infectious diseases Flashcards
1
Q
which pathogen should be considered in the case of a long incubation period( diarrhoea)
A
Amoebiasis
2
Q
which pathogens have an incubation of 48-72 hours
A
campylobacter and shigella
3
Q
what is the incubation period of salmonella
A
12-48 hours
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
5
Q
what is Lyme disease caused by?
A
Borrelia burgdorferi
6
Q
what is the pattern of rash seen in Lyme disease
A
circular rash which is worse in the centre and the edges
7
Q
how does bacterial vaginosis present ?
A
fishy / offensive discharge
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
9
Q
what is the treatment of BV in symptomatic women ?
A
Oral metronidazole for 5-7 days
10
Q
how does trichomonas vaginalis present
A
frothy , yellow-green discharge
strawberry cervix
11
Q
when would you not give IV dexamethasone in a patient with meningitis ?
A
Meningococcal septicaemia
immunocompromised
septic shock
meningitis following surgery
12
Q
How does infectious mononucleosis present ?
A
sore throat
lymphadenopathy ( in anterior and posterior triangles of the neck)
pyrexia
13
Q
which virus causes Infectious Mono
A
EBV
14
Q
which bacteria most commonly causes meningitis in neonates
A
GBS
15
Q
which bacteria causes meningitis in immunosuppressed patients
A
Listeria Moncytogenes
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.
17
Q
what is the first line management of chlamydia
A
Doxycycline ( 7 day course)
18
Q
which medications are recommended for severe cellulitis
A
oral /IV Co-amoxiclav
oral/IV Clindamycin
IV cefuroxime
IV ceftriaxone
19
Q
what is the first line management of mild-moderate cellulitis ?
A
Oral Flucloxacillin
20
Q
what is the causative organism of BV
A
Gardnerella vaginalis
21
Q
gold standard investigation for spinal epidural abscess
A
full spinal MRI
22
Q
what is the most common cause of a spinal epidural abscess
A
staph. Aureus
23
Q
which organism is most likely to cause pneumonia in an alcoholic ?
A
Klebsiella
24
Q
how do you manage UTI in a pregnant woman ?
A
first line : Nitrofurantoin ( to be avoided near term)
25
what organism causes Syphilis ?
Treponema Pallidum
26
what are the primary features of syphilis ?
- Chancre ( painless ulcer at the site of sexual contact)
- Local non-tender lymphadenopathy
27
what are the secondary features of syphilis ?
- 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)
28
tertiary features of syphilis
-Gummas ( granulomatous lesions of skin and bones)
-ascending aortic aneurysms
paralysis
-tabes dorsalis
29
what is the qSOFA score ? What are its components ?
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)
30
Most common complication of Gonorrhoea
Infertility secondary to PID
31
what is the latest time that HIV post exposure prophylaxis can be given?
72 hours after the event
32
what organism causes Kaposi's sarcoma
HHV-8
33
most common cause of travellers diarrhoea
E.Coli
34
what medication causes a disulfram like reaction
Metronidazole
35
What is the investigation of choice for Genital herpes
NAAT
36
what is an indication to start antibiotics in Lyme disease
Erythema Migrans
37
what antibiotic is used in the management of Lyme disease
Doxycycline
38
what type of bacteria is s. pneumonia
gram positive diplocci
39
give an example of a gram negative diplococci that causes meningitis
N. Meningitidis
40
how is rabies managed
human rabies immunoglobulin + full course of vaccination
41
what can be used for facial cellulitis around the eyes
amoxicillin and clavulanic acid
42
what is the next step after patient has a positive HIV test
repeat test
43
what is the management of Gonorrhoea
single dose of IM Ceftriaxone ( 1g)
44
what are the components of sepsis 6
blood cultures
urine output ( hourly)
fluids ( 500 ml crystalloid over < 15 mins)
antibiotics ( broad spectrum)
lactate
oxygen ( keep >94)
45
what is the first line management of Chlamydia
Doxycycline ( 7 day course)
46
specific feature of PCP on investigation
exercise induced desaturation
47
what is the treatment recommendation for suspected bacterial meningitis in a patient > 50
IV Cefotaxime + Amoxicillin
48
what is the most commonly affected site in Nectrotising Fasciitis
perineum
49
what is the management of necrotising fasciitis
surgical referral, IV Abx
50
what is the treatment recommendation for UTIs in non pregnant women
Trimethoprin / Nitrofurantoin for 3 days
51
what is the treatment recommendation for UTIs in pregnant women
nitrofurantoin for 7 days ( to be avoided near term)
52
At what CD count is PCP most likely to occur
< 200 cells / mm3
53
what is the management of gonorrhoea if the patient refuses treatment with IM Ceftriaxone
Cefixime + Azithromycin
54
what is the management of PCP ? what are the components of the medication
Co-Trimoxazole - contaning trimethoprim and sulfamethoxazole
55
the most common malignancy associated with Hepatitis B is
Hepatocellular carcinoma
56
what is the management of UTI's in men
trimethoprim or nitrofurantoin first line for 7 days
57
what is the threshold for commencement of ART in HIV
no threshold - should be commenced in all patients diagnosed
58
when is a stool microbiological investigation recommended in children ?
immunocompromised child
blood / mucus in stool
suspected septicaemia
59
what is the first line management of Trichomonas Vaginalis ?
5-7 day course of Oral Metronidazole
60
give 3 key features of Trichomonas Vaginalis
frothy, yellow green discharge
vulvovaginitis
strawberry cervix
61
what is the management of acute pyelonephritis ?
broad spectrum cephalosporin / quinolone for 10-14 days
62
How does Hepatitis A present ?
flu-like symptoms
RUQ pain
tender hepatomegaly
deranged LFT's
63
how does Hep A spread ?
Faeco-oral spread
64
what tests guides treatment choice for TB ?
Sputum culture
65
which bacteria causes diarrhoea after consuming rice
bacillus cereus
66
which is the most common organism found in central line infections ?
staph. epidermis
67
how would you treat a patient with suspected tetanus with an uncertain vaccination history
booster vaccine + immunoglobulin
68
what additional test should be offered to someone who has tested +ve for TB
HIV test
69
give three features of Mycoplasma pneumonia
- dry cough
-erythema multiforme
( target shaped rash with central blister)
reticulonodular shadowing of the right lung
70
what needs to be checked before commencing terbinafine on a patient for a fungal nail infection
LFTs
71
how soon after the first positive combined HIV test should the second one be commenced
12 weeks later
72
what is type one and type two necrotising fasciitis caused by
type 1 : mixed anaerobes and aerobes
type 2 : streptococcus pyogenes
73
what is the antibiotic of choice in cellulitis in pregnancy if the patient is allergic to penicillin
erythromycin
74
what medication should be used in the management of legionella
erythromycin / claritrhomycin
75
what is the prophylaxis given to close contacts of patients with confirmed bacterial meningitis
1 dose of oral ciprofloxacin
76
what is the dosing of metronidazole in the management of bacterial vaginosis ?
Metronidazole 400 mg bd for 5 days
77
where is legionella normally found
water tanks and air conditioning systems
78
what is the criteria for diagnosis of staphylococcus toxic shock syndrome
-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
what is the management of staphylococcus toxic shock syndrome
-removal of infection focus
-IV fluids
-IV Abx
80
what is the most common cause of traveller's diarrhoea ?
E. Coli
81
give 3 features of E. Coli diarrhoea
common amongst travellers
watery stools
abdominal cramps and nausea
82
give 3 features of diarrhoea caused by Cholera
profuse, watery diarrhoea
severe dehydration that may lead to weight loss
uncommon amongst travellers
83
how soon should antiretroviral therapy be started after HIV diagnosis
ASAP
84
what is included in antiretroviral therapy for HIV
-2 nucleoside reverse transcriptase inhibitors
-protease inhibitor
85
what are the features of dengue fever ?
fever
retro-orbital headache
myalgia, bone pain and arthralgia ( break bone fever)
facial flushing
maculopapular rash
86
what are warning signs of dengue fever
abdominal pain
hepatomegaly
persistent vomiting
clinical fluid accumulation
87
give 3 features of dengue on blood results
leukopenia
thrombocytopenia
raised aminotransferases
88
what are the features of dengue haemorrhagic fever ?
thrombocytopenia
spontaneous bleeding
89
what is the first line investigation for HIV screening ?
combined HIV antibody / antigen test
90
give 2 features of early Chagas disease
Chagoma at site of infection
Periorbital oedema
91
what is a severe complication of Chagas disease
cardiomyopathy
92
what is the investigation of choice to diagnose Hepatitis C infection?
HCV RNA
93
what is the incubation period of Ebola virus ?
2-21 days
94
how does Ebola spread
human to human transmission
broken skin/ mucus membranes
blood
secretions
organs
other bodily fluids
95
when should you suspect Ebola in a patient
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
what is the most common cause of viral meningitis in adults
enteroviruses such as Coxsackie B virus
97
name 3 antibiotics commonly used in the management of MRSA
Vancomycin
Teicoplanin
Linezolid
98
__________ is used to assess drug sensitivities in TB
sputum culture
99
what medication causes red man syndrome? what are its symptoms? how do would you manage it ?
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
what is the greatest risk factor for invasive aspergillosis
immunocompromised
101
how does an aspergilloma present on chest xray ?
Rounded opacities with a crescent shaped sign
102
Most common organism found in central line infections
Staphylococcus epidermidis
103
what is the best way to assess response to Hepatitis C treatment ?
viral load
104
what is the definition of chronic hepatitis C ?
persistence of HCV RNA in the blood for 6 months.
105
what is an alternative to metronidazole for patients with bacterial vaginosis ?
Topical clindamycin
106
what class of medication of is ritonavir
Protease inhibitor
107
how long should antibiotics be given in septic arthritis
4-6 weeks of flucloxacillin or clindamycin if penicillin allergic
108
how does hepatitis A normally present
flu-like symptoms
RUQ pain
tender hepatomegaly
deranged LFT's
109
who should be offered the hepatitis A vaccine?
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
what is the first line management of campylobacter infection ?
Clarithromycin
111
how does Neisseria gonorrhoea present under the microscope?
gram negative diplococci
112
what treatment should be given to a new-born who's mum is surface antigen positive
Hep B vaccine
hep B immunoglobulin - within 12 hours of birth
further vaccine at 1-2 months
further vaccine at 6 months
113
what is strep. viridans infective endocarditis associated with?
poor dental hygiene
114
Antibiotic management for Lyme disease
Doxycycline followed by Amoxicillin
115
School exclusion rules for Hand Foot and Mouth disease
no exclusion required
116
what is the most common cause of infective endocarditis
staph aureus, staph epidermis if < 2 months post valve surgery
117
why are antivirals prescribed for shingles
as it reduces the incidence of post-herpetic neuralgia
118
what is the best way to remove a tick ?
using fine-tipped tweezers, grasping the tick as close to the skin as possible and pulling upwards firmly
119
what is the causative agent of Lyme disease
Borrelia Burgdorferi
120
what tests to do before commencing antibiotic treatment for TB
U+E, LFT's, vision testing, FBC
121
When should PCP prophylaxis be given? What is given?
CD count < 200 / mm3
Co-trimoxazole
122
what is the gold standard test for TB
Sputum culture
123
the most common organism found on ascitic fluid culture is
E. coli
124
what is the most common neurological infection seen in HIV
cerebral toxoplasmosis
125
which is the most common cause of osteomyelitis in patients with sickle cell disease
salmonella
126
how soon after exposure should testing be done in asymptomatic patients for HIV? Is a repeat test required?
4 weeks
Yes at 12 weeks after initial negative test
127
what are the standard tests for diagnosing and screening HIV
Combination tests (HIV p24 antigen and HIV antibody)
128
most common cause epididymo-orchitis
chlamydia trachomatis
129
what causes false positive result in syphilis
Some Times Mistakes Happen
SLE, TB , Malaria, HIV
129
