Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FCM Matrix > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

What is candidiasis?

A

thrush

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Features of candidiasis

A
  1. ‘Cottage cheese’, non-offensive discharge
  2. Vulvitis: superficial dyspareunia, dysuria
  3. Itch
  4. Vulval erythema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Investigations for vaginal candidiasis

A

a high vaginal swab is not routinely indicated if the clinical features are consistent with candidiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Management of vaginal candidiasis

A

1st line = single dose oral fluconazole

if contraindicated = intravaginal pessary clotrimazole

Vulval symptoms - topical imidazole with oral or intravaginal antifungal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is cryptococcosis?

A

Opportunistic fungal infection

  • Caused by environmental fungus found worldwide
  • often found in soil contaminated with bird droppings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does cryptococcosis infection present?

A
  1. Meningitis is the most frequently seen presentation
  2. Clinical manifestation can vary:
    - Headache
    - Lethargy
    - Pyrexia
    - Productive cough
    - SOB
    - personality changes will develop over 2-4 weeks (sometimes months)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Investigation for cryptococcosis

A
  1. Lumbar puncture will feature high opening pressure, lymphocytic CSF, high protein and low glucose
    - CSF CrAg: Sensitivity 93 - 100%, Specificity 93 - 98%
  • Gold standard diagnostic test is culture*
    2. Serum Cryptococcal Antigen (CrAg) also used
    3. India ink stain: round, encapsulated yeast
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Gold standard diagnostic test for cryptococcosis

A

Culture!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Management of cryptococcosis

A

mild to moderate disease:
1st line = fluconazole (6-12 months)

Severe disease and CNS involvement:
Amphotericin B + Flucytosine followed by fluconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is histoplasmosis?

A

Histoplasma capsulatum - another environmental fungus
- found worldwide
but most commonly America in soil with bird/bat droppings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is histoplasmosis transmitted?

A

Via inhalation of microscopic spores, incubation 3-17d

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Features of histoplasmosis

A
  1. Flu-like (fever/cough/lethargy/headache)
  2. Consider in patients with pneumonia and mediastinal LN, pulmonary nodule, pericarditis with LN, pulmonary manifestations with arthralgia
  3. Severity depends on host immunity and intensity of exposure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Investigations for histoplasmosis

A 
1st line = CXR
common findings for histoplasmosis pneumonia:
- nodules
- mediastinal or hilar lymphadenopathy
- cavitary lesions
- pleural effusions

Gold standard /Diagnostic:
Culture of pulmonary secretions

Other: Histoplasma antigen on serum or urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Management of histoplasmosis

A

Asymptomatic, Mild + immunocompetent = observe

Mild + immunocompromised =
itraconazole (azole antifungals)

Severe (for acute pulmonary cases) = Amphotericin B followed by itraconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is pneumocystis jiroveci pneurmonia also known as?

A

Pneumocystis carinii pneumonia (PCP)

- common opportunistic infection in AIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Featues of pneumocystis jiroveci

A

dyspnoea
dry cough
fever
very few chest signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Investigations for pneumocystis jiroveci

A
  1. CXR:
    - bilateral interstitial
    pulmonary infiltrates
    - lobar consolidation.
    - May be normal
  2. exercise-induced desaturation
  3. sputum often fails to show PCP
  4. bronchoalveolar lavage (BAL) = silver stain shows characteristic cysts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Most common complication of pneumocystis jiroveci

A

Pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Management of pneumocystis jiroveci

A
  1. co-trimoxazole
  2. IV pentamidine in severe cases
    - alternative: aerosolized pentamidine (less effective in pneumothorax)
  3. steroids if hypoxic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Epstein-Barr virus?

A

Infectious mononucleosis (glandular fever)

EBV, also known as human herpesvirus 4, HHV-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Features of EBV

A

Classic triad of :

  1. sore throat
  2. pyrexia
  3. lympadenopathy
  • Symptoms typically resolve after 2-4 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Diagnostic test for EBV

A

heterophil antibody test (Monospot test)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Management of EBV

A
  1. Management is supportive and includes:
    o rest during the early stages, drink plenty of fluid, avoid alcohol
    o simple analgesia for any aches or pains
    o avoid playing contact sports for 8 weeks after having glandular fever to reduce the risk of splenic rupture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Types of herpes simplex virus

A

HSV-1 : oral lesions (cold sores)

HSV-2 for genital herpes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Features of HSV

A
  • primary infection: may present with a severe gingivostomatitis
  • cold sores
  • painful genital ulceration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Management of HSV

A
  1. gingivostomatitis: oral aciclovir, chlorhexidine mouthwash
  2. cold sores: topical aciclovir
  3. genital herpes: oral aciclovir.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is mumps?

A

Mumps is a caused by RNA paramyxovirus and tends to occur in winter and spring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How do mumps spread?

A
  • by droplets
  • respiratory tract epithelial cells → parotid glands → other tissues
  • infective 7 days before and 9 days after parotid swelling starts
  • incubation period = 14-21 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Symptoms of mumps

A
  • fever
  • malaise, muscular pain
  • parotitis (‘earache’, ‘pain on eating’): unilateral initially then becomes bilateral
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Investigations of mumps

A
  1. Serum mumps IgM – Positive igM confirms diagnosis.
  2. Negative IgM does not rule out mumps infection
  3. Serum Mumps IgG
  4. Viral culture (Saliva)
  5. Consider CT Head if there are focal neurological symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Management of mumps

A
  1. Self-limiting - rest
  2. paracetamol for high fever/discomfort
  3. notifiable disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is roseola infantum?

A

AKA as exanthem subitum is a common disease of infancy caused by the human herpes virus 6 (HHV6).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Features of Roseola infantum

A
  1. high fever: lasting a few days, followed later by a
  2. maculopapular rash
  3. Nagayama spots: papular enanthem on the uvula and soft palate
  4. febrile convulsions
  5. diarrhoea and cough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

How is Roseola infantum diagnosed?

A

Clinical diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Treatment of Roseola infantum

A

Self-limiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is rubella AKA and causative organism?

A

AKA German measles, is a viral infection caused by the togavirus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

When is rubella infectious?

A

infectious from 7 days before symptoms appear to 4 days after the onset of the rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Features of rubella

A
  1. prodrome, e.g. low-grade fever
  2. rash: maculopapular, initially on the face before spreading to the whole body, usually fades by the 3-5 day
  3. lymphadenopathy: suboccipital and postauricular
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Gold standard for rubella

A

Serological and/or polymerase chain reaction (PCR) testing is the gold standard.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Management of Rubella

A

Self-limiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Causative organism of Measles

A

RNA paramyxovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Transmission of Measles

A
  1. spread by droplets
  2. infective from prodrome until 4 days after rash starts
  3. incubation period = 10-14 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Features of Measles

A
  1. prodrome: irritable, conjunctivitis, fever
  2. Koplik spots (before rash): white spots (‘grain of salt’) on buccal mucosa
  3. rash: starts behind ears then to whole body, discrete maculopapular rash becoming blotchy & confluent
  4. diarrhoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Investigation of Measles

A

IgM antibodies can be detected within a few days of rash onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Management of Measles

A
  1. mainly supportive
  2. admission may be considered in immunosuppressed or pregnant patients
  3. notifiable disease → inform public health
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Causative organism of Erythema Infectiosum

A

Parvovirus B19 is a DNA virus which causes a variety of clinical presentations.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Symptoms of Erythema Infectiosum

A
  1. ‘slapped cheek’ rash
  2. An erythematous maculopapular rash on the trunk, back, and limbs may develop a few days after the facial rash
  3. This then fades to produce a lace-like, reticular rash.
  4. low-grade fever
  5. Prodromal viral infection prior to onset of rash
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Investigations of Erythema Infectiosum

A

Only done in pregnant/immunocompromised patients = serology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Management of Erythema Infectiosum

A

Self-limiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Causative organism of rabies

A

Rhabdoviridae family

51
Q

What is rabies?

A

viral disease that causes an acute encephalitis

52
Q

Features of rabies

A
  1. Prodrome: headache, fever, agitation
  2. Hydrophobia
  3. hypersalivation
53
Q

Investigations for rabies

A
  1. Clinical suspicion

2. immunofluorescence from saliva/CSF or anti- rabies antibodies

54
Q

Treatment of rabies

A
  1. Contact PHE
  2. Late-stage Rx:
    - Symptomatic Mx:
     Quiet
     private room
     benzodiazepines
     haloperidol
     analgesia
     anti-cholinergics
  3. At risk countries:
    - HRIG
55
Q

Define Cytomegalovirus Infections

A

Cytomegalovirus is part of the Herpesvirus family

- Primary infection presentation = EBV

56
Q

How CMV transmitted?

A

Sex/close contact (URT & Urine) / blood/transplant

57
Q

Features of CMV

A

Manifest as colitis, hepatitis, encephalitis, pneumonitis, retinitis

58
Q

Investigations for CMV

A

Serology (IgM & IgG), CMV DNA PCR, Histology (‘inclusions’)

59
Q

Treatment of CMV

A
  1. Supportive in immunocompetent

2. Antiviral in immunocompromised (Cidofovir/Foscarnet/Ganciclovir)

60
Q

What pathogen causes influenza?

A

RNA virus - orthomyxoviridae

61
Q

What are the symptoms of influenza?

A
  • Coryzal symptoms
  • Fever
  • Headache
  • Non-productive cough
  • Sore throat
62
Q

How is influenza diagnosed?

A

Clinical diagnosis

- viral culture - PCR

63
Q

Management of influenza and indication for medication

A

Antivirals:
Selective use of antivirals : oral oseltamivir and inhaled zanamivir
Indication:
1) if able to start treatment within 48 hours of symptoms onset
2) Known circulation of virus in community
3) High-risk : pregnant, obese, > 65 + < 6 y.o, immunocompromised, comorbidities

Conservative:

  • analgesia
  • increase fluid intake
  • rest
64
Q

What is varicella-zoster infection?

A

Chickenpox

- shingles is reactivation of VZV (herpes zoster)

65
Q

Symptoms of shingles

A

prodromal period
1. burning pain over the affected dermatome for 2-3 days

  1. fever, headache, lethargy

rash
1. initially erythematous, macular rash over the affected dermatome

  1. quickly becomes vesicular
  2. does not cross the midline.
66
Q

Management of shingles

A
  1. Anti-viral if you are seeing the patient within 72 hours of the onset of the rash
  2. Acyclovir 800 mg po 5 times per day x 7d
  3. Pain control
    - Opiates
    - Anticonvulsants
    - Tramadol
    - ? steroids
67
Q

Facts about salmonellosis

A

Leading cause of foodborne illness
(poultry, eggs, milk products)
- Incubation period 8-72h post exposure (ingestion of contaminated food/water)

68
Q

Features of salmonellosis

A
  1. Diarrhoea
  2. Nausea
  3. Vomiting
  4. Fever
  5. abdo cramps
69
Q

Investigation for salmonellosis

A

Stool Microscopy, Culture & Sensitivities (MCS)

70
Q

Management of salmonellosis

A
  1. Often self-limiting, 4-10d. <5% develop bacteraemia
  2. Supportive (hydration
  3. if severe – Ciprofloxacin/Azithromycin
  4. Isolate until 48 hours after the last episode of diarrhoea or vomiting
  5. Notifiable disease
71
Q

What is shigellosis?

A

Shigella species cause a diarrhoeal illness

72
Q

Transmission of shigellosis

A

Faeco-oral transmission, can be sexually acquired

73
Q

Features of shigellosis

A
  • Diarrhoea (often bloody)
  • fever
  • abdominal pain
74
Q

Investigation for shigellosis

A

Stool MCS

75
Q

Management of shigellosis

A
  1. Cipro/Azithro if unwell

2. Hand hygiene, Notify

76
Q

Causative organism of tetanus

A

tetanospasmin exotoxin released from Clostridium tetani

77
Q

How does tetanus affect the body?

A

Prevents release of GABA

78
Q

How is tetanus transmitted?

A

Spores of the bacteria enter the body through a wound

79
Q

Features of tetanus

A
  1. painful muscle contractions esp Masseter and neck muscles
  2. prodrome: fever, lethargy, headache
  3. trismus (lockjaw)
  4. risus sardonicus (distorted grin)
  5. opisthotonus (arched back, hyperextended neck)
  6. spasms (e.g. dysphagia)
80
Q

Management of tetanus

A
  1. Supportive: ventilatory support, muscle relaxants
  2. wound debridement
  3. Metronidazole
  4. NB Tetanus does not confer immunity post infection, re-vaccinate every 10 years
81
Q

Diagnosis of tetanus

A

clinical

82
Q

What is cholera?

A

Acute diarrhoeal illness caused by toxin-producing strains of gram negative Vibrio cholerae.

83
Q

How is cholera transmitted?

A

ingesting contaminated food or water

84
Q

Features of cholera

A
  1. Diarrhoea - profuse ‘Rice water stool’
  2. Dehydration
  3. hypoglycaemia
85
Q

Management of cholera

A
  1. Aggressive volume repletion (oral or IV)
  2. adequate nutrition
  3. antibiotics for severe cases = doxycycline, ciprofloxacin
86
Q

Investigation for cholera

A
  1. Largely clinical

2. Stool MCS

87
Q

Causative organism for diphtheria

A

Gram-positive bacillus Corynebacterium diphtheriae

88
Q

Features of diphtheria

A
  1. sore throat –> with diphtheric membrane’ : grey pseudomembrane on the posterior pharyngeal wall
  2. bulk cervical lymphadenopathy –> ‘bull neck’
  3. low-grade fever
89
Q

Investigation for diphtheria

A

Culture of throat swab: uses tellurite agar or Loeffler’s media

90
Q

Management of diphtheria

A
  1. intramuscular penicillin
    - Erythromycin
  2. diphtheria antitoxin
  • Notify
  • Contact trace + prophylaxis
91
Q

What is botulism?

A

Rare, but potentially life-threatening neuroparalytic syndrome caused by a neurotoxin of Clostridium botulinum

92
Q

Features of botulism

A

Acute onset bilateral cranial neuropathies with symmetric descending weakness

  1. patient usually fully conscious with no sensory disturbance
  2. flaccid paralysis
  3. diplopia
  4. ataxia
  5. bulbar palsy
93
Q

Investigation for botulism

A

Clinical suspicion, anaerobic culture

94
Q

Management of botulism

A

Botulism antitoxin and supportive care

- antitoxin is only effective if given early - once toxin has bound its actions cannot be reversed

95
Q

What is Atypical Mycobacterial Disease?

A

Opportunistic infection
E.g. Mycobacterium avium and Mycobacterium kansasii

  • context of HIV, CD4 <50 are at higher risk of disseminated disease
  • environmental organism
96
Q

Transmission of Atypical Mycobacterial Disease

A

Transmission occurs via the respiratory or GI tract

97
Q

Features of Atypical Mycobacterial Disease

A
  1. fever, night sweats, weight loss, lymphadenopathy, hepatomegaly
  2. Anaemia, leucopenia, hypoalbuminaemia
98
Q

Investigation for Atypical Mycobacterial Disease

A

Mycobacterial cultures (blood/bone marrow/lymph node/ sputum/stool)

99
Q

Management of Atypical Mycobacterial Disease

A

Clari-/Azithromycin) + Ethambutol + Rifabutin for > 3mo

100
Q

Causative organis of threadworks

A

Infestation with threadworms (Enterobius vermicularis, sometimes called pinworms) is extremely common amongst children in the UK.

101
Q

Transmission of threadworms

A

Infestation occurs after swallowing egg

102
Q

Features of threadworms

A

Usually asymptomatic

  • perianal itching, particularly at night
  • girls may have vulval symptoms
103
Q

How do you diagnose threadworms?

A

Cellophane test/ Clinical suspicion

104
Q

Treatment for threadworms

A

1st line = Mebendazole with repeat dose in 2/52

  • Treat entire family, hygiene measures
105
Q

What is hookworm?

A

Hookworm (Ancylostoma duodenale and Necator americanus) as well as Ascaris (up to 35mm) and Trichuris (whipworm) are all soil-transmitted helminths account for the majority of infection

106
Q

Transmission of hookworm

A

Mainly acquired through walking barefoot in contaminated soil

107
Q

Features of hookworm

A
  • Majority asymptomatic
  • Some GI symptoms
  • anaemia
  • mild cough
  • serum eosinophilia
108
Q

Investigation for hookworm

A

Stool Ova, Cysts and Parasites

109
Q

Treatment of hookworm

A

Albendazole or Mebendazole

110
Q

Causative organism of amoebiasis

A

Entamoeba histolytica

111
Q

Transmission of amoebiasis

A

Spread by the faecal-oral route

112
Q

Symptoms of amoebiasis

A
  • Infection can be asymptomatic
  • cause mild diarrhoea
  • severe amoebic dysentery
113
Q

Sx, Ix & Mx of amoebic dysentery

A
  • profuse, bloody diarrhoea

Ix: stool microscopy may show trophozoites if examined within 15 minutes or kept warm (known as a ‘hot stool’)

Mx: metronidazole

114
Q

Causative organism of malaria

A

Mosquito-borne infection caused by Plasmodium protozoa

Four kinds of malaria parasite: Plasmodium falciparum, P. vivax, P. ovale and P. malariae

115
Q

Features of malaria

A
  1. Fever, arthralgia, headache, nausea, abdominal pain (often non-specific symptoms)
  2. Signs: Tachycardia, tachypnoea, fever, anaemia, thrombocytopenia, transaminitis, splenomegaly
116
Q

Management of malaria

A

Urgent prompt IV therapy, inform senior, if DGH consider referral to Tertiary referral centre, inform ITU

Depends on severity of falciparum malaria

(CHECK NOTES)

117
Q

Management of falciparum malaria

A

1st line = artemisinin-based combination therapies (ACTs)

Severe:
IV artersunate
? bacterial septicaemia if haemodynamic collapse

118
Q

Management of non- falciparum malaria

A

1st line = artemisinin-based combination therapy (ACT) or chloroquine

Give Primaquine following acute treatment with chloroquine to destroy liver hypnozoites and prevent relapse.

119
Q

Causative organism of toxoplasmosis

A

Infection with a worldwide distribution caused by Toxoplasma gondii

120
Q

Transmission of toxoplasmosis

A
  1. Ingestion of infectious oocysts from soil/water
  2. Ingestion of tissue cysts in the meat of an infected animal
  3. Vertical transmission
  4. Transmission from organ transplantation from an infected donor
121
Q

Features of toxoplasmosis

A
  1. Immunocompetent person: primary infection usually asymptomatic
  2. If symptomatic: fever, sweats, headache, myalgia, hepatosplenomegaly
  3. Most common manifestation is bilateral, symmetrical non-tender cervical lymphadenopathy
  4. Labs: Lymphocytosis, raised LFTs, moderate increase in CRP
122
Q

Investigations of toxoplasmosis

A

Serology

123
Q

Management of toxoplasmosis

A

no treatment unless severe infection or immunosuppressed

Tx: pyrimethamine and sulfadiazine

Advice: avoid raw/undercooked meat, avoid changing cat litter

FCM Matrix (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions