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Y 3 Medicine > infectious diseases > Flashcards

infectious diseases Flashcards

1
Q

what does RILE stand for with regards to the heart

A

right murmurs loudest on inspiration, left murmurs loudest on expiration

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2
Q

Which valve does the patient lean forward for

A

Aortic

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3
Q

Which valve does the patient lean to the side for

A

mitral

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4
Q

Features of atypical pneumonia

A

dry cough, malaise, fever, joint pain, longer history

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5
Q

key things in cardiology exam

A

parasternal heave LHS, check for thrills over each valve

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6
Q

What does stoney dull indicate

A

pleural effusion

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7
Q

Things to remember from cardio exam that you need in resp

A

JVP and apex beat

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8
Q

Ptosis on respiratory exam

A

Horners syndrome, pancoast tumour

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9
Q

fever definitions

A

Continuous fever - fluctuates within 1 degree but remains high
Intermittent - fluctuates between baseline and high
Remittent - there is fluctuation but always 1 degree above baseline at least

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10
Q

systems review

A

CNS headache, seizures, neck stiffness, photophobia, vision changes. Skin - colour changes, rash, pruritis, tenderness. MSK - joint pain or mobility issues. GI- stool problems, abdominal pain. Resp- cough, SOB. Cardiac - chest pain, palpiatation, SOB. Urinary - dysuria, anuria, discharge, flank pain. Red flags- lumps and bumps, malignancy, fever, rash, weight loss, sweats. Metabolic - heat or cold intolerance, mood changes.

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11
Q

In general examination always mention

A

pulses

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12
Q

Jaundice associations -

A

changes in colour of urine and stools, itching of skin, dull achy pain in right hypochondrium, vomiting

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13
Q

Haemolysis history

A

= chills and back pain, blood problems, sickle cell, G6PH etc

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14
Q

Liver disease stigmata =

A

rectal varices, skin

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15
Q

investigation for TB patient

A

CXR and bronchoscopy

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16
Q

pyelonephritis treatment

A

co-amox IV

17
Q

treatment for line infection with coagulating neg staph (neutropenic sepsis)

A

IV tazocin

18
Q

What does this show

A

gametocyte = malaria

19
Q

What does this show

A

Area of consolidation could be pneumonia in apex of right upper zone with effusion of horizontal fissure

20
Q

organism and treatment

A

Group A streptococcus - gram positive cocci chains
IV benzylpenicillin/Flucloxacillin would be the appropriate choice

21
Q

response to penicillin allergic reaction anaphylaxis

A

Allergic reaction - anaphylaxis to antibiotic
IM adrenaline 0.5mg in 500ml
Antihistamine, salbutamol nebulised, steroid treatment e.g. hydrocortisone

Stop antibiotic treatment

22
Q

Falciparum malaria =

A

headphones on blood film (treatment is artemisinin (IV artesunate and PO Riamet)

23
Q

Dengue features

A

Dengue = classically presents with rash
* Lasts 1-5 days
* Improves 3-4 days after rash
* Supportive treatment only
* Re infection can be dangerous

24
Q

Fever, headache +/- abdo pain (dry cough) =

A

Fever, headache +/- abdo pain (dry cough) = Typhoid and paratyphoid/enteric fever (most common in Leic), faecal-oral (salmonella typhi)
* Invades Payer’s patches not mucosa (hence not necessarily diarrhoea)
* Low infectious dose, survives gastric acid, reside within macrophages
* Incubation 7-14 days
* 10% mortality
* +tive blood culture
* Treat with IV ceftriaxone or azithromycin (Meropenem if Ceftriaxone resistance)
* Takes 7-10 days to settle even with antibiotics

25
Q

Difference between meningitis and encephalitis

A

Meningitis is inflammation of the meninges surrounding brain and spinal cord, encephalitis is inflammation of the brain itself

Meningitis: fever, headache, vomiting, photophobia, stiff neck
Encephalitis: altered consciousness, seizures and focal deficits

26
Q

Immediate management of meningitis

A

Single dose of parenteral benzylpenicillin IV/IM
Corticosteroids
Paracetamol for temperature
Oxygen/fluids/pain relief if indicated

27
Q

Investigations to confirm meningitis diagnosis

A

Blood culture
CT scan
Spinal tap - cerebrospinal fluid culture

28
Q

Examples of notifiable diseases

A

Botulism, legionnaires disease, measles, TB

29
Q

CSF result in meningitis that is bacterial

A

CSF results: Increased opening pressure, high protein, high WBC count between 10-10,000, decreased glucose concentration <45 mg/dL, cloudy

30
Q

What infectious disease are associated with patients travelling to sub saharan africa

A

HIV, TB, malaria, schistosomiasis

31
Q

Most likely parasitic infection from sub saharan africa

A

Schistosomiasis - microscopic visualisation of eggs in stools or urine, or serological testing of affected tissues for detection
Treat with praziquantel

32
Q

Types of TB

A

TB meningitis/CNS TB, pericardial TB, Miliary TB, pulmonary TB

33
Q

TB meningitis key points

A

TB meningitis. MRI would show leptomeningeal enhancement. LP will show high protein, low glucose and lymphocytosis

Given steroids when starting treatment and treatment is longer (12 months)

34
Q
A

Y 3 Medicine (6 decks)

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