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MSRA > Infection/Haem > Flashcards

Infection/Haem Flashcards

1
Q

Listeriosis - tx
Listeriosis meningitis - to

A

Amox or ampicillin
If meningitis - add gentamicin

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2
Q

Syphilis tx

A

Benzathine benzylpenicillin

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3
Q

Congenital toxoplasmosis - tx

A

Spiramycin for infection in pregnant mum

pyrimethmine and sulfadiazine for infected foetus

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4
Q

Cause of hand foot and mouth disease

A

Coxsackie virus A

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5
Q

Cause of fifth disease aka erythema infantiosum

A

Slapped cheek rash
Parvovirus b19

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6
Q

tx of giardiasis

A

metronidazole

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7
Q

when can you get shingles vaccination?

A

age 70-79

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8
Q

tx of neisseria gonorrhoea

A

IM ceftriaxone

OR ciprofloxacin OR tetracycline

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9
Q

investigation for chlamydia

tx of chlamydia

A

Ix: NAAT

1st line: doxycycline 7/7
2nd line: azithromycin 3/7

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10
Q

tx of bacterial vaginosis and trichomoniasis

A

BV: metronidazole (PO/TOP) or clindamycin
Trichomoniasis: metronidazole

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11
Q

tx of syphillis

A

benzylpenicillin

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12
Q

which organism causes fungal meningitis for west africa patient?
PC: fever, headache, diarrhoea, weight loss

A

cryptococcus neoformans

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13
Q

what level of CD4 count must you aim with anti-retroviral tx?

A

> 350

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14
Q

abx prophylaxis for meningococcal patients-contacts

A

ciprofloxacin
rifampicin - 2nd line

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15
Q

prophylaxis for malaria

A

1st line: doxycycline
2nd line: atovaquone/proguanil

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16
Q

HIV positive with recent travel to tropics and severe diarrhoea ? organism

A

cryptosporidium

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17
Q

what causes hand, foot and mouth disease?

A

Coxsackie virus A type 16

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18
Q

contraindication to doing LP

A

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

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19
Q

?diagnosis - homeless person, initial scab on face, itchy and increase swelling, pyrexia and cannot open eye due to swelling

A

erysipelas
organism: Group A strep (strep pyogenes)
tx: penicillin

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20
Q

swimming in lake malawi. urinary symptoms. ?organism

A

schistosomia haematobium (look for ovum in microscopy)

Tax: praziquantel

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21
Q

differences in the plasmodiums

A

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.

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22
Q

rose spots - ?organism

A

salmonella
(can cause splenomegaly, constipation earlier on then diarrhoea)
Ix: blood culture
tx: ciprofloxacin

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23
Q

return from south africa - high swinging fever with diarrhoea and tenderness in RUQ ? organism

A

likely liver abscess
amoebiosis

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24
Q

difference in number of cells in LP for:
viral, bacterial, TB, cryptococcal meningitis

A

viral: 5-1000, lymphocyte
bacterial: >100, neutrophil
TB: 5-100, lymphocyte
cryptococcal: 5-100, lymphocyte

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25
Q

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

A

rubella

26
Q

organism causing mumps

A

rubulavirus

27
Q

organism causing scarlet fever

A

Group A beta-hameolytic streptococcus

28
Q

farm worker. headache, fever, severe myalgia, petechial rash, jaundiced, raised urea
?diagnosis

A

leptospirosis AKA weil’s disease

Tax: benzylpenicillin/doxy

29
Q

strawberry cervix ?diagnosis

A

trichomoniasis (but only visible for 1-2% of cases under colposcopy)

30
Q

tx of CMV colitis in HIV patients

A

IV gaciclovir

31
Q

salmon-pink rash on trunk

A

adult still’s disease aka juvenile idiopathic arthritis

32
Q

clue cells - what is it?

A

vaginal epithelial cells covered with gram negative rods

found in bacterial vaginosis

33
Q

HIV nephropathy - how is it different to nephrotic syndrome?

A

in nephrotic syndrome - high cholesterol

in HIV nephropathy - normal/low cholesterol and no HTN. renal USS will reveal large echogenic kidneys

34
Q

abx post-dog bite

A

co-amoxiclav

35
Q

tx of cryptococcal meningitis

A

amphotericin tx followed by long-term prophylactic fluconazole

36
Q

which abx works best intracellularly?

A

macrolides
quinolones
ketolides

37
Q

tx of lyme disease

A

doxycycline

38
Q

strawberry tongue

A

kawasaki disease

39
Q

difference between TRALI and TACO

A

blood pressure!
TRALI- hypo
TACO- hyper

40
Q

APTT vs PT

A

APTT tests for intrinsic and common pathways - factor 8, 9,11,12

PT tests for extrinsic and common pathways - factor 2,5,7,10

41
Q

what is SCID?

A

recurrent infections, diarrhoea, dermatitis, failure to thrive
compromise in number and function of T-cells, B-cells and natural killer cells

42
Q

treatment/prophylaxis for C1 inhibitor deficinecy

A

tx: C1-INH concentrate of FFP (during acute attack)
prophylaxis: androgens (danazol) increase production of C1-INH, fibrinolysis inhibitors (tranexamic acid)

43
Q

works as a vet and notice large right axillary lymph node which was fluctuant and tender
?diagnosis

A

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

44
Q

warm VS cold autoimmune haemolytic anaemia

A

warm: idipathic, SLE, lymphoma, CLL, Evan’s syndrome

cold: paroxysmal cold haemaglobinuria, mycoplasma pneumoniae, lymphoma, glandular fever

45
Q

pel-ebstein fever - what is it? what disease associated with it?

A

temperature is high for one week and then low for another week
associated with hodgkin’s lymphoma

46
Q

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

A

typhoid
ix: blood culture

47
Q

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

A
48
Q

lymphadenopathy, splenomegaly, weight loss, fatigue, night sweats

?diagnosis

A

non-hodgkin’s lymphoma

49
Q

what type of anaemia does a patient with pica has?

A

microcytic anaemia

50
Q

anti-cardiolipin antibodies can be found in which conditions?

A

antiphospholipid syndrome
SLE
ITP
RA
Psoriatic arthritis
Sjogren syndrome

51
Q

sudden coldness then followed by rigor and then fever and sweating

?diagnosis

A

malaria

52
Q

how long must the patient stay in A&E after anaphylaxis reaction?

A

6 hours
- recurrence of smptoms can occur

53
Q

what is the mode of inheritance for ‘hairy ears’?

A

Y-chromosome linked

54
Q

abdominal pain, ascites and hepatomegaly for patient with polycythaemia

?what has happened

A

Budd CHiari syndrome
- occlusion of hepatic veins that drain the liver

55
Q

for patient with polycythaemai - if they also complain of tenderness of the sternum, what complication is arising?

A

acute myeloid leukaemia

56
Q

patient has egg allergy, which vaccine should they NOT take?

A

influenza
tick-borne encepahalitis
yellow fever

57
Q

low MCV and normal ferritin
?diagnosis

A

thalassemia

58
Q

what is the summary of these HIV complications:
- cryptosporidiosis
- cryptococcosis
- coccidiodomycosis

A

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.

59
Q

examples of encapsulated bacteria

A

SHiN SKiS
Strep pneumoniae
Haem influenza type B
Neisseria meningitidis
Group B strep
Klebsiella pneumoniae
Salmonella typhi

60
Q

scromboid food poisoning

A

ingestion of fresh, canned or smoked fish with hihg histamine levels due to improper processing/storage.

flushing, rash, urticaria, palpitations, headacem difccuje

61
Q

most common organism for meningitis in:
- adults
- neonates

A

adults: strep pneumoniae. others: neisseria, haem influenza
neonates: strep agalactiae, e.coli, strep pneumonia and listeria

MSRA (21 decks)

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