Infectious Diseases

Question 1

What is the most common isolated organism from animal bites?

Answer 1

Pasteurella multocida

Question 2

What is the management of an animal bite?

Answer 2

• Clean wound

- Prescribe co-amoxiclav (if penicillin allergy prescribe doxycycline and metronidazole)

Question 3

What is the most common cause of infective endocarditis?

Answer 3

Staph aureus

Question 4

What is infective endocarditis?

Answer 4

Infection of the inner surfaces of the heart, usually the valves

Question 5

What are the symptoms of infective endocarditis?

Answer 5

• Fever
• New or changed heart murmur
• Night sweats
• Dyspnoea
• Splinter haemorrhages
• Weight loss
• Splenomegaly
• Clubbing

Question 6

What is the classic presentation of shingles?

Answer 6

Burning pain over the affected dermatome for 2-3 days (sometimes interfering with sleep). The rash will then develop (erythematous to start, then vesicular). The rash has a dermatome distribution that does not cross the midline.

Question 7

What is shingles?

Answer 7

Herpes zoster infection is an acute, unilateral blistering rash caused by reactivation of the varicella-zoster virus.

Question 8

What happens to the varicella-zoster virus after chicken pox?

Answer 8

It lies dormant in the dorsal root or cranial nerve ganglia.

Question 9

Who is at highest risk of shingles?

Answer 9

• Older patients
• HIV patients
• People with immunosuppressive conditions

Question 10

What are the most commonly affected dermatomes in shingles?

Answer 10

T1-L2

Question 11

What is the management of shingles in patients who are not immunocompromised?

Answer 11

1st line = oral antiviral therapy (famciclovir or valaciclovir)

• NSAIDs (ibuprofen and paracetamol) and calamine topical lotion for analgesia
• More severe pain give opioid analgesics

Question 12

What is the management of shingles in patients who are immunocompromised?

Answer 12

1st line = oral antiviral therapy (aciclovir or famciclovir or valaciclovir)

• NSAIDs (ibuprofen and paracetamol) and calamine topical lotion for analgesia
• More severe pain give opioid analgesics
• 2nd line = IV aciclovir

Question 13

What are the complications of shingles?

Answer 13

• Post-herpetic neuralgia
• Herpes zoster ophthalmicus
• Herpes zoster oticus (Ramsay Hunt syndrome)

Question 14

What is the mechanism of action of macrolide antibiotics?

Answer 14

They inhibit protein synthesis

Question 15

Erythromycin, clarithromycin and azithromycin are all examples of _________ antibiotics.

Answer 15

Macrolide

Question 16

What are the two most common causes of acute enteritis?

Answer 16

Campylobacter jejuni followed by campylobacter coli

Question 17

Where do most campylobacter jejuni infections come from?

Answer 17

Consuming poultry

Question 18

What is campylobacter jejuni also linked to?

Answer 18

Guillain-Barré syndrome

Question 19

What are the main symptoms of a campylobacter infection?

Answer 19

Diarrhoea and abdominal pain

Question 20

What is the treatment for campylobacter infection?

Answer 20

Fluid replacement therapy

Question 21

What is chlamydia proctitis?

Answer 21

Inflammation of the lining of the rectum caused by the bacteria chlamydia trachomatis

Question 22

What is shigellosis?

Answer 22

A form of diarrhoeal disease caused by the enterobacteria shigella

Question 23

What kind of bacteria are shigella?

Answer 23

Aerobic, non-motile, non-lactose-fermenting gram-negative rods

Question 24

How is shigellosis spread?

Answer 24

Faecal-oral contact and contaminated food and water

Question 25

When do you use antibiotics in the treatment of shigella?

Answer 25

When the patient has bloody diarrhoea and abdominal cramping

Question 26

What is the first-line antibiotic used to treat shigellosis?

Answer 26

Ciprofloxacin

Question 27

What is ascending lymphangitis and how does it present?

Answer 27

Inflammation of the lymphatic channels that occurs due to infection distal to the channel.

Presents as ascending erythematous line along the lymph vessel with swelling and itching

Question 28

What is filariasis?

Answer 28

An infectious tropical disease caused by thread-like parasitic round worms associated with elephantiasis (oedema with thickening of the skin and underlying tissues when the parasite blocks lymph vessels)