Infectious diseases pastest

Question 1

What a common side affect of the HIV treatment Lamivudine (a nucleoside reverse transcriptase inhibitor)

Answer 1

bone marrow suppression causing anaemia, leucopenia, thrombocytopenia

Peripheral neuropathy, pancreatitis is a very rare side effect

Question 2

What test is used for HIV ?

Answer 2

p24 antigen

Question 3

Describe the serology of acute and previous epstein bar virus infection

Answer 3

IgM positive 4-8 weeks after acute infection.

IgG remains positive for life after infection.

Question 4

What are the features of progressive multifocal leukoencephalopathy?

Answer 4

Associated with HIV

Hemipareses, speech / vision disturbance, progressive dementia.

MRI shows diffusely enhances lesions

Question 5

What are the characteristic CT findings of Toxoplasmosis?

Answer 5

Ring-enhanced lesions

Question 6

How does toxoplasmosis typically present?

Answer 6

Neuro signs developing over days to weeks
seizures
Headaches and vomiting secondary to raised ICP.

Question 7

What are the CNS signs of cytomegalovirus encephalitis?

Answer 7

• progressive disorientation
  -withdrawal and apathy
• CN palsies and nystagmus

CT - Ring enhancing lesions

Question 8

How to treat CMV encephalitis

Answer 8

Ganciclovir

Question 9

infectious causes of erythema nodusum affecting respiratory system

Answer 9

Streptococcus
Mycoplasma pneumonia
H.Capsulatum (fungal)
Tuberculosis
Coccidiodomycosis
Blastomycosis

Question 10

What is oral hairy leukoplakia?

Answer 10

an AIDs defining illness
White oral plaques that cannot be dislodged.
Caused by ebstein-barr virus
Treatment is to start ante-retroviral therapy. It will resolve as CD4 count rises.

Question 11

What is a renal complication of atazanavir?

Answer 11

Crystal nephropathy

Treat with IV fluids

Question 12

How does typhoid present in a returning traveller?

Answer 12

salmon-pink muculopapular rash
constipation
high fever
headachhe

Question 12

HIV positive, excoriated papules and pustules on chest, back and extensor surface of arms. CD4 count <300

Answer 12

Eosinophilic Folliculitis

Question 13

What are the side effects of Zidovudine (a nucleoside reverse transcriptase inhibitor) used for HIV

Answer 13

• lipodystrophy (with peripheral fat loss and increased abdominal obesity)
• insulin resistance

Question 14

What might an addissonian crisis look like in someone with CMV adrenalitis

Answer 14

Low BP, Tachycardia, Postural drop
Low sodium
Raised Potassium
Dizziness, Vomiting, Abdo pain, diarrhoea

Question 15

Why is dapsone contraindicated in G6PD deficiency?

Answer 15

haemolysis

Question 16

HIV associated with TTP (Thrombotic Thrombocytopenic Purpura) would require urgent treatment with plasmapheresis and steroids. What are the pentad of associated features of TTP?

Answer 16

• Thrombocytopenia
  -fever
  -neurological symptoms
• haemolytic anaemia
• renal impairment

Question 17

describe the serology of late latent syphilis

Answer 17

Latent syphillis occurs 2 years after infecrtion with granuloma formation.

TPHA (T.pallidum haemagglutination assay) stays positive permenantly.

RPR becomes negative following treatment and indicates no longer infectious

Question 18

What is the treatment for latent syphilis

Answer 18

IM Bencathine penicillin X 3 doses

Question 19

What organism causes Lymphogranuloma Venerum?

Answer 19

Chlamydia

Question 20

What signs / symptoms are typical of lymphogranuloma verenum?

Answer 20

Tender lymph nodes, tenesmus, pain on defaecation, bloody / mucopurulent discharge

Question 21

What is the treatment for lymphogranuloma venerum

Answer 21

21 days oral doxycycline

Question 22

What is the treatment regime for CNS tuberculosis?

Answer 22

9 months with combination of 4 drugs

Question 23

What is the treatment fot latent TB (no symptoms, normal CXR and positive quantiferon test)

Answer 23

3 months with Isoniazid/ rifampicin combination therapy or 6 month with only isoniazid.

Question 24

What is the criteria for latent TB?

Answer 24

1. positive TB skin test or quantiferon test
2. No symptoms
3. normal cXR
4. Negative sputum smears / cultures

Question 25

What investigation is used to make the definitive diagnosis of cholangiopathy ?

Answer 25

ERCP

Question 26

What is CMV retinitis

Answer 26

An AIDs defining illness.
Visual loss may occur suddenly as a result of haemorrhage or retinal detachment. or more slowly due to progressive involvement of macula and optic nerve.

Treat with Ganciclovir

Question 27

What are the lumbar puncture findings of TB meningitis?

Answer 27

• raised opening pressure
• lymphocytic
• raised protein
• low glucose

Question 28

What test is used to diagnose cryptococcal meningitis?

Answer 28

India ink stain / positive cryptococcal antigen

Question 29

What is the treatment for strongyloids?

Answer 29

Ivermectin