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Medicine > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

Which types of hepatitis viruses cause chronic infection?

A

Blood borne viruses

Hep B, C

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2
Q

Which hepatitis viruses do we vaccinate against?

A

A, B

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3
Q

Which hepatitis viruses are RNA and DNA-based?

A

B - DNA
Others - RNA

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4
Q

Which heptitis viruses are enteric?

A

A, E

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5
Q

Name one key complication of hepatitis A

A

fluminant hepatitis (liver failure)

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6
Q

What is odd about Heptitis D?

A

You can only get it if you have Hepatitis B, as it attaches to the ABsAg

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7
Q

How would you treat Hepatitis D?

A

Pegylated IFN-alpha

only 20% respond though

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8
Q

Which Hep E genotypes are more common in the developing and the developed world?

What is the difference in mortality between the two?

A

Developing - !, 2
20-25% mortality in pregnancy women

Developed - 3, 4
self-limiting illness yay

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9
Q

What is the risk of developing chronic hep B in different populations?

A

90% for neonates
30% for children <5
<10% for adolescents

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10
Q

What proportion of patients with chronic Hep B will develop complications?

A

Liver cirrhosis <5%
Hepatocellular carcinoma <0.05%

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11
Q

What does HBsAg suggest?

A

Active infection

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12
Q

What doe HBeAg suggest?

A

Viral replication, high infectivityWha

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13
Q

What does HBcAb suggest?

A

past / current infection

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14
Q

What does HBsAb suggest?

A

Vaccination or past or current infection

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15
Q

Which children do you test for Hep B?

A

Hep B + mums
Migrants from endemic areas
Close contacts

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16
Q

How do you reduce the risk of vertical Hep B transmission?

A

within 24 hours

Vaccine
Ig Infusion

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17
Q

What proportion of adults with Hep C develop chronic Hep C?

A

75%

Relatively few of these will develop cirhrosis / hepatocellular carcinoma

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18
Q

How do you test foor Hep C?

A

Hep C Ab - screening
RNA - confirmation

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19
Q

What is the vector for dengue fever?

A

Aedes aegypti mosquito

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20
Q

How do you manage dengue fever?

A

Supportive management

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21
Q

What are the 3 phases of Dengue fever?

A

Febril days 1-7 (fever rash)

Critical days 3-5 (abdo pain)

Recovery days 2-3 (isle of white rash)

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22
Q

How might you classify dengue?

A

Probably dengue

Dengue with warning signs (abdo pain, bleed…)

Severe dengue (plasma leak, haemorrhage, organ involvement)

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23
Q

What 3 tests would you use to investigate Dengue?

A

NS1 antigen (1st 4 days)
IgM (after 5 days illness)
IgG (after 7 days)

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24
Q

How migh you differentiate EBV from a run of the mill URTI?

A

Tonsilitis
Splenomegaly (50%)
Jaundice / hepatomegalu (rare)

Use centor criteria / FeverPAIN to differentiate from bacterial tonsilitis

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25
Q

How do you manage EBV?

A

AVOID ABX

resolves within 1-2 weeks

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26
Q

What is the vector for Malaria?

A

Female Anopheles mosquitoesN

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27
Q

Name 5 types of malaria

A

Plasmodium falciparum
… vivax
… ovale
… malariae
… knowlesi

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28
Q

Who gets really ill with plasmodium falciparum?

A

Those with their first acute infection later on in life

Those who grow up with it might not be that affected

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29
Q

What problem is associated with Plasmodium vivax and ovale?

How would you overcome this?

A

Have a dormant stage in the liver

May relapse so you offer primaquine to target them in the liver

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30
Q

What is the incubation period of malaria?

A

1-4 weeks

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31
Q

Name 3 key signs of malaria on examination

A

Pallor (anaemia)
Hepatosplenomegaly
Jaundice (haemolysis)

+ fever

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32
Q

How do you diagnose malaria?

A

Malaria blood film -> EDTA bottle

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33
Q

How do you exclude malaria?

A

3 negative samples over 3 consecutive days

34
Q

Where is plasmodium vivax more common and how is it treated?

A

Pakistan / India

Chloroquine

35
Q

How would you manage plasmodium falciparum?

A

Artersunate

Artemether with lumefantrine (Riamet)

36
Q

How long is the incubation and prodromal phase for measles?

A

Incubation - 10 days
Prodromal - 2-4 days

37
Q

What dermatological finding is pathognomic of measles?

What else might you see?

A

Koplik’s spots

Then after 1-2 days, an erythematous maculopapular rash from the face to the trunks and limbs

38
Q

How do you investigate measles?

A

NOTIFIABLE DISEASE

Measle-specific IgM/IgG ELISA

39
Q

How do you manage Measles?

A

self-limiting, IV Fluids as leaky

Vitamin A if really unwell

Off school / work for 4 days after rash has apeared

40
Q

How is the MMR vaccine offered?

A

2 doses
1 year
3 years and 4 months

Post-exposure prophylaxis, if over 6 months old and within 72 hours of exposure

41
Q

What is the incubation period for mumps?

A

14-25 days

42
Q

How do you manage mumps?

A

Self-limiting, supportive management

NOTIFIABLE DISEASE

43
Q

What is the defining feature of mumps?

What might indicate a complication?

A

Parotid gland swelling

Abdominal pain - pancreatitis
Testicular pain - orchitis
Confusion - meningitis / encephalitis

44
Q

How is Rubella treated?

A

NSAIDs, supportive treatment

45
Q

How is Rubella contracted?

A

Aerosoled particles from RTIs of affected individuals

46
Q

When does Rubella disseminate to other organs?

A

Within 5-7 days of infection

47
Q

When does Rubella develop a rash?

A

Within 2-8 days of dissemination

48
Q

When is Rubella infectious?

A

8 days before to 8 days after the onset of the rash

49
Q

What are the two key characteristics of Rubella?

A

Lymphadenopathy
Rash (face then extremities)

50
Q

What oral feature is seen in 20% of rubella patients?

A

Forchheimer spots

51
Q

How is Rubella diganosed?

A

Specific IgM

Reinfection 4x increase in IgG, differentiating it from a primary infection

52
Q

When are babies at risk of congenital rubella syndrome?

A

During first 10 weeks of gestation

53
Q

How would you manage congenital rubella syndrome?

A

<18 weeks - consider termination of pregnancy

> 18 weeks - US monitoring, supportive management

54
Q

What kind of bacteria do you find on the skin generally?

A

Gram-positive Cocci

55
Q

What kind of bacteria do you find in the gut generally?

A

Gram negative rods

56
Q

Name 3 examples of gram - rods

A

Ecoli
chigella
klebsiella

57
Q

Name 2 examples of gram - cocci

A

Neisseria gonorrhoea
Pasteurella

58
Q

Name 2 example of gram + rods

A

C. perfringens
C. tetani

59
Q

Name 2 examples of gram + cocci

A

Staph aureus
Streptococcus

60
Q

What infection causes Whooping Cough?

A

Bordetella Pertissus

61
Q

What are the 3 phases of Whooping cough?

A

Catarrhal 1-2 weeks (viral URTI)

Paroxysmal 2-8 weeks (severe, inspiratory whooping)

Convalescent - subsides

62
Q

How do you diagnose whooping cough?

A

Acute cough >14 days, no cause + one of
- Paroxysmal cough
- Inspiratory whoop
- Post-tussive vomiting
- Undiagnosed apnoeic attacks in young infants

PCR and serology

63
Q

How would you manage Whooping cough?

A

Oral macrolide if cough onset in last 21 days

Household contacts - prophylaxis

School exclusion 48hrs after commencing Abx or 21 days from symptom onset if no Abx

64
Q

What causes Lyme disease?

A

Borrelia Burgdorferi, spread by ticks

65
Q

How might Lyme disease present?

A

Early - illness, erythema migrans (bulls-eye)

Late (30+ days) - cardiovascular, neurological

66
Q

How do you investigate Lyme disease

A

Erythema migrans -> Abx

ELISA might be helpful

67
Q

How do you treat Lyme disease?

What do you have to be wary of?

A

Early - doxycycline
Disseminated - Ceftriaxone

Jarish-herxheimer reaction

68
Q

Summarise the different structures of common fungal types

A

Yeasts - unicellular
Molds - multi-cellular
Dimorphic - mould in environment, yeast in body

69
Q

How do you treat oral and oesophageal candidiasis?

A

Topical - nystatin mouth wash, clotrimazole, miconazole

Oral - Fluconazole 200g OD

70
Q

How do you treat invasive candidiasis?

A

Echinocandin
Fluconazole
Amphotericin B

71
Q

What type of fungi is Aspergillus?

A

mould

72
Q

Who gets ABPM?

A

Asthmatics
CF

73
Q

How do you treat ABPM?

A

Prednisolone
Maybe Itraconazole

74
Q

What 2 conditions are classified as chronic pulmonary aspergilliosis?

A

Aspergillioma
Chronic cavitary pulmonary aspergillosis

75
Q

How gets chronic pulmonary aspergilliosis?

A

Those with chronic lung disease like COPD or TB

76
Q

How do you diagnose chronic pulmonary aspergillosis?

A

Isolate the organism or IgG in serum

77
Q

How do you treat chronic pulmonary aspergillosis?

A

Itraconazole
relevant surgery

78
Q

Who is susceptible to Invasive Aspergillosis?

A

Prolonged neutropenia
HSCT / SOT
GvHD

79
Q

How would you treat Invasive Aspergillosis?

A

Voriconazole / Amphotericin B

80
Q

Name the 6 main causes of rigor

A

Malaria
UTI
URTI
Biliary sepsis
Abscess
Central line sepsis

81
Q

What are the contraindications to statins?

A

Pregnancy

Macrolides (stop statins until patients complete their Abx course)

Medicine (20 decks)

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