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MSRA > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Chlamydia:
management (1)
How to treat Chlamydia in pregnancy

A

doxycycline (7 day course) if first-line

Pregnancy: Azithromycin, erythromycin or amoxicillin

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2
Q

investigation of choice chlamydia

A

NAT test (nuclear acid amplification tests)

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3
Q

CF: most common cause of pneumonia

A

Pseudomonas > Staphylococcus aureus > Haemophilus influenzae > Legionella > Klebsiella.

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4
Q

Meningitis management

A

IV CEFOTAXIME

3 months - 50 years: BNF recommends cefotaxime (or ceftriaxone)
> 50 years: BNF recommends cefotaxime (or ceftriaxone) + amoxicillin (or ampicillin) for adults

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5
Q

Trichomonas vaginalis treatment (1)
pH (1)
discharge (1)

A

metronidazole
4.5
green

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6
Q

UTI and catehter

A

DONT treat unless symptoms even with positive MSU

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7
Q

Bacterial vaginosis management (1)
in pregnancy (1)

A

metronidazole
SAME

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8
Q

Campylobacter jejuni: management (1)
what is it associated with (1)

A

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

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9
Q

HPV vaccine age

A

all 12-13yo

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10
Q

how long to take ART for after needlestick

A

4 weeks

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11
Q

BV - what cells

A

clue cells

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12
Q

BV - alterative treatment to metronidazole

A

topical clindamycin

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13
Q

Staphylococcus aureus gastroenteritis is characterised by

A

a short incubation period and severe vomiting

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14
Q

Erythema chronicum migrans

A

(‘bulls-eye’) rash occurs in around 80% of patients with Lyme disease

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15
Q

which common vaccine is an inactivated preparation of the organism or virus?

A

influenza

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16
Q

how many doses of tetanus is enough

A

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

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17
Q

Bacterial vaginosis (BV) is overgrowth of what organisms

A

anaerobic organisms such as Gardnerella vaginalis.l

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18
Q

Lyme disease management

A

14-21 day course of oral doxycycline

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19
Q

meningitis prophylaxis for contacts

A

Oral ciprofloxacin or rifampicin is used as prophylaxis for contacts of patients with meningococcal meningitis

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20
Q

Genital wart treatment

A

Genital wart treatment
multiple, non-keratinised warts: topical podophyllum
solitary, keratinised warts: cryotherapy

21
Q

most common cause travellers diarrhoea

A

E Coli

22
Q

Trichomonas vaginalis + bacterial vaginosis are associated with a pH

A

> 4.5

23
Q

Live attenuated vaccines

A

BCG
MMR
oral polio
yellow fever
oral typhoid

24
Q

incubation periods

A

Incubation period
1-6 hrs: Staphylococcus aureus, Bacillus cereus*
12-48 hrs: Salmonella, Escherichia coli
48-72 hrs: Shigella, Campylobacter
> 7 days: Giardiasis, Amoebiasis

25
Q

Lyme disease in pregnnacy

A

amoxicillin

26
Q

how long ABx in UTI in pregnancy

A

7 days

27
Q

uncertain tetanus vaccine Hx?

A

given a booster vaccine + immunoglobulin unless very very minor

28
Q

Lyme disease investigation

A

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

29
Q

mastitis during breast feeding

A

flucloxacillin

30
Q

EBV malignancies

A

Burkitt’s lymphoma
Hodgkin’s lymphoma
nasopharyngeal carcinoma

31
Q

HIV: kaposi sarcoma

A

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

32
Q

Typhoid is caused by…

A

Salmonella typhi

33
Q

features of typhoid

A

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

34
Q

complications of typhoid

A

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)

35
Q

Latent TB CXR

A

CXR: A small (1-2cm) calcified nodule is visible in the lateral area of the right mid zone.

(Ghon complex)

36
Q

Clostidia

A

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

37
Q

HIV patients and vaccines

A

no live vaccines

38
Q

sewage workers, farmers, vets or people who work in an abattoir (rat urine)

A

Leptospirosis (Weil’s disease)

39
Q

Leptospirosis features

A

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

40
Q

Leptospirosis management

A

diagnosis= SEROLOGY

management= DOXYCYCLINE/ azithromycin
severe= IV benpen

41
Q

Legionella and mycoplasma treatment

A

macrolide (erythromycin)w

42
Q

when to do ELISA for ?Lyme

A

if SYMPTOMATIC (otherwise don’t bother)

43
Q

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?

A

viral load

44
Q

BV treatment if can’t have metronidazole

A

clindamycin

45
Q

slapped cheek/ parvoivirus in pregnancy

A

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

46
Q

Borrelia burgdorferi

A

Lyme

47
Q

when to treat Lyme

A

start doxycycline 14-21 days (and send serology for Berrelia burgorderi)- DON’T wait for serology result

48
Q

cefalexin in pregnancy

A

OK

MSRA (22 decks)

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