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clinical reasoning > infectious disease > Flashcards

infectious disease Flashcards

1
Q

examples of infectious disease

A
  • yellow fever
  • MERS
  • ebola virus
  • monkey pox
  • HFMD
  • dengue
  • avian influenza (bird flu)
  • AIDS/HIV
  • zika
  • influenza
  • tuberculosis
  • gastroentritis
  • COVID19
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2
Q

routes of transmission

A
  • air
  • physical contact
  • food
  • sexual contact
  • objects
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3
Q

factors associated with high rates of antimicrobial resistance

A
  • pressure on antibiotic use
  • severity of illness
  • numerous of invasive devices
  • length of hospital stay
  • immunosuppression
  • malnutrition
  • ease of cross transmission of antimicrobial resistant pathogens
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4
Q

areas at risk of infection

A
  • common waiting areas
  • procedure holding areas
  • examination rooms
  • procedure units
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5
Q

measures to minimise infection risk

A
  • hand hygiene
  • use of PPE
  • dept protocol
  • disinfect all equipment between cases
  • schedule infected patients at end of cases
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6
Q

main imaging investigation required for patients carrying or suspected of having a lung infection

A
  • chest radiography
  • CT imaging
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7
Q

what can pneumonia be classified into

A
  • community acquired pneumonia (CAP)
  • hospital acquired pneumonia (HAP)
  • ventilator-associated pneumonia (VAP)
  • healthcare associated pneumonia (HCAP)
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8
Q

how does chest radiograph with pneumonia look like

A
  • patchy shadowing
  • lobar density
  • absent/ ill-defind heart borders and hemidiaphragm
  • air bronchogram
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9
Q

why is CT strongly recommended for chest imaging

A
  • very sensitive to detecting early disease
  • assessing the nature and extent of lesions
  • discovering subtle changes that are often not visible on chest radiographs
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10
Q

factors used to describe imaging features of lesions

A
  • distribution
  • quantity
  • shape
  • pattern
  • density
  • concomitant signs
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11
Q

what is pneumothorax

A

visceral pleural line is visualised, paralleling the contour of the chest wall

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12
Q

what is atelectasis

A
  • increased density of atelactic portion of the lung and displaced of thorax structures
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13
Q

role of CT in pulmonary infections

A
  • lack of specificity in standard radiography alone especially in immunocompromised patients
  • ability to confirm any associated abnormalities such as lymphadenopathy, pleural effusion and/or empyema and any cavities
  • assist clinicians to make treatment decisions, especially in emergency and immunocompromised patients
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14
Q

predisposed vulnerable population groups to MSK infections

A
  • elderly and patients with comorbidities such as diabetes mellitus
  • end-stage renal failure and immunosuppressed states
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15
Q

plain radiography of msk infection assesses

A
  • osseous alignment and mineralisation
  • joint spaces
  • soft tissue
  • pertinent implants/ FB
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16
Q

osseous findings can be characterised as

A
  • periosteal reaction
  • erosions
  • osteolytic or osteoblastic lesions
  • fractures
17
Q

role of CT in msk infections

A

provides
- superior cross sectional and anatomical eval of bone
- particularly of cortical and trabecular anatomy with
- provision for multiplanar volumetric reconstructions

defines
- osseous erosions and destruction
- soft tissue gas inflammation and fluid collections which may not be detectable on radiographs

18
Q

advantages of using US for msk infections

A
  • provides good soft tissue contrast and spatial resolution
  • reliably distinguishing solid tissue and fluid collections
  • can screen for a joint effusion which is an early sign of an infected joint
  • non-ionising radiation, suited for paeds
19
Q

limitations of US for msk infections

A
  • highly operator dependent which directly dictates the propensity for false-neg and false-pos findings
  • has limited to no capacity to assess deep-seated or intra-osseous pathologies
20
Q

why is mri the preferred imaging modality in most msk infections

A
  • safe and non-ioninsing imaging modality
  • MPI
  • able to image edema and detect pathological processes
21
Q

limitations of mri in msk infection

A
  • expensive, long scanning times and limited availability
  • contra-indications such as presence of metallic implants/ cardiac pacemakers
  • patient factors: size, claustrophobic
22
Q

role of nuclear med in msk infection

A
  • locate multifocal or occult infections particularly the osseous rather than soft tissue infections
23
Q

spine infection classification

A
  • spondylodiscitis
  • epidural abscess
  • facet joint arthropathy
24
Q

radiologic imaging on spine infections

A
  • pyogenic
  • non-pyogenic
  • post procedural infections
25
Q

what is spondylodiscitis

A
  • infection of the vertebral body or disc and may also involve epidural space, posterior elements, and paraspinal soft tissues
26
Q

classic findings seen on radiographs for spondylodiscitis

A
  • reduced intervertebral disc height
  • endplate erosions
  • vertebral osteopenia
  • paraspinal soft tissue density
27
Q

symptoms of abdominal infections

A
  • acute, diffuse or focal abdominal pain
  • fever and chills, vomiting, altered bowel transit and general malaise
28
Q

common cause for abdominal pain or sepsis

A
  • appendicitis, enteritis, iletis, colitis, diverticulitis
  • urinary pathologies are pyelonephritis and perinephric abscess
  • biliary-pancreatic pathologies –> hepatitis, cholecystitis, cholangitis, liver abscess
29
Q

advantages of US in abdominal infection

A
  • no radiation exposure
  • relatively low cost
  • readily available
30
Q

disadvantages of US in abdominal infections

A

operator limitations

technical limitations
- adipose tissue thickness
- mobility
- cooperation
- bloating
- intense pain (affect adequate compression)

31
Q

role of CT in abdominal infections

A
  • speed –> avoids or drastically reduces patient motion artifact
  • high definition images with multiplanar reconstructions
  • completely independent of patient constitution and diagnosis is independent of operator
32
Q

how does DWI help in diagnosis of abdominal infections

A
  • differentiate between benign and malignant lesions, and between fluid collection and abscess
  • can highlight both oncological and non-oncological lesions
33
Q

appendicitis findings in US

A
  • alteration of density or echogenicity of pericolonic fat
  • presence of a coprolite obstructing the lumen at the level of the appendiceal origin
  • non compressible lumen of appendix
34
Q

pyogenic can be categorised into

A
  • micro or macro abcesses
  • single or multiple
35
Q

imaging features of pyelonephritis and perinephric abscess on mri

A
  • edema, hemorrhage, congestion of the parenchyma, abscesses and perirenal collections can be observed
  • inflammatory lesions and collections are hypointense on T1W and hyperintense on T2W
  • wedge-like hypovascular lesions with a focal or diffuse stretch-mark pattern
  • gadolinium helps to better visualise lesions

clinical reasoning (4 decks)

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