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Year 4 part 2 > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

What is the role of Folic Acid

A

Synthesis and regulation of DNA within bacteria

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2
Q

What does gram negative bacteria mean

A

They do not have a cell wall

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3
Q

How to treat MRSA

A

Teciplanin or vancomycin

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4
Q

Name three beta lactams (antibiotics that inhibit cell wall synthesis)

A

Penicillin
Carbapenems (meropenem)
Cephalosporins

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5
Q

Name two antibiotics that inhibit wall synthesis but are not beta lactams

A

Vancomycin

Teicoplanin

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6
Q

What antibiotic inhibits folic acid metabolism

A

Trimethoprim

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7
Q

Why is tazocin typically added after co-moxiclav

A

To cover pseudomonas (co amoxiclav does not cover atypical bacteria)

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8
Q

Describe the stepwise approach of escalating antibiotic treatment in a hospital patient

A
  1. Amoxicillin
  2. Co-Amoxiclav
  3. Tazocin
  4. Meropenem to cover ESBLs
  5. Teicoplanin to cover MRSA
  6. Clarithromycin
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9
Q

What is the pathological consequence that leads to raised blood lactate in the body

A

Cause hypoperfusion of the tissues = anaeraobic respiration

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10
Q

First line management of septic shock

A

IV Fluids

if IV fluids does not improve BP, switch to inotropes (noradrenaline)

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11
Q

At what level of lactate should sepsis be suspected

A

> 2 mmol/L

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12
Q

What medications can cause neutropenic sepsis

A 
Clozapine
Hydrocychloroquine (RA)
Methotrexate (RA)
Sulfsalazine (RA)
Carbimazole
Quinine
Infliximab
Rituximab

Chemotherapy

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13
Q

Treatment of neutropenic sepsis

A

IMMEDIATE IV Pipperacillin with Tazobactam

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14
Q

First line management of UTIs in pregnancy

A

Nitrofurantoin 7 days

Then Cefalexin

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15
Q

What antibiotic should be avoided in the first trimester for UTIs

A

Trimethoprinm

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16
Q

What antibiotic should be avoided in the third trimester for UTIs

A

Nitrofurantoin

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17
Q

First line management of Pyelonephritis

A

Cefalexin for 7-10 days

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18
Q

What classification is used to grade Cellulitis

A

Eron

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19
Q

What antibiotic is given for cellulitis

A

Flucloxacillin

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20
Q

First line management of sinusitis

A

Phenoxymethylpenicillin for a 5 day course

Second line: Co-Amoxiclav

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21
Q

Management of intra-abdominal infections

A

Co-Amoxiclav

or

Amoxicillin + Gentamycin + Metronidazole

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22
Q

First line management of spontaneous bacterial peritonitis

A

Tazocin

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23
Q

What disease is spontaneous bacterial peritonitis seen in

A

Liver Failure

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24
Q

Diagnosis of influenza

A

Viral nasal swabs -> PCR

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25
Q

Management of influenza

A

Oral Oseltamivir 75mg twice daily for 5 days

within 48 hours to reduce risk of complication

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26
Q

What post-exposure prophylaxis is given for influenza

A

Oral Oseltamivir

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27
Q

What species is the most comon cause of traveller’s diarrhoea

A

Campylobacter jejuni

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28
Q

How does campylobacter jejuni spread

A

Raw poultry

Unpasteurised milk

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29
Q

Incubatino period of campylobacter jejuni

A

2-5 days

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30
Q

Antiibtiotcs for campylobacter jejuni infection

A

Azithromycin

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31
Q

Treatment of shigella

A

Azithromycin

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32
Q

What species causes diarrhoea from leftover fried rice left at room temperature

A

Bacillus Cereus

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33
Q

Management of bacillus cereus infection

A

leave for 24 hours

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34
Q

Treatment of giardiasis

A

Metronidazole

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35
Q

What is meningococcal septicaemia

A

Where the meningococcus bacterial infection spreads in the blood

This causes the classic non-blanching rash from DIC

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36
Q

What is meningococcal meningitis

A

Bacteria infetcing the meninges and CSF around the brain and spinal cord

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37
Q

What is the most common cause of bacterial meningitis in neonates

A

Group B strep

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38
Q

What is the criteria for lumbar puncture in children

A

<1 month with fever
1-3 months with fever and are unwell
<1 year with unexplained fever + other features of serious illness

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39
Q

What is the kernig’s test

A

Lie on back, flex one hip at 90 degrees and slowly straighten (causes pain)

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40
Q

What is the Brudzinski’s test

A

Lying the patient flat on their back and gently using your hands to lift their head and neck off the bed (cause involuntary flexing of their hips and knees)

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41
Q

Management of meningitis in the community

A

IM Benzylpenecillin

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42
Q

Management of meningitis <3 months

A

Cefotaxime + Amoxicillin

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43
Q

Management of meningitis >3 months

A

Ceftriaxone

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44
Q

At what age can dexamethasone be given to children with meningitis

A

> 3 months

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45
Q

Post-exposure prophylaxis for meningitis

A

Ciprofloxacin

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46
Q

Most common cause of viral meningitis

A

HSV

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47
Q

Management of Viral Meningitis

A

Aciclovir

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48
Q

Glucose levels in Bacterial vs Viral meningitis

A

Low vs High

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49
Q

Appearance of CSF fludi in bacterial vs virus

A

Cloudy vs clear

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50
Q

Protein levels in bacterial vs viral meningitis

A

High vs Normal

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51
Q

Appearance of disseminated miliary TB on a chest X-rAy

A

Millet seeds uniformly distributed across the lung fileds

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52
Q

In what lobes in reactivated TB found in

A

Upper Zones of the lungs

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53
Q

Management of latent TB (those at risk of re-activation)

A

Isoniazide + Rifampicin for 3 months

Then

Isoniazid for 6 months

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54
Q

Management of Acute Pulmonary TB

A

RIPE

R + I for 6 months

P + E for 2 months

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55
Q

Side-effect of isoniazid

A

Peripheral neuropathy

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56
Q

How to prevent peripheral neuropathy from isoniazid

A

Prescribe B6

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57
Q

Side-effect of Pyrazinamide

A

Hyperuricaemia

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58
Q

Side-effect of Ethambutol

A

Colour Blindness

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59
Q

What is the problem with antibocyd testing in HIV

A

Can be negative for up to 3 months

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60
Q

Three ways we can test for HIV

A

Antibody testing

p24 antigen testing

PCR tetsing for HIV RNA to get viral load

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61
Q

How to monitor HIV progression

A

CD4 count

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62
Q

What is the normal CD4 count

A

500 +

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63
Q

When is a virla load referred to as undetectable

A

<100

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64
Q

Treatment of HIv

A

2 NRTIs (Tenofovir and emricitabine) + third agent

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65
Q

Management of Pneumocytis jirovecii pneumonia

A

Co-Tramoxazole

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66
Q

How does birth change in women with a viral load

A

Require C-Sections

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67
Q

WHat is post-exposure prophylaxis given for HIV

A

Truvada + Reltegravir for 28 days

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68
Q

What is the most dangerous species of malaria

A

Plasmodium Flaciparum

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69
Q

Which species of malaria lie dormant in the liver (as hypnozoites) for years

A

P. vivax

P. Ovale

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70
Q

IN which organ to malarial species mature in

A

Liver

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71
Q

Where do merozoites move to after maturing in the liver

A

RBCs where they reproduce and destroy the cells = haemolytic anaemia

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72
Q

Describe the pattern of fevers in malaria

A

High fever spikes every 48 hours as that’ show long it takes for meroxoites to reproduce inside RBCs

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73
Q

Incubation period of malaria

A

1-4 weeks

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74
Q

Diagnosis of Malaria

A

Blood film (EDTA bottle) - 3 samples over 3 days

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75
Q

Management of uncomplicated malaria (orally treatable)

A

Artemether with lumefantrine

Proguanil + Atovaquone

Quinine

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76
Q

IV Management of severe malaria

A

Artesunate

or

Quinine Dihydrochloride

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77
Q

What prophylaxis can be given for malaria

A

Proguanil + Atovaquone

second line:

Mefloquine (but can cause bad dreams)

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78
Q

What antibody in Heb B implies past or current infection

A

HBcAb

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79
Q

What antibody indicates vaccination or precious infection in Hep B

A

HBsAb

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80
Q

What does a CT scan show for toxoplasmosis gondii infections

A

Multiple ring enhancing lesions

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81
Q

What does a CT scan show for Primary CNS lymphoma

A

Single lesion

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82
Q

What does a CT show for HIV caused encephalitis

A

Oedematous brain

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83
Q

Most common fungal infection of the CNS

A

Cryptococcus

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84
Q

What stain is used to check for cryptococcus infections

A

India ink staining

85
Q

Symptoms of progressive multifocal leukoencephalopathy

A

Widespread demyelination

Behavioural changes, speech, motor and visual impairment

86
Q

What does an MRI show for PML

A

Widespread demyelination

87
Q

What does stool microscopy show for amoebiasis

A

Trophozoites

88
Q

Treatment for amoebiasis

A

Oral metronidazole

89
Q

What causes yellow fever

A

Aedes mosquitos (zoonotic infections)

90
Q

Symptoms of yellow fever

A

Sudden onset fever, rigors, nausea and vomiting

Then remission

Then jaundice and oliguria

91
Q

What is seen under microscopy for yellow fever

A

Concilman bodies

92
Q

Management of encephalitis

A

Ceftriaxone and acyclovir

93
Q

Clinical features of trypanosomiasis

A

Painless subcutaneous nodule at site of infection + fever

then get sleepiness and headaches later on

94
Q

Management of trypanosomiasis

A

IV pentamidine

Late IV melarsoprol (CNS involvement)

95
Q

What type of microbe is toxoplasmosis

96
Q

If someone’s received a full 5 dose of the tetanus vaccine in the past 10 years, should they receive another at A&E?

A

No. Over 10 = yes

97
Q

Clinical features of schistosomiasis

A

Swimmer’ itch

Fever, cough and diarrhoea

98
Q

Why does schistosomiasis cause bladder cancer

A

Deposit eggs in the bladder causing inflammation

99
Q

Investigation for schistosomiasis

A

Asymptomatic: Serum schistosome antibodies

Symptomatic: Urine or stool microscopy

100
Q

Complications of rubella

A

Thrombocytopaenia
Arthritis of small hands
Encephalitis
Myocarditis

101
Q

Management of p oval and vivax infections

A

Chloroquine and THEN primaquine to destroy liver hypnozoites - prevents relapse

102
Q

Management of leptospirosis

A

Benzylpenicillin

103
Q

What species causes leprosy

A

Mycobacterium leprae

104
Q

Clinical features of leprosy

A

Patches of hypo pigmented skin affecting the buttocks, face and extensors

Sensory loss

105
Q

What typiclaly causes acute pyelonephritis

106
Q

What type of bacteria is entamoeba histolytica

107
Q

Symptoms of amoebiasis

A

Profuse and bloody diarrhoea
Long incubation period

108
Q

Investigation for suspected amoebiasis

A

stool microscopy - hot stool + trophozoites

109
Q

Management of amoebiasis

A

Metronidazole

110
Q

Management of liiver amoebic abscess

A

Metronidazole (usually a singular mass in the liver)

111
Q

Features of anthrax

A

Painless black eschar (pus)
Oedema
GI Bleeding

112
Q

Management of Anthrax

A

Ciprofloxacin

113
Q

How is anthrax spread

A

Infected carcasses

114
Q

Management of PID

A

Oral Ofloxacin + Metronidazole

Ceftriaxone + doxycycline + Metronidazole

115
Q

Management of c.diff

A

Oral vancomycin

second line: Fidaxomicin

116
Q

Antibiotic given for salmonella and shigella

A

Ciprofloxacin

117
Q

What antibiotic typically results in c.diff infections

A

Clindamycin

118
Q

Name two conditions that can predispose someone to aspergilliosus

A

TB
Lung cancer
CF

119
Q

Management of botulism

A

Botulism antitoxin and supportive care

120
Q

How do people get boutlism toxins

A

From food that has not been preserved well

121
Q

Incubation of campylobacter infections

122
Q

What species causes cat scratch disease

A

Bartonella Henslae

123
Q

Criteria for IV antibiotics in cellulitis

A

Class III or IV cellulitis on the eron scale
Rapidly deteriorating
<1 years old
Immunocompromisd
Facial cellulitis

124
Q

Management of cellulitis in pregnancy

A

Erythromycin

125
Q

Management of Class III + Cellulitis

A

IV co amoxiclav

126
Q

What species causes a chancroid

A

Haemophilus ducreyi

127
Q

Mangement of cholera

A

Oral Rehdyration therapy first

Doxycycline

128
Q

How is the cholera vaccine given

129
Q

What species causes pseudomembranous colitis

130
Q

What type of species is cryptosporidium

131
Q

Symptoms of cryptosporridium infection

A

Wstery diarrhoea
Abdominal cramps

132
Q

Stool sample results in cryptosporidium infections

A

Red cysts on ziehl-neelsen stain

133
Q

Management of cryptosporridium infection

A

Supoprtive

Rifaximin if severe symptoms

134
Q

Microscopy in CMV infections

A

Owl’s eye

135
Q

Three symptoms of CMV infection

A
  1. Slow growth
  2. Blueberry muffin rash
  3. Microcephaly
136
Q

Management of CMV retinitis

A

IV Ganciclovir

(has pizza retina)

137
Q

What mosquito typically carry dengue

A

Aedes Aegypti mosquito

138
Q

Symptoms of dengue fever

A

Fever
Bone pain
Haemorrhages

Warning signs: Hepatosplenomegaly + ascites

139
Q

Complication of dengue

140
Q

Diagnostic test of dengue

A

NAAT
Serology

141
Q

Management of dengue

A

Supportive

142
Q

What bacteria causes diptheria

A

Gram positive: Cornyebacterium diptheriae

143
Q

Presentation of diptehria

A

Greying of the posterior pharyngeal wall
Cervical lymphadenopathy (causes bulky neck)
Heart block

144
Q

Invetsiation of diptheria

A

Throat swab

145
Q

Management of diptheria

A

IM penecillin + antitoxin

146
Q

What virus is the only one that is single stranded

A

Parvovirus

147
Q

What species causes ebola

A

Filoviridae

148
Q

How is ebola spread

A

Througgh direct contact (secretions etc)

149
Q

Incubation period of ebola

150
Q

What species causes typhod

A

Salmonella

151
Q

Features of typhoid

A

Bradycardia
Constipation (even though salmonella usually causes diarrhoea)
Rose spots on trunk

152
Q

What species causes osteomyelitis in SCA

A

Salmonella

153
Q

Name two types of lymphomas associated with EBV

A

Burkitt’s lymphoma
HOdgkin’s lymphoma

154
Q

What diarrhoeeal infection has appendicitis type symptoms

A

Campylobacter infections

155
Q

What is the most common cause of infective diarrhoea in HIV +ve patients

A

Cryptosporidium infections

156
Q

What species causes Kaposi’s sarcoma

A

Human Herpes Virus 8

157
Q

Management of Kaposi’s sarcoma

A

Radiotherapy + Resection

158
Q

Management of HIV

A

Two NRTIs + PI or NNRTI

159
Q

What virus is associated with Primary CNS lymphoma

160
Q

A patient presents with headache, fever and malaise - india ink stain is positive. What species has caused this invasion of the CNS

A

Cryptococcus

161
Q

Management of oesophageal candidiasis

A

FLuconazole + Itraconazole

162
Q

What species causes hairy leukoplakia

163
Q

Under what CD4 count should all HIV patients recieve PCP prophylaxis

164
Q

COmplication of PCP

A

Pneumothorax

165
Q

What examination finding is consistent with PCP

A

Excercise-induced desaturation

166
Q

What is diagnostic of PCP

A

Bronchoalveolar lavage - silver stain shows cysts

167
Q

Management of PCP

A

Co-trimoxazole

or

IV pentamidine

168
Q

When should steroids be given in PCP

A

pO2 < 9.3kPa

169
Q

What factor in HIV diagnosis correlates to poor long term prognosis

A

Symptom severity

170
Q

When should a repeat test be offered in asymptomatic patients for HIV

A

4 weeks after exposure

Tehn 12 weeks after

171
Q

When do HIV antibodies get detected in the blood

A

4-6 weeks after infection

172
Q

What HPV strains are linked to cervical cancer

173
Q

What is the triad seen in infectious mononucleosis

A

Sore throat
Pyrexia
Lymphadenopathy
Splenomegaly

174
Q

When should the monospot test be conducted

A

2nd week of illness

175
Q

How is the influenza vaccine given to children

A

INtranasally (live vaccine)

176
Q

Contradinications to the influenza vaccine

A

People taking aspirin for kawasaki
Egg allergy
Pregnancy
Asthma
<2 years

177
Q

Diganosis of legionella pneumophilia

A

Urinary antigen

178
Q

Management of legionella

A

Erythromycin

179
Q

How is leishmaniasis spread

A

Sandflies bites

180
Q

Signs of a leishmaniasis bite

A

Underlying red ulcer

181
Q

How is leishmaniasis diagnosed

A

Punch biopsy

182
Q

Where is leishmaniasis spread

A

South america

183
Q

What is a positive mantoux test

A

Erythema > 10mm = previous exposure including BCG

184
Q

Signs of false negative mantoux test

A

Sarcoidosis
Lymphoma
Fevers

185
Q

How does IV antibiotics change for managing meningitis 3 months - 50 years and > 50 years

A

3 months - 50 years: IV Cefotaxime

50 + : IV cefotaxime + Amoxiccillin

186
Q

Side-effects of metronidazole

A

Increases anticoagulant effects of warfarin

Causes bad experiences with alcohol intake

187
Q

Management of MRSA

A

Vancomycin

188
Q

Triad for congenital toxoplasmosis

A

Cerebral calcification
Hydrocephalus
Chorioretinitis

189
Q

Management of latent TB

A

3 months of isoniazid (with pyridoxine) + rifampicin

6 months of isoniazid (with pyridoxine)

190
Q

Management of TB

A

First 2 motnhs: RIPE

Next 4 months: RI

191
Q

Side effect of pyrazinamide

192
Q

What is yellow fever

A

It is a viral haeemorhagic fever from aedes mosquitos

193
Q

What strain of HIV is common in the world

194
Q

Name trhee cells that carry CD4+ cells

A

T-helper cells
Macrophages
Dendritic cells

195
Q

Describe how HIV molecules get into cells

A

Bind to CD4 cells by GP120 receptors on their cell surface

Then GP120 binds to CXCR4 co receptor

Has to bind to both to get in

196
Q

WHat enzyme causes the RNA HIV virus to be turned into DNA

A

Reverse transcriptase enzymes

Basically: whenever you get an infection in the body, these immune cells try and replicate but the viral DNA gets replicated instead - producing more HIV cells by accident!

197
Q

What causes the acute stage of HIV

A

The dentritic cells just chill in the epithelium - then migrate to the lymph nodes to elsewhere in the body. High concentrtaion of immune cells means HIV has a field day and infects all the other cells

198
Q

Symptoms of teh acute phase of HIV

A

Flu like symptoms:

By 12 weeks, the HIV virus reaches almost zero.

Then we enter the chronic phase

199
Q

What happens in the chronic phase

A

Some HIV strains carry an X4 receptor that SPECFICIALLY targets T-cells. It hides in the lymphoid tissues and attacks the T4 cells causing them to deceline.

HIV count goes up

200
Q

Symptoms of HIV at 200-500 T cells

A

Swollen lymph nodes
Hairy leukoplakia (EBV)
Oral candidiasis

201
Q

Name four AIDS defining illnesses

A

Kaposi’s lymphoma
Pneumocystis pneumonia
Candidiasis of oesophagus
Primary CNS lymphoma
Progressive multifocal leucoencepholopathy
Toxoplasma gondii infection

202
Q

Name two conditions that are protective against amalria

A

SCA
Thalassamia
G6PD deficiency

203
Q

Where do the sporozoites in malaria develop

A

IN the liver - form merozoites

204
Q

Name two species that go dormant in the liver

A

p.vivax

p.ovale

called hypnozoites at this point

205
Q

How does malaria cause haemolysis

A

The merozoites invade the blood stream and bind to RBCs

(p.vivax typically only infects reticulocytes)

Then reproduce inside the RBCs to form trophozoites

They eat up haemoglobin from inside the cells: Schizont (they are differentiated)

Burst the RBCs and go into the blood

206
Q

What species causes the worts malarial infections

A

p.falciparum

207
Q

Complication of p.falciparum infections

A

Blocks up blood vessels
Blocks blood supply to spleen
Blocks blood supply to the brain (seizures)
BLocks blood supply to the liver.

Causes RBCs to clump together

208
Q

Diagnosis of malaria

A

Blood smear

Year 4 part 2 (10 decks)

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