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Year 3 - Medical Block Workbooks > Infectious Diseases > Flashcards

Infectious Diseases 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
Malaria - Treatment
Malaria Mx 1. Chloroquine - Hydroxychloroquine 2. Resistance - Quinine + Doxy - Artesunate+melfloquine 3. Primaquine 4. Parenteral if no PO - IV Artesunate 5. Intensive care
26
Typhoid - 8 S&S
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
Typhoid - Blood changes
Typhoid Bloods 1. Leucopenia 2. Lymphopenia 3. CRP raised
28
Typhoid | - Mx
Typhoid 1. IV Ceftriaxone 2. Switch if sensitive - PO Cipro - PO Azithro
29
PUO on IDU - Definition
Pyrexia of Unknown Origin 1. Temp>38 2. Illness > weeks 3. 7+days no DDx
30
PUO | - Differentials
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
PUO | - Approach
PUO approach 1. DDx 2. No ABx until Ix 3. Consult rheum+haem 4. Front sheet of Ix 5. Outpatient if stable
32
Latent TB | - Ix
Latent TB Screen 1. CXR 2. Interferon gamma (T cell release of interferon gamma on exposure) - quantiFERON - T-SPot
33
Latent TB | - Mx
Latent TB Mx 1. 3 months R+I Or 2. 6 months R
34
Active TB | - Imaging
Active TB Imaging 1 CXR - Mediastinal lymphadenopathy - Cavitating pneumonia - Pleural effusion 2. CT - Lymphadenopathy - Visceral lesions 3. MRI - Leptomeningeal enhacement
35
Active TB | - Culture acquisition
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
TB - Paradoxical reaction - Mx
TB Paradox 1. Inflammation as bacteria die at start of treatment 2. Steroids if problematic - Meningeal - Spinal - Pericardial
37
TB | - MDR Mx
MDR TB 1. Negative pressure room 2. Sensitivity based
38
TB | - ABx Regimen
TB ABx 1. Intensive 2 months - RIPE - Pyridoxine (Vit B) 2. Continuation phase - PI - Pryridoxine
39
STI | - NAATs on the ward
STIs 1. NAATs for - Gonorrhoea (GC) - Chlamydia (CT) 2. Male first-pass urine 3. Vulvo-vaginal swab 4. Pharyngeal or rectal swab
40
HIV | - Baseline investigations
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
HIV | - Opportunistic infections Prophylaxis
HIV Prophylaxis 1. PCP - Co-trimoxazole 2. MAI (Non-TB Myco) - Azithromycin 3. CMV - Dilated fundoscopy
42
HIV | - PEP
HIV PEP 1. IDU Call Consultant 2. Occupational Health 3. GUM doctor

Year 3 - Medical Block Workbooks (7 decks)

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