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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
management for shigella
supportive - hydrate if really unwell = ciprofloxacin/azithromycin reinforce hand hygiene and notify PHE
26
prodrome = fever, lethargy., headache trismus (lockjaw) spasms (dysphagia) opisthotonus - arched back/hyperextended neck
tetanus
27
management of tetanus
usually in ICU setting - wound debridement - ceftriaxone and metronidazole - vaccinate supportive treatment, muscle relaxants and IM tetanus Ig
28
diarrhoea = 'rice-water stool' abdo pain vomiting hypoglycaemia/dehydration
cholera
29
Dx of cholera
largely clinical and stool MSC
30
management of cholera
aggressive volume repletion (oral/IV) | adequate nutrition & Abx ciprofloxacin/doxycycline
31
flaccid paralysis (paresthesia/weakness) diplopia ataxia bulbar palsy hx of contaminated food ingestion or IV drug use
botulism
32
management for botulism
supportive care, close monitoring and botulism antitoxin
33
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
diptheria
34
Ix fro diptheria
throat swabs with MCS
35
management of diptheria
erythromycin contact trace and prophylaxis notify PHE
36
fever night sweats weight loss lymphadenopathy hepatomegaly = anaemia, leucopenia and hypoalbuminaemia
atypical mycobacterium disease
37
Ix for atypical mycobacterium disease
mycobacterial cultures
38
management for atypical mycobacterium disease
macrolide and ethambutol and rifabutin for more than 3/12
39
``` majority asymptomatic some GI symptoms anaemia mild cough serum eosinophilia ``` walking in contaminated soil
hookworm
40
Ix for hookworm
stool ova cysts and parasites
41
perianal itching more predominant at night soreness around anus
threadworms (enterobiasis and pinworms)
42
diagnosis of threadworm
cellophane test and clinical suspicion
43
management of threadworm
albendazole/mebendazole for 2 weeks treat the entire family reinforce specific hygiene measures avoid medication in pregnancy and breastfeeding
44
abdo pain diarrhoea bloody stools or mucus fever (mainly asymptomatic
amoebiasis
45
Ix of amoebiasis
stool OCP microscopy/PCR, serology | USS liver
46
management of amoebiasis
metronidazole for invasive colitis | followed by puromycin or diloxanide furoate
47
``` fever, headache, nausea arthralgia, anaemia and abdominal pain tachycardia/pnoea thrombocytopenia high transaminase levels splenomegaly ```
malaria
48
management of malaria
uncomplicated malaria - oral artemether lumefantrine OR malarone/Quinine and doxycycline severe complication = IV artesunate 24hrs followed by riamet or IV quinine
49
``` fever night sweats headaches myalgia hepatosplenomegaly lymphocytosis, increased LFTs and CRP ``` affects immunocompromised people
toxoplasmosis
50
Ix for toxoplasmosis
serology and PCR
51
management of toxoplasmosis
acute is usually self-limiting in immunocompetent severe disease = pyrimethamine and sulfadiazine
52
``` sore throat lymphadenopathy (anterior/posterior triangles) pyrexia splenomegaly maculopapular rash - post amoxicillin transient hepatitis ```
infectious mononucleosis/ glandular fever
53
Ix for glandular fever
monospot test
54
management for glandular fever
plenty of fluids, analgesia | avoid alcohol and contact sport
55
fever malaise myalgia parotitis = presents as earache/pain on eating typically unilateral
mumps
56
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
roseola (exanthem subitam)
57
management of roseola
analgesia to calm the fever | rest and hydration
58
prodrome = low grade fever rash = maculopapular initially on face but then spreads to the body usually resolves within 3-5days lymphadenopathy - suboccipital and postauricular
rubella
59
Ix for rubella
serological and PCR
60
management for rubella
fluids, rest and analgesia
61
prodrome = irritable, conjunctivitis and fever maculopapular rash - starts behind ears and spreads to the whole body diarrhoea koplik spots
measles
62
Ix for measles
IgM antibodies
63
management for measles
mainly supportive - inform PHE admit if immunocompromised or pregnant unimmunised contacts should be offered vaccine within 72hrs
64
initially fever itchy rash starting on the had/trunk before spreading to the rest of the body macular -> papular -> vesicular
varicella zoster virus /chickenpox
65
management of chickenpox
mainly supportive calamine lotion school exclusion till the all the lesions have crusted over immunocompromised/newborns = VZIG and IV aciclovir
66
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
slapped cheeks/Parvovirus B19/ erythema infectiosum
67
Ix for slapped cheeks
B19 specific IgM and IgG and PCR test for B19
68
management of slapped cheeks
conservative symptomatic treatment | avoid contact with at risk individuals
69
``` fever headache myalgia fatigue cough sore throat runny/stuffed nose ``` usually seasonal
influenza
70
management of influenza
fluids, analgesia and rest
71
primary infection = severe gingivostomatitis cold sores painful genital ulceration
herpes simplex virus
72
management of herpes simplex virus
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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