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MEDICINE NEW > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

In a patient with pneumonia, what investigation should be included to identify atypical bacterial causes?

A

Blood serology- mycoplasma, legionella, 2 chlamydias

Will give co-amoxicillin (streps) + clarithromycin (atypicals)

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2
Q

Gram +ve Diplococci identified on sputum on a patient with a pneumonia, causative organism?

A

Strep pneumonia

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3
Q

Who are particularly at risk of streptococci pneumoniae?

A

Hyposplenic patients (encapsulated like neisseria meningitidis)

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4
Q

Type of streptococci causing brain abscess:

A

Strep milleri

6 weeks of penicillin + anaerobe cover- metronidazole

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5
Q

Which organisms causing osteomyelitis have a predilection for spine?

A

TB
Brucella

Staph aureus is always a common cuase of osteomyelitis

Sodium fusidate/fusidic acid can help antibiotic uptake in bone

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6
Q

MRSA treatment?

A

Vancomycin, Teicoplanin, Penems

Contact isolation

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7
Q

Investigations for TB:

A

Sputum- acid fast bacilli
Skin test- Mantoux (may be -ve if sick patient)

Interferon-gamma release assay- cultures patient’s T cells to different antigens and measures response

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8
Q

Under what circumstances do you isolate a TB patient?

A

If they are infectious- organism seen on sputum

Coughing + sick

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9
Q

Side effects of quinine given for malaria:

A

Hypoglycaemia (mimics insulin)

Tinnitus

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10
Q

3 sequelae of group A streptococcal infection:

A

Scarlet fever
Glomerulonephritis
Rheumatic fever

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11
Q

What is the commonest type of Nisseria Meningitidis (the one we get immunised against) + Rx:

A

Type B

(Type A- is in developing countries)

Rx: Ceftriaxone
Respiratory isolation (droplet spread)
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12
Q

STI caused by gram negative diplococci?

A

Neisseria gonorrhoea

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13
Q

3 organisms potentially causing neonatal sepsis?

A

Group B strep- (pneumoniae)
E Coli
Listeria

Rx: Benzylpenicillin + Gentamicin

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14
Q

Investigation to confirm post-surgical abdominal abscess?

A

Ultrasound is best
No need for CT

Aspirate abscess

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15
Q

Abdominal abscess following surgery to the gut, what are likely type of organisms?

A

Gut flora- gram negative aerobes (E Coli, Klebsiella etc)
Anaerobes

Rx: Co-amoxiclav (has anaerobic activity)

Can add gentamicin to mop up bacteria in the blood stream- good for resistant Gram Negative

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16
Q

Antipseudomonal antibiotics

A

CAMP

Ciprofloxacin
Ceftazadime (3rd gen cephalosporin)
Aminoglycoside
Meropenem
Pipercillin Tazabactam (tazocin)
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17
Q

Which antibiotics cause C Diff?

A 
All the C's
Co-amoxiclav
Ciprofloxacin
Cephalosporins
Clindamycin
18
Q

What level of dilatation does large bowel obstruction become toxic mega colon?

A

9cm is bowel obstruction

12cm is toxic megacolon

19
Q

Which antibiotics cause cholestasis?

A

A NIT FLEW and CLAWed to have a Cip

FluCloxacillin
Nitrofurantoin
Clauvanate
Ciprofloxacin (fluoroquinolone)

20
Q

Live vaccines that should not be given if a patient is immunosupressed?

A

Tie My BiG Yellow Pole (aka Oli):

Typhoid
MMR
BCG
Yellow fever
Polio
21
Q

Name some tropical diseases with a short incubation time?

<10 days

A

Dengue
Rickettsia- tick typhus
Borella- relapsing fever (lyme)

22
Q

Name some infectious diseases with an intermediate incubation period?
10-21 days

A

Malaria
Typhoid- salmonella typhi (enteric fever)

Typanosomiasis (protozoa)
Chagas disease (another type of trypanosome) 
Brucellosis- unpasteurised milk
Leptospirosis
Q fever- coxiella
23
Q

Infections with long incubation period?

>21 days

A 
Malaria
Amoebic liver abscess
Leishmaniasis
Hepatitis
HIV
24
Q

Patient who has a fever + a rash, onset on last day of 7 day holiday in thailand, no sexual contacts. Possible cause?

A

Dengue fever- short incubation period

Malaria would be more like 10+ days to occur
Get low platelets and low lymphocytes, with transaminitis

25
Q

What kinds of rash occur with Dengue fever?

A

Early- erythroderma
Petechiae
Late- desquamation

26
Q

Patient swims in lake malawi and now has haematuria, probable cause?
IHx to confirm diagnosis?

A

Schistosomiasis

Eosinophilia
ELISA +ve

Cystoscopy +bladder biopsy

27
Q

3 types of helminth?

A

Nematodes- roundworm
Soil transmitted = ascaris, hookworm, strongyloides
Filaria = bancroftian, onchocerca (may obstruct lymphatics)

Trematodes- flukes
Schistosoma

Cestodes- tapeworms
Hydatid
Cysticercosis

28
Q

Out of the soil transmitted helminths (roundworms), which are faeco-oral transmitted and which are percutaneously transmitted?

A

Faeco-oral: ascaris

Percutaneous: hookworm, strongyloides

29
Q

In suspected a tropical infectious disease, when would you do a urine MC+S rather than a stool parasites + ova?

A

In suspected schistosoma haemotobium

30
Q

What does the thick film and thin film tell you in malaria?

A

Thick film- sensitivity
Thin film- severity + species of falciparum

Can do a ‘rapid diagnostic test’ also

31
Q

Name some opportunistic infections with low pathogenicity that cause problems for those immunocompromised

A

Normally low pathogenicity:

Coagulase negative staphlococci (S. epidermidis)
Pseudomonas
Candida albicans
Pneumocystic jiroveci
CMV
32
Q

A CD4 count under 100 puts HIV patients at risk of which diseases?

A

Toxoplasmosis
Cryptosporidiosis
Cryptococcus
CMV

Mycobacterium avium (<50)

33
Q

Rx of cerebral toxoplasmosis?

A

Sulphadiazine
Pyrimethamine
Folinic acid

34
Q

An immunocompromised patient has a blood culture which shows a gram positive rod, name the likely organism:

A

Listeria

Rx: amoxicillin

35
Q

What CD4 count in HIV do you start giving co-trimoxazole to prevent PCP?

A

<200

36
Q

Why does penicillin not affect gram negative bacteria?

A

They have a lipopolysaccharide layer around the peptidoglycan wall, which protects it from antibiotic attack

Amoxicillin is semi-synthetic and between able to permeate this layer so is more effective against gram negatives

37
Q

What antibiotic is needed for pseudomonas or extended-spectrum beta lactamase microbes (can get around flucloxacillin + co-amoxiclav)

A

Piperacillin + tazobactam

Or other z-containing drugs

38
Q

For staph aureus and staph epidermidis that are methicillin resistant, which antibiotic is recommended?

A

Glycopeptides- inhibit synthesis of peptidoglycan wall
Vancomycin or Teicoplanin

If resistant to this too, Linezolid

39
Q

Which antibiotics work on pseudomonas?

A

Ciprofloxacin (quinolone, prevents supercoiling, 50% resistant)

Gentamicin, ceftaZadime, taZocin, meropenem

40
Q

In a patient with gastroenteritis, what makes campylobacter more likely than shigella/salmonella/ E Coli, and how is Rx different?

A

PC: Severe abdominal cramps
3 day incubation period (whereas the other’s have a 2 day incubation)

IHx: gram negative spirals, the others are gram negative rods

Rx: macrolide, whereas salmonella, E Coli etc, you use ciprofloxacin

41
Q

What side effect occurs in long term metronidazole?

A

Peripheral nephropathy- interferes with B6 metabolism (pyridoxine)

MEDICINE NEW (22 decks)

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