Infectious Diseases 2

Question 1

An 70 year old man has been in hospital for the past two weeks for a severe pneumonia. He develops bloody diarrhoea, colitis, and a reduced urine output. He has a raised CRP, WCC and a low albumin.

Campylobacter
C. difficile 
Bacillus cereus
E. coli
Vibrio cholera

Answer 1

C. Diff

Reduced urine output = kidney damage
Low Albumin = Liver damage

C diff = multi organ damage

Question 2

An 18 year old girl on her gap year comes back from her travels, presenting to hospital with profuse diarrhoea of rice water appearance. There is no blood. She is shocked.

Entamoeba histolytica 
Staph aureus
Bacillus cereus
E. coli
Vibrio cholera

Answer 2

Vibrio cholera

Rice water diarrhoea

Question 3

A man presents suffering with bloody, foul smelling diarrhoea. He attended a barbeque earlier in the day where he suspects he ate undercooked chicken. He has a fever and severe abdominal pain.

Campylobacter
Shigella
Bacillus cereus
E. coli
Salmonella

Answer 3

Campylobacter

Undercooked chicken

Question 4

Bacterial causes Bloody Diarrhoea

Answer 4

Campylobacter/C diff
Haemorrhagic E coli 
Entamoeba histolytica
Shigella 
Salmonella

Question 5

Bacterial causes non-bloody diarrhoea

Answer 5

Campylobacter
C diff
Staph aureua
Vibrio Cholera
E coli
Bacillus cerues
Salmonella

Question 6

Buzzword C diff

Answer 6

Use broad spectrum Abx
>70 years,
past C. diff,
antiperistaltic drugs

Question 7

S. aureus

Answer 7

1-6hrs after eating,

lasts less than 12 hrs

Question 8

Vibrio Cholera

Answer 8

Rice water diarrhoea
poor sanitation
shock

Question 9

E coli

Answer 9

Leafy veg

Question 10

Bacillus cereus

Answer 10

Reheated rice

can cause cerebral abscess

Question 11

Salmonella

Answer 11

Eggs
might also have constipation
multiplies in Payer’s patches of the intestine

Question 12

Campylobacter

Answer 12

uncooked poultry

Question 13

Organisms likely if polymorphs seen on MC+S?

Answer 13

Campylobacter
E. coli
Shigella

Question 14

Organisms likely if NO polymorphs seen on MC+S?

Answer 14

Salmonella
E. coli
C. difficile

Question 15

The same 18 year old gap year student with resolved diarrhoea has gone back to do more travelling. About a month later, she presents with high swinging fevers and general malaise. You suspect malaria. Which of the following would be your most useful investigation for diagnosis.

FBC
U&Es
ESR/CRP
ABG
Thick and thin blood film

Answer 15

Thick and thin blood film

Thick to see parasites, thin to differentiate

Question 16

A 5 year old child comes home from nursery complaining of feeling like she needs to throw up, and isn’t hungry. A couple of days later a rash develops on her trunk, palms and soles of her feet, which is extremely itchy. What is the most likely causative organism?

Herpes virus 1
Herpes virus 2
Herpes virus 3
Herpes virus 4
Herpes virus 5

Answer 16

HHV 3 = VZV

Chicken Pox

Question 17

A 70 year old man presents developing a rash across one side of his trunk which is painful and tingling, preceded by a headache and a fever. He had the chickenpox as a child. What is the most likely diagnosis.

Second episode of chickenpox
Herpes simplex virus infection
Shingles
Contact dermatitis 
Fungal infection

Answer 17

Shingles

Question 18

What does Varicella Zoster virus cause?

Answer 18

Chicken Pox

Shingles

Question 19

Entamoeba histolytica - history clues?

Answer 19

poor sanitation, tropical places,
Men having sex with men (MSM)

+ RUQ pain (liver abscess), weight loss, cough, fever

Question 20

Shigella - history clues?

Answer 20

person-to-person contact, travel in areas with poor sanitation, MSM