infectious diseases Flashcards by Evie Wood

How long does a full course of tetanus last for?

10 years from last dose

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What do you do if someone has a high risk wound and their last tetanus jab was >10 years ago?

tetanus booster
tetanus IgG

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How many doses of tetanus injections do you require for life-long protection?

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What is the treatment for latent TB?

3 months of isoniazid, pyridoxine and rifampicin
or
6 months of isoniazid with pyridoxine

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What should you do before getting a BCG vaccine?

a Mantoux test - if they may have been exposed

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What are contraindications to the BCG vaccine?

Previous vaccine, past TB, HIV, pregnancy

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What is the causative organism of lyme disease?

Borrelia burgdorferi

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What is the management of confirmed lyme disease?

Doxycycline or amoxicillin if pregnant
if disseminated disease - ceftriaxone

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When can someone go back to school after scarlet fever?

24hrs after starting antibiotics

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Do all contacts of meningococcal meningitis need abx prophylaxis?

Yes, irrespective of vaccine status, should have a single dose of ciprofloxacin

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What is the management of shingles?

Acyclovir within 72 hours of onset in most patients, unless mild and under 50

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What is the first line management for chicken-pox exposure in pregnancy?

Check maternal blood for varicella zoster antibodies.
If none, oral aciclovir at day 7 to 14 after exposure

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What are the features of foetal varicella zoster?

skin scarring, micropthalmia, limb hypoplasia, microcephaly and learning disabilities

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What should be assessed before starting TB treatment?

Visual acuity

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What are the common side effects of rifampicin?

hepatitis, orange secretions, flu-like-symptoms

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What are the common side effects of isoniazid?

peripheral neuropathy (take with B6 to prevent), hepatitis, agranulocytosis, lupus

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What are the common side effects of Pyrazinamide?

hyperuricaemia (gout), arthralgia, myalgia, hepatitis (painful things)

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What are the side effects of ethambutol?

optic neuritis

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How do you diagnose C.Diff?

C.Diff toxin in the stool

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What is the first line management of C.Diff?

Oral vancomycin for 10 days

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What is the management of a life-threatening C.Diff infection?

Oral vancomycin and IV metronidazole

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What drugs should be given in someone with a CD4 count less than 200?

Co-trimoxazole - for pneumocystitis jiroveci prevention

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What is the first-line test for HIV?

Viral antibodies and antigens

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What are the features of diptheria?

recent travel abroad, sore throat with ‘diptheric membrane’ - grey membrane on tonsils and pharynx, lymphadenopathy, neuritis

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What is the management of diptheria?

IM penicillin (caused by corynebacterium diptheriae), diptheria antitoxin

What are the common travel related conditions?

Malaria, Typhoid, Arbovirus

How do you know a fever in a returning traveller is not malaria?

There is no rash in malaria (test too)

How is typhoid spread?

Faeco-oral - through contaminated food or water

What are the clinical features of typhoid?

gradual onset of fever (rose spots on trunk), malaise, headache, dry cough week 2: persistent high fever, abdominal pain and diarrhoea or constipation. hepatosplenomegaly

What are the complications of typhoid?

GI perforation

How do you diagnose typhoid?

Blood culture

How do you treat typhoid?

IV ceftriaxone if complex PO azithromycin if uncomplicated

What do you see on blood film with malaria?

Ring trophozoites

What causes malaria?

P.falciparum (much worse) and non-falciparum malaria (can present months to years after but not as bad)

What is the treatment for malaria?

IV artesunate

Give some examples of viral haemorrhagic fevers?

Lassa, Ebola, Marburg - person-to-person transmission

What are the features of lymphogranuloma venerium?

Caused by chlamydia a painless genital lesion which then forms an ulcer, painful inguinal lymphadenopathy and proctitis

What causes Chancroid?

Haemophilus ducreyi

How do you diagnose legionnella?

Urinary antigen test

What are the features of legionnella?

Flu-like symptoms, dry cough, lymphopaenia, hyponatraemia, deranged LFTs

What is the management of legionella pneumonia?

Erythro/clarithromycin

What are the features of Campylobacter gastroenteritis?

Prodrome, abdominal pain and bloody diarrhoea. 1-6 day incubation

What are the features of salmonella gastroenteritis?

12-48hrs incubation, severe vomiting and high fever

At what age are children offered the HPV vaccine?

Aged 12-13

What is the gold standard investigation for active TB?

Sputum culture

What is the first line antibiotic used for an animal/human bite?

Co-amoxiclav. If pen allergic - give doxycycline plus metronidazole

What is the management of a UTI in the first trimester?

7 days nitrofurantoin

Which test results show active syphilis?

Non-treponoma test positive, treponoma specific positive

Which test results show treated syphilis?

Non-treponoma test negative, treponoma specific positive

What are the features of malaria?

Swinging fever - fever on alternate days. Trophozoites on blood film

What are the features of giardia?

steatorrhoea, bloating, abdo pain, weight loss, can cause malabsorption and lactose intolerance

what are the features of E.Coli gastroenteritis?

Commonest among travellers, watery stools, abdo cramps and nausea

What are the CSF findings in bacterial meningitis?

Cloudy, low glucose, protein > 1g, raised polymorphs

What are the CSF findings in viral meningitis?

Clear/cloudy, 60-80% of plasma glucose, normal protein, raised lymphocytes

What are the CSF findings in TB meningitis?

cloudy/web like. low glucose, high protein (>1g), raised lymphocytes

What is the management of latent TB?

3 months of isoniazid, rifampicin, pyridoxine 6 months of isoniazid with pyridoxine

What is the first line treatment of gonorrhoea?

IM ceftriaxone 1g

What are the features of Hep A?

Flu-like prodrome, RUQ pain, hepatomegaly, jaundice, deranged LFTs (faeco-oral spread)

What is the diagnostic test for Lyme disease?

Antibody titres for Borrelia Burgdorferi

What should you do if someone is unwell when they are supposed to have a vaccine?

Postpone until they get better

What type of pneumonia is associated with erythema multiforme and erythema nodosum?

Mycoplasma

What is the first line management of syphilis?

IM benzathine penicillin

What are the features of cerebral toxoplasmosis?

Immunocompromised, headache, confusion, drowsy, CT shows ring enhancing lesion

What causes painful genital ulcers? And what causes painless ones?

painful: herpes (and chancroid) Painless: syphilis

What organism stains with india ink?

Cryptococcus

What are the features of trichomonas vaginalis?

yellow/green vaginal discharge, strawberry cervix. trophozoites

What is the management of trichomonas vaginalis?

Oral metronidazole for 5-7 days