Infectious Diseases

Question 1

Fever, lymphadenopathy, white coating in throat, developing country

Answer 1

Diphtheria

Question 2

Difficulty swallowing + immunosuppression risk factors (e.g. HIV, renal transplant, inhaled steroid use). What’s diagnosis?

Answer 2

Oesophageal candidiasis

Question 3

What baseline Investigations needed prior to starting TB treatment of RIPE?

Answer 3

FBC, UEs, LFTs, Vision Testing

Question 4

Who should have an annual pneumococcal vaccination?

Answer 4

Anyone with chronic disease of organs

(i.e. heart, lungs, liver, kidney, spleen)

Question 5

Which vaccines are live, attenuated?

Answer 5

MMR (makes sense as not end of the world if you get mumps)
Polio
Yellow fever

Question 6

How do you assess someone’s response to Hep B vaccine and how to manage?

Answer 6

<10 - non responder, repeat 3 vaccine course

10-100 - booster dose now and re-assess

> 100 - responder

Question 7

Which STIs are the following caused by?

1) Initial Painless ulcer followed by rash on body which also affects palms

2) Painful ulcer and inguinal lymphadenopathy

3) Green penile discharge

4) Vesicles

5) Painless ulceration which then heals

Answer 7

1) Syphillis (initial painless ulcer is known as chancre)

2) Chancroid

3) Gonorrhoea

4) HSV2

5) Lymphogranuloma venereum

Question 8

Following wound/injury -> fever, black blisters, smelly gas/discharge? Which bacteria is most commonly responsible?

Answer 8

Gas gangrene

Clostridium perfringens

Question 9

When would you need Tetanus vaccine booster +/- immunoglobulins?

Answer 9

If you have had full 5 course vaccination, with latest booster in last 10 years - no action needed

If you have had full 5 course, but latest bootees >10 years ago - need booster (+immunoglobulin if high risk)

If unsure of vaccination status - same as above

Question 10

What should be measured when testing for HIV diagnosis?

Answer 10

HIV p24 antigen + HIV antibody

Question 11

In addition to oral and genital ulcers (plus uveitis), what else can happen in Behcet’s?

Answer 11

DVTs

Question 12

What is lymphogranuloma venereum caused by?

Symptoms?

Answer 12

Chlamydia

Painless ulcer with painful inguinal lymphadenopathy

Question 13

Symptoms of chancroid?

Answer 13

Painful ulcer + painful inguinal lymphadenopathy

Question 14

Management of human bites?

Answer 14

If broken skin + bleeding -> co-amoxiclav

If in high risk areas (hands, feet, face, genitals, near cartilaginous structures) -> always give Abx

Question 15

Is influenza vaccine live or inactivated?

Answer 15

Inactivated

Question 16

Symptoms of genital herpes?

Answer 16

usually have prodrome of fever then get painful genital vesicles +/- dysuria