Infection/Haem Flashcards
Listeriosis - tx
Listeriosis meningitis - to
Amox or ampicillin
If meningitis - add gentamicin
Syphilis tx
Benzathine benzylpenicillin
Congenital toxoplasmosis - tx
Spiramycin for infection in pregnant mum
pyrimethmine and sulfadiazine for infected foetus
Cause of hand foot and mouth disease
Coxsackie virus A
Cause of fifth disease aka erythema infantiosum
Slapped cheek rash
Parvovirus b19
tx of giardiasis
metronidazole
when can you get shingles vaccination?
age 70-79
tx of neisseria gonorrhoea
IM ceftriaxone
OR ciprofloxacin OR tetracycline
investigation for chlamydia
tx of chlamydia
Ix: NAAT
1st line: doxycycline 7/7
2nd line: azithromycin 3/7
tx of bacterial vaginosis and trichomoniasis
BV: metronidazole (PO/TOP) or clindamycin
Trichomoniasis: metronidazole
tx of syphillis
benzylpenicillin
which organism causes fungal meningitis for west africa patient?
PC: fever, headache, diarrhoea, weight loss
cryptococcus neoformans
what level of CD4 count must you aim with anti-retroviral tx?
> 350
abx prophylaxis for meningococcal patients-contacts
ciprofloxacin
rifampicin - 2nd line
prophylaxis for malaria
1st line: doxycycline
2nd line: atovaquone/proguanil
HIV positive with recent travel to tropics and severe diarrhoea ? organism
cryptosporidium
what causes hand, foot and mouth disease?
Coxsackie virus A type 16
contraindication to doing LP
raised ICP signs (GCS<9, drop in GCS of 3, relative bradycardia and HTN, focal neurological signs, abnormal posturing, anisocoria/unequal pupils, papilloedema, tense or bulging frontonelle)
haemodynamic instability
extensive or spreading purpura
seizures ongoing
coagulation abnormalities (platelet<100)
infection at site of LP
respiratory compromise
?diagnosis - homeless person, initial scab on face, itchy and increase swelling, pyrexia and cannot open eye due to swelling
erysipelas
organism: Group A strep (strep pyogenes)
tx: penicillin
swimming in lake malawi. urinary symptoms. ?organism
schistosomia haematobium (look for ovum in microscopy)
Tax: praziquantel
differences in the plasmodiums
falciparum:
malariae: fever recur every 3 days, less severe than falciparum/vivax, found in Africa only.
vivax: fever recur every 2 days, can lie dormant for years -> leading to recurrence. found in latin America and Asia.
Treatment depends on chloroquine sensitivity/resistance. But you can use artemisin-drugs for both. Eg lumefantrine, mefloquine, amodiaquine, sulfadoxine/pyrimethamine, piperaquine and chlorproguanil/dapsone
P.ovale and vivas should be given primaquine to ensure that liver hypnozoites are destroyed.
rose spots - ?organism
salmonella
(can cause splenomegaly, constipation earlier on then diarrhoea)
Ix: blood culture
tx: ciprofloxacin
return from south africa - high swinging fever with diarrhoea and tenderness in RUQ ? organism
likely liver abscess
amoebiosis
difference in number of cells in LP for:
viral, bacterial, TB, cryptococcal meningitis
viral: 5-1000, lymphocyte
bacterial: >100, neutrophil
TB: 5-100, lymphocyte
cryptococcal: 5-100, lymphocyte
rose-pink maculopapular rash
before the rash - conjunctivitis, pain on eye movement, sore throat, general malaise, low grade fever
Forchheimer sign (pinpoint or larger petechiae)
?diagnosis
rubella
organism causing mumps
rubulavirus
organism causing scarlet fever
Group A beta-hameolytic streptococcus
farm worker. headache, fever, severe myalgia, petechial rash, jaundiced, raised urea
?diagnosis
leptospirosis AKA weil’s disease
Tax: benzylpenicillin/doxy
strawberry cervix ?diagnosis
trichomoniasis (but only visible for 1-2% of cases under colposcopy)
tx of CMV colitis in HIV patients
IV gaciclovir
salmon-pink rash on trunk
adult still’s disease aka juvenile idiopathic arthritis
clue cells - what is it?
vaginal epithelial cells covered with gram negative rods
found in bacterial vaginosis
HIV nephropathy - how is it different to nephrotic syndrome?
in nephrotic syndrome - high cholesterol
in HIV nephropathy - normal/low cholesterol and no HTN. renal USS will reveal large echogenic kidneys
abx post-dog bite
co-amoxiclav
tx of cryptococcal meningitis
amphotericin tx followed by long-term prophylactic fluconazole
which abx works best intracellularly?
macrolides
quinolones
ketolides
tx of lyme disease
doxycycline
strawberry tongue
kawasaki disease
difference between TRALI and TACO
blood pressure!
TRALI- hypo
TACO- hyper
APTT vs PT
APTT tests for intrinsic and common pathways - factor 8, 9,11,12
PT tests for extrinsic and common pathways - factor 2,5,7,10
what is SCID?
recurrent infections, diarrhoea, dermatitis, failure to thrive
compromise in number and function of T-cells, B-cells and natural killer cells
treatment/prophylaxis for C1 inhibitor deficinecy
tx: C1-INH concentrate of FFP (during acute attack)
prophylaxis: androgens (danazol) increase production of C1-INH, fibrinolysis inhibitors (tranexamic acid)
works as a vet and notice large right axillary lymph node which was fluctuant and tender
?diagnosis
cat scratch disease
- Bartonella henselae
- infection affeting the lymph nodes that drain the sites of inoculation form a cat scratch/bitec
tx: paracetamol, local heat to relieve pain of enlarged lymph nodes, trimethoprim-suxamethoxazole, ,ciprofloxacin, azithromycin
warm VS cold autoimmune haemolytic anaemia
warm: idipathic, SLE, lymphoma, CLL, Evan’s syndrome
cold: paroxysmal cold haemaglobinuria, mycoplasma pneumoniae, lymphoma, glandular fever
pel-ebstein fever - what is it? what disease associated with it?
temperature is high for one week and then low for another week
associated with hodgkin’s lymphoma
fever that rises each day and drops by next morning. also has maculopapular rash.
- 1st week: abdo pain, constipation
- 2nd week: splenomegaly and bradycardia
- 3rd week: abdo distension, pea-soup diarrhoea, can also have bowel perforation and peritonitis
- 4th week: fever, confusion and abdo distension improves.
?diagnosis
typhoid
ix: blood culture
high fever begins in day 3 and lasts 5-7 days. preceded by chills, erythematous skin mottling, facial flushing.
for children: fever abates for a day and then returns (saddleback fever)
also complain of myalgia, arthralgias
, haemorrhagic manifestations, abdo pain
lymphadenopathy, splenomegaly, weight loss, fatigue, night sweats
?diagnosis
non-hodgkin’s lymphoma
what type of anaemia does a patient with pica has?
microcytic anaemia
anti-cardiolipin antibodies can be found in which conditions?
antiphospholipid syndrome
SLE
ITP
RA
Psoriatic arthritis
Sjogren syndrome
sudden coldness then followed by rigor and then fever and sweating
?diagnosis
malaria
how long must the patient stay in A&E after anaphylaxis reaction?
6 hours
- recurrence of smptoms can occur
what is the mode of inheritance for ‘hairy ears’?
Y-chromosome linked
abdominal pain, ascites and hepatomegaly for patient with polycythaemia
?what has happened
Budd CHiari syndrome
- occlusion of hepatic veins that drain the liver
for patient with polycythaemai - if they also complain of tenderness of the sternum, what complication is arising?
acute myeloid leukaemia
patient has egg allergy, which vaccine should they NOT take?
influenza
tick-borne encepahalitis
yellow fever
low MCV and normal ferritin
?diagnosis
thalassemia
what is the summary of these HIV complications:
- cryptosporidiosis
- cryptococcosis
- coccidiodomycosis
cryptosporidiosis: protozoan. watery diarrhoea with abdo cramps, loss of appetite, low fever, n&v.self-limiting. Tx: nitazoxanide for >1yo or antiretroviral tx for CD40>100.
cryptococcosis: fungal infection. any organ affected - but usually lungs, menigitoencephalitis. tx: oral fluconazole 1st line. severe disease/CNW: amphotericin B and flucytosine.
coccidiodomycosis: fungal infection. via inhalation. if CD40<350cells/mm3. mild to severe pneumonia. extrapulmonary infection of skin, soft tissues, skeletal or CNS. fever, headache, dry cough, myalgia, arthralgia, rash. Tx: azoles.
examples of encapsulated bacteria
SHiN SKiS
Strep pneumoniae
Haem influenza type B
Neisseria meningitidis
Group B strep
Klebsiella pneumoniae
Salmonella typhi
scromboid food poisoning
ingestion of fresh, canned or smoked fish with hihg histamine levels due to improper processing/storage.
flushing, rash, urticaria, palpitations, headacem difccuje
most common organism for meningitis in:
- adults
- neonates
adults: strep pneumoniae. others: neisseria, haem influenza
neonates: strep agalactiae, e.coli, strep pneumonia and listeria
