Infectious disease Flashcards
Examples of inactivated vaccines
Polio
Flu
Hepatitis A
Rabies
Examples of conjugate vaccines
Pneumococcus
Menigococcus
Hepatitis B
Pertussis - whooping cough
Haemophilus influenza
HPV
Shingles
Examples of live attenuated vaccines
MMR
BCG
Chicken pox
Nasal influenza
Rotavirus
Clinical signs of sepsis
Deranged physical observations
Prolonged capillary refill time
Fever or hypothermia
Deranged behaviour
Poor feeding
Inconsolable or high pitched weak cry
Reduced consciousness
Reduced tone - floppy
Skin colour changes - cyanosis, mottled, ashen
Immediate management of sepsis
Oxygen
IV access
Blood cultures
Bloods - FBC, UE, CRP, Clotting, gas lactate acidosis
Urine dip and culture
Antibiotics -
IV fluids 20ml/kg bolus
Prolonged management of sepsis
CXR
Abdo and pelvic ultra sound
Lumbar puncture
Meningococcal PCR
Serum cortisol
Define meningitis
Inflammation of the meninges
Common organism in meningitis
Neisseria meningitidis
Streptoccus pneumoniae
Group B strep - neonates
Presentation of meningitis
Fever
Neck stiffness
Vomiting
Headache
Photophobia
Altered consciousness
Seizures
Non blanching rash
Hypotonia
Poor feeding
Lethargy
Hypothermia
Bulging fontanelle
Investigation in meningitis
LP
Kernig’s test
Brudzinski’s
Define Kernig’s test
Patient lying on back, flex hip and knee to 90 then slowly extend knee
Stretches meninges - pain or reduced movement
Define Brudzinski’s test
Lie patient on back and lift head and neck off the bed - flex chin to chest
Positive test will demonstrate flexion at the hips and knees
Community management of meningitis
Benzylpenicillin IM
Management of meningitis
LP
Menigoncoccal PCR
<3 months - cefotaxime plus amoxicillin
>3 months - ceftriaxone
Steroids
Management of meningitis close contacts
Single dose Ciprofloxacin within 24 hours
LP appearance in bacterial meningitis
Cloudy
High protein
low glucose
High white cells
Culture +ve bacteria
CSF appearance in viral meningitis
Clear
Normal proein
Normal glucose
High white cells
Negative culture
Define encephalitis
Inflammation of the brain!
Most commonly viral infection but can be anything
Presentation of encephalitis
Altered consciousness
Altered cognition
Unusual behaviour
Acute onset
Focal neurological symptoms
Focal seizure
Fever
Investigations in encephalitis
LP - PCR testing
CT scan
MRI
EEG
Swabs
HIV testing
Management of encephalitis
Acivlovir - herpes simplex virus
Ganciclovir - CMV
Repeat LP
Define infectious mononucleosis
Condition caused by infection with EBV - kissing disease, glandular fever, mono - dound in saliva of infected individuals spread by kissing sharing cups toothbrushes
Features of infectious mononucleosis
Fever
Sore throat
Fatigue
Lymphadenopathy
Tonsillar enlargement
Splenomegaly - rupture!
Investigations in infectious mononucleosis
Monospot test
Paul-Bunnell test
Antibody tests - viral capsid antigen
Management of infectious mononucleosis
Self limiting
Supportive care
Avoid alcohol
Avoid contact sports
Define mumps
Viral infection spread by respiratory droplets -
Presentation of mumps
Flu like prodrome
Parotid swelling
Fever
Muscle ahces
Lethargy
Reduced appetite
Headache
Dry mouth
Abdo pain - pancreatitis
Testicular pain - orchitis
Confusion - meningitis, encephalitis
Management of mumps
PCR and antibody testing
Notifiable
Supportive management
Complications of mumps
Pancreatitis
Orchitis
Meningitis
Sensorineural hearing loss
Define HIV
Human immunodeficiency virus - causes infection that makes someone immunocompromised. Leads to the sundrome AIDS
When is HIV spread
Unprotected anal, vaginal or oral sexual activity
Mther to child at any stage of pregnancy, birth or breast feeding
Mucous membranes - sharing needles, blood contact
HIV prevention during birth
Viral load <50 copies/ml - normal vaginal delivery
> 50 - consider caesarean
>400 - caesarean
>10000 - IV zidovudine
When to test for HIV
Babies to HIV +ve parents - tested at 3 and 24 month
Immunodeficiency is suspected - unusual severe or frequent infection
Young people who are sexually active and concerned
Other risk factors - needle stick, sexual abuse, IVDU
Management of HIV
Antiretroviral therapy
Vaccines
Prophylactic co-trimoxazole
Treat infections
Define Hepatitis B
DNA virus transmitted by contact with blood or bodily fluids
What does HBsAg suggest
Active infection
What does HBeAg suggest
Marker of viral replication and implies high infectivity
What does HBcAb suggest
Implies past or current infection
What does HBsAb suggest
Vaccination or past or current infection
What does HBV DNA suggest
Direct count of viral load
When to test for hepatitis
Children of hep B +ve mums
Migrants from endemic areas
Close contacts
Management of hep B
Often asymptomatic
Regular monitoring
Antivirals?
Define Hep C
RNA virus spread by blood and body fluids
