Infectious disease Flashcards
Which presenting symptoms should get your mind thinking about possible infectious disease/infection?
Fever Shivers/rigors Diarrheoa Cough Rash Urinary symptoms i.e. dysuria
What are rigors?
A feeling of being cold (chills) With SEVERE shivering even though temperature is elevated (fever).
can be accompanied by sweating
What are some probing questions for a fever history?
Name some associated symptoms to ask about?
How long?
Pattern?
- night sweats - flu, tb
- every few days (2-3 days) - malaria
Associated symptoms - sore throat, cough, nasal congestion
Why can some infections cause headache?
its a non specific link;
fever and vasodilation caused by infection results in headache
myalgia points to what?
very non specific sign.
if v. sever think
influenza or typhoid
Questions to ask about rash?
where did it start? behind ear, trunk?
is it itchy?
When is meningitis an emergency situation?
If its bacterial/pyogenic meningitis;
acute/rapid onset - very life threatening
MUST GIVE Benzylpenicillin or ceftriaxone IMMEDIATELY even before doing tests lest they fall into coma.
A BROAD spectrum antibiotic is first choice for immediate treatment of suspected bacterial meningitis. A GP might give PENICLLIIN where as a hospital doctor might be more likely to give cef-uro-xime, or, cef-ota-xime, or cef-tria-xone
In viral meningitis you see they will have been unwell for approx 1 week
What questions to ask when suspecting diarrhoea?
- Stool frequency
- Consistency - liquid, mucus, blood
- Colour
- Floats?
- Abdo pain
- Vomiting
Rabbit pellet stools more likely to be IBD
Rice water stools point to?
Green stools point to?
Cholera
take travel history!
Bilious
Floating pale stools point to?
Mucous stools point to?
malabsorption of fat
irritable bowel
diarrhoea + vomiting points to?
salmonella;
they ate something with uncooked or partially cooked eggs (chocolate mousse)/chicken
diarrhoea + crampy/colicky abdo pain poiints to?
campylobacter infection
define gastroenteritis
name some symptoms
inflammation of the stomach and intestines, typically resulting from bacterial toxins or viral infection and causing vomiting and diarrhoea, also usually abdominal pain
Fever, lack of energy, and dehydration may also occur
Patient presents with night sweats. Indications?
TB is the classic association. However night sweats are seen in a wide range of other medical conditions such as endocarditis, abscesses, lymphoma, and antidepressant use.
Other questions to ask about to help with diagnosis?
• Travel, especially in the last 2 years - where did they stay? cities less likely to get exotic diseases than rural. dodgy hotel aircon
- Must ask they exact dates they travelled there and back
- ask if holiday or business
• Dietary • Others • Pets • Hobbies - Occupation
What kind of rash do you see in dengue fever?
A maculopapular, scarlatiniform rash (resembling scarlet fever)
MP rash - is a type of rash characterized by a flat, red area on the skin that is covered with small confluent bumps
What is the aetiology of dengue haemmorhagic fever?
when some1 gets reinfected with the same strain of dengue, an immune reaction can occur
why shouldnt nebulisers be used on patients with certain respiratory diseases?
increases transmission
examples in SARS
Name a zoonosis?
Brucellosis
arabian princess may have camel - if they drank the camels milk… danger
Important questions for social history?
Conatct with other infected people!
Important questions for drug history?
Ask about over the counter medications
Can get some infections from Herbal Remedies
Antifungals can cause rigors
High respiratory rate points to?
Chest infection i.e. pneumonia
or PE
Generalised lymphadenopathy points to?
Lymphadenopathy in the neck points to?
General - HIV, glandular fever, CMV
Localised - tonsil infection
what organ is enlarged in many different infections?
spleen
