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Part 1 MRCP > Infectious diseases and STIs > Flashcards

Infectious diseases and STIs Flashcards

To make the user a complete germophobe

1
Q

Flu feeling, abdo cramps and haemorrhaging from bodily holes indicates what?

A

Viral haemorrhagic fever

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2
Q

What vaccines are available for haemorrhagic fever?

A

Yellow fever
*Dengue and ebola available but not widespread

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3
Q

How do you manage VHFs?

A

Supportive
Ribavarin used for Lassa

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4
Q

How can you distinguish VHFs based on vectors?

A

Rodents: Lassa
Mosquito, tick: Yellow, Dengue
Bats and primates: Ebola, Marburg

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5
Q

Use pain to differentiate causes of genital ulcers

A

Pain: Herpes simplex, H.ducreyi (chancroid)
No pain: Syphilis, C.trachomatis (stage 1 LGV)

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6
Q

What infections cause genital ulcers and painful lymphadeopathy

A

H. ducreyi (unilateral)
Chlamydia trachomatis (LGV stage 2)

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7
Q
A
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8
Q

Match the gastroenteritis pathogen to its incubation period

A

1-6 hours: S.aureus, B.cereus
12-48 hours: Salmonella, E.Coli
48-72 hours: Shigella, Campylobacter
>7 days: Giardiasis, amoebiasis

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9
Q

Which abx inhibit protein syntheis via…
30S
50S

A

30s: Aminoglycosides, tetracyclines
50s: Chloramphenicol, clindamycin, macrolides

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10
Q

How do aminoglycosides and tetracyclines differ on 30S?

A

amino causes misreading of mRNA
Tetra blocks aminoacyl-tRNA

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11
Q

How do chloramphenicol, clindamycin and macrolides inhibit 50S?

A

chloramphenicol: inhibits PTase
clindamycin and macrolides inhibit tRNA translocation

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12
Q

Which protein synth inhibitor causes
Toxic ears and kidneys
discoloured teeth, photosensitivity
Aplastic anaemia
C. Difficile
Nausea, QT prolongation

A

Toxic ears and kidneys: Aminoglycosides
discoloured teeth, photosensitivity: tetracyclines
Aplastic anaemia: Chloramphenicol
C. Difficile: Clindamycin
Nausea, QT prolongation: Macrolides

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13
Q

How do you treat P.carinii (jiroveci) infection?

A

Co-trimoxazole
Pentamidine if severe (IV is better than aerosol with pneumothorax risk)
ADD Steroids if hypoxic

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14
Q

List examples of live attenuated vaccinations

A

BCG
MMR
Influenza (nasal)
Rotavirus
Polio
Yellow fever
Oral typhoid

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15
Q

Separate pathogen type via these CSF parameters
Appearance
Glucose
Protein
WCC

A

Bacterial // viral // TB // Fungal
Cloudy // clear/cloudy // mild cloudy // cloudy
Low // normal // low // low
High // normal/raised // high // high
<=5k // <=1k // <=300 // <=200

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16
Q

Which infections cause bloody diarrhoea and how can they be distinguished?

A

Campylobacter: Prodromal headache, nausea, fever, incubation 1-6 days
E Coli

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17
Q

Interpret and manage the following Anti-Hb levels

A

> 100: Indicates adequate response, nil further
10-100: Suboptimal. Give further dose of vaccine
<10: Non-responder, test for Hx infection. need further course (3 doses). Failure to respond requires HbIG if exposed.

18
Q

What treatment is used for Hep B

A

peg IFa
Antivirals (eg telbivudine)

19
Q

Diarrhoea associated with itchy rashes on feet, buttocks, hands in a traveler

A

Strongyloides

20
Q

How do you treat strongyloides stercoralis

A

Ivermectin, albendazole

21
Q

Neisseria meningitidis + Neisseria gonorrhoeae, also Moraxella catarrhalis are examples of what type of bacteria?

A

Gram negative cocci

22
Q

What are gram positive cocci?

A

Staph, strep (+ enterococci)

23
Q

List the gram negative rods

A

ABCD L
Actinomyces
Bacillus anthracis (anthrax)
Clostridium
Diphtheria: Corynebacterium diphtheriae
Listeria monocytogenes

24
Q

Outline primary, secondary and tertiary syphilis

A

1: PAINLESS ulcer, PAINLESS lymph nodes
2: Truncal/ventral rash, snail track mouth ulcers, PAINLESS genital warts
3: granulomatous lesions, AR pupil, tabes dorsalis (shock pains, ataxia, genital dysfunction

25
Q

Which viral meningitis can have a low glucose CSF?

A

Mumps
Herpes encephalitis can also do this

26
Q

How would you distinguish toxoplasmosis from infectious mononucleosis?

A

Check for encephalitic or myocarditis features
Serology

27
Q

How is toxoplasmosis managed

A

Self limiting usually
If severe/immunocompromised: pyrimethamine + sulphadiazine

28
Q

An HIV patient with headache and reduced GCS gets a CT, what makes you think it could be toxoplasmosis?

A

Ring enhancing lesions +/- mass effect

29
Q

How does age affect likely meningitis pathogens?
<=3 months
3m-6y
6-60y
>60y

A

0-3m: GBS, E.Coli, L.monocytogenes
3m-6y: N.meningitidis, S.pneumoniae, H.influenzae
6-60y: N.meningitidis, S.pneumoniae
>60: Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes

30
Q

How does terbinafine work?

A

Inhibits squalene epoxidase, causing cell death

31
Q

Flu like illness , remission, then jaudice and bleeding from holes indicates what condition?

A

Yellow fever

32
Q

How can you differentiate sleeping sickness and Chaga’s disease?

A

SS // Chagas
Both can have chancre at infection site
Intermittent fevers, enlarged lymph nodes, hyper/hypoactivity // systemically well initially then reduced GI motility and cardiac symptoms
IV pentamidine/suramin, IV Melarsoprol // benzidazole, nifurtimox

33
Q

In what instances should LP be delayed for bacterial meningitis?

A

Sepsis, cardio-resp compromise
Bleed risk
Raised ICP (focal neuro, papilloedema, seizures, GCS <=12)

34
Q

What guidance aid deciding if senior review is needed?

A

Meningitis Research Foundation Algorithm

35
Q

How to manage bacterial meningitis

A

Blood cultures
LP first < 1hour < Abx first
IV cefotazime (+amoxicllin if >50 years)
IV dexamethasone within 12 hours of Abx

Dont give dex in septic shock, meningococcal septicaemia, immunocompromise, or post-op

36
Q

What is the targeted therapy for bacterial meningitis?

A

Mostly cefotaxime
meningococcal: IV benpen also option
Listeria: IV Amox + gent

37
Q

Flu symptoms, dry cough, reduced GCS, sodium and heart rate after travelling indicates which infection

A

Legionella pnuemophilia

38
Q

How is legionella diagnosed?

A

GS: Urinary antigen
+ mid-lower predominant patchy consolidation

39
Q

How is legionella treated?

A

Macrolides

40
Q

A 34-year-old woman presents with fatigue and weight loss. She admits to having intermittent abdominal pain and nausea but no vomiting or loose stools. She was diagnosed with pulmonary tuberculosis three years ago, took medications for three months, and prematurely stopped taking them.

On examination, she appears slim. Her abdomen is soft and non-tender. Her blood pressure is 110/80 mmHg when sitting and 90/60 mmHg when standing. Blood results are as follows:

Na+ 128 mmol/L (135 - 145)
K+ 5.8 mmol/L (3.5 - 5.0)
Urea 4 mmol/L (2.0 - 7.0)
Creatinine 75 µmol/L (55 - 120)

What is the next best investigation to determine the underlying cause?

A

Part 1 MRCP (2 decks)

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