Infectious disease Flashcards
URTI symptoms + amoxicillin → maculopapular rash
Infectious mononucleosis.
Infectious mononucleosis Rx :
Self-limiting condition
Infectious mononucleosis Diagnostic Test:
Monospot Test(Heterophile antibody test)
Atypical Lymphocytes is seen in :
Infectious Mononucleosis.
Which antibiotics causes Infectious Mononucleosis ?
Amoxicillin.
Bisexual man+ Rectal Discharge+ Pain on passing stools+ Procotoscopy- Red Mucossa + Yellow Discharge +Shallow ulcers. Dx
Lymphogranuloma venereum/ Chlamydia Trachomatis.
Lymphogranuloma venereum/ Chlamydia Trachomatis.
Bisexual man+ Rectal Discharge+ Pain on passing stools+ Procotoscopy- Red Mucossa + Yellow Discharge +Shallow ulcers. Dx
Chlamydia + Pregnant. Rx:
Macrolides- Erythromycin, Azithromycin.
Tb vaccine in children protects them for ?
Tb meningitis.
Chlamydia Rx:
Doxycycline.
Bloody Diarrhoe since 2 days. Return from Ghana. Rx:
Shigella= squgella= Rx= ciprofloxacin
Long incubation (2 months) + Bloody diarrhoea:
Amoebiasis
7 days of Iv Metronidazole + 10 days of Diloxanide Farate.
Rx of Amoebiasis:
7 days of Iv Metronidazole + 10 days of Diloxanide Farate.
Anthrax Rx:
Ciprofloxacin
Farmer+ Painless black Escher
Anthrax
Anthrax is gram ?
Gram positive Bacilli.
Lemierre’s syndrome. complication:
Septic Pulmonary embolism.
Herpes in pregnancy :
Treat with Supressive therapy.
Acyclovir safe in pregnancy.
Dx of Mycloplasma Pneumonia
Serology.
Fever+Flu+Dry Cough + Erythema multiforme. Which Pneumonia ?
Mycloplasma Pneumonia.
PBS of Mycloplasma Pneumonia
Red cell agglutination.
CXR of Mycloplasma Pneumonia :
B/L Consolidation.
Rx of Mycoplasma Pneumonia
Doxycycline or Macrolides.
Mycoplasma Pneumonia
Fever+Flu+Dry Cough + Erythema multiforme. + B/L consolidation+ Red cell agglutination
Jarisch-Herxheimer reaction. RX:
Paracetamol.
Primary syphilis—treatment—Unwell + Fever. Dx?
Jarisch-Herxheimer reaction
Meningitis + Very low CSF Glucose. Dx:
Mumps.
Which Antibiotic promotes acquisition of MRSA?
Ciprofloxacin.
Viral Meningits Rx:
No treatment required.
Meningitis + CSF Glucose < 1/2 plasma glucose. Dx:
Viral Meningitis.
Viral Meningitis Dx:
Meningitis + CSF Glucose < 1/2 plasma glucose.
H/o travel + Fever lethargy + Urticaria + Eosinophilia +CXR-B/l infiltrates. Dx:
Acute shishtosomiasis.
Rx: Praziquentel.
Acute shishtosomiasis.
H/o travel + Fever lethargy + Urticaria + Eosinophilia +CXR-B/l infiltrates. Dx:
Amphotericin B MOA:
Binds with Ergosterol.
Live vaccines given by injection may be either given concomitantly or a minimum interval of :
4 weeks.
shortest erythrocytic replication cycle In Malaria :
Plasmodium Knowlesi.
Differentiate Mumps meningitis and Tb Meningitis:
Both: CSF glucose low and high lymphocytes.
TB meningitis : CSF protein high.
Course: subacute or chronic course in TB meningitis.
Assymetric limited number of lesion with sensory loss, hair loss + Thickened Tender nerves. Dx:
Tuberculoid leprosy.
Culture negative Endocarditis. Dx?
Coxiella Burnetti/ Q fever.
Coxiella Burnetti/ Q fever.
Culture negative Endocarditis
Asymptomatic + Serology positive for syphilis. DX and Rx:
Latent Syphilis.
Treat latent syphilis as sponataneous clearance of syphilis does not occur.
Dysuria + Urethal irritation + Milky discharge + Micro = Lymphocytes.
Test negative for chlamydia and gonorrhea. Dx:
Non gonococcal Urethritis (Non specific urethritis )
Inflammatory cells present, but No gonococcal bacteria on swab.
Rx: Doxyycycline for 1 week.
Non gonococcal Urethritis (Non specific urethritis )Rx :
Rx: Doxyycycline for 1 week.
Painful genital ulcers+ painful Lymphadenopathy + Ragged edges + Dx:
Chacroid.
Trip to Thailand + No prophylaxis to malaria—fever rigors headache+ fever spike every 24 hours. Dx:
Plasmodium Knowlesi.
The most common causes of viral meningitis in adults are :
Enterovirus= Echovirus.
tenosynovitis, migratory polyarthritis, dermatitis. Dx:
Disseminated gonococcal infection
Neisseria Gonorhea.
Disseminated gonococcal infection
tenosynovitis, migratory polyarthritis, dermatitis.
Patients who are immunosuppressed secondary to long-term steroids or methotrexate should :
Check blood for antibodies—if no antibodies—give varicella zoster immunoglobulin.
Post-exposure prophylaxis for HIV:
Oral antiretroviral therapy for 4 weeks—Repeat HIV test at 12 weeks.
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?
Acute HIV infection.
PID first line:
IM Ceftriaxone + Followed by 14 days of oral doxycycline and oral Metronidazole.
PID 2nd line :
Oral orfloxacin + Oral Metronidazole
Solitary genital wart lesion Rx:
Cryotherapy.
Multiple genital wart lesion Rx:
Topical Podphyllum
Granulma inguinale features and organism :
Multiple painless ulcers—caused by Kleibsella Granulomatis.
Human Bite infection :
Eikenella Corrodens
Strongylodiasis Rx:
Ivermectin
Strongylodiasis is ass with which larvae?
Rhabditiform Larvae.
H/o TB + symptoms of fatigue and weight loss, and postural hypotension with hyponatraemia and hyperkalaemia . Dx:
Adrenal TB.
Dx: Serum Cortisol.
Diagnostic test for Adrenal TB:
Serum Cortisol.
Tetracycline S/e:
Photosensitivity.
Botulinum toxin inhibits the release of :
Acetylcholine at synapses
IV drug user + Flaccid paralysis + Complex Opthalmoplegia + Ataxia + Bulbar Palsy. Dx:
Clostridium Botulinum.
Returning traveller with fever/flu-like symptoms, anaemia/jaundice/renal impairment →
Falciparum malaria
Visceral Leishmaniasis cause:
Leishmaniasis Donovani.
Visceral Leishmaniasis features :
H/o Travel to Sudan +Fever+ rigors+sweating +Massive splenomegaly + Hepatomegaly + Pancytopenia + skin = dark and ashen.
H/o Travel To Sudan + Fver + Rigors+ Sweating + Massive splenomegaly + Hepatomegaly + Pancytopenia + skin = dark and ashen.
Visceral Leishmaniasis
Visceral leishmaniasis blood picture :
Pancytopenia
Visceral leishmaniasis Rx:
Sodium Stibugluconate.
Bloody Diarrhoea + Incubation period : Weeks.
Amoebiasis
H/o Travel to African/ South American countries + presents with flu like illness → brief remission→ followed by jaundice and haematemesis
Yellow fever.
Yellow Fever.
H/o Travel to African/ South American countries with flu like illness → brief remission→ followed by jaundice and haematemesis
Influenza plus Cavity. Dx:
Staph Aureus infection.
Trypanosoma Cruzi Rx:
Benznidazole.
Chaga’s disease is caused by :
Trypanosoma Cruzi.
Chaga’s Disease features :
Flu + Periorbital signs + Complication: Megaoesophagus and Dialted cardiomyopathy
Indication of severe Falciparum :
Schizoints on blood Film.
Telbivudine MOA:
Nucleoside Analogue.
Old men are DINE-ing with Nuclear family.
H/o Travel to South East Asia + Flu + Maculopaularsh—Trunks—to Extremities.
Dx:
Scrub Typhus.
Doxycycline.
Scrub typhus
H/o Travel to South East Asia + Flu + Maculopaularsh—Trunks—to Extremities.
Scrub typhus Rx:
Doxycycline.
Terbinafine MOA:
Inhibtion of Squalene Epoxidase.
Amantidine MOA;
Inhibits uncoating of virus in the cell.
HIV + watery diarrhoea. Dx:
Cryptosporidiosis.
Rx: supportive
Treatment for Refractory Cryptosporidiosis—Nitazoxanide.
Cryptosporiodosis Rx:
Supportive Treatment
Cryptosporidiosis Refractory Rx:
Nitazoxanide.
exotoxins are produced which type of bacteria ?
Gram positive bacteria.
Teatanus Rx:
Immunoglobulins + IV metronidazole.
chronic hepatitis C becomes pregnant. Approximately what is the chance of the virus being transmitted to her child?
< 10 %
Fever + Malaise + extensive painful ulceration around mouth and lips+ Submandibular Lymphadenopathy
HSV infection
Differentiate HSV and Epstein Barr virus :
Epstein Barr virus often causes posterior cervical or generalized lymphadenopathy rather than isolated submandibular lymphadenopathy.
Epstein Barr has longer prodorme period.
Epstein Barr virus association with which cancers?
Hodkins
Burkits
Nasopharyngeal
Hairy Leukoplakia
Nasopharyngeal carcinoma ass with which virus ?
Epstein Barr virus ( type of herpes virus)
Which anti retrovirals causes Nephrolithiasis ?
Indinavirs.
Which protease inhibitor does not cause Nephrolithiasis ?
Ritonavir
student undergoes primary immunisation against hepatitis B. Following the full cource of vaccines, his post immunisation bloods are reported as follows:
Anti HbS < 10 :
Test for current or past hepatitis B + Repeat course ( ie : 3 doses of vaccine )
Prophylaxis of Malria:
Atovaquane + Proguanil.
How does Trimethoprim increase creatinine ?
Trimethoprim competitively inhibiting the tubular secretion of creatinine.
Staph Saprophyticus is gram ?
Gram positive cocci , Coagulase= Negatice.
Ribavirin MOA:
interferes with the capping of viral mRNA
Mycobacterium Avium Complex. Rx:
MAC- RICE meal in MCD.
Rifampicin + Clarthromycin + Ethambutol.
Ricketsia Conorii ass with which skin lesion ?
Black Eschar
Ascending or Descending paralysis in Clostrodium Botolinum ?
Descending
Doc for UTI in pregnancy in First trimester ?
Nitrofurantoin.
DOC for UTI in pregnancy in Last trimester
Trimethoprim
Spastic paralysis is caused be
Clostrodium Tetanus.
Clostrodium tetany blocks
GABA
Travel history + Watery diarrhoea + occurs within one week. Dx:
Ecoli ( Traveller’s diarrhoea )
Syphilis Rx:
Benzyl penicillin
Severe hepatitis in a pregnant woman - which hepatitis ?
Hepatitis E.
prodromal symptoms, Koplik spots. maculopapular rash starting behind the ears and conjunctivitis:
Measles
Nature of rash in Measels :
Maculopapular Rash starting behind the ears and conjunctivitis—then to whole body.
Injury in soil—Lock jaw + Muscle Spasm. Dx:
Clostrodium Tetany
Gram negative diplococci :
Neisseria gonorhea.
Which colour does gram negative stain ?
Red.
All patients with a CD4 count lower than 200/mm3 should:
prophylaxis against Pneumocystis jiroveci pneumonia—Co trimoxazole
prophylaxis against Pneumocystis jiroveci pneumonia
Co trimoxazole , when CD4 count is less than 200/mm3
Risk factor for staphylococcal toxic shock syndrome
Tampon use.
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:
Staphylococcal Toxic Shock Syndrome.
Staphylococcal Toxic Shock Syndrome.
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:
H/o Travel to srilanka/africa + Fever + maculopapular rash+ Severe Joint pain- 10/10–unable to walk, can’t do examination + Platelets=normal.
Chickengunya.
How to differentiate Chickenunya and dengue /
Chickengunya platelet=normal
And severe joint pain
Dengue= Platelet is low + joint pain is mid.
Pubic Lice Rx:
Permethrin Cream.
In case of injury, when not to give vaccine and immunoglobulins for tetanus ?
If patient has 5 doses of tetanus vaccine and last dose was 10 years ago.
K/C/O of HIV+ Purple papules and plaques. Diagnosis.
Kaposi sarcoma/ HHV 8
Necrotising Fasciitis Rx:
Surgical Debridement + IV antibiotics
Rifampicin MOA :
Inhibits RNA synthesis
Toxoplasmosis + Asymptomatic. Rx:
No treatment
Toxoplasmosis + Symptomatic
Pyrimethamine/sulphadiazine
Lymphograuloma venereum is ass with:
Chlamydia Trachomatis
Travel History to South America + ulcers in mouth + lower lip ( Mucocutaneous ulceration )
Cutaneous leishmaniasis.
Leishmania brasiliensis`
Sewage / Farmer + Fever/Flu + Muscle ache/Calf pain + B/L Conjunctival Haemorhage. Dx:
Leptospirosis.
Rx: Benzylpenicillin.
Leptospirosis Rx:
Benzylpenicillin.
Epiglottis is ass with :
Haemophilus influenza.
Mycoplasma Pneumonia—allergic to Macrolides. Rx?
Give tetracyclines ( Doxycycline )
n a patient who has not been previously immunised against rabies and has sustained a potential rabies exposure
give immunglobulin + vaccination
Severe Malaria + parasitaemia >2 %. Rx:
IV Artseumate.
Severe Malaria + Parasitaemia >10%
IV Artseumate + Exchange Transfusion.
Pneumocystis jiroveci pneumonia+ Sudden Dyspnoea + Sudden chest pain.
Pneumothorax—common complication of pneumocystis jiroveci.
Pneumonia + Hyponatremia + Bradycardia
Legionella.
Patients with an uncertain tetanus vaccination history should be:
Tetanus Immunoglobulins + Tetanus Vaccine.
Moraxella Cattrhalis :
Gram negative cocci.
Gram positive cocci example :
Staph, Strepto, Enterococcus
Acyclovir MOA :
DNA Polymerase Inhibitor.
What extra-pulmonary manifestation is most commonly seen with this infection
Hypoadrenalism
When to give Varicella immunoglobulin ?
Patient exposed to chicken pox+ Immunosupressed + VZv Antibodies <150.
Patient exposed to chicken pox+ Immunosupressed + VZv Antibodies <150
Give Varicella immunoglobulin
Pregnancy related complication in Parvo virus :
Fetal hydrops
Parvo Virus features:
Erythema Infectiousum+ Fifth Disease + Slap cheek + Fetal Hydrops
Travel to south Asian country 2 months ago + fever malaise , maculopapular rash + aphthous ulcers. Dx:
HIV seroconversion
Longer incubation period, an apthous ulcers and lack of retroorbital headache points more towards HIV seroconversion and not Dengue.
Patients with hyposplenism should be vaccinated against:
pneumococcal, Haemophilus type B and meningococcus type C.
Renal Transplant + Infection—
Cytomegalovirus.
Disseminated Lymes Rx:
IV Ceftriaxone.
Lymes Rx:
Oral Doxycycline
Pregnancy Plus Lymes Rx:
Oral Amoxicillin
First line Ix in Lymes :
ELISA
Lymes mnemonic and features :
Face to heart.
Facial palsy + Meningitis + Neck Stiffness + Heart Block—prolonged PR + Myocarditis
H/o Rash during trip—now LMN facial palsy. Dx?
Lymes
Diarrohoea—Decreased urine output+ Renal Failure with High Urea and Creatinine + Hemolyitic anaemia— Low Hb + Schistocytes.
E.coli O157: H7—Hemolytic Uraemic Syndrome.
Hemolytic Uraemic Syndrome caused by :
E coli: 0157:H7
HUS symptom :
Diarrohoea—Decreased urine output+ Renal Failure with High Urea and Creatinine + Hemolyitic anaemia— Low Hb + Schistocytes.
H/o Travel to India + Consuming Pork + Swelling/Painless nodules on Face + neck + Arm + passing of Noodles like material. Dx:
Cysticercosis.
Rx: Bendazoles
Cysticercosis.
H/o Travel to India + Consuming Pork + Swelling/Painless nodules on Face + neck + Arm + passing of Noodles like material. Dx:
Breast feeding in HIV :
Not recommended
Which Drug to avoid with Methotrexate ?
Trimethoprim and Co-trimoxazole
Which test is most likely to allow for accurate speciation of the malarial pathogen?
Thin Film
____ can commonly cause UTI in sexually active young women
Staph saprophyticus
Staph saprophyticus
Gram Positive, Coagulase Negative.
Travel to South East Asian country+ fever + malaise + headache—Black eschar. Dx?
Scrub typhus.
Rx: Doxycycline
Enteric Fever Diagnostic Test:
Large Volume Blood Culture.
Amoebic colitis, Diagnostic tests ?
A ‘hot stool’ (a stool examined within 15 minutes of passage, or kept warm)
Back pain + Fever + weight loss + night sweats + CXR: perihilar nodularity. Dx:
Spine TB
Post exposure prophylaxis of HIV, when is HIV testing repeated ?
12 weeks.
High risk wound + symptoms of tetanus. Rx:
IM tetanus immunoglobulin
Carbapenem resistance cause :
New Delhi metallo-beta-lactamase 1
Lassa fever Is caused by :
The excreta of infected African rats
TB treatment :
Isoniazid and Pyridoxine—6 Months.
Isoniazid+Pyridoxine +Rifampicin—3 Months.
Listeria Rx:
Ampicillin/Amoxicillin + Gentamycin.
Cholera Rx:
Doxycycline
Human African Trypanosomiasis Rx:
Pentamidine.
Human African Trypanosomiasis Clinical feature :
Reversal of sleep cycle.
Is Meningism a feature of Leptospirosis ?
Yes
Is AKI a feature of Leptospirosis ?
Yes
Is hepatitis a feature of Leptospirosis ?
Yes
Is Pulmonary complication feature of leptospirosis ?
No
Bite from Hep B known Source, patient who got the bite is known responder :
Hep B vaccine booster dose.
Farmer + small, raised, red papule but has now become larger—haemorrhagic lesion is seen
Orf.
Orf.
Farmer + small, raised, red papule but has now become larger—haemorrhagic lesion is seen
Conjugate vaccines are those :
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.
Conjugate vaccine example:
Meningococcal vaccine
E. coli causes what brain related illness ?
Neonatal meningitis
False negative tests may be caused by:
Military TB
Sarcoidosis
HIV
Lymphoma
Very young age (e.g. < 6 months
Differentiate Shistosomiasis hematobium from Black water fever:
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
Return from Africa—Fever + Rigors + Hepatsosplenomegaly+ haemoglobinuria—Dark red urine + Jaundice + AKI:
Microscopy—No red cell cast. Dx:
Blackwater fever
Black water fever
Return from Africa—Fever + Rigors + Hepatsosplenomegaly+ haemoglobinuria—Dark red urine + Jaundice + AKI:
Microscopy—No red cell cast. Dx:
Trip to Malawi + Itchiness + Visible Hematuria. Dx:
Shistosomiasis Hematobium
Rx for Shistosomiasis Hematobium
Praziquantel
Cold sore on lower lips + Pneumonia symptoms. Dx:
Strptococcus Pneumonia
Suspected Lymes. Next step ?
ELISA antibody test, and start Doxycycline while awaiting the results.
Travel h/o Brazil + Pruritic Rash around feet and anus + raised eosinophils. DX:
Strongylodiasis
HPV vaccination should be offered to men who:
who have sex with men under the age of 45 to protect against anal, throat and penile cancers.
Cold sore + Pneumonia =
Streptococcus pneumonia
Which Anti viral induces p450 ?
Nevirapine (a non-nucleoside reverse transcriptase inhibitor (NNRTI)
Most common cause of Bladder calcification ?
Shistosomiasis Hematobium
Schistosomiasis is a risk factor for?
Squamous cell bladder cancer
chloroquine-resistant strains of Plasmodium vivax Rx:
Artemisin based combination therapy—Artemether+ Lumefantine.
Genital warts are caused by HPV number?
HPV 6 and 11.
Alcoholics + cavitation + Pneumoniae:
Kleibsella
Kleibsella
Alcoholics + cavitation + Pneumoniae:
Diagnosis of Severe Malaria based on paristaemia :
Parasitaemia > 2 %
Staph Aureus is Coagulase ?
Coaglase Positive.
Coagulase Negative staph ?
Saprophyticus
Epidermidis
Cephalosporin MOA :
Inhibition of cell wall synthesis
What kind of virus is HIV ?
HIV is RNA retrovirus
Enterovirus example :
Coxsackie B virus
Macrolides MOA
Macrolides inhibit the 50S subunit of ribosomes
Asymptomatic bacteriuria: Rx:
Do not Treat.
Animal bites are generally polymicrobial but the most common isolated organism is :
Pasteurella multocida
Rocky mountain spotted fever
Rickettsia ricketsii
Fish tank granuloma is caused By :
Mycobacterium marinum
Malaria severe parasitaemia (>10%)
Artesunate + Exchange Transfusion
Pregnant hyperemesis Gravidarum + UTI :
Nitrofurantoin
As hyperemesis gravidarum occurs in first term and trimethoprim is C/I. In first term.
Travel H/o from India+ Lethargy + Syncope + SOB + itchy rash on feet— low Hb+ High Eosinophils. Dx and diagnostic test:
Hookworm
Stool sample for : ova, cyst and parasite.
Diagnostic test for hookworm
Stool sample for ova, cyst and parasite.
How to prevent norovirus ?
handwashing with soaps and warm water before and after contact with those infected with norovirus
Measels is spread by ?
Aerosol.
Integrase inhibitors (‘gravirs’)
blocks the enzyme that inserts the viral genome into the DNA of the host cell
Pneumocystis jiroveci/carnii which stain ?
Silver stain
Erysipelas caused by ?
Streptococcus
Does strep causes pneumonia ?
No
Does Jarich herxheimer reaction occur with Lymes ?
No.
ECG findings of Lymes ?
Prolonged PR interval
Skin condition in Lymes ?
Erythema Migrans( Bull’s eye ), and not erythema marginatum.
Is Erythema Marginatum a feature of Lyme’s ?
No , It’s a feature of Rheumatic.
Erythema Migrans is a feature of Lymes.
Cellulitis Rx:
Flucoxacillin (penicillin )
If allergy—Give Macrolides—Clarithromycin.
Cellulitis + Penicillin allergy—
Rx: Give Macrolides—Clarithromycin
U/l Lesion on limb+ Painful Hot Tender.
Dx: Cellulitis.
The single most important step To avoid MRSA:
Hand Hygiene
Varicella pneumonia Rx:
IV acyclovir
Characteristic feature of Pneumocystis carinii/Jiroveci pneumonia
Normal chest auscultations
High suspect for Hep C. How to do the testing ?
First- HCV antibody test
Second- HCV RNA test.
Oseltamavir MOA:
Neuraminidase inhibitor ( Oswald had Neuro issues)
For zanamivir (Relenza) for suspected influenza. Which one of the following underlying problems may increase the likelihood of side-effects?
Asthama
Phlebotomist with Needle stick injury with HIV patient—chances of developing HIV ?
0.3 %
following tests is most likely to remain positive in a patient with syphilis despite treatment
TPHA
Most common complication in repeated PID:
Infertility
Gram negative organism test what on nitrate test ?
Gram negative test positive on Nitrate test.
Sepsis patient—Fluid resuscitation ?
500 ML Blous Stat over 15 mins.
Travel history+ 15 day history of non Bloody Diarrhoea. Dx:
Giardiasis.
Rx:Metronidazole
Long incubation + Non bloody Diarrhoea :
Giardiasis
Giardiasis Treatment of choice :
Metronidazole
Long incubation diarrhoea :
Giardiasis—Non bloody diarrhoea
Amboebiasis—Bloody diarrhoea
Cutaneous larva migrans Rx;
Bendazoles
Pneumocystis Jiroveci + Hyppoxia. Rx:
Co-trimoxazole + Prednisolone
Rabbit related infection :
Tularaemia
What is the most important factor determining your risk of HIV transmission in this case?
Viral load of the patient
Aspergilloma Rx:
Surgical resection
the presence of lymphadenopathy above and below the inguinal ligament is more classical of:
LGV.
Groove sign is a feature of
LGV- Chlamydia Trachomatis
Chlamydia Rx:
Doxycycline for 7 days.
Pregnant chlamydia Rx:
Macrolides—1 Gram single dose
Cerebral Toxoplasmosis Rx:
Pyrimethamine and sulphaiazine
Legionella pneumonia confirmatory test:
Urinary antigen
Anti retroviral therapy is started when:
At the time of diagnosis
Meningits symptoms plus Gram positive bacilli. Which organism ?
Listeria
Diarrhoe + H/o Eating rice
Bacillus cereus
Which virus is ass with nasopharyngeal cancer ?
Epstein Barr virus
Meningits sumps+ CSF= Polymorphs + Low Glucose. Dx:
bacterial meningitis
Streptococcus pneumonia causes Meningits in which age group ?
6-60 years of age group
Bilateral, mid-to-lower zone patchy consolidation in an older patient, which pneumonia ?
Legionella
CXR finding is Legionella :
Mid-to-lower zone patchy consolidation.
Neisseria Gonorrhoea Rx:
IM ceftriaxone
Meningitis symptoms + CSF glucose=Normal + High lymphocytes + Normal opening pressure. Dx:
Viral meningitis.
Strongyloides stercoralis gains access to the body by penetrating the skin
by penetrating the skin
H/O Swimming in Ghana + Calcification in bladder. Dx:
Shistosomiasis Hematobium
Clostrodium Difficile is a type of ?
Gram positive bacill/Rods
What kind of vaccine is Yellow fever vaccine ?
Live attenuated.
C/I in HIV, Post transplant
What type of vaccine is Tb ?
Live attenuated
Diagnostic test for HIV seroconversion:
HIV-1/2 Ab/Ag Immunoassay
Screening test to exclude HIV seroconversion :
P24 antigen test.
Screening test for asymptomatic patients for HiV seroconversion :
Rapid HIV antibody ELISA + P24 antigen test.
HbsAg—positive, Anti Hbc—IgM , Anti HD—IgM—Positive
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.
Which of the following vaccinations is contraindicated in egg allergy?
Yellow fever.
Screening test for TB:
Mantoux test.
Most common cause of visceral larva migrans?
Toxocara canis
Tubercular Meningitis
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol + + + Prednisolone.
Oral poliomyelitis is which type of vaccine ?
Live attenuated
Which vaccines in splenectomy patients ?
pneumococcus, Haemophilus, meningococcus + lifelong penicillin
primary genital herpes is made. What is the most appropriate management?
Oral Acyclovir
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?
give an accelerated course of the hepatitis B vaccine + hepatitis B immune globulin
Pharyngitis is caused by :
Streptococcus pyogenes
A 29-year-old woman develops severe vomiting four hours after having lunch at a local restaurant. What is the most likely causative organism?
Staphylococcus aureus food poisoning.
Tuberculin skin tests are an example of type IV (delayed) hypersensitivity reactions. Mediated by :
Mediated by interferon-γ
Most reliable method to assess a patient’s response to hepatitis C treatment.
Viral load. Viral load, or HCV RNA level,
Linezolid is active against ?
MRSA
Vancomycin resistant enterococcus
Hepatitis features + Diet= Sea food. Dx:
Hepatitis E
Hyadatid cyst. First line ?
Albendazole.
In Elective Surgery, when to give Pneumococcal vaccine?
Give vaccine 2 weeks before surgery.
Is oposthotonous a feature of Rabies ?
No.
Rabies feature ?
Fever + Headache + Agitation
+ Hdrophobia
+ Hypersalivation
+ Negri bodies
which bodies are seen in rabies ?
Negri bodies
H/o Travel + Eating outside + seizures + Headache CT head— demonstrated numerous small focal calcification Dx?
Neurocysticercosis
Filariasis cause :
Wuchereria Bancrofti
southern India presents with chronic swelling of both lower legs, they are brawny and indurated with marked skin trophic changes
Filariais
Unpasteurised Milk + Prodorme features ( Fever+ Headache+ Malaise) + Bloody Diarrhoae. Dx:
Campylobacter
when to give Rx in Campylobacter Diarrhoea ?
> 8 episodes of bloody diarrhoea + Symptoms do not resolve in one week +
Rx: Oral Clarithromycin.
Bacterial vaginalis is caused by ?
Gardenella vaginalis.
Plasmodium vivax malaria. He is treated initially with chloroquine then later given primaquine. What is the benefit of the primaquine?
Primaquine is used in non-falciparum malaria to destroy liver hypnozoites and prevent relapse
Travel history to South Asian country + Hypopigmentation + Sensory loss. Dx:
Leprosy.
Gardenella vaginosis is :
Gram positive cocobacilli
Necrotising fasciitis. Rx:
IV Antibiotics+ Surgical debridement
Diagnostic test for Pneumocystis Jiroveci :
Bronchoalveolar lavage.
A newly qualified staff nurse at the local hospital undergoes vaccination against hepatitis B.
Anti HbS 10-100
One further dose of vaccine
A newly qualified staff nurse at the local hospital undergoes vaccination against hepatitis B. Anti HbS < 10
Test for current or past infection .
Vaccine + Immunoglobulins
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?
Diphtheria
HIV + He has coarse crackles on the right side of his chest. A chest x-ray shows consolidation of the right mid zone.
Community acquired pneumonia—Streptococcus pneumonia
Pneumocystis jiroveci has clear chest
Treated for Gonorrhoea. No improvement. Possible Diagnosis ?
Co existent chlamydia
Aspergilloma Diagnostic test:
Serology for aspergillus precipitins
K/C/O HIV + Headache + Drowsiness + CT= Single Lesion=
Lymphoma
describes the prevention and treatment of hepatitis C?
No vaccine is available but treatment is successful in the majority of patients.
Campylobacter Diarrhoea > 7 Days. Rx:
Macrolides
Meningococcal Meningitis with penicillin allergy. Rx:
Chloramphenicol
Suspected Bacterial/meningococcal meningitis in hospital setting. Rx:
IV Cefotaxime
Differentiating between toxoplasmosis and lymphoma
SPECT
Pneumococcus Meningits , what precautions need to be taken by close contact ?
No action needed.
Unpasteurised cheese +Flu + wet hay smell . Dx?
Brucellosis
Rx:- Doxycycline
On Rx for LRTI— suffered Achilles tendon rupture as side effect—now meningococcal septicaemia—what prophylaxis to be given to the partner ?
Achilies tendon rupture—s/e of ciprofloxacin
Therefore give 2nd option—Oral Rifampicin.
Hospital-acquired pneumonia
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)
Brucellosis Dx:
Brucellosis serology
Shigella Rx:
Ciprofloxacin
Natalizumab MOA :
Prevents Leucocyte migration.
