Infectious diseases Flashcards
1
Q
What are the key signs and symptoms of glandular fever?
A
Fever
Sore throat
Fatigue
Hepatosplenomegaly
2
Q
What causes glandular fever (mono)?
A
EBV
3
Q
What is diagnostic test for EBV?
A
EBV serology - confirms presence of IgM antibodies
4
Q
What is treatment for c.diff?
A
Oral vancomycin
5
Q
What must be started after chloroquine has been used for acute malaria?
A
Primaquine
6
Q
What is primaquines role?
A
Only effective drug against hypnozoites - dormant liver stage parasites of plasmodium
Primaquine prevents another malaria relapse
7
Q
What is the incubation period for plasmodium?
A
7-30 Days
8
Q
What is gold standard diagnosis of malaria?
A
Thick and thin blood films
9
Q
Which pneumonia is associated with reactivation of herpes?
A
Strep peumoniae
10
Q
Which malarial prophylaxis should be avoided in epileptics ?
A
Mefloquine
11
Q
What does periosteal reaction on X-ray indicate?
A
Presence of new bone formation in response to abnormal stimuli
12
Q
How can osteomyelitis present?
A
Periosteal reaction
Fever
Pain
Positive blood cultures for salmonella typhi
Spleen impairment
13
Q
What is the most common causative organism of osteomyelitis?
A
Staph aureus
AND
coagulase negative staph
14
Q
What are the risk factors of osteomyelitis?
A
DM
PVD
Malnnourished
Immunosuppressed
Malignancy
Extreme age
15
Q
How does osteomyelitis present?
A
Fever
Pain at rest
Swelling
Erythema at affected sight
16
Q
What is gold standard management for osteomyelitis?
A
MRI
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
18
Q
What is antibiotic used in pen allergic in osteomyelitis?
A
Clindamycin
19
Q
What is recommended first line prophylaxis for meningitis?
A
Ciprofloxacin
20
Q
What would show up on a CT head with HSV encephalitis?
A
Focal bilat temporal lobe involvement
21
Q
What are the signs/ symptoms of viral hsv encephalitis?
A
Rash around mouth
Headache
Behaviour changes
Drowsiness
Neck stiffness
Confused
22
Q
What would you see on CT head with toxoplasmosis?
A
Ring enhancing lesions
23
Q
Where does the measles rash start?
A
Behind ears and back of head
24
Q
How does measles present?
A
4D’s - 4 days of fever and the 3C’s
3c: cough, conjunctivitis, coryza
25
How can hep d be contractedd?
Only if the person has contracted hep b as well - this is the druggy one
26
Which hep is usually vaccinated against before travel?
HepA
26
Which hep doesn't have a vaccine?
Hep E
27
How can Hep E present?
Flu like illness
Jaundice
Hepatosplenoegaly
28
How is hep E spread?
Faecal oral route
29
What is cryptosporidiosis and what is it's treatment?
Common cause of diarrhoea in HIV patients
Treat by starting them on anti-retrovirals
30
What is the most common cause of invasive fungal nail disease?
Trichophyton rubrum
31
What is treatment for trichophyton rubrum causing nail disease?
Oral terbinafine - 3-6 months
32
What is the most common cause of gastroenteritis?
Campylobacter jejuni
33
What is campylobacter jejuni incubation period?
48-72 hours
34
When does campylobacter jejuni occur?
After raw meat, dairy and drinking untreated water
35
Which bacterial meningitis usually presents with a non-blanching rash?
Neisseria meningitidis
36
What amount of parasitaemia is worrying for severe malaria vs severe disease?
more than 2% then more than 105
37
What is sugar levels like in severe malaria?
Hypoglycaemic - a blood glucose lower than 2.2 is worrying and needs admitting
38
What would be hospital treatment for severe malaria?
IV artesunate
39
What does oral hairy leucoplakia indicate?
Primary HIV infection
40
If patient is pen allergic what can be given for a CAP?
Clarithromycin of doxycycline
41
Which bacteria is found in reheated rice?
Bacillus cereus - due to improper cooking and refrigeration
42
Which disease has otitis media as a common complication?
Measles
43
What is treatment for uncomplicated malaria?
Oral artemisinin and combo therapy
44
What is first line treatment for impetigo - then second line when first line is not tolerated?
Topical hydrogen peroxide
If not tolerated then fusidic acid
45
How does mumps present?
Fever
Parotid gland swelling
Orchitis - in some cases
46
What is treatment for mumps?
Supportive care
47
What is gram staining of pertussis?
Gram negative coccobacillus
48
What's the most common cause of CAP vs HAP?
CAP: strep pneumoniae
HAP: pseudomonas aerginosa
49
What is the most common cause of viral meningitis?
Coxsackie
50
Which pneumonia reactivates herpes sores around mouth?
Strep pneumoniae
51
How to test for strep pneumoniae?
Urinary antigen test
52
Which pneumoniae is associated with haemolytic anaemia ?
Mycoplasma
53
When should anti-retrovirals be started in HIV patients if patient has TB?
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
What should be co-prescribed with isoniazid and why?
Vitamin B6 - Pyridoxine - because isoniazid can cause peripheral neuropathy
55
What is classic presentation of schistosomiasis exposure?
Abdo pain
Diarrhoea
Haematuria
Parasitic worms usually in infested waters with snails
56
What is the treatment for schistosomiasis?
Two doses of praziquantel
57
Which TB medication can cause orange discolouration of body fluids - like urine, sweat and tears
Rifampicin
58
What are EBSL?
E.coli and klebsiella species
59
Which antibiotics are first line for ESBL producing organisms?
Carbapenems
60
Give an example of a carbapenem?
Meropenem
61
When are carbapenam's contraindicated?
If patient has had a anaphylactic reaction to penicillin
62
What is first line investigation for mumps?
Mumps salivary IgM
63
Which cholera serogroups are causative of cholera?
o1 and o139
64
Which is gram staining of cholera?
Gram negative comma-shaped and single polar flagellum
65
What are the signs and symptoms of cholera?
Sudden onset watery diarrhoea
Abdo cramps
Nausea
Vomiting
Thirst
Dry mouth
Dry skin
Oliguria
Drowsy
Lethargic
66
What is the gold standard test for cholera?
Stool culture
67
What is mainstay of treatment for cholera?
Aggressive fluid replacement
68
Which antibiotic is used in cholera treatment?
Doxycycline
69
What is treatment of tinia capitis - ringworm on head and why?
Topical ketoconazole and oral itraconazole - because there is poor penetration of topical agents through root of hair follicle to oral needed to
70
What is antibiotic treatment of cellulitis?
Flucloxacillin + benzylpenicillin if severe
71
If patient is pen allergic which medication is used for cellulitis?
Clarithromycin or clindamycin
72
If a patient has lymphoedema with cellulitis - how long would the antibiotics need to be taken for?
1-2 months
73
How long should a child stay of school with mumps?
Should not attend school for 5 days from onset of parotitis
74
What would be a positive result for TB induration?
5mm or more
75
What is treatment of gas gangrene?
Penicillin and clindamycin and debridement
76
Why may a rash present when amoxicillin is given for a sore throat?
EBV could be present
77
Which infectious disease presents with salmon coloured spots and non bloody diarrhea?
Salmonella - which can be called typhoid or enteric fever
78
What is a complication of Strep pyogenes?
Scarlet fever which can cause a rough erythematous desquamating rash
79
How is scarlet fever rash treated?
Oral phenoxymethylpenicillin - Pen V
80
Which antigen for hep b if found suggests vertical transmission to baby?
HBe antigen - as these patients are most infective
81
What is the gram staining of pseudomonas?
Gram negative aeruginosa
82
What is the treatment of pseudomonas?
Oral ciprofloxacin
83
What is treatment for asymptomatic tick bite?
Removal or tick - no antibiotic needed
84
What is treatment of suspected or confirmed lyme disease?
Oral doxycycline
85
Which pathogen causes leprosy?
Myobacterium leprae
86
What are the signs and symptoms of leprosy?
Coppery or hypopigmented anaesthetic patches
Nose destruction
Ear swelling
Leonine faces - face resembles a lion
Nerve thickening - commonly ulnar, median and radial
87
What is treatment for leprosy?
Rifampicin
Clofazimine
At least 1-2 years
88
What is treatment for cryptococcal meningitis?
2 weeks of IV amphotericin B and oral flucytosine followed by 8 weeks of fluconazole
89
What is treatment for CNS toxoplasmosis?
Oral pyrimethamine and sulfadiazine and folinic acid for 6 weeks after clinical resolution followed by long term maintance therapy
90
What's the most common cause of wound associated botulism?
IV drug use
91
What investigation is used to detect toxin use?
Stool toxin ELISA
92
What antibiotic is used in whooping cough treatment?
Clarithromycin
93
What is the empirical treatment choice for osteomyelitis?
IV flucloxacillin and rifampicin
94
If a patient presents to GP with meningitis what is the treatment?
Ambulance and benzylpenicillin 1.2g IM
95
What is decolonisation therapy for MRSA? BTW MRSA colonisation on skin does not indicate infection and therefore antibiotics are not necessary
Nasal mupirocin
Chlorhexidine wash
96
What is the best medication for rheumatic fever?
Benzylpenicillin
97
What can indicate rheumatic fever?
Strep A
Erythema marginatum
Raised anti-strep O titre
98
What is staph scalded skin syndrome?
Red blistering skin and a positive Nikolsky sign - prodrome of sore throat or conjunctivitis may occur
99
Which TB drug is most likely to cause hepatotoxicity?
Pyrazinamide
100
How is leprosy transmitted?
Respiratory secretions
101
What is the medical management for a brain absess?
cephalospori + metronidazole for several weeks
and dexamethasone if there is raised ICP
102
What is treatment for pseudomonas UTI?
Gentamicin
103
Which antibiotic is used for vancomycin resistant enterococci?
Teicoplanin
104
If teicoplanin is not able to be used in vanc resistance what can be used?
Linezolid
105
When is interferon gamma release assay (IGRA) acid fast bacilli?
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
What test can help diagnose dengue fever?
Positive tourniquet test
107
What is the tourniquet test?
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
What is katayama syndrome?
Acute early inflammatory reaction to migrating eggs and larvae of schistosoma worm
109
What's the most common zoonosis?
Brucellosis - livestock, unpasteurised milk
110
What is treatment for brucellosis?
Dual antibiotic for uncomplicated
Triple for complication - rifampicin, doxycycline, gentamicin or streptomycin for several weeks
111
What is empirical treatment for bacterial meningitis in kids younger than 3 months
IV cefotaxime and ampicillin
112
How can brucellosis present?
Unexplained fevers
Night sweats
Myalgia
Joint pain
Lymphadenopathy
Hepatosplenomegaly
113
Why does smoking increase risk of BV?
Anti-estrogenic effects from the polyaromatic hydrocarbons present in smoke
114
What is the most common causative agent of osteomyelitis?
Staph aureus
115
Which bacteria causes fever and gradual onset muscle spasms - trismus of jaw and tetanus ?
Clostridium tetanii
116
Which antibiotic is used for c.diff infection?
Vanc
117
What is first line treatment of acute rheumatic fever?
Stat dose of IV benzylpenicillin
118
What's the treatment for schistomiasis?
Corticosteroids and praziquantel
119
What is best diagnostic imaging for osteomyelitis?
MRI
120
Which bones does osteomyelitis in sickles usually affect?
Femoral or humeral head
121
If a patient with co-morbidities presents with influenza what is the treatment?
Oral oseltamivir
122
What is Kehr's sign?
Referred pain to shoulder tip caused by irritaition of diaphragm by intra-abdominal fluid
123
What is definitive management of hep c?
Antiviral combo therapy
124
What would investigations show with EBV?
Elevated liver enzymes
Leukocytosis
Positive heterophile antibody test
125
In which hep - hep A or E is the person at risk of contracting a more severe infection?
Hep E
126
What is treatment for lyme disease with arthritis?
Oral doxycycline for 28 days
127
Which TB medication can cause arthralgia ?
Pyrazinamide
128
If C diff becomes life threatening what is medication?
IV metronidazole + Oral vanc
129
Which medication can increase risk of C diff infection?
PPI
130
Which TB medication can cause liver derangement?
Pyrazinamide
131
