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MRCP > Infectious Diseases And GUM > Flashcards

Infectious Diseases And GUM Flashcards

1
Q

Gonnorhea

A

N.Gonnorhea - Encapsulated and therefore resitant to phagocyosis

Large ASx resevoir - Pharynx/rectal/cervical

Disseminated dx - in females = penicillin sensitive

Opthalmoplegia neonartu - Systemix Abx and Eye drops

> 10% = resistant to Penicillin + quinolones

–> Tx = CEPHLASPORIN - IM CEFTRAXONE + PO azithromycin

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2
Q

Syphillis

A

Treponem Pallidum

Transmission: SExual > Blood borne.

Diagnosis:
1) Serology = 2 x specific Ag test (EIA or TPHA) + Quantitive PCR

2) Dark ground microscopy - of tissue from Chancre or rash
3) Treponem PCR - Early syphillis Ulcer

In secondary syphillis - haem spread:

  • Mucocutaneous - non-itchy rash
  • LN
  • Neuro - CN palsy/ Meningitis
  • Occular - ant. uveitis
  • GI - Hepatitis or proctitis
  • Rheu - polyarthritis

Tx = Benzylpenicillin or Tetracycline

REINFECTION ??? –> use rapid plasma reagin - all others stay +ve despite txx

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3
Q

Chlamydia

A

Most common bacterial UTI –> Non-gonnocal urethritis.

Complications:

  • Female - PID.
  • Male - prostatitis/epididymitis
  • Babies - Neonatal conjunctivitis or pneumonitis - Systemic Erythromycin

In UK serovaa D + K most common

Other Complications:

  • Trachoma - corneal scarring = Serova A/B/C
  • Lymphogranuloma venerum = rectal inflamm + prostatitis - in MSM - Serova L1/L2/L3

Inx - NAATs

Mx in Adults = TETRACYCLINE OR AZITHROMYCINE

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4
Q

Risk factors for Aids

A

Most common transmission is M+F > MSM > Blood > IVDU

HIV 1 - most common worldwide
HIV2 - Most common in West Africa

RF:

  • Seroconversion or adv disease
  • concurrent STI
  • Concurrent Hep C
  • High Viral Load

Maternal –> Fetal RF = BREASTFEEDING reduce transmission by:

  • Antiretroviral before 3rd trimester
  • Avoid Breastfeeding
  • If detect VL @ 36 weeks –> C-section
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5
Q

HIV Mechanism

A

HIV follows CD4 cells: T-helper, B cells, Macrophages and CNS cells

HIV –> Decreased CD4 and therefore a low CD4:CD8

Markers assoc w/ Progression:

  • Low CD4
  • High Viral Load

Seroconversion:

  • up to 3/12
  • General unwekk sx, can ave meningo-encephalitis or arthropathy
  • Can’t detect HIV antibody during this time
  • Can detect HIV p24 Ag or HIV-1 (at 1 month)
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6
Q

Stages of HIV infection

A

Stage 1: Seroconversion

Stage 2: ASx

Stage 3: Persistent Generalised LN

Stage 4a: AIDS related complex –> Not AIDS defining disease

Stage 4b: AIDS defining illnesses

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7
Q

HIV - PCP

A

Q Stem: Persistent cough, with low sats or desat on exercise and HIV (CD4<200)

CXR: Bilat perihilar LN

Inx - Brochoalveolar lavage (BAL) –> Silver stain or immunoflourescence

Mx:

  • IV Co-Trimaoxazole or IV pentamidine (Sev dx)
  • Steroids - improve prognosis

Prophylaxis - Co-trimox and nebulised pentamidine:
- Prev PCP or CD4 <200 (until >200)

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8
Q

HIV - Pulm TB

A

Q Stem - may be similar to PCP –> AFRICAN PT or EXPOSURE –> Extrapulm TB or Mycobacterium Avium intracellulare

Atypical features:

  • Atypical CXR
  • Extrapulmonary Spread
  • Atypical organism - Mycobacterium avium intracellulare
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9
Q

HIV - GI disease

A

Common:

  • Oesophageal candida
  • oral hairy lukoplakia
  • KArposi sarcoma
  • gingivitis
  • lymphoma
  • CMV
  • HSV

Diarrhoea:
Cryptosporidium –> porfuse watery diarrhoea

Salmonella –> Atypical severity –> bacteraemia.

Inx - Stool culture or ZN Stain (Cryptosporidium) Or Biopsy

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10
Q

HIV - Neuro diseases

A

Cerebral Toxoplasmosis:

  • Px - Focal Neuro
  • Inx: CT - ring enhancing lesions + Toxoplasmosis IgG serology
  • Tx: Pyrimethamine + Sulfadiazine

CNS Lymphoma:

  • EBV
  • Assoc. with EBV
  • CT
  • Tx = Steroid + Chem

NOTE: distnguish between toxoplasmosis and lymohoma with Thalium SPECT (neg in toxo and pos in lymphoma)

Cryptococcal meningitis:

  • Px: Mengitis
  • Inx - Cryptocoocal Ag in Blood or CSF
  • Tx - Amphotericin or Fluctosine –> Liver/renal fx

Neurosyphillis:

  • Myopathy, retinitis, meningitis
  • Inx - Syphillis serology
  • Tx - IM Procaine penicillin + PO Probenacid

CMV Retinitis:

  • CD4< 50
  • Px : Blurred or LOV
  • Signs: Soft Exudate + Retinal haemorrhage
  • Tx: Ganciclovir.
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11
Q

HIV/ AIDS Tx

A

HAART = 2x NNRTI + (NRTI or PI)

IL-2 can be used to icrease CD4 # if good supression of HIV but poor CD4 count

If Fx respond to Tx –> Salvage therapy = Add Enfuvirtide

Monitoring:

  • Clinical assess
  • CD4
  • Viral Load
  • Renal/Hepatic fn
  • Cholesterol/BGL
  • Lactate

If Viral Load high on 2x ocassions –> Test for Viral Resistance

These patients req >90% Adherence

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12
Q

PEP and PrEP

A

4 weeks of Truvada / Kahetra

Take within 72 hours –> decrease transmission by 70-80%

PrEP - if high risk but not infected - req LT adherance (As long as exposure)

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13
Q

Live vaccines

A

Give 4 weeks apart

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14
Q

Human bite organisms and management

A

Staph A
Strep
Eikonella corrodons

CO-AMOXICLAV

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15
Q

Hep B vaccination response

A

Measure anti-HBs

> 100 —> no further bad

10-100 —> one additional vax dose

<10 —-> test for current or post infection and and repeat course of 3 vaccines

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16
Q

Urine dip tests

A

+ nitrates and + luecocytes
Then gram negative - E. coli

If symptomatic and only leukocytes consider a Gram + infection

G+ can’t concert nitrates to nitrites and therefore will be negative on urine dip

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17
Q

Bacterial vaginosis

A

Fishy discharge

Amsel criteria:

  • thin white homogenous discharge
  • clue cells on microscopy
  • vaginal pH >4.5
  • positive whiff test

Management
PO metronidazole

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18
Q

Renal transplant and infection

A

Think CMV

If imunnosupressed and approx 4/12 after commencement of immunosuppressant then think CMV

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19
Q

Genital warts

A

HPV 6 + 11 —> predispose to cervical Ca

Single + keratinised- cryotherapy

Multiple and non-keratinised - topical podophyllum

2nd line - topical imiquimod

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20
Q

Rubella in preg

A

Adult - headache/fever/URTI

1st trimester:

  • congenital rubella syndrome
  • deafness
  • cataract
  • pda
  • developmental delay
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21
Q

Toxoplasmosis

A

Parasite from cat faeces

Features:

  • primary —> infectious mononucleosis like sx
  • reactivation —> CNS multiple ring enhanced lesions

Pregnancy:

  • Early - frontal retinochoroiditis, encephalo-myelitis, hydrocephalus or microceph
  • late: develop above but as an infant - NORMAL BIRTH

Inx = serology
IgG - previous
IgM - acute

Mx:

Non specific tx

If reactivation —> Pyrimethamine, sulfadiazine + Folinic acid

Pregnancy - Spiramycin

Toxoplasmosis vs CNS Lymphoma

  • both increased Immuno deficiency:

Toxo - multiple lesions. Lymphoma- single

Thallium spect: toxo neg. lymphoma +

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22
Q

CMV

A

Ft:

Intraceebral calc
Helatosplenomegaky
Retinitis - in HIV - CD4 <50 —> IV ganciclovir

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23
Q

Varicella

A

Primary infection. - chickenpox —> latent in. Sensory ganglia

Reactivation —> dermatomal shingles

Pregnancy:
- if contact and unsure if immune:
VZIG
- untreated —> congenital varicella syndrome = limb hypoplasia + scarring of dermatomes

If adult gets exposed and unsure if exposed —> test IgG —> negative —> VZIg

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24
Q

Parvovirus in preg

A

Foetal anaemi

Hydrous fetalis - accumulation in fluid in >=2 feral compartments has

Foetal death

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25
Q

Gram +ve mnemonic

|Str|ange |Staph|y’s |act| |list| |enter|ed |my| |new| |Cl| |C|arrier |ba|g

A 
Strep
Staph
Actinomyosis
Listeria
Enterrococcus 
Mycobacteria 
Pneumococcus
Clostridia
Corynbacterium - diptheria 
Bacillus
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26
Q

G+ve Bacilli

CLara DATTA

A 
Clostridia
Listeria 
Diptheria
Anthrax 
TB
Tetanus 
Actinomyces
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27
Q

Strep Pnemo + Viridans

A

Alpha Knight tournament

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28
Q

Strep Pyogenes

A

Pyogenie bakery

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29
Q

Strep Agalactiae

A

Galactic Baby

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30
Q

Staph A

A

Golden Staph of Aureus

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31
Q

HSV

A

HSV-1 –> life long carriers
HSV-2 –> used to be known for genitals but now crossover

Can get mengitis or temporal lobe encephalitis.

Diagnosis of enceph: Viral PCR on CSF + MRI

Mx: IV Aciclovire

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32
Q

VZV

A

primary infection –> Chickenpox –> latent in sensory ganglia

Reactivation –> Shingles

Complications –> Pneumonitis or cerebral ataxia –> IV antiviral

If pregnant exposure and NOT immine –> VZIG

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33
Q

CMV

A

Primary –> ASx or Gladnular fever-like or GBS or BElls

> 80% of >60 yr olds have it, but becomes an issue if immunosupressed.

AIDS + CMV –> CMV retinitis, oesophagitis or colitis

Tx - ganciclovir

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34
Q

EBV

A 
Ingectious mononucleosis 
Burkitts Lymphoma 
Lymphoma in HIV 
Nasopharygeal Ca
Oral Hairy Leukoplakia
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35
Q

HHV8

A

KArposis sarcoma
Primary effusion lymphoma
Castlemans disease - lymphoproliferative disorder with enlarged LN

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36
Q

ABx Mechanism of action - non-protein synth inhibitors.

NITtu MET |SUL|tan in CEPtember with a |FLU|id PEN and a CAR

A

DNA synth inhib:
Nitrofurans
Metronidazole

Tetrahydrofolate inhib:
Sulphonamides - Trimethoprim

Peptidoglycan inhib:
- Cephlasporin
Penicillin
Carbapenems

DNA Gyrus inhib:
Fluroquinolones

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37
Q

ABx Mechanism of Action - Protein synth inhibs

Ma LIfe A-T C-E-Ll

A

Macrolides - 50s
Linezolid - 50s

Aminoglyclosides - 30s
Tetracycline - 30s

Clindamycin - 50s
Erythromycin - 50s
Linezolid - 50s

38
Q

Bacteriocidal (BANG Q RIP) vs Bacteriostatic (MS COLT)

A

Bacteriocidal:

Beta lactams - Penicillin/Carbepenems/Cephlasporin
Aminoglycloside (neomycin/gentamycin/streptomycin)
Nitroimidazole (MEtro)
Glycopeptides (Vanc)

Quinolones (-floxacin)

Rifampixin
Polymixin

BActeriostatic:

Macrolides (erythromycin/arithro/clarithro)
Sulfanamides (trimethoprim)

Chloramphenicol
Oxazolidones
Lincosamide (clindamycin)
Tetracycline

39
Q

Pregnancy and congenital infections

A 
Rubella 
Toxoplasmosis
CMV 
VZV 
Parvovirus
40
Q

IVDU infections

A

I.E. - see IE card in cardio

BBV

Soft tissue —> abscess or gangrene or next fasc

Clostridia infections

Botulinism:
- typically transmitted in food with toxin
-IVDU —> wound infection –> prevent ACTH release
-Px: acute descending symmetrical FLACCID paralysis
- can affect CNS —> eventually leads to resp
Fx
-Inx: toxin detection
- Mx: Pencillin/clindamycin + metronidazole & supportive.

Tetanus:

  • travels via motor neurone —> CNS. —> block NT release
  • Px = trismus, opisthotonos, dysphasia ( RIGID paralysis)

Inx - clinical + PCR

Mx - anti-tetanus Ig + metronidazole

41
Q

Splenectomy

A

High risk of encapsulated organisms:

  • s.pneumonia
  • H.influenza
  • N.mengitidies
  • campylobacter canimorous
  • malaria
  • babesiosis
Immunisation:
HiB 
N.mengitides 
Pneumonia 
Annual influenza

Prophylaxis:

Abx prophylaxis up to 16yrs
Or 2yrs post splenectomy

42
Q

Sickle cell disease

A

Functional hyposplenism

In particular:

Pneumococcus/meningococcus —> sepsis
OM due to salmonella
Increase morbidity and mortality from malaria —> haemolytic and infarctive crisis

43
Q

Toxic shock syndrome:

A

Toxin mediated
Staph or strep

From indwelling foreign body - tampon or
Surgical

Ft:

  • macular rash —> disseminated
  • shock

Inx: clinical suspicion and r/o other causes

Mx:

  • Abx - specific and clindamycin or linezolid
  • consider MrSA
  • if nec fasc —> surgical debridement
44
Q

Live attenuated vax

|y|ou |m|usnt |p|rescribe BCG |I|ncase |T|hey |r|IP |S|tat

Don’t prescribe in HIV

A

Yellow fever

MMR

POLIO

BCG

INFLUENZA

TYPHOID

ROTAVIRUS

SHINGLES

45
Q

Infectious mononucleosis

A

Glandular fever - EBV

Ft:

  • sore throat
  • exudative tonsillitis
  • malaise
  • splenomegaly
  • widespread maculopalukar rash

Inx:

  • monospot test (Paul burnnell test)
  • high lymphocytes = atypical on blood film
  • raised transaminasss

Mx:
Supportive
Avoid ampicillin —> maculopap rash
If airway comp —> steroids

Complications:

Splenic rupture 
Haemolytic anaemi 
Thrombocytopenia 
GBS 
Meningitis
46
Q

Diphtheria

A

Spore forming G+ bacteria

Transmission = resp droplets

Px

  • patient from endemic area or missed vaccines
  • temp / ant cervical LN / soft tissue oedema —> bulls neck
  • membranous pharyngitis —> airway obstruct

Inx - throat culture swab

Mx:

  • diphtheria anti-toxin + penicillin or erythromycin
  • immunisations
  • notify public health
47
Q

Lenierres disease

A

Caused by fuspbacter

Tonsillitis

Septic emboli —> IJV thrombosis and abscess

48
Q

Atypical pneumonia causes

A

Do not conform to lobar pattern

Mycoplasma pneumonia 
Legionella 
Chlamydia pneumonia 
Chlamydia psitaccia 
Coxellia burnetti
49
Q

Meningitis

A

CSF

bacteria

  • cloudy
  • neutrophils
  • high protein. Low glucose

Viral

  • clear
  • lymphocytes
  • glucose normal
  • high protein
tb 
- cloudy 
- lymphocytes 
Glucose low 
- protein very high 
Cryptococcal 
- clx 
- leukocytes 
Glucose N 
Protein N 
- ZN stains/India ink

Bacteria - gram stain
Virus - viral pcr
tB - ZN again
Crypto - ZN stain

Mx
- benzylpenicilin in communit 
- cefuroxime or cefotaxime 
Ampicillin if >55 
Ampicillin and gent if listeria

Contacts:

If meningococcus —> ciprofloxacjn

50
Q

Encephalitis

A

Most common UK cause HSV1 > HSV2

Inx - CSF PCR + MRI

TX - Aciclovir

51
Q

Brain abscess

A

Q stem - think of
Route of entry

OM/dental surgery/ sinusitis/CNS infection

Mx: cephalosporin + metro

52
Q

GI Infection - Staph A

A

Rapid onset. - 4-6 hours

53
Q

GI infection - E Coli

A

Most common travellers diarrhoea

12-72 hours

Can cause HUS

54
Q

Amoebiasis

A

Transmission faeces - oral

Q stem. - area of poor sanitation

Amoeba multiply in gut —> Bloody diarrhoea - invasive colitis

dysentery

Amoebic liver abscess —> anchovy paste ours

Inx: stool microscopy —> trophozites

Mx: metronidazole + diloxanide furoate

55
Q

Giardiasis

A

Travellers diarrhoea

Chronic watery diarrhoea

Inx
Stool microscopy —> cysts
SB biopsy —> trophozites

Mx:

Metronidazole or tinidazole

56
Q

Tropical sprue

A

Get post infection malabsorption - 2/12

E. coli / klebsiella / enterobacter

57
Q

Cryptosporidium GI infection

A

Water Bourne protozoan infection

Watery diarrhoea

ZN STAIN —> red cysts

Mx:
- tx HIV —> increase WCC

58
Q

C Diff

A

Risk factors:

  • increased age
  • Clindamycin > cephalosporin > cipro > coamox
  • acid suppression e.g ppi

Markers of severity:

WCc >15
Raised Cr > 50% baseline
Temp >38.5
Evidence of sever colitis

Mild:

  • <3 stools/day
  • WCc N

Mod

  • 3-5 stools
  • WCc <15

Sev:

  • > 5 stools
  • WCc > 15
  • creatinine / temp as above
  • High lactate —> very poor prognosis

Inx: stool culture = 2 stage

—> PCR/EIA For GDH —-> + —-> EIA for toxin —-> + then treat

Mx;
Mild = PO METRO

Mod = PO VANC

Sec = PO VANC AND IV METRO

59
Q

Hytadid disease

A

Dog tapeworm - echincoccus

Larvae enter blood

Mature in liver and for cysts

Can disseminate —> lungs and brain

Liver cyst rupture —> life threatening anaphylaxis

Inx: Liver US + serology

Mx:

Surgical removal of cyst

Bendazole or praziquantel

60
Q

Leptospirosis

A

Urine of infected animals —> broken skin

Q stem:

  • occupational exposure - sewage worker or agriculture
  • social exposure - fishing or water sports

Px:
Headache temperature neck stiff - initial

Then get a vasculitic rash

Can get weils disease: jaundice + renal impairment + proteinuria

Inx:

Culture - blood CSF urine
Serology
PCr

Mx:
Tetracycline + penicillin

61
Q

TB

A

RF:

  • HIV
  • Contact
  • Origin
  • Institution

Drug resistant TB - incomplete/wrong tx :

  • E.Europe, Russia + central Addia
  • MDR-TB = resitant to R + I
  • XDR-TB - resistant to R + I + Fluroquinolone

Inx:

Mantoux test = point of care = est for latent TB:

  • False neg: Lymphoma, miliary TB, Sarcoid, HIV, CKG 4,
    v. young

IFN-gamma:
- if + Mantoux –> distinguish between IMMS or exposure

Best = ZN stain for AAFB

Mx - RIPE

Rifamp –> Red-orange body secretion
Isoniazid - INH –> Iron increase, neuropathy, hepatitis
Pyrazinamide –> hyperuricacidaemia –> Gout
Ethambutol –> Eyes –> optic neuritis + colour vision loss

Give 3/12 of R + I (+/- P) or 6/12 of I (+/-P)

if CNS + cardiac infecton –> 10/12 of RI and extra two of PE –> 12/12 AND STEROIDS

Tx neuropathy with Vit B6 = PYROXIDINE

BCG Vax if:

  • neonate with first degree relatives from high risk
  • Neonate with FHx of TB
  • Neonate recent arrval from high risk
  • Unvaccinated and mantoux neg with occupational risk
  • Remember live attenuated –> therefore CI HIV
62
Q

Non-TB mycobacter

A

all mycobacter except: M. TB M. Bovis M. Africanum

Risk if :

  • Established chronic lung disease - bronchitis or emphysema
  • Cavitation from Prev TB
  • Immunocomp

Inx:
if pulm dx –> 2 specimens 7 days apart

Mx:
as for TB but longer

Mycobacter Avium complex - common
- includes m.avium and m.intracellulare.

Causes dx in 2 was:

1) dx resembles TB in elderly smoker w/CLD
2) Nodular infilitrates + bronchiectasis w/o CLD ( looks like CLD but no CLD) - Lady Windemere syndrome

Tx:

  • TB tx
  • Prophylaxis in HIV if CD4< 50 - AZITHROMYCIN
63
Q

Malaria - Causativ agents

A

Plasmodium Falciparum - mst severe –> death

P. Ovale

P. Vivax

P. Malariae

Transmission:

  • Blood transfusion
  • Mosquitos
64
Q

Malaria Px + Inx

A

Px:

  • Constitutional symptoms
  • Headache
  • PRE HEPATIC JAUNDICE –> due to haemolysis

Complications:

  • Cerebral malaria - focal neuro - not meingitis
  • Pulm oedema/ARDS
  • Sev haemoytic anaemia
  • hypoglycaemia
  • Sepsis
  • Splenomegaly

Inx:

  • THICK FILM –> trophozites
  • Shiztones can be seen on this film and i present SEVERE
  • Ag test can distinguisg between types

Markers of severity:

  • Parasitaemia >2%
  • Shiztones present
  • Multiorgan involvement
65
Q

Malaria Mx

A

P.Falciparum:
Severe dx –> IV Artesunate
Not Severe –> PO Quinine

Non-falciparum:

1) Azythromycine or Lumefantrine
2) Primaquine (Check G6PD deficiency first)

66
Q

Typhoid ( Salmon dinner on sketchy micro) - SEAGULL

A

traveller returning from indian subcontinent

Seagull - harbors in GBladder

Transmission is faeco-oral –> there increase risk if DECREASED STOMACH H+

Ft:

  • Rose spots
  • Hepatosplenomegaly
  • Fever
  • Abdo pain
  • Diarrhoea ( Pea soup)
  • Change in mental state
  • OM in sickle cell dx.

Inx:
- Culture –> G- BACILLUS

Tx:

  • Ciprofloxacin
  • if recent travel to |A|sia then give |A|zithromycin

There is a live attenuated Vax

67
Q

Ameobiasis

A

Faeco-oral –> therefore RF is poor sanitation

Amoeba multiply in gut:

  • Bloody diarrhoea
  • Dysentry
  • Liver abscess –> Assoc. pain —> Anchovy paste –> if discharges into abdo cavity –> peritonitis

Inx:
- Stool microscopy —> Amoebic trophazites

Mx:
- Metronidazole + Diloxanide Fuorate

68
Q

Plase positive in VDRL/RPR

SomeTimes Mistakes Happen

A

SLE

TB

MAlaria

HIV

69
Q

Non falciparum malaria treatment

A

If pt from a chloroquine resistant area —> artemisinin based tx

If not —> chloroquine

Use orimaquine to get rid of liver hypnoZites

70
Q

Disseminated gonnococal infection

A

Migratory arthritis + tensosynovitis + Dermatitis

71
Q

Anthrax - Eschar tx

A

Tx = Ciprofloxacin

72
Q

Cat scratch disease causative agent

A

Bartonella.

73
Q

Tx of Pubic lice

A

permithrin cream full body wash –> rpt at 1/52 –> rretest 1/52 after.

74
Q

HSV in preg

A

Primary attack >28 weeks –> C-sec

if not:
- Aciclovir from 36 weeks

75
Q

PElvic inflammatory dx

A

Causes:

  • most commonly chlamidyia
  • N. gonnorhea - contact pr + swab
  • mcyoplasma genitaiium
    0 mycoplasma hominus

Px:

  • Lower abdo pain
  • fever
  • deep dyspareunia
  • dysuria/menstrual irref
  • discharge
  • cervical excitation
  • Prehepatits = Fitz-hugh curtis syndrome

inx:
- test for chlamiyia/gonnorhea

Mx:
PO olfoloxacin + PO metro

Im Cef + PO doxy + PO metro

if IUD –> consider removal

complcition

  • infertility
  • chronic pain
  • ectopics
76
Q

Malaria chemoprophylaxis

A

Chloroquine - common

south east asia - Chlroquine resistance:

  • Atovaquone
  • proguanil
  • mefloquine
  • Doxy
Pregnant women:
- Avoid if possible 
if not:
- Chloroquiene
- proguanil + Folate 
MAlorone

DOXY CI and MEFLOQUINE + Cautio

77
Q

Japanese encephalitis

A

Flavivirus

Transmitted by mosquitos found in rice paddy fields

Can px with low GCS and PARKINSONIAN FEATURES

Diagnosis - PCR or serology

Mx - supportive

78
Q

Measles presentation

A

diffuse rahs

Koplik spots on cheek mucosa

79
Q

Yellow fever

A

Presents similair to. Dengue haemorrhagic fever

80
Q

PCP

A

Investigatuon is beta D-glucagan - prwsent in fungal cell wall

81
Q

Which malria infections can be dormant?

A

P. Ovale and P. Vivax

82
Q

What to do if r\aised ALT following TB treatmentr

A

if ALT >5x ULN –> STOP ALL

83
Q

HEaf Test - TB

A

grade 0: no response - nothing
Grade 1: 1 - 4 dots - unequivocal
Grade 2: coalesce to form ring with normal skin in middle - Prev BCG
Grade 3: Coalesce with abnormal skin - active disease
Grade 4 Solid lesion >10mm +/- ulceration/vesicles = active dx

84
Q

HIV Drugs rule of thumb with names

A

-navir- N”avir” trust a protease inhibitor

NRTI -ine-

NNRTI - others

85
Q

Hantar Virus

A

HEamorrhagic dx with renal fx

endemic ins outh asia/korea

86
Q

Loa Loa treatment

A

DEC

Diethylcarbamazine

87
Q

Visceral vs cutaneous Leishmaniasis

A

both caused by sand fly.

Visceral lleishmaniasis almost always assoc. by hepto/splenomegaly

88
Q

Leishmaniasis

A

Caused by SAND fly

3 types:

Cutaneous:

  • Leishamni tropica or mexicana
  • PApule at site of bite –> Ulcer

Mucocutaneos:

  • Brazilienis
  • Similair to above + mucosa

Visceral (Kala=azar):

  • Donovani
  • med/asia/south america/africa
  • HEPATOSPLENOMEGALY
  • systmically unwell.
  • GREY SKIN - (Black sickness)
89
Q

Leptospirosis management

A

Doxy or. Benpen

90
Q

Whipples dx Management

A

IV Ceftriaxon

MRCP (20 decks)

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