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MEDICINE > Infections > Flashcards

Infections Flashcards

1
Q

Features of underlying immunodeficiency in shingles

A

Severe disease

Prolonged duration of rash

Multiple dermatomal involvement

Recurrence

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2
Q

CNS involvement in shingles

A

Ramsay Hunt syndrome

  • due to geniculate ganglion
  • facial palsy
  • I/L loss of taste
  • buccal ulceration
  • rash in external auditory canal

Myelitis
Cranial nerve palsy
Encephalitis

Granulomatous cerebral angiitis - stroke like syndrome a/w shingles (esp in an ophthalmic distribution)

Post herpetic neuralgia

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3
Q

Post herpetic neuralgia

A

Persistent pain following healing of the rash of shingles

  • for 1-6 months or longer
  • common with advancing age

Rx :
- Aggressive analgesia

  • Amitriptyline 25-100 mg daily OR
    Gabapentin (start at 300 mg daily, increase slowly to 300 mg twice daily or more)
  • Capsaicin cream (0.075%)
  • Corticosteroids (controversial)
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4
Q

Complications of EBV infection

A

Severe pharyngeal edema

Antibiotic induced rash (80-90 % with ampicillin)

Hepatitis (80%)

Prolonged post viral fatigue (10%)

Jaundice (

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5
Q

CNS & CVS complications of EBV infection

A

CNS

  • Cranial nerve palsies
  • Polyneuritis
  • Transverse myelitis
  • Meningoencepahilitis

CVS

  • Myo & Pericarditis
  • ECG abnormalities
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6
Q

Hematological complications of EBV infection

A

Hemolytic anemia

Thrombocytopenia

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7
Q

Renal abnormalities of EBV infection

A

Abnormal urine analysis

Interstitial nephritis

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8
Q

EBV associated malignancy

A

Nasopharyngeal Ca

Burkitt’s lymphoma

Primary CNS lymphoma

Hodgkin’s disease

Duncan’s syndrome - lymphoproliferative disease in immuno compromised

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9
Q

How does vertical transmission occurs in dengue ?

A

If infection occurs within 5 weeks of delivery

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10
Q

How long does the protection of yellow virus vaccination last ?

A

Single vaccination with a live attenuated vaccine lasts for atleast 10 years

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11
Q

Bartonellosis - Name the diseases

A

Trench fever
Cat scratch disease
Bacillary angiomatosis

Bacteremia & endocarditis in the homeless

Oroya fever & verruga peruana (Carrion’s disease)

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12
Q

Brucella spp

A

B.melitensis - most severe
B.abortus
B.suis - a/w abscess formation
B.canis

G -ve
Intracellular
Survive for long periods in the RE system

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13
Q

C/F of acute brucellosis

A

High swinging temperature
Rigors
Lethargy

Headache
Joint & muscle pain
Scrotal pain

CNS - Delirium
GIT - Abdominal pain, Constipation

Signs

  • Enlarged LN
  • Splenomegaly –> hypersplenism, thrombocytopenia
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14
Q

CNS involvement in brucellosis

A

Meningitis
IC or SAH
Stroke

Cranial nerve palsies

Myelopathy
Radiculopathy

Eyes

  • Uveitis
  • Retinal thrombophlebitis
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15
Q

CVS involvement in brucellosis

A

Endocarditis

Myocarditis

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16
Q

Respiratory system involvement in brucellosis

A

Pneumonitis or abscesses

Hilar LAP

17
Q

Bone involvement in brucellosis

A

Spinal spondylitis or sacroiliitis
Paravertebral or psoas abscess

Suppurative arthritis
Synovitis
Bursitis
Osteomyelitis

18
Q

GIT & GU involvement in brucellosis

A

Splenic abscess or calcification
Hepatitis

Epididymo-orchitis

19
Q

Hematological abnormality in brucellosis

A

Pancytopenia

20
Q

General examination finding in brucellosis

A

Malodorous perspiration

LAP

21
Q

MC HIV related cancer

A

HHV-8 related Kaposi’s sarcoma

22
Q

EBV related cancers occurring in HIV patients

A

Non-Hodgkin lymphoma

Hodgkin lymphoma

23
Q

HPV related cancers occurring in HIV patients

A

Anal Ca

Cervical Ca
Vulval Ca

Penile Ca

24
Q

CNS involvement in HIV

A

Cognitive Impairement

ICSOLs

Meningitis

25
Q

ICSOLs occurring in AIDS patients

A

Toxoplasmosis
Primary CNS lymphoma
Tuberculoma
Cryptococcoma

26
Q

Causes of meningitis in AIDS patients

A

Cryptococcal
TB
Pneumococcal
HIV

27
Q

Post exposure prophylaxis for AIDS

A

1st dose asap (preferably within 6-8 hours)

NO use starting PEP after 72 hours

Low risk exposure - Dual NRTIs (Tenofovir + Emtricitabine)

High risk exposure - Dual NRTIs + PI or Efavirenz (NNRTI)

HIV antibody testing at 6, 12, 24 weeks after exposure

28
Q

Common causes of chronic watery diarrhoea in AIDS patients

A

When CD4+ T cell count

29
Q

Opportunistic infections in AIDS reduced by Cotrimoxazole

A

Pneumocystis jiroveci pneumonia
Isospora belli diarrhoea
Cerebral toxoplasmosis

Dose : 960 mg daily

30
Q

Opportunistic infections in AIDS along with Rx

A

Cryptococcosis - Fluconazole 200 mg daily

CMV - Valganciclovir 900 mg daily

MAC

  • Clarithromycin 500 mg BD
  • Ethambutol 800 mg daily
31
Q

MC drug rash occurring in HIV patients

A

Erythematous MP rash - maybe scaly

MC drugs

  • Sulphonamides
  • NNRTIs

Life threatening features of rashes

  • Blistering
  • TEN ( blistering >30% of surface area)
  • SJS (involves mucous membranes)
  • Systemic involvement with fever or organ dysfunction
32
Q

Organisms causing mucormycosis

A

Mucoraceous moulds

  • Lichthemia (Absidia)
  • Rhizomucor spp
  • Mucor spp
  • Rhizopus spp
33
Q

Disease patterns in mucormycosis

A

Rhinocerebral/Craniofacial
Pulmonary
Cutaneous
Systemic

34
Q

Predisposing factors for mucormycosis

A

Profound immunosuppression

  • Neutropenia
  • HSC transplantation

Uncontrolled DM
Iron chelation therapy - Desferrioxamine
Severe burns

35
Q

Rx of mucormycosis

A

Antifungal therapy

  • Amphotericin B
  • Posaconazole

Surgical debridement

Correction of predisposing factors

36
Q

Rx of schistosomiasis

A

PRAZIQUANTEL

  • 20 mg/kg orally
  • twice daily for 1 day
  • Kills adult worms & stops egg laying
  • In early infection, it reverses hepatomegaly, UB wall thickening & granuloma

SURGERY

  • for residual lesions
  • Eg: Ureteric strictures, small fibrotic UB, granulomatous masses in brain & spinal cord
37
Q

C/F of shingles (herpes zoster)

A

Burning discomfort in the affected dermatome

  • Thoracic dermatomes
  • Ophthalmic (Vth CN) - vesicles appear on cornea –> ulceration –> blindness

Discrete vesicles appear 3-4 days later (a/w brief viremia)

Zoster sine herpetica - paraesthesia occurs without rash

MEDICINE (10 decks)

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