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AKT > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

Most common isolated organism for animal bites

A

Pasteurella multocida

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2
Q

Mx animal bite + human
Non medical
Abx (1)
Pen allergic abx (2)

A

Clean wound
Abx - co-amox or if pen allergic then doxy and metro

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3
Q

Abx for:
Exacerbation of chronic bronchitis
CAP (+ pen allergic)
CAP if staph suspected i.e in which condition?
Atypical pneumonia
HAP <5/7 >5/7

A

Bronchicitis Amoxi or doxy or clarithro
CAP Amoxi (Doxy or clarithro)
If staph Add fluclox i.e in influenza
Atypical Clarithro
Within 5/7 of admission coamox or cefuroxime
>5/7 taz or ceftazidime or cipro

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4
Q

Abx
Pyelo (2)
Prostatitis (2)

A

Cephalosporin or cipro
Cipro or trimethoprim

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5
Q

Impetigo abx
Top (1)
PO (2)

A

Top hydrogen peroxide
PO fluclox or erythro if widespread

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6
Q

Erysipelas abx (1)
Pen allergic (3)

A

Fluclox
Clarithro/ erythro/ doxy if pen allergic

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7
Q

Cellulitis if pen allergic (3)

A

Clarithro/ erythro/ doxy

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8
Q

Cellulitis near eyes or nose
Abx (1)
Pen allergic (2)

A

Coamox
Clarithro + metro

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9
Q

Gingivitis acute necrotising ulcerative abx

A

Metro

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10
Q

Sinusitus

A

Phenoxymethylpenicillin

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11
Q

Otitis media pen allergic
Externa

A

Erythro
Fluclox

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12
Q

Gonorrhoea (1)
Chlamydia (2)

A

IM ceftriaxone
Doxy/azithro

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13
Q

PID (2) OR (3)

A

Oflox + metro OR
IM ceftriaxone + doxy + metro

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14
Q

Syphillis mx
(1) OR (1) OR (1)

A

Benzathine benpen OR
Doxy OR
Erythro

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15
Q

BV mx (1) or (1)
Treatment length range

A

PO or topical metro
OR
topical clinda
5-7 days

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16
Q

C diff mx
First episode
Second or subsequent episode

A

PO vanc
PO fidaxomicin

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17
Q

Abx mx
Campylo (1)
Salmonella (1)
Shigellosis (1)

A

Clarithro
Cipro
Cipro

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18
Q

BV bacterium
pH
Description
Microscopy
Amsell’s criteria

A

Gardnerella vaginalis
Raised pH >4.5
Fishy offensive smell
Clue cells
3 out of 4 criteria should be present, clue cells, +ve Whiff’s test, thin, white discharge, pH >4.5

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19
Q

Who is offered the BCG? (7)

A

All infants 0-12 months:
1. in areas where incidence is >40/100,000
2. parent or grandparent born in a country where incidence is >40/100,000 (and older children >6yo need a tuberculin test first)
3a unvaccinated tuberculin negative contacts of TB
3b unvaccinated, tuberculin negative, new entrants <16yo who were born in or lived for >3 months) in a country with incidence > 40/100,000
4. HCP
5. Prison staff
6. Staff of care home of the elderly
7. People who work with the homeless

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20
Q

CI to BCG (5)
Age cut off

A

Prev BCG
Positive tuberculin test
HIV
Pregnancy
PMH TB

35yo

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21
Q

Bed bugs cause (1)
Mx (1)

A

Cimex hempteru
Topical hydrocort

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22
Q

Bed bugs cause (1)
Mx (1)

A

Cimex hempteru
Topical hydrocort

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23
Q

Middle East
Farmers, vets, abattoir workers
2 week incubation period

Fever, malaise, hepatosplenomegaly, sacroilitis, spinal tenderness, leukopenia

= which condition?
Dx screening and best test
Mx (2)

A

Brucellosis
Rose Bengal plate test
Brucella serology

Doxy or streptomycin

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24
Q

When to treat campylobacter?
Abx
OR

Complications (3)

A

Severe symptoms, fever, bloody diarrhoea, or >8stools per day OR sx >1 week
Clarithro OR cipro

Guillain Barre
Reactive arthritis
Sepsis, endocarditis, arthritis

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25
Q

Bartonella henselae
Gram +ve or negative
Disease name

A

Gram negative rod
Cat scratch disease

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26
Q

Eron classification of cellulitis (1-4)

A

I no systemic sx no co-morbidities
II systemic sx or not but with co-morbidities
III sig systemic sx
IV sepsis or severe/life threatening

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27
Q

Cellulitis common causes (2)

A

Strep pyog
Staph aur

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28
Q

Painful genital ulcers with unilateral painful inguinal lymph nodes
Sharply defined, ragged, undermined border (ulcers) = which condition

A

Chancroid

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29
Q

Mx chlamydia and length
(1) or (1)

A

Doxy (7/7) OR azithro 1g OD for 1/7 then 500mg OD for 2/7

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30
Q

Chlamydia:
For men with urethral symptoms which contacts should be contacted?
For women and asymptomatic men who should be contacted?

A

All contacts since and in the four weeks prior to the onset of sx

All partners from the last six months or most recent partner

Treat then test

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31
Q

Gram +ve rods (5)

Gram negative cocci (2)
Gram +ve cocci (2)

A

Actinomyces
Bacillus anthracis
Clostridium
Diphtheria
Listeria

Neisseria + morzella catarrhalis
Staph and strep

Remaining organisms are gram negative rods

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32
Q

HIV and young children with watery diarrhoea =

Dx

Mx

A

Cryptosporidiosis

Ziehl Neelsen stain - characteristic red cysts

Mx supportive or nitazoxanide or rifaximin

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33
Q

intensely itchy, ‘creeping’ serpiginous rash = which condition?

Mx (2)

A

Cutaneous larva migrans

Mx albendazole or ivermectin

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34
Q

Recent visitors to Eastern Europe/ Russia/ Asia
sore throat
grey, pseudomembrane on the posterior pharyngeal wall
Bulky cervical lymphadenopathy
Bull neck appearancce
Neuritis
Heart block =

Mx (2)

A

Diphtheria
Mx IM penicillin or diphtheria antitoxin

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35
Q

Strawberry cervix, vulvovaginitis, pH >4.5, green discharge =
Microscopy
Mx

A

TV
Motile trophozites
PO metro 5-7 days

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36
Q

HSV 1
HSV 2
Sx (2)

A

1 = cold sore
2 = genital

Multiple painful ulcers
Primary attacks severe with fever, subsequent less severe

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37
Q

Painless ulcer (chancre) =

A

Syphillis primary stage

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38
Q

Small painless pustule –> ulcer –> painful inguinal lymphadenopathy –> proctocolitis =

Mx

A

Lymphogranuloma venerum
Mx doxy

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39
Q

Parapox virus
Animals: Scabby lesions around the mouth and nose
Humans: Hands and arms affected
Small, raised, red blue papules initially then flat topped and haemorrhagic and increase in size = which condition?

A

Orf

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40
Q

Systemic upset
Relative bradycardia
Constipation
Faecal oral route spread
Gram negative rods
Contaminated food and water =

Compliactions (4)

A

Typhoid

GI bleed
Osteomyelitis
Meningitis
Cholecystitis

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41
Q

EBV associated conditions (3)

A

Lymphomas
Nasopharyngeal carcinoma
Hairy leukoplakia

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42
Q

Most common cause of traveller’s diarrhoea

A

E coli

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43
Q

Food poisoning most common bacteria (3)

A

Staph aureus
Bacillus cereus
Clostridium perfringens

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44
Q

Bloody diarrhoea (3)

A

Shigella
Campylobacter
Amoebiasis

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45
Q

Prolonged non bloody diarrhoea

A

Giardiasis

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46
Q

Short incubation period and severe vomiting =

A

Staph aureus

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47
Q

Flu like prodrome followed by AP, fever, diarrhoea, bloody
May mimic which condition?
Complication (1)

A

Campylobacter
Appendicitis
Guillian Barre

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48
Q

Gradual onset bloody diarrhoea + AP which may last for weeks

A

Amoebiasis

49
Q

Incubation period
1-6 hours (2)
12-48 hours (2)
48-72 hours (2)
> 7 days (2)

A

Bacillus, Staph Aur
E coli, Salmonella
Shigella, Campylo
Amoebiasis, Giardiasis

50
Q

Genital warts caused by which HPV?
Mx
1st line (2)
2nd line (1)

A

6&11
Topical podophyllum or cryo
Imiquimod topical

51
Q

Swimming/ drinking water from a river/ lake
Foreign travel
Faeco-oral route
Male to male sexual contact =

Mx

A

Giardiasis
Metronidazole

52
Q

Hep A,B,C,D,E
RNA or DNA
Spread of transmission
Which one is self limiting, doesn’t cause HCC

A

All but B is RNA
Hep B = double stranded DNA

A+E faecal oral route
B&D bodily fluids

Hep A (self limiting)

53
Q

Gonorrhoea mx (1)

A

IM ceftriaxone 1g

54
Q

Most common cause of septic arthritis in young adults

A

Gonococcal

55
Q

Classic triad features of disseminated gonococcal infection (3)

A

Tenosynovitis
Migratory polyarthritis
Dermatitis

56
Q

When and who is anti-HBs tested?
Interpretation
>100
10-100
<10

A

Those at risk of occupational exposure
1-4 months after primary immunisation

> 100 adequate response, should receive booster at 5 years
10-100 suboptimal response, one additional vaccine
<10 x3 doses vaccine course as non responder

57
Q

Which hepatitis requires another hep surface antigen to complete its replication and transmission cycle

A

Hep D requires hep B

57
Q

Which hepatitis requires another hep surface antigen to complete its replication and transmission cycle

A

Hep D requires hep B

58
Q

Herpes simplex mx
Gingivostomatitis (2)
Cold sores (1)
Genital herpes (1)
Mode of delivery

A

Aciclovir + chlorhexidine mouthwash
Topical aciclovir
PO aciclovir
ELCS if primary attack occurs >K28

59
Q

Features herpes simplex (3)

A

Cold sores
Painful genital ulcers
Severe gingivostomatitis

60
Q

Most common cause of infective diarrhoea in pts with HIV
Microscopy

A

Crytptosporidium
Red cysts on Ziehl Neelsen

60
Q

Most common cause of infective diarrhoea in pts with HIV
Microscopy

A

Crytptosporidium
Red cysts on Ziehl Neelsen

61
Q

What is Kaposi’s sarcoma caused by?

A

HHV-8 (human herpes virus 8)

62
Q

What is Kaposi’s sarcoma caused by?

A

HHV-8 (human herpes virus 8)

63
Q

presents as purple papules or plaques on the skin or mucosa (e.g. gastrointestinal and respiratory tract)
skin lesions may later ulcerate
respiratory involvement may cause massive haemoptysis and pleural effusion
=

A

Kaposi’s sarcoma

64
Q

HIV mx

SE of NRTI

A

Start as soon as diagnosis has been made with x2 NRTI + PI/NNRTI

peripheral neuropathy

65
Q

Multiple ring or nodular enhancing lesions, SPECT negative =
Mx (2)

A

Toxoplasmosis
Sulfadiazine/ pyrimethamine

66
Q

Single or multiple homogenous enhancing lesions, SPECT +ve =
Associated with which virus?
Mx

A

CNS lymphoma
EBV
Steroids

67
Q

Most common fungal infection of CNS in HIV pt
CSF High opening pressure, India ink test positive
Focal neurological deficit

A

Cryptococcus

68
Q

symptoms, subacute onset : behavioural changes, speech, motor, visual impairment
CT: single or multiple lesions, no mass effect, don’t usually enhance. MRI is better - high-signal demyelinating white matter lesions are seen

A

Progressive multifocal leukoencephalopathy (PML)

69
Q

When should testing for HIV occur in an asymptomatic pt?

A

4 weeks after possible exposure then again at 12 weeks

70
Q

HPV vaccination is offered to (2)

A

12 and 13 year old girls and boys (2 doses)
Men who have sex with men <45yo

71
Q

Triad of sx for EBV/ glandular fever
Why should they avoid playing contact sports?

A

Sore throat, pyrexia, lymphadenopathy
Risk of splenic rupture

72
Q

Influenza vaccine children
Route
Age
Type of vaccine

Who needs two doses?
How effective in adults?

A

Intranasal
2-3yo
Live vaccine

Children aged 2-9 who have not received an influenza vaccine before
75% effective

73
Q

Air conditioning bacteria =

Other features (6)
Dx
Mx

A

Legionella

Dry cough
Relative bradycardia
Hyponaetraemia
Derranged LFTs
Pleural effusions
Lymphopenia

Urinary antigen
Erythro/ clarithro

74
Q

Haemolytic anaemia
ITP
Erythema multiforme
Myocarditis
= which bacteria causing pneumonia

A

Mycoplasma

75
Q

Sand flies
Crusted liesion at the site of bite
Underlying ulcer
Can spread to nose, pharynx =

A

Leishmaniasis

76
Q

Infected rat urine, sewage workers, farmers, vets, returning traveller =

Mx (2)

A

Leptospirosis

Benpen or doxy

77
Q

Spread by ticks = which condition
Typical rash
First line investigation

Mx (2)
If desseminated

A

Lyme disease
Bulls eye rash (erythema migrans)
ELISA antibodies

Mx doxy/ amoxi
Ceftriaxone

78
Q

Most common cause of non falciparum malaria (and location) =
Next most common and location

A

Vivax = Central America
Ovale = Africa

79
Q

Features of vivax/ovale versus malariae
Malariae is associated with ?

A

Cyclical fever every 48 hours versus 72 hours
Nephrotic syndrome

80
Q

Antimalarial of choice in pregnancy

A

Chloroquine

81
Q

Which anti-malarial can cause neuropsychiatric disturbance?
GI upset
CI in epilepsy
Oesophagitis/ photosensitivity

A

Mefloquine
Malarone
Chloroquine
Doxy

82
Q

Mx meningitis in GP
In hospital
If <3 months or >50yo add in
If caused by listeria give
Meningococcal meningitis

If pen allergic

A

IM benpen
IV cefotaxime
Amoxi
IV amoxi

IV benpen or cefotaxime

Chloramphenicol

83
Q

Prophylaxis of meningitis to close contacts =

A

Cipro

84
Q

Metronidazole does what to warfarin?
Avoid with

A

Increases anticoagulant effect
ETOH

85
Q

Live attenuated vaccines (7)

A

BCG
MMR
Influenza (intranasal)
PO rotavirus
PO polio
Yellow fever
PO typhoid

86
Q

When to send a urine culture?

A

> 65yo
Visible or non visible haematuria

87
Q

Nitro and trimethorpim in pregnancy

A

Nitro avoid near term
Trimethoprim avoid in first trimester (and throughout pregnancy)

88
Q

Active TB Mx

A

Rifampacin
Isoniazid
Pyrazinamide
Ethambutal

(2 months)

then R + I for a further 4 months

89
Q

Latent TB Mx

A

3 months of R + I
OR
6 months I

90
Q

SE x1 each
Rifampacin
Ison
Pyraz
Etham

A

R: orange secretions
I: peripheral neuropathy, agranulocytosis
P: gout
E: optic neuritis

91
Q

Disease spread by the tsetse fly
Features (3)
Mx

A

= sleeping sickness (African trypanosomiasis)

Painless subcutaneous nodule at site of infection
Intermittent fever
Enlargement of posterior cervical lymph nodes

Mx IV pentamidine or suramin

92
Q

What is Chagas disease?
Affects which which organs?
Mx

A

American tryponasomiasis
Heart and GI tract
Benznidazole

93
Q

Adverse effects of tetracyclines (4)

A

Discoloration of teeth (<12 years)
Photosensitivity
Angioedema
Black hairy tongue

94
Q

Tetanus vaccination
Patient has had a full course of tetanus vacc (x5) with the last dose <10 years =

Patient has had a full course of tetanus vaccines, with the last dose > 10 years ago
If tetanus prone wound:
High risk wounds:

If vaccination history is incomplete or unknown
All wounds
Tetanus prone and high risk

A

No vaccine, IG is needed

Vaccine
Vaccine + IG

Vaccine
Tetanus prone and high risk vaccine + IG

95
Q

Syphillis features
Primary (2)
Secondary (3)
Tertiary (3)

A

Chancre - painless ulcer
Local non tender lymphadenopathy

Systmic sx
Rash on trunk, palms and soles
Snail track ulcers (buccal)
Warty lesions on the genitalaia

Tertiary
Paralysis of the insane
Argyll Robertson
Granulomatous lesions (gummas)

96
Q

Congenital syphillis symptoms(4)

A

Hutchinson’s teeth
Rhagades
Saddle nose
Deafness

97
Q

SE of cotrimoxazole =

A

High K

97
Q

SI of cotrimoxazole =

A

High K

98
Q

diarrhoea
abdominal pain/bloating
papulovesicular lesions where the skin has been penetrated by infective larvae e.g. soles of feet and buttocks
larva currens: pruritic, linear, urticarial rash
if the larvae migrate to the lungs a pneumonitis similar to Loeffler’s syndrome may be triggered
=

Mx

A

strongyloides

Mx ivermectin and albendazole

99
Q

MRSA suppression =

A

Nose: mupirocin 2% in white soft paraffin TDS 5/7
Skin: chlorhexidine OD 5/7

99
Q

MRSA suppression =

A

Nose: mupirocin 2% in white soft paraffin TDS 5/7
Skin: chlorhexidine OD 5/7

100
Q

Complications of mumps (3)

A

Orchitis
Hearing loss
Pancreatitis

101
Q

Features of mycoplasma pneumonia
(3)

Dx (2)
Mx

A

Prolonged and gradual onset
Dry cough
Bilateral consolidation on CXR

serology
positive cold agglutination test

Mx doxy or erythro or clarithro

102
Q

Gram negative diploccoci
Purulent urethral discharge =

A

Gonococcal

103
Q

Unpasteurized eggs or milk + bloody diarrhoea =

A

Salmonella

104
Q

Rose red rash (slapped cheek syndrome)
Does not involve palms or soles
Warm bath, sunlight, heat or fever will trigger recurrence of the rash
=

School?

A

Parvovirus B19
Can still go to school

105
Q

CAP most common bacteria
COPD
After influenza infection
ETOH
Atypical

A

Strep pneum
H. influe
Staph A
Klebsiella
Mycoplasma

106
Q

rapid onset
high fever
pleuritic chest pain
herpes labialis (cold sores)
=

A

Strep pneum

107
Q

prodrome: headache, fever, agitation
hydrophobia: water-provoking muscle spasms
hypersalivation
Negri bodies: cytoplasmic inclusion bodies found in infected neurons
=

A

Rabies

108
Q

How do you manage a dog bite in at risk countries (3)

A

Clean wound
If immunised then give x2 further doses of vacc
If not then Human rabies IG + full course of vacc locally around the wound

109
Q

Name the pathogen
Bronchiolitis
Croup
Common cold
Flu
Common cause of pneumonia in HIV pts

A

RSV
Parainfluenza
Rhinovirus
Influenza
Jiroveci

110
Q

What is caused by togavirus?

A

Rubella

111
Q

prodrome, e.g. low-grade fever
rash: maculopapular, initially on the face before spreading to the whole body, usually fades by the 3-5 day
lymphadenopathy: suboccipital and postauricular
=

A

Rubella

112
Q

Swimmers itch + eosinophillia, cough, diarrhoea =

A

Schisto = parasitic worm
Acute

113
Q

frequency
haematuria
bladder calcification
swimmers itch

Mx

A

= chronic schisto

Mx PO praziquantel

114
Q

Vaccinations needed with splenectomy
Abx prophylaxis

A

Hib, men A&C
Annual influenza
5 yearly pneumococcal

Penicillin V

AKT (52 decks)

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