Infectious diseases Flashcards
First line treatment in syphilis
What is a complication following initiating treatment
IM benzathine penicillin
Jarisch-Herxheimer reaction following first dose (fever, rash, tachcyardia)
First line chlamydia treatment?
What if patient is pregnant
Doxycycline
If pregnant: azithromycin
First line treatment campylobater enteritis
clarithromycin
Treatment of uncomplicated falciparum malaria
Oral artemisinin based combination therapies
A 20-year-old man presents in summer with gradually worsening flu-like symptoms and a dry cough. On examination he is noted to have erythema multiforme - mycoplasma pneumonia. Whats the likely pathogen?
Mycoplasma pneumoniae
what virus has a high mortality rate in women?
Hepatitis E virus
First line for salmonella (non typhoid)?
Ciprofloxacin
What vascular problem is assoc with hepatitis B?
polyarteritis nodusum (vasculitis)
Complications of Mycoplasma pneumoniae
cold agglutins (IgM): may cause an haemolytic anaemia, thrombocytopenia Erythema multiforme
chance of transmission in needle stick injury hep B, C and HIV?
Hep B 30%
Hep C 3% (2%)
HIV 0.3%
What is the initial Mx for meningitis in <3 month olds and 50yo+?
IV cef + ampicillin/amox
addition of ampicillin due to this patient group being higher risk of Listeria
What antibiotic for legionella pneumonia?
Clarithromycin
Diagnosis of legionella vs mycobacterium pneumoniae
legionella: urinary antigen
Mycobacterium: serology
In HIV brain lesions: What is the most effective method to help differentiate between lymphoma and toxoplasmosis?
Thallium SPECT
What defines severe falciparum malaria?
High parasitaemia (>2%) Hypoglycaemia Severe anaemia Renal failure Pulmonary oedema Metabolic acidosis Abnormal bleeding Multiple convulsions Seizures Shock
What is the treatment for severe falciparum malaria?
IV artesunate
What is the treatment for non-severe falciparum malaria?
oral artesunate combination therapy (ACT)
What is the treatment of non-falciparum malaria?
oral ACT (artesunate combination therapy)
why is chloroquine used with caution in treating malaria?
High rates of resistance in some areas of the world
Treatment of anthrax
Ciprofloxacin
What skin lesion is associated with lyme’s disease?
What about any ECG changes?
Erythema migrans
ECG: Heart block (prolonged PR interval)
What is Jarish Herxherimer reaction?
Phenomena: Fever, rash, tachycardia after first dose of antibiotic in Lyme’s disease (don’t confuse with allergic reaction - no wheeze or SOB)
What occurs if you treat someone with infectious mononucelosis with amoxicillin?
widespread erythematous rash
Retro-orbital headache, fever, facial flushing, rash, thrombocytopenia in returning traveller - what could this be?
Possibly dengue fever
post exposure prophylaxis for VZV if not immunised?
First check if IgG - if not then treat (if pregnant or immunosuppressed)
Treatment of Lyme’s disease?
Doxycycline
Of pregnant/allergic: amoxicillin
Live vaccines
BCG MMR oral polio yellow fever oral typhoid
Treatment of schistosomiasis
praziquantel
What is the acute presentation of schistosomiasis?
Swimmer’s itch
Katayama fever: fever, urticaria, arthralgia, myalgia, cough, diarrhoea, hepatosplenomegaly
CXR - pulmonary infiltrates
With eosinophilia on blood
Treatment for cryptosporidium?
Nitazoxanide
Commonest causes of viral meningitis in adults?
coxsackie virus/enteroviruses
Strongyloides treatment
Ivermectin
Treatment of PCP pneumonia
Co-trimoxazole
Severe: IV pentamidine
steroids if hypoxic
Treatment of schistosomiasis?
praziquental
Two types of leprosy and how to distinguish? + bacteria
Mycobacterium leprae
- Lepromatous leprosy (extensive skin involvement + symmetrical nerve involvement)
- Tuberculoid leprosy (limited skin involvement + asymmetrical nerve involvement)
Treatment of toxoplasmosis in immunocompetent patients
No treatment / supportive
Treatment of toxoplasmosis in immunocompromised patients
pyrimethamine and sulfadiazine and folinic acid
Complications of PID
fitz Hugh curtis
infertility
chronic pelvic pain
ectopic pregnancy
Treatment of PID
po ofloxacin + po metronidazole
or
IM ceftriaxone + po doxycycline + po metronidazole
Cat scratch disease - causative organism
Bartonella Henselae
Human bite organisms
Streptococci spp. Staphylococcus aureus Eikenella Fusobacterium Prevotella
Animal bite organisms
Pasteurella multocida
HIV, neuro symptoms, widespread demyelination on MRI
Progressive multifocal leukoencephalopathy
What is seen macroscopically in CSF fluid of TB meningitis?
Fibrin web
MOA aciclovir
Inhibits DNA polymerase
Triad of disseminated gonococcal infection
tenosynovitis, migratory polyarthritis, dermatitis
commonest cause of infection in platelet transfusion
Staph epidermidis
What is the gold standard Ix for determining if someone is infectious with TB?
Multiple sputum smear + cultures (as other tests will be positive in latent disease)
What is quantiferon gamma test specific to?
mycobacteria infections!!!!!
Treatment for legionairres
Fluoroquinolones e.g. levofloxacin
OR macrolides e.g. clarithromycin or azithromycin
What test remains positive after syphilis treatment?
TPHA
What tests are negative after syphylis treatment?
RPR + VDRL
HIV Cryptosporidias treatment?
Nitazoxanide
What is blackwater fever?
Fatal but rare complication malaria
large intravascular haemolysis –> haemoglobinuria, anaemia, jaundice, AKI, fever
urine classically black
Complication of peritonsillar abscess?
Lemierre’s syndrome (thrombophlebitis of IJV) –> risk of septic PE
Cat scratch disease organism
bartonella henselae
Culture negative IE –> what organism?
Coxiella burnetti
Treatement HBV?
Pegylated IFN alpha
Antivirals: tenofovir, entecavir and telbivudine
IE organism associated with colorectal cancer?
Strep bovis (more specifically strep gallolyticus)
treatment of toxoplasmosis HIV +ve
PYRIMETHAMINE + sulfadiazine + folinic acid
