infectious diseases

Question 1

incubation period of malaria

Answer 1

1-4 wks

Question 2

IV Tx of mod-severe malaria

Answer 2

artensuate + quinine

Question 3

How to get a diagnosis of malaria

Answer 3

• malaria blood film (sent in EDTA bottle)
  3 samples over 3 days to catch in 48hr life cycle of the parasite

Question 4

whats the worst malaria

Answer 4

palmodium falciprum

Question 5

Malaria prophylaxis options

Answer 5

progunail and atovaquone
mefloquine
doxycycline

Question 6

Proguanil and atovaquone as malaria prophylaxis

Answer 6

AKA MALARONE
- Taken daily 2 days before, during and 1 week after being in endemic area
- Most expensive (around £1 per tablet)
- Best side effect profile

Question 7

Mefloquine as malaria prophylaxis

Answer 7

• Taken once weekly 2 weeks before, during and 4 weeks after being in endemic area
• Can cause bad dreams and rarely psychotic disorders or seizures

Question 8

Doxycycline as malaria prophylaxis

Answer 8

• Taken daily 2 days before, during and 4 weeks after being in endemic area
• Broad-spectrum antibiotic therefore it causes side effects like diarrhoea and thrush
• Makes patients sensitive to the sun causing a rash and sunburn

Question 9

MRSA carrier Tx

Answer 9

nose: mupirocin 2% in white soft paraffin, tds for 5 days

skin: chlorhexidine gluconate, od for 5 days. Apply all over but particularly to the axilla, groin and perineum

Question 10

how to MRSA screening

Answer 10

charcoal swabs
nasal swab and skin lesions or wounds
the swab should be wiped around the inside rim of a patient’s nose for 5 seconds
the microbiology form must be labelled ‘MRSA screen’

Question 11

who should be screened for MRSA

Answer 11

all elective and emergency admissions

Question 12

Ix for syphilis

Answer 12

(serological tests!!!)
NON TREPONMONAL TESTS
- not specific for syphilis, therefore may result in false positives
- based upon the reactivity of serum from infected patients to a cardiolipin-cholesterol-lecithin antigen
- assesses the quantity of antibodies being produced
- becomes negative after treatment
- examples include: rapid plasma reagin (RPR) and Venereal Disease Research Laboratory (VDRL)

TREPONMONAL SPEIFIC TESTS
- more complex and expensive but specific for syphilis
- qualitative only and are reported as ‘reactive’ or ‘non-reactive’
- examples include: TP-EIA (T. pallidum enzyme immunoassay), TPHA (T. pallidum HaemAgglutination test)