Infectious Disease Flashcards

1
Q

Antibiotic for animal bites

A

Co-amox
Doxy and metronidazole if pen allergic

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2
Q

Antibiotic for human bites

A

Co-amox

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3
Q

Antibiotic for exacerbations of chronic bronchitis

A

Amox, tetracycline, or clarithromycin

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4
Q

Antibiotic for uncomplicated CAP

A

Amox
Doxy or clarithro in pen allergic, add fluclox if staph suspected e.g. in influenza

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5
Q

Antibiotic for ?atypical pneumonia

A

Clarithromycin

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6
Q

Antibiotic for HAP

A

If within 5 days of admission - co-amox or cefuroxime
If more than 5 days after admission - taz or broad spectrum ceph, e.g. ceftazidime, or quinolone e.g. cipro

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7
Q

Antibiotic UTI

A

Trimethoprim or nitro

Alternative: amox or cephalosporin

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8
Q

Antibiotic acute pyelonephritis

A

Broad spectrum cephalosporin or quinolone

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9
Q

Antibiotic acute prostatitis

A

Quinolone or trimethoprim

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10
Q

Antibiotic impetigo

A

Topical hydrogen peroxide
Oral fluclox or erythromycin if widespread

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11
Q

Antibiotic cellulitis

A

Fluclox
Clarithromycin, erythromycin, or doxycycline if pen allergic

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12
Q

Antibiotic cellulitis near the eyes or nose

A

Co-amox
Clarithromycin and metronidazole if pen allergic

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13
Q

Antibiotic erysipelas

A

Fluclox
Clarithromycin, erythromycin, or doxy if pen allergic

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14
Q

Antibiotics mastitis

A

Fluclox

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15
Q

Antibiotics throat infections

A

Phenoxymethylpenicillin
Erythromycin if pen allergic

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16
Q

Antibiotic sinusitis

A

Phenoxymethylpenicillin

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17
Q

Antibiotic otitis media

A

Amoxicillin
Erythromycin if pen allergic

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18
Q

Antibiotics otitis externa

A

Fluclox
Erythromycin if pen allergic

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19
Q

Antibiotics periapical or periodontal abscess

A

Amox

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20
Q

Antibiotics acute necrotising ulcerative gingivitis

A

Metronidazole

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21
Q

Antibiotics gonorrhoea

A

IM ceftriaxone

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22
Q

Antibiotics Chlamydia

A

Doxycycline or azithromycin

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23
Q

Antibiotics pelvic inflammatory disease

A

Oral ofloxacin and oral metronidazole
or
IM ceftriaxone and oral doxy and oral metronidazole

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24
Q

Antibiotics syphilis

A

Benzathine benzylpenicillin
or
Doxycycline and erythromycin

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25
Q

Antibiotics bacterial vaginosis

A

Oral or topical metronidazole
or
Topical clindamycinA

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26
Q

Antibiotics C. diff

A

First episode: oral vancomycin
Second/subsequent episode: oral fidaxomicin

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27
Q

Antibiotics campylobacter enteritis

A

Clarithromycin

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28
Q

Antibiotics salmonella (non-typhoid)

A

Ciprofloxacin

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29
Q

Antibiotics shigellosis

A

Ciprofloxacin

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30
Q

Adverse effects aminoglycosides

A
  • Nephrotoxicity
  • Ototoxicity
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31
Q

Adverse effects tetracyclines

A
  • Discolouration of teeth
  • Photosensitivity
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32
Q

Adverse effects chloramphenicol

A

Aplasia anaemia

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33
Q

Adverse effects clindamycin

A

C. Diff

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34
Q

Adverse effects macrolides

A

Nausea (esp erythromycin)
P450 inhibitor
Prolonged QT

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35
Q

Adverse effects azoles

A

P450 inhibition
Liver toxicity

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36
Q

Adverse effects amphotericin B

A

Nephrotoxicity
Flu like symptoms
Hypokalaemia
Hypomagnasaemia

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37
Q

Adverse effects griseofulvin

A

Induces P450 system
Teratogenic

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38
Q

Adverse effects flucytosine

A

Vomiting

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39
Q

Adverse effects caspofungin

A

Flushing

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40
Q

Contraindications BCG vaccine

A
  • Previous BCG vaccine
  • Past history TB
  • HIV
  • Pregnancy
  • Positive tuberculin test
  • Over 35 (no evidence it works)
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41
Q

Most common bacterial cause of infectious intestinal disease in UK

A

Campylobacter

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42
Q

Features of campylobacter

A

Prodrome of headache and malaise
Often bloody diarrhoea
Abdo pain

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43
Q

Most common protozoal cause of diarrhoea in UK

A

Cryptosporidiosis

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44
Q

Features of cryptosporidial diarrhoea

A
  • More common in immunocompromised and young children
  • Watery diarrhoea
  • Abdominal cramps
  • Fever
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45
Q

Complication of cryptosporidial diarrhoea in immunocompromised

A

Entire GI tract may be affected resulting in sclerosing cholangitis and pancreatitis

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46
Q

Management of cryptosporidial diarrhoea -

A
  • Supportive if immunocompetent
  • Nitazoxanide or rifaximin for immunocompromised
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47
Q

Features of diptheria

A

Diptheric membrane on tonsils - grey, pseudomembrane on posterior pharyngeal wall
Bulky cervical lymphadenopathy
Neuritis, e.g. cranial nerve
Heart blocka

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48
Q

Management of diptheria

A

IM penicillin
Diptheria antitoxin

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49
Q

Features of enteric fever (typhoid/paratyphoid)

A
  • Systemic features - fever, headache, arthralgia
  • Relative bradycardia
  • Abdominal pain and distention
  • Constipation
  • Rose spots (more common in paratyphoid)
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50
Q

Complications of enteric fever

A

Osteomyelitis
GI bleed/perforation
Meningitis
Cholecystitis
Chronic carriage

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51
Q

Most common cause of travellers diarrhoea

A

E coli

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52
Q

Most common causes of acute food poisioning

A
  • Staphylococcus aureus
  • Bacillus cereus
  • Clostridium perfringens
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53
Q

Features of E coli gastroenteritis

A

Watery stools
Abdominal cramps and nauseaF

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54
Q

Features of giardiasis gastroenteritis

A

Prolonged, non-bloody diarrhoea
Foul smelling burps
Bloating
Steatorrhoea
Malabsorption and lactose intolerance

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55
Q

Features of cholera gastroenteritis

A

Profuse, watery diarrhoea
Severe dehydration resulting in weight loss

Not common in travellers

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56
Q

Features of shigella gastroenteritis

A

Bloody diarrhoea
Vomiting and abdominal pain

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57
Q

Features of S aureus gastroenteritis

A

Severe vomiting
Short incubation period

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58
Q

Features of campylobacter gastroenteritis

A

Flu-like prodrome usually followed by crampy abdominal pain, fever, and diarrhoea which may be bloody
Can mimic appendicitis

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59
Q

Features of bacillus cereus gastroenteritis

A

Vomiting within 6 hours
Diarrhoeal illness occurring after 6 hours

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60
Q

Features of amoebiasis gastroenteritis

A

Gradual onset bloody diarrhoea, abdominal pain, and tenderness which may last several weeks

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61
Q

Which pathogens causing gastroenteritis have incubation period of 1-6 hours

A

Staph aureus
Bacillus cereus

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62
Q

Which pathogens causing gastroenteritis have incubation period 12-48 hours

A

Salmonella
E coli

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63
Q

Which pathogens causing gastroenteritis have incubation period 48-72 hours

A

Shigella
Campylobacter

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64
Q

Which pathogens causing gastroenteritis have incubation period >7 days

A

Giardiasis
Amoebiasis

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65
Q

Virus causing genital herpes

A

HSV-1 and HSV-2 (more so HSV-2)

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66
Q

Management of HSV in pregnancy

A

Elective section at term if primary attack of herpes after 28 weeks
Recurrent herpes in pregnancy treated with suppressive therapy, risk of transmission to baby is low

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67
Q

Virus causing genital warts

A

HPV 6 and 11

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68
Q

Virus causing cervical cancer

A

HPV 16, 18, 33

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69
Q

First line treatment for genital wards

A

Topical podophyllum if multiple, non-keratinised warts
Cryotherapy if solitary keratinised warts

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70
Q

Second line treatment for genital warts

A

Imiquimod

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71
Q

Treatment for giardiasis

A

Metronidazole

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72
Q

Features of hepatitis A

A

Flu like prodrome
Abdominal pain, typically RUQ
Tender hepatomegaly
Jaundice
Deranged LFTs

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73
Q

Features of acute hepatitis B

A

Fever
Jaundice
Raised LFTs

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74
Q

Complications of hepatitis B

A
  • Chronic hepatitis (5-10%)
  • Fulminant liver failure (1%)
  • Hepatocellular carcinoma
  • Glomerulonephritis
  • Polyarteritis nodosa
  • Cryoglobulinaemia
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75
Q

Risk factors for non-response to hep B vaccine

A
  • Age over 40
  • Obesity
  • Smoking
  • Alcohol excess
  • Immunosuppression
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76
Q

Criteria for testing anti-HBs to assess response to hep B vaccine

A
  • Risk of occupational exposure
  • CKD
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77
Q

What anti-HBs level indicates adequate response

A

> 100

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78
Q

What anti-HBs level indicates suboptimal response

A

10-100

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79
Q

Management of suboptimal response to hep B vaccine

A

One additional vaccine dose given. If immunocompetent, no further testing required

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80
Q

What anti-HBs level indicates non-responder

A

<10

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81
Q

Management of non-responder to hep B vaccine

A

Test for current or past infection
Give further vaccine course (3 doses again) and then testing

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82
Q

Management of non-responder to hep B vaccine after repeat course

A

HBIG for protection if exposed to virus

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83
Q

Management of hepatitis B infection

A

Pegylated interferon-alpha

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84
Q

Breastfeeding and hep C

A

Not contraindicated

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85
Q

Features of acute hep C infection

A
  • Transient rise in serum aminotransferases/jaundice
  • Fatigue
  • Arthralgia

Only about 30% get these symptoms

86
Q

Complications of chronic hep C

A
  • Rheumatological probelms
  • Sjorgens syndrome
  • Cirrhosis
  • Hepatocellular cancer
  • Cryoglobulinaemia
  • Porphyria cutanea tarda
  • Membranoproliferative glomerulonephritis
87
Q

Rheum problems in chronic hep C

A

Arthralgia
Arthritis

88
Q

Management of chrnoic hep C

A

Combination of protease inhibitors e.g. sofosbuvir + daclatasvir or simeprevir, with or without rivavirin

89
Q

SEs of ribavirin

A

Haemolytic anaemia
Cough
Teratogenic (no pregnancy for 6 months after stopping)

90
Q

SEs of interferon alpha

A

Flu like symptoms
Depression
Fatigue
Leukopenia
Thrombocytopenia

91
Q

Cause of Kaposi’s sarcoma

A

HHV-8 (in HIV patient)

92
Q

Features of Kaposi’s sarcoma

A

Purple papules or plaques on skin or mucosa, e.g. GI, resp tract
Skin lesions may later ulcerate
Resp involvement → haemoptysis and pleural effusion

93
Q

HIV treatment

A

At least 3 drugs - typically 2 nucleoside reverse transcriptase inhibitors (NRTI) and either protease inhibitor (PI) or non-nucleoside reverse transcriptase inhibitor (NNRTI)

94
Q

Examples of NRTI

A

Zidovudine
Tenofovir
Didanosine

95
Q

General SEs NRTIs

A

Peripheral neuropathy

96
Q

SE tenofovir

A

Renal impairment
Osteoporosis

97
Q

SEs zidovudine

A

Anaemia
Myopathy
Black nails

98
Q

SEs didanosine

A

Pancreatitis

99
Q

Examples of NNRTI

A

Nevirapine
EfavirenzS

100
Q

SEs NNRTI

A

P450 enzyme interaction
Rashes

101
Q

Examples protease inhibitors

A

Indinavir
Nelfinavir
Ritonavir

102
Q

SEs protease inhibitors

A

Diabetes
Hyperlipidaemia
Buffalo hump
Central obesity
P450 enzyme inhibition

103
Q

SEs indinavir

A

Renal stones
Asymptomatic hyperbilirubinaemia

104
Q

SEs ritonavir

A

Potent inhibitor of P450

105
Q

CXR findings PCP pneumonia

A

Bilateral interstitial pulmonary infiltrates
May be normal

106
Q

Features of PCP pneumonia

A

Dyspnoea
Dry cough
Fever
Exercise induced desat
Very few chest signs

107
Q

Management PCP pneumonia

A

Co-trimoxazole
IV pentamidine in severe cases
Steroids if hypoxic

108
Q

Cause of infectious mononucleosis

A

EBV aka HHV-4

109
Q

Features of infectious mononucleosis

A
  • Sore throat
  • Lymphadenopathy (anterior and posterior triangles)
  • Pyrexia
  • Palatal petechiae
  • Splenomegaly (50%)
  • Hepatitis, transient rise in ALT
  • Lymphocytosis
  • Haemolytic anaemia
110
Q

Infectious mononucleosis + amoxicillin =

A

Maculopapular, pruritic rash

111
Q

Diagnosis of infectious mononucleosis

A

Heterophil antibody test (monospot test)

112
Q

Mode of administration of child flu vaccine

A

Intranasal

113
Q

Nasal flu vaccine live or inactivated

A

Live

114
Q

Contraindications nasal flu vaccine

A

Immunocompromised
Aged <2
Current febrile illness or blocked nose/rhinorrhoea
Current wheeze or history of severe asthma
Egg allergy
Pregnancy/breastfeeding
If child taking aspirin (risk of Reye’s syndrome)

115
Q

Adult flu vaccine live or inactivated?

A

Inactivated

116
Q

Contraindications adult flu vaccine

A

Hypersensitivity to egg protein

117
Q

Features of Legionnaire’s disease

A

Flu like symptoms inclduing fever
Dry cough
Relative bradycardia
Confusion
Lymphopenia
Hyponatraemia
Deranged liver function test
Pleural effusion

118
Q

Diagnosis of Legionnaire’s disease

A

Urinary antigen

119
Q

CXR findings Legionnaire’s disease

A

Mid to lower zone predominance of patchy consolidation
Pleural effusions in 30%

120
Q

Management of Legionnaires disease

A

Erythromycin/clarithromycin

121
Q

Features leptospirosis

A

Early phase (lasts around a week):
- Mild or subclinical
- Fever
- Flu like symptoms
- Subconjunctival redness/haemorrhage

Second immune phaes (Weil’s disease)
- AKI
- Hepatitis - jaundice and hepatomegaly
- Aseptic meningitis

122
Q

Management leptospirosis

A

Mild-to-moderate - doxycycline or azithromycin
Severe disease - IV benzylpencillin

123
Q

How is leptospirosis spread

A

Rat urine

124
Q

Diagnosis of Lyme disease

A

Clinical diagnosis of erythema migrans present
ELISA antibodies to Borrelia burgdorferi if doubt. If neg and still suspected, repeat ELISA in 4-6 weeks. If still negative and symptomatic for 12 weeks, immunoblot test

125
Q

Management of Lyme disease

A

Doxycycline if early disease, amox if contraindicated
Ceftriaxone if disseminated disease

126
Q

Features of plasmodium vivax

A

Found in central America and Indian subcontinent
Fever, headache, splenomegaly
Cyclical fever every 48 hours

127
Q

Features of plasmodium ovale

A

Typically from Africa
Cyclical fever every 48 hours
Fever, headache, splenomeglay

128
Q

Features of plasmodium malariae

A

Fever, headache, splenomegaly
Nephrotic syndrome

129
Q

Treatment for non-falciparum malaria

A

In chloroquine sensitive areas, either artemisinin based combo therapy (ACT) or chloroquine
In resistant areas, ACT

Patients with ovale or vivax - primaquine following acute treatment to prevent relapse

130
Q

Options for malaria prophylaxis

A

Malarone (atovaquone and proguanil)
Chloroquine
Doxycycline
Lariam (meflouquine)
Paludrine (proguanil)

131
Q

SEs malarone

A

GI upset

132
Q

When to take malarone prophylaxis

A

1-2 days before
7 days after

133
Q

SEs chloroquine

A

Headache

134
Q

Contraindications chloroquine

A

Epilepsy

135
Q

When to take chloroquine

A

1 week before
4 weeks after

Taken weekly

136
Q

SEs doxycyline (malaria prophylaxis)

A

Photosensitivity
Oesophagitis

137
Q

When to take doxycycline malaria prophylaxis

A

1-2 days before
4 weeks after

138
Q

SEs mefloquine

A

Dizziness
Neuropsychiatric disturbance

139
Q

CIs mefloquine

A

Epilepsy

140
Q

When to take mefloquine malaria prophylaxis

A

2-3 weeks before
4 weeks after

141
Q

When to take proguanil malaria prophylaxis

A

1 week before
4 weeks after

142
Q

Considerations pregnancy and malaria

A

Avoid travelling to regions where malaria endemic, diagnosis difficult as parasites may not be detected due to placental sequesteration

143
Q

Malaria prophylaxis in pregnancy

A

Chloroquine ok
Proguanil - needs folate supplements
Malarone - avoid, if essential then folate
Avoid mefloquine
Doxy contraindicated

144
Q

Malaria prophylaxis for children

A

Avoid travel

DEET spray - repels 100% mosquitos if used correctly, can be used from 2 months
Doxycyline if over 12

145
Q

CSF findings in bacterial meningitis

A
  • Cloudy
  • Low glucose (<1/2 plasma)
  • High protein (>1g/L)
  • 10-5,000 white cells
146
Q

CSF findings viral meningitis

A
  • Clear/cloudy
  • 60-80% plasma glucose
  • Normal/raised protein
  • 15-1000 white cells
147
Q

CSF findings tuberculous meningitis

A
  • Slightly cloudy, fibrin web
  • Low glucose (<1/2 plasma)
  • High protein (>1g/L)
  • 30-300 white cells
148
Q

CSF findings fungal meningitis

A
  • Cloudy
  • Low glucose
  • High protein
  • 20-200 white cells
149
Q

Empirical antibiotics bacterial meningitis <3 months

A

IV cefotaxime and amox

150
Q

Empirical antibiotics bacterial meningitis 3 months - 50 years

A

IV cefotaxime or ceftriaxone

151
Q

Empirical antibiotics bacterial meningitis

A

IV cefotaxime (or ceftriaxone) and amoxicillin (or ampicillin)

152
Q

Antibiotics meningococcal meningitis

A

IV benzylpenicillin or cefotaxime (or ceftriaxone)

153
Q

Antibiotics pneumococcal meningitis

A

IV cefotaxime (or ceftriaxone)

154
Q

Antibiotics haemophilus influenzae meningitis

A

IV cefotaxime (or ceftriaxone)

155
Q

Antibiotics listeria meningitis

A

IV amoxicillin (or ampicillin) and gentamicin

156
Q

Antibiotics meningitis contact prophylaxis

A

Ciprofloxacin or rifampicin

157
Q

Antibiotics MRSA

A

Vancomycin
Teicoplanin
Linezolid

158
Q

Treatment mumps

A

Rest
Paracetamol

Notifiable

159
Q

Complications mumps

A

Orchitis
Hearing loss
Meningoencephalitis
Pancreatitis

160
Q

Features of mycoplasma pneumonia

A

Prolonged and gradual onset
Flu like symptoms preceding dry cough
Bilateral consolidation on XR

161
Q

Complications mycoplasma pneumonia

A
  • Cold agglutins → haemolytic anaemia, thrombocytopenia
  • Erythema multiforme, erythema nodosum
  • Meningoencephalitis, Guillain-Barre syndrome
  • Bullous myringitis
  • Pericarditis/myocarditis
  • Hepatitis, pancreatitis
  • Acute glomerulonephritis
162
Q

Treatment mycoplasma pneumonia

A

Doxycycline or macrolife (erythromycin/clarithromycin)

163
Q

Presentation of parvovirus B19

A

Erythema infectiosum aka slapped cheek syndrome
Pancytopenia in immunosuppressed
Aplastic criss in sickle cell
Hydrops fetalis if pregnant

164
Q

Features of erythema infectiosum

A

Mild feverish illness
Bright red cheeks appear as child feels better
Can be triggered by warmth for months afterwards

165
Q

Most common cause of CAP

A

Streptococcus pnuemoniae

166
Q

CAP after flu

A

Staph aureus

167
Q

Pneumonia in alcoholics

A

Klebsiella

168
Q

PEP hep A

A

Human normal immunoglobulin (HNIG) or hep A vaccine

169
Q

PEP hep B positive source

A

If known responder to vaccine, booster dose given
If non-responder (<10), hep B immune globulin and booster vaccine

170
Q

PEP hep B unknown source

A

If known responder to vaccine, consider booster
If non-responder, HBIG and vaccine
If in process of being vaccinated, accelerated course

171
Q

PEP hep C

A

Monthly PCR - if seroconversion, inferon +/- ribavirin

172
Q

PEP HIV

A

Combination of oral anti-retrovirals ASAP (ideally within 1-2 hours, up to 72 hours) for 4 weekse
Serological testing 12 weeks following completion of PEP

173
Q

PEP varicella zoster

A

VZIG in IgG neg preg women/immunocompromised

174
Q

Rabies treatment (animal bite in at risk countries)

A

Wash wound
If immunised, 2 further doses of vaccine
If unimmunised, human rabies immunoglobulin (HRIG) given with full course of vaccination - if possible, administer locally around wound

175
Q

Most common cause of bronchiectasis exacerbations

A

H influenzae

176
Q

Rubella features

A

Prodrome - low grade fever
Maculopapular rash, initially on face → body
Suboccipital and postauricular lymphadenopathy

177
Q

Complications rubella

A

Arthritis
Thrombocytopenia
Encephalitis
Myocarditis

178
Q

Features of chancroid

A

Painful genital ulceration
Unilateral painful inguinal lymph node enlargement
Sharply defined, ragged, undermined border

179
Q

Cause of lymphogranuloma venereum

A

Chlamydia trachomatis

180
Q

Features of lymphogranuloma venereum

A

Stage 1 - small painless pustule which later forms ulcer
Stage 2 - painful inguinal lymphadenopathy
Stage 3 - proctocolitis

181
Q

Treatment for lymphogranuloma venereum

A

Doxycycline

182
Q

Features primary syphilis

A

Chancre (painless ulcer at site of sexual contact)
Local non-tender lymphadenopathy

Often not seen in women (may be on cervix)

183
Q

Features secondary syphilis

A

Systemic features - fevers, lymphadenopathy
Rash on trunk, palms, soles
Buccal ‘snail track’ ulcers
Condylomata lata (painless, warty lesions on genitalia)

184
Q

Features tertiary syphilis

A

Gummas (granulomatous lesions of skin and bones)
Ascending aortic aneurysms
General paralysis of the insane
Tabes dorsalis
Argyll-Robertson pupil

185
Q

Features of congenital syphilis

A
  • Blunted upper incisor teeth
  • Rhagades (linear scars at angle of mouth)
  • Keratitis
  • Saber shins
  • Saddle nose
  • Deafness
186
Q

Treatment syphilis

A

IM benzathine penicillin, doxy if contraindicated

187
Q

What can occur after antibiotic treatment for syphilis

A

Jarisch-Herxheimer reaction - fever, rash, tachycardia after first dose of antibiotic. No wheeze or hypotension.

188
Q

Routine tetanus vaccine given at…

A

2, 3, 4 months
3-5 years
13-18 years

189
Q

What is classified as tetanus prone wound

A

Puncture type injuries in contaminated environment, e.g. gardening injuries
Wounds containing foreign bodies
Compound fractures
Wounds or burns with systemic sepsis
Certain animal bites and scratches

190
Q

What is classified as high risk tetanus prone wounds

A

Heavy contamination with material likely to contain tetanus spores, e.g. soil, manure
Wounds or burns with extensive devitalised tissue
Wounds or burns requiring surgical intervention

191
Q

Management of tetanus prone wounds

A

If full course vaccines with last dose <10 years ago, no action
If full course vaccines with last dose >10 years ago, reinforcing dose of vaccine
If vaccination history incomplete or unknown, reinforcing dose of vaccine and tetanus immunoglobulin

192
Q

Management of high-risk tetanus prone wound

A

If full course vaccines with last dose <10 years ago, no action
If full course vaccines with last dose >10 years ago, or vaccine history unknown/incomplete reinforcing dose of vaccine and tetanus immunoglobulin

193
Q

Examples of tetracyclines

A

Doxycycline
Tetracycline

194
Q

Adverse effects tetracyclines

A

Discolouration of teeth (should not be used <12 years of age)
Photosensitivity
Angioedema
Black hairy tongue

195
Q

Tetracyclines in pregnancy/breastfeeding

A

Do not use due to risk of teeth discolouration

196
Q

Toxoplasmosis in immunosuppressed/HIV can cause…

A

Cerebral toxoplasmosis
Chorioretinitis

197
Q

Features of cerebral toxoplasmosis

A

Constitutional symptoms
Headache
Confusion
Drowsiness

198
Q

CT features cerebral toxoplasmosis

A

Usually single or multiple ring enhacing lesions, mass effect may be seen

199
Q

Management cerebral toxoplasmosis

A

Pyrimethamine plus sulphadiazine for at least 6 weeks

200
Q

Features of congenital toxoplasmosis

A

Neuro damage
- Cerebral calcification
- Hydrocephalus
- Chorioretinitis

Opthalmic damage
- Retinopathy
- Cataracts

201
Q

Features of trichomonas vaginalis

A

Vaginal discharge - offensive, yellow/green, frothy
Vulvovaginitis
Strawberry cervix
pH >4.5

Usually asymptomatic in men, can cause urethritis

202
Q

Investigation findings trichomonas vaginalis

A

Microscopy of wet mount shows motile trophozoites

203
Q

Management trichomonas vaginalis

A

Oral metronidazole 5-7 days (or one off dose 2g metronidazole)

204
Q

Diagnosis of latent TB

A

Positive tuberculin skin test or interferon gamma release assay, with normal CXR to exclude active TB

205
Q

Treatment latent TB

A

3 months of isonazid + pyridoxine and rifampicin (if under 35 and hepatotoxicity a concern)
6 months of isonidazid with pyridoxine (if interactions with rifamycins a concern, e.g. HIV, transplant)

206
Q

Treatment active TB

A

2 months - rifampicin, isoniazid, pyrizinamide, ethambutol
Then next 4 months - rifampicin, isoniazid

207
Q

Treatment meningeal TB

A

Prolonged treatment (at least 12 months) wtih steroids

208
Q

Live attenuated vaccines

A

BCG
MMR
Intranasal flu
Oral rotavirus
Oral polio
Yellow fever
Oral typhoid

209
Q

Inactivated vaccines

A

Rabies
Hepatitis A
IM flu

210
Q

Toxoid vaccines

A

Tetanus
Diptheria
Pertussis

211
Q

Subunit/conjugate vaccine

A

Pneumococcus
Haemophilus
Meningococcus
Hep B
HPV