Infections

Question 1

What are the features of leptospirosis/weils disease?

Answer 1

Fever, flu-like Sx, renal failure, liver failure (jaundice), subconjunctival haemorrhage, headache (meningitis)

Sewage workers/farmers/ vets - infected rat urine.

Rx- high dose benylpenicillin

Question 2

Checking someone’s Anti-hepB level after immunisation and it’s <10 what is your response?

Answer 2

Test for past/current infection - give another course eg 3 doses.
If still fails to respond and person is exposed to virus HBIG is recommended.

Question 3

Checking someone’s Anti-hepB level after immunisation and it’s 10-100 what is your response?

Answer 3

Suboptimal response

One extra dose needed

Question 4

Checking someone’s Anti-hepB level after immunisation and it’s >100 what is your response?

Answer 4

Responded well

5 year booster

Question 5

Treatment for hep B?

Answer 5

Pegalated INF- A

Others: tenofovir and entecavir

Question 6

Features of mononucleosis?

Answer 6

Triad: sore throat, pyrexia and lymphadenopathy

Others:
Palatal petechiae
Splenomegaly and rupture 
Hepatitis
Lymphocytosis
Haemolytic anemia
Rash with amoxicillin/ ampillcin

Question 7

Diagnosis for infectious mononucleosis

Answer 7

Heterphil antibody test (monospot test) and FBC

Question 8

Cause of glandular fever?

Answer 8

Aka infectious mono

EBV

Common in young people

Question 9

Treatment for meningitis?

Answer 9

Cefotaxime (+amoxicillin in Young and old)

Question 10

What needs to be done before someone is given BCG vaccine?

Answer 10

Tuberculin skin test (to see past expose to BCG or TB toxin) both contraindications to vaccination

Question 11

Someone who has an URTI which doesn’t response to amoxicillin and gets worse with a rash.. what is the underlying problem? And how to confirm Dx?

Answer 11

Infectious mononucleosis (glandular fever) 
Need to do heterophil antibody test (mono spot)