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MSRA > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

What is the treatment of choice for gonorrhoea?

A

Intramuscular ceftriaxone

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2
Q

How do we treat bacterial meningitis?

A

IV cefotaxime

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3
Q

How do we cover for animal or human bites?

A

Co-amox

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4
Q

How do we treat bacterial vaginosis?

A

Metronidazole 400mg BD for 7/7

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5
Q

A 30-year-old who is currently 27 weeks pregnant comes to see you about a thin, white discharge. Swabs are taken and clue cells are seen on microscopy. Dx?

A

Bacterial vaginosis

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6
Q

What is a disulfiram-like reaction?

A

The combination of metronidazole and ethanol can cause a disulfiram-like reaction. Clinical features of this include head and neck flushing, nausea and vomiting, sweatiness, headache and palpitations.

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7
Q

Which bacteria is often seen in under-re-heated rice?

A

Bacillus cereus

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8
Q

Which type of vaccine are contraindicated in HIV positive patients?

A

Live attenuated, e.g. TB, Yellow fever
Oral polio
Intranasal influenza
Varicella
Measles, mumps and rubella (MMR)

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9
Q

How do we treat trichomonas vaginalis?

A

oral metronidazole

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10
Q

What is trichomonas vaginalis?

A

Trichomonas vaginalis is a protozoan parasite that causes trichomoniasis, a sexually transmitted infection. Metronidazole is an antiprotozoal medication used to treat infections caused by protozoa such as Trichomonas vaginalis. It works by inhibiting nucleic acid synthesis by disrupting the DNA of microbial cells. In the UK, according to BASHH guidelines, oral metronidazole 2g single dose or 400mg twice daily for 5-7 days are recommended first-line treatments for trichomoniasis.

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11
Q

A 30-year-old woman is admitted with pneumonia to hospital. She has a fever and a dry cough. On examination erythema multiforme is noted and bloods show she has a normocytic anaemia. What is the most likely causative organism?

A

Mycoplasma pneumoniae causes haemolysis

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12
Q

How do we treat genital herpes?

A

Oral aciclovir

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13
Q

How does legionella affect U&Es?

A

Hyponatraemia - inappropriate secretion of antidiuretic hormone secondary to bacterial pneumonia, Vasopressin decreases water excretion by the kidneys. As a result, more water is retained in the body, which dilutes the level of sodium in the body.

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14
Q

What is the most common cause of cold sores?

A

Herpes simplex virus type 1.

Type 2 often causes genital herpes

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15
Q

Where do you see rose spots on the abdomen?

A

Salmonella typhi infection can cause rose spots on the abdomen

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16
Q

How do we test for Lyme disease?

A

ELISA (blood test for serology) is the first-line investigation for suspected Lyme disease in patients with no history of erythema migrans

17
Q

Which organism causes syphilis?

A

Treponema pallidum

18
Q

How does syphilis present?

A

The first stage typically involves a painless genital ulcer (chancre), as reported by the patient two months ago. The second stage, which can occur weeks to months after the initial infection, is characterised by a widespread maculopapular rash and mucosal lesions such as mouth ulcers.

19
Q

How do we treat pneumocystis jiroveci pneumonia?

A

Pneumocystis jiroveci penumonia is treated with co-trimoxazole, which is a mix of trimethoprim and sulfamethoxazole

20
Q

What causes infectious mononucleosis?

A

Infectious mononucleosis (glandular fever) is caused by the Epstein-Barr virus (EBV, also known as human herpesvirus 4, HHV-4) in 90% of cases. Less frequent causes include cytomegalovirus and HHV-6. It is most common in adolescents and young adults.

21
Q

How does mono present?

A

The classic triad of sore throat, pyrexia and lymphadenopathy is seen in around 98% of patients:
sore throat
lymphadenopathy: may be present in the anterior and posterior triangles of the neck, in contrast to tonsillitis which typically only results in the upper anterior cervical chain being enlarged
pyrexia

22
Q

Which rash can sometimes be seen in infectious mononucleosis?

A

A maculopapular, pruritic rash develops in around 99% of patients who take ampicillin/amoxicillin whilst they have infectious mononucleosis

23
Q

How do we diagnose mono?

A

Monospot test

heterophil antibody test (Monospot test)
NICE guidelines suggest FBC and Monospot in the 2nd week of the illness to confirm a diagnosis of glandular fever.

24
Q

How do we manage mono?

A

Management is supportive and includes:
rest during the early stages, drink plenty of fluid, avoid alcohol
simple analgesia for any aches or pains
consensus guidance in the UK is to avoid playing contact sports for 4 weeks after having glandular fever to reduce the risk of splenic rupture

25
Q

The parents of a 19-year-old man have just been messaged by their son who is currently backpacking in Thailand. Earlier in the day he was bitten by a dog whilst staying in a rural community. Prior to travelling, he received vaccination against rabies as he was going to be visiting many rural areas. What is the most appropriate advice?

A

He should urgently seek local medical attention, for the consideration of abx and further booster vaccination

26
Q

What is the main side effect to be aware of for ethambutol?

A

E for eyes (optic neuritis)

27
Q

What can pyrazinamide cause?

A

Gout

28
Q

What is the main side effect to be aware of for isoniazid?

A

IsoNERVEzid - peripheral neuropathy

29
Q

How do we treat positive syphilis in pregnancy?

A

IM benzathine penicillin G

30
Q

What is Kaposi’s sarcoma?

A

Kaposi’s sarcoma
caused by HHV-8 (human herpes virus 8)
presents as purple papules or plaques on the skin or mucosa (e.g. gastrointestinal and respiratory tract)
skin lesions may later ulcerate
respiratory involvement may cause massive haemoptysis and pleural effusion

31
Q

How do we treat Kaposi’s sarcoma?

A

radiotherapy + resection

32
Q

How would cryptococcus neoformans present on LP?

A

cryptococcus neoformans stains well with india ink allowing it to be detected on a lumbar puncture

33
Q

How does mycoplasma pneumoniae present?

A

Stereotypical history of mycoplasma pneumonia: worsening flu-like symptoms and a dry cough. Erythema multiforme is noted on examination

34
Q

Should you treat asymptomatic bacteria in catheterised patients?

A

No

35
Q

Where do you see strawberry cervix?

A

Trichomonas

36
Q

What are Amsel’s criteria for BV?

A

Amsel’s criteria for diagnosis of BV - 3 of the following 4 points should be present
thin, white homogenous discharge
clue cells on microscopy: stippled vaginal epithelial cells
vaginal pH > 4.5
positive whiff test (addition of potassium hydroxide results in fishy odour)

37
Q

What causes disulfiram-like reaction?

A

These effects are caused by accumulation of acetaldehyde, a major but toxic metabolite of alcohol formed by the enzyme alcohol dehydrogenase

38
Q
A

MSRA (21 decks)

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