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Difficult Passmed- MLA > Infectious disease > Flashcards

Infectious disease Flashcards

1
Q

Malaria Tx

A

Chloroquine sensitive areas - ACT or chloroquine
If chloroquine res - ACT (Artemisinin based combo therapy)
In ovale/vivax then primaquine after acute tx to destroy hypnozoites + prevent rlapse

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2
Q

Typically farmer, fever, transaminitis, atypical pneumonia, endocarditis.

Dx, Mx

A

Q Fever
Coxella burnetii (a rickettsia)
Typically farmer, fever, transaminitis, atypical pneumonia, endocarditis.
doxycycline

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3
Q

Traveller
Flu like illness.
Sudden onset high fever, rigors, N&V, bradycardia.
Brief remission then jaundice, haematemesis, oliguria

Dx

A

yellow fever

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4
Q

Retro Orbital headache, fever, facial flushing, rash, thrombocytopenia in returning traveller

A

dengue fever

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5
Q

Initially headache, fever, arthralgia ->
Relative bradycardia, abdo pain, constipation, rose spots on trunk

dx

A

Typhoid (Enteric fever)

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6
Q

Most asymp or resemble infectious mononucleosis. Can get headache/drowsy in imunocompromised
Ring enhancing lesions on CT

dxmx

A

Toxoplasmosis
Most asymp or resemble infectious mononucleosis. Can get headache/drowsy in imunocompromised
Ring enhancing lesions on CT

Only Tx in immunosuppressed - pyrimethamine + sulphdiazine at least 6 weeks

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7
Q

Lymes disease features and mx

A

<30d - erythema migrans bulls eye rash, systemic features.
>30d = CV (heart block, peri/myocarditis), neuro
Dx is clinical but Start Abx (ELISA is test)
Doxy
Jarish-Herxheimer reaction can occur

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8
Q

Commonly sewqage workers, farmers, vets or in tropics (returning traveller). FLu like symptoms then more severe with AKI, Hepatitis aseptic meningitis

dx, mx

A

Leptospirosis
Commonly sewqage workers, farmers, vets or in tropics (returning traveller). FLu like symptoms then more severe with AKI, Hepatitis aseptic meningitis
High dose benzylpenicillin or doxycycline

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9
Q

Parasitic fresh water worm - lake Malawi

Dx, mx

A

Schistosomiasis
Parasitic fresh water worm
Need praziquantel

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10
Q

Syphilis Mx and reaction with meds

A

Benzathine penicillin (fine in preg)
Treponema pallidum
Jarisch-Herxheimer reaction after Tx - fever, rash, tachy. Give antipyretics like paracetamol

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11
Q

Gonorrhea mx

A

Im ceftriaxone
Vulvovaginal swab

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12
Q

Disseminated gonococcal infection

A

Tenosynovitis, migratory polyarthritis, dermatitis

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13
Q

BV features and mx

A

Fishy like discharge, clue cells, ph>4.5, thin white discharge
Metronidazole

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14
Q

Pubic lice mx

A

malathion

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15
Q

Chlamydia test, mx

A

NAAT
Vulvovaginal swab
Doxycycline - treatment given on basis exposure rather than proven infection
In pregnancy - azithromycin, erythromycin, amoxicillin

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16
Q

Oral ulcers, genital ulcers, uveitis

Dx

A

Oral ulcer,s genital ulcers, uveitis

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17
Q

Genital wart tx

A

Multiple non keratoinised need topical podophyllum
SOlitary keratinised - cryotherapy

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18
Q

Trichomonas vaginalis
symptoms, mx

A

urethral discharge + dysuria.
Oral metronidazole

19
Q

Human and animal bites meds

A

Human/ animal bites need Co-amoxiclav
Consider tetanus in animals
Clean, don’t suture puncture wounds unless cosmesis at risk
In human bites consider HIV/Hep c risk

20
Q

Tetanus symptoms and mx

A

tetanus: Fever, facial spasms, dysphagia. Iv IVDUNo booster if had vaccines in last 10 yearsIf last dose >10d ago then in a prone wound will need vaccine reinforcing and if high risk then vaccine + immunoglobulin If hx unknown then reinforce vaccine regardless severity and if prone then Vacc + IgG

21
Q

Abx for otitis media

A

Amoxicillin

22
Q

Sinusitis mx

A

<10d = no abx
10d + nasal steroids
10+ bacterial = Abx (pen V)

22
Q

Sinusitis mx

A

<10d = no abx
10d + nasal steroids
10+ bacterial = Abx (pen V)

23
Q

Cellulitis Abx - and if allergic to penicillins

A

Flucloxicillin or if allergy them erythromycin

24
UTi Mx
3d = simple UTI in female 5-10d = immunosuppressed F 7d= men/preg/catheter Pyelonephritis = 7-10d Trimethoprim/ nitrofurantoin(P) N Unless close to term then trimethroprim
25
Which pneumonia with target like lesions
Mycoplasma pneumonia
26
Legionella pneumonia features and mx
Legionella - urinary antigen test. Clarithromcyin/erythromycin. Dry cough, brady, confusion, deranged LFT,s ↓ Na
27
Which pneumonia ass with cold sores (reactivation HSV)
Pneumonia by strep pneumoniae is ass with cold sores
28
Atypical pneumonia - ABx
Atypical pneumonia = clarithromycin
29
TB tests for latent
Manntoux test >5mm = previous immunological response IGRAs confirm latent in M+ False negative - can be from long temr prednisolone, AIDs, lymphoma, fever, anaemia..
30
Latent vs active TB tx
Latent= Isoniazid + rifampicin = 3m or Isoniazid 6m Active= Rifampicin + Isoniazid for 6m AND Pyrazinamide + Ethambutol for 2m R= Red/orange urine I= Peripheral neuropathy so take pyridoxine also P = ↑ uric acid E = ↓ visual acuity
31
Abx choice in Meningitis <3/>3m
Benzylpenicillin then <3m = cefotaxime + amoxicillin >3m = ceftriaxone Steroids reduce cx but not in meningococcal/septic shock or immunoc
32
Post exposure meds for meningitis
Ciprofloxacin if <7d
33
When to give Abx before LP in meningitis
LP before Abx unless: cant be done <1hr, signs severe sepsis or rapidly evolving rash, singifiant bleeding risk, signs raised ICP
34
Meds for Campylobacter Jejuni gastroenteritis
Azizthromycin/ciprofloxacin
35
Meds for Campylobacter Jejuni gastroenteritis
Azizthromycin/ciprofloxacin
36
Meds for Campylobacter Jejuni gastroenteritis
Azizthromycin/ciprofloxacin
37
Bacillus cereus features
Rice Vom 5h, diarrhea 8hr, resolution 24hours
38
Parasite, chronic diarrhea Lethargy, bloating, flatulence, steatorrhoea W; +/- recent travel
giardiasis
39
Consider in dysentry presentation after long incubation period Gradual onset blood, abdo pain, tender, few weeks
amoebiasis
40
Profuse rice watery stool, WL Hypoglycaemia type, mx
Cholera Profuse rice watery stool, WL Hypoglycaemia Doxy/ciprfloxacin
41
Hep B post exposure prophylaxis
If positive - if known responder to vaccine then booster and If non responder then vacc + immunoglobulin If unknown on patient if they have it: You are known repsonder then booster, if known non responder then accelerated course
42
Testing HIV
P24 antigen + antibody testing in 4 week time and in 3months time
43
undercooked pork. Facial oral route. which hep
E

Difficult Passmed- MLA (26 decks)

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