Infectious disease

Question 1

Kaposi’s sarcoma - a complication in HIV

• Symptoms
• Pathogen

Answer 1

• caused by human herpes virus 8
• presents with purple papules or plaques on the skin and mucosa (e.g. mouth, GI and resp tract); skin lesions may later ulcerate

Question 2

What is the most common cause of diarrhoea in HIV patients?

Answer 2

Cryptosporidium

Question 3

HIV seroconversion takes how long?

Answer 3

3-12 weeks

Question 4

If a patient at risk of HIV (risk incident happened a month ago) tested negative for an ELISA, what is the most appropriate advice to give?

Answer 4

Come back in 2 months (as re-do of test recommended in 3 months) as they could still have HIV

Question 5

The pneumococcal vaccine (one-off) is advised to be given to following people:

Answer 5

ALL adults AGE 65 and over and those with:

1. Asplenia or splenic dysfunction
2. Chronic respiratory disease
3. Chronic heart disease (controlled HTN is not an indication)
4. CKD - at stages 4/5, nephrotic syndrome, kidney transplant
5. Chronic liver disease
6. DM if needing meds
7. Immunosuppression (disease or treatment), incl. HIV patients of any stage
8. Cochlear implants
9. Patients with CSF leaks

Question 6

Amsel’s criteria for the diagnosis of bacterial vaginosis

Answer 6

3 of the 4 points should be present:

1. Thin, white homogenous dsc
2. Clue cells on microscopy
3. Vaginal pH >4.5
4. Positive whiff test (addition of potassium hydroxide results in fishy odour)

Question 7

Management of BV

Answer 7

Oral metronidazole for 5-7d

Question 8

Ddx for BV (another infection which causes an offensive discharge, pH >4.5 and also Mx with metronidazole)

Answer 8

Trichomonas

S&S:

1. Frothy, yellow-green dsc
2. Vulvovaginitis
3. Strawberry cervix
4. Wet mount: motile trophozoites

Question 9

At what point should anti-retroviral therapy for HIV be started?

Answer 9

At the time of diagnosis