Infection Formative

Question 1

What is the most common cause of an outbreak of nausea and vomiting on a cruise ship?

Answer 1

Norovirus

Question 2

What is the commonest cause of traveller’s diarrhoea?

Answer 2

Enterotoxigenic E.coli

Question 3

Which diarrhoea is not Dx by culture?

Answer 3

Clostridium Difficile

Question 4

A 22 year M presents to A& E with this a non-blanching petechial rash which extends in patches over his chest, abdomen and leg and developed over 6hrs. He is hypotensive (80/50) and pyrexial (39.1) Suspecting meningococcal septicaemia what should your immediate actions be?

Answer 4

Call for senior help
Give fast IV fluids
IV high dose Abx (e.g Ceftriaxone)
Blood cultures

Question 5

What should family/close contacts be given as meningococcal septicaemia prophylaxis

Answer 5

Rifampicin or Ciprofloxacin

Question 6

What is the most likely reason for hypotension, low sodium and high potassium 4 days after meningococcal septicaemia

Answer 6

Adrenal Insufficiency

Waterhouse-Friderichsen Syndrome

Question 7

Which component of Neisseria Meningitidis causes septic shock?

Answer 7

Lipo-polysaccharide

Question 8

For which of the following infections is there no vaccine?
HAV
HCV 
Polio 
Typhoid 
Yellow fever

Answer 8

HCV

Question 9

Which of the following is true of active immunisation?

1. always contains live organism
2. contains immunoglobulin
3. gives immediate protection against infection
4. stimulates the host immune response

Answer 9

Stimulates the host immune response

Question 10

Which organism is the most likely to cause oral thrush

Answer 10

Candida albicans

Question 11

You are taking blood from an acutely ill HIV positive patient in the infection unit at midnight and you accidentally stab yourself with the needle. What do you do first?

Answer 11

Wash the wound and encourage bleeding

Question 12

Risk of blood borne virus transmission is highest in?
HIV
HCV
HBV

Answer 12

HBV

Question 13

What is the commonest bacterial cause of infective diarrhoea in the UK

Answer 13

Campylobacter

Question 14

In meningococcal meningitis what would you expect to find in the CSF regarding glucose, protein and organism

Answer 14

High protein
Low glucose
Gram -ve cocci

Question 15

You have isolated E.coli from two sets of blood cultures taken on a jaundiced patient who was admitted in septic shock.
Which of the following is a likely source?

1. biliary sepsis
2. gastroenteritis
3. infective endocarditis
4. osteomyelitis
5. pneumonia

Answer 15

Biliary sepsis (clue is in the jaundice)

Question 16

27yr F
6 wk Hx of dry cough, weight loss and fever
3 months after returning from working in a Bolivian Orphanage
Most likely Dx is

Answer 16

Tuberculosis

TB

Question 17

Which rapid test would help confirm TB

Answer 17

ZN stan

Question 18

What is the treatment of TB

Answer 18

RIPE 
Rifampicin 
Isoniazid 
Pyrazinamide 
Ethambutol 

all for 4
R and I for further 2

Overall 6 months treatment

Question 19

How do you confirm the diagnosis of legionella pneumonia

Answer 19

Urinary antigen

Question 20

What is the treatment for E.coli O157

Answer 20

No medication

Supportive only

Question 21

Why do you not give abx in E.coli O157 infection

Answer 21

It increases the risk of Heamolytic Uremic Syndrome

Question 22

What is the most important Ix in the suspection of malaria

Answer 22

Malaria film +/- antigen test

Question 23

A blood film confirms Plasmodium Falciparum infection with a parasitaemia of 6%
What is the most appropriate Rx

Answer 23

IV Artesunate

Question 24

Name the components of CURB65

Answer 24

Confusion 
Urea >7mmol/l 
Resp. Rate >30
Blood pressure (diastolic <60, systolic <90)
Age 65 or over

Question 25

Name a common complication of pneumonia

Answer 25

Empyema

Question 26

What is the management of empyema

Answer 26

Commence Abx therapy
Drainage of pleural fluid
USS guided diagnostic aspiration