Infectious Diseases Flashcards
Define the 3 stages of HIV?
Primary
Asymptomatic
Advanced
- Primary HIV infection, which is associated with symptoms and high infectivity along with immune activation.
- Asymptomatic phase, associated with a low transmission risk. As viral diversity increases, the virus begins to evade the immune response.
- Advanced HIV disease (AIDS) whereby the immune system is compromised giving rise to opportunistic infections and malignancies
What is the most important prognostic factor in HIV?
Early diagnosis and management which can prevent progression to advanced disease
Name HIV-defining illnesses via system?
Constitutional symptoms
Respiratory
Neurological
Malignancy
Skin
Oral
Gastrointestinal
Genital
Bloods
Weight-loss, night sweats and fevers
Respiratory- pneumocystis pneumonia, TB, recurrent resp infections
Neurological- meningitis, cerebral toxoplasmosis
Malignancy- Kaposi’s sarcoma, lymphoma, cervical cancer
Skin- fungal skin/ nail infections
Oral- candidiasis, ulcers, hairy leucoplakia
Gastrointestinal- oesophageal candidiasis, diarrhoea, hepatitis
Genital- candida, herpes, warts
Unexplained FBC abnormalities
Second line management for C. diff?
Oral fidaxomicin
First-line management for C. diff?
Oral vancomycin for 10 days
Third line management for C. diff?
Oral vancomycin +/- IV metronidazole
Life-threatening management for C. diff?
oral vancomycin + IV metronidazole
specialist advice - surgery may be considered
Abx for giardiasis?
metronidazole
Abx for Cholera?
Tetracycline- doxycycline
Abx for Campylobacter?
Clarythromycin
Abx for amoebiasis?
Metronidazole
High-risk groups for influenza?
> 65 years old
pregnant women
chronic disease of respiratory, cardiac, renal, hepatic or neurological nature
diabetes
immunosuppression
morbid obesity
Antivirals for influenza?
First line: oseltamivir
Second line: zanamivir
Uncomplicated malaria?
Parasitaemia <2%
No schizonts
No clinical complications
Temperature <39
Patient ambulant
Severe malaria?
-Parasitaemia >2% - requires parenteral treatment
-Parasitaemia <2% with schizonts reported on blood film
-Patient non-ambulant
-Parasitaemia <2% with complications
Gold standard investigation for malaria?
Thick and thin blood films
Thick- presence of parasites
Thin- determines species
Uncomplicated falciparum treatment?
artemisinin-based combination (ACT) Artemether with lumefantrine therapy
Severe falciparum treatment?
IV artesunate
Uncomplicated non-falciparum treatment?
artemisinin-combination (ACT) therapy or chloroquine
Features of Legionella?
flu-like symptoms including fever (present in > 95% of patients)
dry cough
relative bradycardia
confusion
lymphopaenia
hyponatraemia
deranged liver function tests
pleural effusion: seen in around 30% of patients
Investigations for Legionella?
Diagnostic: urinary antigen
CXR: mid-lower zone patchy consolidation and pleural effusions in 30%
Management for Legionella?
erythromycin/clarithromycin
Name the SEPSIS 6 protocol?
Give 3
Take 3
Give:
Oxygen (aim for sats >94%) +/- COPD
IV Abx
IV fluids (500ml bolus/ 15mins)
Take:
Blood cultures
Serum lactate
Measure urine output hourly
What feature should be used to determine the severity of infection?
White cell count
