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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
Q

UTi Mx

A

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
Q

Which pneumonia with target like lesions

A

Mycoplasma pneumonia

26
Q

Legionella pneumonia features and mx

A

Legionella - urinary antigen test. Clarithromcyin/erythromycin. Dry cough, brady, confusion, deranged LFT,s ↓ Na

27
Q

Which pneumonia ass with cold sores (reactivation HSV)

A

Pneumonia by strep pneumoniae is ass with cold sores

28
Q

Atypical pneumonia - ABx

A

Atypical pneumonia = clarithromycin

29
Q

TB tests for latent

A

Manntoux test >5mm = previous immunological response
IGRAs confirm latent in M+

False negative - can be from long temr prednisolone, AIDs, lymphoma, fever, anaemia..

30
Q

Latent vs active TB tx

A

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
Q

Abx choice in Meningitis <3/>3m

A

Benzylpenicillin then
<3m = cefotaxime + amoxicillin
>3m = ceftriaxone
Steroids reduce cx but not in meningococcal/septic shock or immunoc

32
Q

Post exposure meds for meningitis

A

Ciprofloxacin if <7d

33
Q

When to give Abx before LP in meningitis

A

LP before Abx unless: cant be done <1hr, signs severe sepsis or rapidly evolving rash, singifiant bleeding risk, signs raised ICP

34
Q

Meds for Campylobacter Jejuni gastroenteritis

A

Azizthromycin/ciprofloxacin

35
Q

Meds for Campylobacter Jejuni gastroenteritis

A

Azizthromycin/ciprofloxacin

36
Q

Meds for Campylobacter Jejuni gastroenteritis

A

Azizthromycin/ciprofloxacin

37
Q

Bacillus cereus features

A

Rice
Vom 5h, diarrhea 8hr, resolution 24hours

38
Q

Parasite, chronic diarrhea
Lethargy, bloating, flatulence, steatorrhoea
W; +/- recent travel

A

giardiasis

39
Q

Consider in dysentry presentation after long incubation period
Gradual onset blood, abdo pain, tender, few weeks

A

amoebiasis

40
Q

Profuse rice watery stool, WL
Hypoglycaemia

type, mx

A

Cholera
Profuse rice watery stool, WL
Hypoglycaemia
Doxy/ciprfloxacin

41
Q

Hep B post exposure prophylaxis

A

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
Q

Testing HIV

A

P24 antigen + antibody testing in 4 week time and in 3months time

43
Q

undercooked pork. Facial oral route. which hep

A

E

Difficult Passmed- MLA (26 decks)

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