Infectious Disease 1

Question 1

C. difficile - high co-infection with?

Answer 1

CMV

Question 2

Stronglyloids stercoralis co-infection with?

Answer 2

HTLV - Human T Lymphotropic virus

Question 3

Mycosis fungoides a/w with what viral infection?

Answer 3

HTLV-2!

Question 4

Treatment for Stronglyloides stercoralis?

Answer 4

Ivermectin and repeat after 2 weeks ( to eradicate larva stage)

Question 5

Toxoplasmosis primary prophylaxis?

Answer 5

TMP-SMX

Question 6

Mucormycosis treatment?

Answer 6

Liposomal Amphotericin B then posaconazole

Question 7

Mucormycosis clinical feature?

Answer 7

Invasive mold infection like aspergillous but in rhinocerebral spread fashion - cause blindness

Question 8

Mucormycosis a/w with what group of people?

Answer 8

DM
Immunocompromised
Covid19 patient - high steroid dose factor
Iron overload

Question 9

Sedosporium apiospermum, profilicants treatment?

Answer 9

Voriconazole

Question 10

Posaconazole used as prophylaxis in what group of patients?

Answer 10

AML/ HSCT

Question 11

Why Voriconazole cant be use in ESRF?

Answer 11

Cyclodextrin component (oligosaccharides)

Question 12

AML patients prophylaxis drugs?

Answer 12

Antifungal - posaconazole
Antiviral- aciclovir
Antibiotics - ? fluoroquinolones to reduce Febrile neutropenia

Question 13

PJP prophylaxis indicated if what steroid dose?

Answer 13

Prednisolone > 25 mg/day > 4 weeks

Dexamethasone > 4mg

Question 14

Only HB core antigen positive - give prophylaxis in what group of patient?

Answer 14

HSCT patients!

Rituximab therapy!

Question 15

Most specific test for EBV?

Answer 15

Heterophile antibody - monospot

Question 16

What part of EBV causes African Burkitt lymphoma and malignancies?

Answer 16

LMP-1 bound to CD40

Question 17

Mechanism of valganciclovir/ganciclovir?

Answer 17

Inhibit CMV DNA polymerase - suppress bone marrow - neutropenia

Question 18

Foscarnet mechanism of action?

Answer 18

Pyrophosphate analogue - inhibit DNA polymerase

Question 19

What viral terminase inhibitor for CMV in HSCT patients?

Answer 19

Letermovir

Question 20

Prophylaxis treatment in woman exposured to varicella?

Answer 20

IF < 4 days - Varicella Immunoglobulin

IF > 4 days - oral aciclovir

Question 21

Treatment of PTLD?

Answer 21

Rituximab - only in lytic stage

Question 22

Measles spread via?

Answer 22

infectious droplets

Question 23

Clinical symptoms of COVID19 mainly through what mechanism?

Answer 23

spike glycoprotein interacts with ACE2 surface receptor

-loss of ACE2 = RAAS uninhibited —-> endothelial injury/inflammatory response/coagulation cascade

Question 24

How Covid19 gain entry?

Answer 24

TMPRSS2 and ACE2 receptor

Question 25

Remdesmivir targets what of covid19?

Answer 25

Rdrp - RNA dependent RNA polymerase

Question 26

Moderna and Pfizer uses what concept?

Answer 26

Nanolipid particles containing RNA - encode of COV2 spike protein

Question 27

What monoclonal antibodies for covid19?

When recommended?

Answer 27

Bamlanivimab + Etesevimab
Alternative : Casirivimab + Imdevimab (Regeneron)

Outpatient Mild covid - at high risk of progression

Question 28

Main mode of transmission of covid19?

Answer 28

1st = Direct transmission

• Droplet
• Contact

Airborne transmission - aerosol - particles suspended longer on air
Indirect transmission - vehicle - clothes/objects

Question 29

Droplet vs airborne difference?

Answer 29

Droplet - particle > 5um diameter ( heavier) so shorter distance , within 1 meter

Airborne - particle < 5um diameter so longer distance, aerosol

Question 30

Which activity transmits most virus particle?

Answer 30

Sneezing

2nd is bowel evacuation

Question 31

When is covid19 infectious?

Incubation period of covid19

Answer 31

Day 0 - day 0 have symptoms till day 5 (highly infectious)

Day 0 - 10 is infectious

Incubation period is 7 days
*Every decade add 1 day