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Finals > Infectious disease > Flashcards

Infectious disease Flashcards

1
Q

What is the most common cause of gastroenteritis?

A

Viral: rotavirus, norovirus, adenovirus

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2
Q

What is the spread of E.coli?

A

Infected faeces, unwashed salad, water

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3
Q

What is the incubation time of campylobacter jejuni?

A

2-5 days

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4
Q

What is the spread of campylobacter jejuni?

A

Raw poultry, untreated water, unpasteurised milk

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5
Q

What are the symptoms of campylobacter jejuni gastroenteritis?

A
  • Cramps
  • bloody diarrhoea
  • fever
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6
Q

What is the incubation time of shigella?

A

1-2 days

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7
Q

What is the spread of shigella?

A

Contaminated water and food

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8
Q

What are the symptoms of shigella?

A
  • abdominal cramps
  • bloody diarrhoea
  • fever
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9
Q

What is the incubation time of salmonella?

A

12 hours to 3 days

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10
Q

What is the spread of salmonella?

A
  • raw egg/poultry
  • contaminated food
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11
Q

What are the symptoms of salmonella?

A
  • watery diarrhoea ± blood/mucus
  • abdominal pain
  • vomiting
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12
Q

What is haemolytic uraemic syndrome?

A
  • Shiga toxin produced by EHEC and sometimes shigella and strep pneumoniae
  • Triad of: microangiopathic anameia, thrombocytopenia and AKI
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13
Q

What should be avoided in haemolytic uraemic syndrome?

A
  • Antibiotics
  • anti-motility agents
  • NSAIDs
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14
Q

What bacteria can cause bloody diarrhoea?

A
  • Campylocbater jejuni
  • shigella
  • EHEC
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15
Q

What bacteria can cause watery diarrhoea?

A
  • Salmonella
  • ETEC, EPEC
  • Bacillus cereus
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16
Q

What is the incubation time for bacillus cereus?

A

5 hours

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17
Q

What is the most common cause of the common cold?

A

Rhinovirus

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18
Q

What are complications of the common cold?

A
  • otitis media
  • sinusitis
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19
Q

What is the presentation of pharyngitis?

A
  • sore throat
  • fever
  • pharyngeal inflammation
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20
Q

In a patient presenting with pharyngitis and mouth vesicles, what is the most likely cause?

A

Enterovirus

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21
Q

What is the peak age of croup infection?

A

2 years old

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22
Q

What are the symptoms of croup?

A
  • fever
  • rhinorrhoea
  • harsh seal like cough
  • tachypnoea
  • subglottic obstruction
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23
Q

What is the cause of croup?

A

Parainfluenza viruses 1-4

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24
Q

What are the symptoms of influenza?

A
  • fever
  • fatigue
  • anorexia
  • muscle aches
  • headache
  • dry cough
  • sore throat
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25
Q

What is the diagnosis of influenza?

A

Viral nasal/throat swab -> PCR

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26
Q

Who should get the vaccine for influenza?

A
  • > 65
  • Young children
  • pregnant women
  • chronic health conditions
  • healthcare workers
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27
Q

What is the treatment for influenza?

A

Oral oseltamivir 75mg twice daily for 5 days if at risk of complications but must be within 49 hours

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28
Q

What are the complications of influenza?

A
  • otitis media
  • sinusitis
  • bronchitis
  • viral pneumonia
  • worsening of health conditions
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29
Q

What type of bacteria is klebsiella?

A

Gram positive ros

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30
Q

What is the marker of a klebsiella respiratory infection?

A

Red currant jelly sputum

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31
Q

Which patient groups is klebsiella more common in?

A

Diabetics and alcoholics

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32
Q

What is the most common cause of pneumonia?

A

Streptococcus pneumonia

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33
Q

What is the most common cause of pneumonia following an influenza infection?

A

Staphylococcus aureus

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34
Q

What is mycoplasma pneumoniae associated with?

A

Erythema multiforme and cold autoimmune haemolytic anaemia

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35
Q

What should you treat mycoplasma pneumoniae with

A

Macrolide

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36
Q

What is MRSA resistant to?

A
  • beta lactams
  • cephalosporins
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37
Q

What is the treatment of MRSA bacteraemia

A

IV vancomycin

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38
Q

What is the treatment of MRSA pneumonia?

A

IV vancomycin

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39
Q

What is the treatment of MRSA UTI?

A

Trimethoprim

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40
Q

What type of bacteria is clostridium difficile?

A

Gram positive rod

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41
Q

What is the presentation of c. diff infection?

A
  • diarrhoea
  • abdominal pain
  • raised white cell count
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42
Q

What is the diagnosis of c diff

A
  • c.diff toxin in the stool
  • c.diff antigen only shows exposure to the bacteria
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43
Q

What is the management of first presentation of c diff infection?

A

oral vancomycin for 10 days

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44
Q

What is the management of recurrent c diff?

A

oral Fidaxomicin for 10 days

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45
Q

What is the management of life threatening c diff?

A

Oral vancomycin and IV metronidazole

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46
Q

Which antibiotics are associated with C diff?

A
  • Cephalosporins
  • clindamycin
  • ciprofloxacin (fluoroquinolones)
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47
Q

What are the complications of c diff?

A
  • ileus
  • toxic megacolon
  • perforation and peritonitis
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48
Q

What are the causes of viral meningitis?

A
  • Enteroviruses
  • HSV
  • mumps
  • Varicella zoster virus
  • WEst nile
  • HIV
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49
Q

CSF in viral meningitis

A
  • clear
  • White blood cell 50-100
  • Protein >50
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50
Q

What is the treatment of viral meningitis?

A
  • supportive care
  • analgesia
  • anti-emetic
  • IV fluids
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51
Q

What are the causes of bacterial meningitis?

A
  • Streptococcus pneumoniae
  • Neisseria meningitidis
  • Haemophilus influenzae
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52
Q

CSF in bacterial meningitis

A
  • Cloudy and turbid
  • WBC >100
  • Low glucose
  • Increased protein
  • increased opening pressure (>25cm H2O)
53
Q

Empirical antibiotics in bacterial meningitis

A

Ceftriaxone IV

54
Q

What are the causes of fungal meningitis?

A

Cryptococcus species

55
Q

CSF in fungal meningitis

A
  • clear/cloudy
  • increased opening pressure
  • white cell count 10-100
  • low glucose
  • increased protein
56
Q

What is the most common cause of bacterial meningitis in 0-3 month olds?

A

Group B strep

57
Q

What is the most common cause of bacterial meningitis in 3mth to 6 year olds?

A

N.meningitidis, strep pneumoniae, haemophilus influenzae

58
Q

What is the most common cause of bacterial meningitis in 6 to 60 year olds

A

N. meningitidis, streptococcus pneumoniae

59
Q

What is the most common cause of bacterial meningitis in immunosuppressed

A

Listeria monocytogenes

60
Q

What is the prophylaxis for meningitis and when does it need to be offered?

A

Oral ciprafloxacin or rifampicin, if they have had close contact with the patient within 7 days of symptom onset

61
Q

What is the presentation of herpes simplex virus?

A
  • prodrome (may experience tingling)
  • genital ulcer
  • oral ulcer
  • dysuria
62
Q

Investigation for herpes simplex virus

A

Viral PCR swab

63
Q

What is the treatment for HSV?

A

1st episode: aciclovir 200mg 5 a day for 7-10 days

64
Q

How can you decrease the transmission of HSV?

A

aciclovir 400mg PO twice a day for 12 months

65
Q

What is the presentation of TB?

A
  • cough
  • fever
  • anorexia
  • weight loss
  • malaise
  • night sweats
66
Q

What are the risk factors of TB?

A
  • immunosuppression
  • HIV
  • Asia/latin america/africa
67
Q

What is the investigation for TB?

A
  • sputum acid-fast bacilli smear and culture
  • CXR: fibronodular opacities in the upper lobes
  • Full blood count: increased WCC and decreased Hb
68
Q

What is the treatment of TB?

A

For four months:
- Isoniazid
- Rifampicin
- Pyrazinamide
- Ethambutol

For a further 2 months:
- Isoniazid
- rifampicin

69
Q

What is the treatment of latent TB?

A

Isoniazid monotherapy

70
Q

What is HIV?

A

A retrovirus that destorys CD4 cells

71
Q

What are the risk factors for HIV?

A
  • IVDU
  • Men who have sex with men
72
Q

What is the presentation of HIV?

A
  • Fever and night sweats
  • Weight loss
  • Oral ulcers
  • angular chelitis
  • oral thrush
  • recent admission due to infection
  • generalised lymphadenopathy
73
Q

What is the investigation for HIV?

A
  • ELISA serum HIV enzyme-linked immmunisorbent assay
  • serum p24 antigen
  • test asymptomatic patients at 4 weeks after possible exposure
74
Q

What CD4 count is considered end stage HIV/AIDS

A

<200

75
Q

What is the antiretroviral therapy for HIV?

A
  • 2x NTRIs and protease inhibitor or non nucleoside reverse transcriptase
  • Start as soon as diagnosed
76
Q

What is the management of HIV?

A
  • Co-trimoxazole if CD4<200 to protect agaisnt pneumocystis jiroveci pneumonia
  • yearly cervical smears
  • vaccination: influenza, pneumococcal, Hep A+B, tetanus, diptheria and polio
77
Q

What is post exposure prophylaxis for HIV?

A
  • <72 hours
  • Truvada (emtricitabine/tenofovir) and raltegravir for 28 days
78
Q

What is meant by undetectable in HIV?

A

Viral load/no. of HIV RNA per ml blood (50-100)

79
Q

What are the AIDS defining illnesses?

A
  • kaposi’s sarcoma
  • Pneumocystis jirovecii pneumonia
  • cytomegalovirus
  • candidiasis
  • lymphoma
  • tuberculosis
80
Q

SIRS

A
  • sweats
  • chills/rigors
  • tachypnoea
  • tachycardia
  • hypotentsion
81
Q

Sepsis

A

Evidence of infection plus organ dysfunction: ≥2 of: hypotension, confusion, or tachypnoea (≥22)

82
Q

What is neutropenic sepsis?

A

Neutrophil count of <0.5 or 1 if recent chemo and fever or hypothermia or SIRS or sepsis/septic shock

83
Q

What is septic shock?

A

Sepsis induced hypotension requiring inotropic support or hypotension which is not responsive to adequate fluid resuscitation

84
Q

What are the risk factors for staphylococcus bacteraemia?

A
  • intravascular and other invasive devices
  • skin and soft tissue infection
  • surgical site infection
  • IVDU
85
Q

Treatment of staph aureus bacteraemia

A

IV flucloxacillin 2 grams 6 hourly

86
Q

Presentation of chlamydia

A
  • asymptomatic
  • cloudy/yellow discharge, post coital or intermenstrual bleeding in women
  • mucoid discharge in men
  • dysuria in men and women
87
Q

Investigation for chlamydia

A
  • NAAT: vulvovaginal in women, urine for men
  • testing should be carried out two weeks after exposure
88
Q

What is the management of chlamydia?

A
  • doxycycline 7 days
89
Q

Presentation of gonorrhoea

A
  • mucopurulent cervicitis
  • urethral discharge in men
90
Q

Investigation for gonorrhoea

A
  • NAAT
  • culture
91
Q

Management gonorrhoea

A
  • ceftriaxone IM 1g
92
Q

Presentation of syphilis

A

Primary:
- chancre: painless ulcer
- local, non tender lymphadenopathy

Secondary:
- systemic symptoms
- rash on trunk, palms and soles
- buccal ‘snail track’ ulcers
- condylomata lata (painless warty lesions on genitals

Territory:
- Gummas
- Neurosyphilis
- aortitis, aortic valve disease, aortic aneurysm

93
Q

Treatment of syphilis

A

Benzathine penicillin IM

94
Q

Presentation of trichomonas vaginalis

A
  • offensive yellow/green and frothy discharge
  • vulvovaginitis
  • strawberry cervix
  • pH>4.5
  • usually asymptomatic in men but may cause urethritis
95
Q

Treatment trichomonas vaginalis

A

Oral metronidazole for 5-7 days

96
Q

What species of plasmodium cause malaria?

A
  • falciparum
  • ovale
  • vivax
  • malariae
97
Q

What causes severe malaria

A

falciparum

98
Q

What are the features of severe malaria?

A
  • schizonts on a blood film
  • parasitaemia >2%
  • hypoglycaemia
  • acidosis
  • temperature >39
  • severe anaemia
99
Q

What are the features of non-falciparum malaria

A
  • fever
  • headache
  • splenomegaly
  • vivax/ovale: cyclical fever every 48 hours, malariae: 72 hours
  • malariae is associated with nephrotic syndrome
100
Q

investigation for malaria

A
  • blood film: thick/thin
  • antigen testing
  • FBC
101
Q

What causes infectious mononucleosis?

A

Epstein barr virus

102
Q

What is the presentation of infectious mononucleosis?

A
  • sore throat
  • pyrexia
  • lymphadenopathy
  • malaise, anorexia, headache
  • palatal petechiae
103
Q

What are the investigations for infectious mononucleosis?

A
  • FBC: lymphocytosis (at least 10% atypical0
  • monospot test (heterophil antibody test)
104
Q

What is the presentation of dengue fever?

A
  • Fever
  • headache
  • myalgia, bone pain, arthralgia
  • pleuritic chest pain
  • facial flushing
  • maculopapular rash
105
Q

Severe dengue

A
  • Haemorrhagic fever
  • thrombocytopenia and spontaneous bleeding
106
Q

Investigation for dengue

A
  • FBC: leukopenia, thrombocytopenia, raised aminotransferases
  • Serology/NAAT
107
Q

What are the causes of enteric fever?

A
  • S.typhi
  • S.paratyphi
108
Q

Presentation of enteric fever

A
  • HEadache, fever, arthralgia
  • Relative bradycardia
  • Abdominal pain and distension
  • Constipation
  • Rose spots
109
Q

What are the investigations for enteric fever?

A
  • blood and stool culture
110
Q

What is schistosomiasis?

A

Parasitic flatworm infection

111
Q

What is the presentation of schistosomiasis ?

A
  • Swimmer’s itch
  • Acute schistosomiasis syndrome: fever, urticaria, arthralgia, cough, diarrhoea
112
Q

Treatment of schistosomiasis

A

Praziquantel

113
Q

What is the most common cause of community acquired pneumonia?

A

Streptococcus pneumoniae

114
Q

What is the treatment of choice for non falciparum malaria?

A

Chloroquine

115
Q

What is the spread of hepatitis A?

A

Faecal-oral

116
Q

What is the spread of hepatitis C?

A

Parenteral, sex, vertical transmission

117
Q

What is the spread of Hep B?

A

Parenteral, sex, vertical transmission

118
Q

What is e coli

A

Gram negative rod

119
Q

Rice

A

Bacillus cereus

120
Q

What is the spread of Hepatitis E?

A

Faecal-oral

121
Q

What is haemophilus influenzae?

A

Gram negative rod

122
Q

Rusty sputum

A

Strep pneumoniae

123
Q

What causes syphilis?

A

Treponema pallidum

124
Q

Which vaccines are live attenuated?

A
  • MMR
  • BCG
  • influenza (intranasal)
  • polio
  • typhoid
  • yellow fever
  • Oral rotavirus
125
Q

India ink positive

A

Cryptococcus

126
Q

clue cell

A

Bacterial vaginosis

127
Q

What is the most common cause of diarrhoea in those with HIV?

A

Cryptosporidium

128
Q

What is the management of hospital acquired pneumonia?

A

Within 5 days of admission: co-amoxiclav or cefuroxime
More than 5 days after admission: piperacillin with tazobactam OR a broad-spectrum cephalosporin (e.g. ceftazidime) OR a quinolone (e.g. ciprofloxacin)

129
Q

What is the length of post exposure prophylaxis?

A

28 days

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