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Year 6 > Infectious disease > Flashcards

Infectious disease Flashcards

1
Q

Incubation period plasmodium falciparum

A

7-10 days

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2
Q

incubation period plasmodium vivax and ovale

A

10-17 days

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3
Q

Incubation period plasmodium malarium

A

18-40 days

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4
Q

Presentation of malaria

A

Flu like prodrome: headache, malaise, myalgia anorexia
Fever paroxysms: shivering <1h, then hot stage 2-6h with temp of 41 degrees, flushed, dry skin, headache N&V
Then sweating for 2-4h as temp falls

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5
Q

Signs of malaria

A

Anaemia
Jaundice
Hepatosplenomegaly
No rash. No lymph nodes

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6
Q

Complications of malaria

A

Cerebral malaria: confusion, coma, fits
Lactic acidosis
Hypoglycaemia
Acute renal failure due to acute tubuar necrosis
Acute respiratory distress syndrome

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7
Q

Investigations for malaria

A

Serial thick and thin blood films
parasitaemia levels
FBC for anaemia and thrombocytopaenia
ABG for lactic acidosis and glucose
U&Es to identify renal failure

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8
Q

Treatment for plasmodium falciparum malaria

A

Arthemeter-lumefantrine
= quinine + doxycycline

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9
Q

Side effects of choloroquine

A

Retinopathy

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10
Q

Sid effects of primaquine

A

Haemolysis if G6PD deficient

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11
Q

Traveller or undercooked minced beef and haemorrhagic diarrhoea?

A

EHEC E. COli (0157:H7) with shiga toxin
Dysentery and haemolytic uraemic syndrome
Mx = supportive, may need dialysis

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12
Q

Risks for infective endocarditits

A

Prosthetic valves
Degenerative valvulopathy
VSD, PDA, coarctation of aorta
Rheumatic fever
Dental problems
Post-op wounds
IV drug users (particularly to the tricuspid valve)
Immunocompromise

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13
Q

Major Duke’s criteria

A

Positive blood culture x2
Positive echo OR new valve regurgitation

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14
Q

Minor Duke’s criteria

A

Predisposition (cardiac lesion, IVDU)
Fever >38
Emboli: septic infarcts, splinters, Janeway lesion
Immune phenomena: glomerulonephritis, Osler nodes, Roth spots, renal failure
Positive blood culture not meeting major criteria

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15
Q

Antibiotic guidelines community acquired endocarditis native valve (or prosthetic valve after >12 months)

A

Amoxicillin +flucloxacillin +gentamicin

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16
Q

Early prosthetic valve endocarditis antibiotics

A

Vancomycin + gentamicin +rifampicin

17
Q

Where picked up hep A

A

faeco-oral spread, often in instritutions.
Incubation period 2-4 weeks

18
Q

Features of hep A

A

Flu like prodrome
Abdo pain esp RUQ
Tender hepatomegaly
Jaundice
Deranged LFTs

19
Q

Hep B transmission

A

Infected blood or fluids, and vertical transmission
Incubation period 6-20 weeks

20
Q

Features ad complications hep B

A

Fever, jaundice, incr liver transaminases initially
Complications
chronic hepatitis 5-10%
Fulminant liver failure 1%
Hepatocellular carcinoma
Glomerulonephritis
Polyarteritis nodosa
Cryoglobulinaemia

21
Q

Immunisation for Hep B

A

Children routinely vaccinated
At risk groups: health care, IVDU, contacts should be vaccinated
10-15% of adults fail to respond to 3 doses of vaccine, so those at risk of occupational exposure should be tested for adequate response. if inadequate, give adidtional vaccine dose.

22
Q

Pulmonary features of TB

A

cough, sputum
malaise
Fever, night sweats, weight loss
Haemoptysis
Pleurisy
Pleural effusion
Aspergilloma may form in TB cavities

23
Q

TB meningitis symptoms

A

Headache, drowsiness
Fever
Vomiting
Meningism
Worsening over 1-3 weeks
Papilloedema, CN palsies

24
Q

Non resp non meningeal TB manifestations

A

Lymph nodes: cervical lymphadenitis = scrofula
GU: frequency, dysuria, loin/back pain, haematuria, but apparently sterile
Bone: vertebral collapse and pott’s vertebra
Skin: lupus vulgaris
Peritoneal: abdominal pain, GI upset, ascites
Adrenal: Addison’s disease

25
Q

CXR for TB

A

Mainly upper lobes, consolidation, cavitaiton, fibrosis, calcification

26
Q

Latent TB testing

A

Tuberculin skin test
IF positive, then intaferon gamma release assays

27
Q

Management principals tb

A

If clinical picture consistent with TB, manage without culture
Stress importance of complicance
Check FBC and liver and renal function.
Test visual acuity and colour vision pre starting

28
Q

Rifampicin

A

Inihibits DNA dependent RNA polymerase
Se: hepatitis, orange urine and secretions. enzyme induction (OCP, steroids)

29
Q

Isoniazid

A

Inhibits mycolic acid synthesis
SE: hepatitis (accept ALT 5x ULN), peripheral sensory neuropathy, decr polymporphs

30
Q

Pyrazinamide

A

SE: hepatitis, arthralgia (gout)

31
Q

Ethambutol

A

Targets cell wall synthesis
SE: optic neuritis

32
Q

TB treatment regime

A

2 months RIPE: 4 months rifampicin and isoniazid. + pyridixamole (B6) to reduce periph neuropathy

33
Q

TB neuropathy treatment

A

RIPE for 2 months
Continuation RI for 10 months
+/- dexamethasone

Year 6 (9 decks)

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