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MSRA > Infectious diseases > Flashcards

Infectious diseases Flashcards

1
Q

Treatment for PJP (PCP) in HIV?

A

Co-trimoxazole

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2
Q

Management of PJP/PCP in HIV?

A
  • 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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3
Q

PJP/PCP presentation?

A

dyspnoea
dry cough
fever
very few chest signs

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4
Q

Vaginal pH in TV and BV?

A

pH > 4.5

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5
Q

Shortest incubation time for Gastroenteritis?

A

Bacillus cereus

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6
Q

E.coli gastroenteritis features?

A

Travellers diarrhoea
Watery stools
Abdominal cramps and nausea

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7
Q

Giardiasis gastroenteritis features?

A

Prolonged, non-bloody diarrhoea

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8
Q

Cholera gastroenteritis features?

A

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

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9
Q

Shigella gastroenteritis features?

A

Bloody diarrhoea

Vomiting and abdominal pain

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10
Q

Staph aureus gastroenteritis features?

A

Severe vomiting

Short incubation period

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11
Q

Campylobacter gastroenteritis features?

A

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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12
Q

Bacillus cereus gastroenteritis features?

A

Two types of illness are seen

  • Vomiting within 6 hours, stereotypically due to rice
  • Diarrhoeal illness occurring after 6 hours
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13
Q

Amoebiasis gastroenteritis features?

A

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

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14
Q

Incubation periods for gastroenteritis?

A

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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15
Q

Norovirus symptoms

A

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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16
Q

How many tetanus doses do you need for lifelong protection?

A

5

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17
Q

management of tetanus prone wounds?

A

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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18
Q

What causes croup?

A

parainfluenza virus

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19
Q

What virus causes the common cold?

A

Rhinovirus

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20
Q

Features/classic presentation of mycoplasma pneumonia?

A

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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21
Q

Treatment for active TB?

A

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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22
Q

Treatment for Latent TB?

A

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

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23
Q

Growth of what organisms is seen in BV?

A

Gardnerella vaginalis

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24
Q

First line treatment for syphillis?

A

intramuscular benzathine penicillin

Alternative is Doxy (can’t use in pregnancy)

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25
Q

Treatment of listeriosis?

A

Listeria is sensitive to amoxicillin/ampicillin (cephalosporins usually inadequate)

Listeria meningitis should be treated with IV amoxicillin/ampicillin and gentamicin

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26
Q

Antibiotics for human and animal bites?

A

Co-amox

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27
Q

Risk factors for developing nec fasc?

A

Recent trauma, burns or soft tissue infections

Diabetes mellitus - particularly if the patient is treated with SGLT-2 inhibitors

intravenous drug use

immunosuppression

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28
Q

Pneumonia in an alcoholic patient?

A

Klebsiella

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29
Q

On vaginal swab what would gram negative diplococci represent?

A

Gonorrhoea

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30
Q

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

A

BV

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31
Q

Presentation of diptheria?

A
  • 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
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32
Q

Gonorrohoea abx of choice?

A

Intramuscular ceftriaxone

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33
Q

Treatment for MSRA?

A

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

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34
Q

Is there a vaccine for Hep C?

A

No

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35
Q

Diagnostic test for HCV?

A

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

36
Q

What’s the bullseye rash in lymes called?

A

Erythema chronicum migrans

37
Q

What types of HPV cause warts?

A

6 and 11

38
Q

Abx for chlamydia?

A

Doxycycline

39
Q

Bacterial vaginosis in pregnancy?

A

Still use oral metronidazole

40
Q

Genital wart treatment?

A

multiple, non-keratinised warts: topical podophyllum

solitary, keratinised warts: cryotherapy

41
Q

Abx for dental abscesses?

A

Amoxicillin

42
Q

Live attenuated vaccines?

A 
BCG
measles, mumps, rubella (MMR)
influenza (intranasal)
oral rotavirus
oral polio
yellow fever
oral typhoid
43
Q

Inactivated vaccines?

A

rabies
hepatitis A
influenza (intramuscular)

44
Q

Toxoid vaccines?

A

tetanus
diphtheria
pertussis

45
Q

Conjugate vaccines?

A 
pneumococcus (conjugate)
haemophilus (conjugate)
meningococcus (conjugate)
hepatitis B
human papillomavirus
46
Q

Toxoplasma treatment?

A

In non-immunocompromised pts then no treatment

if immunocompromised:
- pyrimethamine plus sulphadiazine for at least 6 weeks

47
Q

When do you treat campylobacter?

A

> 8 bloody stools a day/severe infection.

48
Q

Abx for campylobacter?

A

Clarithromycin

49
Q

Abx for an infective exacerbation of COPD?

A

Amoxicillin or tetracycline or clarithromycin

50
Q

Acute pyelonephritis treatment of choice?

A

Broad-spectrum cephalosporin or quinolone

51
Q

Painless ulcer in what STI?

A

Syphillis - Chancre (NOT chancroid)

52
Q

What connective tissue disease can cause genital ulceration?

A

Behcets

53
Q

Most likely cause for LRTI in CF patients?

A

Pseudomonas

54
Q

Treatment for slamonella enteritis (Typhoid)

A

Cipro

55
Q

what antimalarial is taken weekly?

A

Chloroquine

56
Q

Abx choice for UTI in pregnancy?

A

Nitrofurantoin unless near term then use cephalexin

57
Q

treatment for lymes disease?

A

14 day course of doxy

58
Q

What age to boys and girls get the HPV vaccine?

A

12-13yrs

59
Q

What is Fitz-Hugh-Curtis syndrome?

A

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

60
Q

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

A

7 days max

61
Q

TV defining characteristics?

A

green discharge and strawberry cervix

62
Q

Pneumonia following influenza likely organism?

A

Staph aureus

63
Q

Abx for meningitis?

A

IV cefotaxime if <3 months or >50 then add amoxicillin

If Meningococcal meningitis can use benzylpenicillin

if listeria: Intravenous amoxicillin (or ampicillin) + gentamicin

64
Q

Who is given BCG jab?

A

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.

65
Q

What malignancies are associated with EBV?

A

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

66
Q

Abx for contact of meningococcal meningitis?

A

ciprofloxacin

67
Q

Cause of gas gangrene - bacterial species?

A

Clostridium perfringens

68
Q

What professions get leptospirosis?

A

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

69
Q

Presentation of Leptospirosis?

A

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
70
Q

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

A

6 weeks

71
Q

Alternative to fluclox in cellulitis?

A

Clarithromycin

72
Q

Management of pts with asymptomatic tick bite?

A

Reassurance

73
Q

Atypical pneumonia treatment?

A

Clarithromycin

74
Q

Add in to ?LRTI after influenza

A

Flucloxacillin (as staph)

75
Q

Features of legionella?

A 
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
76
Q

Monospot test tests for?

A

Glandular fever (mono)

77
Q

Who needs tuberculin skin test before BCG?

A

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

78
Q

Shigella or giardiasis cause bloody diarrhoea?

A

Shigella - bloody

Giardiasis - Prolonged non-bloody diarrhoea

79
Q

Abx for TV?

A

Metronidazole

80
Q

Chance of developing HIV post needlestick injury?

A

0.03%

81
Q

Extensive otitis externa abx?

A

Fluclox

82
Q

PID abx?

A

Doxycycline + metronidazole + ceftriaxone

83
Q

features of croup?

A

stridor
barking cough (worse at night)
fever
coryzal symptom

84
Q

Causative organism of croup?

A

Parainfluenza virus

85
Q

Prostatitis abx?

A

Ciprofloxacin

86
Q

Alternative to doxy to treat lymes

A

Amox

87
Q

What abx are associated with C.diff?

A

clindamycin, cephalosporins, penicillins and fluoroquinolones

MSRA (22 decks)

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