Infectious Diseases Flashcards
What is the first line treatment for pneumocystis jiroveci?
Co-trimoxazole
What is pneumocystis jiroveci also known as?
Pneumocystis carinii = PCP (pneumocystis carinii) - all used interchangeably.
What is the most common opportunistic infection in AIDS?
PCP - those with a CD4 count of <200 should have PCP prophylaxis
What is a common complication of PCP?
Pneumothorax
Which Abx should be added to the treatment of pneumonia, if that pneumonia is secondary to influenza?
Flucloxacillin
What is the most likely cause of pneumonia in an alcoholic?
Klebisiella
What is the most common cause of pneumonia after influenza infection?
S.aureus (hence need to add fluclox)
When is the tetanus vaccine given?
2 months 3 months 4 months 3-5 years 13-18 years
Do patients with a tetanus-prone wound require any further treatment with regard to tetanus risk if they received a full course, their last dose being <10 years ago?
No
If the patient has a ‘tetanus-prone’ would, had a full vaccination course, but last dose was >10 years ago, what treatment do they require?
A reinforcing dose of vaccine
What sort of wounds are ‘high-risk- for tetanus?
- Compound fractures
- Delayed surgical intervention
- Significant degree of devitalised tissue
What treatment is required if a patient has a high risk wound, but last tetanus dose >10 years ago?
Reinforcing dose of vaccine + tetanus immunoglobulin
What should be done if the tetanus vaccination Hx is incomplete or unknown?
Reinforcing dose of vaccine, regardless of the wound severity
For tetanus prone and high-risk wounds: reinforcing dose of vaccine + tetanus immunoglobulin
Which are the live attenuated vaccines?
- BCG
- MMR
- Influenza (intranasal)
- Oral rotavirus
- Oral polio
- Yellow fever
- Oral typhoid
What are the inactivated vaccines?
- Rabies
- Hepatitis A
- Influenza (intramuscular)
What are the toxoid (inactivated toxin) vaccines?
- Tetanus
- Diphtheria
- Pertussis
What are the subunit or conjugate vaccines?
- Pneumococcus (conjugate)
- Haemophilus (conjugate)
- Meningococcus (conjugate)
- Hepatitis B
- HPV
Which malignancies are associated with EBV?
- Burkitt’s lymphoma
- Hodgkin’s lymphoma
- Nasopharyngeal carcinoma
Which virus is responsible for croup?
Parainfluenza virus
What is the most common cause of bronchiectasis exacerbation?
Haemophilus influenzae
How may mycoplasma pneumoniae present?
Flu-like symptoms classically precede a dry cough. Complications include haemolytic anaemia and erythema multiforme
How may legionella pneumophilia present?
Dry cough, lymphopenia, deranged liver function tests and hyponatraemia
What are the features of atovaquone + proguanil (Malarone) malarial prophylaxis?
S/Es - GI upset
Start - 1-2 days before
End - 7 days after
What are the features of chloroquine malarial prophylaxis?
S/Es - headache C/I - epilepsy Dosing - weekly Start - 1 week before End - 4 weeks after
What are the features of doxycycline malarial prophylaxis?
S/Es - photosensitivity; oesophagitis
Start - 1-2 days before
End - 4 weeks after
What are the features of mefloquine (Lariam) malarial prophylaxis?
S/Es - dizziness; neuropsychiatric disturbance C/I - epilepsy Dosing - weekly Start - 2-3 weeks before End - 4 weeks after
What are the features of proguanil (Paludrine) malarial prophylaxis?
Start - 1 week before
End - 4 weeks after
What are the features of proguanil + chloroquine malarial prophylaxis?
Start - 1 week before
End - 4 weeks after
Which malarial prophylaxis agents can be used in pregnancy?
Chloroquine
Proguanil - if folate supplementation given
Over what age can DEET be used?
Children >2 months
What should be given to contacts of meningococcal meningitis?
Oral ciprofloxacin or rifampicin
Which Abx should be given in early lyme disease?
14 day course of doxycycline
Which GI upset bugs have a 1-6 hour incubation period?
Staphylococcus aureus
Bacillus cereus
Which GI upset bugs have a 12-48 hour incubation period?
Salmonella
Escherichia coli
Which GI upset bugs have a 48-72 hour incubation period?
Shigella
Campylobacter
Which GI upset bugs have a >7 days incubation period?
Giardiasis
Amoebiasis
Which drug poses a particular risk of nec fasc in T2DM?
SGLT-2 inhibitors - e.g. dapagliflozin
Which Abx may be used in the treatment of campylobacteur?
Clarithromycin
What is the most common cause of CAP?
Streptococcus pneumoniae
What is the name of the rash seen in early lyme disease?
Erythema chronicum migrans
What is Kaposi sarcoma caused by?
HHV-8
What should happen to immunosuppressed patients who come into contact with VZV?
Patients who are immunosuppressed secondary to long-term steroids or methotrexate should receive VZIG if they are exposed to chickenpox and have no antibodies to varicella
What is the most common cause of traveller’s diarrhoea?
E.coli
How is latent TB treated?
3 months of isoniazid (with pyridoxine) and rifampicin
or
6 months of isoniazid (with pyridoxine)
Which Abx is used to treat salmonella?
Ciprofloxacin
What are the characteristics of adult Still’s disease?
Arthritis + recurrent fever + typical rash which is a non-itchy small spots that are salmon-coloured, affecting limbs and trunk that look worst when fever is present
How does rabies present?
Hydrophobia - classical Muscles spasms Headache Fever Agitation
How is rabies diagnosed?
Clinical diagnosis
How does Typhus present?
Headache Vomiting Photophobia Deafness Pink papular rash affecting chest
How is Typhus diagnosed?
Serology - IgM and IgG by indict fluorescent antibody testing
How does rotavirus appear on electron microscopy?
Circulating virus particles with radiating spokes
What is Q fever caused by?
Coxiella burnetii - from ticks, cattle, goats and sheep
Where in the world is brucellosis more common?
Middle East, usually from drinking un-pasteurised milk. Complication include IE, EO, arthritis and meningitis
Which type of malaria can cause recurrence of infection?
Plasmodium vivax
What infection might cause a rash similar to guttate psoriasis?
Pityriasis versicolor - caused by an infection with Malassezia furfur, a type of yeat, infection is more common in hot, humid climates where a person may have sweated excessively
What is the mode of action of aciclovir?
Competes for viral DNA polymerase
What are the encapsulated bacteria?
S - strep pneumoniaa Hi - HiB N - neisseria meningitidis S - GBS Ki - klebsiella S - salmonella typhi
What is cat scratch disease caused by?
Bartonella henselae
What is one of the most common causes of chronic lymphadenopathy in children and adults?
Cat scratch disease
Which antibody is most specific for drug-induced lupus?
Anti-histone Ab
Which drugs are in particular associated with drug-induced lupus?
Isoniazid - used to treat TB
Which antibody is associated with CREST syndrome?
Anti-centromere Ab
Which drugs may be used for PEP for influenza?
Oseltamivir
Zanamivir
Which antibodies are most associated with Sjogren’s syndrome?
Anti-Ro - 75%
Anti-La - 50-50%
Which antibodies are most associated with diffuse scleroderma?
Anti-topoisomerase Ab
What is the vector for Bartonella bacilliformis?
Sand fly
What is the vector Trypansoma sansei (that causes sleeping sickness)?
Tsetse fly
