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My Final Year 4 Revision > Infectious diseases > Flashcards

Infectious diseases Flashcards

This is hard stuff

1
Q

Hepatitis C walks into a bar and the barman says “we don’t serve your kind here.”

A

directactingantivarals

The Hep. C replies “your not a very good host!”

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2
Q

What strategies can be used when using antibiotics?

A

Empirical

Targeted therapy

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3
Q

What main mechanism do antibiotics act via?

A

Bacteriacidal

Bacteria static

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4
Q

When are antibiotics used empirically?

A

Before antibiotic sensitivity or cultures are back and the patient is at risk.

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5
Q

Pencillin (Betalactam) in an example of what type of antibiotic?

A

Bacteriacidal

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6
Q

Does dose matter with antibiotics?

A

Only with Dose dependent antibiotics: Increase dose to be more effective antibiotics

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7
Q

What are time dependent antibiotics?

A

The effectiveness relies on the antibiotic being in the therapeutic window therefore frequency of the antibiotic is increased rather than the dose

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8
Q

What is an example of a time dependent antibiotic?

A

Penecillin

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9
Q

Some antibiotics also have anti-inflammatory effects. Which?

A

Macrolides

Tetracyclins

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10
Q

35yo female has dysuria , , foul smelling urine, increase frequency, There is no fever or lion pain. What is the diagnosis?

A

simple UTI

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11
Q

What bacteria are responsible for UTIs?

A

Colifrims -originate from the GI tract. E coli, Klebsiella etc.

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12
Q

How can Chemotherapy causes a blood stream infection (BSI) other than immunosuppression?

A

Chemotherapy causes mucocytis which leads bacterial entering blood stream

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13
Q

What are some features of non-fermenter bacteria?

A

Usually opportunistic

Strict aerobes

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14
Q

Which bacteria present with fever?

A

Ebola
Malaria
Dengue

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15
Q

What bacteria are associated with hospital infection?

A

CPE
MRSA
norovirus
Ebola

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16
Q

What factors cause patients to be immunocompromised?

A

Chemotherapy
HIV
Trauma
Burns

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17
Q

Name some infectious disease which cause rashes?

A

Lyme
meningococcal
CMV

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18
Q

What infections can develop from IVDU?

A

Infective Endocarditis
Influenza A
Hep c

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19
Q

What medications are used to treat Hep C?

A

Ribavarin

interferon

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20
Q

What medications are used to trea herpes simplex?

A

Aciclovir

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21
Q

What medications are used to treat HIV?

A

Tenovir

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22
Q

What pathogens can cause splenomegaly?

A

Hep C
EBV
Plasmodium falciparum

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23
Q

What infections can cause abnormal vaginal discharge?

A

Bacterial vaginosis
Chlamydia
Trichomonas
Candida infection

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24
Q

What staining can be used for mycobacteria?

A

Ziehl-Neelson staining rather than gram staining

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25
Q

What does cocci mean?

A

Round

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26
Q

Is Staph A gram + or - ?

A

Gram positive

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27
Q

Is E coli gram + or - ?

A

Gram negative

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28
Q

How is travellers diarrhoea treated?

A

Self limiting
Fluids
Antibiotics only if there is a positive culture

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29
Q

What bacteria cause travellers diarrhoea?

A 
Shigella 
Salmonella 
Yersinia enterocolitica 
Campylbacter 
E coli
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30
Q

When should a patient with travellers diarrhoea be referred to hospital?

A

Bacteraemia

Dystentry

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31
Q

What post infective complication are there of travellers diarrhoea?

A

reactive arthritis
IBS
Guillian-barré syndrome

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32
Q

What is the most common causative organism for Guilian-Barré syndrome?

A

Campylobacter

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33
Q

What is onychomycosis?

A

Fungal infection under toe nails

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34
Q

What causes chicken pox?

A

Primary infection of Varicella zoster virus

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35
Q

How does Varicella zoster virus cause shingles?

A

The virus remains dormant in ganglia and when it is activated spread through the distribution of the dermatome causing a rash

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36
Q

What management should be used for a pregnant lady with no history of chickenpox?

A

Tested for IgG marker for varicella zoster. If negative antibodies for VZV should be given

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37
Q

A 35 yo male IVDU presents with 5 day history of leathery and rigors. There is no sexual or travel history.

On examination there is a systolic murmur.

What is the likely diagnosis?

A

Infective endocarditis

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38
Q

What investigations should be done for infective endocarditis?

A

CXR - septic emboli
TTE
Bloods and cultures

39
Q

When would a TOE be done instead of a TTE?

A

TOE is better but only needed for prosthetic valves or myocardial invasion

40
Q

What criteria is used when suspecting infective endocarditis?

A

Dukes criteria

41
Q

What investigations should be done for meningitis?

A

Viral/ bacteria throat swabs
Pneumococcal urinary antigen
Lumbar puncture
Meningoccal PCR

42
Q

When would a CT be done before a lumbar puncture?

A

Only when a patient has focal neurological deficits, symptoms of raised ICP, History of CNS disease.

A CT doesn’t exclude raised ICP

43
Q

What investigation could be done with septic arthritis?

A

Blood cultures

Left knee aspiration

44
Q

What is SIRS?

A

Systematic inflammatory response syndrome

45
Q

What is the SIRS criteria?

A 
SIRS criteria is 2 or more: 
o	36 > Temp > 38C
o	HR > 90
o	RR > 20 
o	WCC 12x 10^ (> 10% neutrophils)
46
Q

What is the seroconversion timeline for HIV?

A

4-12 weeks

47
Q

What is procalcitonin?

A

A liver enzyme which indicates bacterial infection

48
Q

What is the differential diagnosis for pyrexia?

A
  • Infections (TB)
  • Autoimmune (Sacoidosis)
  • Malignancy (lymphoma)
49
Q

What is pyrexia of unknown origin definition?

A

> 3 weeks

Negative 1st line test results

50
Q

What is Jobs syndrome

A

Autosomal dominant IgE syndrome.

An immunodeficiency leading to recurrent infections (pneumonia)

51
Q

What types of penicillin allergy are there

A

Severe - anaphylaxis

MIld - SE usually rash after few hours

52
Q

Which antibiotics have 10% cross reactivity penicillin?

A

Cephalosporins

53
Q

What can penicillin treat?

A

Streptococcus

Neisseria meninngitis

54
Q

What is Amoxacillin used to treat?

A

Better water solubility

Gram+ve cocci

55
Q

What Abx treat Staph. ?

A

Flucloxacillin

Co-Amoxiclav

56
Q

What treats pseudomonas?

A

Penicillin, Beta lacam + inhibitor

57
Q

What do Carbopenamase treat?

A

Treats ESBL - extended spectrum beta lactamases

58
Q

How do bacteria gain Abs resistance?

A
  • Efflux pumps
  • Enzymes
  • Impermeability (Influx pumps)
  • Change of the Abc target
59
Q

What does Vancomycin target?

A

Cell wall of the bacteria

60
Q

What Abx target the ribosomes?

A
  • Macrolides
  • Tetra/Doxy - cyclin
  • Aminoglycosides
61
Q

What Abx target folate synthesis of the bacteria?

A

Trimephopren

62
Q

What main categories of Fungi are there?

A

Molds and yeast

63
Q

Aspergilosis is an example of a mold or an yeasts?

64
Q

PCP is an example of a mold or yeast?

65
Q

What WBC is raised when there is an infection with moulds?

A

Neutrophils

66
Q

What WBC is raised when there is an infection with yeast?

A

T cells (lymphocytes)

67
Q

What type of fungal infection is typical with chemotherapy treatment?

A

Aspergilosis, Neutropenia (+/- sepsis) means mold fungi cannot be fought by the body as well

68
Q

What type of fungal infection is typical with HIV?

A

PCP, decreased T cells/ lymphocytes mean that yeast fungi cannot be fought of by the body as well

69
Q

Darren has a widespread, itchy, vesicular rash. Breathlessness, low oxygen saturations and tachypnoea. What is the diagnosis?

A

Chicken pox (varicella zoster)

70
Q

Prodrome of fever, malaise, conjunctivitis and cough. A maculpapular rash start on the face and moves down the body. What is the diagnosis ?

71
Q

A syndrome of fever, sore throat and lymphadenopathy. Patients are either in infancy and teenage years. What is the diagnosis?

A

Glandular fever (Infectivious mononucleosis). Caused by EBV or CMV

72
Q

Which parasites can be acquired in the UK?

A

Giardia
Public lice
Toxoplasmosis

73
Q

What are neuraminidase inhibitors?

A

Anti virals for flu, Used for decreasing transmission rather than treatment

74
Q

What is antigenic shift?

A

Where microorganisms combine to form a strain which changes/combines its surface antigens and is therefore “new” to the body

75
Q

What is antigenic drift?

A

Accumulation of mutations therefore altering the antigen susceptibility

76
Q

What are the usually symptoms of uncomplicated influenza?

A 
Fever 
Coryzal
Headache 
Malaise 
Myalgia 
Arthralgia
77
Q

What is complicated influenza?

A

Influenza infection which requires hospital admission

78
Q

What is a secondary bacterial pneumonia?

A

Superimposed bacterial infection after influenza. Usually strep. or staph.

79
Q

Who is eligible for the annual influenza vaccination?

A 
ALL health care workers 
Care homes 
Chronic condition 
Pregnant 
< 17 yo 
>65 yo
80
Q

What is the Beta-D-glucan test used for?

A

Ruling out yeast/fungal infection if negative

81
Q

What is the Galactommannan test used for?

A

Diagnosing mould infection like aspergillosis.

82
Q

How does candida enter the blood to cause candidaemia?

A

From the gut when the epithelium is broken like in sepsis or infection

83
Q

How is candidaemia treated?

A
  • Iv antifungals like casporin for 2 weeks after -ve blood cultures
  • Echo - candida on valves
  • Replace lines
84
Q

Bacteria which cause diarrhoea?

A 
Campylobacter 
Shigella
Salmonela 
E coli O157 
C diff
85
Q

What viruses cause Diarrhoea?

A

Rotavirus
Noravirus
CMV - specially immunocompromised

86
Q

What interaction happen with HAART?

A

Look at BNF - omeprazole and ranitidine

87
Q

What does IgM and IgG for Hep A indicate?

A

IgM shows current or recent infection

IgG shows immunity to Hep A

88
Q

What does a Anti-HBs show?

A

Vaccination or immunity to Hep B

89
Q

What does Anti-HBC show?

A

Show previous exposer to Hep B

90
Q

What does HBs-Ag show?

A

That there is an active Hep B infection

91
Q

What does an antibody to Hep C show and what test should be ordered next?

A

Previous Hep C exposer, PCR will show active infection.

92
Q

What symptoms would an infection with Entamoeba histolytic show?

A
  • Fever, RUQ pain, Rigor

- +ve Travel history ≠ 12 weeks ago

93
Q

What investigation would be done if Liver access was detected?

A

Ultrasound with an hypoechoic area of the liver. Would need to be drained and antibodies screened of E histolytica

94
Q

What is an indicator illness?

A

A illness linked to HIV that would therefore prompt HIV testing.

My Final Year 4 Revision (16 decks)

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