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MSRA my cards > Infectious disease/ skin > Flashcards

Infectious disease/ skin Flashcards

1
Q

Common cx pneumonia in alcoholics

A

Klibsielal

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2
Q

Pneumonia with influenza predispsoses to?

A

Staphj aureus pneumonia

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3
Q

flu-like symptoms, bilateral consolidation and erythema multiforme, painful vesicles in ear, renal impairment, low platelets

A

Mycoplasma - to serology. TX: doxycycline/ erythromycine/ clindamycin

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4
Q

Derranged LFts, flu like SX, cough, bradycardia, lymphopenia, confusion low sodium

A

Legionella - erythromycin/ clarithromycin. confirm urinary antigen

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5
Q

fishy smell’ down below. Microscopy reveals the presence of clue cells.

A

Gardnerella vaginalis - 5 days metronidazole 400mg BD

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6
Q

fever, malaise, and myalgia, which may precede the appearance of painful vesicular eruptions in the genital area.

A

Herpes Simplex

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7
Q

Campylobacter enteritis TX

A

Clarithromycin

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8
Q

Salmonella/ shigella TX

A

Ciprofloxacin

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9
Q

Pelvic inflammatory disease TX

A

Oral ofloxacin + oral metronidazole or intramuscular ceftriaxone + oral doxycycline + oral metronidazole

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10
Q

Animal or human bite TX abx

A

Co-amox (allergy - doxy and metronidazole)

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11
Q

Mastitis during breast feeding?

A

Fluclox

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12
Q

Meningitis tx summary: if
meningoccocal?
if <3m or 50+
if listeria suspected?
when to start dexamethasone?
What to give contacts?

when to delay LP?

what could suggest cryptococcal meningitis?

A

IV cefotaxime, if <3 months or 50+ add amoxicillin (or ampicillin).
If meningococcal - ben pen or cefotaxime.
listeria give IV amoxicillin and gent.
IV dex before abx, avoid in septic shock, in sus pneumococcal meningitis in adults

contact: Oral ciprofloxacin or rifampicin for 7 days

delay LP: GCS<12, focal neuro sx, papilloaedema, seizures continued

cryptococal meng - high opening pressure LP, sex worker, AIDS, yeast and capsule in CSF stained with india ink

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13
Q

Painless genital ulcers causes?

A

Syphilis (single) - Treponema pallidum.
Lymphogranuloma venereum (LGV) - cuased by chlamydia, tx doxycycline.
donovanosis (granuloma inguinal)
multiple - HPV warts

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14
Q

Unilateral, painful inguinal lymph node enlargement. with single painful genital ulcer? sharp, jagged border

A

Chancroid - Haemophilus ducreyi (painful, patients do cry)

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15
Q

Tetanus vaccine uk?

A

2, 3, 4 months
3-5 yrs,
13-18 yrs

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16
Q

Cellulitis TX

A

flucloxacillin,
allergy - macrolide such as clarithromycin or erythromycin or another medication such as doxycycline.

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17
Q

UTI TX in pregnancy women

A

tx asap 7 days first-line: nitrofurantoin (should be avoided near term)
second-line: amoxicillin or cefalexin
trimethoprim is teratogenic in the first trimester and should be avoided during pregnancy

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18
Q

GE with short intubation period and severe vomitting no diarrhoea

A

Staphylococcus aureus

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19
Q

GE incubation period of 3-4 days and causes diarrhoea that usually becomes bloody, lasting up to a week.

A

E-coli

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20
Q

48-72 hrs GE A flu-like prodrome, crampy abdominal pains, fever and diarrhoea which may be bloody
May mimic appendicitis
Complications include Guillain-Barre syndrome

A

Campylobacter - tx clarithromycin

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21
Q

HIV patient, hepatospenlomegaly, pneumonia signs, clear chest. cx?
tx?

A

Pneumocystitis jiroveci. Need broncheolar lavage, TX co-trimoxazole. Risk pneumothorax. need proph abx if cd4 <200.
tx: co-trimoxazole. consider steroids if hypoxic

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22
Q

lymes disease progression? early (in 30 days. late?
and tx?

first line test?

A

early: erythema migrans 1-4 weeks after, painless, malaise, arthralgia.

later: heart block, peri/myocarditis. :neurological:
facial nerve palsy,radicular pain,meningitis.

TX:
doxycycline / amoxicillin - in pregnancy/allergy as doxy is CI./ if disseminated - ceftriaxone

IX: ELISA antibody to borrelia burgdorferi. if neg and still sus, do in 4-6 weeks after

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23
Q

Flu sx, raised, red painful rash on legs and face?

A

erysipelas- Flucloxacillin* (clarithromycin, erythromycin or doxycycline if penicillin-allergic)

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24
Q

ID cx: difficulty in breathing and swallowing. A grey coating surrounding the tonsils, fever, and cervical lymphadenopathy, travel to india

A

Diptheria - can present with cranial nerve sydfunction. IM penicillin

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25
pneumonia cx: worsening flu-like symptoms and a dry cough. Erythema multiforme is noted on examination. Infective changes on CXR
Mycoplasma pneumoninae
26
URTI SX, given amoxicillin then got rash? DX? lymphadenopathy, raised ALT,
EBV/ glandular fever. do monospot test, do FBC and LFT (lymphocytosis, raised ALT, haemolytic anaemia)
27
Fishy discharge, clue cells. allergic to penicillin
Metronidazole if not allergic/ topical clindamycin for BV
28
Cellulitis - abx for pregnant and pen allergy?
pregnant - erythromycin Pen allergy - clarithromycin
29
Syphillis stages? 6-10 weeks after? tx?
painless chancre on penis, local painless LN, men / or lesion on cervix 6-10 weeks: fevers, LN, snail track buccal ulcers, condulomata lata (painless warty lesions on genitalia, rash on trunk and arms risks: aortic aneurysms, gummas, tabes dosalis - neuro issues/ bladder issues/ muscle wasting, argyll-robertson pupil Normal: IM benzathine penicillin or doxyclycine (not in pregnancy) Common reaction - fever, tachy, fever no wheeze. (jarisch herxheimer reaction)
30
Non-bloody diarrhoea, fatty stools, 15 days after exposure, bloating, flatulent
Giardiasis is caused by the flagellate protozoan Giardia lamblia. Swimming anal sex etc. chronic - risk of low vitamins, malnoutrition
31
purple papules or plaques on the skin or mucosa (e.g. gastrointestinal and respiratory tract)
Kaposi's sarcoma - radiotherapy/ resection. Caused by HHV 8.
32
malaise,headache and mild abdominal pain. Constipation, bloated, sparse, macular rash on chest. CX of GE? what are other complications? common risk in sickle cell disease?
Salmonella typhi - enteric fever (constipation and rose spots), low HR risks: osteomyelitis (esp sickle cell), GIB, meng, cholecystitis,
33
single painless ulcer with small lymphadenopathy/ then 2 months later widespread maculopapular rash and ulcers in mouth, systemic features
Stages of syphillis, trepenoma pallidum.
34
t2DM on SGLT2 - dapagliflozin, painful and numb to touch in perineum, purple rash with bullae
Necrotising fascitis / fournier's gangrene (in perineum) other type - t1DM post op
35
what are the live vaccines? (MY BOOTI)
MMR, yellow fever, BCG, ORal polio, oral rotavirus, typhoid, intranasal influenza
36
Tx for toxoplasmosis in immunocompromised ppl?
Pyrimethamine and sulphadiazine are management options for immunocompromised patients. complications: chorioretiinits, seziures, anaemia
37
multiple painful blisters and ulcers around her labia. She has been feeling like she has the flu for the past five days. It is extremely painful when she urinates.
Herpes simplex
38
oral ulcers, genital ulcers and uveitis. Venous thromboembolism is also seen.
Small cell vasculitis, behcet's
39
Chlamydia treatment? pregnant ?
Doxycycline 7 days, if pregnancy - erythromycin, azithromycin,
40
Dry cough, target lesions around trunk, works in school? CXR?
Mycoplasma pneumoniae (erythema multiforme) CXR: reticulo nodular shadowing of right lung
41
URTI in CF, hot tub folliculutus, otitis externa in diabetics, UTIs.
Pseudomonas aeruginosa
42
EBV associated malignancies?
Burkitt's lymphoma* Hodgkin's lymphoma nasopharyngeal carcinoma HIV-associated central nervous system lymphomas
43
non tender LN with cats at home, unwell, fever, sore throat? How does neuro manifestation of this condition present?
toxoplasmosis: in HIV aids - most common is neuropsych/ hemiperesis/speech abdnormality
44
dysentry, no sx, liver mass from recent travel?
AMoebiasis tx - metronidazole, uss
45
urticarial rash on body swimming in thialand lake, very unwell generally, myalgia ?
shistosomiasis
46
malaria detected by
giesma stained thicka nd thin blood films
47
typhoid fever characteristics?
7-14 post ingestion fever worsens over day and gets better by morning 1st week: GI sx, truncal blanching/ inflamed peyers patches and maculopapules week2: splenomegaly, brady cardia week3: abdo distension, pea soup diarrhoea, nectroic peyers pathces lead to perforation/ peritonitis IX: bone marrow culture
48
face flushing, chills, skin mottling before fever on 3rd day lasting 5-7 days. children get fever that gets better for 1 day then returns. bleeding from gums/ melena/ haemorrhagic effects
Dengue fever cx aedes mosquitos need serology raised antibody titre in apired IGG/ IGM low patelets, leukopenia also: abdo pain, hypotension, restlessness,
49
aplastic anaemia? marrow criteria and film critera? cx?
bone marrow failure with peripheral pancytopenia, marrow hypoplasia (marrow criteria) film criteria: neutrophil <0.9, platelet <20 reticulocyte <1% bimodal age distribution cx: autoimmune, infections, anti drugs (abx, anti cancer, antiepileptic, antithyroid, antiemetic, anticancer, antihyperglycaemics SX: bleeding, anaemia, infections
50
allergic contact dermatitis and tubercilin tests example of?
Type 4 sens. lymphocytes, secondary cellular response
51
erythema nodosum is an example of what type of hypersensitivity?
type 3: immune complexes, activate complement and cause local damage
52
Causes of haemolytic anaemia/ features?
jaundice, anaemia, splenomegaly Autoimmune - warm (IGG, cold IGM Microangiopathic haemolytic anaemia - DIC, ITP, TTP, inherited: G6pd (x linked
53
21YO, genetic disorder. changed diet recently - has ataxia/ collapsing attacks after rash on face, arms and legs, becomes anxious/ emotional/ aggressive?
hartnup syndrome (AR). attacks normally happen from 3-9YO. this is rare. need high protein diet.
54
is AO and AB parent have children could they be blood gorup o/
no absence of A/B give O group. AB can donate to anyone
55
explain blood group donation?
a can donate to AB and A B can donate to AB and B O can donate to anyone AB can receive from anyone but only donate to AB O can donate to anyone
56
what is sideroblastic anaemia ?
body produces iron but is not able to put into HB. iron accumulation in the mitochondria of erythoid precursors
57
ESR in sickle cell?
low bc unable to form rouleax
58
post splenectomy, what infections ar eu most likely to get? Shin Skis what vaccines do you get?
spleen protects against encapsulated microbes SHIN SKIs step pneumoniae h influenzae neisseria meng Group B strept klibsiella salmonella tphyi vaccines:hib, pneumococcl, meningococcal, annual flu
59
Likelihood of getting down's syndrome? 20/ 30/ 40/ 35/ 40/ 45?
20:1/1500, 30:1/800, 35: 1/270 40: 1/100 45: 1/50+
60
Child recurrent sinusitis, chronic diarrhoea, URTI, / has reactions to IVG / transfusions?
selective immunoglobulin IGA deficiency
61
classic malaria symptom re fever?
fever paroxysm: suddenly cold, with rigor then fever and sweating
62
when does rash appear for lyme disease? Cx? TX?
7 days post bite, unwell, fever, neuro sx. CX: borrelia burgdorferi TX: doxycycline 14-21 days (CI pregnancy)/ amox then cefuroxime <12 YO: amoxicillin then cefuroxime
63
undiagnosed neuro condition is CI to which vaccine?
MMR
64
25YO hiv+, diarrhoea, ziehl neelson cysts on stool sample
cryptosporidiosis
65
what is passive and active immunity?
passive - provide IGG., short lived active - acquired/ natural exposing body to antigen to respond
66
erythematous, well demarcated warm plaque sharp border 6cm upper arm, malaise, fever 48 hours. skin biopsy: beta-haemolytic group A streptococcal infection in the upper dermis. abx tx?
ersyipelas - flucloxacillin
67
farmer, high fever, sweating. several black blisters which produce foul smelling discharge. cx organism?
clostridium perfringens - can cause gas gangrene and haemolysis
68
infection from canned foods and honey prevents acetylcholine (ACh) release leading to flaccid paralysis
clostridium boutilism
69
Impetigo abx tx?
topical hydrogen peroxide/ orial fluclox or erythromycin if widespread
70
GE causes: sudden vomiting and non blood D, with short intubation period? similar to above but presents in children < 5 N+V cramp like pain, bloody D, longer intubation 3-4 days, abdominal crmaping??
sudeen GE - norovirus. resolve within 72 hs child <5 - rotavirus 3-4 day intubation epriod = ecoli appendicitis like: cambylobnacter. tx clarithromycin
71
B/G chlamydia with RUQ pain, low grade fever. negative pregnancy test, negative KUB and urine dip neg.
Fitx-hugh curtis (perihepatitis) caused by chlamydia, PID
72
complications of chlamydia? IX/DX
epididymitis pelvic inflammatory disease endometritis ectopic pregnancies infertility reactive arthritis perihepatitis (Fitz-Hugh-Curtis syndrome) IX: women - vulvovaginal swba first line men - urine. 2 weeks after exposure TX: doxycycline 7 days. if CI - azithromycin pregnanct: azithromycin/ erythromucin/ amox
73
sore throat, fever, LN anterier and posterior neck. bruises in mouth, raised ALT, haemolytic anaemia. tried amoxicillin for URTI but got rash? cx? AF/ other sx? when to sx resolve? DX?
glandular fever - EBV/HHV4 AF: splenomegaly, palatal petechiae, rash after pencillin, haemolytic anaemia (cold agglutin IMG), rash after penicllin. low socioeconomic status sx go in 2-4 weeks DX: monospot (heterophil antibody)
74
hx of sickle cell disease, low platelets, HB, WBC (all cell lines), recent febrile illness. now has petechiae and bruises over trunk and limbs. DX? aplastic slaptastic crisis?
parvovirus b19 - pancytopenia - also causes slapped cheek
75
Jarisch herxheimer reaction seen in?
this is fever, rash after first abx dose. syphillis, lymes, glandular fever
76
Exposure to hep C tx?
do monthly PCR, if seroconversaion give interferon+- ribavirin
77
Person with incomplete course of hep B vaccine is exposed to a positive hep B patient, how do we treat? if we don't know the exposed blood was hep b positive?
not responder if anti-HBs <10 in 1-2 months post immunization. give hep B IG and booster vaccine. if unknown source - give vaccine / accelerated vaccine
78
Person immune to hep b already and a responder exposed to patient with Hep B positive? what if unknown exposure?
give booster or consider giving booster if unknown source
79
post exposure HIV tx?
oral antiretrovirals within 1-2 hrs, but could be started up to 72 hrs after for 4 weeks. do testing at 12 weeks after completion
80
most common cx of bronchiectasis exacerbations/ acute epiglottitis/ CAP?
Haemophilus influenzae
81
cx of penumonia - erythema multiforme, normocytic anaemia?
mycoplasma pneumoniae
82
UTI tx men/ pregnant? non pregnant? when to send urine culture? when to give prophylaxis
nitro/trim 3 days. do MSU in 65+/ visable/ non visable haematura/ men tx in asymptomatic pregnany women pregnant/ men/ catheter - 7 days.
83
farmer with initial mild flu like sx red eyes. then unwell with AKI. cx? DX? tx?
leptospirosis first subconjivical haemorrhages, flue. then aKI/ hepatitis/ asceptic meningitis DX?- serology (antibodies after 7 days), PCR, CSF leptospirosis tx: doxy/ azithromycin then IV benpen if severe
84
Complications of hep B? immunisation of hep B schedule? how to test for hep b repsonse?
chronic hep, HCC, GN, polyateritis nodosa, crytpoglobulinaemia child - 2,3,4 months, occupational workers test for occupation exposure: do anti HBs. is 100+ - adequate response. give booster in 5 yrs 10 -100 - sub-optimal response, give another dose. no testing needed <10- test for past infection/ give 3 doses again. no response then consider HB1G
85
BV - pathogen? Amsel's criteria for dx? tx? risks if BV in pregnancy? how does trichomonas rpesent?
gardngerella vaginalis amsel's - 3+ of thin white discharge, clue cells, ph 4.5+, positive whiff tx: metronidazole if sx 5-7 days/ 2g metronidazole if adherence issue. topical clindamycin. pregnany risks: chorioamniotis, late miscarriage, LBW, preterm labour TV: frothy, yellow green, vulvovagintis, strawberry cervic, motile trophozoites
86
common cx of infection in animal bites?
strepococci spp, staph A, eikenella, fusobacterium, prevotella
87
Which antimalarial should be avoided in someone with hx of depression/ epilepsy and taken weekly? which one is photosensitive? which should be given with folate supplementation
mefloquine (mental health) photosens - doxycylcine folate with proguanil
88
cx of coup/ bronchiolitis common cold cx? pneumonia cx likely in smokers? IECOPD most common cx?
croup - parainfluenza, bronch - RSV cold - rhinovirus smoker's pneumonia - streptococcus pneumoniae IECOPD - haemophilus influenzae
89
Cellultiis tx? if pen allergy? if pregnant? when to consider admitting?
fluclox, po clarithromycin ( if allergy). erythromycin if pregnant eron class 3-4 (sepsis/ systemic upset or co-morbilities, vasc compromise, lymphedema, facial cellulitis, frail or <1yr
90
HBsAG positive how long what does it mean? Anti hbs?. anti hbc?
HBsAg - acute disease (present for 1-6 months) > 6 months then this implies chronic disease (i.e. Infective) Anti-HBs immunity/ exposure. negative in chronic disease Anti-HBc previous (or current) infection. IgM anti-HBc appears during acute or recent hepatitis B infection and is present for about 6 months HbeAg - infectivity
91
risks of chronic hep C (6 months)
rheumatoid, sojrens, cirrhosis, HCC, cryoglobulinaemia, porphyria cutanea tarda memranoproliferatvie GN
92
Tetanus when to give booster/ ig? what is clean wound
clean:Wounds less than 6 hours old, non-penetrating with negligible tissue damage if 10yrs +/ unknown/ not vaccinated - give booster regardless. if high risk/ tetanus prone - give IG
93
Complications of mycoplasma penumonia?
haemoyltic anaemia (igM) erythema multiforme, erythema nodosum GBS, bullous myringitis (painful vesicles on Tympanic membrane) GI - hep/pancreatitis acute GN
94
young man, painful blisters and ulcers on penis, unprotected sex. dysuria and pruritus. malaise dx? tx? mx in pregnancy?
genital herpes. aciclovir. HSV1 and 2 genital warts - HPV 6 and 11 recurrent eps less severe. other first sx: inguinal LN, urine retention DX: NAAT. HSV serology if unknown cause of ulcer pregnant - if 28weeks+, C-s. if recurrent, suppressive therapy
95
Sx of metronidazole with alcohol?
disulfiram like reaction - head and neck flushing, N+V, sweating, headache, palpatations
96
Tx of genital warts?
HPV 6+ 11 topical podophyllum (for multiple non keratinised)/ cyrotherapy (single keratinised) imiquimod topical (2nd line)
97
before giving BCG vaccine, what to test?
tuberculin test in anyone over 6YO who have had no contact with TB. CI: HIV, pregnancy, positive tuberculin, past TB,
98
HIV DX tests and screening. when would you test in asymptomatic patients? if negative and still sus?
p24 antigen (1-4 week) and HIV antibody (4-6 weeks after infection positive). no sx: do 4 weeks after possible exposure. if negative, repeat test at 12 weeks
99
Worker in africa, incidental CXR of 2cm calcified nodule in mid right zone, non smoker.
TB latent - ghon complex TX: RI - 3 months (I+P) or 6 months ISOniazid +Pyridoxine

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