Infectious Diseases

Question 1

causative agent in typhoid

Answer 1

salmonella typhi

Question 2

complications of typhoid fever

Answer 2

intestinal perforation
intestinal haemorrhage
secondary pneumonia
encephalitis
myocarditis
sepsis

Question 3

4 aims of early goal directe therapy in sepsis

Answer 3

1. CVP>8mmHG
2. MAP >65mmHG (or SBP>90)
3. Urine O/p over 0.5ml/hr
4. Scvo2>75%

Question 4

name of target rash in lyme disease

Answer 4

Erythema chronicum migrans

Question 5

pathogen causing lyme disease

Answer 5

borriela burgdorferi

Question 6

treatment of lyme disease

Answer 6

doxyxycline 100mg tds 3/52

amoxicillin 500mg tds 3/52

Question 7

relatice bradycardia in typhod is called

Answer 7

faget’s sign

Question 8

most common cause of travellers diarrhoea

Answer 8

Enterotoxignenic e coli

Question 9

specific tests for HIV

Answer 9

p24 antigen test

HIV RNA levels

Question 10

drug of choice for treatment of malaria

Answer 10

artesunate

Question 11

investigation of malaria

Answer 11

3x thick and think blood films

Question 12

causes of adult bacterial menigitis, most to least frequesnt

Answer 12

1. meningococcus(N.meningitidis)
2. Pneumococcus (S.pneumoniae)
3. Haemophilus influenzae

Question 13

causes of neonatal meningitis

Answer 13

group b strep. e coli, pneumococus, listeria monocytogenes

Question 14

causes of childhood (Not neonatal!) meningitis

Answer 14

n. meningitidis

s. pneumoniae

Question 15

bacterial meningitis CSF findings

Answer 15

turbid appearance, neutrophil/polymorph predominance, elevated cell count. glucose <0.5 plasma level, protein >1.5

Question 16

viral meningitis CSF findings

Answer 16

clear appearance, mononuclear/lymphocyte predominance, normal WCC, glucose >0.55 plasma, protein<1

Question 17

when should corticosteroids be administered in meningitis

Answer 17

in adults with suspected bacterial meningitis esp pneumococcus
children with CSF results suggesting bacterial meningitis

Question 18

when shoudl corticosteroids not be administerd in meningitis

Answer 18

in shock/septicaemia

Question 19

When should children with a petechial rash be treated for meningococcal disease?

Answer 19

petechiae start to spread
rash becomes purpuric
clinical sings of bacterial meningitis
signs of meningococcal septicaemia
patient appears ill

Question 20

empirical antibiotics for meningococcal disease >3 months

Answer 20

IV ceftriaxone 80mg/kg

Question 21

empiral antibitoics for meningococcal disease <3 motnhs

Answer 21

cefotaxime 80mg/kg and amipicillin

Question 22

antibiotics for meningococcal dissease in adults

Answer 22

2g ceftriaxone and 2g ampicillin if over 55

remember to consider dexamethasone if predominantly meningitic symptoms

Question 23

clinical features of viral haemorrhagic fever

Answer 23

acute onset of fvere in severely ill patient
haemorrhagic manifestations
no conditions predisposing to haemorrhage
no alternative diagnosis

Question 24

Risk assesment for viral haemorrhagiv fever

Answer 24

FEVER >38 wihin past 24 hours
travel history to VHF endemic country
Epidemiological exposure to individual suspected/known to have VHF in past 21 dydays

Question 25

When is Hep B Ig indicated post needlestick?

Answer 25

from hepB postive donor to unvaccinated recipient or known vaccine none responder

Question 26

how long should PEP be given for

Answer 26

4 weeks or less if donor proved hiv neg