INFECTIOUS DISEASE 2

Question 1

Discuss initial HIV testing:

Question 2

If initial screening tests suggest HIV, what are the next line investigations to confirm it?

Question 3

Why are Mycobacterium tuberculosis (rod) difficult to culture in a lab, and difficult to gram stain / what different stain is used?

Question 4

TB is mostly spread through saliva droplets. There are 4 outcomes once in the body, what are they?

Question 5

Patients with latent TB are not symptomatic and CANNOT spread the bacteria. If it is reactivated, the infection can develop. What can trigger reactivation of TB?

Question 6

Diagnosis and management of latent TB:

Question 7

How does the IGRA work?

Question 8

Diagnosis of active TB:

Question 9

Relative sensitivity of active TB tests:

Question 10

What does the BCG vaccine involve?

Question 11

TB can present with non-specific systemic symptoms, like cough, lethargy, fever and night sweats, weight loss and lymphadenopathy. Give some more specific features it may present with:

Question 12

CXR features of primary TB, reactivated TB and disseminated miliary TB:

Question 13

NICE guidelines specify the need for ‘deep cough’ sputum samples for TB. If these are not able to be collected, what are the 2 other options for sputum culture, and 2 further culture options:

Question 14

Most common cause of viral URTI:

Question 15

Conditions that may present with a recent URTI (infrequent, vs rare):

Question 16

Clostridia are gram-positive, obligate anaerobic bacteria. State 4 types, and give identifying features of each:

Question 17

Drug causes of C.difficile:

Question 18

What is a classical blood marker used in C.difficile, and what can it be used for?

Question 19

Life-threatening features of C.Diff:

Question 20

Severe features of C.Diff:

Question 21

First episode of C.difficile management, 1st , 2nd and 3rd line:

Question 22

Management of recurrent episode of C.difficile:

Question 23

Management of life-threatening C.difficile infection:

Question 24

3 Ms of herpes simplex pap smear features:

Question 25

When is an elective CS advised in reference to herpes?

Question 26

Most common cause of encephalitis, which area of the brain does it most likely affect + likely symptoms:

Question 27

Investigating suspected HSV encephalitis:

Question 28

Herpes zoster ophthalmicus describes reactivation of the varicella-zoster virus in the area supplied by which nerve?

Question 29

HZO presents as a vesicular rash around the eye. What sign would indicate high likelihood for developing ocular involvement?

Question 30

Management of HZO:

Question 31

Complications of HZO:

Question 32

Investigation of choice in genital herpes, which present with painful genital ulceration +/- dysuria and pruritis, with the primary infection sometimes including headache, fever, malaise. Tender inguinal lymphadenopathy and urinary retention can sometimes occur.

Question 33

Management of primary genital herpes <28 weeks, or recurrence of genital herpes in pregnancy:

Question 34

Which virus may present atypically in the fact that it will present with a low CSF glucose compared to other viruses in meningitis:

Question 35

When should an LP be delayed in the investigation / management of meningitis?

Question 36

If an LP cannot be done within the first hour, it should be delayed and IV antibiotics should be started straight away. Which antibiotic should be given in which situation?

Question 37

Antibiotic for listeria;

Question 38

If the patient has a history of immediate hypersensitivity reaction to penicillin or cephalosporins, which abx should be used?

Question 39

Who should be offered antibiotic prophylaxis and what should they get (if exposed to confirmed bacterial meningitis):

Question 40

Senior review is indicated if any of the following warning signs are present:

Question 41

Most common traveller’s diarrhoea:

Question 42

Causes of gastroenteritis by incubation period:

Question 43

Salmonella typhi and paratyphi is transmitted by the faeco-oral route, and also contaminated food and water. Give some clinical features, and differentiators between typhi and paratyphi:

Question 44

Complications of typhoid:

Question 45

Incubation period of typhoid is between 5-21 days. What does this depend on?

Question 46

Dengue fever is a viral infection that can progress to ? Other causes of this complication include yellow fever and ebola.

Question 47

Describe some symptoms of dengue fever:

Question 48

‘Warning signs’ in dengue fever before it progresses to dengue haemorrhagic fever (DIC with thrombocytopenia and spontaneous bleeding):

Question 49

A patient experiences a sudden onset of high fever, rigors, nausea and vomiting. They have a brief remission and then jaundice, haematemesis and oliguria occurs. What are they likely suffering from?

Question 50

Primary vs secondary vs tertiary features of syphilis:

Question 51

Treponema pallidum cannot be grown on artificial media - how is syphilis tested for and what might the results of the combinations of tests indicate?

Question 52

Causes of false positive non-treponemal (cardiolipin) tests:

Question 53

Mnemonic for features of an Argyll-Robertson pupil is ARPPRA:

Answer 53

Accommodation Reflex Present

Pupillary Reflex Absent

Question 54

Management of threadworms, and species name:

Question 55

Mx Lyme disease: