Infectious Disease Flashcards
Chlamydia:
management (1)
How to treat Chlamydia in pregnancy
doxycycline (7 day course) if first-line
Pregnancy: Azithromycin, erythromycin or amoxicillin
investigation of choice chlamydia
NAT test (nuclear acid amplification tests)
CF: most common cause of pneumonia
Pseudomonas > Staphylococcus aureus > Haemophilus influenzae > Legionella > Klebsiella.
Meningitis management
IV CEFOTAXIME
3 months - 50 years: BNF recommends cefotaxime (or ceftriaxone)
> 50 years: BNF recommends cefotaxime (or ceftriaxone) + amoxicillin (or ampicillin) for adults
Trichomonas vaginalis treatment (1)
pH (1)
discharge (1)
metronidazole
4.5
green
UTI and catehter
DONT treat unless symptoms even with positive MSU
Bacterial vaginosis management (1)
in pregnancy (1)
metronidazole
SAME
Campylobacter jejuni: management (1)
what is it associated with (1)
usually selt limiting
if v unwell/ immunocomprimsied –> calrithromycin
there are always mice (ClarithroMYCin) at the camp (CAMPylobacter)
A/W Guillain barre
reactive arthritis
septicaemia
endocarditis
arthritis
HPV vaccine age
all 12-13yo
how long to take ART for after needlestick
4 weeks
BV - what cells
clue cells
BV - alterative treatment to metronidazole
topical clindamycin
Staphylococcus aureus gastroenteritis is characterised by
a short incubation period and severe vomiting
Erythema chronicum migrans
(‘bulls-eye’) rash occurs in around 80% of patients with Lyme disease
which common vaccine is an inactivated preparation of the organism or virus?
influenza
how many doses of tetanus is enough
5 doses of tetanus vaccine, with the last dose < 10 years ago, they don’t require a booster vaccine nor immunoglobulins, regardless of how severe the wound is
Bacterial vaginosis (BV) is overgrowth of what organisms
anaerobic organisms such as Gardnerella vaginalis.l
Lyme disease management
14-21 day course of oral doxycycline
meningitis prophylaxis for contacts
Oral ciprofloxacin or rifampicin is used as prophylaxis for contacts of patients with meningococcal meningitis
Genital wart treatment
Genital wart treatment
multiple, non-keratinised warts: topical podophyllum
solitary, keratinised warts: cryotherapy
most common cause travellers diarrhoea
E Coli
Trichomonas vaginalis + bacterial vaginosis are associated with a pH
> 4.5
Live attenuated vaccines
BCG
MMR
oral polio
yellow fever
oral typhoid
incubation periods
Incubation period
1-6 hrs: Staphylococcus aureus, Bacillus cereus*
12-48 hrs: Salmonella, Escherichia coli
48-72 hrs: Shigella, Campylobacter
> 7 days: Giardiasis, Amoebiasis
Lyme disease in pregnnacy
amoxicillin
how long ABx in UTI in pregnancy
7 days
uncertain tetanus vaccine Hx?
given a booster vaccine + immunoglobulin unless very very minor
Lyme disease investigation
blood test for serology (ELISA)
if negative and Lyme disease is still suspected in people tested within 4 weeks from symptom onset, repeat the ELISA 4-6 weeks after the first ELISA test. If still suspected in people who have had symptoms for 12 weeks or more then an immunoblot test should be done
if positive or equivocal then an immunoblot test for Lyme disease should be done
mastitis during breast feeding
flucloxacillin
EBV malignancies
Burkitt’s lymphoma
Hodgkin’s lymphoma
nasopharyngeal carcinoma
HIV: kaposi 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
radiotherapy + resection
Typhoid is caused by…
Salmonella typhi
features of typhoid
initially systemic upset as above
relative bradycardia
abdominal pain, distension
constipation: although Salmonella is a recognised cause of diarrhoea, constipation is more common in typhoid
rose spots: present on the trunk in 40% of patients, and are more common in paratyphoid
complications of typhoid
osteomyelitis (especially in sickle cell disease where Salmonella is one of the most common pathogens)
GI bleed/perforation
meningitis
cholecystitis
chronic carriage (1%, more likely if adult females)
Latent TB CXR
CXR: A small (1-2cm) calcified nodule is visible in the lateral area of the right mid zone.
(Ghon complex)
Clostidia
C. perfringens
produces α-toxin, a lecithinase, which causes gas gangrene (myonecrosis) and haemolysis
features include tender, oedematous skin with haemorrhagic blebs and bullae. Crepitus may present on palpation
C. botulinum
typically seen in canned foods and honey
prevents acetylcholine (ACh) release leading to flaccid paralysis
C. difficile
causes pseudomembranous colitis, typically seen after the use of broad-spectrum antibiotics
produces both an exotoxin and a cytotoxin
C. tetani
produces an exotoxin (tetanospasmin) that prevents the release of glycine from Renshaw cells in the spinal cord causing a spastic paralysis
HIV patients and vaccines
no live vaccines
sewage workers, farmers, vets or people who work in an abattoir (rat urine)
Leptospirosis (Weil’s disease)
Leptospirosis features
the early phase is due to bacteraemia and lasts around a week
may be mild or subclinical
fever
flu-like symptoms
subconjunctival suffusion (redness)/haemorrhage
second immune phase may lead to more severe disease (Weil’s disease)
acute kidney injury (seen in 50% of patients)
hepatitis: jaundice, hepatomegaly
aseptic meningitis
Leptospirosis management
diagnosis= SEROLOGY
management= DOXYCYCLINE/ azithromycin
severe= IV benpen
Legionella and mycoplasma treatment
macrolide (erythromycin)w
when to do ELISA for ?Lyme
if SYMPTOMATIC (otherwise don’t bother)
You are reviewing a 31-year-old man in the liver clinic. He is currently on triple therapy for hepatitis C. What is the best way to assess his response to treatment?
viral load
BV treatment if can’t have metronidazole
clindamycin
slapped cheek/ parvoivirus in pregnancy
hydrops fetalis
parvovirus B19 in pregnant women can cross the placenta in pregnant women
this causes severe anaemia due to viral suppression of fetal erythropoiesis → heart failure secondary to severe anaemia → the accumulation of fluid in fetal serous cavities (e.g. ascites, pleural and pericardial effusions)
treated with intrauterine blood transfusions
Borrelia burgdorferi
Lyme
when to treat Lyme
start doxycycline 14-21 days (and send serology for Berrelia burgorderi)- DON’T wait for serology result
cefalexin in pregnancy
OK
