Infectious Diseases

Question 1

What are the components of a septic screen?

Answer 1

Bloods: FBC, Blood culture, CRP
Other: LP, Urinalysis, CXR

Question 2

According to NEWS score what temperature is classed as fever?

Answer 2

38

Question 3

Give some causes of night sweats?

Answer 3

Infection: TB, HIV, Osteomyelitis
Drugs: antidepressants, antipsychotics
Endocrine: hyperthyroid, DM
Other: menopause, anxiety

Question 4

What is a rigor? what does it suggest? example cause?

Answer 4

Uncontrollable limb shaking and teeth chattering
Looks like seizure but no LOC

suggests severe fever
Cause- sepsis, empyema, malaria

Question 5

Give 3 examples of viral causes of gastroenteritis

Answer 5

Norovirus
Rotavirus
Adenovirus

Question 6

What are the potential complications of gastroenteritis?

Answer 6

Lactose intolerance, IBS, GBS, reactive arthritis

HUS (after e.coli 0157)

Question 7

Does inflammatory or non-inflammatory diarrhoea produce watery and profuse diarrhoea?

Answer 7

Non-inflammatory

e.g cholera, staph aureus, enterotoxigenic diarrhoea, giardia

Question 8

Give several causes of non-inflammatory diarrhoea?

Answer 8

Cholera, staph aureus, enterotoxigenic diarrhoea, giardia

Question 9

What is the formal name for travellers diarrhoea?

Answer 9

Enterotoxigenic diarrhoea

Question 10

What is dysentry?

Answer 10

Infection of intestines which causes diarrhoea which contains mucus/blood

Question 11

What are the basic principles of management of gastroenteritis?

Answer 11

Fluid intake- PO, ORS, IV
Infection control e.g isolation
Anti-emetics/anti-diarrhoeals (only if severe NOT in dysentry)
Antibiotics if systemically unwell

Question 12

Bacterial causes of gastroenteritis?

Answer 12

Campylobacter jejuni, c.diff, chloera

shigella, salmonella, e.coli

Question 13

Give an example of a protozoal cause of gastroenteritis?

Answer 13

Giardia, cryptosporidium

Question 14

Commonest cause of meningitis?

Answer 14

Viral

Question 15

2 common causes of bacterial meningitis?

Answer 15

Neisseria meningitiddis, strep pneumonia

Question 16

What clinical feature might make you suspect pneumococcus as the cause of meningitis?

Answer 16

Ear ache

Question 17

Patient has staph aureus bacteraemia, give 4 things you should do.

Answer 17

IV flucloxacillin
Repeat blood cultures to check if tx working
Transthoracic echo (heart valves)
MRI spinse (staph loves bones)

Question 18

Patient has staph aureus bacteraemia, you’re about to start them on IV flucloxacillin but notice in the medical records they are penicillin allergic, what antibiotic do you prescribe instead?

Answer 18

Vancomycin

Question 19

Patient is HBsAg (+), what has happened?

Answer 19

They have active infection of Hep B or they have v.recently had the vaccine (which injects HBsAg)

Question 20

Patient is HBsAb (+), what does this mean?

Answer 20

They have been vaccinated or they have been infected previously with HepB

Question 21

How can Hep B be transmitted?

Answer 21

Blood, sex, vertical

Question 22

Give an example of a common respiratory condition which is an indicator for a HIV test?

Answer 22

Community acquired pneumonia

Question 23

Typical CXR features for TB patient

Answer 23

Apeical consolidation
Cavities
Hilar lymphadenopathy

Question 24

Investigations for TB

Answer 24

Sputum Microscopy and Culture

CXR

Question 25

What questions would you ask someone to assess their risk of having contracted TB?

Answer 25

``` Spent time / travelled to high TB incidence country e.g sub-saharan africa, india, south-east asia Previous history of TB Had BCG vaccine Close contact with anyone with TB Occupational risk e.g health care worker PMH of immunosuppression ```

Question 26

What are the tests for latent TB

Answer 26

Mantoux test | QuantiferonTB

Question 27

Rifampicin's effect on the liver reduces the effectiveness of COCP, what is the implication?

Answer 27

Use barrier contraceptives | note that rifampicin doesn't harm baby if get pregnant

Question 28

Antibiotics and treatment lengths for TB?

Answer 28

Rifampicin, Isoniazid, Pyrazinamide, Ethambutol All for 2 months R.I. only for following 4 months

Question 29

Patient on treatment for TB complains of changes to their vision, which medication is causing this?

Answer 29

Ethambutol- optic neuritis | E- Eyes

Question 30

Patient on treatment for TB complains of red coloured urine, which medication is causing this?

Answer 30

Rifampicin- red urine | R- Red

Question 31

Patient on treatment for TB complains of joint pains, which medication is causing this?

Answer 31

Pyrazinamide- arthrlaia / gout | P- Pain

Question 32

A potential side effect of isoniazid treatment in TB is neuropathy, this is caused by a deficiency in which vitamin?

Answer 32

Vitamin B6 | Hence give vit b6 supplements to prevent this

Question 33

What is meant by incubation period?

Answer 33

Time between exposure to infection and presentation of first symptoms

Question 34

What is the incubation period of COVID-19

Answer 34

2-14 days

Question 35

What are the inflammatory causes of gastroenteritis

Answer 35

``` CCESSPIT Camplyobacter, Clostridium dificile, E.Coli 0157, Salmonella Shigella (Produce Inflammatory Turds) ```

Question 36

Mx of giardiasis?

Answer 36

Metronidazole

Question 37

How does E.coli cause HUS?

Answer 37

E.coli 0157 causes shiga toxin which destroys RBCs | therefore if E.coli suspected avoid abx

Question 38

Which gastroenteritis causing bacteria have the potential to cause HUS?

Answer 38

E.coli 0157 Shigella (cause shiga toxin)

Question 39

Describe bacillus cerus as a cause of gastroenteritis?

Answer 39

Caused by inadequately cooked food (classically grows on food not immediately refrigerated) V within 5 hrs Diarrhoea after 8hrs Resolve within 24hrs

Question 40

Which viral cause of gatroenteritis is typically associated with hospital / cruise ship infections?

Answer 40

norovirus

Question 41

Which gastroenteritis cause is the commonest cause of infant mortality?

Answer 41

Cholera

Question 42

How often does a malaria patient fever spike and why?

Answer 42

48hrs, | this is cycle of replication for plasmodium falciparum