infection formative Flashcards
A 23 year old lady who presents with recurrent abscesses. Otherwise healthy. On examination she had four areas of abscesses, two of which on her arm. She was haemodynamically stable. Which antibiotic is likely to help this lady?
linezolid
A 23 year old lady who presents with recurrent abscesses. Otherwise healthy. On examination she had four areas of abscesses, two of which on her arm. She was haemodynamically stable. Which organism is most likely to cause this?
staph aureus
A 23 year old lady who presents with recurrent abscesses. Otherwise healthy. On examination she had four areas of abscesses, two of which on her arm. She was haemodynamically stable. Which toxin is likely to cause this presentation?
panton-valentine Leukocidin toxin
30 yr old iv drug user was admitted with jaundice. Investigations show the following, HBV surface antigen negative HBV core antibody positive HBV surface antibody positive HAV igM antibody positive
he has acute hepatitis A infection
This 28 year old man presents with a 3 week history of swallowing difficulties.
The most likely organism to cause this appearance is:
candida albicans
which of the following is an unlikely underlying cause for candida albicans infection:
a. HIV
b. Smoking
c. Proton pump inhibitors
d. Lymphoma
e. Inhaled steroid use
smoking
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?
wash the wound and encourage bleeding
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 is the highest risk of blood borne virus transmission?
a. Hepititis B
b. HIV
c. Hepatitis C
hep B
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?
a. Pneumonia
b. Osteomyelitis
c. Gastroenteritis
d. Biliary sepsis
e. Infective endocarditis
biliary sepsis
A 5 year old farmer’s daughter with the following:
History: –3 days ago developed diarrhoea –Worsened 2 Days ago –Blood PR for 24 Hours –Abdominal Pain –Reduced Urine Output
Examination: –HR 84, BP 150/95, T 36.50C –Tender Abdomen
Investigations Hb 95 (120-140) WBC 20 (4-10) Plat 90 (140-400) Urea 20 (3-7) Creat 450 (60-100)
What is the most likely infecting organism?
E. coli 0157
A 5 year old farmer’s daughter with the following:
History: –3 days ago developed diarrhoea –Worsened 2 Days ago –Blood PR for 24 Hours –Abdominal Pain –Reduced Urine Output
Examination: –HR 84, BP 150/95, T 36.50C –Tender Abdomen
Investigations Hb 95 (120-140) WBC 20 (4-10) Plat 90 (140-400) Urea 20 (3-7) Creat 450 (60-100)
Which antibiotic would you commence?
none
A 40 year old man with a background history of alcohol excess was admitted to hospital with 3 month history of significant weight loss, non productive cough and shortness of breath. He travels frequently with his work.
Chest auscultation only revealed a few basal crepititions, saturations were 92% on air. But he desaturates to 80% on minimal exertion.
Bloods -WCC 3.9, Platelets 100, CRP 23.
What is the most likely diagnosis?
pneumocystis jiroveci pneumonia
A 40 year old man with a background history of alcohol excess was admitted to hospital with 3 month history of significant weight loss, non productive cough and shortness of breath. He travels frequently with his work.
Chest auscultation only revealed a few basal crepititions, saturations were 92% on air. But he desaturates to 80% on minimal exertion.
Bloods -WCC 3.9, Platelets 100, CRP 23.
What is the underlying diagnosis?
HIV
A 40 year old man with a background history of alcohol excess was admitted to hospital with 3 month history of significant weight loss, non productive cough and shortness of breath. He travels frequently with his work.
Chest auscultation only revealed a few basal crepititions, saturations were 92% on air. But he desaturates to 80% on minimal exertion.
Bloods -WCC 3.9, Platelets 100, CRP 23.
What is the likely CD 4 Count?
<200
A 19 year old male with a 4 day history of fever of 40 degrees C, conjunctivitis, cough and coryzal symptoms •Appears unwell •New spreading macular rash visible on neck and face What is one of the most important first management steps for this patient?
isolate patient
A 19 year old male with a 4 day history of fever of 40 degrees C, conjunctivitis, cough and coryzal symptoms
•Appears unwell
New spreading macular rash visible on neck and face
Which is the likely mode of transmission if this is a case of measles?
droplet transmission
A 19 year old male with a 4 day history of fever of 40 degrees C, conjunctivitis, cough and coryzal symptoms
Appears unwell
New spreading macular rash visible on neck and face
Which of these are not Infection Prevention and Control precautions?
a. Single use equipment
b. 5 moments of hand hygiene
c. Personal protective equipment
d. Ice bath
e. Cohorting patients
ice bath
45 year old lady admitted with fever and right flank pain. On examination she has a GCS of 15, temperature of 39C, tachycardia of 115/min, blood pressure of 90/60. She has flank tenderness. Urine dipstick shows positive protein, blood and leucocytes. Which of these is a poor prognostic indicator?
a. High lactate
b. High temperature
c. Tachycardia
d. High white cell count
e. High CRP
high lactate
45 year old lady admitted with fever and right flank pain. On examination she has a GCS of 15, temperature of 39C, tachycardia of 115/min, blood pressure of 90/60. She has flank tenderness. Urine dipstick shows positive protein, blood and leucocytes.
You start the patient on the Sepsis 6 bundle. Which of these is NOT part of the bundle?
a. Measurement of lactate
b. Measurement of conscious level
c. Giving antibiotics
d. Measurement of urine output
e. Intravenous fluids
measurement of conscious level
45 year old lady admitted with fever and right flank pain. On examination she has a GCS of 15, temperature of 39C, tachycardia of 115/min, blood pressure of 90/60. She has flank tenderness. Urine dipstick shows positive protein, blood and leucocytes.
Despite giving 4 litres of intravenous fluids, her BP remains low and her lactate is 5.
What is your next course of action?
dicuss the patient w/ medical high dependency
A 70 year old diabetic lady is referred with a rapidly spreading cellulitis of her leg. She is in severe pain. Temp is 39C, pulse110/mini. BP:85/50. Right leg as shown.
What is the diagnosis?
necrotising fasciitis
A 70 year old diabetic lady is referred with a rapidly spreading cellulitis of her leg. She is in severe pain. Temp is 39C, pulse110/mini. BP:85/50.
You start this lady on Sepsis 6. What is the main priority in management of the lady?
urgent plastics review to do fasciotomy
A 70 year old diabetic lady is referred with a rapidly spreading cellulitis of her leg. She is in severe pain. Temp is 39C, pulse110/mini. BP:85/50.
what antibiotics would you start this patient on:
a. Benzyl penicillin
b. Flucloxacillin
c. Clindamycin
d. Gentamicin
e. All of the above
all of the above
A 45 year old gentleman presents to Acute Medicine with a few day history of fever and cough productive of green sputum. GCS 13 Resp rate 30/min Temp38 C Pulse 115 irreg BP 110/65 qSOFA = 2 All of these are criteria for qSOFA except
a. Pulse
b. Resp rate
c. GCS
d. Blood Pressure
pulse
A 45 year old gentleman presents to Acute Medicine with a few day history of fever and cough productive of green sputum. GCS 13 Resp rate 30/min Temp38 C Pulse 115 irreg BP 110/65 qSOFA = 2 .
Patient continues to deteriorate with multiorgan failure. Which of these is a sign of organ dysfunction?
a. High albumin levels
b. High platelets
c. Low prothrombin time
d. Low bilirubin
e. Ileus
ileus
A 45 year old gentleman presents to Acute Medicine with a few day history of fever and cough productive of green sputum. GCS 13 Resp rate 30/min Temp38 C Pulse 115 irreg BP 110/65 qSOFA = 2 .
Despite adequate treatment this gentleman continues to deteriorate. All of these are possible reasons except for ?
a. Development of empyema
b. Development of lung abscess
c. Infection with multidrug resistant organism
d. Drug hypersensitivity
drug hypersensitivity
A 45year old man develops fevers, severe abdominal pain and diarrhoea two days after attending a barbecue. Which of the following is the commonest infection associated with this presentation?
a. Salmonella enteritidis
b. Campylobacter jejuni
c. E. Coli 0157
d. Giardia lamblia
e. Shigella sonnei
campylobacter jejuni
An 80 year old woman develops diarrhoea one week after starting treatment for a respiratory tract infection. You suspect a C. Diff infection. Which of the following treatments would be most appropriate?
a. Antidiarrhoels
b. Oral Metronidazole
c. Intravenous vancomycin
d. Oral Ciprofloxacin
e. None of the above
oral metrondiazole
A 65 year old man presents with four weeks of fevers and nights sweats. He complains of muscle stiffness and headaches. His blood tests show him to be anaemic with a raised ESR of 105 mmin the first hour. Blood cultures are negative on three occasions and a CT of his chest and abdomen is reported as normal. Which of the following is the most likely diagnosis?
a. Lymphoma
b. HIV
c. Temporal arteritis
d. Endocarditis
e. Tuberculosis
temporal arteritis
A 31 year old man is diagnosed with HIV infection when a test is performed at an occupational health medical. He is asymptomatic, has never injected drugs and has no current sexual partner. He is referred to the clinic to discuss treatment; Which of the following treatment options is most appropriate?
a. A combination of three antivirals should be offered only if the viral load is >100,000
b. He should be offered to start treatment immediately with a combination of three antivirals
c. A combination of three antivirals should be offered only if his CD4 count is <200
d. He should be offered to start treatment immediately with a single antiviral
e. A single antiviral should be offered once HIV resistance test results are available
he should be offered to start treatment immediately w/ a combination of 3 antivirals
A 28 year-old oil worker returns from a month working offshore in Nigeria. He is febrile, vomiting and unwell. The most important investigation is:
a. Urgent stool microscopy and culture for typhoid
b. Blood cultures
c. An urgent HIV test
d. A malaria film +/- antigen test
e. A chest X-ray
malaria film +/- antigen test
A 28 year-old oil worker returns from a month working offshore in Nigeria. He is febrile, vomiting and unwell.
What should he be treated with
IV artesunate
What are the components of the “6 in 1” childhood vaccination?
diphtheria
tetanus
Bordatella pertussis
polio
Haemophilus influenzae
hepatitis B
What kind of vaccine is the tetanus vaccine?
purified toxoid vaccine
Name the three most popular medicines for malaria prophylaxis?
malarone (proquanil, atovaquone)
doxycycline
mefloquine
What is the first-line treatment for schistosomiasis?
praziquantel
Which following infection is not transmitted through the bite of an infected aedes mosquito?
a. Dengue
b. Malaria
c. Yellow fever
d. Zika
e. Chikungunya
malaria
Zika virus could be transmitted by the following routes?
a. All of the above
b. Sex
c. Mother to child
d. Mosquitos (Aedes species)
e. Blood transfusion
all of the above
What organism causes typhoid fever?
salmonella typhi
What are the “four C antibiotics”? (associated with Clostridium difficile infection) ?
ceftriaxone (cephalosporins)
co-amoxiclav
clindamycin
ciprofloxacin (quinolones)
Following is not a treatment option for MRSA and Staph aureus (MSSA) infections in patients allergic to penicillin?
a. Daptomycin
b. Ceftriaxone
c. Teicoplanin
d. Linezolid
e. Vancomycin
ceftriaxone
What is the most likely cause of an outbreak of nausea and vomiting on a cruise ship?
norovirus
For which of the following infections is there no vaccine?
a. Polio
b. Hepatitis A
c. Hepatitis C
d. Yellow fever
e. Typhoid
hepatitis C
Which of the following is true of active immunisation?
Select one:
a. Gives immediate protection against infection
b. Contains immunoglobulin
c. Stimulates the host immune response
d. Always contains live organism
stimulates the host immune response
