Infection/Sexual Health Flashcards
Treatment cellulitis
Mild - flucloxacillin, doxycycline if allergic, macrolide if pregnancy
Severe - co-amox
Identify giardiasis
Prolonged incubation
Non-bloody floating stool
Treatment giardiasis gastroenteritis
Metronidazole
Identify shigella gastroenteritis
Blood diarhoea with pain
Haemolytic uraemic syndrome
Identify e-coli gastroenteritis
Common travellers
Watery stool
Treatment shigella gastroenteritis
Azithromycin or ciprofloxacin
Identify staph aureus gastroenteritis
Short incubation
Severe vomiting
Identify compylobacter gastroenteritis
Flu like prodrome then crampy pain
Maybe blood diarrhoea
Treatment compylobacter gastroenteritis
Azithromycin or ciprofloxacin
Identify ameobiasis gastroenteritis
Gradual onset bloody diarrhoea
Abdominal pain lasts several weeks
Onset salmonella gastroenteritis
Short incubation
Watery diarrhoea, maybe blood/mucous
gastroenteritis cause if <6h
Staph aureus or bacillis
gastroenteritis if 12h to 2d
Salmonella or ecoli
gastroenteritis if 2 to 3d
Shigella or compylobacter
gastroenteritis if >7d
Giardiasis or ameobiasis
Treatment shingles
1) Aciclovir if <3d onset and analgesia
Antibiotics treat MRSA
Vancomycin
Teicoplanin
Linezolid
Diagnosis HIV
Combination test (p24 antigen and antibody) Repeated if positive
Testing asymptomatic HIV
Done 4w after exposure then 3m after this
Treatment HIV
2 nucleoside transcriptase inhibitors (NRTI) and either protease inhibitor (PI) or non-nucleoside transcriptase inhibitor (NNRTI)
Antibiotics in HIV
Co-trimoxazole if CD4 < 200
Cause HIV diarrhoea
Cryptosporodium most common
CMV
Treatment HIV oesophageal candidiasis
1) Fluconazole or itraconazole
Cause kaposi sarcoma
Human herpes virus 8 (HHV 8)
Treatment kaposi sarcoma
Radiotherapy and resection
Treatment pneumocystitis jeroveci pneumonia
Co-trimoxazole
Identify toxoplasmosis HIV lesion
Multiple lesions, ring enhances, SPECT -ve
Identify primary CNS lymphoma HIV lesion
Single lesion, solid enhancement, SPECT +ve
Identify TB HIV brain lesion
Single enhancing lesion
Identify cryptococcus HIV brain lesion
Meningeal enhancement
Cerebral oedema
India ink +ve
Identify encephalitis HIV
Oedematous brain, caused by CMV or HIV
Identify progressive multifocal leukoencephalopathy
Widespread demyelination due to JC virus
Really low CD4
Subacute behaviour changes
4Cs of C Diff
Ciprofloxacin
Co-amoxiclav
Clindamycin
Cephalosporin
Severity C Diff
Mild - normal WCC
Moderate - WCC < 15
Severe - WCC > 15 or AKI or temp or severe colitis
Life threatening - hypotension, toxic megacolon, ileus
C Diff diangosis
CD toxin in stools
Treatment C Diff first episode
1) Oral vancomycin 10d
Treatment recurrent C Diff
Within 12h:
1) Fidaxomycin
Treatment life threatening C Diff
1) Oral vancomycin and IV metronidazole
Recognise enteric fever
Caused by salmonella typhi
Rose spots
Relative bradycardia
Recognise bacillis
Associated rice
First 6h - vomiting
Second 6h - diarrhoea
Treatment bacillis
1) Supportive, usually resolves 24h
2) Vancomycin if antibiotic needed
Recognise malaria
Jaundice
Fever which comes and goes
Hepatosplenomegaly
Diagnose malaria
Blood film - 3 samples over 3d
Treatment falciparum malaria
IV artesunate
Prophylaxis malaria
Proguanil and atovaquone (Malarone) 2 days before and 1w after
Deoxycycline taken 2d before and 4w after
Treatment non-falciparum malaria
Chloroquine
Meningitis cause <3m
Group B strep
Meningitis cause 3m-60y
Neiserria meningitis
Meningitis cause >60y
Strep pneumonia
Meningitis viral cause
Enterovirus - coxsacie, echovirus are most common
HSV and VZV also
Diagnose menignitis
LP if no signs raised ICP
Treatment menigntis <3m
IV cefotaxime and amoxicillin
Treatment meningitis 3m-50y
IV ceftriaxone
Treatment meningitis >50y
IV ceftriaxone and amoxicillin
Always give with antibiotics for meningitis
IV dexamethasone
Meningitis prophylaxis
Oral ciprofloxacin
Staining for TB
Ziel-Neelson stain (bright red)
Screening latent TB
Mantoux test
Treatment TB
RIPE:
- rifampicin and isonizid 6m
- pyrazinumide and ethambutol 2m
Rifampicin adverse
Orange secretions
Isoniazid adverse
Peripheral neuropathy
Pyrazinamide adverse
Gout
Ethambutol adverse
Optic neuritis
Treatment UTI woman
uncomplicated - trimethoprim or nitrofuranoin 3d
Complicated or renal - 5 to 10d
Treatment UTI pregnant woman
1) Nitrofurantoin 7d
2) Amoxicillin or cefalaxin
Treatment UTI men
1) Same as non-pregnant woman but 7d
Common cause pyelonephritis
E. Coli
Diagnose brain abscess
CT scan
Treatment brain abscess
3rd gen cephalosporin and metronidazole
Dexamethasone for ICP
Identify vaginal candidiasis
Cottage cheese - non-offensive
Treatment vaginal candidiasis
1) Oral fluconazole
Common cause encephalitis
HSV 1
Treatment encephaltiis
IV aciclovir if suspected
Identify infectious mononucleosis
Classic triad:
- sore throat
- lymphadenopathy
- pyrexia
Never take in infectious mononucleosis
Amoxicillin - rash
Diagnosis infectious mononucleosis
Antibody test (monospot test)
Treatment infectious mononucleosis
Rest and analgesia
Avoid contact sport 4w
Treatment influenza
Supportive
Oral oseltamavir if risk complication
Identify staph toxic shock syndrome
Fever
Hypotension
Diffuse rash
Treatment lyme disease
Deoxycycline
Assess risk in sepsis
qSOFA:
- RR>22
- altered mental
- systolic BP <100
Sepsis 6
Take: - blood lactate - blood cultures - urine output Give: - oxygen - broad antibiotics - IV fluids
Diagnose chlamydia
Nuclear acid amplication test (NAATs):
- woman vulvovaginal swab
- men first void urine sample
Treatment chlamydia
1) Deoxycycline
2) Azithromycin in pregnancy
Gonorrhoea bacteria
Gram negative diplococci (neisseria gonorrhoea)
Identify disseminated gonorrhoea
Classic triad:
- tenosynovitis
- migratory polyarthritis
- dermatitis (rash)
Treatment gonorrhoea
1) IM ceftriaxone single dose
2) Oral cefaxime and oral azithromycin single dose
Syphillis cause
Treponema pallidum - spirocete
Identify syphillis
Primary - painless single ulcer and non-tender lymphadnopathy
Secondary - skin and mucous membrane involvement
Tertiary - many organs
Diagnose syphillis
Antibody testing
+ve non-Treponema and +ve Treponema
Active infection
+ve non-Treponema and -ve Treponema
False positive
-ve non-Treponema and +ve Treponema
Successfully treated
Treatment syphillis
IM benzylpenicillin
Identify herpes
Multiple painful ulcers
Tender lymphadenopathy
Treatment herpes
Aciclovir
Diagnose herpes
NAAT
Identify trichonomas vaginalis
Offensive discharge - green
Strawberry cervix
Diagnose trichonomas vaginalis
Miscroscopy - mobile trophozites
Treatment trichonomas vaginalis
Oral metronidazole 7d
Cause bacterial vaginosis
Gardnerella vaginalis
Identify bacterial vaginosis
Fishy discharge
Clue cells
Bacterial vaginosis
Treatment bacterial vaginosis
Oral metronidazole
Treatment genital warts
Multiple - topical podophylum
Single - cryotherapy
Identify chancroid
Painful ulcers with sharp borders
Unilateral painful lymphadenopathy
Identify dengue
Retro-orbital headache
Thrombocytopenia
EBV associated malignancy
Burkitt lymphoma
Hodgkin lymphoma
Nasopharangeal carcinoma
Diagnose legionella
Urinary antigen
Diagnose mycoplasma
Serology
Identify leptospirosis
Often farmer or sewage worker
AKI and hepatitis
Identify ly,phogranuloma venereum
HIV and proctatitis
Causes false negative montoux
Immunosuppresion
Sarcoidosis
Identify mumps
Parotitis, pain on eating
Cause necrotising fascitis
Strep pyogenes
Identify schistosomiasis
Haematuria and hepatomegaly
Risk for SCC bladder cancer
Identify rubella
Prodrome fever then rash on face
Then spreads to rest of body
Suboccipital lymphadenopathy
Live attenuated vaccines
BCG MMR Intranasal influenza Rotovirus Polio
Post splenectomy sepsis
Haemophilus influenza
Central line bacteria
Staph epidermidis
Infection after renal transplant
CMV
Latest time for HIV prophylaxis
72h post exposure
