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FINALS medicine > Infectious diseases > Flashcards

Infectious diseases Flashcards

1
Q

How do you screen for atypical pneumonia?

A

Blood for serology- looks for antibiotics

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2
Q

How do you screen for mycoplasma and influenza?

A

Nasal swab PCR

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3
Q

How do you screen for pneumocystis (atypical pneumonia)?

A

Sputum PCR (or bronchial lavage PCR)

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4
Q

Key/first test for infective endocarditis?

A

blood cultures 3 sets from different venepuncture sites over a period of time

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5
Q

Likely pathogen of infective endocarditis in an IVDU?

A

staph aureus

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6
Q

What is onchomycosis?

A

Fungal nail infection

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7
Q

Key test in febrile illness on return from sub-saharan africa?

A

Malaria blood film

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8
Q

Myalgia, headache, high fever, sometimes rash on return from SE asia- what key test?

A

Dengue serology (IgM and IgG)

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9
Q

Dengue incubation period?

A

1w

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10
Q

What time of day does the dengue mosquito bite?

A

Day time

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11
Q

What is Q fever?

A

Coxiella burnetii

from infected farm animals such as sheep, cattle and goats- breathing in the bacteria

Risk in pregnant, immune-suppressed, heart valve disease

Can lead to atypical pneumonia

Chronic- endocarditis - fatal if untreated

Serology and Abx

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12
Q

What should you do if you think the source of sepsis is an indwelling line?

A

PAIRED cultures- one peripheral (normal) and one from the line.

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13
Q

What to do in a pt presenting with fever post operatively?

A

Find source- it may not be wound/perforation- could also be catheter, lines, HAP etc.

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14
Q

How do you screen for latent TB

A

IGRA- interferon gamma release assay

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15
Q

Pathogens of bac meningitis

A 
N meningitidis
S pneumoniae
Hib
Listeria
Group B strep (neonates)
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16
Q

Which babies should get an LP?

A

<1m and fever

1-3m fever and unwell

<1y unexplained fever and features of serious illness

17
Q

C/Is to LP

A
  1. sepsis/rapidly evolving rash
  2. severe resp/CV compromise
  3. sig bleeding risk
  4. signs of shifting brain compartments e.g. FND/papilloedema/seizures/GCS <12 –> CT head first as long as stable!!
18
Q

In Rx bac meningitis when do you add amoxicillin to the cephalosporin?

A

Immune comp/>50yo

19
Q

In Rx bac meningitis when do you add vancomycin to the cephalosporin?

A

If there is a risk of penicillin resistant pneumococcal infection e.g. recent travel or prolonged Abx exposure

20
Q

What do you give as well as Abx in Rx bacterial meningitis?

A

IV dex 10mg AT THE SAME TIME AS THE ANTOIBIOTICS to reduce neuro complications particularly in pneumococcal

21
Q

When do you avoid giving Dex in bacterial meningitis

A

Septic shock

Meningococcal septicaemia

Immune compromised

Meningitis following surgery

22
Q

Public health implications of bac meninigitis

A

Notifiable

Contacts should get prophylaxis cipro or rifampicin

23
Q

Risk factors for pneumococcal meningitis?

A

Immune compromise

Splenectomy

Smoking

Pneumococcus infection at another site e.g. lung/otitis media/sinusitis

Skull injuries

24
Q

Spinal level of an LP

A

L3-L4

25
Q

Viral causes of meningitis

A

Enteroviruses (echovirus and coxsackie)

HSVII

VZV

mumps

26
Q

Which type of meningitis is less acutely unwell

A

viral

27
Q

Treatment of viral meningitis

A

Supportive

28
Q

Is there evidence for aciclovir in viral meningitis?

A

No as HSVII not I

29
Q

How do you distinguish meningitis and encephalitis

A

clinical

30
Q

How do the clinical signs differ in encephalitis compared to meningitis?

A

Enceph- fever/behav. changes/confusion/seizure

Meningitis- neck stiff/photophobia/headache

31
Q

What might mimic enceph in elderly

A

derlirium from infection

32
Q

Cause of encephalitis

A

HSV1 majority

rarer= EBV, VZV, HIV, HHV6, rabies, japanese enceph, tick borne, zika

33
Q

What is the classical MRI finding in encephalitis?

A

temporal lobe inflammation

34
Q

Why might you do a CT head in ?encephalitis?

A

Rules out important differentials e.g. brain abscess, stroke, SOL

35
Q

Does a normal CSF r/o encephalitis?

A

yes

36
Q

Rx encephalitis?

A

IV aciclovir 10mg/kg TDS for 14-21 days.

Start empirically and continue if confirmed

37
Q

Can you get non-infective encephalitis?

A

Yes- autoimmune/paraneoplastic/acute disseminated encephalomyelitis

FINALS medicine (8 decks)

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