Infectious disease Flashcards
What are differentials for a shingles rash? What is 1st line treatment and usage?
Folliculitis, insect bites, cellulitis, allergic/irritant dermatitis, eczema herpeticum. Valaciclovir 1g TDS 7 day, Famciclovir 500mg TDS. Reduces pain, duration, ocular complications, not neuralgia. < 72hr in immunocompetent, always use in immunosuppressed.
What are the non-pharm aspects of shingles mx? How is neuralgia managed?
Cover rash, wash hands, avoid touching, avoid pregnant/infants/immunosuppresed. Lidocaine 5% patch if dry, simple analgesia, gabapentinoids 1st, oral steroids (50mg 1 week), amitriptyline at night or duloxetine in morning.
What are the features of history in a traveller with fever?
Where (city/rural, accomodation), when (climate, duration), what (animals, bites, food/water, sex/drugs/tattoos, sick contacts), immunisation history, prophylactic meds and repellents.
What traveller’s conditions cause fever + diarrhoea? Fever + resp? Hepatosplenomegaly?
FD: malaria, typhoid, dengue, hepatitis, cholera, traveller’s diarrhoea. FR: malaria, flu, pneumonia, TB. HS: malaria, typhoid, dengue.
Features of malaria, dengue, typhoid, chikingunya
M: fever, malaise, abdopain, anaemia. Test 3d in a row. D: acute fever, headache/eyes, macular rash (tourniquet), vomit, muscle/bone pain. T: Stepladder fever, abdo pain, low HR,rose spots on abdo. C:Fever, severe joint pain, muscle pain, rash.
How does EBV present? Differentials? Mx.
Fever, sore throat, lymphadenopathy, fatigue - usually 2-3 weeks. CMV, acute HIV, Group A strep, toxo, phenytoin, isoniazid, lymphoma. Mx: rest, simple analgesia, no contact sport 3-4 weeks, avoid sharing saliva.
What are the acute and chronic complications from EBV infection?
Morbilliform rash (penicillin), hepatitis, airway obstruction from swelling, spleen rupture. C: fatigue, chronic active EBV, cancer in transplant pt. Can cause anaemia, DIC, meningitis, GBS.
Q-fever - cause, symptoms, dx, tx, complications, vaccination.
Inhalation of aerosolised particles from animals, 2-4 weeks post. Atypical pneumonia, hepatitis or just fever. PCR early + serology. Doxy or self resolve. C: chronic q fever, hepatitis, endocarditis, post q-fever fatigue syndrome. If vax, do skin + serum test first as can react to vaccine.
Leptospirosis - transmission, symptoms, dx, tx.
From urine of animals, in NT. Fever, headache, rash, conjunctivitis, large muscle pains. PCR diagnose. Doxy treats, can self resolve.
Ross river virus - transmission, symptoms, duration.
Mosquitoes in Aus + NT/PNG. WIthin 3 weeks, polyarthritis, rash, fever headache. Joint pain can persist. Usually resolves in 6 mo.
Lyme disease features/cause. Brucellosis - transmission, symptoms, duration.
L: ticks in NA/europe. Erythema migrans (bullseye), fever, aches - later neuro/cardiac and arthritis. B: sheep/pigs, cut with infected fluid. Fever, headache, back pain, abdo inflammation. Resolve 2-4 weeks.
Features of TB screening tests? How/when to test for active TB? What tests after an exposure?
Interferon gamma release assay - not affected by BCG. Tuberculin ST - subdermal injection, read 72hr later, BCG affect. If positive, check symptoms do CXR. If CXR or symptoms do 3 early morning sputums for AFB. Post expo - either screening test first, repeat 8-12 weeks later.
How is latent TB treated? SE? When is BCG vaccine recommended?
Isoniazid: GI, acne, hepatotoxicity, peripheral neuropathy (Use B6 to prevent). Safe in under 35 and no liver disease. V: children < 5yo going to TB country for 4 weeks OR healthcare worker going somewhere recommended. Takes 3mo for effect.
How is traveller’s diarrhoea treated? Features and complications of mumps?
Azith 1G stat or norflox 800mg. Fever, headache then gland swelling within 48hr. Self limiting, risks: orchitis, meningitis, deafness.
What are 9 aspects of a pre-travel consult?
Food safety (avoid raw), water (bottled), wildlife/animals (rabies), swimming in contaminated water, blood viruses (tattoos, IVDU, sex), Road safety, Meds/first aid kit/know hospitals; stockings/walk on flight for DVT; mosquitoes: 15-30% DEET, sleeves, netting, avoid perfume, dusk/dawn.
