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Infectious Disease Flashcards

1
Q

What is the causative agent of Dengue fever?

A

Dengue virus (DENV) with 4 serotypes: DEN-1, DEN-2, DEN-3, DEN-4.

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2
Q

How is Dengue fever transmitted?

A

By Aedes aegypti and Aedes albopictus mosquitoes.

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3
Q

What are the three phases of Dengue fever?

A

Febrile phase, Critical phase, Recovery phase.

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4
Q

What are common symptoms in the Febrile phase of Dengue?

A

Abrupt high-grade fever, facial flushing, body ache, myalgia, arthralgia, retro-orbital pain, photophobia, nausea, and vomiting.

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5
Q

What critical sign occurs in the Critical phase of Dengue?

A

Plasma leakage leading to hemoconcentration and hypovolemia or shock.

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6
Q

What is the characteristic rash seen in Dengue recovery phase?

A

Isles of white in the sea of red, pruritic rash.

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7
Q

What are warning signs of severe Dengue?

A

ALL-LOVE: Abdominal pain, Lethargy, Liver enlargement, Organ impairment, Vomiting persistently, Edema.

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8
Q

What is the gold standard diagnostic test for Dengue?

A

NS1 antigen for early detection (day 1-3), IgM (primary infection), IgG (secondary infection).

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9
Q

What is the first-line IV fluid for Dengue shock?

A

Normal saline (NS) 10-20 mL/kg over 30 minutes as the first bolus.

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10
Q

What is the common causative virus for Chickenpox?

A

Varicella-zoster virus (VZV), a double-stranded DNA virus from the herpesvirus family.

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11
Q

What is the characteristic rash of Chickenpox?

A

Vesicular rash appearing in crops, progressing from macules to papules, vesicles, pustules, and scabs.

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12
Q

What is the incubation period of Chickenpox?

A

14 to 16 days.

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13
Q

What is the most serious complication of Varicella in immunocompromised patients?

A

Disseminated varicella leading to pneumonia, hepatitis, or encephalitis.

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14
Q

What antiviral is given for severe Chickenpox?

A

IV Acyclovir within 24 hours of rash onset.

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15
Q

What is the characteristic blood film finding in Malaria?

A

Presence of Plasmodium species in blood film malaria parasite (BFMP) test.

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16
Q

What are the first-line treatments for Malaria?

A

Artemether/Lumefantrine (Riamet) and Primaquine.

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17
Q

What is the key diagnostic test for Tuberculosis (TB)?

A

Mantoux Tuberculin Skin Test (TST) or IGRA, Mycobacterial culture.

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18
Q

What are the first-line drugs for TB treatment?

A

HRZE: Isoniazid, Rifampicin, Pyrazinamide, Ethambutol.

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19
Q

What is the characteristic finding in a chest X-ray of TB?

A

Miliary nodules, cavitation, or hilar lymphadenopathy.

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20
Q

What is the characteristic X-ray finding in Acute Epiglottitis?

A

Thumb sign on lateral neck X-ray.

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21
Q

What is the key feature of Acute Epiglottitis?

A

Severe sore throat, drooling, stridor, and tripod positioning.

22
Q

What is the immediate management of Acute Epiglottitis?

A

Urgent admission, airway protection, IV antibiotics (Amoxicillin-Clavulanate), and IV Dexamethasone.

23
Q

What is the primary vaccine used for Pneumococcal infections?

A

PCV13 for children, PPV23 for high-risk individuals above 2 years old.

24
Q

What is the key investigation for Streptococcal pneumonia?

A

Gram stain and culture of blood, sputum, or CSF.

25
Physical Exam: Hypovolemic Shock (dengue)
Cold & clammy extremities, prolonged CRT>2s, tachycardia (rapid & weak/feeble pulse), reduced urine output, narrow pulse pressure.
26
Physical Exam: Compensated Shock (dengue)
Systolic BP maintained (normal SBP) but with signs of reduced perfusion.
27
(dengue) Physical Exam: Decompensated Shock
Hypotension/unrecordable BP, signs of reduced perfusion, metabolic acidosis/hypercapnea/Kussmaul breathing.
28
(dengue) Indications for Hospitalization
Presence of warning signs, infants (0-12 months), comorbidities (DM, renal failure, immune compromise, hemoglobinopathy, obesity), social factors (far hospital, transport issue).
29
(dengue) 3 Aims in Hospitalized Patients
1) Replacement of plasma fluid, 2) Early recognition/treatment of hemorrhage, 3) Prevention of fluid overload.
30
Dengue Rapid Test Findings
NS1 Ag: Detect antigen (D1-3), IgM: Primary infection (D3-3 months), IgG: Secondary infection (D5-forever).
31
(dengue) FBC Findings
Hb: Anaemia (occult bleeding), TWCC: Normal/leukopenia (febrile phase), Platelet: Thrombocytopenia (critical phase), HCT: Haemoconcentration (dehydration).
32
(dengue) Renal Panel (RP) Findings
Hypo-Na, K: Electrolyte imbalance (persistent vomiting/diarrhea), High urea & creatinine: AKI 2° to dehydration.
33
LFT Findings(dengue)
Transaminitis (warning sign).
34
(dengue) Coagulation Profile
TRO coagulopathy & liver impairment.
35
(dengue) VBG Findings
TRO DKA/compensated metabolic acidosis (early sign shock in DF).
36
(dengue) DXT Findings
Stress-induced hyperglycemia, TRO DKA.
37
(dengue) Cardiac Enzymes Findings
Myocarditis/rhabdomyolysis (cx of DF).
38
(dengue) Management Step 1
Notify nearest health office within 24 hours.
39
(dengue) Management Step 2
Insert 2 large bore IV cannula.
40
(dengue) Management Step 3
Initiate IV fluid resuscitation with IV NS 10-20ml/kg over 30 minutes as 1st bolus.
41
(dengue) Management Step 4
Reassess general condition + haemodynamic status (CCTVR) + vital signs + dengue charting.
42
(dengue) Management: Rapid Haemodynamic Assessment
CCTVR: Skin colour (cyanosis), CRT (prolonged), Temp (cold extremities), Pulse volume (weak), Pulse rate (abnormal).
43
(dengue) Management: If Shock Persists
Repeat IV NS 10-20ml/kg over 30 minutes (2nd bolus).
44
(dengue) Management: Continuous Monitoring
Monitor dengue charting & I/O chart every 6 hours (sudden drop HCT & platelet = warning sign).
45
(dengue) Management: If Improved
Continue fluid maintenance IV NS 5-7ml/kg/hr for 1-2 hrs → reduce IV NS 3-5ml/kg/hr for 2-4 hrs → reduce IV NS 2-3ml/kg/hr for 2-4 hrs.
46
(dengue) Management: If Not Improving
Decrease HCT + unstable vitals → suspect occult bleeding → transfuse fresh whole blood or packed cells.
47
(dengue) Management: Transfusion Guidelines
Fresh blood <7 days old (best 1-2 days). Give blood component matching (plt, RBC, clotting factors).
48
(dengue) Management: Monitoring
Always monitor vital signs, I/O chart, dengue chart.
49
(dengue) Management: Symptom Relief
+/- Antipyretic (avoid disrupting critical phase). Give for severe pain, tepid sponging for fever.
50
(dengue) Management: Hydration
Encourage oral fluids.
51

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