Infectious diseases

Question 1

Causative organism of watery travellers’ diarrhoea with stomach cramps + nausea

Answer 1

Enterotoxigenic E. coli

Question 2

Causative organism of traverllers’ diarrhoea with bloody stools + abdominal pain

Answer 2

Campylobacter jejuni

Question 3

Classic course of rheumatic fever

Answer 3

Immunological reaction 2-4 weeks following streptococcus pyogenes infection

Question 4

Major criteria for rheumatic fever

Answer 4

Erythema marginatum
Sydenham’s chorea (late feature)
Polyarthritis
Carditis + valvulitis e.g. pancarditis
Subcutaneous nodules

Question 5

Minor criteria for rheumatic fever

Answer 5

Raised ESR or CRP
Pyrexia
Arthralgia (only if arthritis not major)
Prolonged PR interval

Question 6

Diagnosis of rheumatic fever

Answer 6

Evidence of recent strep infection e.g.
- Raised/rising streptococci antibodies
- Positive throat swab
- Positive rapid group A strep antigen test

+ 2 major criteria, or 1 major + 1 minor criteria

Question 7

Management of rheuamtic fever

Answer 7

Anti-inflammatories e.g. NSAIDs or aspirin (for arthritis)
Antibiotics
Management of complications

Question 8

1st line antibiotic management rheumatic fever

Answer 8

IM benzathine benzylpenicillin
Oral pen V if IM refused
Erythromycin if pen allergic