Infectious disease Flashcards
Constipation Bradycardia rose spots Aerobic gram - rods hepatosplenomegaly
Salmonella typhi
Complications of salmonella
Osteomyelitis GI bleed/perf meningitis cholecystitis chronic
Pregnant woman with UTI tx
Nitrofurantoin (not if term)
amoxicillin, cefalexin
Rapidly growing painful skin rash
temp 38.2
t2dm
Perineum
Necrotising fasciitis
(fourniers gangrene)
type1: anaerobes/aerobes
DM/ post surgery
type2: strep pyogenes
Mx: urgent surgical debridement.
IV abx
mortality 20%
painless ulcer on penis
local non tender LN
Syphillis
treponema pallidum
Secondary syphiliis features
6 weeks after Fevers, LNs Rash on trunk, palmas, soles. buccal snail track ulcers condylomata lata - painless warts genitals
tertiary features - gummas, -ascending aortic aneursyms -tabes dorsalis argll robertson pupil
congenital -blunt incisors -rhagades- scars mouth -keratitis saber shins saddle nose deaf
IV quinine moniroting
cardiac- arrythmias
BMs - hypoglycaemia
Follow up for f.malaria
p vivax/ovale
IV artenusate -> oral artemisinin
viv/ov -> primaquine prevent relapse due to hepatic hypnoozites.
Meningitis public health actions
Side room - droplet precautions until 24h antibiotics.
Masks and face protection for intubation.
Masks all <3ft.
Inform infection control
Inform local Health protection consultant by phone, even if OOHs.
treat close contacts w prophylactic abx, assisted by Health protection agency.
Purpura fulminans
meningococcal, pneumococcal, staphylococcal sepsis(if hyposplenism)
meningitis mx
IV ceftriaxone 2g every 12h
Chloramphenicol if pen allergic.
IV Dexamethasone 8.3mg every 6h. up until 12h after first abx dose. for 4 days.
Ix PCP
WCC LFTs HIV serology ABG Blood culture
CXR
CT
BAL
Pulmonary function tests
Mx PCP
2L o2 via nasal specs
IV Co trimoxazole
pO2 <9.5 -> systemic steroids.
Patient consent counselling
Prophylactic cotrimoxazole when CD4 <200.
bacteria of cellulitis
s. aureus
Strep pyogenes
Classification of cellulitis
Class 1: no systemic signs or symptoms
Class 2: Comorbid affects recovery
Class 3: + limb threatening conditions/confusion
Class 4: life threatening infection or sepsis
Mx Cellulitis
Class 1: Oral fluclox as outpatient
Class 2: Oral/IV abx in opd.
Class 3: admit + IV abx
Class 4: urgent admit, intensive multiple therapy and specialist consultation.
Follow up: Clinical review in 2 days. Elevate leg. moisturise. Analgesia.
Causes of lymphopenia
Chronic Leukaemia HIV Marrow infiltration by cancer Renal failure Steroid therapy
Ix HIV meningism (e.g. toxo)
differential CD4 count toxo serology Viral hepatitis serology Blood cultures CXR CT/MRI head - ring enhancing lesions + perilesional oedema
cervical LN biopsy
counselling and HIV testing
Causes of ring enhancing lesions
Atypical infection (toxoplasma gondii) Bacterial cerebral abscess Cerebral glioma Cerebral lymphoma Cerebral metastases
Mx Toxoplasmosis
Sulphadiazine
Pyrimethamine
- serial MRI monitoring.
Folic acid supplementation.
features of toxo
Paranoid psychosis chorioretinitis. Meningism. focal neurology headache
Septic shock definition
sepsis with refractory hypotension
raised lactate despite adequate fluid resus.
indications for CT in meningitis
GCS <15
signs of Raised ICP
no c.i.s to LP
Ix Meningitis
bacterial throat swab blood cultures Clotting screen EDTA for bacterial PCR plasma glucose LP (if icp not raised/GCS 15)
Complications of bacterial meningitis
Cerebral oedema
venous sinus thrombosis
hearing loss
long term neuro damage.
Hep A phases
- Prodrome flu 3-10 days. can have RUQ pain.
2. Jaundice 1-3weeks
transmission of hep A
faeco oral
sexual contact
Ix Hep A
LFTs Serum hep A igM, (positive for 6m) igG can be from vaccine, stays lifelong. Clotting screen. (PT >5s = decompensation)
USS if LFts abnormal.
Screen for Hep B/C
Mx Hep A
Mild/mod - mx as OPt.
Fluids for dehydration.
avoid food handling, avoid unprotected sex.
for 2 weeks before, 1w after jaundice.
inform sexual partners/household contacts.
inform public health.
Severe: vomiting, profound dehydation, hepatic decompensation
- urgent
