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Phase 4 > Infectious diseases 2 > Flashcards

Infectious diseases 2 Flashcards

1
Q

What tests should be done into TB?

A

Bloods:

  • FBC
  • CRP
  • U&Es
  • LFTS

**HIV test

Orifices:

  • sputum smear - Ziehl Neelsen stain
  • 3 samples
  • Early morning
  • Acid fast Bacilli *if positive should start treatment
  • Sputum Culture
  • 1-3 weeks to grow

X-ray:
- CXR

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2
Q

Complications of TB?

A

Massive haemoptysis
Cor Pulmonale
Bronchiectasis

Enteritis
Pericarditis
Pott’s disease
Anorectal disease - due to swallowed sputum

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3
Q

After a diagnosis of TB - who should be contacted?

A

Public health - TB is a notifiable disease

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4
Q

What are some of the complications of Malaria?

A

Severe anaemia

Intracerebral anaemia

Shock
- AKI

Hypoglycaemia

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5
Q

What would you expect the bloods to be in malaria?

A

Anaemia
Thrombocytopenic
Parasitaemia
Deranged coagulation

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6
Q

What are the symptoms for croup and how is it managed?

A

*caused by parainfluenza virus

Barking cough
Difficulty breathing
Hoarse voice
Males

Treatment:

  • Steroids
  • Supportive

Severe:

  • Nebulised Adrenaline
  • Oxygen therapy
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7
Q

What are the symptoms of viral pharyngitis?

A 
Sore throat 
Hyperaemia of adenoids 
Coryzal symptoms 
Hoarseness to voice 
Dysphagia
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8
Q

What is the management for epiglottitis?

A

Caused by: H.Influenza

FBC
Blood Cultures
laryngoscope

Treatment:

  • oxygen
  • IV Ceftriaxone + Clindamycin
  • Nebulised Adrenaline
  • Inhaled corticosteroids
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9
Q

What are the antibiotics given for Necrotising Fasciitis?

A 
Benzylpenicillin
Flucloxacillin
Gentamicin 
Metronidazole 
Clindamycin
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10
Q

How is the urine sample collected for STI from men?

A

First void urine

- which is then sent for NAAT

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11
Q

What are the symptoms of chlamydia in women?

A 
Dysuria 
Clear discharge from the vagina 
Bleeding between periods 
Dyspareunia
Prostatitis
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12
Q

What are the symptoms of chlamydia in men?

A

Dysuria
Watery discharge of penis
Pain in the testicles

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13
Q

What are some of the complications of gonorrhea?

A

Septic arthritis

Gonococcal conjunctivitis

Pelvic inflammatory disorder

Urethral strictures

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14
Q

What are the complications of TB:

A

Cervical lymphadenopathy

TB meningitis

Intestinal TB

Adrenal TB - hypoadrenalism

Kidney TB
- sterile pyuria

Peritoneal - TB ascites

Testicular infiltration
- infertility

Aspergilloma formation
- invades into the TB cavity

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15
Q

What are the diagnostic tests for TB?

A

Ziehl Neelsen Stain

Cultures
- 10 weeks

Liquid media Based radiometric assays
- picks up the metabolic activity of TB

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16
Q

What drug must be given with isoniazid?

A

Vitamin B6

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17
Q

If you are giving Rifampicin and patient is on warfarin, what do to do?

A

Rifampicin is an Inducer and thus will break down warfarin

- higher doses are needed

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18
Q

Which TB drug can cause vision defects including vision colour changes?

A

Ethambutol

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19
Q

What radiological signs may you see on x-ray of pneumonia?

A

Consolidation

Air-bronchograms (where the bronchi passess throughthe aveoli with high amount of fluid in them)

Pleural effusions

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20
Q

What are the types of pneumonia?

A

CAP
HAP
Aspiration
Ventilator associated

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21
Q

What are the risk factors for pneumonia?

A 
Influenza 
Alcoholics
Smokers 
<5 years old, >65 years 
Previous pneumonia 
Chronic lung disease 
Neurological pneumonia
Immunosuppressed
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22
Q

What are the systemic signs of pneumonia?

A 
Fever 
Herpes labias - known to reactivate 
Shock 
Central cyanosis 
AF
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23
Q

Whilst monitoring a patient with pneumonia, they are not improving, what should you do?

A

• Repeat Chest x-ray
• Tap any pleural effusions
• Re-culture for resistance organisms
- Reconsider diagnosis

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24
Q

Following a pneumonia and a patient deteriorates again what things may have caused the complication?

A

Empyema

Cellulitis
- from where the IV line was in

C. Diff

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25
Q

What is a differential for cellulitis?

A

Erysipelas

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26
Q

What are some complications of cellulitis?

A

Sepsis

Endocarditis

Necrotizing fasciitis

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27
Q

What are some complications of Infectious mononucleosis?

A

Splenic rupture

Malignancy - Lymphoma

Encephalitis

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28
Q

What type of vaccine is the BCG and who is it offered to?

A

Live attenuated vaccine with M. Bovis

Offered to those at risk:
- children with positive mantoux parents

It doesn’t prevent pulmonary TB but prevents extrapulmonary and meningitis

29
Q

When taking a history from a patient with a fever after traveling, what questions do you want to ask?

A

Location
- risk of certain infections

Travel dates
- malaria etc usually presents 1 month later

Activities while away

  • out in the open?
  • water?

Prophylactic medication prior

  • use of nets
  • DDT

Past medical history

Viral hemorrhagic risk

30
Q

What are the varying types of necrotizing fasciitis?

A

Type I: polymicrobial

Type II: haemolytica Step A

Type III: Marine

Type IV: Fungi

31
Q

What are some complications of HSV-1?

A

Herpetic Keratitis - eye ulceration

Encephalitis

Bell’s palsy

Herpetic whitlow

32
Q

What are the complications of chickenpox?

A

Pneumonia - 1-6 days after infection

Bacterial super-infection of the skin

Dissemination and spread to internal organs - especially in immunocompromised host

Encephalitis

*risk to pregnant women

33
Q

How is VZV tested for and how is it treated?

A

Tzanck test

PCR testing

Serology

Treatment:
- Aciclovir >16 years old

+ IgG immunoglobulins (zoster Immunoglobulins) - for immunocompromised

Pregnancy:
<20 weeks: IgG immunoglobulins

> 20 weeks: Aciclovir *must be given 7 days after exposure

34
Q

What is the classic triad of symptoms of EBV?

A

Headache
Malasia
Sore throat
Lymphadenopathy

+
Palatal Petechiae
Macular rash (usually due to penicillin use)

35
Q

Complications of EBV:

A

Guillain Barre syndrome

Splenic rupture

Encephalitis

Lymphoma

36
Q

What is the recommended antibiotic for enteric fever?

A

Ciprofloxacin

37
Q

How many a child have a positive HIV antibody but not be HIV infected?

A

IgG antibodies from the mother can cross the placenta

38
Q

List some AIDs defining illnesses:

A

Candidiasis of esophagus/ Bronchi

CMV

Kaposi’s sarcoma

Primary lymphoma - especially of brain

Disseminated TB

Pneumocystis Jiroveci

39
Q

List some effects of HIV:

A

Neurological:

  • AIDS Dementia Complex
  • Neuropathies

Mucocutaneous Manifestations:

  • maculopapular rash
  • Puritiis

Haematological:

  • Lymphopenia
  • isolated thrombocytopenia

G.I:
- malabsorption

Renal:

  • HIV nephropathy
  • Nephrotic syndrome

Cardio:
- cardiomyopathy

40
Q

What is the natural history of HIV?

A

Initial infection: usually asymptomatic

Seroconversion:

  • fever
  • maculopapular rash etc

Asymptomatic phase:
- usually have persistent generalised lymphadenopathy

AIDs related Complex
- prodromal features: weight loss, night sweats, HSV

AIDs

  • AIDS defining features
  • CD <200
41
Q

Name a nucleotide reverse transcriptase inhibitor and non nucleotide reverse transcriptase inhibitor

A

Truvada (combination)

Efavirenz

42
Q

What can cause a false positive for HIV test and how is it confirmed?

A

Lupus
Syphilis

Western blot can confirm diagnosis

43
Q

What screening test can be done into HIV?

A

Rapid HIV testing
- needs follow up with ELSIA testing

ELSIA involves:

  • p24
  • HIV antibody
44
Q

What is the confirmatory test done for HIV?

A

Western Blot test

45
Q

Practical points in the Anti-retroviral drugs for HIV:

A

Must be taken as prescribed

Should not be stopped suddenly

Can be compromised by other drugs such as inducers and herbal medicines

  • Rifampicin
  • St John’s wort

Associated with adverse drug reactions

May exacerbate comorbidities

46
Q

Complications of HAART therapy?

A

Allergic reactions
Lipodystrophy and metabolic syndrome
Mitochondrial

47
Q

How is pneumocystis Jiroveci diagnosed?

A

High resolution CT

conformation:
- Bronchoalveolar lavage
- Blood test for PCR of pathogen DNA

48
Q

What are some specific illnesses to complicate HIV?

A

Pneumocystis Jiroveci

CMV
- retinitis

Toxoplasmosis

Cryptococcal meningitis

  • headache
  • papilloedema

Progressive multifocal leukoencephalopathy
- JC virus

Kaposi sarcoma
- HHV8

49
Q

What are some complications of Gonorrhoea?

A 
Prostatitis 
Epididymitis 
Reactive arthritis 
Septic arthritis 
PID
50
Q

How is syphilis diagnosed?

A

Serology for antigens

  • Group Specific: TPHA
  • Non specific: Cardiolipin, VDRL, RPR

*group specific always positive, non-specific should go down with treatment.

Dark Field microscopy

51
Q

What are some differentials for malaria?

A

Dengue fever
Yellow fever
Pneumonia
Enteric Fever

52
Q

What is the granuloma called in TB and what is it called when the lymph node is attached? and what is it called when its scared over?

A

Ghon focus

Ghon Complex

Ranke Complex

53
Q

What are the treatment options for Flu and how are they delivered?

A

Oseltamivir - Oral - 5 days

Zanamivir - Nasal spray - 5 days

54
Q

What are some of the complications of flu?

A

Febrile seizures
- in children

Secondary bacterial pneumonia

Viral pneumonia

Encephalitis

Croup

55
Q

What are some common causes of a fever of unknown origin:

A

Usually defined as >38C for >3 weeks

Infections
Cancer - leukemia
Autoimmune/ vasculitis

  • Adult’s still disease - this is a disease of exclusion and characterised by:
  • myalgia
  • lymphadenopathy
  • splenomegaly
56
Q

List some causes of a fever:

A 
Infection 
Cancer
Drug abuse - amphetamines 
VTE 
Trauma/ Surgery 
Heat stroke 
Epilepsy
57
Q

What are the differentials for meningitis?

A

Migraine

SAH

Dengue fever

Malaria

Encephalitis

58
Q

What should you do when doing an LP during meningitis?

A

Record opening pressures.

- they will be elevated

59
Q

What are some poor prognostics of bacterial meningitis?

A

Pneumococcal

Lowered GCS

> 60 years old

Focal neurological signs

60
Q

What further test should be conducted on those who suffered from meningitis after the infection has settled?

A

Pure tone Audiometry test

61
Q

What are some of the signs seen on MRI of toxoplasmosis infection?

A

Enhancing ring lesions

patients present with:

  • headache
  • focal neurological
  • confusion
62
Q

What is the pathogen which causes cholera? and list some complications:

A

Vibro Cholera

Dehydration
Electrolyte disturbance

Replaced needs:

  • fluids
  • sodium correction
  • K+
  • glucose
63
Q

List some specific intracerebral complications associated with HIV infection:

A

Toxoplasmosis Gondi
- most common cause and will present with raised intracranial pressure

Crytococcal Mengitis

HIV encephalopathy

Progressive Multifocal leukoencephalopathy
- caused by the JC virus

64
Q

What are the complications of Hepatitis B?

A

Hepatocellular carcinoma

Fulminant disease

Polyarteritis nodosa

Chronic Hep B

65
Q

List some features present in trichomonas vaginalis to help distinguish it from bacterial vaginosis:

A

Frothy yellow discharge

Strawberry cervix

Vulvovaginitis

66
Q

Which set of infections present in a very similar way to EBV infection?

A 
CMV 
Toxoplasmosis 
HIV 
- pharyngitis 
- lymphadenopathy 
- splenomegaly 
- fever
67
Q

What does Entamoeba histolytica cause and why may it cause shoulder tip pain or fullness?

A

Causes Amoebiasis

  • can cause liver abscess formation which leads to liver enlargement causing diaphragmatic irritation
  • require US and biopsy of cysts
68
Q

Schistosomiasis:

A

Infection caused by swimming infected water.

Presents:
1. Swimmers wash - pruritic rash initially

  1. 4 weeks later:
    - Asthma like fevers
    - Diarrhoea
    - Eosinophilia
    - Hepatomegaly
    - urticaria

Diagnosis:

  • urine sample for ova
  • serology

Treatment:
- Praziquantel

Complication:
- bladder cancer - squamous type

Phase 4 (49 decks)

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