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MRCP Part 1 > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

Organinism? pneumonia, Green sputum + cold sore

A

Streptococcal

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2
Q

CAP organisms

A

Community acquired pneumonia (CAP) may be caused by the following infectious agents:
Streptococcus pneumoniae (accounts for around 80% of cases)
Haemophilus influenzae
Staphylococcus aureus: commonly after influenza infection
atypical pneumonias (e.g. Due to Mycoplasma pneumoniae)
viruses

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3
Q

Tetanus toxin MoA

A

Tetanus toxin (tetanospasmin) blocks the release of the inhibitory neurotransmitters GABA and glycine resulting in continuous motor neuron activity

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4
Q

ABx choice for meningococcal menigitis in penicillin allergy

A

Chloramphenicol is the antibiotic of choice for treating meningococcal infection in patients with a known penicillin allergy,

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5
Q

Katayama fever

A

Katayama fever, an acute manifestation of acute schistosomiasis.

The intermediate snail host of the parasitic flatworm which causes schistosomiasis is commonly found in the waters of Lake Malawi. Katayama fever typically presented with fever, urticarial rash, hepatosplenomegaly and bronchospasm.

acute schistosomiasis syndrome (Katayama fever)
fever
urticaria/angioedema
arthralgia/myalgia
cough
diarrhoea
eosinophilia

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6
Q

most common bacterial cause of pharyngitis (sore throat)

A

Streptococcus pyogenes. This organism, also known as Group A Streptococcus (GAS), is the most common bacterial cause of pharyngitis (sore throat) in children and young adults.

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7
Q

Which vaccinations is contraindicated in egg allergy

A

Yellow fever

(yellow like egg yolk)

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8
Q

Camylobacter ABx

A

Clarithromycin

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9
Q

4 viral heamorrhagic fevers

A

Yellow fever, Ebola, Lassa fever & Dengue

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10
Q

Yellow fever typical presentation

A

Yellow fever typically presents with flu like illness → brief remission→ followed by jaundice and haematemesis

Zoonotic inection - spread my mosquitos

classic description involves sudden onset of high fever, rigors, nausea & vomiting. Bradycardia may develop. A brief remission is followed by jaundice, haematemesis, oliguria
if severe jaundice, haematemesis may occur
Councilman bodies (inclusion bodies) may be seen in the hepatocytes

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11
Q

Fish tank granuloma organism

A

Mycobacterium marinum

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12
Q

The most common causes of viral meningitis in adults

A

enteroviruses e.g. coxsackie

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13
Q

Borrelia burgdorferi

A

Lyme disease

Burger with a lyme.

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14
Q

Bartonella henselae

A

Cat scratch fever

Bart has a cat.
A cat will try to scratch Barton’s Hens

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15
Q

Black Eschars in ID questions

A

think Anthrax or Rickettsia or Scrub typhus

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16
Q

Animal bites organism in cultures

A

Pasteurella multocida is a gram-negative coccobacillus which is the most likely organism to be isolated after a dog bite.

Send the animal out to pasture

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17
Q

Chancriod presentation

A

ChanCRIED in pain

Painful ulcer with ragged borders

SyphiLESS (painless)
LGV mix (starts with lymph so this is the painful bit)
ChanCRIED in pain

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18
Q

Syphilis ulcer presentation

A

Painless genital ulcer & painless IL

SyphiLESS (painless)
LGV mix (starts with lymph so this is the painful bit)
ChanCRIED in pain

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19
Q

LGV ulcer presentation

A

Painless ulcer painful IL

SyphiLESS (painless)
LGV mix (starts with lymph so this is the painful bit)
ChanCRIED in pain

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20
Q

Dapsone used for what?

A

Dapsone is an antimicrobial most commonly used in the treatment of leprosy and dermatitis herpetiformis. It has anti-inflammatory properties helpful in managing these conditions

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21
Q

all helminths rx = bendazoles

(excepts schisto + clonorchis = praziquantel

loa + wuchereria + toxocara canis = di-ethyl-carbamazine

river blindness + strongyloides = ivermectin)

A

all helminths rx = bendazoles

(excepts schisto + clonorchis = praziquantel

loa + wuchereria + toxocara canis = di-ethyl-carbamazine

river blindness + strongyloides = ivermectin)

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22
Q

TB meningitis CSF signs

A

can present with lymphocytic predominance, TB meningitis typically has a much higher protein level (>1 g/L), very low CSF glucose, and often has an opening pressure >25 cmCSF

In case of lynphocytosis of CSF, glucose must be checked. If higher than half of serum glucose, viral cause should be considered, otherwise TB Meningitis.

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23
Q

Normal CSF:serum glucose

A

> 0.6 is normal

Ratio less than this is bacterial or TB

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24
Q

South america + flulike illnes + periorbital oedema?

A

Chagas disease (American trypanosomiasis)

(siminal organism to african sleeping sickness)

Organism: Trypanosoma cruzi (Penelope cruz is from south america (not really shes from spain but for the purposes of remembering)

‘Americans drive Mercedes-BENZ’ (Benznidazole used in Chagas’ disease/American trypanosomiasis)

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25
Q

Cocci
makes catalase: Staphylococci
does not make catalase: Streptococci

Staphylococci
makes coagulase: S. aureus
does not make coagulase: S. epidermidis (novobiocin sensitive), S. saprophyticus (novobiocin resistant)

A

Cocci
makes catalase: Staphylococci
does not make catalase: Streptococci

Staphylococci
makes coagulase: S. aureus
does not make coagulase: S. epidermidis (novobiocin sensitive), S. saprophyticus (novobiocin resistant)

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26
Q

Abx for cholerra

A

Doxycycline

I think of Love in the Time of Cholera, and with love comes Chlamydia.. and with Chlamydia comes doxycycline

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27
Q

A grey dense pseudomembrane covering the tonsils is classically seen in

A

Diphtheria

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28
Q

anthrax Mx

A

Anthrax caused by Bacillis and treated by Cipro

MNEMONIC IS ABC

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29
Q

Leismanisis characeteristics

A

sandflies
Sudan
MASSIVE SPLENOMEGALY
ASHEN SKIN

presents with fever, weight loss, massive splenomegaly and pancytopenia. The additional clinical feature of ‘dark and ashen’ skin suggests visceral leishmaniasis as the cause

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30
Q

HIV: Mycobacterium avium complex management

A

Management
rifampicin + ethambutol + clarithromycin

MAC=REC ( both 3 letters)

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31
Q

Fite’s Faraco is a stain used to identify

A

mycobacterium leprae.

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32
Q

Ziehl-Neelsen stain (AKA Acid fast stain) reveals red cysts in the stool of infected individuals

A

Cryptosporidium (parasite)

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33
Q

Pruritic rash on the buttocks or soles + eosinophilia

A

Pruritic rash on the buttocks or soles ?Strongyloides stercoralis

Strongyloides stercoralis gains access to the body by penetrating the skin
This typically occurs via the soles of the feet but autoinfection in the perianal area may also occur.

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34
Q

Haemophilus ducreyi.

A

Chancroid : a tropical disease caused by Haemophilus ducreyi. It causes painful genital ulcers associated with unilateral, painful inguinal lymph node enlargement. The ulcers typically have a sharply defined, ragged, undermined border.

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35
Q

1st line option for immunocompromised patients requiring treatment for cerebral toxoplasmosis

A

Parasitic infection

Immunocompromised patients with toxoplasmosis are treated with pyrimethamine plus sulphadiazine

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36
Q

HIV, neuro symptoms, widespread demyelination + neuro Sx cause?

A

PML

Pogressive myltufocal leukoencephalopathy

due to infection of oligodendrocytes by JC virus (a polyoma DNA virus)

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37
Q

Lymphogranuloma venereum organism

A

Chamydia Trachomatis

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38
Q

Groove sign is separation inguinal nodes by the inguinal ligament and is characteristic of what disease?

A

Lymphgramuloma venerum

39
Q

Rifamacin MoA?

A

Rifampicin inhibits RNA synthesis

Ri-fampicin Ri-bonucleic Acid (RNA)
RNA synthesis - Rifampicin

40
Q

Anthrax treatment

A

Ciprofloxacin

41
Q

Hepatitis A & E associated with which foods?

A

A - shellfsih
E - undercooked meat

E is assocaited with worse mortality in pregnant people if they contract it

42
Q

How to diffeerentitate between two viral haemorrhagic fevers:yellow fever and Lassa fever?

A

Disease course

Yellow fever: jaundice and bipashic disease course
Lassa fever: NO JAUNDICE and one continuous disease course

Yellow - he first stage classically causes a non-specific illness which is often described as ‘flu-like’ with fever, malaise, nausea, myalgia and headache. This stage is due to the circulating virus in the bloodstream (viraemic stage). There is then a recovery stage when the viraemia clears. Most patients recover completely following this stage and do not progress to the third stage. Around 15% of patients progress after about 3-7 days after the onset of symptoms which presents with fever, nausea and vomiting, acute kidney injury, hepatitis with jaundice, and haemorrhage

43
Q

Leishmaniasis subtypes (3) and how they present

A

Leismaniasis is a protozoa spread by sandflie bites in SOUTH AMERICA

  1. Cutaneous -> Leshmaniasis MEXICANA
  2. Mucocutaneous -> Leishmaniasis BRAZILIENSIS
  3. Visercral -> THIS ONE IS BAD
    Leimanisasis DONOVANOSIS

Donovan is bad and grey

44
Q

Paul Bunnell test used for what and what other name does it go by?

A

Used for infectious mononucleosis

AKA Heterophile antibodies

Paul Bunnell = Monospot = heterophile antibody test

In patients with infectious mononucleosis, empirical treatment with amoxicillin often leads to a morbilliform rash. A heterophile antibody test (Paul-Bunnell) has high specificity and moderate sensitivity for infectious mononucleosis.

45
Q

Strongolodies treatment

A

Ivermectin - Ivan is a strongman
Al-bendazole is an al-ternative

Praziquant-lel - for shis (shistosomasis) and giggles

46
Q

Remember:
Gram-positive cocci = staphylococci + streptococci (including enterococci)
Gram-negative cocci = Neisseria meningitidis + Neisseria gonorrhoeae, also Moraxella catarrhalis

Therefore, only a small list of Gram-positive rods (bacilli) need to be memorised to categorise all bacteria - mnemonic = ABCD L
Actinomyces
Bacillus anthracis (anthrax)
Clostridium
Diphtheria: Corynebacterium diphtheriae
Listeria monocytogenes

Remaining organisms are Gram-negative rods, e.g.:
Escherichia coli
Haemophilus influenzae
Pseudomonas aeruginosa
Salmonella sp.
Shigella sp.
Campylobacter jejuni

A
47
Q

Live attenuated vaccines

A

Yellow fever, MMR, oral poliovirus

BCG
measles, mumps, rubella (MMR)
influenza (intranasal)
oral rotavirus
oral polio
yellow fever
oral typhoid

48
Q

Vaccines contrindicated in ALL HIV patients

A

TB
Oral polio virus
CHolera

other live attenuated vaccines ar CI if CD4 count <200

Reminds me of Umbrella by Rihanna!
When CD4’s over two hundred
You can stand under my measles mumps rubella, yellow, varicella
ay ay ay§

49
Q

second most common cause of UTIs in sexually active young women

A

Staphylococcus saprophyticus

gram-positive coccus that grows in clusters and is coagulase-negative.

50
Q

Bacteria vaginosis organism

A

Bacterial vaginosis - overgrowth of predominately Gardnerella vaginalis

Your lady gadren smells fishy

51
Q

Genital wart treatment

A

Genital wart treatment

52
Q

Which antiboitic promotes acquision of MRSA

A

Ciprofloxacin

This is a FLUORQUINONLONE therfore could kill

53
Q

american trypanosomiasis

A

Chagas - everything enlarges

African chagas - lymph nodes enalargement, CNS enalargement ( headache, meningo encephalitis

American chagas ( just like their life style ) - Cardiac enlargement ( cardiomyopathy) , GI enlargements ( megacolon , megaoesophagus)

Americans cruse (Cruzi) in Mercedes Benz (benznidazole)

54
Q

conjugate vaccines

A

Conjugate vaccines are those that use a protein that attaches to the polysaccharide outer coat of the pathogen to make it more immunogenic. This is because polysaccharides alone are not very immunogenic, especially in infants and young children. By linking these polysaccharides to a protein, the immune system can recognise and respond more effectively to the pathogen.

e.g meningococcal

55
Q

Diptheria characteristics

A

sore throat, bulky cervical lymph nodes, and a greyish-white membrane on the tonsils

Throat swab microscopy with methylene blue staining demonstrates a ‘Chinese letter pattern’ with metachromatic granules. -> Corynebacterium diphtheria

56
Q

Tetnus protocol for woinds

A

Full course 5 vaccines, last within 10 years: No Ig or booster
Incompletely immunised + tetanus-prone wound: Tetanus Ig (give distant to vax site)
Incompletely immunised: immediate vaccine dose + further to complete schedule

57
Q

Chiknguyna =

A

JOINT PAIN + fevers

ChikunGUNya
joint feels like you shot me with a GUN
If you shot with a GUN your bloods would be normal
shooting would be ABRUPT onset (abrupt fever onset)
no medical treatment for gun shots

he absence of a rash makes chikungunya more likely than dengue. and dnegue associated with thrrombocytopenia

58
Q

HIV screening

A

P24 + antibody (immunoassay)

If patient is very recently infected -> test for HIV-1 NAAT (or) P24

If seroconversion symptoms / >10 days after exposure –> it means body has produced antibody –> prioritise immunoassay to test for antibody

59
Q

Retro-orbital headache, fever, facial flushing, rash, thrombocytopenia in returning traveller → ?

A

dengue

60
Q

viral haemorrhagic fever s

A

yellow fever, Lassa fever, Ebola, dengue

61
Q

Botulinum toxin works by

A

inhibiting the release of acetylcholine at synapses of the nervous system, both peripherally and centrally

62
Q

Typhoid fever

A

Typhoid fever, also known as typhoid, is a disease caused by Salmonella typhi bacteria. Symptoms may vary from mild to severe and usually begin 6 to 30 days after exposure, accompanied by weakness, abdominal pain, constipation, headaches, and mild vomiting. Some people develop a skin rash with rose coloured spots

63
Q

tetracycline moa

A

Tetracyclines inhibit the 30S subunit of ribosomes

T = THIRTY S

64
Q

Following a splenectomy patients are particularly at risk from

A

pneumococcus, Haemophilus, meningococcus and Capnocytophaga canimorsus* infections

65
Q

Cavitating lung lesions on CXR with which pneumonia

A

Staph aureas

also associated with preceding viral UTI

66
Q

Pneumonia + Alcoholic + Cavitation = Klebsiella
Pneumonia + Prior Flu = Staph Pneumonia
Pneumonia + Chicken Pox Rash = Varicella Pneumoniae
Pneumonia + Hemolytic Anemia = Mycoplasma
Pneumonia + Hyponatraemia + Travel History = Legionella
Pneumonia + Fleeting opacities = Cryptogenic Pneumonia
Penumonia + Fits/LOC = Aspiration Pneumonia
Pneumonia + HSV oral lesion = Strept Pneumonia.
Pneumonia + parrot = Chyledmia psitatssi
Pneumonia + farm animals = Q fever (coxillea brunte)
Pneumonia + HIV = think pcp but if straight forward case strep pneumonia is still most common
Pneumonia + Cystic fibrosis = consider pseudomonas/Burkohdera.
COPD + Pneumonia (or exacerbation) - Haemophilus Influenza

A
67
Q

Buy AT 30:
- Aminoglycosides
- Tetracyclines

CELL at 50
- Clindamycin
- Erythromycin
- Linezolid

A
68
Q

Nitazoxanide

A

broad-spectrum antiparasitic agent and can be used to treat immunocompromised patients with cryptosporidiosis

69
Q

first-line antibiotic treatment for tetanus

A

metronisazole (give allongside immunoglobulin)

70
Q

ABX FOR CAMYLOBACTER

A

CLARITHROMYCIN

71
Q

Ribavirin

A

Ribavirin is an antiviral medication that works with other medications to treat hepatitis C.

72
Q

Cat scratch disease - caused by

A

Cat scratch disease - caused by Bartonella henselae

73
Q

Diloxanide furoate

A

Diloxanide furoate = ‘luminal agent’ (to eliminate intraluminal cysts) with metro in amoebiasis

74
Q

most common cause of viral meningitis is

A

enetervirus e.g. coxsackie B

75
Q

leptospirosis treatmnt

A

erythromycin/azithromycin is non severe

benpen if severe (neurological signs)

76
Q

1st line treatment for severe p falcifurm infection

A

IV arestunate

77
Q

Amantdadine MoA

A

Amantadine - inhibits uncoating (M2 protein) of virus in cell. Also releases dopamine from nerve endings

78
Q

nitazoxanide

A

For patients with chronic refractory cryptosporidiosis, especially immunocompromised patients, nitazoxanide may be used - typically a 14-day course

79
Q

Praziquantel

A

Praziquantel is used to treat schistosomiasis.

going for a waz PrWAZiquantal - shisto and bladders

80
Q

Pneumonic for live vaccines: You Musn’t Prescribe BCG Incase They RIP

A

Yellow fever, MMR, Polio, BCG, Influenza, Typhoid, Rotavirus

81
Q

anthrax treatment

A

CIprofloxacin

82
Q

Rubeanic acid stain

A

Rubeanic acid = copper (Wilson’s)

83
Q

Perl’s Prussian blue

A

= iron (Haemochromatosis)

84
Q

Rose Bengal

A

= corneal damage

85
Q

Congo red

A

= amyloidosis

86
Q

Ziehl-Neelsen stain

A

= red cysts= Cryptosporidium infection

87
Q

Warthin-Starry staining

A

= Bartonella henselae

88
Q

Giemsa stain

A

= Toxoplasma gondii

89
Q

Silver stain

A

= Pneumocystis carini

90
Q

Granuloma inguinale organism

A

Klebsiella granulomatis. Granuloma inguinale, also known as Donovanosis, is a sexually transmitted infection caused by the bacterium Klebsiella granulomatis. It presents with painless genital ulcers and can progress to cause significant tissue destruction if left untreated.

91
Q

Patients with hyposplenism should be vaccinated against

A

pneumococcal, Haemophilus type B and meningococcus type C

ABC - pneum A Haem B men C.

92
Q

rhabditiform larvae are diagnostic of

A

strongyloidiasis

Strongyloides stercoralis exist as rhabditiform larvae in soil (non-infective first stage larvae) and as filariform larvae in humans (infective third stage larvae)

93
Q
A

MRCP Part 1 (11 decks)

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