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APhase 3b flashcards > Infectious diseases > Flashcards

Infectious diseases Flashcards

1
Q

Mode of transmission of each hepatitis vaccine

A 
A = Food and drink contaminated with faeces of an infected individual.
B = blood transmission.
C = blood transmission.
D = blood or sexual contact.
E = raw/undercooked meat.
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2
Q

Which hepatitis’ are there vaccines for?

A

A, B (some protection over D)

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3
Q

Non hepatitis virus causes of hepatitis

A

Autoimmune
Alcohol
EMV and CMV

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4
Q

Short term/acute symptoms of hepatitis

A 
Nausea
Right upper quadrant abdo pain
Fatigue + malaise
Jaundice
Myalgia and arthralgia
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5
Q

Which hepatitis virus’ cause acute and which cause chronic hepatitis and what time scale defines which it is?

A 
Acute = All can occur as acute symptoms.
Chronic = B, C, D.

Chronic = infection longer than 6 months.

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6
Q

Complications of chronic hepatitis

A

Cirrhosis
Liver failure
Hepatocellular carcinoma

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7
Q

Investigation for immunity to hepatitis B

A

HBsAb - Hepatitis B surface antibody (either from vaccine or previous infection). Vaccine injects HBsAg which mounts immune response and produces HBsAb to give immunity (as no HBeAg or HBcAg injected no chance of acquiring chronic viral hepatitis).

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8
Q

Investigation to show current Hep B infection

A 
Abnormal LFTs
Positive: 
HBsAg
HBeAg (from replication)
Viral load high on PCR
HBcAb with esp high IgM
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9
Q

Treatment of acute hepatitis B

A

Self-limiting so no treatment.

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10
Q

Ways to spread Hep B

A

Risky sexual behaviours (HBV > HCV for sexual transmission)
Vertical - mother to newborn.
Sharing needles.
Blood transfusions and dialysis.

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11
Q

Treatment for hepatitis B

A

Nucleoside reverse transcriptase inhibitors.
Tenofovir or Entecavir.

Prevent DNA replication (can still produce cell proteins). Reduces HBeAg. Potentiates seroconversion and limits liver damage.

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12
Q

Ways to spread Hep C

A

Needle sharing
Needle injuries at work
Tattooing needles
Bloodstained toothbrushes

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13
Q

Symptoms of acute hep C

A

None, flu-like not worth seeing doctor about.

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14
Q

Extra-hepatic manifestations of hepatitis C

A 
Glomerulonephritis 
Cryoglobinaemia
Autoimmune thyroid disease
Porphyria cutanea tarda
Lichen planus
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15
Q

Ix for Hep C

A

Enzyme immunoassay and immnoblot assay for Hep C antibodies.

PCR for HCV RNA.

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16
Q

How many genotypes fo Hep C are there?

A

6🤙

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17
Q

Chronic liver disease with Hep C

A

1 in 3 with chronic HCV infection will get end stage liver disease.

Need close follow up for cirrhosis and HCC.

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18
Q

Tumour marker for hepatocellular carcinoma

A

AFP - alpha fetoprotein.

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19
Q

Treatment for Hep C

A 
Is curative!
Novel = Direct acting antiviral drugs.
NS3/4A protease inhibitors e.g. Grazoprevir.
NS5A inhibitors e.g. Velpatasvir.
NS5B inhibitors e.g. Sofosbuvir.
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20
Q

Who are most at risk for chronic Hep B infection

A

Perinatal or early childhood infected patients.

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21
Q

Investigations for suspected viral hepatitis

A 
LFTs - elevated ALT/AST, alk phos and bilirubin, low albumin.
FBC - microcytic anaemia
Coagulation - can have high INR/PT
Serology
Ultrasound of liver
AFP for HCC
Liver biopsy

Hep B = Serum HbSAg, HbS IgM antibodies

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22
Q

Investigations to show chronic Hep B infection

A 
Positive:
HBsAg
HBeAb
HBcAb esp high IgE
Viral load lower on PCR

No HbsAb as they obviously cant clear the virus and HBsAb is the only antibody to resolve virus.

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23
Q

‘Resolved’ Hep B infection pathophysiology and investigations

A

4% a year resolve. This can occur after a chronic infection of many years or after an acute infection.
The only resolves when complete seroconversion from HBsAg to HBsAb.

Ix: positive for
HBcAb esp high in IgE
HBeAb
HBsAb

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24
Q

Difference between Hep B and Hep C

A

Hep B is a DNA virus and is harder to treat - never cured only resolved.
Hep C is a RNA virus so able to cure patients.

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25
Q

Investigations for Hep A

A

IgM antibody for HAV in acute illness and long term high IgG HAV antibodies.
Abnormal LFTs
Elevated serum bilirubin

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26
Q

Management of Hep A

A

Supportive care - fluids, good nutrition.
Hep A vaccine
IV immunoglobulins

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27
Q

Pathophysiology of Hep D

A

Can replicate independently once inside cell but require HBV surface antigen for propagation.

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28
Q

Organism for TB

A

Mycobacterium tuberculosis

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29
Q

Risk factors for TB

A 
HIV
Older age (weaker immune system)
Vit D deficiency
DM
Immunosppression e.g chemo/steroids
Silicosis and lung fibrosis disease
Alcohol and smoking
Poverty
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30
Q

S+S of pulmonary TB

A 
Night sweats
Haemoptysis
Chronic cough
Weight loss
Fever
Malaise, fatigue, anorexia
O/E:
Tachypnoea
High temp
Hypoxia
Clubbing
Apical lung sounds
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31
Q

Investigations for pulmonary TB

A

3 x Acid Fast Bacilli of sputum sample.
If +ve = infective, if -ve doesn’t rule out TB, just less infective/bacteria present.
Blood PCR
CXR - fibronodular opacities in upper lobes with or without cavitation, Gonn focus from calcification and fibrosis around granuloma.
FBC - anaemia, raised WCC

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32
Q

Treatment for pulmonary TB

A

NOTIFY PHE!!!!!!!! Contact tracing.

Drugs: 
Isoniazid (H)
Rifampicin (R)
Ethambutol (E)
Pyrazinamide (Z)

Isoniazid + Rifampicin for 6 months daily.
Ethambutol + Pyrazinamide for first 2 months daily only.

Test of cure CXR.

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33
Q

How to treat a TB patient who you are worried wont comply?

A

Directly Observed Therapy - higher drug doses are given 3 times a week. The patient is observed taking them.

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34
Q

Multi-drug resistant TB

A

Resistance to at least Isoniazid and Rifampicin.

Patients treated with range of 5-8 drugs for up to 2 years.

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35
Q

Side effects of HREZ drugs

A

Isoniazid - peripheral neuropathy, agranulocytosis.
Rifampicin - thrombocytopenia, orange urine, many drug interactions including warfarin, oral contraceptives, methadone!
Ethambutol - ocular toxicity.
Pyrazinamide - hepatotoxic, arthralgia, gout/hyperuricaemia.

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36
Q

Latent TB test

A

Tuberculin skin test / Mantoux test:
- Doesn’t discriminate against those who are vaccinated and those who have previous infection.
- Can get false negative if patient is immunocompromised.
ALTERNATIVE
Interferon Gamma Release Assay (IGRA):
- 2 types = QUANTIferon and T-Spot.
- Distinguishes between vaccinated and latent TB but will also be +ve with active/acute infection.
- Therefore need thorough clinical assessment and CXR.

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37
Q

Locations for extra-pulmonary TB

A 
CNS - TB meningitis
TB osteomyelitis
TB lymphadenitis
Abdominal TB
Pericardial TB
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38
Q

Pott’s disease

A

TB osteomyelitis in the vertebrae.

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39
Q

Pathophyisology of HIV

A

RNA virus

Enters cells which express CD4 receptor. Mostly T-lymphocytes, macrophages and dendritic cells.
Inside the host’s cell the virus replicates using viral enzymes reverse transciptase and protease) and harnessing host’s proteins to form new viral particles.
Host’s immune system tries to destroy these viral infected cells leading to reduction in CD4 cell count.

Can have host’s immune system control the viral infected cells creating asymptomatic phase (+10yrs) where viral load stays at set point and steady gradual decrease in CD4.

When CD4 T-lymphocyte count is so low that the host is predisposed to opportunistic infections = acquired immunodeficiency syndrome (AIDS).

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40
Q

Risk factors for HIV infection

A 
IVDU needle sharing
Unprotected sexual intercourse
Vertical transmission to baby
Occupational needle stick injury
Blood product transfusion e.g haemophiliacs before screening was introduced.
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41
Q

Differential diagnosis for acute primary HIV illness

A

infectious monoculeosis

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42
Q

S+S in acute, primary HIV illness

A 
Fever
Night sweats
Myalgia + arthralgia
Anorexia
Nausea and diarrhoea
Lymphadenopathy
Maculo-papular rash on trunk and torso
Weight loss
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43
Q

Things in a history to suspect HIV

A 
Recurrent UTI
Recurrent oral candidias
Severe bacteria infections for unexplained reasons e.g. pneumonias.
Herpes zoster history
Persistent lymphadenopathy
Social risk factors
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44
Q

Investigations for HIV/newly diagnosed HIV patient

A 
HIV status via ELISA  (p24 antigen), PCR
HIV viral load
CD4+ count - usually <450cells/mL
Offer full STI screen
Viral hepatitis antibodies/Blood born virus screen
FBC - low Hb
U+E
LFT and synthetic liver function test esp before starting drugs.
Bone profile
Tuberculin skin test
Urinanalysis
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45
Q

Window period for HIV status testing after exposure

A

4 weeks. Can get false negative if test immediately after exposure. Give post exposure prophylaxis.

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46
Q

Framework for HIV Management

A

HAART.
Drug classes used:
Nucleoside reverse transcriptase inhibitors.
Non-nucleoside reverse transcriptase inhibitors, Protease inhibitors.
Entry inhibitors
Fusion inhibitors

Most combinations use 2NRTI and 1PI or NNRTI.

99% reduction in viraemia in 8 weeks.
Can interrupt treatment and can manipulate Rx.
Monitor response with CD4+ count.

Non drug parts = annual flu vaccine, counselling and psych support, annual cervical screening for females, safe sex advice.

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47
Q

Pharmacology, side effects and examples of NRTI

A

Prevent DNA replication from virus’ RNA.
SE = hypersensitivity (fever/rash)
Examples = Abacavir, Zidovudine

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48
Q

Pharmacology, side effects and examples of NNRT

A

Prevent DNA synthesis but not as a analogue to nucleotide.
SE = nightmares, hepatotoxic.
Examples = Etravirine, Efavirenz.

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49
Q

Pharmacology, side effects and examples of protease inhibitors

A

Prevent production of functional proteins from polyprotein.
SE = hyperlipidaemia, diarrhoea, peripheral neuropathy.
Examples = Atazanavir, Darunavir

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50
Q

AIDS

A 
Acquired Immune Deficiency Syndrome
CD4+ count of <200cells/mL
AIDS defining illness:
Pneumocytis jirovecii pneumonia
CMV retinitis
TB
Kaposi's sarcoma
Non-Hodgkin's Lymphoma
ect etc (many more)
51
Q

HIV and pregnancy:
Pre-conception advice
Drug given to new born
Post-partum advice

A

3 months of undetectable viral load = untrabnsmittable to baby so can have NVD. If viral load is detectable have C/S.
Zidovudine for 4 weeks
No breastfeeding.

52
Q

Prevention measure in HIV

A

Post exposure prophylaxis (Truvada)

Trials ongoing for pre-exposure prophylaxis.

53
Q

NICE guideline for genotype 1 HCV

A

12 weeks. Sofosbuvir (NS5Bi) and NS5Ai Velapatasvir. get clearance of virus.

54
Q

Virus associated with Kaposi’s sarcoma

A

Herpes simplex virus 8

55
Q

Life cycle of malaria parasite

A

Host is infected when bitten by an infected female Anopheles mosquitoes.
Malaria sporozoite enters human via mosquito’s saliva.
The sporozoite travels to the host’s liver where it enters hepatocytes and matures to form schizonts.
Rupture releases thousands of meozoites into the blood of the host.
In the blood the meozoites enter RBCs and cause the clinical picture seen in malaria. They also mature in male and female gametes in the RBCs.
When a mosquito bites the host again they ingest the gametes in the blood and go on to create more sporozoites and spread the disease.

56
Q

Species of malaria

A 
Plasmodium falciparum - most prevalent and responsible for most deaths.
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae
Plasmodum knowlesi (monkeys)
57
Q

Complications of malaria

A 
Cerebral malaria - seizures, coma.
ARDS
Jaundice
Severe anaemia
Hypoglycaemia
AKI
Splenic rupture
58
Q

S+S of malaria infection

A 
Presentation can be delayed.
Fever
Sweats +/- chills
Headache
Malaise, fatigue, anorexia
Nausea, abdo pain, d+v
Myalgia, arthralgia
Sore throat
Cough
59
Q

WHO criteria for severe malaria

A 
Impaired level of consciousness
Resp distress
Convulsions
Circulatory collapse/hypovolaemic shock
Pulmonary oedema
Abnormal bleeding/DIC
Jaundice
Haemoglobinuria (red dark urine)
Severe anaemia
Hypoglycaemia
Acidosis
Renal impairment
Hyperlactataemia
Hyperparasitaemia (>2%)
60
Q

Investigations of malaria

A 
Giemsa-stained thick and think blood film microscopy. Thick to see if parasite present, and thin to look at morphology and species identification.
Rapid diagnostic tests e.g. Antigen detection test
FBC - low Hb
Clotting profile - prolonged PT.
U+Es
LFT - elevated bilirubin
BM
Urinanalysis
ABG
61
Q

Management of malaria

A

NOTIFY PHE!
Based on WHO guidance.

Treatment of uncomplicated P.falciparum:
3 days of
Artemisinin-based chemo (ACT) e.g Artemether + Lumefantrine

Treatment of severe malaria:
IV Artesunate then 3 days or oral artesunate.

Beware of P.falciparum resistance (Chloroquine esp)

62
Q

Differential diagnosis for malaria

A 
Influenza flu
Dengue fever
Zika virus
Chikungunya virus
Enteric fever - thyphoid, parathyphoid, Salmonella infection.
63
Q

Malaria prophyalxis

A

DEET spray (min 20%)
Mosquito nets
Covering clothes
Chemoprophyalxis e.g Doxycyline or atovaquone/proguanil (malarone)

64
Q

Bacteria involved in meningococcal meningitis and meningococcal septicaemia

A

Neisseria meningitidis

65
Q

Signs pointing to meningococcal disease rather than other meningitis

A

Skin rash - non-blanching purpuric, starts distal and moves proximal.
CV instability - hypotensive, prolonged CRT,

66
Q

Bacteria in pneumococcal disease

A

Streptococcus pneumoniae meningitis.

67
Q

Treatment of suscpected meningococcal disease

A

In community - IM benxylpenicillin.
In hospital - IV Ceftriaxone or IV Chloramphenicol if penicillin anaphylaxis Hx + Dexamethasone (esp if ?streptococcal cause)

68
Q

Prophylaxis for close contact in meningococcal disease

A

If over 5yrs - Ciprofloxacin

If under 5 - Rifampicin

69
Q

Treatment for Legionella pneumonia

A

IV Clarithromycin

70
Q

Bacteria causing blood in stool

A 
Any colitis can but sterotypically:
Campylobacter jejuni
E.coli
Shigella
Salmonella
Yersinia
71
Q

Antibiotics for C.difficile infection

A

Metronidazole

Vancomycin

72
Q

Antibiotics for gastroenteritis

A

Not routinely prescribed - supportive care.

If any given commonly Azithromycin

73
Q

How many blood cultures needed for infective endocarditis

A

3

74
Q

Common bacteria in cellulitis and antibiotics used

A

Streptococcus pyogenes
Staphylococcus aureus

First line = Flucloxacillin

75
Q

Treatment of Pneumocytis jiroveci pneumonia

A

IV co-trimoxazole

Prednisolone

76
Q

A complication of starting anti-retroviral treatment when a patient is suffering from opportunistic infection

A

Immune reconstitution inflammatory syndrome (IRIS). Will cause massive inflammation at area of oppertunistic infection.

77
Q

Where will IVDU patients get infective endocarditis

A

In the right side of heart e.g. tricuspid valve.

78
Q

Empirical treatment for infective endocarditis

A

IV amoxicillin + gentamycin

If known S.aureas = flucloxacillin

79
Q

Differentials for photophobia

A

Meningitis
SAH
Migraine

80
Q

Pyrexia of unknown location

A

At least 3 weeks of fever with all investigations finding nil of note.

81
Q

Differentials for night sweats

A

TB
Cancer (lung)
Infection (pneumonia, endocarditis)
Menopause

82
Q

Fevers spiking every 24 hrs indicative of…

A

Malaria

83
Q

Investigations to do before starting a patient on TB drugs

A 
Eye test (ethambutol = ototoxic)
LFT
Renal function
84
Q

Treatment for latent TB (picked up on IGRA)

A

6 months of Isoniazid or
3 months of Isoniazid + Rifampicin.

Doesn’t cure TB but reduces reactivation by 2/3.

85
Q

Stain for Cryptococcus

A

India ink

86
Q

Kaposi’s sarcoma

A

Malignancy of endothelial cells (vascular)
HSV8
Is an STI.

87
Q

Granuloma

A

Aggreggation of epitheloid histiocytes.

88
Q

Natural history of TB

A

TB infection enters lung and macrophages try and combat it but bacilli proliferate inside macrophage and forms granuloma. This can lead to dormancy until reactivation by triggers such as low CD4 HIV

89
Q

Recent travel to conference, dry cough and deranged LFT. Ix and Mx

A

Legionella. Colonised in water tanks so comes out in air conditionings.
Urine antigen test, FBC, CXR (nothing exciting), sputum sample (gram negative rod).
Rx = IV Clarithromycin

90
Q

Transmission of Leishmaniasis

A

Vector - female phlebotomine sandfly

91
Q

Types of Leishmaniasis and clinical features

A

Cutaneous, mucocutaneous or visceral
Skin/cutaneous = most common, papules, skin nodules, ulcerations.
Mucocutaneous = oral and nasal mucosa ulcerations.
Visceral = affects spleen, liver and bone marrow = fever, weight loss, splenomegaly, pancytopenia, hypergammaglobulinaemia.

92
Q

Ix and Mx for Leishmaniasis

A 
Ix = FBC, LTF, creatinine, microscopy of tissue samples.
Mx = Stibogluconate, amphotericin B, miltefosine.
93
Q

Pathogen for Syphilis

A

Treponema pallidum
Spirochete, gram negative parasite.
Needs human body host to survive.

94
Q

Transmission of Syphilis

A

Acquired - sexual, contact of a chancre, needles.

Congenital - from mother to fetus/new baby

95
Q

Stages of acquired Syphilis

A

Primary = early stage, localised disease. Painless ulcers - CHANCRE at area where disease was acquired (genitals, hand). Resolve in 3-8weeks.

Secondary = dissemination of T.pallidum via lymph. Occurs 4-10 weeks after initial chancre. Lymphadenopathy, macular-papular rash on trunk and spreads to extremities, moist warm areas get CONDYLOMATA LATA at anus and perineum, hepatosplenomegaly. Meningitis, uveitis, glomerulonephritis. Systemic symptoms of fever, myalgia, malaise, headaches. Resolve 3-12 weeks.

Latent = asymptomatic disease but serology shows infection. Develop granulomas - GUMMA.

Tertiary = chronic end-organ damage 20-40 years after initial infection, occurs in 1/3 of untreated patients. Cardiovascular neuro and gummatous.

96
Q

S+S of tertiary syphilis

A 
Neurosyphilis = dementia, personality change, psychosis. Damage to dorsal column areflexia, paraesthesia, ataxia.
Cardiovasc = aortitis, aortic regurgitation, aortic aneurysm, angina.
Gummata = granulomatous lesions. Plaques, fibrous nodules mostly on bones and skin.
97
Q

Ix for syphilis

A

HIV test!!!!
Cardiolipin serology via RPR or VDRL, correlate to disease activity. Positive within week of chancre appearance, but not specific. Can use to monitor effect of Rx.
Treponemal specific serology via EIA or TPHA assays, are positive for life but not correlated to disease activity.
Biospy/swab of infected lesion or lymph node for - Dark ground microscopy and PCR

FBC, LFT, U+E, LP and CSF serology, x-ray of bones.

98
Q

Congenital syphilis

A

Most are asymptomatic at birth, develop symptoms in 5 weeks.

S+S = rash, lymphadenopathy, hepatosplenomegaly, condylomata lata, glomerulonephritis lots and lots.

99
Q

Mx of syphilis

A

Benzathine penicillin. Single dose in primary, 3 doses (once a week) for latent. Can be used in pregnancy.
If penicillin allergic = doxycycline.

Neurosyphilis = Procaine penicillin + benzylpenicillin.

100
Q

Pathogen in typhoid and parathyoid

A 
Salmonella enterica (gram negative).
Typhoid = serotype S typhi.
Only reservoir is humans.
101
Q

Presentation of typhoid

A

Week 1: FEVER, dry cough, relative bradycardia, (Faget’s sign), headache, malaise.
Week 2: Apathy, confused, swinging fevers (worse in evening, better in morning), rose spots on chest and abdo, green pea soup diarrhoea, furred tongue.
Week 3: Weight loss, pyrexia, confused, abdo distention, foul diarrhoea, weak. Complications of disease present.
Week 4: Could be slowly improving.

102
Q

Ix for typhoid

A 
Stool mc+s
Blood cultures
Widal test = serology for agglutinating antibodies against H and O S.typhi antigens. Not very good.
FBC = normal WBC
LFT = raised ALT and AST.
103
Q

Mx for typhoid

A

NOTIFY PHE!!!!
Rehydration
Good hygiene
ABx azithromycin, ceftriazone.

104
Q

Dengue fever cause, presentation, Ix and Rx.

A
  • Spread by mosquitos.
  • CFx = fever, skin flushing, arthralgia, headache, petechiae and purpura from haemorrhage fever variant.
  • Ix:
    FBC = low platelets, high WCC.
    LFT = elevated AST and ALT.
    Serum albumin = low (hypoalbuminaemia)
    Serology = ELISA fro IgM and IgG
  • Rx = NOTIFY PHE, fluids, supportive care, monitor LFT, FBC, UOP, coagulation.
105
Q

What is dysentery

A

Diarrhoea with blood +/- mucus.

Bacterial = Shigella.

106
Q

4 ways to catch urine and what is each for?

A
  1. First catch in morning = TB PCR
  2. First catch of stream = STI
  3. Mid-stream = UTI
  4. Terminal = schistosomiasis
107
Q

Viral Haemorrhagic fever

A
  • Suspect with travel Hx. Incubation of 2-21 days.
  • Increased exposure to bats (caves) and rodents.
  • RNA virus’s e.g. Filoviruses.
  • Diseases such as Lassa Fever, West Nile virus, Ebola, Argentine haemorrhage fever.
  • S+S = FEVER, petechiae, conjunctival injection (red eye), myalgia, sore throat, headache, fatigue, N+V, hypotension, oedema, altered mental state.
  • ISOLATE THEM IF YOU SUSPECT IT!
  • Ix for malaria (GIEMSA thick and thin blood film) and blood RT-PCR (RNA virus) to ∆.
  • Mx: prevent spread (barrier nurse, contact trace, notify PHE). Supportive with fluids, anti-emetic, analgesia.
108
Q

What to do with positive HIV test within 4week window period

A

Confirm it with repeat test!

109
Q

CFx of Kaposi’s sarcoma and what virus causes it?

A

Purple brown rash on shins

HSV8

110
Q

Causes of headache in HIV +ve and how to Ix

A

Cryptococcal meningitis - India ink stain of CSF.
TB meningitis - AFB of CSF
Neurotoxoplasmosis - CT head

Also common Strep pneumoniae meningitis, tension headache, cluster headache!

111
Q

Prophylactic treatment in HIV

A

When CD4 count <200
Cotrimoxazole for PCP, toxoplasmosis and bacterial infections.
Azithromycin for MAI lung disease
Gancylovir for CMV.

112
Q

Blood borne virus risk of infection from needle stick injury

A 
HIV = 0.3%
HCV = 3%
HBC = 30%
113
Q

Mx of chlamydia and gonorrhoea

A 
C = Azithromycin
R = Azithromycin + ceftriaxone Im STAT dose.
114
Q

Rash on soles and palms?

A

Secondary syphilis

115
Q

What are warts associated with secondary syphilis and name some other skin presentations of syphilis

A
  • Condylomata lata.
  • Chancre scares
  • Snail track ulcers in mucosa
  • Rash on palms and soles.
116
Q

Testing for syphilis

A
  1. Treponemal specific serology e.g. EIA or TPHA assays, are positive for life but not correlated to disease activity.
    If negative no syphilis, if positive then do:
  2. Non-treponemal specific e.g. RPR or VDRL, correlate to disease activity. Positive within week of chancre appearance, but not specific. Can use to monitor effect of Rx.
117
Q

How does malaria cause the features of severe malaria e.g pulmonary oedema

A

Infected RBC aggregate and block blood vessels. This damages vessel walls. Allows leakage form vessels. Hence pulmonary oedema, cerebral oedema, DIC

118
Q

Mx of Leishmaniasis

A

Stibogluconate

119
Q

Complications of hookworm

A

Anaemia, malabsorption.

120
Q

Mx of liver abscess (amoeba)

A

Metronidazole and drainage (anchovy paste pus)

121
Q

Blood test in Schistosomiasis and Mx

A

Eosinophilia on FBC

Praziquantel

122
Q

Name 4 non-malaria mosquitoes transmitted diseases

A

Dengue
Yellow fever
West Nile Fever
Chikungunya

123
Q

Ix in suspected viral hemorrhagic fever

A

Malaria thick and thin GIEMSA blood film
FBC, U+E, LFT, clotting, blood cultures, BM
Isolate and get senior help!!

124
Q

Prevention of Isoniazid induced peripheral neuropathy

A

Pyridoxine

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