Infectious Diseases Flashcards
What is the management of early Lymes Disease?
Oral Doxycycline
What is the management of Disseminate Lymes Disease?
Ceftriaxone
Scarlet fever how is it managed?
Oral Penicillin for 10 days
Azithromycin in pen allergic
Return to school after 24hrs of abx
Scarlet Fever - Presentation
Sandpaper rash
Strawberry tongue
Desquamation of hands and feet
Fever malaise
How is someone managed who has been exposed i.e needle stick to a HIV +ve person?
Oral Antiretroviral for four weeks
What is used to treat Schistosomiasis?
Even asymptomatic infection is treated with Praziquantel.
Typhoid - organism
Salmonella
Blood culture is diagnostic
Typhoid Presentation
Abdominal Distension Constipation or pea green diarrhoea Rose Spots Systemically Unwell Relative bradycardia
Dengue Fever - Presentation
Fever Headache Bone Pain Myalgia Maculopapular Rash Haemorrhagic Manifestations
Dengue Fever - Lab results
Thrombocytopenia
Leukocytosis
Dengue Fever - Management
Symptomatic treatment only
Severe Campylobacter Treatment
Clarithromycin
What is the treatment of someone who is immunosuppressed with Toxoplasmosis Gondi
Pyrimethamine + Sulphadiazine
What is the treatment of Toxoplasmosis Gondi who is non immunocompromised?
No treatment
If someone has received all their tetanus jabs in the last ten years. What is their management if they cut themselves on a dirty object.
No vaccine or booster is needed regardless of the severity.
What Vaccination is given to all students?
Meningitis ACWY
Bilateral Conjunctivitis
Bilateral Calf Pain
High Fevers
Leptosporosis
Sewage worker is BUZZWORD
What causes an Amoebic Abscess?
Entamoeba Histolytica
MSM or Anal sex are risk factors
Signs of Amoebic Abscess
RIgors
Swinging fevers
Colitis
Anchovy sauce aspirate
Management of an Amoebic Abscess
IV metronidazole / Tinidazole
Surgical drainage if rupture risk or 72hs or abx and no improvement
Management of Osteomyelitis
WAIT for culture from bone biopsy IV Flucloxacillin + Fusidic Acid/Rifampacin Vancomycin in MRSA Clindamycin in Pen Allergic Surgical debridement is key
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How does osteomyelitis differ from Cellulitis?
Osteomyelitis is usually more subacute
History of deep penetrating injury
Discharging Sinus
Rheumatic Fever - organism
Immune response weeks after Strep Pyogenes infection
Signs and symptoms of rheumatic fever.
Erythema Marginatum - erythematous borders clear in middle Chorea- late presentation Polyarthritis Carditis or vulvitis Subcutaneous nodules
Management of rheumatic fever
Oral Penicillin V
NSAIDs
Painful large sharply defined undermined ulcer - genitals
Painful unilateral inguinal nodes
Chancroid
Small Painless ulcer
Painful inguinal lymphadenopathy
Proctatitis
LGV
Doxycycline
Hepatitis - HBs means
SAFE
Immunisation if isolated
Previous infection if alongside HBc
Hepatitis - HBc
Caught
Previous Hep B infection
Sign of Syphilis disease activity
Rapid Plasma Regain
1/2 is less activity that 1/8 - amount of times you need to dilute the sample to get no syphilis
Sign of current or past syphilis infection
TPPA - very sensitive
Sign of a current syphilis infection
High RPR i.e 1/32
ELISA Acute IgM present
Syphilis post penicillin reactions
Some can develop a fever and rash
Simple Paracetamol is all that’s required
Cause of lymes disease
Borellai Burgdorferi
Some longterm affects of untreated lymes disease
Bilateral facial palsy
Presentation of lymes disease
Erythema Migrans - clinically diagnoses from this
Joint pain
Fever
Headache
A concurrent infection of what two thing puts you at an increased risk of N. Fascitis?
Chicken Pox (Varicella Zoster) Group A Strep ( Strep. Pyogenes)
Successfully treated syphilis will present with what on serological testing?
-ve non treponemal test - reactivity of the serum i.e RPR
+ve treponemal test - TPHA and other enzyme assays
Management of shingles
If within 72 hours antivirals should be given
Paracetamol and NSAIDs are used for pain management - amitriptyline in severe
When can antivirals not be used in shingles?
If under 50 with a mild infection and limited pain,
What is the benefit of giving antivirals in shingles?
Reduces risk of developing post herpetic neuralgia
When is shingles no longer infectious?
when the vesicles have crusted over - usually 5-7 days
Reduce infectivity by covering up the rash
A CD4 count under 400 what should be given?
Co-Trimoxazole
White patches typically affecting the lateral border of the tongue, painless. Not removed with light pressure.
Oral Hairy Leukoplakia
Linked to EBV and underlying HIV infection
Treatment involves management of HIV and will generally resolve with antiretrovirals.
White patches in the mouth that lift with light pressure.
Oral candidas
What is the commonest form on non falciparum malaria?
Plasmodium Vivax
Plasmodium Vivax
Fever - cyclical every 48 hours
Headache
Splenomegaly
How do you manage plasmodium vivax malaria?
Acute - Chloroquine or ACT Artemismin Base Combunation Therapy.
- avoid ACT in pregnancy
Post acute - Primaquine is given to prevent relapse by destroying dormant vivax.
What causes Necrotising fasciitis type 1?
Mixed anaerobes and aerobes - diabetics post surgery - commonest type of NF
What causes type 2 NF
Strep Pyogenes
Hep A
Faeco-oral
No chronic disease no increased cancer risk
Flu + RUQ pain + deranged LFTs + jaundice
RNA virus 2-4 week incubation
Effective vaccine - endemic areas, MSM
What is first line for threadworm?
Mebendazole
Acid Fast Bacilli test is positive in
TB
Leprosy
Any mycoplasma
If someone test positive for HIV at week 4 with an antigen and antibody test. What is the management?
Start antiretrovirals now
Retest at 12 weeks
All new TB diagnoses require what other test?
HIV test
How long post infection does HIV seroconversion occur?
3-12 weeks
For how long post exposure can you give Post exposure prophylaxis for in HIV?
72 hours
What is the commonest cause of a chronically infected wound?
Pseudomonas
Chagas Disease
Everything gets big
Big dilated heart oesophagus and colon - dysfunctional
What test can help you distinguish Dengue fever
Torniquet test - applying a tourniquet casting petechia to develop.
Gram +ve diplococci - chains
Strep Pneumonia
Gram -ve bacilli
E.coli
Gram -ve coccobacili
H.Influenzae
Gram +ve cocci
Listerian Monocytogene
Antibiotic of choice in ESBL producing bacteria
Meropenem
Carbapenem
What additional treatment may be required a the management of sepsis?
Adrenaline or epinephrine - to counter vasodilation
Malaria + drowsiness + confusion = what type
Plasmodium Falciparum
