Infection

Question 1

what does high neutrophils indicate?

Answer 1

bacterial infection
sepsis
metastatic cancer
acidosis
corticosteroid therapy
trauma, surgery, burn
myeloproliferative disorders (proliferation of blood cells but not leukaemia)
MI

Question 2

Signs of pancreatitis?

Answer 2

epigastric pain
radiating to the back
nausea and vomiting
raised serum amylase

Question 3

Bronchiolitis: cause and clinical signs

Answer 3

RSV - respiratory syncytial virus
most common serious respiratory infection in infancy
present <18months
winter months - peak in jan and feb
coryza symptoms 2-3 days
followed by: dry cough, increasing breathlessness, fever, difficulty feeding, symptoms worse at night

Question 4

Bronchiolitis: investigations and management

Answer 4

nasal swab - RSV
CXR
Blood gases

supportive management

Question 5

why are prophylactic antibiotics given after contaminated abdominal surgery?

Answer 5

to prevent wound infections

Question 6

what type of bacteria is associated with hospital acquired pneumonia after abdominal surgery ?

Answer 6

gram negative - E. coli

Question 7

gram positive diplococcus that causes bacterial meningitis

Answer 7

streptococcus pneumoniae

Question 8

raised eosinophils

Answer 8

parasitic infection

Question 9

raised neutrophils

Answer 9

bacterial infection

Question 10

raised lymphocytes

Answer 10

viral infection

Question 11

rubella: features

Answer 11

rubivirus
spread of the virus is by droplets from the respiratory tract
incubation period of 14 days up to 21 days, after which clinical features may include:
- fever
- headache
- malaise
- upper respiratory symptoms
- a pink macular rash on the face, trunk and limbs
- cervical lymphadenopathy
- grittiness of the eyes and suffusion (redness) of conjunctivae
rubella rash is pin-head sized

Question 12

mumps: features

Answer 12

acute contagious RNA paramyxovirus
mainly in childhood
salivary glands, most often the parotids, but other tissues may be affected, including the testes in postpubertal males. incubation period of 16 to 21 days followed by:
- fever
- malaise
- enlargement of one or both parotid glands
- developing over a period of 1 to 3 days.
There is no rash with mumps

Question 13

measles: features

Answer 13

RNA paramyxovirus
contracted via the respiratory tract

• fever, coryza (runny nose), conjunctivitis, and cough
• Koplik spots - on the buccal mucosa, especially on the inside of the cheeks
• rash appears 3 to 5 days later, maculopapular, firstly behind the ears, then down the body

measles rash is red and blotchy.

Question 14

mycoplasma pneumoniae: FBC results, features, management

Answer 14

very small bacteria, more like a virus
doesn’t raise neutrophils but also doesn’t raise lymphocytes
common in mid to late teens - boarding
gram negative - tetracyclines or macrolides

Question 15

scarlet fever: features ad management

Answer 15

difficulty swallowing - sore throat
fever
malaise
painful neck - enlarged lymph nodes
distinctive macular rash (a macule is a well defined flat area of skin up to 1 cm in diameter that is different in colour from the surrounding skin)
perioral sparing and a bright red or ‘strawberry’ tongue
It is caused by group A streptococcus.
When antibiotics are required, the treatment of choice is a 10 day course of penicillin.