Infectious diseases and STIs Flashcards
Live attenuated vaccines
BCG measles, mumps, rubella (MMR) influenza (intranasal) oral rotavirus oral polio yellow fever oral typhoid
inactivated vaccines
rabies
hepatitis A
influenza (intramuscular)
Toxoid vaccines
tetanus
diphtheria
pertussis
subunit and conjugate vaccines
ins to make them more immunogenic pneumococcus (conjugate) haemophilus (conjugate) meningococcus (conjugate) hepatitis B human papillomavirus
HIV count for live vaccines
CD4 >200
viral meningitis with low CSF glucose
mumps
BV cause and gram stain
Gardnerella vaginalis
Gram positive coccobacilli
raised pH due to outcompeting lactobacilli. clue cells.
BV treatment
oral metronidazole 5-7days
migrating rash on buttocks and feet
Strongyloides stercoralis
Larvae penetrate the skin and are carried via the blood to the lungs where they are coughed up and swallowed. Adult worms reproduce in the GI tract (causing symptoms of bloating, discomfort and diarrhoea) and larvae are passed in the stool. Auto-infection can occur through the GI tract or peri-anal skin. Larva currens is the characteristic skin eruption of Strongyloides stercoralis. It causes an urticarial band that typically starts in the peri-anal area. The rash rapidly migrates, more quickly than the rash of cutaneous larva migrans.
Strongyloides stercoralis treatment
ivermectin and albendazole are used
infective bloody diarrhoea cause
Campylobacter
E.coli 0157
shigella
Campylobacter presentation
prodrome: headache malaise
diarrhoea: often bloody
abdominal pain: may mimic appendicitis
incubation period 1-6 days
campylobacter gram stain
gram negative bacillus
campylobacter management
usually self-limiting
the BNF advises treatment if severe or the patient is immunocompromised. Clinical Knowledge summaries also recommend antibiotics if severe symptoms (high fever, bloody diarrhoea, or more than eight stools per day) or symptoms have last more than one week
the first-line antibiotic is clarithromycin
ciprofloxacin is an alternative although the BNF states that ‘Strains with decreased sensitivity to ciprofloxacin isolated frequently’
campylobacter complications
Guillain-Barre syndrome may follow Campylobacter jejuni infections
Reiter’s syndrome
septicaemia, endocarditis, arthritis
leprosy cause
Mycobacterium leprae
Mycobacterium leprae features
patches of hypopigmented skin typically affecting the buttocks, face, and extensor surfaces of limbs
sensory loss
The degree of cell mediated immunity determines the type of leprosy a patient will develop.
Low degree of cell mediated immunity → lepromatous leprosy (‘multibacillary’)
extensive skin involvement
symmetrical nerve involvement
High degree of cell mediated immunity → tuberculoid leprosy (‘paucibacillary’)
limited skin disease
asymmetric nerve involvement → hypesthesia
hair loss
leprosy management
rifampicin, dapsone and clofazimine
genital warts cause
HPV, especially types 6 & 11. It is now well established that HPV (primarily types 16,18 & 33) predisposes to cervical cancer.
genital warts management
- topical podophyllum / cryotherapy
2. Imiquimod
ribavarin machanism
Guanosine analog which inhibits inosine monophosphate (IMP) dehydrogenase, interferes with the capping of viral mRNA
ribavarin indications
Chronic hepatitis C, RSV
ribavarin adverse effects
Haemolytic anaemia
Aciclovir mechanism
Guanosine analog, phosphorylated by thymidine kinase which in turn inhibits the viral DNA polymerase