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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
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)
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)
26
Abx for cholerra
Doxycycline I think of Love in the Time of Cholera, and with love comes Chlamydia.. and with Chlamydia comes doxycycline
27
A grey dense pseudomembrane covering the tonsils is classically seen in
Diphtheria
28
anthrax Mx
Anthrax caused by Bacillis and treated by Cipro MNEMONIC IS ABC
29
Leismanisis characeteristics
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
30
HIV: Mycobacterium avium complex management
Management rifampicin + ethambutol + clarithromycin MAC=REC ( both 3 letters)
31
Fite's Faraco is a stain used to identify
mycobacterium leprae.
32
Ziehl-Neelsen stain (AKA Acid fast stain) reveals red cysts in the stool of infected individuals
Cryptosporidium (parasite)
33
Pruritic rash on the buttocks or soles + eosinophilia
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.
34
Haemophilus ducreyi.
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.
35
1st line option for immunocompromised patients requiring treatment for cerebral toxoplasmosis
Parasitic infection Immunocompromised patients with toxoplasmosis are treated with pyrimethamine plus sulphadiazine
36
HIV, neuro symptoms, widespread demyelination + neuro Sx cause?
PML Pogressive myltufocal leukoencephalopathy due to infection of oligodendrocytes by JC virus (a polyoma DNA virus)
37
Lymphogranuloma venereum organism
Chamydia Trachomatis
38
Groove sign is separation inguinal nodes by the inguinal ligament and is characteristic of what disease?
Lymphgramuloma venerum
39
Rifamacin MoA?
Rifampicin inhibits RNA synthesis Ri-fampicin Ri-bonucleic Acid (RNA) R*NA synthesis - R*ifampicin
40
Anthrax treatment
Ciprofloxacin
41
Hepatitis A & E associated with which foods?
A - shellfsih E - undercooked meat E is assocaited with worse mortality in pregnant people if they contract it
42
How to diffeerentitate between two viral haemorrhagic fevers:yellow fever and Lassa fever?
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
Leishmaniasis subtypes (3) and how they present
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
Paul Bunnell test used for what and what other name does it go by?
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
Strongolodies treatment
Ivermectin - Ivan is a strongman Al-bendazole is an al-ternative Praziquant-lel - for shis (shistosomasis) and giggles
46
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
47
Live attenuated vaccines
Yellow fever, MMR, oral poliovirus BCG measles, mumps, rubella (MMR) influenza (intranasal) oral rotavirus oral polio yellow fever oral typhoid
48
Vaccines contrindicated in ALL HIV patients
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
second most common cause of UTIs in sexually active young women
Staphylococcus saprophyticus gram-positive coccus that grows in clusters and is coagulase-negative.
50
Bacteria vaginosis organism
Bacterial vaginosis - overgrowth of predominately Gardnerella vaginalis Your lady gadren smells fishy
51
Genital wart treatment
Genital wart treatment
52
Which antiboitic promotes acquision of MRSA
Ciprofloxacin This is a FLUORQUINONLONE therfore could kill
53
american trypanosomiasis
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
conjugate vaccines
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
Diptheria characteristics
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
Tetnus protocol for woinds
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
Chiknguyna =
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
HIV screening
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
Retro-orbital headache, fever, facial flushing, rash, thrombocytopenia in returning traveller → ?
dengue
60
viral haemorrhagic fever s
yellow fever, Lassa fever, Ebola, dengue
61
Botulinum toxin works by
inhibiting the release of acetylcholine at synapses of the nervous system, both peripherally and centrally
62
Typhoid fever
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
tetracycline moa
Tetracyclines inhibit the 30S subunit of ribosomes T = THIRTY S
64
Following a splenectomy patients are particularly at risk from
pneumococcus, Haemophilus, meningococcus and Capnocytophaga canimorsus* infections
65
Cavitating lung lesions on CXR with which pneumonia
Staph aureas also associated with preceding viral UTI
66
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
67
Buy AT 30: - Aminoglycosides - Tetracyclines CELL at 50 - Clindamycin - Erythromycin - Linezolid
68
Nitazoxanide
broad-spectrum antiparasitic agent and can be used to treat immunocompromised patients with cryptosporidiosis
69
first-line antibiotic treatment for tetanus
metronisazole (give allongside immunoglobulin)
70
ABX FOR CAMYLOBACTER
CLARITHROMYCIN
71
Ribavirin
Ribavirin is an antiviral medication that works with other medications to treat hepatitis C.
72
Cat scratch disease - caused by
Cat scratch disease - caused by Bartonella henselae
73
Diloxanide furoate
Diloxanide furoate = 'luminal agent' (to eliminate intraluminal cysts) with metro in amoebiasis
74
most common cause of viral meningitis is
enetervirus e.g. coxsackie B
75
leptospirosis treatmnt
erythromycin/azithromycin is non severe benpen if severe (neurological signs)
76
1st line treatment for severe p falcifurm infection
IV arestunate
77
Amantdadine MoA
Amantadine - inhibits uncoating (M2 protein) of virus in cell. Also releases dopamine from nerve endings
78
nitazoxanide
For patients with chronic refractory cryptosporidiosis, especially immunocompromised patients, nitazoxanide may be used - typically a 14-day course
79
Praziquantel
Praziquantel is used to treat schistosomiasis. going for a waz PrWAZiquantal - shisto and bladders
80
Pneumonic for live vaccines: You Musn't Prescribe BCG Incase They RIP
Yellow fever, MMR, Polio, BCG, Influenza, Typhoid, Rotavirus
81
anthrax treatment
CIprofloxacin
82
Rubeanic acid stain
Rubeanic acid = copper (Wilson's)
83
Perl's Prussian blue
= iron (Haemochromatosis)
84
Rose Bengal
= corneal damage
85
Congo red
= amyloidosis
86
Ziehl-Neelsen stain
= red cysts= Cryptosporidium infection
87
Warthin-Starry staining
= Bartonella henselae
88
Giemsa stain
= Toxoplasma gondii
89
Silver stain
= Pneumocystis carini
90
Granuloma inguinale organism
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
Patients with hyposplenism should be vaccinated against
pneumococcal, Haemophilus type B and meningococcus type C ABC - pneum A Haem B men C.
92
rhabditiform larvae are diagnostic of
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
macrophages containing amastigotes.
Visceral leshimaniasis (Tx with sodium stibogluconat)
94

MRCP Part 1 (13 decks)

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