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Infectious diseases Flashcards

1
Q

Gram positive bacteria (peptidoglycan cell wall staining)

A

Streptococci
Staphylococci
Enterococci
Clostridium

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2
Q

Gram negative bacteria

A 
Neisseria 
H. pylori
Escherichia coli 
Shigella, Salmonella, Campylobacter
Haem influenzae
Bordetella pertussis
Cholerae
Yersinia pestis
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3
Q

Cocci shape

A

Round

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4
Q

Bacilli

A

Rod shaped

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5
Q

Risk factors for latent TB reactivation

A 
Immunosuppression 
Organ transplant
New infection 
HIV
Malnutrition
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6
Q

Testing times for HIV

A

Most should be picked up 4-6 weeks after exposure (p24 antigen from 1-4 weeks)
Testing again at 12 weeks will confidently exclude the diagnosis (99% have HIV antibodies at 12 weeks)

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7
Q

Treatment of pneumocystis jiroveci

A

Co-trimoxazole

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8
Q

Chancroid features

A

Painful genital ulcers associated with unilateral painful inguinal lymphadenopathy
Ulcers have sharp jagged borders

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9
Q

Causes of genital ulcers

A 
Herpes simplex (type 2)
Syphilis
Chancroid
Lymphogranuloma venereum- chlamydia trachomatis 
Behcet's disease
Carcinoma
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10
Q

Antibiotics for acute pylonephritis

A

Broad spectrum cephalosporin or quinolone (ciprofloxacin)

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11
Q

Antibiotics for acute prostatitis

A

Quinolone or trimethoprim

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12
Q

Treatment for throat infections and acute sinusitis

A

Phenoxymethylpenicillin

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13
Q

Antibiotics for otitis media

A

Amoxicillin (or erythromycin)

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14
Q

Antibiotics for otitis externa

A

Flucloxacillin (or erythromycin)

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15
Q

Antibiotics for gonorrhoea

A

Stat dose of IM ceftriaxone

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16
Q

Antibiotics for chlamydia

A

Doxycycline or azithromycin

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17
Q

What is carcinoembryonic antigen CEA used for?

A

Tumour marker for several cancers

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18
Q

Clinical features of trichomonas vaginalis

A 
pH>4.5
Frothy green discharge
Strawberry cervix
Vulvovaginitis 
Asymptomatic or urethritis in men
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19
Q

Meningitis causing organisms from 0-3 months

A

Group B strep
E. coli
Listeria monocytogenes

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20
Q

Meningitis causing organisms from 3 months-6 years

A

Neisseria meningitides
Strep pneumoniae
Haemophilus influenza B

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21
Q

Meningitis causing organisms from 6-60

A

Neisseria meningitides

Strep pneumoniae

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22
Q

Meningitis causing organisms from 60+

A

Neisseria meningitides
Strep pneumoniae
Listeria monocytogenes

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23
Q

Most likely organism to cause central line infections

A

Staphylococcus epidermis

24
Q

First line antibiotic for campylobacter jejuni if severe or patient is immunocompromised

A

Clarithromycin

25
Q

Klebsiella pneumoniae is classically seen in

A

Alcoholics

26
Q

Prophylaxis for contacts of meningococcal meningitis

A

Ciprofloxacin or rifampicin

27
Q

Diagnostic tests for latent TB

A

Tuberculin skin testing- Mantoux test- intradermal injection of purified protein leading to skin induration, size dependent on the positivity
Interferon gamma release assays

28
Q

Active pulmonary TB diagnostic tests

A

CXR- calcification, cavitation, typically upper lobe, miliary disease, effusion, lymphadenopathy
Sputum smear- stained for acid-fast bacilli, early morning samply needed
Sputum culture more sensitive but takes longer- can assess drug sensitvity
NAAT

29
Q

Treatment for TB

A

RIPE
2 months intensive with rifampicin, isoniazid, pyrazinamide and ethambutol
4 months continuation with rifampicin and isoniazid

30
Q

Antivirals for influenza if high risk or complicated

A

Inhibitors of influenza neuraminidase
Oseltamivir- first line
Zanamivir

31
Q

Prevention of HIV transmission

A

Sexual transmission- barrier methods
PrEP and PEP- short term use of antiviral therapy before and after sexual or occupational exposure- can be given up to 72 hours after
ART from 24 weeks gestation
Neonatal PEP given from 4 weeks

32
Q

Presentation of primary HIV infection

A

Typically 2-4 weeks after infection- acute retroviral syndrome/ seroconversion illness
Fever, rash, myalgia, pharyngitis, mucosal ulceration, lymphadenopathy, headache, aseptic meningitis
Persistent generalised lymphadenopathy

33
Q

Treatment for pneumocystis jirovecii

A

Co-trimoxazole 21 day course

34
Q

Complications of HIV

A

PCP pneumocystis jirovecii
Candidiasis
Cryptococcus neoformans (commonest systemic fungal infection in HIV)
Toxoplasma gondii abscesses (commonest cause of intracranial lesions when CD4 count <200)
CMV
Cryptosporidium- chronic diarrhoea
Kaposi’s sarcoma- most common tumour in HIV and AIDS
Lymphoma- non-Hodgkin’s

35
Q

Presentation of toxoplasmosis abscesses

A

Focal neurological signs and seizures, headache and vomiting if raised ICP
Ring enhanced lesions on MRI

36
Q

Presentation of Kaposi’s sarcoma

A

Cutaneous or mucosal lesions- patch, plaque or nodular

37
Q

Herpes encephalitis

A

Transfer of virus from the peripheries to the brain via neuronal transmission
Fever, malaise, headache, nausea and then encephalopathy

38
Q

Treatment for herpes simplex

A

Aciclovir

Will not prevent latent HS infection

39
Q

When is VZV vaccine given?

A

70 to prevent shingles reactivation

40
Q

Treatment of VZV

A

Aciclovir within 48hrs of rash

IV if pregnant, immunosuppressed or disseminated disease

41
Q

Presentation of EBV

A

Infectious mononucleosis in 50% of infections in adults
Fever, sore throat, anorexia, lymphadenopathy, palatal petechiae, hepatosplenomegaly, jaundice, malaise
Resolution of symptoms usually within 2 weeks

42
Q

Diagnosis of EBV

A

Blood film- lymphocytosis
Monospot test- heterophile antibody test
Serology- IgM to EBV viral capsid antigen, IgG if past infection

43
Q

What is a nosocomial infection?

A

Healthcare associated

44
Q

Three stages of syphilis

A

1) Painless chancre with central slough with defined rolled edges
2) Dissemination after chancre, maculopapular rash on soles and palms, mucous patches, fever, headache, myalgia, lymphadenopathy, hepatitis
3) 20-40yrs after infection, neurosyphilis, aseptic meningitis, focal neurology, seizures, psychiatric, Argyl Robertson pupil, gummatous syphilis, cardiovascular

45
Q

Treatment of syphilis

A

IM Benzylpenicillin

46
Q

Cause of lymphogranuloma venerum

A

Chlamydia trachomatis

47
Q

What are vaginal triple swabs?

A

Endocervical NAAT swab
Endocervical charcoal swab
High vaginal charcoal swab

48
Q

Treatment for genital candidiasis

A

Topical clotrimazole (or other)
Pessary if possible, cream if vulval symptoms
Oral if severe

49
Q

Tropical fresh water infections

A

Leptospirosis

Schistosomiasis

50
Q

Fever in the returning traveller investigations

A 
Guided by exposure and travel history
Full examination 
Malaria film/ rapid diagnostic testing
HIV test
FBC, LFT
Blood culture 
Consider specific serology
51
Q

Typhoidal enteric fever classic history

A

Marked fever rising stepwise, progressing throughout the day
Salmonella typhi
pea-soup diarrhoea

52
Q

Malaria differential diagnoses

A

Dengue fever, typhoid, hepatitis, meningitis, viral haemorrhagic fever

53
Q

Treatment for uncomplicated malaria

A

Artemisinin combination therapies (ACT)

54
Q

Presentation of dengue fever

A 
3-14 day incubation period
Fever
N+V
Headache
Retroorbital pain
Arthralgia
55
Q

Yellow fever classic course

A

Fever, headache, myalgia, anorexia
Remission
Severe symptoms 48 hours later
Epigastric pain, AKI, jaundice, cardiac instability

56
Q

Features of Legionella infection

A 
Flu like symptoms
Dry cough
Relative bradycardia
Confusion
Lymphopenia
Hyponatraemia
Deranged LFTs
Pleural effusion

PT prep (9 decks)

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