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infectious diseases Flashcards

1
Q

which pathogen should be considered in the case of a long incubation period( diarrhoea)

A

Amoebiasis

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2
Q

which pathogens have an incubation of 48-72 hours

A

campylobacter and shigella

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3
Q

what is the incubation period of salmonella

A

12-48 hours

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4
Q

what is the Jarisch Herxhemier reaction

A

it can be seen following treatment of syphilis with antibiotics thought to be due to the release of endotoxins - presenting as a fever , rash and tachycardia . but no WHEEZE + HYPOTENSION

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5
Q

what is Lyme disease caused by?

A

Borrelia burgdorferi

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6
Q

what is the pattern of rash seen in Lyme disease

A

circular rash which is worse in the centre and the edges

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7
Q

how does bacterial vaginosis present ?

A

fishy / offensive discharge

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8
Q

what is amsels criteria

A

used for diagnosis of BV -
3 out of 4 needed to make a diagnosis

  • thin, white homogenous discharge
  • clue cells on microscopy
  • vaginal pH > 4.5
    -positive whiff test
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9
Q

what is the treatment of BV in symptomatic women ?

A

Oral metronidazole for 5-7 days

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10
Q

how does trichomonas vaginalis present

A

frothy , yellow-green discharge
strawberry cervix

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11
Q

when would you not give IV dexamethasone in a patient with meningitis ?

A

Meningococcal septicaemia
immunocompromised
septic shock
meningitis following surgery

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12
Q

How does infectious mononucleosis present ?

A

sore throat
lymphadenopathy ( in anterior and posterior triangles of the neck)
pyrexia

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13
Q

which virus causes Infectious Mono

A

EBV

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14
Q

which bacteria most commonly causes meningitis in neonates

A

GBS

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15
Q

which bacteria causes meningitis in immunosuppressed patients

A

Listeria Moncytogenes

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16
Q

what is Fitz Hugh Curtis syndrome

A

It is a complication of PID in which the liver capsule becomes inflamed causing RUQ pain leading to scar tissue formation and peri-hepatic adhesions.

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17
Q

what is the first line management of chlamydia

A

Doxycycline ( 7 day course)

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18
Q

which medications are recommended for severe cellulitis

A

oral /IV Co-amoxiclav
oral/IV Clindamycin
IV cefuroxime
IV ceftriaxone

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19
Q

what is the first line management of mild-moderate cellulitis ?

A

Oral Flucloxacillin

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20
Q

what is the causative organism of BV

A

Gardnerella vaginalis

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21
Q

gold standard investigation for spinal epidural abscess

A

full spinal MRI

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22
Q

what is the most common cause of a spinal epidural abscess

A

staph. Aureus

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23
Q

which organism is most likely to cause pneumonia in an alcoholic ?

A

Klebsiella

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24
Q

how do you manage UTI in a pregnant woman ?

A

first line : Nitrofurantoin ( to be avoided near term)

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25
Q

what organism causes Syphilis ?

A

Treponema Pallidum

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26
Q

what are the primary features of syphilis ?

A
  • Chancre ( painless ulcer at the site of sexual contact)
  • Local non-tender lymphadenopathy
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27
Q

what are the secondary features of syphilis ?

A
  • occurs 6-10 weeks after primary infection
  • systemic features such as fever and lymphadenopathy
  • rash on trunk, palms and soles
  • buccal ‘ snail track’ ulcers
    -Condylomata Lata ( painless, warty lesions on the genitalia)
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28
Q

tertiary features of syphilis

A

-Gummas ( granulomatous lesions of skin and bones)
-ascending aortic aneurysms
paralysis
-tabes dorsalis

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29
Q

what is the qSOFA score ? What are its components ?

A

The qSOFA score is a bedside prompt that may identify patients with suspected infection.
it has 3 criteria :
Low BP ( SBP < 100 mmHg)
High resp rate ( > 22 breaths / min)
Altered GCS ( GCS<15)

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30
Q

Most common complication of Gonorrhoea

A

Infertility secondary to PID

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31
Q

what is the latest time that HIV post exposure prophylaxis can be given?

A

72 hours after the event

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32
Q

what organism causes Kaposi’s sarcoma

A

HHV-8

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33
Q

most common cause of travellers diarrhoea

A

E.Coli

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34
Q

what medication causes a disulfram like reaction

A

Metronidazole

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35
Q

What is the investigation of choice for Genital herpes

A

NAAT

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36
Q

what is an indication to start antibiotics in Lyme disease

A

Erythema Migrans

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37
Q

what antibiotic is used in the management of Lyme disease

A

Doxycycline

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38
Q

what type of bacteria is s. pneumonia

A

gram positive diplocci

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39
Q

give an example of a gram negative diplococci that causes meningitis

A

N. Meningitidis

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40
Q

how is rabies managed

A

human rabies immunoglobulin + full course of vaccination

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41
Q

what can be used for facial cellulitis around the eyes

A

amoxicillin and clavulanic acid

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42
Q

what is the next step after patient has a positive HIV test

A

repeat test

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43
Q

what is the management of Gonorrhoea

A

single dose of IM Ceftriaxone ( 1g)

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44
Q

what are the components of sepsis 6

A

blood cultures
urine output ( hourly)
fluids ( 500 ml crystalloid over < 15 mins)
antibiotics ( broad spectrum)
lactate
oxygen ( keep >94)

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45
Q

what is the first line management of Chlamydia

A

Doxycycline ( 7 day course)

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46
Q

specific feature of PCP on investigation

A

exercise induced desaturation

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47
Q

what is the treatment recommendation for suspected bacterial meningitis in a patient > 50

A

IV Cefotaxime + Amoxicillin

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48
Q

what is the most commonly affected site in Nectrotising Fasciitis

A

perineum

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49
Q

what is the management of necrotising fasciitis

A

surgical referral, IV Abx

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50
Q

what is the treatment recommendation for UTIs in non pregnant women

A

Trimethoprin / Nitrofurantoin for 3 days

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51
Q

what is the treatment recommendation for UTIs in pregnant women

A

nitrofurantoin for 7 days ( to be avoided near term)

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52
Q

At what CD count is PCP most likely to occur

A

< 200 cells / mm3

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53
Q

what is the management of gonorrhoea if the patient refuses treatment with IM Ceftriaxone

A

Cefixime + Azithromycin

54
Q

what is the management of PCP ? what are the components of the medication

A

Co-Trimoxazole - contaning trimethoprim and sulfamethoxazole

55
Q

the most common malignancy associated with Hepatitis B is

A

Hepatocellular carcinoma

56
Q

what is the management of UTI’s in men

A

trimethoprim or nitrofurantoin first line for 7 days

57
Q

what is the threshold for commencement of ART in HIV

A

no threshold - should be commenced in all patients diagnosed

58
Q

when is a stool microbiological investigation recommended in children ?

A

immunocompromised child
blood / mucus in stool
suspected septicaemia

59
Q

what is the first line management of Trichomonas Vaginalis ?

A

5-7 day course of Oral Metronidazole

60
Q

give 3 key features of Trichomonas Vaginalis

A

frothy, yellow green discharge
vulvovaginitis
strawberry cervix

61
Q

what is the management of acute pyelonephritis ?

A

broad spectrum cephalosporin / quinolone for 10-14 days

62
Q

How does Hepatitis A present ?

A

flu-like symptoms
RUQ pain
tender hepatomegaly
deranged LFT’s

63
Q

how does Hep A spread ?

A

Faeco-oral spread

64
Q

what tests guides treatment choice for TB ?

A

Sputum culture

65
Q

which bacteria causes diarrhoea after consuming rice

A

bacillus cereus

66
Q

which is the most common organism found in central line infections ?

A

staph. epidermis

67
Q

how would you treat a patient with suspected tetanus with an uncertain vaccination history

A

booster vaccine + immunoglobulin

68
Q

what additional test should be offered to someone who has tested +ve for TB

69
Q

give three features of Mycoplasma pneumonia

A
  • dry cough
    -erythema multiforme
    ( target shaped rash with central blister)
    reticulonodular shadowing of the right lung
70
Q

what needs to be checked before commencing terbinafine on a patient for a fungal nail infection

71
Q

how soon after the first positive combined HIV test should the second one be commenced

A

12 weeks later

72
Q

what is type one and type two necrotising fasciitis caused by

A

type 1 : mixed anaerobes and aerobes
type 2 : streptococcus pyogenes

73
Q

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

A

erythromycin

74
Q

what medication should be used in the management of legionella

A

erythromycin / claritrhomycin

75
Q

what is the prophylaxis given to close contacts of patients with confirmed bacterial meningitis

A

1 dose of oral ciprofloxacin

76
Q

what is the dosing of metronidazole in the management of bacterial vaginosis ?

A

Metronidazole 400 mg bd for 5 days

77
Q

where is legionella normally found

A

water tanks and air conditioning systems

78
Q

what is the criteria for diagnosis of staphylococcus toxic shock syndrome

A

-fever: temperature > 38.9 c
-Hypotension, systolic < 90 mm Hg
-diffuse erythematous rash
-desquamation of rash ( esp on palms + soles)
-involvement of 3 / more organ systems

79
Q

what is the management of staphylococcus toxic shock syndrome

A

-removal of infection focus
-IV fluids
-IV Abx

80
Q

what is the most common cause of traveller’s diarrhoea ?

81
Q

give 3 features of E. Coli diarrhoea

A

common amongst travellers
watery stools
abdominal cramps and nausea

82
Q

give 3 features of diarrhoea caused by Cholera

A

profuse, watery diarrhoea
severe dehydration that may lead to weight loss
uncommon amongst travellers

83
Q

how soon should antiretroviral therapy be started after HIV diagnosis

84
Q

what is included in antiretroviral therapy for HIV

A

-2 nucleoside reverse transcriptase inhibitors
-protease inhibitor

85
Q

what are the features of dengue fever ?

A

fever
retro-orbital headache
myalgia, bone pain and arthralgia ( break bone fever)
facial flushing
maculopapular rash

86
Q

what are warning signs of dengue fever

A

abdominal pain
hepatomegaly
persistent vomiting
clinical fluid accumulation

87
Q

give 3 features of dengue on blood results

A

leukopenia
thrombocytopenia
raised aminotransferases

88
Q

what are the features of dengue haemorrhagic fever ?

A

thrombocytopenia
spontaneous bleeding

89
Q

what is the first line investigation for HIV screening ?

A

combined HIV antibody / antigen test

90
Q

give 2 features of early Chagas disease

A

Chagoma at site of infection
Periorbital oedema

91
Q

what is a severe complication of Chagas disease

A

cardiomyopathy

92
Q

what is the investigation of choice to diagnose Hepatitis C infection?

93
Q

what is the incubation period of Ebola virus ?

94
Q

how does Ebola spread

A

human to human transmission
broken skin/ mucus membranes
blood
secretions
organs
other bodily fluids

95
Q

when should you suspect Ebola in a patient

A

fever of 37.5/ history of fever in past 24 h and have visited affected areas / come into contact w person or animal known to have it

96
Q

what is the most common cause of viral meningitis in adults

A

enteroviruses such as Coxsackie B virus

97
Q

name 3 antibiotics commonly used in the management of MRSA

A

Vancomycin
Teicoplanin
Linezolid

98
Q

__________ is used to assess drug sensitivities in TB

A

sputum culture

99
Q

what medication causes red man syndrome? what are its symptoms? how do would you manage it ?

A

Caused by rapid intravenous infusion of vancomycin.
Symptoms include redness, pruritus and burning sensation, predominantly in the upper body ( face, neck and upper chest).

management : cessation of infusion and restarting at a slower rate when the symptoms have resolved.
antihistamines and IV Fluids if recquired

100
Q

what is the greatest risk factor for invasive aspergillosis

A

immunocompromised

101
Q

how does an aspergilloma present on chest xray ?

A

Rounded opacities with a crescent shaped sign

102
Q

Most common organism found in central line infections

A

Staphylococcus epidermidis

103
Q

what is the best way to assess response to Hepatitis C treatment ?

A

viral load

104
Q

what is the definition of chronic hepatitis C ?

A

persistence of HCV RNA in the blood for 6 months.

105
Q

what is an alternative to metronidazole for patients with bacterial vaginosis ?

A

Topical clindamycin

106
Q

what class of medication of is ritonavir

A

Protease inhibitor

107
Q

how long should antibiotics be given in septic arthritis

A

4-6 weeks of flucloxacillin or clindamycin if penicillin allergic

108
Q

how does hepatitis A normally present

A

flu-like symptoms
RUQ pain
tender hepatomegaly
deranged LFT’s

109
Q

who should be offered the hepatitis A vaccine?

A

chronic liver disease
travelling to areas of high / medium prevalence
haemophilia
men who have sex with men
IVDU
working sewage plants, lab workers etc

110
Q

what is the first line management of campylobacter infection ?

A

Clarithromycin

111
Q

how does Neisseria gonorrhoea present under the microscope?

A

gram negative diplococci

112
Q

what treatment should be given to a new-born who’s mum is surface antigen positive

A

Hep B vaccine
hep B immunoglobulin - within 12 hours of birth

further vaccine at 1-2 months
further vaccine at 6 months

113
Q

what is strep. viridans infective endocarditis associated with?

A

poor dental hygiene

114
Q

Antibiotic management for Lyme disease

A

Doxycycline followed by Amoxicillin

115
Q

School exclusion rules for Hand Foot and Mouth disease

A

no exclusion required

116
Q

what is the most common cause of infective endocarditis

A

staph aureus, staph epidermis if < 2 months post valve surgery

117
Q

why are antivirals prescribed for shingles

A

as it reduces the incidence of post-herpetic neuralgia

118
Q

what is the best way to remove a tick ?

A

using fine-tipped tweezers, grasping the tick as close to the skin as possible and pulling upwards firmly

119
Q

what is the causative agent of Lyme disease

A

Borrelia Burgdorferi

120
Q

what tests to do before commencing antibiotic treatment for TB

A

U+E, LFT’s, vision testing, FBC

121
Q

When should PCP prophylaxis be given? What is given?

A

CD count < 200 / mm3
Co-trimoxazole

122
Q

what is the gold standard test for TB

A

Sputum culture

123
Q

the most common organism found on ascitic fluid culture is

124
Q

what is the most common neurological infection seen in HIV

A

cerebral toxoplasmosis

125
Q

which is the most common cause of osteomyelitis in patients with sickle cell disease

A

salmonella

126
Q

how soon after exposure should testing be done in asymptomatic patients for HIV? Is a repeat test required?

A

4 weeks
Yes at 12 weeks after initial negative test

127
Q

what are the standard tests for diagnosing and screening HIV

A

Combination tests (HIV p24 antigen and HIV antibody)

128
Q

most common cause epididymo-orchitis

A

chlamydia trachomatis

129
Q

what causes false positive result in syphilis

A

Some Times Mistakes Happen
SLE, TB , Malaria, HIV

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