Infectious disease Flashcards
Incubation period plasmodium falciparum
7-10 days
incubation period plasmodium vivax and ovale
10-17 days
Incubation period plasmodium malarium
18-40 days
Presentation of malaria
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
Signs of malaria
Anaemia
Jaundice
Hepatosplenomegaly
No rash. No lymph nodes
Complications of malaria
Cerebral malaria: confusion, coma, fits
Lactic acidosis
Hypoglycaemia
Acute renal failure due to acute tubuar necrosis
Acute respiratory distress syndrome
Investigations for malaria
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
Treatment for plasmodium falciparum malaria
Arthemeter-lumefantrine
= quinine + doxycycline
Side effects of choloroquine
Retinopathy
Sid effects of primaquine
Haemolysis if G6PD deficient
Traveller or undercooked minced beef and haemorrhagic diarrhoea?
EHEC E. COli (0157:H7) with shiga toxin
Dysentery and haemolytic uraemic syndrome
Mx = supportive, may need dialysis
Risks for infective endocarditits
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
Major Duke’s criteria
Positive blood culture x2
Positive echo OR new valve regurgitation
Minor Duke’s criteria
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
Antibiotic guidelines community acquired endocarditis native valve (or prosthetic valve after >12 months)
Amoxicillin +flucloxacillin +gentamicin
Early prosthetic valve endocarditis antibiotics
Vancomycin + gentamicin +rifampicin
Where picked up hep A
faeco-oral spread, often in instritutions.
Incubation period 2-4 weeks
Features of hep A
Flu like prodrome
Abdo pain esp RUQ
Tender hepatomegaly
Jaundice
Deranged LFTs
Hep B transmission
Infected blood or fluids, and vertical transmission
Incubation period 6-20 weeks
Features ad complications hep B
Fever, jaundice, incr liver transaminases initially
Complications
chronic hepatitis 5-10%
Fulminant liver failure 1%
Hepatocellular carcinoma
Glomerulonephritis
Polyarteritis nodosa
Cryoglobulinaemia
Immunisation for Hep B
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.
Pulmonary features of TB
cough, sputum
malaise
Fever, night sweats, weight loss
Haemoptysis
Pleurisy
Pleural effusion
Aspergilloma may form in TB cavities
TB meningitis symptoms
Headache, drowsiness
Fever
Vomiting
Meningism
Worsening over 1-3 weeks
Papilloedema, CN palsies
Non resp non meningeal TB manifestations
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
