Infectious Diseases

Question 1

What test is standard for screening and diagnosis of HIV?

Answer 1

HIV p24 antigen and HIV antibody
(Note viral load is usually to assess response to treatment)

Question 2

Treatment for genital warts? Multiple vs solitary

Answer 2

Multiple, non-keratinised warts: topical podophyllum
Solitary, keratinised warts: cryotherapy

Question 3

When is tetanus immunoglobulin given in addition to the booster, vs just the booster alone?

Answer 3

Add for high risk wounds if no booster in last 10 years. Add to both high risk and tetanus prone wounds if vaccination history is unknown or incomplete

Question 4

If someone is bitten by a tick, when is treatment started? What is first and second line?

Answer 4

Only if symptomatic or confirmed Lyme with erythema migraines target lesions or positive ELIA serology assay.
1. Doxycycline (14-21 day course). 2. Amoxicillin

Question 5

Which age group gets HPV vaccine?

Answer 5

12-13 (year 8)

Question 6

How would meningococcal meningitis be treated in community (before hospital) vs in hospital?

Answer 6

Benzylpenicillin in community; cefotaxime or ceftriaxone in hospital

Question 7

What are rules for antibiotics for UTI in pregnancy?

Answer 7

Always treat UTI in pregnancy, even if symptomatic
Treatment is 7 days as opposed to usual 3 days
Nitro is safe in 1st and 2nd trimester
Trimethoprim is not recommended in the first trimester

Question 8

What is used as prophylaxis for contacts of someone with confirmed meningococcal meningitis?

Answer 8

Ciprofloxacin is 500 mg administered as a single dose in patients aged 12 years or older. (or rifampicin BD for 2 days)

Question 9

Which strain of HPV causes genital warts vs cervical cancer?

Answer 9

Genital warts - 90% are caused by HPV 6 & 11
HPV (primarily types 16,18 & 33) predisposes to cervical cancer.

Question 10

What should be done 2/52 after treatment for gonorrhoea?

Answer 10

A test of cure should be done for all patients.

Question 11

Which antibiotics are commonly used for MSRA?

Answer 11

Vancomycin
Teicoplanin
Linezolid
Trimethoprim/sulfamethoxazole (TMP/SMX).
Ceftaroline.
Daptomycin.
Clindamycin.
Doxycycline.
Delafloxacin.

Question 12

Which antibiotic is used for human and animal bites? And for how long?

Answer 12

Co-amoxiclav for 3 days

Question 13

What gram positive obligate organism is often implicated in gas gangrene?

Answer 13

Clostridium perfringens

Question 14

For gonorrhoea, if ceftriaxone is refused (e.g. needle-phobic) then what is next line treatment?

Answer 14

Oral cefixime 400mg (single dose) + oral azithromycin 2g (single dose) should be used

Question 15

Where is parvovirus B19 relevant in paeds, obstetrics and haematology?

Answer 15

Paeds - causes slapped cheek disease (5th disease; erythema infectiosum)
Obstetrics - in pregnancy can cause hydros fetalis
Haem - aplastic crisis in sickle cell or pancytopenia in the immunocompromised

Question 16

Management for HSV herpes in pregnancy?

Answer 16

Oral aciclovir until delivery and delivery by caesarean section due to high risk of neonatal transmission

Question 17

What is the decolonisation regime for MRSA?

Answer 17

Nasal mupirocin + chlorhexidine for the skin.

Question 18

What additional treatment is given for meningitis to reduce the risk of neurological sequelae and improve outcomes?

Answer 18

Dexamethasone

Question 19

First-line treatment for prostatitis?

Answer 19

Ciprofloxacin

Question 20

What additional medication is used to treat people with meningitis who are above 50 or immunocompromised and why?

Answer 20

Ampicillin (or amoxicillin). To cover the additional risk of Listeria monocytogenes, which is more common in older adults and immunocompromised individuals.

Question 21

What virus causes croup?

Answer 21

Parainfluenza virus

Question 22

What are the treatment options for latent TB?

Answer 22

Latent tuberculosis treatment options:
3 months of isoniazid (with pyridoxine (B6) ) and rifampicin, or
6 months of isoniazid (with pyridoxine (B6) )

Question 23

How long is the intensive phase of TB treatment. How long is treatment for the continuation phase and which drugs are used?

Answer 23

RIPE drugs for 2 months
Active phase for 6 months with RI– : rifampicin & isoniazid

Question 24

What is the only exception to the tuberculin skin test before receiving the BCG vaccine?

Answer 24

Any person being considered for the BCG vaccine must first be given a tuberculin skin test. The only exceptions are children < 6 years old who have had no contact with tuberculosis

Question 25

Most common pathogen in IECOPD?

Answer 25

Haemophilus influenzae

Question 26

What is the mono spot test used for? (Heterophile antibody)

Answer 26

EBV (infectious mononucleosis)

Question 27

Which type of HSV is typically cold sores vs STI?

Answer 27

HSV 1 for cold sores, HSV 2 for STI

Question 28

What type of GI infection may mimic appendicitis?

Answer 28

Campylobacter jejuni infection may cause marked right iliac fossa pain mimicking appendicitis