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Gastroenterology > Infectious disease > Flashcards

Infectious disease Flashcards

1
Q

URTI symptoms + amoxicillin → maculopapular rash

A

Infectious mononucleosis.

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2
Q

Infectious mononucleosis Rx :

A

Self-limiting condition

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3
Q

Infectious mononucleosis Diagnostic Test:

A

Monospot Test(Heterophile antibody test)

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4
Q

Atypical Lymphocytes is seen in :

A

Infectious Mononucleosis.

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5
Q

Which antibiotics causes Infectious Mononucleosis ?

A

Amoxicillin.

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6
Q

Bisexual man+ Rectal Discharge+ Pain on passing stools+ Procotoscopy- Red Mucossa + Yellow Discharge +Shallow ulcers. Dx

A

Lymphogranuloma venereum/ Chlamydia Trachomatis.

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7
Q

Lymphogranuloma venereum/ Chlamydia Trachomatis.

A

Bisexual man+ Rectal Discharge+ Pain on passing stools+ Procotoscopy- Red Mucossa + Yellow Discharge +Shallow ulcers. Dx

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8
Q

Chlamydia + Pregnant. Rx:

A

Macrolides- Erythromycin, Azithromycin.

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9
Q

Tb vaccine in children protects them for ?

A

Tb meningitis.

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10
Q

Chlamydia Rx:

A

Doxycycline.

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11
Q

Bloody Diarrhoe since 2 days. Return from Ghana. Rx:

A

Shigella= squgella= Rx= ciprofloxacin

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12
Q

Long incubation (2 months) + Bloody diarrhoea:

A

Amoebiasis

7 days of Iv Metronidazole + 10 days of Diloxanide Farate.

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13
Q

Rx of Amoebiasis:

A

7 days of Iv Metronidazole + 10 days of Diloxanide Farate.

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14
Q

Anthrax Rx:

A

Ciprofloxacin

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15
Q

Farmer+ Painless black Escher

A

Anthrax

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16
Q

Anthrax is gram ?

A

Gram positive Bacilli.

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17
Q

Lemierre’s syndrome. complication:

A

Septic Pulmonary embolism.

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18
Q

Herpes in pregnancy :

A

Treat with Supressive therapy.

Acyclovir safe in pregnancy.

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19
Q

Dx of Mycloplasma Pneumonia

A

Serology.

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20
Q

Fever+Flu+Dry Cough + Erythema multiforme. Which Pneumonia ?

A

Mycloplasma Pneumonia.

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21
Q

PBS of Mycloplasma Pneumonia

A

Red cell agglutination.

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22
Q

CXR of Mycloplasma Pneumonia :

A

B/L Consolidation.

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23
Q

Rx of Mycoplasma Pneumonia

A

Doxycycline or Macrolides.

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24
Q

Mycoplasma Pneumonia

A

Fever+Flu+Dry Cough + Erythema multiforme. + B/L consolidation+ Red cell agglutination

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25
Q

Jarisch-Herxheimer reaction. RX:

A

Paracetamol.

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26
Q

Primary syphilis—treatment—Unwell + Fever. Dx?

A

Jarisch-Herxheimer reaction

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27
Q

Meningitis + Very low CSF Glucose. Dx:

A

Mumps.

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28
Q

Which Antibiotic promotes acquisition of MRSA?

A

Ciprofloxacin.

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29
Q

Viral Meningits Rx:

A

No treatment required.

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30
Q

Meningitis + CSF Glucose < 1/2 plasma glucose. Dx:

A

Viral Meningitis.

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31
Q

Viral Meningitis Dx:

A

Meningitis + CSF Glucose < 1/2 plasma glucose.

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32
Q

H/o travel + Fever lethargy + Urticaria + Eosinophilia +CXR-B/l infiltrates. Dx:

A

Acute shishtosomiasis.
Rx: Praziquentel.

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33
Q

Acute shishtosomiasis.

A

H/o travel + Fever lethargy + Urticaria + Eosinophilia +CXR-B/l infiltrates. Dx:

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34
Q

Amphotericin B MOA:

A

Binds with Ergosterol.

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35
Q

Live vaccines given by injection may be either given concomitantly or a minimum interval of :

A

4 weeks.

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36
Q

shortest erythrocytic replication cycle In Malaria :

A

Plasmodium Knowlesi.

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37
Q

Differentiate Mumps meningitis and Tb Meningitis:

A

Both: CSF glucose low and high lymphocytes.

TB meningitis : CSF protein high.
Course: subacute or chronic course in TB meningitis.

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38
Q

Assymetric limited number of lesion with sensory loss, hair loss + Thickened Tender nerves. Dx:

A

Tuberculoid leprosy.

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39
Q

Culture negative Endocarditis. Dx?

A

Coxiella Burnetti/ Q fever.

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40
Q

Coxiella Burnetti/ Q fever.

A

Culture negative Endocarditis

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41
Q

Asymptomatic + Serology positive for syphilis. DX and Rx:

A

Latent Syphilis.

Treat latent syphilis as sponataneous clearance of syphilis does not occur.

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42
Q

Dysuria + Urethal irritation + Milky discharge + Micro = Lymphocytes.
Test negative for chlamydia and gonorrhea. Dx:

A

Non gonococcal Urethritis (Non specific urethritis )

Inflammatory cells present, but No gonococcal bacteria on swab.

Rx: Doxyycycline for 1 week.

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43
Q

Non gonococcal Urethritis (Non specific urethritis )Rx :

A

Rx: Doxyycycline for 1 week.

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44
Q

Painful genital ulcers+ painful Lymphadenopathy + Ragged edges + Dx:

A

Chacroid.

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45
Q

Trip to Thailand + No prophylaxis to malaria—fever rigors headache+ fever spike every 24 hours. Dx:

A

Plasmodium Knowlesi.

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46
Q

The most common causes of viral meningitis in adults are :

A

Enterovirus= Echovirus.

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47
Q

tenosynovitis, migratory polyarthritis, dermatitis. Dx:

A

Disseminated gonococcal infection

Neisseria Gonorhea.

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48
Q

Disseminated gonococcal infection

A

tenosynovitis, migratory polyarthritis, dermatitis.

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49
Q

Patients who are immunosuppressed secondary to long-term steroids or methotrexate should :

A

Check blood for antibodies—if no antibodies—give varicella zoster immunoglobulin.

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50
Q

Post-exposure prophylaxis for HIV:

A

Oral antiretroviral therapy for 4 weeks—Repeat HIV test at 12 weeks.

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51
Q

A 39-year-old man returns from a two week business trip to Kenya. Four weeks after his return he presents complaining of malaise, headaches and night sweats. On examination there is a symmetrical erythematous macular rash over his trunk and limbs associated with cervical and inguinal lymphadenopathy. What is the most likely diagnosis?

A

Acute HIV infection.

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52
Q

PID first line:

A

IM Ceftriaxone + Followed by 14 days of oral doxycycline and oral Metronidazole.

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53
Q

PID 2nd line :

A

Oral orfloxacin + Oral Metronidazole

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54
Q

Solitary genital wart lesion Rx:

A

Cryotherapy.

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55
Q

Multiple genital wart lesion Rx:

A

Topical Podphyllum

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56
Q

Granulma inguinale features and organism :

A

Multiple painless ulcers—caused by Kleibsella Granulomatis.

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57
Q

Human Bite infection :

A

Eikenella Corrodens

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58
Q

Strongylodiasis Rx:

A

Ivermectin

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59
Q

Strongylodiasis is ass with which larvae?

A

Rhabditiform Larvae.

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60
Q

H/o TB + symptoms of fatigue and weight loss, and postural hypotension with hyponatraemia and hyperkalaemia . Dx:

A

Adrenal TB.

Dx: Serum Cortisol.

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61
Q

Diagnostic test for Adrenal TB:

A

Serum Cortisol.

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62
Q

Tetracycline S/e:

A

Photosensitivity.

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63
Q

Botulinum toxin inhibits the release of :

A

Acetylcholine at synapses

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64
Q

IV drug user + Flaccid paralysis + Complex Opthalmoplegia + Ataxia + Bulbar Palsy. Dx:

A

Clostridium Botulinum.

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65
Q

Returning traveller with fever/flu-like symptoms, anaemia/jaundice/renal impairment →

A

Falciparum malaria

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66
Q

Visceral Leishmaniasis cause:

A

Leishmaniasis Donovani.

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67
Q

Visceral Leishmaniasis features :

A

H/o Travel to Sudan +Fever+ rigors+sweating +Massive splenomegaly + Hepatomegaly + Pancytopenia + skin = dark and ashen.

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68
Q

H/o Travel To Sudan + Fver + Rigors+ Sweating + Massive splenomegaly + Hepatomegaly + Pancytopenia + skin = dark and ashen.

A

Visceral Leishmaniasis

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69
Q

Visceral leishmaniasis blood picture :

A

Pancytopenia

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70
Q

Visceral leishmaniasis Rx:

A

Sodium Stibugluconate.

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71
Q

Bloody Diarrhoea + Incubation period : Weeks.

A

Amoebiasis

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72
Q

H/o Travel to African/ South American countries + presents with flu like illness → brief remission→ followed by jaundice and haematemesis

A

Yellow fever.

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73
Q

Yellow Fever.

A

H/o Travel to African/ South American countries with flu like illness → brief remission→ followed by jaundice and haematemesis

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74
Q

Influenza plus Cavity. Dx:

A

Staph Aureus infection.

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75
Q

Trypanosoma Cruzi Rx:

A

Benznidazole.

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76
Q

Chaga’s disease is caused by :

A

Trypanosoma Cruzi.

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77
Q

Chaga’s Disease features :

A

Flu + Periorbital signs + Complication: Megaoesophagus and Dialted cardiomyopathy

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78
Q

Indication of severe Falciparum :

A

Schizoints on blood Film.

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79
Q

Telbivudine MOA:

A

Nucleoside Analogue.

Old men are DINE-ing with Nuclear family.

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80
Q

H/o Travel to South East Asia + Flu + Maculopaularsh—Trunks—to Extremities.
Dx:

A

Scrub Typhus.

Doxycycline.

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81
Q

Scrub typhus

A

H/o Travel to South East Asia + Flu + Maculopaularsh—Trunks—to Extremities.

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82
Q

Scrub typhus Rx:

A

Doxycycline.

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83
Q

Terbinafine MOA:

A

Inhibtion of Squalene Epoxidase.

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84
Q

Amantidine MOA;

A

Inhibits uncoating of virus in the cell.

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85
Q

HIV + watery diarrhoea. Dx:

A

Cryptosporidiosis.
Rx: supportive

Treatment for Refractory Cryptosporidiosis—Nitazoxanide.

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86
Q

Cryptosporiodosis Rx:

A

Supportive Treatment

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87
Q

Cryptosporidiosis Refractory Rx:

A

Nitazoxanide.

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88
Q

exotoxins are produced which type of bacteria ?

A

Gram positive bacteria.

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89
Q

Teatanus Rx:

A

Immunoglobulins + IV metronidazole.

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90
Q

chronic hepatitis C becomes pregnant. Approximately what is the chance of the virus being transmitted to her child?

A

< 10 %

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91
Q

Fever + Malaise + extensive painful ulceration around mouth and lips+ Submandibular Lymphadenopathy

A

HSV infection

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92
Q

Differentiate HSV and Epstein Barr virus :

A

Epstein Barr virus often causes posterior cervical or generalized lymphadenopathy rather than isolated submandibular lymphadenopathy.

Epstein Barr has longer prodorme period.

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93
Q

Epstein Barr virus association with which cancers?

A

Hodkins
Burkits
Nasopharyngeal
Hairy Leukoplakia

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94
Q

Nasopharyngeal carcinoma ass with which virus ?

A

Epstein Barr virus ( type of herpes virus)

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95
Q

Which anti retrovirals causes Nephrolithiasis ?

A

Indinavirs.

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96
Q

Which protease inhibitor does not cause Nephrolithiasis ?

A

Ritonavir

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97
Q

student undergoes primary immunisation against hepatitis B. Following the full cource of vaccines, his post immunisation bloods are reported as follows:
Anti HbS < 10 :

A

Test for current or past hepatitis B + Repeat course ( ie : 3 doses of vaccine )

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98
Q

Prophylaxis of Malria:

A

Atovaquane + Proguanil.

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99
Q

How does Trimethoprim increase creatinine ?

A

Trimethoprim competitively inhibiting the tubular secretion of creatinine.

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100
Q

Staph Saprophyticus is gram ?

A

Gram positive cocci , Coagulase= Negatice.

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101
Q

Ribavirin MOA:

A

interferes with the capping of viral mRNA

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102
Q

Mycobacterium Avium Complex. Rx:

A

MAC- RICE meal in MCD.

Rifampicin + Clarthromycin + Ethambutol.

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103
Q

Ricketsia Conorii ass with which skin lesion ?

A

Black Eschar

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104
Q

Ascending or Descending paralysis in Clostrodium Botolinum ?

A

Descending

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105
Q

Doc for UTI in pregnancy in First trimester ?

A

Nitrofurantoin.

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106
Q

DOC for UTI in pregnancy in Last trimester

A

Trimethoprim

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107
Q

Spastic paralysis is caused be

A

Clostrodium Tetanus.

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108
Q

Clostrodium tetany blocks

A

GABA

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109
Q

Travel history + Watery diarrhoea + occurs within one week. Dx:

A

Ecoli ( Traveller’s diarrhoea )

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110
Q

Syphilis Rx:

A

Benzyl penicillin

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111
Q

Severe hepatitis in a pregnant woman - which hepatitis ?

A

Hepatitis E.

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112
Q

prodromal symptoms, Koplik spots. maculopapular rash starting behind the ears and conjunctivitis:

A

Measles

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113
Q

Nature of rash in Measels :

A

Maculopapular Rash starting behind the ears and conjunctivitis—then to whole body.

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114
Q

Injury in soil—Lock jaw + Muscle Spasm. Dx:

A

Clostrodium Tetany

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115
Q

Gram negative diplococci :

A

Neisseria gonorhea.

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116
Q

Which colour does gram negative stain ?

A

Red.

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117
Q

All patients with a CD4 count lower than 200/mm3 should:

A

prophylaxis against Pneumocystis jiroveci pneumonia—Co trimoxazole

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118
Q

prophylaxis against Pneumocystis jiroveci pneumonia

A

Co trimoxazole , when CD4 count is less than 200/mm3

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119
Q

Risk factor for staphylococcal toxic shock syndrome

A

Tampon use.

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120
Q

fever: temperature > 38.9ºC
hypotension: systolic blood pressure < 90 mmHg
diffuse erythematous rash+

desquamation of rash, especially of the palms and soles
involvement of three or more organ systems:

A

Staphylococcal Toxic Shock Syndrome.

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121
Q

Staphylococcal Toxic Shock Syndrome.

A

fever: temperature > 38.9ºC
hypotension: systolic blood pressure < 90 mmHg
diffuse erythematous rash+

desquamation of rash, especially of the palms and soles
involvement of three or more organ systems:

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122
Q

H/o Travel to srilanka/africa + Fever + maculopapular rash+ Severe Joint pain- 10/10–unable to walk, can’t do examination + Platelets=normal.

A

Chickengunya.

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123
Q

How to differentiate Chickenunya and dengue /

A

Chickengunya platelet=normal
And severe joint pain

Dengue= Platelet is low + joint pain is mid.

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124
Q

Pubic Lice Rx:

A

Permethrin Cream.

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125
Q

In case of injury, when not to give vaccine and immunoglobulins for tetanus ?

A

If patient has 5 doses of tetanus vaccine and last dose was 10 years ago.

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126
Q

K/C/O of HIV+ Purple papules and plaques. Diagnosis.

A

Kaposi sarcoma/ HHV 8

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127
Q

Necrotising Fasciitis Rx:

A

Surgical Debridement + IV antibiotics

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128
Q

Rifampicin MOA :

A

Inhibits RNA synthesis

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129
Q

Toxoplasmosis + Asymptomatic. Rx:

A

No treatment

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130
Q

Toxoplasmosis + Symptomatic

A

Pyrimethamine/sulphadiazine

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131
Q

Lymphograuloma venereum is ass with:

A

Chlamydia Trachomatis

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132
Q

Travel History to South America + ulcers in mouth + lower lip ( Mucocutaneous ulceration )

A

Cutaneous leishmaniasis.
Leishmania brasiliensis`

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133
Q

Sewage / Farmer + Fever/Flu + Muscle ache/Calf pain + B/L Conjunctival Haemorhage. Dx:

A

Leptospirosis.
Rx: Benzylpenicillin.

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134
Q

Leptospirosis Rx:

A

Benzylpenicillin.

135
Q

Epiglottis is ass with :

A

Haemophilus influenza.

136
Q

Mycoplasma Pneumonia—allergic to Macrolides. Rx?

A

Give tetracyclines ( Doxycycline )

137
Q

n a patient who has not been previously immunised against rabies and has sustained a potential rabies exposure

A

give immunglobulin + vaccination

138
Q

Severe Malaria + parasitaemia >2 %. Rx:

A

IV Artseumate.

139
Q

Severe Malaria + Parasitaemia >10%

A

IV Artseumate + Exchange Transfusion.

140
Q

Pneumocystis jiroveci pneumonia+ Sudden Dyspnoea + Sudden chest pain.

A

Pneumothorax—common complication of pneumocystis jiroveci.

141
Q

Pneumonia + Hyponatremia + Bradycardia

A

Legionella.

142
Q

Patients with an uncertain tetanus vaccination history should be:

A

Tetanus Immunoglobulins + Tetanus Vaccine.

143
Q

Moraxella Cattrhalis :

A

Gram negative cocci.

144
Q

Gram positive cocci example :

A

Staph, Strepto, Enterococcus

145
Q

Acyclovir MOA :

A

DNA Polymerase Inhibitor.

146
Q

What extra-pulmonary manifestation is most commonly seen with this infection

A

Hypoadrenalism

147
Q

When to give Varicella immunoglobulin ?

A

Patient exposed to chicken pox+ Immunosupressed + VZv Antibodies <150.

148
Q

Patient exposed to chicken pox+ Immunosupressed + VZv Antibodies <150

A

Give Varicella immunoglobulin

149
Q

Pregnancy related complication in Parvo virus :

A

Fetal hydrops

150
Q

Parvo Virus features:

A

Erythema Infectiousum+ Fifth Disease + Slap cheek + Fetal Hydrops

151
Q

Travel to south Asian country 2 months ago + fever malaise , maculopapular rash + aphthous ulcers. Dx:

A

HIV seroconversion

Longer incubation period, an apthous ulcers and lack of retroorbital headache points more towards HIV seroconversion and not Dengue.

152
Q

Patients with hyposplenism should be vaccinated against:

A

pneumococcal, Haemophilus type B and meningococcus type C.

153
Q

Renal Transplant + Infection—

A

Cytomegalovirus.

154
Q

Disseminated Lymes Rx:

A

IV Ceftriaxone.

155
Q

Lymes Rx:

A

Oral Doxycycline

156
Q

Pregnancy Plus Lymes Rx:

A

Oral Amoxicillin

157
Q

First line Ix in Lymes :

A

ELISA

158
Q

Lymes mnemonic and features :

A

Face to heart.

Facial palsy + Meningitis + Neck Stiffness + Heart Block—prolonged PR + Myocarditis

159
Q

H/o Rash during trip—now LMN facial palsy. Dx?

A

Lymes

160
Q

Diarrohoea—Decreased urine output+ Renal Failure with High Urea and Creatinine + Hemolyitic anaemia— Low Hb + Schistocytes.

A

E.coli O157: H7—Hemolytic Uraemic Syndrome.

161
Q

Hemolytic Uraemic Syndrome caused by :

A

E coli: 0157:H7

162
Q

HUS symptom :

A

Diarrohoea—Decreased urine output+ Renal Failure with High Urea and Creatinine + Hemolyitic anaemia— Low Hb + Schistocytes.

163
Q

H/o Travel to India + Consuming Pork + Swelling/Painless nodules on Face + neck + Arm + passing of Noodles like material. Dx:

A

Cysticercosis.
Rx: Bendazoles

164
Q

Cysticercosis.

A

H/o Travel to India + Consuming Pork + Swelling/Painless nodules on Face + neck + Arm + passing of Noodles like material. Dx:

165
Q

Breast feeding in HIV :

A

Not recommended

166
Q

Which Drug to avoid with Methotrexate ?

A

Trimethoprim and Co-trimoxazole

167
Q

Which test is most likely to allow for accurate speciation of the malarial pathogen?

A

Thin Film

168
Q

____ can commonly cause UTI in sexually active young women

A

Staph saprophyticus

169
Q

Staph saprophyticus

A

Gram Positive, Coagulase Negative.

170
Q

Travel to South East Asian country+ fever + malaise + headache—Black eschar. Dx?

A

Scrub typhus.
Rx: Doxycycline

171
Q

Enteric Fever Diagnostic Test:

A

Large Volume Blood Culture.

172
Q

Amoebic colitis, Diagnostic tests ?

A

A ‘hot stool’ (a stool examined within 15 minutes of passage, or kept warm)

173
Q

Back pain + Fever + weight loss + night sweats + CXR: perihilar nodularity. Dx:

A

Spine TB

174
Q

Post exposure prophylaxis of HIV, when is HIV testing repeated ?

A

12 weeks.

175
Q

High risk wound + symptoms of tetanus. Rx:

A

IM tetanus immunoglobulin

176
Q

Carbapenem resistance cause :

A

New Delhi metallo-beta-lactamase 1

177
Q

Lassa fever Is caused by :

A

The excreta of infected African rats

178
Q

TB treatment :

A

Isoniazid and Pyridoxine—6 Months.

Isoniazid+Pyridoxine +Rifampicin—3 Months.

179
Q

Listeria Rx:

A

Ampicillin/Amoxicillin + Gentamycin.

180
Q

Cholera Rx:

A

Doxycycline

181
Q

Human African Trypanosomiasis Rx:

A

Pentamidine.

182
Q

Human African Trypanosomiasis Clinical feature :

A

Reversal of sleep cycle.

183
Q

Is Meningism a feature of Leptospirosis ?

A

Yes

184
Q

Is AKI a feature of Leptospirosis ?

A

Yes

185
Q

Is hepatitis a feature of Leptospirosis ?

A

Yes

186
Q

Is Pulmonary complication feature of leptospirosis ?

A

No

187
Q

Bite from Hep B known Source, patient who got the bite is known responder :

A

Hep B vaccine booster dose.

188
Q

Farmer + small, raised, red papule but has now become larger—haemorrhagic lesion is seen

A

Orf.

189
Q

Orf.

A

Farmer + small, raised, red papule but has now become larger—haemorrhagic lesion is seen

190
Q

Conjugate vaccines are those :

A

Conjugate vaccines are those that use a protein that attaches to the polysaccharide outer coat of the pathogen to make it more immunogenic.
Example of conjugate vaccine: Meningococcal vaccine.

191
Q

Conjugate vaccine example:

A

Meningococcal vaccine

192
Q

E. coli causes what brain related illness ?

A

Neonatal meningitis

193
Q

False negative tests may be caused by:

A

Military TB
Sarcoidosis
HIV
Lymphoma
Very young age (e.g. < 6 months

194
Q

Differentiate Shistosomiasis hematobium from Black water fever:

A

Shistosomiasis : Red cell cast in urine —Because direct damage to kidneys

Black water fever: No red cell cast. As there is hemolysis and no direct damage to Kidneys

195
Q

Return from Africa—Fever + Rigors + Hepatsosplenomegaly+ haemoglobinuria—Dark red urine + Jaundice + AKI:
Microscopy—No red cell cast. Dx:

A

Blackwater fever

196
Q

Black water fever

A

Return from Africa—Fever + Rigors + Hepatsosplenomegaly+ haemoglobinuria—Dark red urine + Jaundice + AKI:
Microscopy—No red cell cast. Dx:

197
Q

Trip to Malawi + Itchiness + Visible Hematuria. Dx:

A

Shistosomiasis Hematobium

198
Q

Rx for Shistosomiasis Hematobium

A

Praziquantel

199
Q

Cold sore on lower lips + Pneumonia symptoms. Dx:

A

Strptococcus Pneumonia

200
Q

Suspected Lymes. Next step ?

A

ELISA antibody test, and start Doxycycline while awaiting the results.

201
Q

Travel h/o Brazil + Pruritic Rash around feet and anus + raised eosinophils. DX:

A

Strongylodiasis

202
Q

HPV vaccination should be offered to men who:

A

who have sex with men under the age of 45 to protect against anal, throat and penile cancers.

203
Q

Cold sore + Pneumonia =

A

Streptococcus pneumonia

204
Q

Which Anti viral induces p450 ?

A

Nevirapine (a non-nucleoside reverse transcriptase inhibitor (NNRTI)

205
Q

Most common cause of Bladder calcification ?

A

Shistosomiasis Hematobium

206
Q

Schistosomiasis is a risk factor for?

A

Squamous cell bladder cancer

207
Q

chloroquine-resistant strains of Plasmodium vivax Rx:

A

Artemisin based combination therapy—Artemether+ Lumefantine.

208
Q

Genital warts are caused by HPV number?

A

HPV 6 and 11.

209
Q

Alcoholics + cavitation + Pneumoniae:

A

Kleibsella

210
Q

Kleibsella

A

Alcoholics + cavitation + Pneumoniae:

211
Q

Diagnosis of Severe Malaria based on paristaemia :

A

Parasitaemia > 2 %

212
Q

Staph Aureus is Coagulase ?

A

Coaglase Positive.

213
Q

Coagulase Negative staph ?

A

Saprophyticus
Epidermidis

214
Q

Cephalosporin MOA :

A

Inhibition of cell wall synthesis

215
Q

What kind of virus is HIV ?

A

HIV is RNA retrovirus

216
Q

Enterovirus example :

A

Coxsackie B virus

217
Q

Macrolides MOA

A

Macrolides inhibit the 50S subunit of ribosomes

218
Q

Asymptomatic bacteriuria: Rx:

A

Do not Treat.

219
Q

Animal bites are generally polymicrobial but the most common isolated organism is :

A

Pasteurella multocida

220
Q

Rocky mountain spotted fever

A

Rickettsia ricketsii

221
Q

Fish tank granuloma is caused By :

A

Mycobacterium marinum

222
Q

Malaria severe parasitaemia (>10%)

A

Artesunate + Exchange Transfusion

223
Q

Pregnant hyperemesis Gravidarum + UTI :

A

Nitrofurantoin

As hyperemesis gravidarum occurs in first term and trimethoprim is C/I. In first term.

224
Q

Travel H/o from India+ Lethargy + Syncope + SOB + itchy rash on feet— low Hb+ High Eosinophils. Dx and diagnostic test:

A

Hookworm

Stool sample for : ova, cyst and parasite.

225
Q

Diagnostic test for hookworm

A

Stool sample for ova, cyst and parasite.

226
Q

How to prevent norovirus ?

A

handwashing with soaps and warm water before and after contact with those infected with norovirus

227
Q

Measels is spread by ?

A

Aerosol.

228
Q

Integrase inhibitors (‘gravirs’)

A

blocks the enzyme that inserts the viral genome into the DNA of the host cell

229
Q

Pneumocystis jiroveci/carnii which stain ?

A

Silver stain

230
Q

Erysipelas caused by ?

A

Streptococcus

231
Q

Does strep causes pneumonia ?

A

No

232
Q

Does Jarich herxheimer reaction occur with Lymes ?

A

No.

233
Q

ECG findings of Lymes ?

A

Prolonged PR interval

234
Q

Skin condition in Lymes ?

A

Erythema Migrans( Bull’s eye ), and not erythema marginatum.

235
Q

Is Erythema Marginatum a feature of Lyme’s ?

A

No , It’s a feature of Rheumatic.
Erythema Migrans is a feature of Lymes.

236
Q

Cellulitis Rx:

A

Flucoxacillin (penicillin )

If allergy—Give Macrolides—Clarithromycin.

237
Q

Cellulitis + Penicillin allergy—

A

Rx: Give Macrolides—Clarithromycin

238
Q

U/l Lesion on limb+ Painful Hot Tender.

A

Dx: Cellulitis.

239
Q

The single most important step To avoid MRSA:

A

Hand Hygiene

240
Q

Varicella pneumonia Rx:

A

IV acyclovir

241
Q

Characteristic feature of Pneumocystis carinii/Jiroveci pneumonia

A

Normal chest auscultations

242
Q

High suspect for Hep C. How to do the testing ?

A

First- HCV antibody test

Second- HCV RNA test.

243
Q

Oseltamavir MOA:

A

Neuraminidase inhibitor ( Oswald had Neuro issues)

244
Q

For zanamivir (Relenza) for suspected influenza. Which one of the following underlying problems may increase the likelihood of side-effects?

A

Asthama

245
Q

Phlebotomist with Needle stick injury with HIV patient—chances of developing HIV ?

A

0.3 %

246
Q

following tests is most likely to remain positive in a patient with syphilis despite treatment

A

TPHA

247
Q

Most common complication in repeated PID:

A

Infertility

248
Q

Gram negative organism test what on nitrate test ?

A

Gram negative test positive on Nitrate test.

249
Q

Sepsis patient—Fluid resuscitation ?

A

500 ML Blous Stat over 15 mins.

250
Q

Travel history+ 15 day history of non Bloody Diarrhoea. Dx:

A

Giardiasis.
Rx:Metronidazole

251
Q

Long incubation + Non bloody Diarrhoea :

A

Giardiasis

252
Q

Giardiasis Treatment of choice :

A

Metronidazole

253
Q

Long incubation diarrhoea :

A

Giardiasis—Non bloody diarrhoea

Amboebiasis—Bloody diarrhoea

254
Q

Cutaneous larva migrans Rx;

A

Bendazoles

255
Q

Pneumocystis Jiroveci + Hyppoxia. Rx:

A

Co-trimoxazole + Prednisolone

256
Q

Rabbit related infection :

A

Tularaemia

257
Q

What is the most important factor determining your risk of HIV transmission in this case?

A

Viral load of the patient

258
Q

Aspergilloma Rx:

A

Surgical resection

259
Q

the presence of lymphadenopathy above and below the inguinal ligament is more classical of:

A

LGV.

260
Q

Groove sign is a feature of

A

LGV- Chlamydia Trachomatis

261
Q

Chlamydia Rx:

A

Doxycycline for 7 days.

262
Q

Pregnant chlamydia Rx:

A

Macrolides—1 Gram single dose

263
Q

Cerebral Toxoplasmosis Rx:

A

Pyrimethamine and sulphaiazine

264
Q

Legionella pneumonia confirmatory test:

A

Urinary antigen

265
Q

Anti retroviral therapy is started when:

A

At the time of diagnosis

266
Q

Meningits symptoms plus Gram positive bacilli. Which organism ?

A

Listeria

267
Q

Diarrhoe + H/o Eating rice

A

Bacillus cereus

268
Q

Which virus is ass with nasopharyngeal cancer ?

A

Epstein Barr virus

269
Q

Meningits sumps+ CSF= Polymorphs + Low Glucose. Dx:

A

bacterial meningitis

270
Q

Streptococcus pneumonia causes Meningits in which age group ?

A

6-60 years of age group

271
Q

Bilateral, mid-to-lower zone patchy consolidation in an older patient, which pneumonia ?

A

Legionella

272
Q

CXR finding is Legionella :

A

Mid-to-lower zone patchy consolidation.

273
Q

Neisseria Gonorrhoea Rx:

A

IM ceftriaxone

274
Q

Meningitis symptoms + CSF glucose=Normal + High lymphocytes + Normal opening pressure. Dx:

A

Viral meningitis.

275
Q

Strongyloides stercoralis gains access to the body by penetrating the skin

A

by penetrating the skin

276
Q

H/O Swimming in Ghana + Calcification in bladder. Dx:

A

Shistosomiasis Hematobium

277
Q

Clostrodium Difficile is a type of ?

A

Gram positive bacill/Rods

278
Q

What kind of vaccine is Yellow fever vaccine ?

A

Live attenuated.
C/I in HIV, Post transplant

279
Q

What type of vaccine is Tb ?

A

Live attenuated

280
Q

Diagnostic test for HIV seroconversion:

A

HIV-1/2 Ab/Ag Immunoassay

281
Q

Screening test to exclude HIV seroconversion :

A

P24 antigen test.

282
Q

Screening test for asymptomatic patients for HiV seroconversion :

A

Rapid HIV antibody ELISA + P24 antigen test.

283
Q

HbsAg—positive, Anti Hbc—IgM , Anti HD—IgM—Positive

A

HbsAg—positive—Hepatitis B surface antigen positive—Hep B infection. Hbc—IgM—Core antibody—IgM—recent infection—superimposed infection , Anti HD—IgM—Positive—Hepatitis D positive.

Hepatitis B positive and a superinfection with hepatitis D.

284
Q

Which of the following vaccinations is contraindicated in egg allergy?

A

Yellow fever.

285
Q

Screening test for TB:

A

Mantoux test.

286
Q

Most common cause of visceral larva migrans?

A

Toxocara canis

287
Q

Tubercular Meningitis

A

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol + + + Prednisolone.

288
Q

Oral poliomyelitis is which type of vaccine ?

A

Live attenuated

289
Q

Which vaccines in splenectomy patients ?

A

pneumococcus, Haemophilus, meningococcus + lifelong penicillin

290
Q

primary genital herpes is made. What is the most appropriate management?

A

Oral Acyclovir

291
Q

A phlebotomist gives herself a needlestick injury whilst taking blood from a patient who is known to be hepatitis B positive. The phlebotomist has just started her job and is in the process of being immunised for hepatitis B but has only had one dose to date. What is the most appropriate action to minimise her risk of contracting hepatitis B from the needle?

A

give an accelerated course of the hepatitis B vaccine + hepatitis B immune globulin

292
Q

Pharyngitis is caused by :

A

Streptococcus pyogenes

293
Q

A 29-year-old woman develops severe vomiting four hours after having lunch at a local restaurant. What is the most likely causative organism?

A

Staphylococcus aureus food poisoning.

294
Q

Tuberculin skin tests are an example of type IV (delayed) hypersensitivity reactions. Mediated by :

A

Mediated by interferon-γ

295
Q

Most reliable method to assess a patient’s response to hepatitis C treatment.

A

Viral load. Viral load, or HCV RNA level,

296
Q

Linezolid is active against ?

A

MRSA
Vancomycin resistant enterococcus

297
Q

Hepatitis features + Diet= Sea food. Dx:

A

Hepatitis E

298
Q

Hyadatid cyst. First line ?

A

Albendazole.

299
Q

In Elective Surgery, when to give Pneumococcal vaccine?

A

Give vaccine 2 weeks before surgery.

300
Q

Is oposthotonous a feature of Rabies ?

A

No.

301
Q

Rabies feature ?

A

Fever + Headache + Agitation
+ Hdrophobia
+ Hypersalivation
+ Negri bodies

302
Q

which bodies are seen in rabies ?

A

Negri bodies

303
Q

H/o Travel + Eating outside + seizures + Headache CT head— demonstrated numerous small focal calcification Dx?

A

Neurocysticercosis

304
Q

Filariasis cause :

A

Wuchereria Bancrofti

305
Q

southern India presents with chronic swelling of both lower legs, they are brawny and indurated with marked skin trophic changes

A

Filariais

306
Q

Unpasteurised Milk + Prodorme features ( Fever+ Headache+ Malaise) + Bloody Diarrhoae. Dx:

A

Campylobacter

307
Q

when to give Rx in Campylobacter Diarrhoea ?

A

> 8 episodes of bloody diarrhoea + Symptoms do not resolve in one week +
Rx: Oral Clarithromycin.

308
Q

Bacterial vaginalis is caused by ?

A

Gardenella vaginalis.

309
Q

Plasmodium vivax malaria. He is treated initially with chloroquine then later given primaquine. What is the benefit of the primaquine?

A

Primaquine is used in non-falciparum malaria to destroy liver hypnozoites and prevent relapse

310
Q

Travel history to South Asian country + Hypopigmentation + Sensory loss. Dx:

A

Leprosy.

311
Q

Gardenella vaginosis is :

A

Gram positive cocobacilli

312
Q

Necrotising fasciitis. Rx:

A

IV Antibiotics+ Surgical debridement

313
Q

Diagnostic test for Pneumocystis Jiroveci :

A

Bronchoalveolar lavage.

314
Q

A newly qualified staff nurse at the local hospital undergoes vaccination against hepatitis B.
Anti HbS 10-100

A

One further dose of vaccine

315
Q

A newly qualified staff nurse at the local hospital undergoes vaccination against hepatitis B. Anti HbS < 10

A

Test for current or past infection .
Vaccine + Immunoglobulins

316
Q

A 29-year-old Russian man who has recently arrived into the country presents with fever and feeling generally unwell. His temperature is 38.2ºC and pulse 96/min. On examination a grey coating is seen surrounding the tonsils and there is extensive cervical lymphadenopathy. What is the most likely diagnosis?

A

Diphtheria

317
Q

HIV + He has coarse crackles on the right side of his chest. A chest x-ray shows consolidation of the right mid zone.

A

Community acquired pneumonia—Streptococcus pneumonia

Pneumocystis jiroveci has clear chest

318
Q

Treated for Gonorrhoea. No improvement. Possible Diagnosis ?

A

Co existent chlamydia

319
Q

Aspergilloma Diagnostic test:

A

Serology for aspergillus precipitins

320
Q

K/C/O HIV + Headache + Drowsiness + CT= Single Lesion=

A

Lymphoma

321
Q

describes the prevention and treatment of hepatitis C?

A

No vaccine is available but treatment is successful in the majority of patients.

322
Q

Campylobacter Diarrhoea > 7 Days. Rx:

A

Macrolides

323
Q

Meningococcal Meningitis with penicillin allergy. Rx:

A

Chloramphenicol

324
Q

Suspected Bacterial/meningococcal meningitis in hospital setting. Rx:

A

IV Cefotaxime

325
Q

Differentiating between toxoplasmosis and lymphoma

A

SPECT

326
Q

Pneumococcus Meningits , what precautions need to be taken by close contact ?

A

No action needed.

327
Q

Unpasteurised cheese +Flu + wet hay smell . Dx?

A

Brucellosis
Rx:- Doxycycline

328
Q

On Rx for LRTI— suffered Achilles tendon rupture as side effect—now meningococcal septicaemia—what prophylaxis to be given to the partner ?

A

Achilies tendon rupture—s/e of ciprofloxacin

Therefore give 2nd option—Oral Rifampicin.

329
Q

Hospital-acquired pneumonia

A

Within 5 days of admission: co-amoxiclav or cefuroxime
More than 5 days after admission: piperacillin with tazobactam OR a broad-spectrum cephalosporin (e.g. ceftazidime) OR a quinolone (e.g. ciprofloxacin)

330
Q

Brucellosis Dx:

A

Brucellosis serology

331
Q

Shigella Rx:

A

Ciprofloxacin

332
Q

Natalizumab MOA :

A

Prevents Leucocyte migration.

333
Q
A

Gastroenterology (6 decks)

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