Infectious diseases Flashcards by leo Olney

Treatment for PJP (PCP) in HIV?

Co-trimoxazole

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Management of PJP/PCP in HIV?

co-trimoxazole
IV pentamidine in severe cases
steroids if hypoxic (if pO2 < 9.3kPa then steroids reduce risk of respiratory failure by 50% and death by a third)

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PJP/PCP presentation?

dyspnoea
dry cough
fever
very few chest signs

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Vaginal pH in TV and BV?

pH > 4.5

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Shortest incubation time for Gastroenteritis?

Bacillus cereus

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E.coli gastroenteritis features?

Travellers diarrhoea
Watery stools
Abdominal cramps and nausea

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Giardiasis gastroenteritis features?

Prolonged, non-bloody diarrhoea

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Cholera gastroenteritis features?

Profuse, watery diarrhoea
Severe dehydration resulting in weight loss
Not common amongst travellers

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Shigella gastroenteritis features?

Bloody diarrhoea

Vomiting and abdominal pain

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Staph aureus gastroenteritis features?

Severe vomiting

Short incubation period

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Campylobacter gastroenteritis features?

A flu-like prodrome is usually followed by crampy abdominal pains, fever and diarrhoea which may be bloody
May mimic appendicitis
Complications include Guillain-Barre syndrome

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Bacillus cereus gastroenteritis features?

Two types of illness are seen

Vomiting within 6 hours, stereotypically due to rice
Diarrhoeal illness occurring after 6 hours

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Amoebiasis gastroenteritis features?

Gradual onset bloody diarrhoea, abdominal pain and tenderness which may last for several weeks

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Incubation periods for gastroenteritis?

1-6 hrs: Staphylococcus aureus, Bacillus cereus*
12-48 hrs: Salmonella, Escherichia coli
48-72 hrs: Shigella, Campylobacter
> 7 days: Giardiasis, Amoebiasis

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Norovirus symptoms

Develop within 15 - 50 hours of infection with patients experiencing nausea, vomiting, and diarrhoea, which may be accompanied by headaches, low-grade fevers, and myalgia.

The majority of patients experience both vomiting and diarrhoea

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How many tetanus doses do you need for lifelong protection?

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management of tetanus prone wounds?

Patient has had a full course of tetanus vaccines, with the last dose < 10 years ago
- no vaccine nor tetanus immunoglobulin is required, regardless of the wound severity

Patient has had a full course of tetanus vaccines, with the last dose > 10 years ago
- if tetanus prone wound: reinforcing dose of vaccine
high-risk wounds (e.g. compound fractures, delayed surgical intervention, significant degree of devitalised tissue): reinforcing dose of vaccine + tetanus immunoglobulin

If vaccination history 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

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What causes croup?

parainfluenza virus

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What virus causes the common cold?

Rhinovirus

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Features/classic presentation of mycoplasma pneumonia?

The disease typically has a prolonged and gradual onset
flu-like symptoms classically precede a dry cough
bilateral consolidation on x-ray
Younger patients

complications include erythema multiforme, cold-agglutins (haemolytic anaemia)

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Treatment for active TB?

First stage (first 2 months):

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

Second stage (next 4 months):

Rifampicin
Isoniazid

If it’s meningeal you would treat for 12 months.

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Treatment for Latent TB?

3 months of isoniazid (with pyridoxine) and rifampicin OR 6 months of isoniazid (with pyridoxine)

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Growth of what organisms is seen in BV?

Gardnerella vaginalis

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First line treatment for syphillis?

intramuscular benzathine penicillin

Alternative is Doxy (can’t use in pregnancy)

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Treatment of listeriosis?

Listeria is sensitive to amoxicillin/ampicillin (cephalosporins usually inadequate) Listeria meningitis should be treated with IV amoxicillin/ampicillin and gentamicin

Antibiotics for human and animal bites?

Co-amox

Risk factors for developing nec fasc?

Recent trauma, burns or soft tissue infections Diabetes mellitus - particularly if the patient is treated with SGLT-2 inhibitors intravenous drug use immunosuppression

Pneumonia in an alcoholic patient?

Klebsiella

On vaginal swab what would gram negative diplococci represent?

Gonorrhoea

On vaginal swab what would gram positive and negative bacteria represent?

Presentation of diptheria?

- recent visitors to Eastern Europe/Russia/Asia - sore throat with a 'diphtheric membrane' - grey, pseudomembrane on the posterior pharyngeal wall - bulky cervical lymphadenopathy- may result in a 'bull neck' appearanace - neuritis e.g. cranial nerves - heart block

Gonorrohoea abx of choice?

Intramuscular ceftriaxone

Treatment for MSRA?

nose: mupirocin 2% in white soft paraffin, tds for 5 days skin: chlorhexidine gluconate, od for 5 days. Apply all over but particularly to the axilla, groin and perineum

Is there a vaccine for Hep C?

Diagnostic test for HCV?

RNA - AntiHCV may be positive - implies eitehr cleared acute infection or chronic Hep C infection

What's the bullseye rash in lymes called?

Erythema chronicum migrans

What types of HPV cause warts?

6 and 11

Abx for chlamydia?

Doxycycline

Bacterial vaginosis in pregnancy?

Still use oral metronidazole

Genital wart treatment?

multiple, non-keratinised warts: topical podophyllum solitary, keratinised warts: cryotherapy

Abx for dental abscesses?

Amoxicillin

Live attenuated vaccines?

``` BCG measles, mumps, rubella (MMR) influenza (intranasal) oral rotavirus oral polio yellow fever oral typhoid ```

Inactivated vaccines?

rabies hepatitis A influenza (intramuscular)

Toxoid vaccines?

tetanus diphtheria pertussis

Conjugate vaccines?

``` pneumococcus (conjugate) haemophilus (conjugate) meningococcus (conjugate) hepatitis B human papillomavirus ```

Toxoplasma treatment?

In non-immunocompromised pts then no treatment if immunocompromised: - pyrimethamine plus sulphadiazine for at least 6 weeks

When do you treat campylobacter?

>8 bloody stools a day/severe infection.

Abx for campylobacter?

Clarithromycin

Abx for an infective exacerbation of COPD?

Amoxicillin or tetracycline or clarithromycin

Acute pyelonephritis treatment of choice?

Broad-spectrum cephalosporin or quinolone

Painless ulcer in what STI?

Syphillis - Chancre (NOT chancroid)

What connective tissue disease can cause genital ulceration?

Behcets

Most likely cause for LRTI in CF patients?

Pseudomonas

Treatment for slamonella enteritis (Typhoid)

Cipro

what antimalarial is taken weekly?

Chloroquine

Abx choice for UTI in pregnancy?

Nitrofurantoin unless near term then use cephalexin

treatment for lymes disease?

14 day course of doxy

What age to boys and girls get the HPV vaccine?

12-13yrs

What is Fitz-Hugh-Curtis syndrome?

Fitz-Hugh-Curtis syndrome is a complication of pelvic inflammatory disease in which the liver capsule becomes inflamed causing right upper quadrant pain.

How long would you delay VZIG for a chickenpox exposure whilst waiting antibody tests?

7 days max

TV defining characteristics?

green discharge and strawberry cervix

Pneumonia following influenza likely organism?

Staph aureus

Abx for meningitis?

IV cefotaxime if <3 months or >50 then add amoxicillin If Meningococcal meningitis can use benzylpenicillin if listeria: Intravenous amoxicillin (or ampicillin) + gentamicin

Who is given BCG jab?

The BCG vaccination is given to children born in areas where tuberculosis (TB) is prevalent, or if their parents or grandparents are from areas with a high rate of TB. It is also given to people who have a high risk of occupational exposure to TB -who are under the age of 35.

What malignancies are associated with EBV?

Burkitt's lymphoma* Hodgkin's lymphoma nasopharyngeal carcinoma HIV-associated central nervous system lymphomas

Abx for contact of meningococcal meningitis?

ciprofloxacin

Cause of gas gangrene - bacterial species?

Clostridium perfringens

What professions get leptospirosis?

sewage workers, farmers, vets or people who work in an abattoir

Presentation of Leptospirosis?

The early phase is due to bacteraemia and lasts around a week, may be mild or subclinical: - fever - flu-like symptoms - subconjunctival suffusion (redness)/haemorrhage second immune phase may lead to more severe disease (Weil's disease) - acute kidney injury (seen in 50% of patients) - hepatitis: jaundice, hepatomegaly - aseptic meningitis

At what point do you perform a chlamydia test of cure in pregnant women?

6 weeks

Alternative to fluclox in cellulitis?

Clarithromycin

Management of pts with asymptomatic tick bite?

Reassurance

Atypical pneumonia treatment?

Clarithromycin

Add in to ?LRTI after influenza

Flucloxacillin (as staph)

Features of legionella?

``` flu-like symptoms including fever (present in > 95% of patients) dry cough relative bradycardia confusion lymphopaenia hyponatraemia deranged liver function tests pleural effusion: seen in around 30% of patients ```

Monospot test tests for?

Glandular fever (mono)

Who needs tuberculin skin test before BCG?

any person being considered for the BCG vaccine must first be given a tuberculin skin test. The only exceptions are children < 6 years old who have had no contact with tuberculosis

Shigella or giardiasis cause bloody diarrhoea?

Shigella - bloody Giardiasis - Prolonged non-bloody diarrhoea

Abx for TV?

Metronidazole

Chance of developing HIV post needlestick injury?

0.03%

Extensive otitis externa abx?

Fluclox

PID abx?

Doxycycline + metronidazole + ceftriaxone

features of croup?

stridor barking cough (worse at night) fever coryzal symptom

Causative organism of croup?

Parainfluenza virus

Prostatitis abx?

Ciprofloxacin

Alternative to doxy to treat lymes

Amox

What abx are associated with C.diff?

clindamycin, cephalosporins, penicillins and fluoroquinolones