infectious diseases Flashcards
How long does a full course of tetanus last for?
10 years from last dose
What do you do if someone has a high risk wound and their last tetanus jab was >10 years ago?
tetanus booster
tetanus IgG
How many doses of tetanus injections do you require for life-long protection?
5
What is the treatment for latent TB?
3 months of isoniazid, pyridoxine and rifampicin
or
6 months of isoniazid with pyridoxine
What should you do before getting a BCG vaccine?
a Mantoux test - if they may have been exposed
What are contraindications to the BCG vaccine?
Previous vaccine, past TB, HIV, pregnancy
What is the causative organism of lyme disease?
Borrelia burgdorferi
What is the management of confirmed lyme disease?
Doxycycline or amoxicillin if pregnant
if disseminated disease - ceftriaxone
When can someone go back to school after scarlet fever?
24hrs after starting antibiotics
Do all contacts of meningococcal meningitis need abx prophylaxis?
Yes, irrespective of vaccine status, should have a single dose of ciprofloxacin
What is the management of shingles?
Acyclovir within 72 hours of onset in most patients, unless mild and under 50
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
What are the features of foetal varicella zoster?
skin scarring, micropthalmia, limb hypoplasia, microcephaly and learning disabilities
What should be assessed before starting TB treatment?
Visual acuity
What are the common side effects of rifampicin?
hepatitis, orange secretions, flu-like-symptoms
What are the common side effects of isoniazid?
peripheral neuropathy (take with B6 to prevent), hepatitis, agranulocytosis, lupus
What are the common side effects of Pyrazinamide?
hyperuricaemia (gout), arthralgia, myalgia, hepatitis (painful things)
What are the side effects of ethambutol?
optic neuritis
How do you diagnose C.Diff?
C.Diff toxin in the stool
What is the first line management of C.Diff?
Oral vancomycin for 10 days
What is the management of a life-threatening C.Diff infection?
Oral vancomycin and IV metronidazole
What drugs should be given in someone with a CD4 count less than 200?
Co-trimoxazole - for pneumocystitis jiroveci prevention
What is the first-line test for HIV?
Viral antibodies and antigens
What are the features of diptheria?
recent travel abroad, sore throat with ‘diptheric membrane’ - grey membrane on tonsils and pharynx, lymphadenopathy, neuritis
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