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infectious diseases Flashcards

1
Q

gingivostomatitis in herpes infection can be treated with

A

oral acyclovir
chlorhexidine mouthwash

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2
Q

during pregnancy, when is herpes risky

A

primary attack of herpes in third trimester - after 28 weeks gestation

needs elective c-section

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3
Q

For patients with suspected Lyme disease, If the ELISA is positive or equivocal, what is the next step

A

Immunoblot test

Abx can be prescribed while awaiting the Immunoblot result

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4
Q

Lyme disease is what pathogen

A

Borrelia burgdorferi

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5
Q

What rash is seen in lyme disease

A

erythema migrans

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6
Q

If erythema migrans rash is present for Lyme disease then you can start what treatment

A

Doxycycline for 21 days

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7
Q

What is the first-line test for Lyme disease

A

ELISA test

assay for antibodies to Borrelia burgdoferi

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8
Q

The ELISA test is the first-line test for Lyme disease. If this is negative, and Lyme disease is still suspected within 4 weeks, what should you do next

A

Repeat ELISA 4-6 weeks after the first

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9
Q

The ELISA test is the first-line test for Lyme disease. If this is negative, and Lyme disease is still suspected for 12 weeks or more, what should you do next

A

Immunoblot test

(4-6 weeks - repeat ELISA)

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10
Q

What treatment is given for disseminated lyme disease

A

ceftriaxone

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11
Q

Eron classification is used for cellulitis. What management is used for Stage 1-4

A

1: oral Abx
2: unwell with comorbidity. May not need admission if community IV Abx and monitoring can happen.
3-4: need admission for IV Abx i.e. periorbital

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12
Q

Genital wart treatment for multiple, non-keratinised warts

A

topical podophyllum

2nd line = imiquimod

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13
Q

For adults with mild facial cellulitis, prescribe …?

A

co-amoxiclav 7 days

(or clarithro if pen allergic)

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14
Q

Genital wart treatment for solitary, keratinised warts

A

cryotherapy

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15
Q

Genital warts (aka condylomata accuminata) are caused by which HPV

A

HPV 6 and 11

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16
Q

Pathogen of bacterial vaginosis

A

Gardnerella vaginalis

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17
Q

Amsel’s criteria for bacterial vaginosis. 3 out of the 4 following points must be present:

A
  1. Thin, white homogenous discharge
  2. Clue cells on MC&S
  3. Vaginal pH >4.5
  4. Whiff test +ve
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18
Q

MC&S slide shows:
Clue cells, stippled vaginal epithelial cells

what is diagnosis

A

bacterial vaginosis

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19
Q

Asymptomatic bacterial vaginosis Rx

A

NOT required
Incidental swab findings
ONLY treat if woman is having a TOP

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20
Q

Symptomatic bacterial vaginosis Rx

A

Oral metronidazole for 5-7 days

OR
single dose of 2g metronidazole

(can also use topical metronidazole or clindamycin as alternatives)

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21
Q

Bacterial vaginosis in pregnancy - symptomatic treatment

A

Oral metronidazole for 5-7 days or topical treatment

The stat 2g dose is not recommended

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22
Q

Both the National Chlamydia Screening Programme and SIGN guidelines support the screening of asymptomatic patients for Chlamydia. Which age group should be targeted?

A

Sexually active patients aged 15-24

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23
Q

Investigation of chice for chlamydia

A

NAAT technique:
Men - 1st pass urine
Women - vulvovaginal swab or cervical swab

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24
Q

When should chlamydia testing be carried out after possible exposure

A

2 weeks

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25
Q

Treatment of chlamydia

A

doxycycline 7 day

If contraindicated/not tolerated: azithromycin 1g OD for one day then 500mg OD for 2 days

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26
Q

If a patient with chlamydia is pregnant what are the antibiotic options

A

Azithromycin
Erythromycin
Or Amoxicillin

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27
Q

For patients with chlamydia, they should contact all partners since what timeframe:
(a) men with urethral symptoms
(b) women and asymptomatic men

A

(a) men with urethral symptoms - 4 weeks before symptoms
(b) women and asymptomatic men - partners from 6 months, or the most recent sexual partner

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28
Q

What is the most common cause of diarrhoea in patients with HIV infection

A

Cryptosporidium

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29
Q

For patients with gonorrhoea, if the patient refuses IM ceftriaxone, what is the alternative oral treatment

A

oral cefixime 400mg + oral azithromycin 2g

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30
Q

First line treatment for gonorrhoea

A

IM ceftriaxone 1g

+/- oral ciprofloxacin 500mg if sensitivities are known

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31
Q

Most common pathogen cause of septic arthritis in young adults

A

Neisseria gonorrhoea

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32
Q

3 key features of disseminated gonococcal infection

A

Tendosynovitis
Migratory polyarthritis
Dermatitis (lesions can be maculopapular or vesicular)

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33
Q

Haematological complication of mycoplasma pneumoniae

A

Cold agglutins (IgM) can cause a haemolytic anaemia
Thrombocytopenia

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34
Q

What rashes are seen with mycoplasma pneumoniae

A

erythema multiforme

(erythema nodosum too)

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35
Q

Investigations to diagnose mycoplasma pneumoniae

A

Mycoplasma serology

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36
Q

Management for mycoplasma pneumoniae

A

doxycycline

or macrolide (erythro/clarithro)

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37
Q

EBV associated malignancies:

A

Burkitt’s lymphoma
Hodgkin’s lymphoma
Nasopharyngeal carcinoma

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38
Q

The non-malignant condition hairy leukoplakia is associated with which viral infection

A

EBV

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39
Q

Treatment of erysipelas

A

Fluclocloxacillin

(clarithro if pen allergic)

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40
Q

What is the pathogen that usually causes erysipelas (superficial infection of the dermis)

A

B-haemolytic group A strep

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41
Q

2 commonest pathogen causes of cellulitis

A
  1. Strep pyogenes
  2. Staph aureus
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42
Q

HIV seroconversion (flu-like illness) typically occurs after how long post-infection

A

3-12 weeks after

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43
Q

Legionella investigation

A

Urinary antigen

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44
Q

Management of legionella

A

Erythromycin or clarithromycin

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45
Q

What are the three types of Leishmaniasis

A
  1. Cutaneous
  2. Mucocutaneous
  3. Visceral (kala-azar)
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46
Q

Cutaneous leishmaniasis presents with…

A

ulcers
crusted lesion at site of the bite
Dx = punch biopsy

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47
Q

What is cutaneous leishmaniasis caused by

A

Leishmania tropica or maxicana

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48
Q

Mucocutaneous leishmaniasis is caused by…

A

Leishmania braziliensis

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49
Q

Visceral leishmaniasis (kala-azar) is caused by…

A

Leishmania donovani

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50
Q

Visceral leishmaniasis (kala-azar) caused by Leishmania donovani presents with..

A

Fevers, rigors
Splenomegaly
Hepatomegaly
Weight loss
Grey skin
Pancytopenia

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51
Q

What is the gold standard test for diagnosis of visceral leishmaniasis (Leishmania donovani)

A

Bone marrow or splenic aspirate

n.b. in cutaneous leishmaniasis, punch biopsy of bite/crusting ulcer can be done

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52
Q

Which HPV strains are linked to cancers

A

16, 18, 33

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53
Q

HPV vaccines are offered to

A

All 12-13 year olds
MSM under 45

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54
Q

First line pregnant woman UTI symptomatic treatment

A

Nitrofurantoin 7 days
(avoid near term)

(Avoid trimethoprim in 1st trimester)

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55
Q

Asyptomatic bacteriuria (UTI) in pregnant women are still treated with antibiotics - what length of course

A

7 days

Nitro (avoid near term), amoxi or cefalexin

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56
Q

Men are treated with a course of UTI antibiotics for what time frame

A

7 days

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57
Q

If a patient who is catheterised has a UTI, what length of Abx course is given?

A

7 days

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58
Q

A patient with acute pyelonephritis should be given broad-spectrum cephalosporin or a quinolone (for non-pregnant women) for how long

A

10-14 days

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59
Q

What is the latest time that HIV post-exposure prophylaxis may be given?

A

72 hours post exposure event

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60
Q

Trichomonas vaginalis - treat with…

A

Oral metronidazole for 5-7 days
(or one-off dose of 2g metronidazole)

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61
Q

microscopy of a wet mount for trichomonas vaginalis shows…

A

motile trophozoites

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62
Q

what is the typical temperature (C) range that the vaccines need to be stored at?

A

2-8 degrees celsius

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63
Q

what pathogen causes croup

A

parainfluenza virus

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64
Q

Travelled to India
Went swimming
Non-bloody diarrhoea
Long incubation period
Bloating
Trophozoite and cysts MC&S

What is likely organism

A

Giardiasis

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65
Q

What is the treatment for giardiasis

A

Metronidazole

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66
Q

Flu-like symptoms
RUQ pain
Tender hepatomegaly
Raised BR
Raised ALT/AST
Normal/slightly raised ALP

what is likely condition

A

Hepatitis

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67
Q

transmission of hepatitis A

A

faecal-oral route

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68
Q

Hep C and D transmission

A

Blood-borne

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69
Q

Hepatitis D only occurs in people who are also infected with

A

Hepatitis B

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70
Q

Which hepatitis do people usually make a full recovery

A

Hepatitis A

85% of people with hep A recover within 3-6 months. There is no chronic liver disease.

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71
Q

Painless penile ulcers are usually caused by

A

syphilis

i.e. treponema pallidum

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72
Q

incubation period of syphilis

A

9-90 days

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73
Q

chancre - painless ulcer is seen in which STI

A

syphilis
(treponema pallidum)

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74
Q

primary features of syphilis

A

chancre
local non-tender lymphadenopathy

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75
Q

secondary features of syphilis (6-10 weeks after primary infection)

A

systemic: fevers
rashes on trunk, palms, soles
buccal snail track ulcers
condylomata lata

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76
Q

tertiary features of syphilis

A

gummas - granulomatous lesions of skin and bones
Argyll-Robertson pupil
tabes dorsalis
aortic aneurysms

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77
Q

What eye pupil condition is seen in tertiary syphilis

A

Argyll-Robertson pupil

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78
Q

blunted upper incisor teeth (Hutchinson’s teeth)
‘mulberry’ molars
rhagades (linear scars at the angle of the mouth)
keratitis
saber shins
saddle nose
deafness

these are seen in which congenital condition

A

congenital syphilis

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79
Q

what transmission is hepatitis E

A

faecal-oral spread

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80
Q

what hepatitis infections are spread via faecal oral route

A

hepatitis A
hepatitis E

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81
Q

what are the tests used for diagnosis and screening of HIV

A

combination tests
(HIV p24 antigen and HIV antibody)

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82
Q

Needlestick injury from HIV positive patient - what is the chance of contracting HIV

A

0.3%

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83
Q

Campylobacter is what type of pathogen

A

Gram negative bacillus

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84
Q

First-line antibiotic for severe campylobacter

A

Clarithromycin

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85
Q

for contacts of patients (within 7 days before onset) with bacterial meningococcal meningitis, what medications can be used

A

oral ciprofloxacin (single dose) or rifampicin

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86
Q

If meningococcal disease is suspected then what medication should be given immediately

A

IM benzylpenicillin

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87
Q

IV antibiotics to treat meningitis (with delayed LP) for patients aged 3 months to 50 years

A

Cefotaxime (or ceftriaxone)

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88
Q

IV antibiotics to treat meningitis (with delayed LP) for patients aged over 50 years

A

Cefotaxime (or ceftriaxone)
And amoxicillin (or ampicillin)

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89
Q

sore throat, fever, a fine red rash over the entire body, flushed face with sparing around the mouth, and ‘strawberry tongue’

what is the diagnosis

A

scarlet fever
(group A strep)

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90
Q

what is scarlet fever treated with

A

10 day course of penicillin (or erythromycin if allergic)

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91
Q

A 44-year-old farmer presents with headache, fever and muscle aches. He initially thought he had a bad cold but his symptoms have got progressively worse over the past week. During the review of systems he reports nausea and a decreased urine output. On examination his temperature is 38.2ºC, pulse 102 / min and his chest is clear. Subconjunctival haemorrhages are noted but there is no evidence of jaundice. What is the most likely diagnosis?

A

Leptospirosis

92
Q

What are investigations for leptospirosis

A

Serology - antibodies develop after 7 days
PCR
Culture

93
Q

Management of leptospirosis

A

High dose benzylpenicillin
Or doxycycline

94
Q

unilateral painful ulcer, painful inguinal lymph node enlargement
ragged, undermined border

what is the diagnosis

A

chancroid
caused by haemophilus ducreyi

95
Q

Pregnant women who have travelled to a Zika virus area are referred immediately to secondary care for what investigations

A

regular ultrasound of the foetus

96
Q

Which 2 malaria prophylaxis medications are contraindicated in epilepsy

A

Chloroquine
Mefloquine (Larium)

97
Q

5 options for malaria prophylaxis

A
  1. Atovaquone + proguanil (Malarone)
  2. Chloroquine
  3. Doxycycline
  4. Mefloquine (Lariam)
  5. Proguanil
  6. Proguanil + chloroquine
98
Q

What malaria prophylaxis can pregnant women have

A

Chloroquine
Proguanil - with folate supplementation

99
Q

diethyltoluamide (DEET) 20-50% has been shown to repel up to 100% of mosquitoes if used correctly. It can be used in children over how old

A

2 months

100
Q

doxycycline is only licensed in the UK for children over the age of…

A

12 years

101
Q

Genital ulcers
painful

what two ddx

A

Herpes
Chancroid (unilateral)

102
Q

Genital ulcers
painless

what two ddx

A

syphilis
lymphogranuloma venereum

103
Q

treatment for initial herpes infection

A

acyclovir for 7-10 days

104
Q

infectious mononucleosis (glandular fever) is caused by EBV - which HHV virus is this

A

HHV-4

(can also be caused by CMV and HHV-6)

105
Q

Triad of infectious mononucleosis (glandular fever)

A

Sore throat
Fever
Lymphadenopathy

106
Q

Diagnosis of infectious mononucleosis (glandular fever) - what tests should be done in the 2nd week of illness

A

Heterophil antibody test (Monospot test)

+ FBC

107
Q

Management of glandular fever (infectious mononucleosis)

A

Rest
Analgesia
Avoid contact sports for 4 weeks

108
Q

which antimalarials can be stopped 7 days after returning from a malarial zone

A

atovaqone + proguanil (malarone)

109
Q

A 40-year-old man develops pneumonia following an episode of influenza. what is the likely causative organism

A

Staph aureus

110
Q

The most common pathogen causing pyelonephritis is

A

E. coli

111
Q

Investigation for acute pyelonephritis

A

MSU
before starting Abx

112
Q

What swabs for chlamydia and gonorrhoea in women should be taken

A

vulvo-vaginal (introitus) swab

113
Q

antibiotic of choice for cellulitis in pregnancy if the patient is penicillin allergic

A

Erythromycin
NOT clari

114
Q

Management of salmonella

A

Ciprofloxacin

115
Q

UTIs in pregnancy - what should be done following completion of Abx to test for cure

A

Repeat urine culture

116
Q

Responders with anti-HBs levels greater than or equal to what level do not require any further primary doses?

A

100

117
Q

Responders with antiHBs levels of what range should receive one additional dose of vaccine at that time.

A

10-100

(over 100 do not need more doses)

118
Q

When antibody levels for anti-HBs response to Hep B vaccine are <10 (i.e. non-response to vaccine), what should be done

A

Test for current/past infection
Repeat vaccine course
Retest 1-2 months after second course

119
Q

What percentage of patients with genital Chlamydia infection are asymptomatic?

A

70% women
50% men

120
Q

annual flu and pneumococcal (one-off) vaccine is recommended for ages above what

A

65 years

121
Q

What condition are there Negri bodies (cytoplasmic inclusion bodies) found in infected neurons

A

Rabies

122
Q

Following an animal bite in at-risk rabies countries what steps should be taken?

A
  1. Wash wound
  2. If patient is already immunised, then further 2 doses of vaccine should be given
  3. If not previously immunised, give human rabies Ig (HRIG) with full course of vaccination
  4. +/- Abx
123
Q

Women who suffer regular urinary tract infection following sexual intercourse can be offered

A

single dose use post-coital Abx prophylaxis

124
Q

cochlear implant she is at risk of what infections

A

pneumococcal

therefore now eligible for the vaccine

125
Q

what type of vaccine is the intranasal influenza vaccine

A

live vaccine

126
Q

What is the most appropriate type of chemical to clean up body fluid spillage e.g. vomit

A

hypochlorite

(chlorine in oxidation state +1)
granular/powder form

or Virkon in some NHS trusts

127
Q

Testing for HIV in asymptomatic patients should be done at what time frame after exposure

A

4 and 12 weeks after

(for antibodies and p24 antigen)

128
Q

Post-exposure prophylaxis for HIV

A

Oral antiretroviral therapy for 4 weeks

129
Q

Mumps is caused by

A

RNA paramyxovirus

occurs inwinter and spring

130
Q

fever
malaise, muscular pain
parotitis (‘earache’, ‘pain on eating’): unilateral initially then becomes bilateral in 70%

what is the condition

A

mumps!

131
Q

what is the management for mumps

A

rest
analgesia
notifiable disease

132
Q

what are 4 complications of mumps

A

orchitis
hearing loss - unilateral, transient
meningoencephalitis
pancreatitis

133
Q

microscopy shows flagellated protozoa

discharge

what is the condition

A

trichomonas vaginalis

134
Q

what is the treatment for pubic lice

A

malathion lotion or permethrin cream

apply and then wash off after 12 hours
reapply 7 days again

135
Q

infective exacerbation of COPD treatment

A

amoxicillin or tetracycline or clarithromycin

136
Q

how many injections does the HPV vaccine require

A

2 injections

137
Q

pneumococcal vaccine is usually a one-off but every 5 years a booster is given if the patient has…

A

splenectomy
or chronic kidney disease

138
Q

in the UK, how many doses of the tetanus vaccine are given over the course of routine immunisation schedule

A

5 doses

139
Q

which pathogen causing diarrhoea has shortest incubation period

A

bacillus cereus

approx 6-15hrs

(also staph aureus)

140
Q

pregnant women are advised to have what vaccine from weeks 16-32

A

whooping cough (pertussis) vaccine

141
Q

all at risk drug misusers should be offered vaccination against

A

hepatitis B

142
Q

BCG live attenuated vaccine is what bacteria

A

Mycobacterium bovis

143
Q

any person being considered for the BCG vaccine must first be given

A

tuberculin skin test i.e. Heaf or Mantoux
(intradermal)

144
Q

5 contraindications to BCG vaccine

A

Previous BCG vaccine
Past history of TB
HIV
Pregnancy
Positive tuberculin test

145
Q

BCG is not given to anyone over the age…

A

35

146
Q

what hepatitis is curable

A

hep C

147
Q

painless genital ulcer and painful lymphadenopathy

A

lymphogranuloma venereum

148
Q

Lymphogranuloma venereum usually involves three stages:

A
  1. painless ulcer
  2. painful lymphadenopathy
  3. proctocolitis
149
Q

preventing the spread of norovirus - handwashing should be done with what

A

soaps + warm water

alcohol gels are less effective

150
Q

what is the treatment for extensive otitis externa

A

flucloxacillin

151
Q

what is the triple Abx treatment for pelvic inflammatory disease

A

doxycycline
metronidazole
ceftriaxone

152
Q

can patients have HPV against parental wishes when they are a child

A

yes

153
Q

What is the most likely complication from repeated infection of gonorrhoea in women

A

infertility
secondary to pelvic inflammatory disease

154
Q

Lymphogranuloma venereum (painless ulcer, painful lymphadenopathy) is caused by what pathogen

A

chlamydia trachomatis

155
Q

suppression of MRSA from a carrier once identified - treatment for nose and skin

A

Nasal mupirocin + chlorhexidine for the skin

156
Q

Live attenuated vaccines (seven)

A

BCG
MMR
Influenza (intranasal)
oral rotavirus
oral polio
yellow fever
oral typhoid

157
Q

Inactivated preparation vaccines (three)

A

rabies
hepatitis A
influenza (intramuscular)

158
Q

Toxoid (inactivated toxins) vaccines (three)

A

tetanus
diphtheria
pertussis

159
Q

Subunit and conjugate vaccines (five)

A

pneumococcus (conjugate)
haemophilus (conjugate)
meningococcus (conjugate)
hepatitis B
HPV

160
Q

Retro-orbital headache, fever, facial flushing, rash, thrombocytopenia in returning traveller

what is a differential

A

dengue

161
Q

raised eosinophils tend to be seen in which tropical viral infection

A

Chagas disease

162
Q

Dengue fever is a RNA virus of Flavivirus. What is it transmitted by

A

Aedes aegypti mosquito

163
Q

Severe dengue haemorrhagic fever can result in disseminated intravascular coagulation (DIC) which results in..

A

Thrombocytopenia
Bleeding

High d-dimer
High PT, APPT
Low fibrinogen

164
Q

Dengue fever treatment

A

Symptomatic
No antivirals are available

165
Q

treatment for shigella and salmonella

A

ciprofloxacin

166
Q

lactose intolerance can develop after which GI infection

A

Giardiasis

167
Q

Patient has had a full course of tetanus vaccines, with the last dose < 10 years ago with wound

what management

A

no vaccine nor tetanus immunoglobulin is required, regardless of the wound severity

168
Q

Patient has had a full course of tetanus vaccines, with the last dose > 10 years ago with:
(a) tetanus prone wound
(b) high risk tetanus prone heavy contaminated wound

A

(a) vaccine dose
(b) vaccine dose + tetanus Ig

169
Q

Patient with vaccination history is incomplete or unknown for tetanus with wound:

A

Vaccine dose
Tetanus Ig

170
Q

if person who is not vaccinated against hep B gets a needlestick from hep B patient, how should they be treated

A

accelerated course of hep B vaccine
and hep B immunoglobulin

171
Q

what vaccines do CKD5 patients require

A

Pneumococcal - every 5 years
Influenza - every year
Hep B

172
Q

For a patient undergoing an elective splenectomy, when is the optimal time to give the pneumococcal vaccine?

A

2 weeks before

173
Q

Within what time frame does Public Health England state you must submit a Notifiable Diseases form?

A

72 hours

174
Q

A patient who was an intravenous drug user in the 1990s asks for a hepatitis C test. What is the most appropriate blood test?

A

Anti-HCV antibody test

175
Q

The majority of malaria cases are caused by

A

plasmodium falciparum

(commonest non-falciparum malaria is plasmodium vivax)

176
Q

Which test is used to confirm the diagnosis for brucellosis?

A

brucella serology

detects antibodies against brucella antigens

177
Q

The most common side effect of atovaquone/proguanil is

A

GI upset

178
Q

what is the pH in trichomonas vaginalis and bacterial vaginosis

A

pH >4.5

179
Q

Children aged 6 months to 2 years who are at high risk of flu are offered …

A

annual INTRAMUSCULAR flu vaccination

180
Q

live intraNASAL influenza vaccine is offered to kids aged from

A

2 years

before that is intramuscular

181
Q

grey coating on tonsils
fever
cervical lymphadenopathy

what is likely condition

A

diptheria

182
Q

how long does a child with erythema infectiosum i.e. fifth disease (slapped cheek syndrome) need to be excluded from school for

A

no exclusion

183
Q

what virus causes erythema infectiosum (fifth disease or slapped cheek syndrome)

A

parvovirus B19

184
Q

patients becoming pregnant should avoid becoming pregnant while in an area with Zika virus and for how long after their return

A

2 months
(3 months if male partner went too)

185
Q

what should be checked before starting ethambutol

A

visual acuity

186
Q

what is the most common Bacterial cause of otitis externa

A

Pseudomonas aeruginosa

187
Q

An 8-year-old boy is brought in by his mother with a history of shortness of breath and fever over the last few hours. On examination, he has a toxic appearance, has inspiratory stridor, and is drooling.
what is the likely cause?

A

ACUTE EPIGLOTTITIS

caused by HiB

188
Q

what is the most common resp infection in COPD

A

Haemophilus influenzae

189
Q

Stat IM benzylpenicillin doses for:
0-1 years
1-10 years
>10 years

A

Start at 3 and double each time!
0-1 years: 300mg
1-10 years: 600mg
>10 years: 1200mg

190
Q

patients with ovale or vivax malaria should be given primaquine following acute treatment with chloroquine. what is the benefit of the primaquine?

A

Primaquine in non-falciparum malaria destroys liver hypnozoites and prevent relapse

191
Q

Plasmodium vivax/ovale has a cyclical fever of how long

A

every 48 hours

192
Q

Plasmodium malariae has a cyclical fever of how long

A

every 72 hours

193
Q

Areas that are known to have malaria that is chloroquine-sensitive, WHO recommend either…

A

chloroquine; or
artemisin-based combination therapy (ACT)

194
Q

Areas that are known to have malaria that is chloroquine-RESISTANT, WHO recommends…

A

artemisin-based combination therapy (ACT)

CONTRAINIDICATED IN PREGNANCY

195
Q

which type of pneumococcal vaccine should adults receive:

polysaccharide or conjugate vaccine

A

pneumococcal POLYSACCHARIDE vaccine

for over 65 years, chronic conditions

196
Q

which type of pneumococcal vaccine should children receive:

polysaccharide or conjugate vaccine

A

Pneumococcal conjugate vaccine

at 3, and 12-13 months

197
Q

bacterial pneumonias secondary to influenza infection are more commonly caused by…

A

staph aureus

198
Q

Triad of Behcet’s disease

A

Oral ulcers
Genital ulcers
Uveitis

+ clots

199
Q

Is tuberculosis a notifiable disease

A

yes

200
Q

What is the most effective single step to reduce the incidence of MRSA?

A

hand hygiene

201
Q

Who should be screened for MRSA?

A
  • all patients awaiting elective admissions
  • all emergency admissions
202
Q

which 3 antibiotics can be used in the treatment of MRSA infections

A

vancomycin
teicoplanin
linezolid

203
Q

standard therapy for active TB (RIPE)

A

Rifampicin - 6 months
Isoniazid - 6 months
Pyrazinamide - 2 months
Ethambutol - 2 months

204
Q

Treatment for latent TB

A

3 months of isoniazid (+ pyridoxine B6) and rifampicin

OR
6 months of isoniazid monotherapy (+ pyridoxine B6)

205
Q

Treatment for meningeal TB

A

At least 12 months of RIPE
With steroids

206
Q

Certain groups e.g. homeless people, poor adherence and prisoners, have directly observed therapy for tuberculosis.

What is their dosing regimen?

A

3 times a week dosing

207
Q

side effects of rifampicin

A

potent liver INDUCER
orange secretions
hepatitis
flu-like symptoms

208
Q

side effects of isoniazid

A

peripheral neuropathy - replace with B6 pyroxidine
hepatitis
agranulocytosis
liver enzyme INHIBITOR

209
Q

which TB drug is a liver enzyme:
(a) inducer
(b) inhibitor

A

(a) rifampicin
(b) isoniazid

210
Q

side effects of pyrazinamide

A

hyperuricaemia (causes gout)
arthralgia
myalgia
hepatitis

211
Q

which TB drugs can cause hepatitis

A

rifampicin
isoniazid
pyrazinamide

212
Q

side effect of ethambutol

A

optic neuritis

check visual acuity before and after treatment

213
Q

For persistent BV in women with an intrauterine contraceptive device, what should be considered

A

removal of device
alternative contraception

214
Q

Orf is caused by the parapox virus which causes scabby red-blue lesions. what animals is it usually found in

A

sheep/goats

FARMERS in questions

215
Q

anthrax is caused by bacillus anthracis. it presents as a painless black eschar. what animals is it associated with

A

hides or wool
livestock animal

216
Q

In acute uncomplicated sinusitis, first-line therapy as per NICE guidelines would be

A

phenoxymethylpenicillin

if pen allergic: doxycycline or clarithromycin

2nd line = co-amoxiclav

217
Q

acute prostatitis (tender boggy prostate) with urinary symptoms

what antibiotic is appropriate

A

ciprofloxacin

218
Q

Patients who are immunosuppressed secondary to long-term steroids or methotrexate and are exposed to chickenpox by someone else should have what

A

Test for varicella antibodies
VZ immunoglobulin

219
Q

How is the BCG vaccine given?

A

intradermally

220
Q

What findings in the full blood count would suggest glandular fever?

A

lymphocytosis

221
Q

what pathogen causes the common cold

A

rhinovirus

222
Q

After an initial negative result when testing for HIV in an asymptomatic patient i.e. at 4 weeks, when should a repeat test be done?

A

at 12 weeks

223
Q

what % of hep C infections turn into chronic hep C

A

55-85%
the majority

224
Q

wasp/bee allergy treatment for prophylaxis in patients with venom-specific IgE

A

venom immunotherapy

225
Q

Ziehl-Neelsen stain of stool in patient with HIV and diarrhoea shows red cysts. what is diagnosis

A

Cryptosporidium

226
Q

what is caused by haemophilus ducreyi

A

chancroid

227
Q

People who’ve had a systemic reaction to an insect bite - follow up management

A

referral to allergy specialist

AKT (25 decks)

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