Infectious Disease 6 Flashcards
Cranial nerve most affected in VZV?
Fifth nerve (trigeminal) - opthalmic branch
VZV affects Fifth nerve - geniculate nucleus
Ramsay Hunt syndrome
Rabies virus targets what?
Neurons via Acetylcholine receptor!
congenital rubella syndrome features?
Rubella ( without congenital) features?
Sensorineural deafness
Congenital heart disease - PDA/pulmonary stenosis
Cataracts
Fever - eruptive descending rash - face to torso+ limbs
What viruses are DNA?
Hep B, B19 parvovirus
CMV
VZV
Commonest aspergillus species to cause disease in humans?
Fumigatus
Histoplasmosis - has dual effect?
inside body = yeast
outside body = mould
Histoplasmosis rare complication?
Mediastinal lymph nodes - inflamed and fibrosis
Ocular chorioretinitis
Treatment for;
Mucormycosis
Histoplasmosis
Cryptococcus neoformans
Amphotericin B (mucormycosis = echinocandins)
Oral candidiasis in HIV/immunosuppressed patients - Treatment?
Oral fluconazole
Antifungals that most ;
Nephrotoxic
Contraindicated in pregnancy, Long QT, agranulocytosis
Pancytopenia
Nephrotoxic = Amphotericin
Contraindicated in pregnancy, Long QT, agranulocytosis = Voriconazole
Pancytopenia = Flucytosine
Special about Mycobacterium TB?
Lipid rich
Likes dry location, slow proliferation
Extrapulmonary TB - most specific and sensitive test?
Pleural biopsy!!!
Pyrazinamide MOA?
Intracellular acidification inside the granuloma
Ethambutol MOA?
disrupt cell wall
Why use moxifloxacin in TB?
To increase Rifampicin dose (synergistic effect)
Meningitis TB
Treatment for MAC TB?
Macrolide - Azith/Clarith
RE for 12 months
Cholera toxin does what?
Latch onto GM1 ganglioside - Increase cAMP - More CI - NA + H20 passively excreted - secretory diarrheal
Commonest cause of Traveller’s diarrheal?
E. Coli ETEC 0157 strain
2nd commonest = shigellalosis
Salmonella presentation and treatment?
Rose-coloured spot + bloody diarrheal + Intestinal perforation
Tx : Fluoroquinolones
Borrellia spirochete causes?
Leptospira spirochete causes?
Borellia - Lyme disease
Leptospira - Leptospirosis
Most severe form of Malaria?
Most highest mortality rate-form of Malaria?
P. Falciparum
P. Vivax
Malaria parasites hides and grow where?
Hepatocytes -become Schizonts
Exo-erythrocytic phase
Erythrocytic phase means?
Merozoites within schizonts rupture - infect more RBC
Malaria mosquitoes picks up what?
Gametocytes - mature to become sporozoites in mosquito salivary gland
P vivax and ovale - what significant about them?
Hyponozoites - dormant phase
Need Primaquine and again - 14 days later
Fever pattern for malaria species;
Falciparum
vivax and ovale
Malarie
Falciparum - continuous fever every 36 hours
Vivax, ovale - Fever every 2nd day
Malarie - Fever every 3rd day
Prophylaxis malaria drug?
Mekong area
Everywhere else
Mekong - Atovaquone + Proguanil
IF Severe form - Artemeter - Lumefantrine for extended period of time
everywhere else Choloroquine
When to use Tenofovir?
1st line + Co-infection with HIV + safest in pregnancy
+ lamivudine resistance
Interferon alpha not useful in what type of Hep B?
Pre-core mutant
American Trypanosomiasis treatment? - Chagas Triatomine
African Trypanosomiasis treatment? - Trypan Brunei
Tx Chagas - Nitro + imidazole
Tx African Trypan - Pentamidine
Commonest cause of CHRONIC Traveler’s diarrhea?
Treatment for it?
Giardiasis lamblia
Metronidazole
Best test to differentiate PUO from factitious fever?
ESR
How hiprex ( methenamine hippurate) works as UTI prophylaxis?
Hiprex contraindicated in?
Hiprex no use in what condition?
Need Acidic urine pH < 5.5
-it will dissolve to form ammonia and formaldehyde ( bactericidal)
Contraindicated;
- Hepatic dysfunction - it releases ammonia
- renal dysfunction
- Sulfonamides usage - it binds to formaldehyde becomes insoluble
No use in;
indwelling catheter - too much drainage - can’t form formaldehyde
Proteus infection - proteus alkaline the urine
Listeria always resistant to what drug?
How it evade immune system?
Cephalosporins - hence use benzylpenicillin
Hijack actin polymerisation propulsion - spread cell to cell without extracellular environment
