Infectious Diseases and Microbiology

Question 1

Papillomas
Trepenoma positive

Answer 1

Yaws

Question 2

Criteria for vaginal delivery in HIV

Answer 2

If viral load <50 can deliver vaginally

Question 3

Rash that starts peripherally and moves centrally
Fever
Headache

Answer 3

Rocky mountain spotted fever

Question 4

What test for syphilis remains positive for life?

Answer 4

Trepenomal tests - even if successful treatment

Question 5

Organism in human bites

Answer 5

Eikenella corrodens

Question 6

Mantoux Test
- what is a positive result?
- what test can differentiate between BCG vaccination and infection?

Answer 6

> 6mm induration = positive result

Can use IGRA test - doesn’t differentiate between active and latent TB

Question 7

Management of PCP
- consideration

Answer 7

Co-trimoxazole
If proven hypoxia e.g. low pO2 on gas - add in steroids

Question 8

Management of measles
- consideration

Answer 8

Usually supportive
If developing country - evidence for giving vitamin A (replace losses)

Question 9

Management of travellers diarrhoea

Answer 9

Conservative
If immunosuppressed - consider ciprofloxacin

Question 10

Eradication of strongoloides

Answer 10

Repeat serology
- stool culture gold standard but only 50% sensitive

Question 11

When do people need antibiotic prophylaxis in meningococcal meningitis?

Answer 11

Close contacts within the last 7 days

Question 12

Management of ESBLs (3)

Answer 12

Carbopenems
Fosfomycin
Nitrofuratoin
- usually in the context of urine infections

Question 13

Management of leprosy

Answer 13

Rifampicin
Clofazimine - riminophenozine antibiotic
Dapsone

Question 14

Management of cerebral toxoplasmosis

Answer 14

Sulfadiazine
Pyrimethamine

Question 15

Management of latent TB

Answer 15

EITHER
3 months isoniazid (with pyridoxine) + rifampicin
OR
6 months isoniazid (with pyridoxine)

Question 16

Live vaccines

Answer 16

Yellow fever
BCG
Polio
Varicella

Question 17

Unimmunised
Immunosuppressed
Confirmed measles contact

Answer 17

Need to give immunoglobulin
(if not immunosuppressed just give vaccine)

Question 18

Management of Chagas Disease

Answer 18

Benzidazole

Question 19

Feature of brucellosis

Answer 19

Sacroilitis

Question 20

Treatment of multi-drug resistant TB

Answer 20

18-24 months of treatment with 5 medications

Question 21

Tick bite management
- erythema migrans + nil clear tick bite
- tick bite + asymptomatic

Answer 21

1. Treat with antibiotics, nil confirmation needed
2. Nil investigation for Lyme’s disease needed

Question 22

Features of leptospirosis (6)

Answer 22

Fever
Coryzal
Conjunctival haemorrhage
AKI
Hepatitis
Aseptic meningitis

Question 23

Management of leptospirosis
Investigation

Answer 23

Doxycycline - if severe benzylpenicillin
Serology positive after 7 days

Question 24

Assessment of response to hepatitis B vaccine

Answer 24

If >100 antiHBs then adequate response
- if less than that give 1 further dose
- if <10 then needs full course again

Question 25

Management of hepatitis B

Answer 25

Pegylated interferon A

Question 26

NRTI (3)

Answer 26

Zidovudine
Tenofovir
Didanosine

Question 27

Protease inhibitor - how to determine

Answer 27

End in -vir
(except tenofovir and integrase inhibitors end in -gravir)

Question 28

NNRTI (2)

Answer 28

Revirapine
Efavirenze

Question 29

Vaccines contraindicated in HIV

Answer 29

Cholera
Nasal influenza
BCG
Polio

Question 30

Marker for hepatitis C

Answer 30

HCV RNA

Question 31

Associations with hepatitis C (6)

Answer 31

Arthritis
Sjogrens
Cirrhosis
HCC
Cryoglobulinaemia
Porphyria cutanea tarda

Question 32

Management of hepatitis C
- caution with

Answer 32

Protease inhibitor + ribavarin
Ribavarin = teratogenic, haemolytic anaemia

Question 33

Management of histoplasmosis

Answer 33

Amphotericin

Question 34

Management of amoebic liver abscess

Answer 34

Metronidazole for 1/52
Diloxanide for 1/52

Question 35

Cryptosporidium
PCP
Neutropaenia
Normal/high levels IgM
Low levels IgA/IgG

Answer 35

Hyper IgM syndrome