infectious disease

Question 1

Mx tick bites

Answer 1

Asx-> NIL tx needed

suspected/ confirmed Lyme disease:
- doxycycline if early diesease. (Amox- preg)
- if allergic to doxy-> amoxicillin

disseminated disease:
- ceftriaxone

Question 2

Tx disseminated Lyme disease

Answer 2

ceftriaxone

Question 3

Mx genital warts

Answer 3

topical podohyllum/ cryotx=> 1st line

topical- multiple lesion
single- cryotx

2nd line: imiquinod topical cream

Question 4

HCV Ix

Answer 4

Check HCV RAN
Pt eventually develop anti-HCV Ab -> even those who spontaneously recover continue to have anti-HCV Ab

Question 5

Definition of chronic HCV

Answer 5

persistent HCV RAN after 6 months

Question 6

Mx HCV + aim of therapy

Answer 6

undetectable serum HCV RAN 6months after end of tx

Protease inhibitors (daclatasvir + sofosbuvir or sofosbuvir + simprevir) +/- Ribavarin

Question 7

Vaccination HBV + checking levels

Answer 7

Children UK: routine HBV 2,3,4 months of age

At risk groups vaccinated

AntiHBs >100 adequate response, receive booster at 5yrs

10-100 suboptimal response one additional vaccine dose give

<10 non-responder, test for current or past infection, another 3 doses again If fails to respond then HBIg required for protection if exposed to virus

Question 8

Mx HBV

Answer 8

pegylated INF-a: reduced viral replication 1st line

Question 9

HBV serology: which indicates disease infectivity/ HBV replication

Answer 9

HBeAg

Question 10

HBV serology: which indicates pt infected by virus rather than vaccination

Answer 10

HBcAg

Question 11

HBV serology for vaccinated pt without infection

Answer 11

Anti-HBs (+)
ALL other HBcA/ HBeAg NEGATVIE

Question 12

Cause of Traveller’s diarrhoea

Answer 12

E Coli

Question 13

influenza vaccine in children: what type vaccine + route

Answer 13

children- live attenuated vaccine + given intranasal

Question 14

eg. of live attenuated vaccin

Answer 14

BCG, MMR, influenza (intranasa), por polio, yellow fever

Question 15

bacterial vaginosis pathogen

Answer 15

Gadrenerella

Question 16

Amsel criteria

Answer 16

Bacterial vaginosis

thin white homogenous discharge
CLUE cell
vag pH >4.5
(+) whiff test

Question 17

Bacterial vaginosis mx

Answer 17

Asx: nil mx

As: po metronidazole 4-7d
single po dose metronidazole 2g if adherence problem

Question 18

Characteristics of Legionella (incl lab findings FBC, UE)

Answer 18

flulike sx
Dry cough
HYPOnatraemia]derranged LFT
lymphopenia

with recent travel/ air conditioning system

Question 19

Legionella mx

Answer 19

erythromycin/ clarithromycin

Question 20

Mycoplasma pneumonia associated disease

Answer 20

atypical pneumonia affect younger pts

prolonged gradual onset
flulike sx
gold agglutins
erythema cultiform/ erythema nodosum.

Question 21

Dx Legionella

Answer 21

urinary Ag

Question 22

Dx Mycoplasma

Answer 22

mycoplasma serology
(+) cold agglutination test

Question 23

Mx Mycoplasma

Answer 23

Doxycyclin, erythromycin/ clarithromycin

Question 24

Listeria mx

Answer 24

Listeria monocytogenes grame (+) bacillus

Amoxicillin/ ampicillin

Listeria meningitis= iv amoxiciilin/ ampicillin + gent

Question 25

Dx Listeria monocytogenes

Answer 25

BC or culture from CSF
serological testing eg IgM limited use due to cross reactivitiy with other species and low snesitivity.

Question 27

Animal bite mx and with pen allergies

Answer 27

Co-amoxiclav
Doxycycline + metronidazole

Question 28

Rabies mx

Answer 28

Wound washed
If already immunised further 2 doses of vaccine should be given, if not preventable immunised- human rabies immunoglobulin given with full course of rabies