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4MB Medicine > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

Outline the criteria for SIRS

A 
2 or more of
Temperature above 38 or below 36
Heart rate above 90
Resp rate above 20 or PaCO2 below 32
WCC over 12k or below 4k
Hyperglycaemia in absence of diabetes
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2
Q

Define “sepsis”

A

Confirmed SIRS and suspected/present infection

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3
Q

Define “severe sepsis”

A

Sepsis with organ dysfunction

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4
Q

Give examples of evidence of organ dysfunction in severe sepsis

A 
Arterial hypoxaemia
Oliguria
Thrombocytopenia
Hypotension
Raised Cr
Raised lactate
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5
Q

Define “septic shock”

A 
Arterial hypotension (systolic below 90, mean below 65) for 1 hour despite fluid resuscitation
Lactate above 4
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6
Q

What is the definition of pyrexia of unknown origin?

A

Temperature above 38.3 for more than 3 weeks with no obvious cause

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7
Q

Suggest some causes of pyrexia of unknown origin

A 
CTD's (Marfan's, EDS)
Rheumatoid arthritis
PMR
Tumours
Drugs
PE
IBD
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8
Q

List some investigations you would do in pyrexia of unknown origin

A

FBC, U+E, albumin
Renal function
CXR
Immunology (antibodies)

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9
Q

What is nosocomial fever?

A

Temperature above 38 occurring 48h after hospital admission, usually as a result of environmental exposure or medical intervention

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10
Q

List causes of nosocomial fever

A 
Risk factors (alcoholism, CVD, faecal incontinence, ulcers, indwelling catheters, malignancy, procedures)
Infection (UTI, pneumonia, skin, prosthesis, AIDS)
Inflammation (vasculitis, aspiration, autoimmunity, drugs)
Ischaemia (MI, stroke, PE, bowel obstruction)
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11
Q

Which organisms cause malaria?

A

P vivax
P ovale
P malare
P falciparum

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12
Q

List some symptoms and signs of malaria

A 
Fever
Rigors
Headache
Dizziness
Jaundice
Flushed
Sweating for hours
Anaemia
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13
Q

How is malaria investigated?

A

Serial thin + thick blood film

FBC

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14
Q

Outline treatment for malaria

A

Chloroquine
Primaquine
Prophylaxis for travellers

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15
Q

Which organism causes typhoid? How is it spread?

A

Salmonella typhi

Faeco-oral

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16
Q

List some symptoms and signs of typhoid

A 
Malaise
High fever
Bradycardia
Cough
Constipation
Abdo pain
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17
Q

How is typhoid investigated?

A

Blood/bone marrow culture

LFT’s

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18
Q

Outline treatment for typhoid

A

Fluid replacement and nutrition

Ciprofloxacin, ceftriaxone

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19
Q

Which organism causes dysentry? How is it spread?

A

Shigella

Faeco-oral

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20
Q

List some symptoms and signs of dysentry

A 
Abdo pain
Bloody diarrhoea
Sudden fever
Headache
Neck stiffness
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21
Q

How is dysentry investigated?

A

Stool culture

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22
Q

Which organism causes cholera? How is it spread?

A

Vibrio cholerae

Faeco-oral

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23
Q

List symptoms and signs of cholera

A

Profuse “ricewater” stools
Fever
Vomiting
Rapid dehydration

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24
Q

How is cholera investigated?

A

Stool culture and microscopy

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25
Q

Outline treatment of cholera

A

Sachet rehydration
Erythromycin, ciprofloxacin
Barrier nursing

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26
Q

List some common signs of tropical infections and suggest diseases behind them

A 
Jaundice (hepatitis, liver abscess, yellow fever)
Diarrhoea, vomiting
Erythema nodosum (sarcoid, TB, Strep)
Itch (scabies)
Ulcers/nodules (leishmaniasis)
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27
Q 
Suggest sources of infection of the following organisms that cause gastroenteritis:
Staph aureus
Bacillus cereus
Salmonella
Clostridium perfringens
Campylobacter
Listeria
E. coli 0157
Cryptosporidium
A 
Staph aureus (meat)
Bacillus cereus (rice)
Salmonella (poultry, dairy)
Clostridium perfringens (meat)
Campylobacter (poultry)
Listeria (cheese)
E. coli 0157 (raw meet)
Cryptosporidium (cows)
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28
Q

Which of the hepatitis viruses are DNA and which are RNA?

A

A, C, D and E are RNA viruses

B is DNA virus

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29
Q

How is hepatitis A spread?

A

Faeco-oral
Travellers
Institutions (workplaces)

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30
Q

List some symptoms and signs of hepatitis A

A 
Fever
Jaundice
Malaise
Arthralgia
Anorexia
Nausea
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31
Q

What are the notable investigation results for hepatitis A?

A

Raised AST and ALT

IgM/IgG antibody

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32
Q

Outline treatment for hepatitis A

A

Supportive
Avoid alcohol
Interferon-alpha

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33
Q

How is hepatitis B spread?

A

Blood products
IV drug use
Sex
Haemophiliacs

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34
Q

List some symptoms and signs of hepatitis B

A 
Fever
Jaundice
Malaise
Arthralgia
Anorexia
Nausea
Extrahepatic features
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35
Q

What are the notable investigation results for hepatitis B?

A

Hep B S Ag

Hep B e Ag

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36
Q

Outline treatment for hepatitis B

A

Vaccination
Avoid alcohol
Peg-interferon
Antivirals

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37
Q

How is hepatitis C spread?

A

Blood transfusions
IV drug use
Sex

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38
Q

List symptoms and signs of hepatitis C

A

Mild/asymptomatic compared to hep A and B

May develop cirrhosis

39
Q

What are the notable investigation results for hepatitis C?

A

Deranged LFT’s
Anti Hep C virus antibody
PCR
Positive liver biopsy

40
Q

Outline treatment of hepatitis C

A

Ribavirin

Peg-interferon

41
Q

How is Giardia spread?

A 
Faeco-oral
Travel
Anal sex
Playgroups
Swimming
Pets, animals
Contaminated water
42
Q

List symptoms and signs of Giardia infection

A 
Bloating
Flatulence
Abdo pain
Loose stools
Explosive diarrhoea
Malabsorption
Loss of weight
43
Q

How is Giardia investigated?

A

Direct fluorescent antibody assay
Repeated stool microscopy
Duodenal fluid analysis

44
Q

Outline treatment of Giardia

A

Good hygiene
Tinidazole
Avoid alcohol and milk

45
Q

Which organism causes tetanus?

A

Clostridium tetanii

46
Q

How is tetanus spread?

A

Spores in faeces, soil, dust, instruments
Diabetics have increased risk
Recent wounds/skin breaks

47
Q

List symptoms and signs of tetanus

A 
May appear 1 day to several months after injury
Fever
Malaise
Headache
Trismus
Grin-like posture
Spasms
Autonomic upset
Arched body
48
Q

How is tetanus treated?

A 
ABCDE approach, may need intubation/tracheostomy
Human tetanus Ig IV
Diazepam for spasms
Metronidazole, benzylpenicillin
Active vaccination, wound cleansing
49
Q

List common infections caused by Staphylococci

A

Pneumonia
Endocarditis
Septic arthritis
Osteomyelitis

50
Q

List common infections caused by Streptococci

A 
Wound and skin infections
Necrotising fasciitis
Pneumonia
Glomerulonephritis
Tonsillitis
Meningitis
51
Q

List common infections caused by Clostridia

A

Tetanus
Gas gangrene
Colitis
Paralysis

52
Q

Which strain of herpes virus is usually associated with genital herpes?

A

HSV-2

53
Q

List symptoms and signs of genital herpes

A

Flu-like ilness
Grouped vesicles/papules around groin and throat
Shallow ulcers

54
Q

How is genital herpes investigated?

A

Viral swab of penetrated ulcer for PCR

55
Q

Which strain of herpes virus is usually associated with encephalitis?

A

HSV-1

56
Q

Which part of the brain does herpes virus typically affect?

A

Frontal and temporal lobes

57
Q

List symptoms and signs of herpes encephalitis

A 
Fever
Fits
Headache
Odd behaviour
Dysphasia
Hemiparesis
58
Q

How is herpes encephalitis investigated?

A

CSF PCR (may be positive up to 5 days after treatment)
CT/MRI/EEG
Antibody titre

59
Q

Which strain of herpes causes chickenpox and shingles?

A

Varicella zoster

60
Q

List symptom and signs of chickenpox and shingles

A 
Contagious febrile illness
Crops of blisters that scab after days
Pain in dermatomal distribution
Fever
Malaise
61
Q

What is the general treatment for herpes virus infections?

A

Aciclovir

Paracetamol

62
Q

What is infectious mononucleosis and which organism causes it?

A

Glandular fever caused by EBV

Attacks B-cells and causes proliferation of cytotoxic T-cells

63
Q

How is infectious mononucleosis transmitted?

A

Kissing

Saliva, droplet spread

64
Q

List symptoms and signs of infectious mononucleosis

A 
Sore throat
Fever
Malaise
Lymphadenopathy
Palatal petechiae
Splenomegaly
65
Q

What are some complications of infectious mononucleosis?

A 
Meningitis, encephalitis
CN lesions (esp. VII)
Neuropathy
Thrombocytopenia
Splenic rupture
66
Q

What investigations are done for infectious mononucleosis?

A 
Blood film (lymphocytosis, atypical lymphocytes)
Monospot antibody test shoes heterophilic antibodies
67
Q

What diseases/conditions can give a false +ve Monospot antibody test?

A 
Hepatitis
Parovirus
Lymphoma
Leukaemia
Pancreatic cancer
68
Q

How is infectious mononucleosis treated?

A

Avoid alcohol
Steroid if very swollen
NEVER AMOXICILLIN

69
Q

When does CMV typically infect? How is it spread?

A

After acute infections

Spread by direct contact esp in health workplaces, blood transfusions, organ transplants

70
Q

List signs and symptoms of CMV infection

A 
Fever
Pneumonitis
Hepatitis
Retinitis
Jaundice
Hepatosplenomegaly
71
Q

How is CMV investigated?

A

Serology (IgM if acute)

PCR of blood/CSF/broncho lavage

72
Q

Outline treatment for CMV

A

Rest and fluids
Ganciclovir IV if serious
Weekly PCR post-transplantation

73
Q

List symptoms and signs of tuberculosis infection

A 
Malaise
Weight loss
Night sweats
Haemoptysis
Pleurisy
Genitourinary disturbance (loin pain, dysuria)
Vertebral collapse
Meningitis
74
Q

How is TB investigated?

A

Latent TB: Mantoux test, IFN-gamma test
Active TB: CXR, sputum microscopy for acid-fast bacilli on ZN staining
Bronchoscopy + lavage if no sputum production

75
Q

List TB investigations in order of fastest to slowest

A

PCR
ZN stain
Culture

76
Q

Outline treatment regime for pulmonary TB

A

RIPE: Rifampicin, Isoniazide, Pyrazinamide, Ethambutol
2 months RIPE, 4 months RI
Monitor renal and liver function

77
Q

Outline treatment regime for CNS TB

A

RIPE: Rifampicin, Isoniazide, Pyrazinamide, Ethambutol
2 months RIPE, 10 months RI
Monitor renal and liver function

78
Q

What are the notable side effects of rifampicin?

A

Hepatitis
Orange secretions
Inactivates OCP

79
Q

What are the notable side effects of isoniazide?

A

Hepatitis
Neuropathy
Agranulocytosis

80
Q

What are the notable side effects of pyrazinamide?

A

Hepatitis
Arthralgia
Gout
Porphyrias

81
Q

What are the notable side effects of ethambutol?

A

Hepatitis

Colour blindness

82
Q

How is influenza investigated?

A

Nasopharyngeal swab for culture/PCR

Serology

83
Q

How is toxoplasma gondii spread?

A

Poorly cooked meat
Animals (esp cats)
Soil, faecal contact (cat litter)

84
Q

List symptoms and signs of toxoplasmosis

A

Sore throat/glandular fever
Eye pain
Focal neurology if serious

85
Q

How is toxoplasmosis investigated?

A

Antibody titre (IgM specific)
PCR
Lymph node and CNS biopsy
CT scan shows ringed lesions

86
Q

Outline toxoplasmosis treatment

A

Self-limiting
Pyrimethanine + sulfadiazine
Cook food properly, good hygiene

87
Q

What type of virus is HIV? How is it spread?

A

RNA retrovirus that attacks and depletes CD4 cells
Spread via sexual contact, infected blood products and IV drug abuse
Also perinatal spread risk

88
Q

List symptoms and signs of HIV infection

A 
Acutely may be asymptomatic with transient illness (fever, malaise, rash, myalgia)
Persistent generalised lymphadenopathy
Night sweats
Fever
Diarrhoea
Weight loss
Opportunistic infections
89
Q

List some opportunistic infections that may occur due to HIV

A 
Oral candidiasis
Herpes
Seborrhoeic dermatitis
Leukoencephalopathy
PCP
Toxoplasmosis
Meningitis
Tuberculosis
90
Q

Outline investigations done for HIV

A 
Serum/salivary HIV antibody (ELISA)
PCR or core p24 antigen in plasma
CD4 count
Home kit testing
Monitor U+E, Cr, Br
Pregnancy test
91
Q

How can HIV be prevented?

A

Safe sex (condoms)
Screen high risk groups
Educate drug users
Control STI’s

92
Q

Outline post-exposure prophylaxis for HIV

A

Wash well
Report to occupational health
Hep B immunosation
Follow up testing at 12 and 24 weeks

93
Q

What therapy is used for HIV?

A

HAART (NNRTi + 2x NRTi)

e.g. efavirenz + zidovudine/emtricatibine/tenofivir/lamivudine

4MB Medicine (19 decks)

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