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MRCP > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

What is the first line treatment for salmonella (non typhoid)?

A

Ciprofloxacin

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2
Q

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

A

E.coli

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3
Q

What bacteria typically cause acute food poisoning?

A

Staph aureus
Bacillus cereus
Clostridium perfringens.

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4
Q

What organism causes Syphilis?

A

Treponema pallidum (spirochaete)

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5
Q

What is the incubation period for syphilis?

A

9-90days

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6
Q

What are the features of primary syphilis?

A
  • chancre - painless ulcer at the site of sexual contact
  • local non-tender lymphadenopathy
  • often not seen in women (the lesion may be on the cervix)
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7
Q

What are the features of secondary syphilis?

A
  • Occurs 6-10 weeks following primary contact
  • systemic symptoms: fevers, lymphadenopathy
  • rash on trunk, palms and soles
  • buccal ‘snail track’ ulcers (30%)
  • condylomata lata (painless, warty lesions on the genitalia )
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8
Q

What are the features of tertiary syphilis?

A
  • gummas (granulomatous lesions of the skin and bones)
  • ascending aortic aneurysms
  • general paralysis of the insane
  • tabes dorsalis
  • Argyll-Robertson pupil
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9
Q

What are the features of congenital syphilis?

A
  • blunted upper incisor teeth (Hutchinson’s teeth), ‘mulberry’ molars
  • rhagades (linear scars at the angle of the mouth)
  • keratitis
  • saber shins
  • saddle nose
  • deafness
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10
Q

What is the first line treatment for Syphilis?

A

Benzylpenicillin usually IM
Doxycycline is alternative

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11
Q

What is Jarisch-Herxheimer reaction?

A
  • Reaction following treatment of syphilis.
    -Fever, rash, tachycardia after the first dose of antibiotic.
    -No wheeze or hypotension.
  • due to the release of endotoxins following bacterial death and typically occurs within a few hours of treatment.
  • no treatment is needed other than antipyretics if required.
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12
Q

What is used to assess the response to treatment of syphilis?

A
  • nontreponemal (rapid plasma reagin [RPR] or Venereal Disease Research Laboratory [VDRL]) titres should be monitored after treatment to assess the response.
  • a fourfold decline in titres is often considered an adequate response to treatment.
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13
Q

What are the CSF findings in bacterial meningitis?

A
  • Cloudy appearance
  • Low glucose (<half of plasma)
  • High protein (>1g/l)
  • 10-5000 polymorphs/mm3 (neutrophils).
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14
Q

What are the CSF findings in viral meningitis?

A
  • Clear/cloudy appearance
  • High glucose (60-80% of plasma)
  • Normal/raised protein
  • 15 - 1,000 lymphocytes/mm³
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15
Q

What are the CSF findings in Tuberculous meningitis?

A
  • Slightly cloudy/fibrin web
  • Low glucose (<half of plasma)
  • High protein (>1g/l)
  • 30 - 300 lymphocytes/mm³
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16
Q

What are the CSF findings in Fungal meningitis?

A
  • Cloudy appearance
  • Low glucose (<half plasma)
  • High protein (>1g/l)
  • 20 - 200 lymphocytes/mm³
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17
Q

What virus can be associated with a low glucose on CSF?

A

Mumps

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18
Q

What is infectious mononucleosis?

A
  • Commonly known as glandular fever
  • Epstein-Barr virus
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19
Q

What are the common features of infectious mononucleosis?

A
  • sore throat
  • lymphadenopathy: may be present in the anterior and posterior triangles of the neck
  • pyrexia
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20
Q

How is infectious mononucleosis diagnosed?

A
  • heterophil antibody test (Monospot test)
  • NICE recommend FBC + mono spot test in 2nd week of illness for diagnosis.
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21
Q

What is the treatment for infectious mononucleosis?

A
  • Supportive management of rest during the early stages, drink plenty of fluid, avoid alcohol
  • simple analgesia for any aches or pains
  • avoid playing contact sports for 4 weeks after having glandular fever to reduce the risk of splenic rupture
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22
Q

What is the treatment for uncomplicated falciparum malaria?

A

Oral artemisinin-based combination therapies

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23
Q

What is the first line treatment for non-gonococcal urethritis?

A

Doxycycline or azithromycin

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24
Q

What is non-gonococcal urethritis?

A

Urethritis with no gonorrhea found on swabbing.
- Often presents with purulent discharge and dysuria.

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25
Q

What are some possible causes of non-gonococcal urethritis?

A
  • Chlamydia trachomatis
    most common cause
  • Mycoplasma genitalium
    thought to cause more symptoms than Chlamydia.

less common causes:
- Ureaplasma urealyticum
- Trichomonas vaginalis
- Escherichia coli

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26
Q

What is the first line treatment of chlamydia?

A

Doxycycline or azithromycin

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27
Q

What are the key features of CNS cryptococcal infection?

A
  • HIV
  • Neurological symptoms
  • Headache
  • CSF india stain positive
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28
Q

What are the adverse affects of aminoglycosides?

A

Nephrotoxicity
Ototoxicity

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29
Q

What is the mechanism of action of aminoglycosides?

A

Binds to 30S subunit causing misreading of mRNA

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30
Q

What are the adverse effects of Tetracyclines?

A

Discolouration of teeth photosensitivity

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31
Q

What is the mechanism of action of tetracyclines?

A

Binds to 30S subunit blocking binding of aminoacyl-tRNA

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32
Q

What is the mechanism of action of chloramphenicol?

A

Binds to 50S subunit, inhibiting peptidyl transferase

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33
Q

What are the adverse effects of chloramphenicol?

A

Aplastic anaemia

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34
Q

What is the mechanism of action of clindamycin?

A

Binds to 50S subunit, inhibiting translocation (movement of tRNA from acceptor site to peptidyl site)

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35
Q

What is the adverse effects of clindamycin?

A

Common cause of C-difficile diarrhoea

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36
Q

What is the mechanism of action of macrolides?

A

Binds to 50S subunit, inhibiting translocation (movement of tRNA from acceptor site to peptidyl site)

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37
Q

What are the adverse effects of macrolides?

A

Nausea (especially erythromycin), P450 inhibitor
Prolonged QT interval

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38
Q

What are the features of Mycoplasma pneumoniae?

A
  • disease typically has a prolonged and gradual onset.
  • flu-like symptoms classically precede a dry cough
  • bilateral consolidation on x-ray
  • complications common
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39
Q

What are the complications associated with Mycoplasma pneumoniae?

A
  • Cold agglutins (IgM): may cause an haemolytic anaemia, thrombocytopenia.
  • Erythema multiforme, erythema nodosum.
  • Meningoencephalitis, Guillain-Barre syndrome and other immune-mediated neurological diseases.
    -Bullous myringitis: painful vesicles on the tympanic membrane.
    -Pericarditis/myocarditis.
  • Gastrointestinal: hepatitis, pancreatitis
  • Renal: acute glomerulonephritis
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40
Q

How is mycoplasma pneumoniae diagnosed?

A
  • Mycoplasma serology
  • positive cold agglutination test → peripheral blood smear may show red blood cell agglutination
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41
Q

What is the management of mycoplasma pneumoniae?

A
  • Doxycycline or a macrolide (e.g. erythromycin/clarithromycin).
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42
Q

What are the features of legionella?

A
  • Flu-like symptoms including fever
  • Dry cough
  • Relative bradycardia
  • Confusion
  • Lymphopaenia
  • Hyponatraemia
  • Deranged LFTs
  • Pleural effusion
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43
Q

What investigations should be carried out in suspected legionella infection?

A
  • Urinary antigen (diagnostic)
  • CXR - mid/lower zone patchy consolidation and pleural effusions.
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44
Q

What is the treatment for legionella?

A

Erythromycin/clarithromycin

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45
Q

How is legionella transmitted?

A
  • Typically colonizes water-tanks so typically transmitted via particles in air-condition systems or water abroad.
  • Person to person transmission is NOT seen.
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46
Q

What are the two main forms of trypanosomiasis?

A
  • African trypanosomiasis (sleeping sickness)
  • American trypanosomiasis (Chagas’ disease)
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47
Q

How is African trypanosomiasis spread?

A

Tsetse fly

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48
Q

What are the features of African trypanosomiasis?

A
  • Trypanosoma chancre (painless subcutaneous nodule at site of infection)
  • Intermittent fever
  • Enlargement of posterior cervical lymph nodes
  • CNS involvement in later stages e.g. somnolence, headaches, mood changes, meningoencephalitis
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49
Q

What is the management for African trypanosomiasis?

A

Early disease: IV pentamidine or suramin
Later disease/CNS involvement: IV melarsoprol

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50
Q

What organism causes Chagas’ disease?

A

Trypanosoma cruzi

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51
Q

What are the features of Chagas’ disease?

A
  • 95% asymptomatic in acute phase
  • Chagoma (erythematous nodule at site of infection)
  • periorbital oedema
  • myocarditis/ dilated cardiomyopathy
  • Megaoesophagus / megacolon
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52
Q

What is the management of Chagas’ disease?

A

Early disease: Azole or nitroderivatives e.g. benznidazole or nifurtimox.
Later disease: Treat complications

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53
Q

What is the mechanism of action of sulphonamides?

A

Inhibition of dihydropteroate synthetase

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54
Q

What are some examples of antibiotic sulphonamides?

A
  • Sulfamethoxazole
  • Co-trimoxazole (sulfamethoxazole + trimethoprim).
  • Sulfadiazine
  • Sulfisoxazole
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55
Q

What are some side effects of co-timoxazole?

A
  • Hyperkalaemia
  • Headache
  • Rash including Steven-Johnson Syndrome
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56
Q

What organism causes Lyme disease?

A

Borrelia Burgdorferi
(spread by ticks)

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57
Q

What are the early features (first 30 days) of Lyme disease?

A
  • Erythema migrans (bulls-eye rash at tick bite site, 1-4 weeks after initial bite, usually painless, slowly increases in size).
  • Headache
  • Lethargy
  • Fever
  • Arthralgia
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58
Q

What are the later features (>30 days) of Lyme disease?

A
  • Cardiovascular - heart block, peri/myocarditis
  • Neurological - facial nerve palsy, radicular pain, meningitis
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59
Q

What investigations are required for Lyme diease?

A
  • Clinical diagnosis if erythema migrans present.
  • ELISA antibodies
  • Immunoblot test if ELISA positive
60
Q

What is the management of Lyme disease?

A
  • Doxycycline in early disease (amoxicillin if contraindicated)
  • ## Ceftriaxone in disseminated disease
61
Q

What are some factors that reduce vertical transmission of HIV?

A
  • Maternal antiretroviral therapy
  • Mode of delivery (c-section)
  • Neonatal antiretroviral therapy
  • Infant feeding (bottle)
62
Q

What should be commenced when a HIV positive woman undergoes a caesarean section?

A
  • IV zidovudine infusion commenced 4 hrs prior to c-section.
63
Q

What neonatal antiviral therapy is used in babies who are born to HIV positive mothers?

A
  • Zidovudine: orally if maternal viral load <50 copies/ml.
  • Triple ART if viral load higher. 4-6 week duration.
64
Q

What organisms commonly cause celluitis?

A

Streptococcus pyogenes
Staphylococcus aureus

65
Q

What are the features of Eron class I cellulitis?

A
  • No systemic toxicity
  • No uncontrolled comorbidities
66
Q

What are the features of Eron class II cellulitis?

A
  • Systemically unwell or well but with a comorbidity which may complicate or delay resolution of infection
67
Q

What are the features of Eron class III cellulitis?

A
  • Significant systemic upset - confusion, tachycardia, hypotension
  • Significant unstable co-morbidities
  • Limb threatening infection due to vascular compromise
68
Q

What are the features of Eron class IV cellulitis?

A
  • Sepsis syndrome
  • Necrotising fasciitis
69
Q

Which patients with cellulitis should be admitted for IV antibiotics?

A
  • Eron class III or IV
  • Severe/ rapidly deteriorating cellulitis
  • Significant lymphoedema
  • Young or frail
  • Immunocompromised
  • Facial or periorbital cellulitis.
70
Q

How is cellulitis managed?

A
  • Flucloxacillin 1st line
  • Clarithromycin, erythromycin or doxycycline in patients allergic to penicillin
  • For severe cellultis (class III or IV) then IV co-amoxiclav, clindamycin, cefuroxime or ceftriaxone may be used.
71
Q

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

A

Staphylococcus epidermidis

72
Q

What are the characteristics of staphylococcus aureus?

A
  • Gram-positive cocci
  • Coagulase positive
  • Skin infections, abscesses, osteomyelitis, toxic shock syndrome.
73
Q

What are the characteristics of staphylococcus epidermidis?

A
  • Gram positive cocci
  • Coagulase negative
  • Central line infections, infective endocarditis
74
Q

What is leprosy?

A
  • Granulomatous disease primarily affecting the peripheral nerves and skin.
  • Mycobacterium leprae
75
Q

What are the features of leprosy?

A
  • Patches of hypopigmented skin typically affecting buttocks, face and extensor surfaces of limbs.
  • Sensory loss
76
Q

What are the two different types of leprosy?

A

Lepromatous leprosy: low degree of cell mediated immunity, extensive skin involvement, symmetrical nerve involvement

Tuberculoid leprosy: high degree of cell mediated immunity, limited skin disease, asymmetric nerve involvement leading to hypesthesia, hair loss.

77
Q

What is the management of leprosy?

A

Triple therapy:
- Rifampicin
- Dapsone
- Clofazimine

78
Q

What is mycobacterium avium complex?

A
  • Atypical mycobacterium infection seen in HIV patients.
  • Caused by mycobacterium avium and mycobacterium intracellulare.
  • MAC is usually seen when CD4 count is <50 cells/mm3.
79
Q

What are the features of mycobacterium avium complex (MAC)?

A
  • fever / sweats
  • abdominal pain
  • diarrhoea
  • dyspnoea
  • cough
  • anaemia
  • lymphadenopathy
    -hepatomegaly
  • deranged LFTs
80
Q

What is the prophylactic treatment for mycobacterium avium complex?

A

Clarithromycin or azithromycin ( when CD4 count < 100 cells/mm3.

81
Q

What is the management of mycobacterium avium complex?

A

Rifampicin + ethambutol + clarithromycin

82
Q

What is the mechanism of action of bictegravir?

A
  • Blocks enzymatic insertion of the viral genome into host DNA.
83
Q

What is the ART used in HIV managment?

A

At least 3 drugs: 2 nucleoside reverse transcriptase inhibitors (NRTI) and either a protease inhibitor (PI) or a non nucleoside reverse transcriptase inhibitor (NNRTI).

To be commenced ASAP following diagnosis, regardless of CD4 count.

84
Q

What are some HIV entry inhibitors?

A
  • Maraviroc
  • Enfuvirtide
85
Q

What are some side effects of nucleoside analogue reverse transcriptase inhibitors (NRTI)?

A
  • Peripheral neuropathy
  • tenofovir : renal impairment, osteoporosis
  • zidovudine : anaemia, myopathy, black nails
  • didanosine : pancreatitis
85
Q

What are examples of nucleoside analogue reverse transcriptase inhibitors (NRTI)?

A

Zidovudine (AZT)
Abacavir
Emtricitabine
Didanosine
Lamivudine
Stavudine
Zalcitabine
Tenofovir

86
Q

What are some examples of non-nucleoside reverse transcriptase inhibitors (NNRTI)?

A
  • Nevirapine
  • Efavirenz
87
Q

What are some side effects of non-nucleoside reverse transcriptase inhibitors (NNRTI)?

A

P450 enzyme interaction
Rashes

88
Q

What are some examples of protease inhibitors?

A

Indinavir
Nelfinavir
Ritonavir
Saquinavir

89
Q

What are the side effects of protease inhibitors?

A
  • Diabetes
  • Hyperlipidaemia
  • Buffalo hump
  • Central obesity
  • P450 enzyme inhibition
    Indinavir: renal stones, asymptomatic hyperbilirubinaemia
    Ritonavir: potent P450 inhibition
90
Q

What are some examples of integrase inhibitors?

A

Raltegravir
Elvitegravir
Dolutegravir

91
Q

What are the common cause of meningitis in children ages 0-3months?

A

Group B streptococcus
E.coli
Listeria monocytogenes

92
Q

What are the common causes of meningitis in 3months - 6 years?

A

Neisseria meningitidis
Streptococcus pneumoniae
Haemophilus influenzae

93
Q

What are the common causes of meningitis between 6 - 60 years?

A

Neisseria meningitidis
Streptococcus pneumoniae

94
Q

What are the common causes of meningitis >60years?

A

Streptococcus pneumoniae
Neisseria meningitidis
Listeria monocytogenes

95
Q

What are the features of chlamydia?

A

Asymptomatic
Cervicitis (discharge, bleeding)
Dysuria
Urethral discharge in men

96
Q

What are potential complications of chlamydia?

A

Epididymitis
Pelvic inflammatory disease
Endometritis
Ectopic pregnancy
Infertility
Reactive arthritis
Perihepatitis (Fitz-Hugh-Curtis syndrome)

97
Q

What is the investigation of choice in identifying chlamydia?

A

Nuclear acid amplification tests (NAATs).
First void urine, vulvovaginal and cervical swabs can be tested using NAATs.

Testing should be carried out 2 weeks post exposure.

98
Q

What are the 3 main types of schistosomiasis?

A

S. mansoni, S. japonicum and S. haematobium

99
Q

What are the features of acute schistosomiasis?

A
  • Swimmers itch
  • Katayama fever (fever, urticarial rash, hepatosplenomegaly, bronchospasm)
  • Cough
  • Arthralgia
  • Diarrhoea
  • Eosinophilia
100
Q

What causes the swimmer’s itch in schistosomiasis?

A

S. Haematobium worms deposit egg clusters (pseudopapillomas) into the bladder causing inflammation.
This can cause obstructive uropathy and kidney damage leading to swimmer’s itch.
This is a risk factor for squamous cell bladder cancer.

101
Q

What are the investigations used in schistosomiasis?

A

Asymptomatic: serum schistosome antibodies
Symptomatic: Urine/stool microscopy

102
Q

What is the treatment of schistosomiasis?

A

Single oral dose praziquantel

103
Q

What is hepatitis B?

A

Double stranded DNA hepadnavirus and is spread through exposure infected blood or bodily fluids. Vertical transmission also possible.
6-20 week incubation period.

104
Q

What are the features of hepatitis B?

A

Fever
Jaundice
Elevated liver transaminases

105
Q

What are the complications of hepatitis B infection?

A

Chronic hepatitis
Fulminant liver failure
Hepatocellular carcinoma
Glomerulonephritis
Polyarteritis nodosa
Cryoglobulinaemia

106
Q

What do anti-HBs levels >100 indicate?

A

Adequate response to hepatitis B immunisation, no further testing required.
Booster in 5 years.

107
Q

What do anti-HBs levels 10 -100 indicate?

A

Suboptimal response - 1 addition vaccine dose required.
No further testing if not immunocompromised.

108
Q

What do anti-HBs levels <10 indicate?

A

Non-responder.
Test for current and past infection.
Give 3 further vaccine doses and testing afterwards.
If remains to not respond then HBIG needed if exposed.

109
Q

What is the treatment of Hepatitis B?

A

Pegylated interferon 1st line
Other antivirals 2nd line e.g. tenofovir, entecavir, telbivudine

110
Q

What are the features of toxocara canis?

A
  • Commonest cause of Visceral larva migrans (condition caused by migration of larvae from parasites through the body).
  • Eye granulomas
  • Liver/lung involvement
111
Q

Who should be screened for Methicillin-resistant Staphylococcus aureus (MRSA)?

A
  • All patients awaiting elective admissions (except day patients having terminations/ophthalmic surgery)
  • All emergency admissions
112
Q

How is MRSA screened?

A

Nasal swab and skin lesion or wounds
5 seconds for nasal swab

113
Q

What antibiotics are commonly used in the treatment of MRSA infections?

A

Vancomycin
Teicoplanin
Linezolid

114
Q

How is MRSA suppressed if identified from a carrier?

A

Nose: Mupirocin 2% in white soft paraffin TDS 5/7.

Skin: Chlorhexidine gluconate OD 5/7. All over but particular care to axilla, groin and perineum

115
Q

Which type of pneumonia is associated with cold sores?

A

Streptococcus pneumoniae.
(reactivates herpes simplex)

116
Q

What is the treatment for genital warts?

A
  • Multiple, non-keratinised warts: topical podophyllum
  • Solitary, keratinised warts: cryotherapy
117
Q

What most commonly causes genital warts?

A

Human papillomavirus (HPV) types 6 and 11

118
Q

What is the mechanism of action of amantadine (antiviral)?

A

Inhibits uncoating (M2 protein) of virus in cell. Also releases dopamine from nerve endings

119
Q

What is amoebiasis?

A

Caused by Entamoeba histolytica (an amoeboid protozoan) and spread by the faecal-oral route.

Infection can be asymptomatic, cause mild diarrhoea or severe amoebic dysentery. Amoebiasis also causes liver and colonic abscesses.

120
Q

What are the features of amoebic dysentery?

A
  • Profuse bloody diarrhoea
  • Long incubation period
  • Trophozoites on hot stool sample
121
Q

What is the treatment for amoebic dysentery and amoebic liver abscesses?

A
  • Oral metronidazole
  • Luminal agent to target intraluminal cysts e.g. diloxanide furoate
122
Q

What are the features of an amoebic liver abscess?

A

-Usually a single mass in the right lobe (may be multiple). The contents are often described as ‘anchovy sauce’
- fever
- right upper quadrant pain
- systemic symptoms e.g. malaise
- hepatomegaly

123
Q

What is Dengue fever?

A

Viral infection that can progress to viral haemorrhagic fever.

-RNA virus of the genus Flavivirus
-Transmitted by the Aedes aegypti mosquito
-Incubation period of 7 days

124
Q

What are the features of dengue fever?

A

-Fever
-Headache (often retro-orbital)
-Myalgia, bone pain and arthralgia (‘break-bone fever’)
-Pleuritic pain
- Facial flushing (dengue)
-Maculopapular rash
- Haemorrhagic manifestations e.g. positive tourniquet test, petechiae, purpura/ecchymosis, epistaxis

‘Warning signs’ include:
-abdominal pain
-hepatomegaly
-persistent vomiting
-clinical fluid accumulation (ascites, pleural effusion)

125
Q

What are the investigations for Dengue fever?

A

Bloods : leukopenia, thrombocytopenia, raised aminotransferases.

serology
nucleic acid amplification tests for viral RNA
NS1 antigen test

126
Q

What is the treatment for Dengue fever?

A

Entirely symptomatic
No antivirals currently available.

127
Q

What is the treatment for campylobacter infection?

A

Usually self limiting after 7 days
Oral clarithromycin first line in severe cases.
Azithromycin and erythromycin are suitable alternatives.

128
Q

What is leprosy?

A

Granulomatous disease primarily affecting the peripheral nerves and skin. It is caused by Mycobacterium leprae.

129
Q

What are the features of leprosy?

A

-Patches of hypopigmented skin typically affecting the buttocks, face, and extensor surfaces of limbs
-Sensory loss

130
Q

What is leptospirosis?

A

Caused by the spirochaete Leptospira interrogans (serogroup L. icterohaemorrhagiae)
Classically being spread by contact with infected rat urine.

131
Q

What people are more commonly infected with leptospirosis?

A

Sewage workers
Farmers
Vets
Abattoir workers
Those returning from tropics

132
Q

What are the features of Leptospirosis?

A

-Early phase is due to bacteraemia and lasts around a week:
may be mild or subclinical
fever
flu-like symptoms
subconjunctival suffusion (redness)/haemorrhage

-Second immune phase may lead to more severe disease (Weil’s disease):
acute kidney injury (seen in 50% of patients)
hepatitis: jaundice, hepatomegaly
aseptic meningitis

133
Q

What investigations should you perform for Leptospirosis?

A

-Serology: antibodies to Leptospira develop after about 7 days
-PCR
-Culture:
growth may take several weeks so limits usefulness in diagnosis
blood and CSF samples are generally positive for the first 10 days
urine cultures become positive during the second week of illness

134
Q

What is the treatment for Leptospirosis?

A

high-dose benzylpenicillin or doxycycline

135
Q

Which species of malaria parasite has the shortest erythrocytic replication cycle?

A

Plasmodium knowlesi

136
Q

What are the most common cause of non-falciparum malaria?

A
  • Plasmodium vivax is most common
  • Plasmodium ovale and Plasmodium malariae accounting for the other cases.
137
Q

What is Chikungunya?

A

Alphavirus disease caused by infected mosquitoes.

Areas affected are Africa, Asia and Indian subcontinent but in recent years there has been seen in a few cases in Southern Europe

138
Q

What are the features of Chikungunya?

A

Prominent symptoms:
- severe joint pain
-abrupt onset of high fever.
-general flu-like illness of muscle ache, headache, and fatigue.

The disease shares its symptoms with dengue but tends to have more joint pain which can be debilitating.

139
Q

What is Trichomonas vaginalis?

A

Trichomonas vaginalis is a highly motile, flagellated protozoan parasite. Trichomoniasis is a sexually transmitted infection (STI).

140
Q

What are the features of Trichomonas vaginalis?

A
  • Vaginal discharge: offensive, yellow/green, frothy
  • Vulvovaginitis
  • strawberry cervix
  • pH > 4.5
  • in men is usually asymptomatic but may cause urethritis
141
Q

What is the treatment for Trichomonas vaginalis?

A

oral metronidazole for 5-7 days, although the BNF also supports the use of a one-off dose of 2g metronidazole

142
Q

What is Tularaemia?

A

Zoonotic infection involving the microorganism F. tularensis Commonly transmitted through lagomorphs such as rabbits, hares and pikas but also in aquatic rodents - beavers and muskrat - and ticks.

143
Q

What are the features of Tularaemia?

A

-Erythematous papulo-ulcerative lesion at the site of the bite
-Reactive and ulcerating regional lymphadenopathy.

144
Q

What is the treatment for Tularaemia?

A

It is treated with antibiotics such as doxycycline.

145
Q

What is the most commonly isolated organism in animal bites?

A

Pasteurella multocida.

MRCP (3 decks)

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