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Year 3 - Medical Block Workbooks > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

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USMLE® Step 1 flashcards
1
Q

Septic Shock

- Definition

A

Septic Shock

  1. A subset of sepsis
  2. Profound abnormalities
    - Circulatory
    - Cellular
    - Metabolic
  3. Associated with greater risk of mortality
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2
Q

Soft tissue ABx

1 Staph aureus

  1. MRSA
  2. Strep

4 Penicillin allergy

A

Soft Tissue ABx

1 Staph aureus
- Fluclox

  1. MRSA
    - Glycopeptide
    (Vanc/teic)
  2. Strep
    - Benpen/Fluclox
  3. Pen allergic
    - Doxy
    - Mero (1% risk)
    - Ceftriax (10% risk)
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3
Q

MSK ABx

  1. Diabetic foot
  2. TB
A

MSK ABx

  1. Diabetic foot
    - Tazocin (broad pen)
    - Carbapenem
  2. TB
    RIPE
    (pyrazinamide)
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4
Q

Resp ABx

  1. Strep p.
  2. Hib
  3. Atypical
  4. Viral
A

Resp ABx

  1. Strep p.
    - Amoxicillin (pen)
    - Erythro/clari (macro)
  2. Hib
    - Co-amox
  3. Atypical
    - Doxy
    - Levoflox (FQ)
  4. Viral
    - Oseltamivir
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5
Q

GI ABx

  1. Viral V+D
  2. Enterobac
    - Camp, shigell, EC
  3. Salmonella spp.
  4. C. diff
  5. Visceral/peritontis
  6. Anaerobic cover
  7. Severe/pen allergic
A

GI ABx

  1. Viral V+D
    - None
  2. Enterobacteria
    - None
    - Cipro (FQ)
    - Clari/azith (mac)
  3. Salmonella
    - Ceft/azith
  4. C. Dif
    - PO Met/Vanc
  5. Visceral/peritonitis
    - Co-amox
    - Cipro
    - Gent (aminoglyc)
  6. Anaerobic
    - Met/Co-amox
  7. Severe/pen allergy
    - Carbapenem
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6
Q

GU ABx

  1. Mild enterobac
  2. Moderate enterobac
  3. Pseudomonas
  4. ESBL/resistant
    - Ext. spec. beta-lactamase
  5. N. gonorrhoea
  6. Chlamydia trach.
A

GU Abx

  1. Mild enterobac
    - PO Nitro, trimeth, co-amox
  2. Mod/severe enterobac
    - IV Co-amox
    - PO Cipro
  3. Pseudomonas
    - Cipro; gent; tazocin
  4. ESBL
    - Carbapenem
  5. N. gonorrhoea
    - IM/IV ceft
  6. C. trachomatis
    - Azithromycin
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7
Q

CNS ABx

  1. Strep, N. menigitidis, Hib
  2. Listeria
  3. Pen allergic
  4. TB
  5. Herpes encephalitis
A

CNS ABx

  1. Strep
    - IV Ceft/cefotaxime
  2. Listeria
    - IV amoxicillin
  3. Pen allergic
    - Mero
  4. TB
    - RIPE
  5. Herpes encepharlitis
    - IV Aciclovir
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8
Q

Endocarditis ABx

  1. Strep
  2. Enterococcie
    E. faecalis, facium
  3. Staph a
  4. “Culture negative”
  5. MRSA
    - Or pen allergic
A

Endocarditis ABx

  1. Strep
    - Benpen +/-gent
  2. Entero
    - Amoxicillin +/- gent
  3. Staph a
    - Fluclox +/- gent +/- rifamp
  4. “Culture negative”
    - Ceftriaxone
  5. MRSA/pen allergic
    - Vancomycin
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9
Q

Line infection: ABx

  1. As for skin
  2. MRSA
A

Line infection

  1. As for skin
  2. MRSA
    - Vancomycin
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10
Q

Hospital-acquired: ABx

  1. Enterobac
  2. Pseudomonas
  3. C. diff
  4. MDR
A

Hospital acquired

  1. Enterobac
    - Co-amox
  2. Pseudomonas spp.
    - Cipro
    - Gent
  3. C. diff
    - Met
    - Vanc
  4. MDR
    - Tazocin
    - Carbapenem
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11
Q

Sepsis: ABx

  • Undifferentiated infx
A

Non-specific Sepsis ABx

  • Meropenem (Stat)
  • Trust guidelines
  • Investigate
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12
Q

Travel infection

- Six questions

A

Travel infection Hx

  1. Region
  2. Dates and onset
  3. Living situation abroad
  4. Activities
    - Animals (bites/ticks)
    - Freshwater (schistosomiasis)
    - Wells (leptospirosis)
  5. Food and water
  6. Sexual history
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13
Q

Travel infection

- PMHx/DHx

A

Travel infection: PM + D Hx

  1. Predisposition
    - DM
    - Immunosuppresive
  2. Vaccination
    - Hep A, B
    - Typhoid
    - Tetanus
  3. Malaria prophylaxis
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14
Q

Traveller infection

  • Six maculopapular rashes
A

Maculopapular rash

  1. Dengue fever
  2. Leptospirosis
  3. Rickettsia
  4. Mono (EBV/CMV)
  5. Childhood (Rubella, parvo)
  6. HIV
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15
Q

Traveller infection

- Rose spots?
2-3mm macules

A

Traveller infection

Typhoid fever

  • 2-3mm rose macules
  • Chest or abdomen
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16
Q

Traveller infection

  • Black necrotic ulcer
  • Erythematous margins
A

Traveller infection

Rickettsia

  • Black necrotic ulcer
  • Erythematous margins
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17
Q

Traveller infection

  • Petechiae
  • Ecchymoses
  • Haemorrhagic lesions
A

Traveler ecchymoses

  1. Dengue fever
  2. Meningococcemia
  3. Viral hemorrhagic fever
    - Dengue
    - Yellow fever
    - Ebola
    - Crimean Congo
18
Q

Traveller infection

  • Conjunctival suffusion
A

Traveller infection

Leptospirosis
- Conjunctival suffusion

19
Q

Traveller infection

  • Five Splenomegalies
A

Traveller’s splenomegaly

  1. Mono
  2. Malaria
  3. Visceral leishmaniasis
    - Sand fly parasite

4.. Typhoid

  1. Brucellosis
    - Unpasteurised dairy
20
Q

Traveller infection

  • Meningo-encephalitis Sx
A

Meningo-encephalitis sx

  1. Fever
  2. Altered mental status
21
Q

Traveller infection

Meningo-encephalitises

A

Meningo-encephalitis

  1. Cerebral malaria
  2. Japanese encephalitis
  3. West Nile Virus encephalitis
  4. Common
    - N. meningitis
    - Strep. p
    - HSV
22
Q

Malaria

- Presentation

A

Malaria S&S
(90% africa, 10% SE asia)

  1. Abrupt onset rigors
  2. High fevers & malaise
  3. Severe headache and myalgia
  4. Vague abdo pain
  5. N&V (&D)
  6. Hepatosplenomegaly
    - Jaundice
23
Q

Malaria

- Four Blood results

A

Malaria bloods

  1. Anaemia
  2. Thrombocytopenia
  3. Leukopenia
  4. LFT derangement
24
Q

Malaria

- Four complications

A

Malaria complications

  1. Hypoglycaemia
  2. Renal failure
  3. Pulmonary oedema
  4. Neurologic deterioration
25
Q

Malaria

  • Treatment
A

Malaria Mx

  1. Chloroquine
    - Hydroxychloroquine
  2. Resistance
    - Quinine + Doxy
    - Artesunate+melfloquine
  3. Primaquine
  4. Parenteral if no PO
    - IV Artesunate
  5. Intensive care
26
Q

Typhoid

  • 8 S&S
A

Typhoid
SE Asia, C/S America

  1. 30-50% Rose Spots
  2. Fever and malaise
  3. Anorexia
  4. Vague abdo pain
  5. Constipation or diarrhoea
  6. Dry cough
  7. Hepatosplenomegaly
  8. Faget’s sign
    - Pulse-temp dissociation
27
Q

Typhoid

  • Blood changes
A

Typhoid Bloods

  1. Leucopenia
  2. Lymphopenia
  3. CRP raised
28
Q

Typhoid

- Mx

A

Typhoid

  1. IV Ceftriaxone
  2. Switch if sensitive
    - PO Cipro
    - PO Azithro
29
Q

PUO on IDU

  • Definition
A

Pyrexia of Unknown Origin

  1. Temp>38
  2. Illness > weeks
  3. 7+days no DDx
30
Q

PUO

- Differentials

A

Unknown origin pyrexia DDx

  1. Infection
    - TB
    - IE
    - Abscesses
  2. Autoimmune
    - Adult Still’s
    - Temporal arteritis
    - Wegener’s
  3. Neoplastic
    - Leukaemia/lymphoma
    - RCC
  4. Other
    - Drugs
    - TE
    - Thyroid/adrenal
31
Q

PUO

- Approach

A

PUO approach

  1. DDx
  2. No ABx until Ix
  3. Consult rheum+haem
  4. Front sheet of Ix
  5. Outpatient if stable
32
Q

Latent TB

- Ix

A

Latent TB Screen

  1. CXR
  2. Interferon gamma
    (T cell release of interferon gamma on exposure)
    - quantiFERON
    - T-SPot
33
Q

Latent TB

- Mx

A

Latent TB Mx

  1. 3 months R+I

Or

  1. 6 months R
34
Q

Active TB

- Imaging

A

Active TB Imaging

1 CXR

  • Mediastinal lymphadenopathy
  • Cavitating pneumonia
  • Pleural effusion
  1. CT
    - Lymphadenopathy
    - Visceral lesions
  2. MRI
    - Leptomeningeal enhacement
35
Q

Active TB

- Culture acquisition

A

Active TB Cultures

6 Weeks Zeihl Neelson

  1. Pulmonary
    - Sputum
    - Bronchoscopy
    - EBUS (endobronchial)
  2. Meningeal
    - LP and PCR
  3. Lymph Node
    - Core biopsy (not fna)
  4. Pericardial
    - Pericardiocentesis
  5. Gastrointestinal
    - Colonoscopy and biopsy
    - US Omentum biopsy
36
Q

TB

  • Paradoxical reaction
  • Mx
A

TB Paradox

  1. Inflammation as bacteria die at start of treatment
  2. Steroids if problematic
    - Meningeal
    - Spinal
    - Pericardial
37
Q

TB

- MDR Mx

A

MDR TB

  1. Negative pressure room
  2. Sensitivity based
38
Q

TB

- ABx Regimen

A

TB ABx

  1. Intensive 2 months
    - RIPE
    - Pyridoxine (Vit B)
  2. Continuation phase
    - PI
    - Pryridoxine
39
Q

STI

- NAATs on the ward

A

STIs

  1. NAATs for
    - Gonorrhoea (GC)
    - Chlamydia (CT)
  2. Male first-pass urine
  3. Vulvo-vaginal swab
  4. Pharyngeal or rectal swab
40
Q

HIV

- Baseline investigations

A

HIV Investigations

  1. Confirmatory HIV Test
  2. Virus
    - Viral Load
    - Resistance profile
  3. Patient
    - CD4 count
    - HLA B*5701 status
    - FBC, U&E, LFT, Bone Marrow
  4. Serology
    - Syphilis, Hep A,B,C
    - Toxoplasmo, measles, varicella, rubella, schistosoma
  5. Anual cervical screen
41
Q

HIV

- Opportunistic infections Prophylaxis

A

HIV Prophylaxis

  1. PCP
    - Co-trimoxazole
  2. MAI (Non-TB Myco)
    - Azithromycin
  3. CMV
    - Dilated fundoscopy
42
Q

HIV

- PEP

A

HIV PEP

  1. IDU Call Consultant
  2. Occupational Health
  3. GUM doctor

Year 3 - Medical Block Workbooks (7 decks)

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