Infectious Diseases Flashcards
Glandula fever aka
Infectious mononucleosis
What organism causes infectious mononucleosis?
EBV aka HHV-4 (human herpesvirus 4)
What is the classic triad of infectious mononucleosis?
- Sore throat
- Fever
- Lymphadenopathy
What are the significant complications of infectious mononucleosis?
Splenomegaly- occurs in around 50% of patients and may rarely predispose to splenic rupture.
Hepatitis
How is glandula fever diagnosed?
Heterophil antibody test (Monospot test)- NICE guidelines suggest FBC and Monospot in the 2nd week of the illness to confirm a diagnosis of glandular fever.
Treatment for glandula fever:
Supportive Mangement:
- rest during the early stages, drink plenty of fluid, avoid alcohol
- simple analgesia for any aches or pains
- consensus guidance in the UK is to avoid playing contact sports for 4 weeks after having glandular fever to reduce the risk of splenic rupture
What types of HPV are associated with developing cervical cancer?
HPV 16 & 18
HPV 6 and 11 are associated with what?
HPV 6 and 11 are non-carcinogenic and associated with genital warts and laryngeal warts which can obstruct the airway.
How do endocervical cells infected with HPV change?
Develop into ‘koliocytes’
- enlarged nucleus
- irregular nuclear membrane contour
- the nucleus stains darker than normal (hyperchromasia)
- a perinuclear halo may be seen
Investigation for measles:
- 1st: measles specific IgM and IgG serology (ELISA) is most sensitive 3-14 days after onset of the rash
- 2nd: measles RNA detection by PCR best for swabs taken 1-3 days after rash onset
What chemoprophylaxis is given for meningococcal meningitis?
Ciprofloxacin
Most common complication following meningitis?
Sensorineural hearing loss
Retro-orbital headache, fever, facial flushing, rash, THROMBOCYTOPENIA in returning traveller → ?
Dengue Fever
Rash = maculopapular blanching erythema over the body which spares the palms and soles.
Treatment for meningitis <3months
IV CEFOTAXIME!! + IV Amoxicillin
Meningitis in children < 3 months: give IV amoxicillin in addition to cefotaxime to cover for Listeria.
Surface antigen(HBsAg)
active infection
E antigen(HBeAg)
marker of viral replication and implies high infectivity
Core antibodies(HBcAb)
implies past or current infection
Surface antibody(HBsAb)
implies vaccination or past or current infection
Hepatitis B virus DNA(HBV DNA)
this is a direct count of the viral load
Screening for hep b
- read well
When screening for hepatitis B, test HBcAb (for previous infection) and HBsAg (for active infection). If these are positive do further testing forHBeAg and viral load(HBV DNA).
How can HBcAb be interpreted?
HBcAb can help distinguish between acute, chronic and past infection. We can measure IgM and IgG versions of the HBcAb. IgM implies an active infection and will give a high titre with an acute infection and a low titre with a chronic infection. IgG indicates a past infection where the HBsAg is negative.
Commonest type of malaria
Falciparum malaria is the commonest type of malaria
Flu like illness → brief remission→ followed by jaundice and haematemesis
Yellow fever
