Infectious diseases pastest Flashcards
What a common side affect of the HIV treatment Lamivudine (a nucleoside reverse transcriptase inhibitor)
bone marrow suppression causing anaemia, leucopenia, thrombocytopenia
Peripheral neuropathy, pancreatitis is a very rare side effect
What test is used for HIV ?
p24 antigen
Describe the serology of acute and previous epstein bar virus infection
IgM positive 4-8 weeks after acute infection.
IgG remains positive for life after infection.
What are the features of progressive multifocal leukoencephalopathy?
Associated with HIV
Hemipareses, speech / vision disturbance, progressive dementia.
MRI shows diffusely enhances lesions
What are the characteristic CT findings of Toxoplasmosis?
Ring-enhanced lesions
How does toxoplasmosis typically present?
Neuro signs developing over days to weeks
seizures
Headaches and vomiting secondary to raised ICP.
What are the CNS signs of cytomegalovirus encephalitis?
- progressive disorientation
-withdrawal and apathy - CN palsies and nystagmus
CT - Ring enhancing lesions
How to treat CMV encephalitis
Ganciclovir
infectious causes of erythema nodusum affecting respiratory system
Streptococcus
Mycoplasma pneumonia
H.Capsulatum (fungal)
Tuberculosis
Coccidiodomycosis
Blastomycosis
What is oral hairy leukoplakia?
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.
What is a renal complication of atazanavir?
Crystal nephropathy
Treat with IV fluids
How does typhoid present in a returning traveller?
salmon-pink muculopapular rash
constipation
high fever
headachhe
HIV positive, excoriated papules and pustules on chest, back and extensor surface of arms. CD4 count <300
Eosinophilic Folliculitis
What are the side effects of Zidovudine (a nucleoside reverse transcriptase inhibitor) used for HIV
- lipodystrophy (with peripheral fat loss and increased abdominal obesity)
- insulin resistance
What might an addissonian crisis look like in someone with CMV adrenalitis
Low BP, Tachycardia, Postural drop
Low sodium
Raised Potassium
Dizziness, Vomiting, Abdo pain, diarrhoea
Why is dapsone contraindicated in G6PD deficiency?
haemolysis
HIV associated with TTP (Thrombotic Thrombocytopenic Purpura) would require urgent treatment with plasmapheresis and steroids. What are the pentad of associated features of TTP?
- Thrombocytopenia
-fever
-neurological symptoms - haemolytic anaemia
- renal impairment
describe the serology of late latent syphilis
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
What is the treatment for latent syphilis
IM Bencathine penicillin X 3 doses
What organism causes Lymphogranuloma Venerum?
Chlamydia
What signs / symptoms are typical of lymphogranuloma verenum?
Tender lymph nodes, tenesmus, pain on defaecation, bloody / mucopurulent discharge
What is the treatment for lymphogranuloma venerum
21 days oral doxycycline
What is the treatment regime for CNS tuberculosis?
9 months with combination of 4 drugs
