roof of the mouth.

75
Q

What are some risks associated with Candida Albicans infection?

A

Lymphoma, HIV, smoking, inhaled steroid use

76
Q

What are the symptoms of oral candidiasis?

A

White or yellow plaques in mouth, mild burning, erythema, altered taste, furry tongue, dysphagia

77
Q

What is Tinea?

A

A fungal infection

78
Q

What is the treatment for ringworm (Tinea corporis)?

A

Topical antifungal cream (e.g., Terbinafine, Clotrimazole, Miconazole)

79
Q

What is a common symptom of threadworm infection?

A

Perianal or vulval itching in a child

The itching is often worse at night.

80
Q

What is the treatment for threadworm?

A

Oral mebendazole and hygiene measures for everyone in the house

81
Q

What is the treatment for fungal nail infections?

A

Topical nail lacquer (Amorolifine) or oral terbinafine

82
Q

How long should topical nail lacquer be applied for fingernails?

83
Q

How long should topical nail lacquer be applied for toenails?

A

9-12 months

84
Q

What should be monitored when treating fungal nail infections with oral terbinafine?

A

Liver function tests (LFT)

85
Q

COMMMN CAUSESOF OTITIS MEDIA - BACTERIA

A

Whilst viral upper respiratory tract infections (URTIs) typically precede otitis media, most infections are secondary to bacteria. The most common is Streptococcus pneumoniae, followed by Haemophilus influenzae and Moraxella catarrhalis