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FCM > INFECTIOUS DISEASE > Flashcards

INFECTIOUS DISEASE Flashcards

1
Q

Mainly with symptoms of meningitis or meningoencephalitis

common cause of HIV-related meningitis

A

cryptococcosis

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2
Q

Ix for cryptococcosis

A

Gold standard = culture CrAg

LP = round encapsulated yeast

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3
Q

management of cryptococcosis

A

Amphotericin B + flucytosine

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4
Q

Hx of being on farm/ construction site

flu -like symptoms, pneumonia symptoms and also any pulmonary manifestations with arthralgia

A

histoplasmosis

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5
Q

Ix for histoplasmosis

A

histology/cytology of lymph node or lung disease

fungal culture

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6
Q

management of histoplasmosis

A

Amphotericin B and itraconazole

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7
Q 
non-productive cough 
exertional dyspnoea 
fever 
tachypnea 
chest pain

usually opportunistic in HIV

A

Pneumocystis Jiroveci

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8
Q

Ix for pneumocystis jiroveci

A

exertional O2 stats = usually drop
induced sputum culture - bronchoalveolar lavage

CXR - typically normal but some cases show bilateral interstitial infiltrates

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9
Q

Management of pneumocystis jiroveci

A

IV/high dose of co-trimoxazole (Septrin) and steroid

check G6PD status

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10
Q

prodrome = headache, fever and agitation
hydrophobia - water provoking muscle spasms
hypersalivation
negri bodies in infected neurons

A

rabies

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11
Q

Ix for rabies

A

usually clinical suspicion

immunofluorescence from saliva/CSF or anti-rabies antibodies

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12
Q

management of rabies

A

contact PHE

vaccines given
if previously vaccinated - 2 doses given
if no prev vaccines - HRIG with full doses of jabs

benzodiazepines, haloperidol analgesia and anticholinergics for spasms

NOTIFY PHE

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13
Q 
manifests as colitis
hepatitis 
encephalitis 
pneumonitis 
retinitis

commonly affects immunocompromised people
transmitted through sex/close contact

A

cytomegalovirus

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14
Q 
'blueberry muffin' lesions on skin 
growth retardation 
sensorineural deafness 
seizures 
hepatosplenomegaly
A

congenital cytomegalovirus syndrome

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15
Q

Ix of cytomegalovirus

A

serology IgM/G

‘owls eye’ inclusions on CMV PCR

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16
Q

management of cytomeglovirus

A

supportive in immunocompetent & antiviral in immunocompromised
cidofovir/foscarnet and ganciclovir

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17
Q 
diarrhoea
nausea 
vomiting 
fever 
abdo cramps
A

salmonella

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18
Q

Ix for salmonella

A

stool MCS

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19
Q

management for salmonella

A

supportive - hydration
if severe, consider ciprofloxacin or azithromycin
isolate for 48hrs after last vomiting/diarrhoea episode and notify PHE

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20
Q 
fever
headaches 
constipation 
dry cough 
rash

complications = confusion/delirium, intestinal perforation

A

Typhoid

salmonella typhi & paratyphi

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21
Q

Investigations of salmonella typhi & paratyphi

A

blood culture
stool MCS
serology unreliable

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22
Q

management of salmonella typhi and paratyphi

A

IV ceftriaxone

follow with oral azithromycin

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23
Q

diarrhoea - often bloody
fever
abdo pain

acquired faeco-oral or sexually transmitted

A

shigella

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24
Q

Ix for shigella

A

stool MCS

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25
Q

management for shigella

A

supportive - hydrate
if really unwell = ciprofloxacin/azithromycin

reinforce hand hygiene and notify PHE

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26
Q

prodrome = fever, lethargy., headache
trismus (lockjaw)
spasms (dysphagia)
opisthotonus - arched back/hyperextended neck

A

tetanus

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27
Q

management of tetanus

A

usually in ICU setting

  • wound debridement
  • ceftriaxone and metronidazole
  • vaccinate

supportive treatment, muscle relaxants and IM tetanus Ig

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28
Q

diarrhoea = ‘rice-water stool’
abdo pain
vomiting
hypoglycaemia/dehydration

A

cholera

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29
Q

Dx of cholera

A

largely clinical and stool MSC

30
Q

management of cholera

A

aggressive volume repletion (oral/IV)

adequate nutrition & Abx ciprofloxacin/doxycycline

31
Q

flaccid paralysis (paresthesia/weakness)
diplopia
ataxia
bulbar palsy

hx of contaminated food ingestion or IV drug use

A

botulism

32
Q

management for botulism

A

supportive care, close monitoring and botulism antitoxin

33
Q

chronic, non-healing sores/shallow ulcers with grey membrane
- oftend preceded by trauma

OR

sore throat, cervical lymphadenopathy and low grade fever
classic grey pseudomembrane
bull neck = stridor

A

diptheria

34
Q

Ix fro diptheria

A

throat swabs with MCS

35
Q

management of diptheria

A

erythromycin
contact trace and prophylaxis
notify PHE

36
Q

fever night sweats
weight loss
lymphadenopathy
hepatomegaly = anaemia, leucopenia and hypoalbuminaemia

A

atypical mycobacterium disease

37
Q

Ix for atypical mycobacterium disease

A

mycobacterial cultures

38
Q

management for atypical mycobacterium disease

A

macrolide and ethambutol and rifabutin for more than 3/12

39
Q 
majority asymptomatic 
some GI symptoms 
anaemia 
mild cough 
serum eosinophilia

walking in contaminated soil

A

hookworm

40
Q

Ix for hookworm

A

stool ova cysts and parasites

41
Q

perianal itching
more predominant at night
soreness around anus

A

threadworms (enterobiasis and pinworms)

42
Q

diagnosis of threadworm

A

cellophane test and clinical suspicion

43
Q

management of threadworm

A

albendazole/mebendazole for 2 weeks
treat the entire family
reinforce specific hygiene measures

avoid medication in pregnancy and breastfeeding

44
Q

abdo pain
diarrhoea
bloody stools or mucus
fever

(mainly asymptomatic

A

amoebiasis

45
Q

Ix of amoebiasis

A

stool OCP microscopy/PCR, serology

USS liver

46
Q

management of amoebiasis

A

metronidazole for invasive colitis

followed by puromycin or diloxanide furoate

47
Q 
fever, headache, nausea 
arthralgia, anaemia and abdominal pain 
tachycardia/pnoea 
thrombocytopenia 
high transaminase levels 
splenomegaly
A

malaria

48
Q

management of malaria

A

uncomplicated malaria - oral artemether lumefantrine
OR
malarone/Quinine and doxycycline

severe complication = IV artesunate 24hrs followed by riamet or IV quinine

49
Q 
fever 
night sweats 
headaches 
myalgia 
hepatosplenomegaly 
lymphocytosis, increased LFTs and CRP

affects immunocompromised people

A

toxoplasmosis

50
Q

Ix for toxoplasmosis

A

serology and PCR

51
Q

management of toxoplasmosis

A

acute is usually self-limiting in immunocompetent

severe disease = pyrimethamine and sulfadiazine

52
Q 
sore throat 
lymphadenopathy (anterior/posterior triangles)
pyrexia 
splenomegaly 
maculopapular rash - post amoxicillin 
transient hepatitis
A

infectious mononucleosis/ glandular fever

53
Q

Ix for glandular fever

A

monospot test

54
Q

management for glandular fever

A

plenty of fluids, analgesia

avoid alcohol and contact sport

55
Q

fever malaise
myalgia
parotitis = presents as earache/pain on eating
typically unilateral

A

mumps

56
Q

high fever for a few days with a subsequent maculopapular rash
can have febrile convulsions
nagayama spots on uvula & soft palate
diarrhoea and cough

common in infancy

A

roseola (exanthem subitam)

57
Q

management of roseola

A

analgesia to calm the fever

rest and hydration

58
Q

prodrome = low grade fever
rash = maculopapular initially on face but then spreads to the body
usually resolves within 3-5days
lymphadenopathy - suboccipital and postauricular

A

rubella

59
Q

Ix for rubella

A

serological and PCR

60
Q

management for rubella

A

fluids, rest and analgesia

61
Q

prodrome = irritable, conjunctivitis and fever
maculopapular rash - starts behind ears and spreads to the whole body
diarrhoea
koplik spots

A

measles

62
Q

Ix for measles

A

IgM antibodies

63
Q

management for measles

A

mainly supportive - inform PHE

admit if immunocompromised or pregnant
unimmunised contacts should be offered vaccine within 72hrs

64
Q

initially fever
itchy rash starting on the had/trunk before spreading to the rest of the body
macular -> papular -> vesicular

A

varicella zoster virus /chickenpox

65
Q

management of chickenpox

A

mainly supportive
calamine lotion
school exclusion till the all the lesions have crusted over

immunocompromised/newborns = VZIG and IV aciclovir

66
Q

prodrome of mild malaise, fever, headache, sore-throat and rhinitis
symptom free period followed by an erythematous rash on the cheeks which disappears after 2-4days

A

slapped cheeks/Parvovirus B19/ erythema infectiosum

67
Q

Ix for slapped cheeks

A

B19 specific IgM and IgG and PCR test for B19

68
Q

management of slapped cheeks

A

conservative symptomatic treatment

avoid contact with at risk individuals

69
Q 
fever 
headache 
myalgia 
fatigue 
cough 
sore throat 
runny/stuffed nose

usually seasonal

A

influenza

70
Q

management of influenza

A

fluids, analgesia and rest

71
Q

primary infection = severe gingivostomatitis
cold sores
painful genital ulceration

A

herpes simplex virus

72
Q

management of herpes simplex virus

A
  1. gingivostomatitis = oral aciclovir, chlorhexidine mouthwash
  2. cold sore = topical acyclovir
  3. genital ulcers = oral aciclovir

elect a c-section at 28 weeks

FCM (16 decks)

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