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UKMLA > Infectious diseases > Flashcards

Infectious diseases Flashcards

1
Q

What are the key signs and symptoms of glandular fever?

A

Fever
Sore throat
Fatigue
Hepatosplenomegaly

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2
Q

What causes glandular fever (mono)?

A

EBV

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3
Q

What is diagnostic test for EBV?

A

EBV serology - confirms presence of IgM antibodies

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4
Q

What is treatment for c.diff?

A

Oral vancomycin

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5
Q

What must be started after chloroquine has been used for acute malaria?

A

Primaquine

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6
Q

What is primaquines role?

A

Only effective drug against hypnozoites - dormant liver stage parasites of plasmodium
Primaquine prevents another malaria relapse

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7
Q

What is the incubation period for plasmodium?

A

7-30 Days

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8
Q

What is gold standard diagnosis of malaria?

A

Thick and thin blood films

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9
Q

Which pneumonia is associated with reactivation of herpes?

A

Strep peumoniae

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10
Q

Which malarial prophylaxis should be avoided in epileptics ?

A

Mefloquine

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11
Q

What does periosteal reaction on X-ray indicate?

A

Presence of new bone formation in response to abnormal stimuli

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12
Q

How can osteomyelitis present?

A

Periosteal reaction
Fever
Pain
Positive blood cultures for salmonella typhi
Spleen impairment

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13
Q

What is the most common causative organism of osteomyelitis?

A

Staph aureus
AND
coagulase negative staph

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14
Q

What are the risk factors of osteomyelitis?

A

DM
PVD
Malnnourished
Immunosuppressed
Malignancy
Extreme age

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15
Q

How does osteomyelitis present?

A

Fever
Pain at rest
Swelling
Erythema at affected sight

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16
Q

What is gold standard management for osteomyelitis?

A

MRI

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17
Q

What is management for osteomyelitis?

A

LTM antibiotic (4-6 weeks for acute or 3-6 months for chronic)
Flucloxacillin plus fusidic acid/ rifampicin

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18
Q

What is antibiotic used in pen allergic in osteomyelitis?

A

Clindamycin

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19
Q

What is recommended first line prophylaxis for meningitis?

A

Ciprofloxacin

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20
Q

What would show up on a CT head with HSV encephalitis?

A

Focal bilat temporal lobe involvement

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21
Q

What are the signs/ symptoms of viral hsv encephalitis?

A

Rash around mouth
Headache
Behaviour changes
Drowsiness
Neck stiffness
Confused

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22
Q

What would you see on CT head with toxoplasmosis?

A

Ring enhancing lesions

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23
Q

Where does the measles rash start?

A

Behind ears and back of head

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24
Q

How does measles present?

A

4D’s - 4 days of fever and the 3C’s
3c: cough, conjunctivitis, coryza

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25
Q

How can hep d be contractedd?

A

Only if the person has contracted hep b as well - this is the druggy one

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26
Q

Which hep is usually vaccinated against before travel?

A

HepA

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26
Q

Which hep doesn’t have a vaccine?

A

Hep E

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27
Q

How can Hep E present?

A

Flu like illness
Jaundice
Hepatosplenoegaly

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28
Q

How is hep E spread?

A

Faecal oral route

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29
Q

What is cryptosporidiosis and what is it’s treatment?

A

Common cause of diarrhoea in HIV patients
Treat by starting them on anti-retrovirals

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30
Q

What is the most common cause of invasive fungal nail disease?

A

Trichophyton rubrum

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31
Q

What is treatment for trichophyton rubrum causing nail disease?

A

Oral terbinafine - 3-6 months

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32
Q

What is the most common cause of gastroenteritis?

A

Campylobacter jejuni

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33
Q

What is campylobacter jejuni incubation period?

A

48-72 hours

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34
Q

When does campylobacter jejuni occur?

A

After raw meat, dairy and drinking untreated water

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35
Q

Which bacterial meningitis usually presents with a non-blanching rash?

A

Neisseria meningitidis

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36
Q

What amount of parasitaemia is worrying for severe malaria vs severe disease?

A

more than 2% then more than 105

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37
Q

What is sugar levels like in severe malaria?

A

Hypoglycaemic - a blood glucose lower than 2.2 is worrying and needs admitting

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38
Q

What would be hospital treatment for severe malaria?

A

IV artesunate

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39
Q

What does oral hairy leucoplakia indicate?

A

Primary HIV infection

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40
Q

If patient is pen allergic what can be given for a CAP?

A

Clarithromycin of doxycycline

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41
Q

Which bacteria is found in reheated rice?

A

Bacillus cereus - due to improper cooking and refrigeration

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42
Q

Which disease has otitis media as a common complication?

A

Measles

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43
Q

What is treatment for uncomplicated malaria?

A

Oral artemisinin and combo therapy

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44
Q

What is first line treatment for impetigo - then second line when first line is not tolerated?

A

Topical hydrogen peroxide
If not tolerated then fusidic acid

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45
Q

How does mumps present?

A

Fever
Parotid gland swelling
Orchitis - in some cases

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46
Q

What is treatment for mumps?

A

Supportive care

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47
Q

What is gram staining of pertussis?

A

Gram negative coccobacillus

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48
Q

What’s the most common cause of CAP vs HAP?

A

CAP: strep pneumoniae
HAP: pseudomonas aerginosa

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49
Q

What is the most common cause of viral meningitis?

A

Coxsackie

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50
Q

Which pneumonia reactivates herpes sores around mouth?

A

Strep pneumoniae

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51
Q

How to test for strep pneumoniae?

A

Urinary antigen test

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52
Q

Which pneumoniae is associated with haemolytic anaemia ?

A

Mycoplasma

53
Q

When should anti-retrovirals be started in HIV patients if patient has TB?

A

Delay retroviral for 4 weeks to prevent development of immune reconstitution inflammatory syndrome - occurs due to reactivation of immune system with antiretrovirals causing worsening of TB symptoms

54
Q

What should be co-prescribed with isoniazid and why?

A

Vitamin B6 - Pyridoxine - because isoniazid can cause peripheral neuropathy

55
Q

What is classic presentation of schistosomiasis exposure?

A

Abdo pain
Diarrhoea
Haematuria
Parasitic worms usually in infested waters with snails

56
Q

What is the treatment for schistosomiasis?

A

Two doses of praziquantel

57
Q

Which TB medication can cause orange discolouration of body fluids - like urine, sweat and tears

A

Rifampicin

58
Q

What are EBSL?

A

E.coli and klebsiella species

59
Q

Which antibiotics are first line for ESBL producing organisms?

A

Carbapenems

60
Q

Give an example of a carbapenem?

A

Meropenem

61
Q

When are carbapenam’s contraindicated?

A

If patient has had a anaphylactic reaction to penicillin

62
Q

What is first line investigation for mumps?

A

Mumps salivary IgM

63
Q

Which cholera serogroups are causative of cholera?

A

o1 and o139

64
Q

Which is gram staining of cholera?

A

Gram negative comma-shaped and single polar flagellum

65
Q

What are the signs and symptoms of cholera?

A

Sudden onset watery diarrhoea
Abdo cramps
Nausea
Vomiting
Thirst
Dry mouth
Dry skin
Oliguria
Drowsy
Lethargic

66
Q

What is the gold standard test for cholera?

A

Stool culture

67
Q

What is mainstay of treatment for cholera?

A

Aggressive fluid replacement

68
Q

Which antibiotic is used in cholera treatment?

A

Doxycycline

69
Q

What is treatment of tinia capitis - ringworm on head and why?

A

Topical ketoconazole and oral itraconazole - because there is poor penetration of topical agents through root of hair follicle to oral needed to

70
Q

What is antibiotic treatment of cellulitis?

A

Flucloxacillin + benzylpenicillin if severe

71
Q

If patient is pen allergic which medication is used for cellulitis?

A

Clarithromycin or clindamycin

72
Q

If a patient has lymphoedema with cellulitis - how long would the antibiotics need to be taken for?

A

1-2 months

73
Q

How long should a child stay of school with mumps?

A

Should not attend school for 5 days from onset of parotitis

74
Q

What would be a positive result for TB induration?

A

5mm or more

75
Q

What is treatment of gas gangrene?

A

Penicillin and clindamycin and debridement

76
Q

Why may a rash present when amoxicillin is given for a sore throat?

A

EBV could be present

77
Q

Which infectious disease presents with salmon coloured spots and non bloody diarrhea?

A

Salmonella - which can be called typhoid or enteric fever

78
Q

What is a complication of Strep pyogenes?

A

Scarlet fever which can cause a rough erythematous desquamating rash

79
Q

How is scarlet fever rash treated?

A

Oral phenoxymethylpenicillin - Pen V

80
Q

Which antigen for hep b if found suggests vertical transmission to baby?

A

HBe antigen - as these patients are most infective

81
Q

What is the gram staining of pseudomonas?

A

Gram negative aeruginosa

82
Q

What is the treatment of pseudomonas?

A

Oral ciprofloxacin

83
Q

What is treatment for asymptomatic tick bite?

A

Removal or tick - no antibiotic needed

84
Q

What is treatment of suspected or confirmed lyme disease?

A

Oral doxycycline

85
Q

Which pathogen causes leprosy?

A

Myobacterium leprae

86
Q

What are the signs and symptoms of leprosy?

A

Coppery or hypopigmented anaesthetic patches
Nose destruction
Ear swelling
Leonine faces - face resembles a lion
Nerve thickening - commonly ulnar, median and radial

87
Q

What is treatment for leprosy?

A

Rifampicin
Clofazimine
At least 1-2 years

88
Q

What is treatment for cryptococcal meningitis?

A

2 weeks of IV amphotericin B and oral flucytosine followed by 8 weeks of fluconazole

89
Q

What is treatment for CNS toxoplasmosis?

A

Oral pyrimethamine and sulfadiazine and folinic acid for 6 weeks after clinical resolution followed by long term maintance therapy

90
Q

What’s the most common cause of wound associated botulism?

A

IV drug use

91
Q

What investigation is used to detect toxin use?

A

Stool toxin ELISA

92
Q

What antibiotic is used in whooping cough treatment?

A

Clarithromycin

93
Q

What is the empirical treatment choice for osteomyelitis?

A

IV flucloxacillin and rifampicin

94
Q

If a patient presents to GP with meningitis what is the treatment?

A

Ambulance and benzylpenicillin 1.2g IM

95
Q

What is decolonisation therapy for MRSA? BTW MRSA colonisation on skin does not indicate infection and therefore antibiotics are not necessary

A

Nasal mupirocin
Chlorhexidine wash

96
Q

What is the best medication for rheumatic fever?

A

Benzylpenicillin

97
Q

What can indicate rheumatic fever?

A

Strep A
Erythema marginatum
Raised anti-strep O titre

98
Q

What is staph scalded skin syndrome?

A

Red blistering skin and a positive Nikolsky sign - prodrome of sore throat or conjunctivitis may occur

99
Q

Which TB drug is most likely to cause hepatotoxicity?

A

Pyrazinamide

100
Q

How is leprosy transmitted?

A

Respiratory secretions

101
Q

What is the medical management for a brain absess?

A

cephalospori + metronidazole for several weeks
and dexamethasone if there is raised ICP

102
Q

What is treatment for pseudomonas UTI?

A

Gentamicin

103
Q

Which antibiotic is used for vancomycin resistant enterococci?

A

Teicoplanin

104
Q

If teicoplanin is not able to be used in vanc resistance what can be used?

A

Linezolid

105
Q

When is interferon gamma release assay (IGRA) acid fast bacilli?

A

IGRA is used to detect latent TB in patients who have already been vaccinated with BCG.
Whereas acid fast bacilli is used for patient who have evidence of active infections

106
Q

What test can help diagnose dengue fever?

A

Positive tourniquet test

107
Q

What is the tourniquet test?

A

A blood pressure cuff is inflated to halfway between the systolic and diastolic blood pressure on the forearm and left in place for five minutes. After two minutes, the number of petechiae (small red or purple spots) is counted within a 2.5 cm square on the skin. The test is positive if there are more than 10 petechiae in the area

108
Q

What is katayama syndrome?

A

Acute early inflammatory reaction to migrating eggs and larvae of schistosoma worm

109
Q

What’s the most common zoonosis?

A

Brucellosis - livestock, unpasteurised milk

110
Q

What is treatment for brucellosis?

A

Dual antibiotic for uncomplicated
Triple for complication - rifampicin, doxycycline, gentamicin or streptomycin for several weeks

111
Q

What is empirical treatment for bacterial meningitis in kids younger than 3 months

A

IV cefotaxime and ampicillin

112
Q

How can brucellosis present?

A

Unexplained fevers
Night sweats
Myalgia
Joint pain
Lymphadenopathy
Hepatosplenomegaly

113
Q

Why does smoking increase risk of BV?

A

Anti-estrogenic effects from the polyaromatic hydrocarbons present in smoke

114
Q

What is the most common causative agent of osteomyelitis?

A

Staph aureus

115
Q

Which bacteria causes fever and gradual onset muscle spasms - trismus of jaw and tetanus ?

A

Clostridium tetanii

116
Q

Which antibiotic is used for c.diff infection?

A

Vanc

117
Q

What is first line treatment of acute rheumatic fever?

A

Stat dose of IV benzylpenicillin

118
Q

What’s the treatment for schistomiasis?

A

Corticosteroids and praziquantel

119
Q

What is best diagnostic imaging for osteomyelitis?

A

MRI

120
Q

Which bones does osteomyelitis in sickles usually affect?

A

Femoral or humeral head

121
Q

If a patient with co-morbidities presents with influenza what is the treatment?

A

Oral oseltamivir

122
Q

What is Kehr’s sign?

A

Referred pain to shoulder tip caused by irritaition of diaphragm by intra-abdominal fluid

123
Q

What is definitive management of hep c?

A

Antiviral combo therapy

124
Q

What would investigations show with EBV?

A

Elevated liver enzymes
Leukocytosis
Positive heterophile antibody test

125
Q

In which hep - hep A or E is the person at risk of contracting a more severe infection?

A

Hep E

126
Q

What is treatment for lyme disease with arthritis?

A

Oral doxycycline for 28 days

127
Q

Which TB medication can cause arthralgia ?

A

Pyrazinamide

128
Q

If C diff becomes life threatening what is medication?

A

IV metronidazole + Oral vanc

129
Q

Which medication can increase risk of C diff infection?

A

PPI

130
Q

Which TB medication can cause liver derangement?

A

Pyrazinamide

131
Q
A

UKMLA (12 decks)

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