Infectious diseases:

Question 1

Whooping cough tx

Answer 1

Azithromycin (macrolide)

Question 2

Investigation and management of gonorrhoea

Answer 2

1. Vulovaginal swab or first pass urine in men, or penile swab
2. Microscopy: gram negative diplococci
3. NAAT
4. Culture

Tx –> CETRIAXONE

Question 3

Side effects of TB drugs

Answer 3

RIPE

R-rifampicin
- Liver toxicitiy, P450 inducer
- haemolysis
I- isoniazid
- peripheral neuropathy (pyridoxine (vitamin B6) to prevent this)
P-pyrazinamide
- liver toxicity
- arthralgia
- hyperuricaemia
E-ethambutol
- EYE disturbances (colour blindness, loss of acuity)
- avoid in CKD

Question 4

This is used to identify patients who may have latent TB infection.

Answer 4

Interferon Gamma Release Assay (IGRA)

Patients w/ evidence of active infection: ACID FAST BACILLI
CXR
Tuberculin skin test to see if patient has been exposed to TB before BCG vaccination

Question 5

Bacterial meningitis in a 3 month year old with conjunctival haemorrhage

Initial empirical antibiotic therapy for children younger than 3 month old ?

Answer 5

1. IV CEFOTAXIME (covers GBS and HI)
2. AMPICILLIN (covers listeria)

HI - haemophillus influenza

Question 6

Criteria for tonsilitis

Answer 6

Centor criteria: absence of cough exudate, nodes and fever

Tx: oral phenoxymethylpenicillin

Question 7

What is rheumatic fever:

Answer 7

systemic, auto-immune complication of a group A beta-haemolytic streptococcus infection (scarlet fever)

The Jones criteria is used to aid clinical diagnosis. Major criteria include arthritis, pancarditis, Sydenham’s chorea, erythema marginatum, and subcutaneous nodules. Minor manifestations include fever, arthralgia, raised acute phase proteins, and prolonged PR interval.

Question 8

This rash is known as:

and seen in:

Answer 8

ERYTHEMA MIGRANS
- early localised phase of lyme disease

Question 9

This rash is known as:

Answer 9

maculopapular rash
- seen in rickettsia

Question 10

This rash is:

Answer 10

Rose spots seen in Typhoid

Question 11

This rash is:

Answer 11

ERYTHEMA MULTIFORME

Question 12

Fungal nail infection management

Answer 12

Dermatophyte
–> if topical tx unsuccessful
–> oral terbinafine (3-6 months) (contraindicated in autoimmune diseases)

Non dermatophyte
–> oral itraconazole

Question 13

70 year old male presents with 2/7 history of scrotal swelling.

Examination reveals a red, hot swollen left testicle that is tender on palpation. There is no regional lymphadenopathy.

Diagnosis and causative organism

Answer 13

EPIDIDYMOORCHITIS
- e.coli

Question 14

Rash and diagnosis

Answer 14

Migrating salmon pink rash and fever.

Type of Juvenile Idiopathic Arthritis
–> ferritin classically high

Question 15

these are first-line treatment for ESBL-producing organisms

Answer 15

CARBAPENEMS such as meropenem