Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Finals > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

Bacteria

what can they be categorised into

A
  • aerobic
  • anaerobic
  • gram +ve
  • gram -ve
  • atypical bacteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Bacteria

gram +ve bacteria cell wall

A

thick peptidoglycan cell wall that stains with crystal violet stain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Bacteria

gram -ve bacteria

A

don’t have this thick peptidoglycan cell wall and doesn’t stain with crystal violet stain

but will stain other stains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Bacteria

atypical bacteria definition

A

cannot be cultured in the normal way or detected using a gram stain

most often implicated in pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Bacteria

what is nucleic acid

A

essential component of bacterial DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bacteria

what are ribosomes

A

where bacteria proteins are synthesised within the bacterial cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Bacteria

what is folic acid essential for

A

synthesis and regulation of DNA within the bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Bacteria

how does folic acid enter the bacteria cell

A

the chain starts with PABA, which is directly absorbed into the cell across the cell membrane

PABA is converted to DHFA which is converted to DHFA which is converted inside the cell to THFA then folic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Bacteria

what is involved in gram staining a bacteria

A
  • add a crystal violet stain which binds to molecules in the thick peptidoglycan cell wall
  • add a counterstain (safranin) which binds to the cell membrane in bacteria that don’t have a cell wall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Bacteria

what colour do gram +ve bacteria turn when gram stained

A

violet (from crystal violet stain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Bacteria

what colour do gram -ve bacteria turn when gram stained

A

pink (from counterstain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Bacteria

name 3 gram +ve cocci

A
  • staphylococcus (clusters)
  • streptococcus (chain)
  • enterococcus (diplo)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Bacteria

name the 5 gram +ve rods

A

Ben Neo Likes My Cat

Bacillus 
Nocardia 
Listeria 
Mycobacteria
Corneybacteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bacteria

name 4 gram +ve anaerobes

A

CLAP

Clostridium
Lactobacillus
Actinomyces
Propionibacterium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Bacteria

name common gram -ve organisms (7)

A
  • Neisseria meningitis
  • Neisseria gonorrhoea
  • Haemophilia influenza
  • E.coli
  • Klebsiella
  • Pseudomonas aeruginosa
  • Moraxella catarrhalis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Bacteria

atypical bacteria that causes atypical pneumonia

A

Legions of Psittaci MCQs

Legionella pneumophila 
chlamydia Psittaci 
Mycoplasma pneumoniae 
Chlamydydophila pneumoniae 
Q fever (coxiella burneti)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Bacteria

what is MRSA

A

Methicillin-Resistant Staphylococcus Aureus

Staphylococcus aureus bacteria that have become resistant to beta-lactam abx such as penicillins, cephalosporins and carbapenems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Bacteria

which people should you think about MRSA in

A
  • hospital admissions
  • nursing home

healthcare settings where abx are commonly sued

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Bacteria

what extra measures can be taken to try to eradicate MRSA and stop spread

A

pts admitted for surgery or trx are screened by taking nasal and groin swabs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Bacteria

what is involved in eradication of MRSA

A

chlorhexidine body washes and antibacterial nasal creams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Bacteria

abx trx options for MRSA

A
  • doxycycline
  • clindamycin
  • vancomycin
  • teicoplanin
  • linezolid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Bacteria

what are ESBLs

A

Extended Spectrum Beta Lactamase bacteria that have developed resistance to beta-lactam abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Bacteria

how are ESBLs resistant to beta-lactam abx

A

they produce beta lactamase enzymes that destroy the beta-lactam ring on the abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Bacteria

ESBLs tend to be ____ or ____

A

e.coli or klebsiella

typically cause UTIs but can also cause other infections eg pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Bacteria

what are ESBLs sensitive to

A

carbapenems such as meropenem or imipenem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Antibiotics

define bacteriostatic

A

abx that stop the reproduction and growth of bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Antibiotics

define bactericidal

A

abx that kill the bacteria directly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Antibiotics

abx that inhibit cell wall synthesis

A

with a beta-lactam ring :

  • Penicillin
  • Carbapenems e.g. meropenem
  • Cephalosporins

without a beta-lactam ring:

  • Vancomycin
  • Teicoplanin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Antibiotics

abx that inhibit folic acid metabolism

A
  • Sulfamethoxazole
  • Trimethoprim
  • Co-trimoxazole
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Antibiotics

how does Sulfamethoxazole work

A

inhibits folic acid metabolism by blocking the conversion of PABA to DHFA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Antibiotics

how does Trimethoprim work

A

inhibits the folic acid metabolism by blocking the conversion of DHFA to THFA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Antibiotics

what is Co-trimoxazole a combination of

A

Sulfamethoxazole and Trimethoprim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Antibiotics

why is Metronidazole effective against anaerobes and not aerobes

A

the reduction of metronidazole into its active form only occurs in anaerobic cells

when partially reduced, metronidazole inhibits nucleic acid synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Antibiotics

abx that inhibit protein synthesis by targeting the ribosome

A
  • Macrolides: erythromycin, clarithromycin, azithromycin
  • Clindamycin
  • Tetracyclines: doxycycline
  • Gentamicin
  • Chloramphenicol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Antibiotics

stepwise process of escalating abx trx

A
  1. start with Amoxicillin which covers strep, listeria + enterococcus
  2. switch to Co-amoxiclav to additionally cover staph, haemophilus, e.coli
  3. switch to Tazocin to additionally cover pseudomonas

4, Switch to meropenem to additionally cover ESBLs

  1. Add Teicoplanin or Vancomycin to cover MRSA

6, Add Clarithromycin or Doxycycline to cover atypical bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Sepsis

what is it

A

a condition where the body launches a large immune response to an infection that causes systemic inflammation and affects the functioning of the organs of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Sepsis

pathophysiology

A

Pathogen recognised by macrophages, lymphocytes and mast cells

they release cytokines, interleukins + TNF which alerts the immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Sepsis

what do cytokines do

A

Cytokines activate NO which causes vasodilation

Cytokines cause the endothelial lining of blood vessels to become more permeable. Fluid leaks out of blood into the extracellular space leading to oedema and reduction in intravascular volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Sepsis

what does oedema around blood vessels lead to

A

creates space between blood and the tissues reducing the amount of O2 that reaches the tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Sepsis

what does activation of the coagulation system lead to

A

deposition of fibrin throughout the circulation further compromising organ and tissue perfusion

also leads to consumption of platelets and clotting factors as they are being used up to form clots within the circulatory system

this leads to DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Sepsis

what is DIC

A

disseminated intravascular coagulopathy:

  • thrombocytopenia
  • haemorrhages
  • inability to form clots + stop bleeding
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Sepsis

why does lactate increase

A

due to hypoperfusion of tissues that starves the tissue of O2 causing them to switch to anaerobic respiration

a waste product of anaerobic respiration is lactate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Sepsis

define septic shock

A

when arterial blood pressure drops and results in organ hypo-perfusion

leads to increased blood lactate as the organs begin anaerobic respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Sepsis

how can septic shock be measured/diagnosed

A
  • systolic BP <90 despite fluid resus

- hyperlactatemia (lactate >4mmol/L)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Sepsis

trx

A

treat aggressively with IV fluids to improve BP and tissue perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Sepsis

trx if IV fluid boluses don’t improve the BP and lactate level

A

escalate to HDU or ICU where they can use inotropes (noradrenalin) to help stimulate the CVS and improve BP and tissue perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Sepsis

define severe sepsis

A

when sepsis is present and results in organ dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Sepsis

severe sepsis examples of organ dysfunction

A
  • hypoxia
  • oliguria
  • AKI
  • thrombocytopenia
  • coagulation dysfunction
  • hypotension
  • hyperlactaemia (>2mmol/L)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Sepsis

RFs

A

any condition that impacts the immune system or makes the pt more frail/prone to infection:

  • very young or old (<1 or >75)
  • chronic conditions: COPD, DM
  • chemo, immunosuppressants or steroids
  • surgery or recent trauma or burns
  • pregnancy or peripartum
  • indwelling medical devices: catheters, central lines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Sepsis

what is used in the UK to pick up the signs of sepsis

A

the National Early Warning Score (NEWS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Sepsis

what does NEWS check

A
  • temp
  • HR
  • RR
  • O2 sats
  • BP
  • consciousness level
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Sepsis

signs on examination

A
  • signs of potential sources: cellulitis, discharge from wound, cough, dysuria
  • non-blanching rash: meningococcal septicaemia
  • reduced urine output
  • mottled skin
  • cyanosis
  • arrhythmias: eg new onset AF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Sepsis

what is often the first sign of sepsis

A

high RR (tachypnoea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Sepsis

what may elderly pts present with

A

confusion or drowsiness or simply ‘off legs’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Sepsis

what may neutropenic or immunosuppressed pts present as

A

normal obs and temp despite being life threatening unwell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Sepsis

blood tests for pts with suspected sepsis

A
  • FBC: WCC + neutrophils
  • U&Es: kidney function, AKI
  • LFTs: liver infection + source of infection
  • CRP: inflammation
  • Clotting: DIC
  • Blood cultures: bacteraemia
  • Blood gas: lactate, pH, glucose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Sepsis

what additional inx can be helpful in locating the source of infection

A
  • urine dipstick and culture
  • CXR
  • CT if intra-abdo infection or abscess is suspected
  • LP for meningitis or encephalitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Sepsis

high risk pts need…

A

urgent attention + mnx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Sepsis

moderate risk pts ….

A

may be managed in the community where the dx is clear and it is safe to do so

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Sepsis

mnx

A

sepsis 6 within 1hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Sepsis

what is Sepsis Six

A

3 tests:

  • blood lactate
  • blood cultures
  • urine output

3 trxs:

  • O2 to maintain O2 sats 94-98% (or 88-92% in COPD)
  • empirical broad spectrum abx
  • IV fluids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Sepsis

what is neutropenic sepsis

A

sepsis in a pt with a low neutrophil count of < 1x10(9) /L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Sepsis

medications that may cause neutropenia

A
  • anti-cancer chemo
  • Clozapine (schizophrenia)
  • Hydroxychloroquine (RA)
  • Methotrexate (RA)
  • Sulfasalazine (RA)
  • Carbimazole (hyperthyroidism)
  • Quinine (malaria)
  • Infliximab (immunosuppression)
  • Rituximab (immunosuppression)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Sepsis

when should you suspect neutropenic sepsis in pts taking immunosuppressants or medications that may cause neutropenia

A

treat any temperature above 38 as neutropenic sepsis until proven otherwise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Sepsis

why is there a high risk of death from sepsis in pts taking immunosuppressants or medications that may cause neutropenia

A

their immune system cannot adequately fight the infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Sepsis

mnx of neutropenic sepsis

A

Each local hospital will have a neutropenic sepsis policy

immediate broad spectrum antibiotics: piperacillin with tazobactam (tazocin)

aspects of mnx are the same for sepsis but with more caution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Urinary Tract Infections

why are they more common in women

A

their urethra is much shorter making it easy for bacteria to get into the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Urinary Tract Infections

what is the main source of bacteria

A

from faeces where the normal intestinal bacteria e.g. E.coli can travel to the urethral opening from the anus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Urinary Tract Infections

methods of spreading bacteria

A
  • sexual activity
  • incontinence
  • hygiene
  • urinary catheters
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Urinary Tract Infections

presentation of a lower UTI (6)

A
  • dysuria
  • suprapubic pain or discomfort
  • frequency
  • urgency
  • incontinence
  • confusion in frail pts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Urinary Tract Infections

presentation of pyelonephritis

A
  • fever
  • loin, suprapubic or back pain. Uni or Bilateral
  • haematuria
  • renal angle tenderness
  • looking + feeling generally unwell
  • vomiting
  • loss of appetite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Urinary Tract Infections

urine dipstick results

A

nitrites: +
leukocytes: +

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Urinary Tract Infections

What to do if

nitrites: -
leukocytes: +

A

should not be treated as a UTI unless there is clinical evidence

nitrites are a better indication of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Urinary Tract Infections

why would nitrites be +ve on a urine dipstick

A

gram -ve bacteria (E.coli) break down nitrates into nitrites

nitrates are a normal waste product in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Urinary Tract Infections

if nitrites and leukocytes are present then what?

A

send midstream urine to microbiology lab to be cultured and to have sensitivity testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Urinary Tract Infections

most common organism

A

E.coli

gram -ve, anaerobic, rod shaped bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Urinary Tract Infections

other causes apart from E.coli

A
  • Klebsiella pneumoniae (gram-negative anaerobic rod)
  • Enterococcus
  • Pseudomonas aeruginosa
  • Staphylococcus saprophyticus
  • Candida albicans (fungal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Urinary Tract Infections

abx choice in the community

A
  • Trimethoprim
  • Nitrofurantoin

alternatives:

  • Pivmecillinam
  • Amoxicillin
  • Cefalexin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Urinary Tract Infections

duration of abx for a simple lower UTI in women

A

3d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Urinary Tract Infections

duration of abx for women that are immunosuppressed, have abnormal anatomy or impaired kidney function

A

5-10d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Urinary Tract Infections

duration of abx for men, pregnant women or catheter related UTIs

A

7d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Urinary Tract Infections

what do UTIs in pregnancy increase the risk of?

A
  • pyelonephritis
  • PROM
  • pre-term labour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Urinary Tract Infections

mnx in pregnancy

A

1st line: nitrofurantoin
2nd line: cefalexin or amoxicillin

for 7d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Urinary Tract Infections

why is nitrofurantoin avoided in the 3rd trimester

A

it is linked with haemolytic anaemia in the newborn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Urinary Tract Infections

why is trimethoprim avoided in the 1st trimester

A

anti-folate effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Urinary Tract Infections

mnx of pyelonephritis

A
  • refer to hospital if there are features of sepsis

1st line abx for 7-10d:

  • cefalexin
  • co-amoxiclav
  • trimethoprim
  • ciprofloxacin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Cellulitis

what is it

A

an infection of the skin and the soft tissues underneath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Cellulitis

presentation

A
  • bullae
  • golden yellow crust
  • erythema
  • warm to touch
  • tense
  • thickened
  • oedematous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Cellulitis

what are bullae

A

fluid-filled blisters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Cellulitis

what may a golden-yellow crust indicate

A

staphylococcus aureus infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Cellulitis

most common causes

A
  • Staphylococcus aureus
  • Group A Streptococcus
  • Group B Streptococcus
  • MRSA (less common)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Cellulitis

name a Group A strep

A

streptococcus pyogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Cellulitis

name a group B strep

A

Streptococcus dysgalactiae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Cellulitis

what is the classification system NICE recommend for the assessment of the severity of cellulitis

A

Eron Classification (Class 1-4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Cellulitis

Eron Classification: Class 1

A

no systemic toxicity or comorbidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Cellulitis

Eron Classification: Class 2

A

systemic toxicity or comorbidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Cellulitis

Eron Classification: Class 3

A

significant systemic toxicity or significant comorbidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Cellulitis

Eron Classification: Class 4

A

sepsis or life-threatening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Cellulitis

when should you admit for IV abx

A

if they are class 3 or 4

consider if frail, very young or immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Cellulitis

trx

A

Flucloxacillin is very effective against staph

PO or IV

alternatively: clarithromycin, clindamycin, co-amoxiclav

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Malaria

what is it caused by

A

members of the Plasmodium family of protozoan parasites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Malaria

what are protozoa

A

single celled organisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Malaria

what is the most severe and dangerous member of the Plasmodium family of protozoan parasites

A

Plasmodium falciparum (75% of cases in UK)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Malaria

how is it spread

A

through bites from the female Anopheles mosquitoes that carry the disease

infected blood sucked up by feeding mosquito

malaria in the blood reproduces in the gut of the mosquito producing thousands of sporozoites (malaria spores)

mosquito bites another human and sporozoites are injected by the mosquito.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Malaria

4 types

A
  • Plasmodium falciparum
  • Plasmodium vivax
  • Plasmodium ovale
  • Plasmodium malariae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Malaria

where do the sporozoites travel to in the newly infected person

A

the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Malaria

what can P.vivax and P.ovale do in the liver

A

lie dormant as hypnozoites for several years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Malaria

how sporozoites cause haemolytic anaemia

A

merozoites mature in the liver into merozoites which enter the blood and infect RBCs

In RBCs, the merozoites reproduce over 48hrs then the RBCs rupture, releasing loads more merozoites into the blood, causing haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Malaria

why do infected people have high fever spikes every 48 hrs

A

in RBCs the merozoites reproduce over 48hrs, after which the red blood cells rupture releasing loads more merozoites into the blood and causing a haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Malaria

incubation period

A

1w after infection with malaria although it can lie dormant for years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Malaria

whom should you suspect malaria in

A

someone who lives or has travelled to an area of malaria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Malaria

non specific sx (5)

A
  • fever, sweats, rigors
  • malaise
  • myalgia
  • headache
  • vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Malaria

signs (3)

A
  • pallor due to the anaemia
  • hepatosplenomegaly
  • jaundice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Malaria

why do pts get jaundice

A

because bilirubin is released during the rupture of RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Malaria

dx

A

malaria blood film (sent in an EDTA bottle) (the red top bottle for FBC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Malaria

how to exclude malaria

A

3 samples of blood film are sent over 3 consecutive days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Malaria

why are 3 samples sent over 3 consecutive days

A

due to the 48 hour cycle of malaria being released into the blood from RBCs

the sample may be -ve on days where the parasite is not released

but +ve later when they are released from the RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Malaria

for advice and mnx, whom should you discuss pts with

A

the local infectious diseases unit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Malaria

which patients should you admit

A

all patients with falciparum malaria

120
Q

Malaria

IV options in severe (falciparum) or complicated malaria

A
  1. Artesunate (most effective but not licensed)

2. Quinine dihydrochloride

121
Q

Malaria

PO options in uncomplicated malaria

A
  1. Artemether with lumefantrine (Riamet)
  2. Proguanil and atovaquone (Malarone)
  3. Quinine sulphate
  4. Doxycycline
122
Q

Malaria

Falciparum complications

A
  • Cerebral malaria
  • Seizures
  • Reduced consciousness
  • Acute kidney injury
  • Pulmonary oedema
  • DIC
  • Severe haemolytic anaemia
  • Multi-organ failure and death
123
Q

Malaria

prophylaxis general advice

A
  • Be aware of locations that are high risk
  • No method is 100% effective alone
  • Use mosquito spray (e.g. 50% DEET spray) in mosquito exposed areas
  • Use mosquito nets and barriers in sleeping areas
  • Seek medical advice if symptoms develop
  • Take antimalarial medication as recommended
124
Q

Malaria

antimalarial options

A
  • Proguanil and atovaquone (Malarone)
  • Mefloquine
  • Doxycycline
125
Q

Malaria

Proguanil and atovaquone (Malarone) facts

A
  • Take daily 2 days before, during and 1 week after being in endemic area
  • Most expensive (around £1 per tablet)
  • Best side effect profile
126
Q

Malaria

Mefloquine facts

A
  • Take once weekly 2 weeks before, during and 4 weeks after being in endemic area
  • SEs: bad dreams and rarely, psychotic disorders or seizures
127
Q

Malaria

Doxycycline facts

A
  • Take daily 2 days before, during and 4 weeks after being in endemic area
  • Broad-spectrum abx therefore it causes SEs like diarrhoea and thrush
  • Makes patients sensitive to the sun causing a rash and sunburn
128
Q

Dengue Fever

what is it

A

a viral infection which can progress to haemorrhagic fever (a form of DIC)

transmitted by the Aedes aegypti misquito

129
Q

Dengue Fever

incubation period

A

7d

130
Q

Dengue Fever

features

A
  • headache (often retro-orbital)
  • facial flushing (dengue)
  • maculopapular rash
  • fever, myalgia, pleuritic pain
131
Q

Dengue Fever

trx

A

entirely symptomatic e.g. fluid resus, blood transfusion

no antivirals currently available

132
Q

Enteric fever (typhoid/paratyphoid)

cause

A

Salmonella typhi and Salmonella paratyphi (types A, B & C) respectively

133
Q

Enteric fever (typhoid/paratyphoid)

features

A
  • initially: headache, fever, arthralgia
  • rose spots on trunk
  • constipation
  • relative bradycardia
  • abdo pain, distension
134
Q

Enteric fever (typhoid/paratyphoid)

what kind of bacteria are Salmonella

A

aerobic, gram -ve rods

135
Q

mnx for Clostridium difficile

A

1st line mild, moderate or severe infection is Vancomycin 125mg PO QDS

2nd line is Fidamomicin 200mg PO BD

resistent or life-threatening infection include using higher doses of Vancomycin or adding PO/IV Metronidazole

136
Q

Tuberculosis

which bacteria is it caused by

A

mycobacterium tuberculosis

137
Q

Tuberculosis

what kind of bacteria is mycobacterium tuberculosis

A

acid-fast bacillus (small rod shaped bac resistant to acids used in the staining procedure)

138
Q

Tuberculosis

what stain is used

A

Zeihl-Neelsen stain

139
Q

Tuberculosis

what colour does Zeihl-Neelsen stain turn mycobacterium tuberculosis

A

bright red against a blue background

140
Q

patient coughing up sputum that grows acid-fast bacilli that stain red with Zeihl-Neelsen staining. what is the dx

A

TB

141
Q

Tuberculosis

whom is TB more prevalent in?

A
  • non-UK born pts
  • immunocompromised
  • those with close contacts with TB
142
Q

Tuberculosis

what is MDR TB

A

multi-drug resistant TB

strains that are resistant to more than one drug, making them very difficult to treat

143
Q

Tuberculosis

what makes TB bacteria difficult to culture and treat

A

very slow dividing with high oxygen demands

144
Q

Tuberculosis

how is it spread

A

by inhaling saliva droplets from infected people

spreads through the lymphatics and blood

granulomas containing the bacteria form around the body

145
Q

Tuberculosis

what is active TB

A

where there is active infection in various areas within the body

in majority of cases, the immune system is able to kill and clear the infection

146
Q

Tuberculosis

what is latent TB

A

when the immune system encapsulates sites of infection and stop the progression of the diseases

147
Q

Tuberculosis

what is secondary TB

A

when latent TB reactivates

148
Q

Tuberculosis

what is miliary TB

A

when the immune system is unable to control the disease which causes a disseminated, severe disease

149
Q

Tuberculosis

where is the most common site of TB infection and why

A

in the lungs where they get plenty of o2

150
Q

Tuberculosis

what is extrapulmonary TB

A

where it infects other areas apart from the lungs

151
Q

Tuberculosis

what is a cold abscess

A

a firm painless abscess caused by TB, usually in the neck

no inflammation, redness or pain

152
Q

Tuberculosis

extrapulmonary TB areas

A
  • lymph nodes
  • Pleura
  • CNS
  • Pericardium
  • GI
  • GU
  • Bones and joints
  • Cutaneous TB affecting the skin
153
Q

Tuberculosis

RFs (5)

A
  • known contacts with active TB
  • immigrants from areas of high TB prevalence
  • close contacts from countries with a high rate of TB
  • immunosuppressed
  • homeless, drug users, alcoholics
154
Q

Tuberculosis

what is the vaccine called

A

BCG vaccine

155
Q

Tuberculosis

whom is the BCG vaccine offered to

A

patients that are at higher risk of contact with TB:
- Neonates born in areas of the UK with high rates of TB; relatives from countries with a high rate of TB; family history of TB

  • Unvaccinated older children and young adults (< 35) who have close contact with TB
  • Unvaccinated children or young adults that recently arrived from a country with a high rate of TB
  • Healthcare workers
156
Q

Tuberculosis

what are patients tested with prior to the BCG vaccine

A

Mantoux test: given the vaccine only if the test is negative

HIV and immunosuppression tested due to risks related to a live vaccine

157
Q

Tuberculosis

what kind of vaccine is the BCG

A

live attenuated (weakened)

158
Q

Tuberculosis

signs and symptoms

A

history of chronic, gradually worsening symptoms:
- lethargy, fever, night sweats, weight loss, lymphadenopathy

  • cough with or without haemoptysis
  • erythema nodosum
  • spinal pain
159
Q

Tuberculosis

what is Pott’s disease of the spine

A

spinal pain in spinal TB

160
Q

Tuberculosis

what are the 2 tests for an immune response to TB caused by previous, latent or active TB

A
  • Mantoux test

- interferon-gamma release assay

161
Q

Tuberculosis

what investigations in patients where the active disease is suspected

A

CXR and cultures

162
Q

Tuberculosis

what does a positive Mantoux test indicate

A

possible previous vaccination, latent or active TB

163
Q

Tuberculosis

what is injected in the Mantoux test

A

tuberculin: a collection of TB proteins that have been isolated from the bacteria (not live bacteria)

164
Q

Tuberculosis

what indicated a positive Mantoux test

A

an induration of the skin at the site of the injection of 5mm or more

165
Q

Tuberculosis

what does interferon-gamma release assay test involve

A

taking sample of blood and mixing it with antigens from the TB bacteria

166
Q

Tuberculosis

what indicates a positive interferon-gamma release test

A

If interferon-gamma is released from the white blood cells

In a person that has had previous contact with TB the white blood cells have become sensitised to those antigens and they will release interferon-gamma as part of an immune response

167
Q

Tuberculosis

what is the interferon-gamma release assay used in

A

pts that do not have features of active TB but do have a positive Mantoux test

to confirm a diagnosis of latent TB

168
Q

Tuberculosis

CXR findings in primary TB

A
  • patchy consolidation
  • pleural effusions
  • hilar lymphadenopathy
169
Q

Tuberculosis

CXR findings in reactivated TB

A

patchy or nodular consolidation with cavitation (gas filled spaces in the lungs) typically in the upper zones

170
Q

Tuberculosis

CXR findings in Disseminated Miliary TB

A

“millet seeds” uniformly distributed throughout the lung fields

171
Q

Tuberculosis

what are the ways to collect cultures

A
  • sputum: may require bronchoscopy with lavage
  • mycobacterium blood cultures
  • lymph node aspiration or biopsy
172
Q

Tuberculosis

why may nucleic acid amplification be used

A

It provides information about the bacteria faster than a traditional culture but is only used where having this information would affect treatment or they are at higher risk of developing complications (i.e. in HIV).

173
Q

Tuberculosis

mnx of latent TB in otherwise healthy pts

A

nothing

174
Q

Tuberculosis

mnx of latent TB in pts at risk of reactivation

A

either:
Isoniazid and rifampicin for 3 months

Isoniazid for 6 months

175
Q

Tuberculosis

mnx of acute pulmonary TB

A

R – Rifampicin for 6 months
I – Isoniazid for 6 months
P – Pyrazinamide for 2 months
E – Ethambutol for 2 months

176
Q

Tuberculosis

what should also be prescribed alongside isoniazid

A

pyridoxine (vit B6)

177
Q

Tuberculosis

why should pyridoxine (vit B6) be prescribed alonside isoniazid

A

isoniazid causes peripheral neuropathy and vit B6 helps prevent this

178
Q

Tuberculosis

whom should you inform of all suspected cases

A

PHE

179
Q

Tuberculosis

SE’s of rifampicin

A
  • red discolouration of secretions (urine + tears)

- potent inducer of CP450 enzymes so reduces the effects of drugs metabolised by the system e.g cocP

180
Q

Tuberculosis

SE’s of Isoniazid

A
  • peripheral neuropathy
181
Q

Tuberculosis

SE’s of Pyrazinamide

A
  • hyperuricaemia (high uric levels) –> gout
182
Q

Tuberculosis

SE’s of ethambutol

A
  • colour blindness

- reduced visual acuity

183
Q

Tuberculosis

what is the common SE of Rifampicin, isoniazid and pyrazinamide

A

hepatotoxicity

184
Q

HIV

which is the most common type

A

HIV-1

HIV-2 is rare outside West Africa

185
Q

HIV

what kind of virus is it

A

RNA retrovirus

186
Q

HIV

what does the virus destroy

A

CD4 T helper cells

187
Q

HIV

how is it spread

A
  1. unprotected anal, vaginal or oral sex
  2. vertical transmission: mother to child via pregnancy, birth or breastfeeding
  3. Mucous membrane, blood or open wound exposure to infected blood or bodily fluids
188
Q

HIV

AIDS-defining illnesses

A
  • Kaposi’s sarcoma
  • Pneumocystis jirovecii pneumonia (PCP)
  • CMV infection
  • Candidiasis (oesophageal or bronchial)
  • Lymphomas
  • TB
189
Q

HIV

can antibody tests be negative for 3 months following exposure?

A

yes so repeat testing is necessary if an initial test is negative within 3 months of a potential exposure

190
Q

HIV

do patients need to give consent for a test

A

yes, verbal consent is okay and should be documented

Patients no longer require formal counselling or education prior to a test.

191
Q

HIV

what is the typical test used in hospitals to screen for HIV

A

antibody blood test

192
Q

HIV

what test can give a positive result earlier in the infection compared with the antibody test

A

Testing for the p24 antigen

which checks directly for the specific HIV antigen in the blood

193
Q

HIV

what test directly for the quantity of the HIV virus in the blood and gives a viral load

A

PCR testing for the HIV RNA levels

194
Q

HIV

how is it monitored

A
  • CD4 count

- viral load

195
Q

HIV

what is the normal CD4 count range

A

500-1200 cells/mm3

196
Q

HIV

what CD4 count is considered as end stage HIV / AIDS

A

<200 cells/mm3

197
Q

HIV

what is the viral load

A

the number of copies of HIV RNA per ml of blood

198
Q

HIV

what does ‘undetectable’ refer to

A

a viral load below the labs recordable range (usually 50 – 100 copies/ml)

199
Q

HIV

recommended trx starting regime

A

2 NRTIs
(e.g. tenofovir and emtricitabine)

plus a third agent of: INI, NNRTI, PI

200
Q

HIV

what are the Highly Active Anti-Retrovirus Therapy (HAART) Medication Classes

A
  • Protease Inhibitors (PIs)
  • Integrase Inhibitors (INIs)
  • Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
  • Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
  • Entry Inhibitors (EIs)
201
Q

HIV

what is given to pts with a CD4 < 200/mm3 and why

A

Prophylactic co-trimoxazole (Septrin)

to protect against pneumocystis

202
Q

HIV

HIV infection increases the risk of developing CVD. How is this monitored

A

close monitoring of RFs and blood lipids and statins

203
Q

HIV

why are yearly cervical smears required for women

A

HIV predisposes to developing cervical human papillomavirus (HPV) infection and cervical cancer

204
Q

HIV

what vaccines should they have and not have

A

avoid live vaccines

They should be up to date with annual influenza, pneumococcal (every 5-10y), hep A and B, tetanus, diphtheria and polio

205
Q

HIV

advise for reproductive health

A
  • condoms
  • dams for oral sex even when both partners are positive
  • undetectable = untransmissible
206
Q

HIV

advise with conceiving

A
  • if undetectable viral load, unprotected sex and pregnancy may be considered
  • safe to conceive with sperm washing and IVF
207
Q

HIV

advise at birth

A
  • vaginal birth considered if VL is undetectable

- c-section otherwise

208
Q

HIV

what should newborns to HIV positive mothers receive

A

ART for 4 weeks after birth to reduce the risk of vertical transmission.

209
Q

HIV

can positive HIV mothers breastfeed

A

considered if VL is undetectable but there may still be a risk of contracting HIV through breastfeeding

210
Q

HIV

what can be given after exposure to HIV to reduce risk of transmission

A

Post exposure prophylaxis

211
Q

HIV

what time period should post exposure prophylaxis be given

A

<72h of exposure

212
Q

HIV

what is post exposure prophylaxis

A

combination of ART therapy for 28d:

  • Truvada (emtricitabine / tenofovir)
  • raltegravir
213
Q

HIV

pt exposed to HIV. When should tests be done

A

immediately

then 3m after exposure
abstain from unprotected sexual activity in this time

214
Q

Meningitis

what is the meninges

A

lining of the brain and spinal cord

215
Q

Meningitis

what kind of bacteria is neisseria meningitidis

A

gram negative diplococcus aka meningococcus

216
Q

Meningitis

what is meningococcal septicaemia

A

when the meningococcus bacterial infection is in the bloodstream

217
Q

Meningitis

what does the non-blanching rash indicate

A

meningococcal septicaemia which has caused DIC + SC haemorrhages

218
Q

Meningitis

what is meningococcal meningitis

A

when the bacteria is infecting the meninges and the cerebrospinal fluid around the brain and spinal cord

219
Q

Meningitis

what are the most common causes of bacterial meningitis in children and adults

A

Neisseria meningitidis (meningococcus)

and Streptococcus pneumoniae (pneumococcus)

220
Q

Meningitis

what is the most common cause in neonates

A

Group B Streptococcus (GBS).

221
Q

Meningitis

typical sx

A
  • fever
  • neck stiffness
  • vomiting
  • headache
  • photophobia
  • altered consciousness
  • seizures
222
Q

Meningitis

where there is meningococcal septicaemia children can present with?

A

a non-blanching rash

223
Q

Meningitis

how may neonates + babies present as

A

very non-specific:

  • hypotonia
  • poor feeding
  • lethargy
  • hypothermia
  • bulging fontanelle
224
Q

Meningitis

NICE recommends LP for children <1m presenting with?

A

a fever

225
Q

Meningitis

NICE recommends LP for children 1-3m presenting with?

A

a fever and are unwell

226
Q

Meningitis

NICE recommends LP for children <1y presenting with?

A
  • unexplained fever

- and other features of serious illness

227
Q

Meningitis

what are the 2 special test to look for meningeal irritation

A
  • Kernigs Test

- Brudzinski’s Test

228
Q

Meningitis

what is involved in Kernig’s test

A
  • lie pt flat
  • flex 1 hip + knee to 90 degrees
  • slowly straighten knee whilst keeping hip flexed
229
Q

Meningitis

+ve Kernig’s test explanation

A

slight stretch in the meninges created

so spinal pain or resistance if there is meningitis

230
Q

Meningitis

what is involved in the Brudzinski’s test

A
  • lie pt flat

- lift pt’s head + neck off bed and flex their chin to their chest

231
Q

Meningitis

+ve Brudzinski test

A

pt involuntarily flex their hips + knees

232
Q

Meningitis

mnx in community of child with suspected meningitis AND non blanching rash

A

urgent stat benzylpenicillin (IM/IV)
< 1 year – 300mg
1-9 years – 600mg
> 10 years + adults – 1200mg

admit

233
Q

Meningitis

mnx in community of child with suspected meningitis AND non blanching rash

but allergic to penicillin

A

transfer should be the priority rather than other antibiotics.

234
Q

Meningitis

inx in hospsital

A

should not delay trx:

  • LP for CSF
  • send bloods for meningococcal PCR
235
Q

Meningitis

mnx in hospital for <3m

A

cefotaxime + amoxicillin

236
Q

Meningitis

mnx in hopsital for >3m

A

ceftriaxone

237
Q

Meningitis

why is amoxicillin added for <3m mnx

A

to cover listeria contracted during pregnancy from the mother

238
Q

Meningitis

when should vancomycin be added to mnx

A

if there is a risk of penicillin resistant pneumococcal infection
e.g. recent foreign travel or prolonged abx exposure.

239
Q

Meningitis

why are steroids given in bacterial meningitis

A

to reduce the frequency and severity of hearing loss and neurological damage.

240
Q

Meningitis

medication if LP is suggestive of bacterial meningitis and >3m

A

ceftriaxone

+ dexamethasone QDS for 4d

241
Q

Meningitis

is bacteria meningitis and meningococcal infection a notifiable disease

A

yes

242
Q

Meningitis

who should be given post exposure prophylaxis

A

for people that have had close prolonged contact within the 7 days prior to the onset of the illness.

243
Q

Meningitis

post exposure prophylaxis

A

single dose of ciprofloxacin ideally within 24 hours of the initial diagnosis of the contact

244
Q

Meningitis

what is the most common cause of viral meningitis

A

HSV, enterovirus, VZV

245
Q

Meningitis

which is milder, bacterial or viral

A

viral

246
Q

Meningitis

mnx of viral

A
  • often only supportive

- Aciclovir for suspected HSV meningitis

247
Q

Meningitis

where does the spinal cord end

A

at L1-L2 vertebral level

248
Q

Meningitis

where is the needle inserted for LP

A

L3-L4

249
Q

Meningitis

LP samples are sent for what

A

bacterial culture, viral PCR, cell count, protein and glucose

250
Q

Meningitis

CSF fluid for bacteria

  • appearance
  • protein
  • glucose
  • WCC
A

cloudy
high protein
low glucose
high neutrophils

251
Q

Meningitis

CSF fluid for viral

  • appearance
  • protein
  • glucose
  • WCC
A

clear
mildly raised/normal protein
normal glucose
high lymphocytes

252
Q

Meningitis

complications

A
  • hearing loss
  • seizures + epilepsy
  • cognitive impairment + learning disability
  • memory loss
  • focal neuro deficits e.g. limb weakness or spasticity
253
Q

Septic Arthritis

presentation

A
  • Hot, red, swollen and painful joint
  • Stiffness and reduced range of motion
  • Systemic symptoms such as fever, lethargy and sepsis
254
Q

Septic Arthritis

most common causative organism

A

staph aureus

other:

  • neisseria gonorrhoea
  • strep pyogenes
  • haemophilus influenza
  • e.coli
255
Q

Septic Arthritis

Ddx

A
  • gout
  • pseudogout
  • reactive arthritis
  • hemarthrosis (bleeding into joint)
256
Q

Septic Arthritis

inx

A
  • joint aspiration

- send sample for gram staining, crystal microscopy, culture and antibiotic sensitivities

257
Q

Septic Arthritis

what should be given until the sensitives are known

A

1st line: IV flucloxacillin + rifampicin

258
Q

Septic Arthritis

abx if allergic to penicillin or MRSA or prosthetic joint

A

vancomycin + rifampicin

or clindamycin

259
Q

Gastroenteritis

what is acute gastritis

A

inflammation of the stomach

N+V

260
Q

Gastroenteritis

what is enteritis

A

inflammation of the intestines

diarrhoea

261
Q

Gastroenteritis

what is gastroenteritis

A

inflammation all the way from the stomach to the intestines

262
Q

Gastroenteritis

what is the most common

A

viral:

  • rotavirus
  • norovirus
  • adenovirus
263
Q

Gastroenteritis

what leads to HUS

A

shiga toxin produced from e.coli 0157

264
Q

Gastroenteritis

what is a common cause of traveller’s diarrhoea

A

Campylobacter Jejuni

265
Q

Gastroenteritis

how is Campylobacter Jejuni spread

A
  • Raw or improperly cooked poultry
  • Untreated water
  • Unpasteurised milk
266
Q

Gastroenteritis

when to consider abx for campylobacter jejuni

A
  • after isolating the organism where patients have severe symptoms
  • or HIV, HF
267
Q

Gastroenteritis

popular abx choice for campylobacter jejuni

A

azithromycin or ciprofloxacin

268
Q

Gastroenteritis

bloody diarrhoea. Drinking contaminated water, food and swimming pools. What is it

A

Shigella

269
Q

Gastroenteritis

what can shigella produce and cause

A

shiga toxin so can cause HUS

270
Q

Gastroenteritis

trx of severe cases

A

azithromycin or ciprofloxacin

271
Q

Gastroenteritis

how is salmonella spread

A
  • eating raw eggs or poultry and food contaminated with infected faeces of small animals
272
Q

Gastroenteritis

sx of salmonella

A
  • watery diarrhoea
  • may be associated with mucus or blood
  • abdo pain + vomiting
273
Q

Gastroenteritis

leftover fried rice that has been left at room temperature.

what could it be

A

Bacillus Cereus

274
Q

Gastroenteritis

typical course of bacillus cereus

A
  • vomiting within 5h
  • diarrhoea after 8h
  • resolution within 24h
275
Q

Gastroenteritis

bacillus cereus: what causes the vomiting within 5h

A

it produces a toxin called cereulide

276
Q

Gastroenteritis

bacillus cereus: what causes the diarrhoea after 8h

A

When it arrives in the intestines it produces different toxins

277
Q

Gastroenteritis

IVDU develops infective endocarditis. What could it be

A

most common: staph

bacillus cereus

278
Q

Gastroenteritis

what kind of bacteria is bacillus cereus

A

gram positive rod

279
Q

Gastroenteritis

what kind of bacteria is Yersinia Enterocolitica

A

gram-negative bacillus

280
Q

Gastroenteritis

how is Yersinia Enterocolitica spread

A
  • eating undercooked pork

- contamination with the urine or faeces of other mammal such as rat and rabbits

281
Q

Gastroenteritis

who does yersinia most frequently affect

A

children

282
Q

Gastroenteritis

presentation of Yersinia Enterocolitica

A
  • watery or bloody diarrhoea
  • abdo pain
  • fever
  • lymphadenopathy
283
Q

Gastroenteritis

how long can sx of Yersinia Enterocolitica last

A

> 3w

284
Q

Gastroenteritis

why can older children or adults present with right sided abdo pain in Yersinia Enterocolitica

A

mesenteric lymphadenitis (inflammation in the intestinal lymph nodes) and fever

285
Q

Gastroenteritis

mnx of Yersinia Enterocolitica

A

abx only in severe cases (guided by stool culture + sensitivities)

286
Q

Gastroenteritis

what is giardia lamblia

A

a type of microscopic parasite. It lives in the small intestines of mammals

It releases cysts in the stools of infected mammals

287
Q

Gastroenteritis

trx of Giardiasis

A

metronidazole

288
Q

Gastroenteritis

principles of mnx

A
  • good hygiene
  • Barrier nursing and rigorous infection control
  • MC&S of faeces
  • fluid challenge
  • Slowly introduce a light diet in small quantities once oral intake is tolerated again
  • stay off work or school for 48h after symptoms have completely resolved
289
Q

Gastroenteritis

should you give loperamide or metoclopramide

A

generally not recommended but may be useful for mild to moderate symptoms

290
Q

Gastroenteritis

post-gastroenteritis complications

A
  • Lactose intolerance
  • IBD
  • Reactive arthritis
  • Guillain–Barré syndrome
291
Q

Tetanus

what is it caused by

A

the tetanospasmin exotoxin released from Clostridium tetani

Tetanus spores are present in soil and may be introduced into the body from a wound

292
Q

Tetanus

features

A
  • prodrome fever, lethargy, headache
  • trismus (lockjaw)
  • risus sardonicus
  • opisthotonus (arched back, hyperextended neck)
  • spasms (e.g. dysphagia)
293
Q

Tetanus

mnx

A
  • supportive: ventilatory support, muscle relaxants
  • IM human tetanus Ig for high-risk wounds (e.g. compound fractures, delayed surgical intervention, significant degree of devitalised tissue)
  • metronidazole

Give tetanus Ig for immediate protection regardless of immunization history, and if this is not up-to-date (or patient is immunocompromised) give additional booster doses of vaccine as well.

294
Q

what does a positive tourniquet test indicate

A

dengue fever

295
Q

hiker with swelling of knee, then flu like illness and now facial nerve palsy. What is it

A

lyme disease

296
Q

what is the most common cause of leg cellulitis

A

strep pyogenes

Finals (47 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions