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Infectious Diseases Flashcards

1
Q

C. diff:

A

> 70 years, past C. diff, use of abx, antiperistaltic drugs

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2
Q

Staph aureus:

A

food, 1-6 hours after eating, last less than 12 hours

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3
Q

Vibrio cholera:

A

rice water diarrhoea, poor sanitation, shock

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4
Q

E. coli:

A

leafy vegetables

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5
Q

Bacillus cereus:

A

reheated rice, can cause cerebral abscess

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6
Q

Salmonella:

A

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

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7
Q

Organisms which can cause diarrhoea and dysentry

A

salmonella, campylobater, c diff, Eoli (haemorrhagic or non)

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8
Q

Diarrhoea only

A

Staph A, Vibro Cholera, E coli, Bacillus Cereus

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9
Q

Campylobacter:

A

uncooked poultry

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10
Q

(Haemorrhagic) E. coli:

A

leafy vegetables

bloody diarrhoea followed by haemolytic uraemic syndrome then it is EHEC

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11
Q

Entamoeba histolytica:

A

poor sanitation, tropical places, MSM(direct or indirect oral anal contact)

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12
Q

Shigella:

A

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

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13
Q

Polymorphs seen

most commonly neutrophils

A

Campylobacter
E. coli
Shigella

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14
Q

No polymorphs

A

Salmonella
E. coli
C. difficile

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15
Q

Antivirals (oseltamivir) if

A 
>65
Pregnant
Diabetes
Immunosuppressed
>40 BMI
Chronic disease
*prophylaxis
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16
Q

Malaria Px

A

Presentation
Fever paroxysms
Cold stage (<1h) – shivering, feeling cold
Hot stage (2-6h) – 41C, flushed, dry skin, N&V, headache
Sweats (3h) – as temperature falls

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17
Q

pattern to fever spikes, especially initially

A

Falciparium Malarium

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18
Q

Ix for malaria

A 
Serial thin &amp; thick blood films
Rapid stick tests are available if microscopy cannot be performed
Others
FBC – anaemia, thrombocytopenia
Clotting
Glucose
ABG – lactic acidosis
U&amp;E – renal failure 
Urine analysis – haemoglobinuria, proteinuria, casts
Blood culture – rule out septicaemia
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19
Q

Tx for malaria

A

Treatment
Chloroquinine 1st choice
Resistance is spreading
Prophylaxis good, but not full protection

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20
Q

Varicella Zoster Virus is which HSV and what does it cause?

A

HSV III

chicken pox and shingles

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21
Q

How contagious is chicken pox

A

Incubation – 11-21 days

Infectious period – 4 days before rash till all lesions scabbed

22
Q

Px of chicken pox

A

Prodrome of nausea, myalgia, anorexia
On examination
Fever
Rash: small erythamatous macules which progress to papules in 12-14 hours. Crusts develop after 5 days, and crusts fall off 1-2 weeks
Common in children
In adults the fever is prolonged and the rash more widespread

23
Q

When do you manage chicken pox

A

Oral aciclovir for an immunocompetent adult or adolescent

24
Q

Complications of chicken pox

A

Complications
DIC
Pneumonitis
Ataxia

25
Q

Shingles presentation

A

Prodrome of abnormal sensation and pain in dermatomal distribution, maybe headache, malaise, fever
Characterised by unilateral rash – vesicular lesions in same dermatomal distribution (normally T1 – L2). Crust in 7-10 days, heal in 2-4 weeks
Neuritis – neuralgic pain over the same area

26
Q

Tx of shingles

A

Information & advice
Start oral aciclovir within 72 hours of rash onset for people aged >50, or who are immunocompromised, non-truncal involvement, or moderate pain/rash
Treat pain – paracetamol

27
Q

How does bacterial meningitis cause death?

A

Cerebral Odema
Raised intracranial pressure
Death

28
Q

Most common bacterial meningitis

A

Step Pneumoniae

Neisseria Meningitidis

29
Q

Meningitis Buzz Words

Streptococcus pneumonia

A

G+ve cocci, elderly

30
Q

Meningitis Buzz Words

Neisseria meningitides:

A

G-ve diplococci

31
Q 
Meningitis Buzz Words
Listeria monocytogenes (neonates/elderly):
A

Cheese/unpasteurised milk, alcoholics

32
Q 
Meningitis Buzz Words
Haemophilus influenzae (children):
A

Unvaccinated children

33
Q

Meningitis Buzz Words

Group B streptococcus (neonates):

A

Extended labour, infection in prev. pregnancy

34
Q

Meningitis Buzz Words

Mycobacterium tuberculosis:

A

Chronic infection. Also, results of CSF sample.

35
Q 
Meningitis Buzz Words
Escherichia coli (neonates):
A

Late neonatal infection

36
Q

Kernig’s sign:

A

with the patient supine and the thigh flexed to a 90° right angle, attempts to straighten or extend the leg are met with resistance

37
Q

Brudzinski’s signs:

A

flexion of the neck causes involuntary flexion of the knees and hips, or passive flexion of the leg on one side causes contralateral flexion of the opposite leg.

38
Q

Non blanching pupuric Rash

A

Bacterial Meningitis: Classically due to meningococcal septicaemia. N. meningitides releases an endotoxin which initiates the clotting cascade leading to disseminated intravascular coagulation. Clotting factors are used up, there will be bleeding, and this leads to the purpuric rash. Eventually there will be signs of shock, and then death. If there is a non-blanching rash, this is an emergency.

39
Q

Viral causes of meningitis

A

Commonly enterovirus, influenza and HSV

Enterovirus can also give non blanching rash

40
Q

What to ask for in an LP for meningitis

A 
Cell count and differential
Protein concentration
Glucose concentration
Culture and gram stain
TB PCR (if TB is suspected)
Cryptococcal/histoplasmosis antigen test (if fungi suspected)
41
Q

When are lumbar punctures contraindicated?

A

Signs of raised intracranial pressure (seizures, frequent vomiting, papilloedema
Superficial infection at the LP site
Coagulation abnormalities
This includes meningococcal septicaemia

42
Q

What tests to do if LP is contraindicated in meningitis?

A

CT scan – Perform is raised intracranial pressure is suspected For example, if there are seizures

Bloods – Perform if there is coagulation, or LP will be delayed.
FBC/CRP– Perform to confirm infection
Meningococcal PCR – Perform to exclude meningococcal sepsis.
Culture

43
Q

Tx of meningitis:

A

For older children and adults the initial broad spectrum antibiotics regimen is:
Ceftriaxone with or without dexamethasone

44
Q

CSF: turbid
Glucose: decreased
WCC: neutrophils
Protien: increased lots

A

Bacterial

45
Q

CSF: clear/cloudy
Glucose: normal
WCC: lymphocytes
Protien: increased

A

Viral

46
Q

CSF: clear/cloudy
Glucose: decreased
WCC: lymphocytes
Protien: increased

A

TB/Fungal

47
Q

HIV Ix

A

Investigations

  • CD4 count
  • HIV RNA
  • HIV antibodies
  • FBC
  • U&E
  • LFT
48
Q

Candida Albicans Px

A
  1. Oral candidiasis, dysphagia
    Tx – Nystatin suspension (1mL swill and swallow)
  2. Pneumonia
  3. Infective endocarditis
  4. Vaginal candidiasis (thrush) – discharge, vagina may be red, fissured, sore
    Risks – pregnancy, immunodeficiency, diabetes, Abx
    Tx – Clotrimazole vaginal pessary + cream for vulva
  5. Urethritis
  6. Systemic candidiasis, sepsis
    Consider this with PUO, candida UTI in DM
    Tx – Fluconazole
49
Q

CT – characteristic multiple ring-shaped contrast enhancing lesions

A

Toxoplamsmosis

Most common cause of intracranial mass in HIV

50
Q

HHV 8

A

Causes Kaposi’s sarcoma in immunocompromised
Px : papules or plaques on skin and mucosa (any organ)
Metastasizes to lymph nodes
Visceral KS can be aggressive – lung (dyspnoea, haemoptysis), bowel (nausea, abdominal pain), rarely CNS, eye, breast, biopsy sites
Tx : optimise HAART, cryotherapy, chemotherapy, radiotherapy

51
Q

EBV – Infectious mononucleosis O/`E

A

Presentation: Sore throat, fever, fatigue, headache, malaise, anorexia, sweating, abdominal pain

Examination
Inflamed tonsils with exudates
Cervical lymphadenopathy
Splenomegaly, hepatomegaly (jaundice)

52
Q

EBV Ix and Tx

A

Investigations
Monospot test – heterophile antibodies
Throat swab
IgM or IgG EBV viral capsid antigen – present during clinical illness
IgG against EBNA – appear 6-12 weeks after onset of symptoms
FBC, U&E, LFT

Management: Rest, paracetamol, NSAIDs

Resp (13 decks)

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