Infectious disease Flashcards
Malaria Tx
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
Typically farmer, fever, transaminitis, atypical pneumonia, endocarditis.
Dx, Mx
Q Fever
Coxella burnetii (a rickettsia)
Typically farmer, fever, transaminitis, atypical pneumonia, endocarditis.
doxycycline
Traveller
Flu like illness.
Sudden onset high fever, rigors, N&V, bradycardia.
Brief remission then jaundice, haematemesis, oliguria
Dx
yellow fever
Retro Orbital headache, fever, facial flushing, rash, thrombocytopenia in returning traveller
dengue fever
Initially headache, fever, arthralgia ->
Relative bradycardia, abdo pain, constipation, rose spots on trunk
dx
Typhoid (Enteric fever)
Most asymp or resemble infectious mononucleosis. Can get headache/drowsy in imunocompromised
Ring enhancing lesions on CT
dxmx
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
Lymes disease features and mx
<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
Commonly sewqage workers, farmers, vets or in tropics (returning traveller). FLu like symptoms then more severe with AKI, Hepatitis aseptic meningitis
dx, mx
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
Parasitic fresh water worm - lake Malawi
Dx, mx
Schistosomiasis
Parasitic fresh water worm
Need praziquantel
Syphilis Mx and reaction with meds
Benzathine penicillin (fine in preg)
Treponema pallidum
Jarisch-Herxheimer reaction after Tx - fever, rash, tachy. Give antipyretics like paracetamol
Gonorrhea mx
Im ceftriaxone
Vulvovaginal swab
Disseminated gonococcal infection
Tenosynovitis, migratory polyarthritis, dermatitis
BV features and mx
Fishy like discharge, clue cells, ph>4.5, thin white discharge
Metronidazole
Pubic lice mx
malathion
Chlamydia test, mx
NAAT
Vulvovaginal swab
Doxycycline - treatment given on basis exposure rather than proven infection
In pregnancy - azithromycin, erythromycin, amoxicillin
Oral ulcers, genital ulcers, uveitis
Dx
Oral ulcer,s genital ulcers, uveitis
Genital wart tx
Multiple non keratoinised need topical podophyllum
SOlitary keratinised - cryotherapy
Trichomonas vaginalis
symptoms, mx
urethral discharge + dysuria.
Oral metronidazole
Human and animal bites meds
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
Tetanus symptoms and mx
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
Abx for otitis media
Amoxicillin
Sinusitis mx
<10d = no abx
10d + nasal steroids
10+ bacterial = Abx (pen V)
Sinusitis mx
<10d = no abx
10d + nasal steroids
10+ bacterial = Abx (pen V)
Cellulitis Abx - and if allergic to penicillins
Flucloxicillin or if allergy them erythromycin
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
Which pneumonia with target like lesions
Mycoplasma pneumonia
Legionella pneumonia features and mx
Legionella - urinary antigen test. Clarithromcyin/erythromycin. Dry cough, brady, confusion, deranged LFT,s ↓ Na
Which pneumonia ass with cold sores (reactivation HSV)
Pneumonia by strep pneumoniae is ass with cold sores
Atypical pneumonia - ABx
Atypical pneumonia = clarithromycin
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..
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
Abx choice in Meningitis <3/>3m
Benzylpenicillin then
<3m = cefotaxime + amoxicillin
>3m = ceftriaxone
Steroids reduce cx but not in meningococcal/septic shock or immunoc
Post exposure meds for meningitis
Ciprofloxacin if <7d
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
Meds for Campylobacter Jejuni gastroenteritis
Azizthromycin/ciprofloxacin
Meds for Campylobacter Jejuni gastroenteritis
Azizthromycin/ciprofloxacin
Meds for Campylobacter Jejuni gastroenteritis
Azizthromycin/ciprofloxacin
Bacillus cereus features
Rice
Vom 5h, diarrhea 8hr, resolution 24hours
Parasite, chronic diarrhea
Lethargy, bloating, flatulence, steatorrhoea
W; +/- recent travel
giardiasis
Consider in dysentry presentation after long incubation period
Gradual onset blood, abdo pain, tender, few weeks
amoebiasis
Profuse rice watery stool, WL
Hypoglycaemia
type, mx
Cholera
Profuse rice watery stool, WL
Hypoglycaemia
Doxy/ciprfloxacin
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
Testing HIV
P24 antigen + antibody testing in 4 week time and in 3months time
undercooked pork. Facial oral route. which hep
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