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MRCP > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

Which antibiotics have anti-anaerobic activity

A

Penicillins, cephalosporins (except ceftazidime), erythromycin, tetracycline, metronidazole

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2
Q

Which antibiotics have no anti-anaerobic activity

A

Ceftazidime, ciprofloxacin, gentamycin

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3
Q

What is the MOA of rifampicin

A

Prevents transcription of DNA to mRNA

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4
Q

What is the MOA of isoniazid

A

Inhibits mycolic acid synthesis

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5
Q

What is the MOA of pyrazinamide

A

Inhibits fatty acid synthase

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6
Q

What is the MOA of ethambutol

A

Inhibits arabinosyl transferase

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7
Q

What are the types of gram positive rods

A

Actinomyces, bacillus anthracis, clostridium, diphtheria, listeria

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8
Q

Which antibiotics inhibit cell wall formation

A

Penicillins, cephalosporins, isoniazid, vancomycin

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9
Q

Which antibiotic targets the 50s subunit of the ribosome

A

Macrolides (erythromycin, clarithromycin, azithromycin)

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10
Q

What is the MOA of tetracyclines

A

Inhibits 30s subunit of ribosome, thereby inhibiting protein synthesis

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11
Q

What drug must be stopped when macrolides are started

A

Statins

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12
Q

Which antibiotics inhibit DNA gyrase

A

Quinolones (ciprofloxacin, levofloxacin)

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13
Q

Which organism is responsible for most central line infections

A

Staph epidermis

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14
Q

Which organism is classified as group A beta-haemolytic streptococcus

A

Strep pyogenes

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15
Q

What is the diagnostic criteria for toxic shock syndrome

A

Temp >38.9, hypotension BP <90, diffuse erythematous rash, desquamation of palms and soles, >2 organs involved

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16
Q

What is the main organism that causes osteomyelitis in sickle cell patients

A

Salmonella

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17
Q

What is the main organism that causes necrotising fasciitis

A

Strep pyogenes

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18
Q

What is the treatment of anthrax

A

Ciprofloxacin

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19
Q

What are the main 3 organisms responsible for meningitis in adults

A

Neisseria meningitidis
Streptococcus pneumoniae
Listeria monocytogenes

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20
Q

Which organism spread by unpasteurised dairy can present with hemiparesis and ataxia

A

Listeria monocytogenes

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21
Q

What is the treatment of Lyme disease presenting with bulls eye lesions but no disseminated disease

A

Doxycycline 2-3 weeks

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22
Q

Which organism spread by infected rat urine causes renal failure in 50% and hepatic failure in 10% of cases

A

Leptospirosis

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23
Q

What is the gold standard investigation for diagnosing Brucellosis

A

Bone marrow aspiration and culture

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24
Q

How many mm is considered positive in Mantoux test

A

6mm

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25
Q

Name 5 causes of false negatives in Mantoux test

A

Miliary TB, HIV, sarcoid, immunosuppression, steroids

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26
Q

What is the treatment of TB meningitis

A

1 year TB treatment + steroids

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27
Q

What organism caught from fresh water produces ‘fish tank granulomas’

A

Mycobacterium marinum

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28
Q

What is the treatment of seizures caused by isoniazid

A

Vitamin B6 (pyridoxine)

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29
Q

How many strands of RNA are present in a HIV cell

A

2 copies of single stranded RNA

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30
Q

What are the envelope proteins present on HIV cells

A

GP120, GP41

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31
Q

What 3 main enzymes do HIV genes encode

A

Reverse transcriptase, integrase, protease

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32
Q

What does GP120 bind to on T cells to allow HIV to enter

A

CD4 and CXCR4

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33
Q

What does GP120 bind to on macrophages to allow HIV to enter

A

CD4, CCR5

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34
Q

What happens to IL-2 production in progressive HIV

A

IL-2 production decreases

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35
Q

Which vaccines are contraindicated in HIV

A

Cholera, intranasal influenza, oral polio, TB

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36
Q

What are the common suffixes to remember ARTs

A

Proteinase inhibitors = -navir

Integrase inhibitors = -gravir

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37
Q

Name 3 common NRTIs used for HIV treatment

A

Abacavir, tenofovir, zidovudine

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38
Q

What are the side effects of protease inhibitors

A

Diabetes, hyperlipidaemia, buffalo hump, central obesity, P450 inhibitors

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39
Q

What is the treatment of PJP

A

IV co-trimoxazole + IV methylprednisolone

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40
Q

What is the commonest causative organism of diarrhoea in HIV

A

Cryptosporidium

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41
Q

Which organism shows red rounded oocysts against blue-green background on acid-fast (Ziehl-Neelsen) stain of stool

A

Cryptosporidium

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42
Q

What two things cause Addison’s disease in HIV patients

A

CMV-Adenitis, TB

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43
Q

What is the most common fungal infection of the CNS in HIV

A

Cryptococcus

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44
Q

How is histoplasmosis diagnosed

A

Adrenal biopsy with groccott stain

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45
Q

What is the treatment of histoplasmosis

A

Itraconazole 3-6 months

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46
Q

How does the clostridium tetani neurotoxin act to cause lockjaw

A

Blocks release of GABA

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47
Q

What does the exotoxin produced by clostridium botulinum do to cause flaccid paralysis

A

Blocks ACh release

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48
Q

What does the shiga toxin act on

A

Inactivates 60S ribosome

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49
Q

Which bacteria release endotoxins

A

Gram negative e.g. Neisseria Meningitidis

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50
Q

Which virus can cause haemoptysis in HIV patients

A

HHV-8 (Kaposi’s sarcoma)

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51
Q

What is the most common cause of blindness in HIV

A

CMV retinitis

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52
Q

What is the MOA of acyclovir

A

Inhibits viral DNA polymerase

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53
Q

Which antiviral is used to treat CMV

A

Gancyclovir

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54
Q

Which antiviral used to treat chronic HCV interferes with capping of viral mRNA

A

Ribavarin

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55
Q

Which two conditions is amantadine used to treat

A

Influenza, Parkinson’s

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56
Q

What are the side effects of Foscarnet - an antiviral used to treat CMV and HSV

A

Nephrotoxic, low calcium, low magnesium

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57
Q

What is the MOA of interferon alpha in the treatment of HBV, HCV and hairy cell leukaemia

A

Inhibits synthesis of mRNA

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58
Q

Which virus in neonates causes skin scarring, eye defects, limb hypoplasia and microcephaly

A

VZV

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59
Q

When should Ramsay hunt syndrome be referred urgently to opthalmology

A

Vesicles on nasolabial folds or tip of nose

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60
Q

What is seen on blood film in EBV

A

At least 10% atypical lymphocytes

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61
Q

Which virus causes oral hairy leukoplakia

A

EBV

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62
Q

Which virus can lead to subacute sclerosing panencephalitis 5-10 years after exposure

A

Measles

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63
Q

Which virus causes Koplik spots

A

Measles

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64
Q

Which virus can cause aplastic crisis in sickle cell anaemia

A

Parvovirus B19

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65
Q

What condition is associated with aspirin exposure in children

A

Reye’s syndrome

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66
Q

What test is used to diagnose chlamydia

A

Nuclear acid amplification tests (NAAT)

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67
Q

What is the incubation of chlamydia

A

7-21 days

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68
Q

What is the treatment of chlamydia

A

Doxycycline

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69
Q

What is the incubation of gonorrhoea

A

2-5 days

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70
Q

What is the treatment of gonorrhoea

A

Ceftriaxone 1g IM single dose

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71
Q

What is the most likely organism seen in urethritis with purulent discharge

A

Gonorrhoea

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72
Q

Which condition presents with rash on trunk, palms and soles and buccal ‘snail track’ ulcers

A

Secondary syphillis

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73
Q

What are the symptoms of tertiary syphillis

A

Gummas (ulcerating skin lesions)
Aortic aneurysms, AR
Neurosyphillis

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74
Q

What are the symptoms of congenital syphillis

A

Blunted upper incisor teeth, saddle nose, deafness

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75
Q

Which organism causes Q fever

A

Coxiella burnetti

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76
Q

Which condition presents similarly to syphillis but is not sexually transmitted

A

Yaws

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77
Q

What is the name of the disease caused by haemophilus ducreyi that presents with painful ulcers

A

Chancroid

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78
Q

Which HPV is responsible for genital warts

A

6&11

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79
Q

Which condition is associated with clue cells

A

Bacterial vaginosis

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80
Q

Which STI is associated with strawberry cervix and raised vaginal pH

A

Trichomonas

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81
Q

What is seen on bloods in plasmodium falciparum

A 
Schizonts on blood film 
Parasitaemia >2%
Severe anaemia <50
Hypoglycaemia
Metabolic acidosis 
Lactate >5
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82
Q

Which types of malaria cause a cyclical fever every 48 hours

A

Vivax and ovale

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83
Q

What is the most common type of malaria other than falciparum

A

Plasmodium vivax

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84
Q

What is the treatment of non-falciparum malaria

A

Chloroquine (+primaquine in ovale and vivax)

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85
Q

Which cancer is more likely to develop after schistosomiasis infection

A

Squamous cell bladder cancer

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86
Q

Which disease is spread by sand flies and causes grey skin in it’s visceral form

A

Leishmaniasis

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87
Q

Which organism causes mucocutaneous leishmaniasis (involving mucosa of nose and pharynx)

A

L. Brasiliensis

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88
Q

Which condition does the tsetse fly spread

A

African trypanosomiasis (sleeping sickness)

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89
Q

Which systems does trypanosoma cruzi affect

A

Chaga’s disease: cardiac (myositis), GI (dysphagia)

90
Q

What intra-abdominal pathology can arise from tapeworm infection

A

Liver cysts leading to obstructive jaundice

91
Q

What causes itching in scabies

A

Type IV hypersensitivity reaction to mites/eggs after 30 days

92
Q

What is the treatment of scabies

A

Permethrin to patient and contacts

93
Q

What organism causes cat scratch disease

A

Bartonella henselae

94
Q

What is the treatment of pyogenic liver abscess

A

Amoxicillin + ciprofloxacin + metronidazole

95
Q

What are the symptoms of tetanus

A

Jaw spasm, risus sardonicus, arched back, hyperextended neck, dysphagia

96
Q

Which organism presents with fever, bradycardia, constipation and salmon-coloured rose spots

A

Salmonella typhi (typhoid)

97
Q

What is the treatment of complicated Salmonella (Typhoid)

A

Ceftriaxone

98
Q

How is giardia diagnosed

A

Duodenal aspirates or string tests

99
Q

Which condition causes profuse rice water diarrhoea

A

Cholera

100
Q

Which condition causes black spots on forearms/thighs and fever

A

African Tick Typhus (Rickettsiae)

101
Q

Which illness spread by ticks causes fever followed by a rash on palms and soles 6 days later

A

Rocky Mountain spotted fever

102
Q

What are the symptoms of dengue fever

A

Retro-orbital pains, back pains, myalgia (break bone fever), high grade pyrexia, rash, facial flushing

103
Q

Which tick-bourne disease causes haemolytic anaemia, haemoglobinuria and polyclonal hypergammaglobulinaemia

A

Babesiosis

104
Q

What is the post exposure prophylaxis for HCV

A

Monthly PCR tests

105
Q

What is the management of botulism

A

ITU for intubation and antitoxin

106
Q

What causes encephalopathy in measles and VZV

A

Post-infectious encephalopathy- brain swelling cause by immune response to infection

107
Q

What is the presentation of histoplasmosis

A

South USA - Erythema nodosum, BHL, cavitating lesions on CXR

108
Q

Which organism causes swimmers ear

A

Pseudomonas aeruginosa

109
Q

Which organism causes cervical lymphadenopathy and an adherent greyish pharyngeal membrane

A

Diphtheria

110
Q

What endotoxin is responsible for toxic shock syndrome in staph aureus infection

A

TSST-1 superantigen

111
Q

Which exotoxins increase cAMP levels

A

Pertussis toxin, Cholera A toxin, Heat labile E. coli toxin

112
Q

What is the MOA of amantadine

A

Inhibits uncoating of virus in the cell

113
Q

Which organism is responsible for pharyngitis

A

Streptococcus pyogenes

114
Q

What is the treatment of Listeria Meningitis

A

Amoxicillin + gentamicin (cephalosporins usually inadequate)

115
Q

What are the symptoms of Legionella

A

Fever, dry cough, bradycardia, confusion, lymphopenia, hyponatraemia

116
Q

What condition causes flu-like illness, then a brief remission, followed by jaundice and haematemesis

A

Yellow fever

117
Q

What is the treatment of cerebral toxoplasmosis in HIV

A

Pyrimethamine + sulphadiazine for 6 weeks

118
Q

Which opportunistic infection presents with exercise-induced desaturation and very few chest signs

A

PJP

119
Q

Which class of antibiotics promotes MRSA along with beta-lactams

A

Quinolones

120
Q

Which organism usually acquired from eggs in dog faeces causes visceral larva migrans

A

Toxocara canis (nematode)

121
Q

What is the first step in chickenpox exposure in pregnancy

A

Check VZV Abs in the mother

122
Q

What is the management of pubic lice

A

Permethrin or malathion cream applied to all body hair, reapplied after 3-7 days

123
Q

How is Lassa fever spread

A

From infected rats or person-to-person

124
Q

What are the 3 criteria for VZV Ig

A
  1. Significant exposure
  2. Clinical condition that increases risk (pregnancy, long term steroids, neonates)
  3. No antibodies to VZV
125
Q

What prophylaxis is given to close contacts of a patient with pneumococcal meningitis

A

None - carriage is extremely common

126
Q

What is the treatment of severe campylobacter

A

Clarithromycin

127
Q

Which organisms are the most common cause of viral meningitis

A

Enteroviruses (coxakie, echovirus)

128
Q

What is the best investigation for PJP

A

Bronchoalveolar lavage

129
Q

What is the treatment of mycobacterium avium infection in HIV patients

A

Rifabutin + ethambutol + clarithromycin

130
Q

What is the immediate management of meningitis in a patient with allergy to penicillins/cephalosporins

A

Chloramphenicol

131
Q

What are the symptoms of chikungunya

A

Severe joint pain, high fever - africa, Asia, Indian subcontinent

132
Q

What is the treatment of invasive amoebiasis

A

7 days metronidazole followed by 10 days diloxanide furoate

133
Q

Which vaccines are live-attenuated

A

BCG, MMR, influenza (intranasal), oral rotavirus, oral polio, yellow fever, typhoid

134
Q

What is the next step in a patient with suspected Lyme disease but no erythema migrans

A

ELISA antibody testing and start doxycycline

135
Q

What is the treatment of cryptosporidium in immunocompromised patients

A

Nitazoxanide

136
Q

Which hepatitis carries significant mortality in pregnancy

A

Hepatitis E

137
Q

Which organism causes filariasis (lymphatic obstruction)

A

Wuchereria Bancrofti

138
Q

What is the treatment of non-specific urethritis

A

Doxycycline 1 week

139
Q

Which bacteria is responsible for bacterial vaginosis

A

Gardnerella vaginalis

140
Q

Which type of leprosy is associated with hair loss

A

Tuberculoid leprosy

141
Q

Which bacterial chest infection is associated with cavitating lesions and is seen after influenza infection

A

Staph aureus

142
Q

Which viral meningitis is associated with unusually low glucose

A

Mumps

143
Q

What is the MOA of telbuvudine in the treatment of HBV

A

Synthetic thymidine nucleoside analogue

144
Q

What is the clinical picture of botulinum toxin

A

Afebrile, descending flaccid paralysis, slurred speech, diplopia, ptosis

145
Q

What is first line treatment of hydatid disease (dog tapeworm Echinococcus granulosus)

A

Albendazole

146
Q

Which bacteria is found in unpasteurised dairy and causes sweating with a ‘wet hay’ smell

A

Brucella melitensis

147
Q

Which antibiotics are bacteriostatic

A

Chloramphenicol, macrolides, tetracyclines, sulphonamides, trimethoprim

148
Q

Which virus is associated with nasopharyngeal carcinoma

A

EBV

149
Q

Which vaccines cannot be used in egg anaphylaxis

A

Yellow fever, MMR

150
Q

Which condition describes an infectious thrombophlebitis of the internal jugular vein

A

Lemierre’s syndrome

151
Q

What are the most common viral organisms that cause meningitis

A

Coxsackie, echovirus

152
Q

What drugs act as CCR5 fusion inhibitors in HIV treatment

A

Maraviroc, enfuviritide

153
Q

Which vaccines are absolutely contraindicated in HIV-infected adults

A

Cholera, intranasal influenza, poliomyelitis, tuberculosis

154
Q

Which complication of malaria can cause haemoglobinuria, AKI and anaemia

A

Blackwater fever

155
Q

What is first line investigation for chlamydia

A

Women: vulvovaginal swab Men: urine test

156
Q

What is second line treatment for genital warts after topics podophyllum

A

Topical imiquimod

157
Q

What does thick film look for in malaria

A

Parasite burden

158
Q

What does thin film look for in malaria

A

Species of malaria

159
Q

What is the management of VZV exposure in >20 weeks pregnancy and not immune

A

Either VZIG or antivirals after day 7-14 of exposure

160
Q

Which antiretroviral is an enzyme inducer

A

Nevirapine

161
Q

What are the symptoms of HIV seroconversion

A

Like EBV (sore throat, lymphadenopathy, malaise, diarrhoea) with rash, mouth ulcers

162
Q

What are the features of leptospirosis

A 
Early: fever, flu, conjunctival erythema 
Immune phase (Weil’s disease): AKI, hepatitis, aseptic meningitis
163
Q

What is the investigation of choice for leptospirosis

A

Serology for leptospira Abs

164
Q

What is the causative organism of Rocky Mountain spotted fever

A

Rickettsia rickettsii

165
Q

What is toxoplasmosis caused by

A

Toxoplasma gondii - intracellular protozoan (parasite)

166
Q

What should be checked before and during ethambutol treatment

A

Visual acuity (causes optic neuritis)

167
Q

How should recurrent HSV outbreaks in pregnancy be managed

A

Suppressive treatment with aciclovir from 36 weeks gestation

168
Q

Which infection is transmitted through rabbit/beaver bites and produces ulcerating regional lymphadenopathy

A

Tularaemia

169
Q

Which organism causes ring enhancing lesions on CT head in patients with HIV

A

Toxoplasmosis

170
Q

What is the treatment of pseudomonas ear infection

A

Gentamicin drops

171
Q

What contributes to the rapid progression of necrotising fasciitis

A

M protein

172
Q

Which organism causes melioidosis

A

Burkholderia pseudomallei

173
Q

What is the difference between oral hairy leukoplakia and oral candidiasis

A

Leukoplakia cannot be scratched off/dislodged

174
Q

What is the most important cause of mortality in diphtheria

A

Myocarditis

175
Q

What is the treatment of choice for severe leptospirosis

A

IV penicillin

176
Q

What is first line treatment of syphillis

A

Benzylpenicillin IM

177
Q

What is the first line treatment of uncomplicated chlamydia

A

7 days doxycycline

178
Q

What is the best treatment for chlamydia in pregnancy

A

Oral azithromycin

179
Q

What is the standard treatment of genital herpes

A

Oral aciclovir

180
Q

What is the treatment of toxoplasma gondii brain abscess

A

Sulphadiazine and pyrimethamine

181
Q

Which organism causes a tick bite eschar

A

Rickettsia conorii

182
Q

What is the treatment of cryptosporidium in immunocompromised patients

A

Supportive therapy + nitazoxanide

183
Q

Which infection associated with cattle farming causes back pain, hepatosplenomegaly and low platelets

A

Brucellosis

184
Q

What is the treatment of brucellosis

A

6 weeks doxycycline + streptomycin/rifampicin

185
Q

What bacteria is spiral shaped on EM

A

Campylobacter

186
Q

What does the nematode Loa loa (loiasis) cause

A

Filariasis

187
Q

What is the most common side effect of lamivudine

A

Bone marrow suppression

188
Q

What spreads dengue fever

A

Aedes mosquito

189
Q

What presents 6-60 days after renal transplant with flu like symptoms and fever

A

CMV infection

190
Q

What is the treatment of CMV infection in renal transplant

A

IV ganciclovir

191
Q

What is the MOA of oseltamivir

A

Neuraminidase inhibitor

192
Q

What is the incubation period of salmonella gastroenteritis

A

6-72 hours

193
Q

Which organism causes African river blindness

A

Onchocerca volvulus (most common cause of infective blindness worldwide)

194
Q

Which organism causes a murmur and hepatitis after exposure in a farm in France

A

Coxiella (Q fever endocarditis)

195
Q

What is the antibiotic of choice for nocardia/actinomycete chest infection in immunocompromised

A

Sulphonamides - sulphadiazine

196
Q

Which HIV ART is associated with fat redistribution and an insulin resistant phenotype

A

Zidovudine

197
Q

What is the most common cause of PID

A

Chlamydia trachomatis

198
Q

What is the causative organism of cysticercosis

A

T.solium (pork tapeworm)

199
Q

What is the most specific investigation for diagnosing neurocysticerosis

A

Fundoscopic examination to directly visualise subretinal parasites

200
Q

What remains positive throughout life and only indicates previous syphillis infection

A

TPHA

201
Q

Which form of leprosy is systemic with symmetrical distribution and more severe

A

Lepromatous leprosy

202
Q

What is the treatment of strongyloides nematode infection

A

Ivermectin (albendazole if concurrent AIDS)

203
Q

What investigation should be performed in adults diagnosed with molluscum contagiosum

A

HIV antigen test

204
Q

Which vaccines are safe in HIV patients with low CD4 count

A

Help A, Hep B, flu, pneumococcal

205
Q

What is the treatment of symptomatic shigella

A

Oral azithromycin

206
Q

What causes gas gangrene

A

Clostridium perfringens (treat with benzylpenicillin + clindamycin)

207
Q

What is the treatment of Coxiella infection

A

Doxycycline

208
Q

What is the investigation for hydatid liver disease

A

ELISA testing for echinococcus

209
Q

What is the treatment for latent TB whilst taking HAART

A

Isoniazid mono therapy 6-9 months

210
Q

What test confirms the diagnosis of leprosy

A

Skin biopsy

211
Q

What is the treatment of chancroid

A

Single dose IM ceftriaxone

212
Q

What classification of bacteria is pertussis

A

Gram-negative coccobacillus

213
Q

What presents with a painless penile ulcer and significant inguinal lymph node enlargement

A

Lymphogranuloma venereum

214
Q

Which NRTI is associated with myocarditis/cardiomyopathy

A

Zidovudine

215
Q

What is used to diagnose cryptococcus meningitis

A

India ink test

216
Q

What are the features of severe malaria

A
  • Hb <50
  • BM <2.2
  • pH <7.30
  • Lactate >5
217
Q

Which paramyxovirus infection presents with parotid swelling and raised amylase level

A

Mumps

218
Q

Which STI is most likely to cause an acute hepatitis

A

Hepatitis B

219
Q

What is the most common hepatitis to be transmitted via homosexual anal intercourse

A

Hepatitis B

220
Q

What is the most important risk factor for spread of Hep C

A

IVDU

221
Q

What is the treatment of systemic primary VZV infection in an immunocompromised patient

A

IV aciclovir

222
Q

Which infections have an incubation period of 1-2 weeks

A

Measles
Malaria
Typhoid
Dengue

MRCP (16 decks)

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