Infectious Diseases

Question 1

What is a Ghon complex?

Answer 1

A pleural lesion caused by primary TB infection in a non immune child

Question 2

What is latent TB and how does it related to secondary TB?

Answer 2

When an individual is infected but with no clinical or radiographic signs of disease. Weakening of the host defences may cause reactivation into secondary TB

Question 3

What are the features of TB meningitis?

Answer 3

Typical meningitis signs, most commonly in an immunocompromised host e.g. HIV

Question 4

What lesion is associated with skin TB?

Answer 4

Lupus vulgaris (jelly like nodules)

Question 5

How do you diagnose latent and active TB?

Answer 5

Latent
Tuberculin skin test, if +ve -> IGRA

Active
CXR - upper lobe involvement
>=3 sputum samples and:
Culture in L-J media
AFB micro with Z-N stain

Question 6

What is the 6 monthly treatment regime for active TB?

Answer 6

2 months - RIPE

4 months - RI

Question 7

What are the side effects of RIPE meds?

Answer 7

Rifampicin - orange secretions, hepatitis
Isoniazid - sensory neuropathy, hepatitis
Pyrizinamide - Hepatitis, arthralgia
Ethambutol - Optic neuritis

Question 8

What is the incubation period, and infectivity pattern of influenza?

Answer 8

Incubation - 1-4 days

Infectivity - 1 day before symptoms to 7 days after

Question 9

What prophylactic measures are available for influenza?

Answer 9

Trivalent vaccine for:
>65s
Immunosuppressed
DM, COPD, any organ failure
Medical staff

Oseltamavir - under 1 year olds (not routine)

Question 10

What are the components of HIV monitoring?

Answer 10

CD4 count
Viral load
routine bloods

Question 11

What are the indications for HAART?

Answer 11

CD4<350
AIDS defining illness
Pregnancy
HBV coinfection

Question 12

Name some AIDS defining illnesses

Answer 12

Oesophageal candidiasis
Cryptococcal meningitis
CMV retinitis
Kaposi sarcoma
Burkitt's lymphoma
PCP
Toxoplasmosis

Question 13

Which is more common, HepB or HepC

Answer 13

Hep B x10 commoner

Question 14

What are the complications of HepB?

Answer 14

Fulminant hepatic failure
Chronic hepatitis
Cirrhosis
HCC

Question 15

Talk about primary syphillis

Answer 15

Macpap ->indurated ulcer AKA Chancre
Regional lymph nodes
Heals in 1-3 weeks

Question 16

Talk about secondary syphillis

Answer 16

6w-6months after chancre
Systemic bacteraemia and volar macpap rash
Warty lesions= condylomata lata

Question 17

Talk about tertiary syphillis

Answer 17

2-20 years latency

Gummas= granulomas in skin, mucosa, bones and joints

Question 18

Talk about quaternary syphillis

Answer 18

Syphillitic aortitis - aneurysm + regurg

Neurosyphillis:
Paralytic dementia
Meningiovascular disease
Tabes dorsalis
Argyll robertson pupil

Question 19

What are the features of quaternary neurosyphilis?

Answer 19

Paralytic dementia

Meningiovascular disease

Tabes dorsalis:
Sensory neuron degeneration
Ataxia 
Romberg +ve
Areflexia
Upgoing plantars
Charcot joints

Argyll Robertson pupil

Question 20

What are the clinical features of falciparum malaria?

Answer 20

Flu-like prodrome

Fever paroxysms (shivering <1hr, flushing, rigours, sweating)

Signs:
Anaemia
Jaundice
HSM
No rash, No LNs

Question 21

What are the complications of malaria?

Answer 21

Cerebral malaria
Lactic acidosis
Hypoglycaemia
ARDS
AKI 2ary to ATN

Question 22

What is a side effect of chloroquine?

Answer 22

Retinopathy