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MedEd Path > MedEd Micro 1 > Flashcards

MedEd Micro 1 Flashcards

1
Q

50M 6/12 Hx of weight loss and haemoptysis. Gold standard test for Dx?

A

sputum culture

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2
Q

why give b6 in TB Tx?

A

protect against side effects of isoniazid

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3
Q

stages of TB infection

A

primary - mycobacterium tuberculosis initial infection, often in childhood. no Sx
latent - suppressed, hanging around in foci, no Sx
post primary / secondary - reactivation of latent, often due to immunosuppression. Sx!!

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4
Q

causes of reactivation of TB

A

HIV infection
started on monoclonal ABs / immunosuppression
illness

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5
Q

3 stages of TB on a CXR

A

ball of macrophages = ghon foci
+ lympahdenopathy = ghon complex
+ calcification = ranki complex

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6
Q

PC of active TB (4)

A

weight loss / fever / night sweats / loss of appetite / fatigue
pulmonary - haemoptysis
lymphadenopathy
erythema nodosum

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7
Q

less common PC of active TB

A

miliary TB
meningeal TB
Pott’s disease
GUM TB
serosal / GI / adrenal / cutaneous

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8
Q

what is miliary TB

A

TB lesion erodes into BV and spreads all over body

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9
Q

how does meningeal TB present, in whom & what complication

A

subacute meningitic sx
HIV pts
++++ morbidity

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10
Q

what is pott’s disease and how does it present

A

TB in vertebrae
back pain / compression fracture / focal neurology

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11
Q

incidental result of GUM TB and why

A

sterile pyuria !! UTI Sx with nothing grown on MCS (bcos they don’t look for TB)

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12
Q

how does miliary TB look on CXR

A

lots of little white dots all over CXR (also all over rest of body but not as easy to see)

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13
Q

name pathognomonic cutaenous presentation of TB

A

lupus vulgaris

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14
Q

gold standard Ix for active TB with medium used

A

sputum culture, on Lowenstein-Jensen media
** buzzword **

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15
Q

what Ix is done for active TB in practice

A

sputum smear and Ziehl Neelson stain for acid fast bacilli
** buzzword **

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16
Q

why isnt sputum culture done for TB Dx in practice

A

takes too long to culture TB

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17
Q

another stain for acid fast bacilli

A

auramine rhodamine stain
(stains red / yellow)
** buzzword **

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18
Q

how is latent TB diagnosed

A

mantoux test
interferon gamma release assay (ellaspot)

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19
Q

difference between mantoux test and IFGRA for TB

A

mantoux - tests positive if you’ve had BCG vaccine OR you have latent TB, cheap
IFGRA - only positive if you have latent TB, expensive

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20
Q

5 drugs for TB Tx

A

RIPE
rifampicin
isoniazid + pyridoxine
pyrazinamide
ethambutol

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21
Q

duration of Tx for TB

A

all 4 RIPE drugs for 2 months,
then just 2 for 4 months (rifampicin and isoniazid)

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22
Q

what is pyridoxine and why is it given with RIPE

A

vitamin b6
isoniazid causes peripheral neuropathy due to depletion of b6

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23
Q

drugs used for drug resistant TB

A

aminoglycosides
fluroquinolones
new drugs
specifics - streptomycin / amicacin

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24
Q

Mx of latent TB

A

just rifampicin and isoniazid (less intensive regime)

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25
Q

2nd most common mycobacterium

A

leprosy (mycobacterium leprae / lepromatosis)

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26
Q

PC of mycobacterium leprae / lepromatosis
(2 Sx, buzzword finding, Hx finding)

A

skin changes - hypo/hyperpigmented lesions
peripheral nerve disease
*thickening of nerves ** buzzword
+ travel Hx / exposure

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27
Q

name other mycobacterium

A

mycobacterium leprae / lepromatosis
MAC - mycobacterium avium complex
mycobacterium marinum
mycobacterium ulcerans

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28
Q

who gets MAC

A

preexisting lung disease / HIV

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29
Q

PC of MAC

A

same as pulmonary TB
slow PC,
FLAWS / cough

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30
Q

PC buzzwords for mycobacterium marinum

A

“fish tank granuloma”
exposure to swimming pools / fish tanks
skin disease

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31
Q

what does mycobacterium ulcerans cause

A

buruli ulcer

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32
Q

PC of buruli ulcer

A

been in the tropics
painless, destructive ulcer

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33
Q

23F 2/52 dry cough, fever, myalgia.
O/E rash, jaundice
CXR bilateral consolidation
Organism?

A

mycoplasma pneumonie

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34
Q

what does LRTI encompass

A

bronchitis
pneumonia
abscess
empyema

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35
Q

describe bronchitis - who gets it / Mx and why / CXR

A

smokers / kids
don’t tend to get that unwell, so don’t usually treat unless supportive
CXR no changes

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36
Q

describe pneumonia - progression / CXR

A

look sick
treat with ABx
CXR shows consolidation

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37
Q

what is an abscess

A

puss filled cavitating lesion within lung parenchyma

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38
Q

2 key PC of abscess

A

FLAWS - esp swinging fevers !
Hx pneumonia - esp pneumonia not responding to ABx = abscess

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39
Q

MX of abscess

A

drainage
ABx alone not enough

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40
Q

what is an empyema

A

infection within an existing space in lung (ie the pleura)

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41
Q

3 classifications of pneumonia with definitions

A

CAPs - develop in community
HAPs - develop >48hrs after hospital admission
VAPs - develop in patients on ventilators

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42
Q

CXR of bronchitis

A

nothing
thickening of central bronchi

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43
Q

CXR of abscess

A

well circumscribed lesion with patchy airspaces within (cavity with fluid in)

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44
Q

what does CXR of empyema look similar to

A

pleural effusion - loss of costophrenic angle with meniscus

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45
Q

why are typicals / atypicals called that

A

typicals all present the same in classic pneumonia fashion
atypicals present weirdly
–> nothing to do with how common they are !!

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46
Q

describe typical pneumonia PC

A

systemically unwell
productive cough, fever, etc
lobar consolidation on CXR

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47
Q

what Mx do typical pneumonias respond to

A

penecillins

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48
Q

how do atypical pneumonias present

A

flu like prodrome
dry cough rather than productive
extra pulmonary manifestations

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49
Q

how does the Mx of atypicals differ from typical pneumonia

A

atypicals respond to macrolides, not penecillins like typicals

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50
Q

3 buzzwords for strep pneumoniae (Sx, unique Ix, path)

A

rusty coloured sputum
gram positive diploccoci
positive urine antigen test

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51
Q

buzzwords for h.influenzae (path, at risk)

A

COPD
gram neg coccobacillus

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52
Q

buzzwords for moraxella catarrhalis (path, at risk)

A

smokers
gram negative coccus

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53
Q

most common pneumonia bug

A

strep pneumoniae

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54
Q

3 buzzwords for staph aureus pneumonia (RFs, CXR lesion, path)

A

post-influenza pneumonia
cavitating lesions - cavity
gram positive cocci (grape like bunch)

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55
Q

4 buzzwords for klebsiella pneumoniae (RFs, CXR lesion, Sx, path)

A

alcoholics !! / post aspiration eg stroke
haemoptysis
cavitating lesions
gram negative rods

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56
Q

who gets chlamydia pneumoniae and how sick are they

A

asthmatics
not very sick
(less important)

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57
Q

3 buzzwords for legionella pneumophilia (RFs, Sx, Ix)

A

air conditioning - plumbers / travellers
very unwell - hepatitis, low Na, lymphopaenia
+ urine antigen test

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58
Q

pt has positive urine antigen test with pneumonia. what bugs?

A

strep pneumonia
legionella

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59
Q

3 buzzwords for mycoplasma pneumoniae (RFs, 2 buzzword signs)

A

young people in close proximity - halls etc
cold AIHA !! (jaundiced)
erythema multiforme !! (target lesions)

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60
Q

2 buzzwords for chlamydia psittaci (RFs, complication)

A

own exotic birds !!
culture negative endocarditis

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61
Q

2 buzzwords for coxiella burnetti (RFs, complication)

A

farm animals !!
culture negative endocarditis

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62
Q

what LRTIs can HIV+ patients get

A

PCP
TB
cryptococcus neoformans
nocardia

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63
Q

how does PCP classically present

A

dry cough
** desaturation on exertion >10%** buzzword

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64
Q

LRTIs in splenectomy pts

A

encapsulated organisms
- haemophilus
- strep

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65
Q

LRTIs in CF

A

pseudomonas aeruginosa
burkolderia cepacia

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66
Q

why is burkholderia cepacia important to know about in CF kids

A

contraindication to lung transplant

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67
Q

what LRTI bugs are people taking monoclonal ABs at risk of

A

TB reactivation

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68
Q

what LRTI bug do people with neutropaenia / asthma get

A

aspergillus

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69
Q

CXR of PCP

A

relatively normal
bat wing shadowing around the hilar

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70
Q

CT of PCP

A

honeycombing - big open spaces
ground glass shadowing

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71
Q

CURB 65 criteria

A

confusion - AMTS <9
urea >7
RR >30
BP <90/60
65 or older

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72
Q

What does a CURB 65 score of 0-1/2/3-5 mean

A

curb65 0-1 = treat at home, PO amoxicillin
curb65 2 = admit, co-amoxicillin and clarithromycin
curb65 3-5 = admit, co-amoxicillin and clarithromycin, consider ICU

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73
Q

standard tx of CAP

A

amoxicillin / co-amoxicillin / clarithromycin
- some combo of this

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74
Q

Tx of HAP
(1st / severe)

A

LOCAL TRUST GUIDELINES
usually 1st = ciprofloxacin and vancomycin
severe = piperacillin / tazobactam and vancomycin

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75
Q

what are you covering for in HAP

A

MRSA
pseudomonas

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76
Q

go to ABx for pseudomonas

A

piperacillin and tazobactam (tazocin)

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77
Q

go to ABx for MRSA

A

vancomycin

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78
Q

ABx for aspiration pneumonia

A

usually aspiration is a pneumonitis not pneumonia (ie chemical acid damage to lung, not infection) so not usually needed

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79
Q

go to ABx for anaerobic cover

A

metronidazole
clindamycin

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80
Q

indications for starting ABx for anaerobic cover

A

MUST be an indication not just if they’ve aspirated
- culture
- empyema / abscess

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81
Q

3 classifications of infective endocarditis

A

subacute
acute
prosthetic

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82
Q

PC of subacute endocarditis

A

indolent presentation
fever of unknown origin
FLAWS
new regurgitant heart murmur
splinter haemorrhages / janeway lesions
septic emboli - brain / spleen / kidney
immune phenomena - roth spots / osler nodes / glomerulonephritis
BUZZWORDS

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83
Q

PC of acute endocarditis

A

rapid onset
VERY septic / unwell

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84
Q

who gets prosthetic endocarditis and when

A

valve replacement pts (1-2 months post op)

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85
Q

location of IE usually

A

most ppl - left side as higher pressure
IVDU - tricuspid / right sides

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86
Q

osler nodes vs janeway lesions

A

oslernodes = painful
janeway lesions = painless

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87
Q

where do roth spots occur

A

retina

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88
Q

common organisms causing IE

A

strep viridans
staph aureus

89
Q

most common organism in UK vs world causing IE

A

UK = staph aureus
world = strep viridans

90
Q

organism causing IE within 2 months of valve replacement

A

staph epidermidis

91
Q

organism causing IE in colon tumours

A

strep bovis

92
Q

organisms causing culture negative IE

A

HACEK organisms

93
Q

organism causing IE in bird keeper

A

chlamydia psittaci

94
Q

organism causing IE in farmer

A

coxiella burnetti

95
Q

organism causing IE in someone who’s had unpasteurised dairy

A

brucella spp.

96
Q

what criteria is used to diagnose IE

A

Dukes

97
Q

major criteria for Dukes IE

A

blood cultures positive for IE - 2+ culture of a bug associated with IE
evidence of endocardial involvement - scan showing vegetations

98
Q

minor criteria for Dukes IE

A

predisposing factor - IVDU / heart condition
fever >38
vascular phenomena - emboli / infarcts / ICH / janeway lesions
immunological phenomena - osler nodes / roth spots / RF+ / GN
microbiological evidence - culture that doesn’t meet major criteria

99
Q

how is IE diagnosed with Dukes

A

definite = 2 major OR 1 major + 3 minor OR all 5 minor
possible = 1 major + 1 minor OR 3 minor

100
Q

Tx of IE

A

long course of ABx
- empirical / broad unless known organisms
- includes gentamicin
+/- surgery if indicated

101
Q

indications for surgery in IE

A

continuing to worsen on ABx
acute heart failure
aortic root abscess
prosthetic valve

102
Q

how is IE abscess development picked up on ECG

A

prolonged PR

103
Q

what is non infective endocarditis

A

endocardial vegatations without infection

104
Q

2 causes of non infective endocarditis

A

mucin producing adenocarcinomas - pancreatic especially
SLE / ALPS - Libman Sacks endocarditis

105
Q

3 groups of presentations of GI infections

A

secretory - normal Sx
inflammatory - bloody diarrhoea
systemic sx

106
Q

what Tx is not really used in GI infections and why

A

ABx - usually not bacterial, but protazoa
NB - exception is c.diff / very high risk and unwell

107
Q

if an ABx is indicated in GI infection, which one is usually given

A

ciprafloxacin

108
Q

organisms causing a secretory diarrhoea

A

bacillus cereus
staph aureus
e.coli
cholera

109
Q

buzzword for bacillus cereus GI infection

A

reheated rice

110
Q

buzzword for staph aureus GI infection

A

BBQs !!
short incubation - damage due to preformed toxins

111
Q

buzzword for e.coli GI infection

A

traveller’s diarrhoea
NB - usually none bloody, only 1 specific type is bloody

112
Q

2 buzzwords for vibrio cholera GI infection (sx and path)

A

ricewater stool
comma shaped bacteria

113
Q

causes of blood diarrhoea

A

CHESS
campylobacter jejuni
haemorrhagic e coli
entamoeba histolytica
salmonella enterides
shigella spp

AND yersinia enterocolitica !!

114
Q

buzzword for salmonella enterides

A

poultry / eggs

115
Q

does salmonella typhi cause bloody diarrhoea

A

NO - causes typhoid which is constipation

116
Q

how does yersinia present

A

bloody or non bloody diarrhoea
terminal ileitis / adenitis –> similar to appendicitis

117
Q

protazoal GI infections

A

entamoeba histolytica
giardia lamblia
cryptosporidium / micosporidium spp

118
Q

PC of entamoeba histolytica

A

bloody diarrhoea / chronic diarrhoea
liver abscess

119
Q

histology of entamoeba histolytica

A

flask shaped ulcer
anchovy paste in abscess
buzzwords

120
Q

tx of entamoeba histolytica

A

metronidazole

121
Q

PC of giardia lamblia

A

chronic diarrhoea
malabsorption
- like coealic !

122
Q

histology of giardia lamblia

A

pear shaped trophozoites
buzzword

123
Q

tx of giardia lamblia

A

metronidazole

124
Q

buzzword / who gets cryptosporidium or microsporidium diarrhoea

A

HIV+ patients

125
Q

who gets c.diff diarrhoea

A

post ABx

126
Q

which ABx cause c.diff diarrhoea

A

cephalosporins, clindamycin, ciprofloxacin

127
Q

Ix for c.diff

A

stool c.difficile toxin
visualise pseudomembrane - looks like wet cornflakes

128
Q

Tx of c.diff
- 1st infection
- 1st recurrence
- further recurrence
- fulminant infection

A

1st = oral vancomycin
recurr = oral fidaxomicin
mutliple recurr = faecal microbiota transplant
fulminant = oral vancomycin + IV metronidazole +/- surgery
(Meeran says 1st line is metronidazole tho)

129
Q

27F with dysuria, smelly urine.
Urine dip shows leucocytes but no nitrites.
why?

A

UTI causes by staph aureus

130
Q

what is a complicated UTI

A

UT abnormality
pregnant
immunocompromised
instrumentation

131
Q

what is lower UTI vs pyelonephritis vs pyonephrosis

A

lower UTI / cystitis = only affects bladder
pyelonephritis = infection to kidneys
pyelonephrosis = pyelonephritis + obstruction

132
Q

Mx of pyelonephritis vs pyonephrosis

A

nephrosis needs a surgical intervention to drain fluid / fix blockage

133
Q

Ix UTI

A

urine dip
MC&S
renal tract imagine - USS or CT

134
Q

what do nitrites signify on urine dip

A

coliform UTI - whether an enzyme is present
–> e.coli mainly makes the enzyme, so nitrites indicate e.coli UTI

135
Q

diagnostic value for any UTI on MC&S

A

> 10^4 colony forming units/ml of any organism

136
Q

diagnostic value for e.coli / staph saprophyticus UTI on MC&S

A

> 10^3 colony forming units/ml

137
Q

MC&S features that show contaminated sample

A

epithelial / squamous cells
staph aurues (doesn’t cause UTI, on skin)
mixed growth

138
Q

who are the only group in whom you’d treat asymptomatic UTI

A

pregnant women

139
Q

most common cause of UTI

A

e.coli

140
Q

most common cause of UTI in young women

A

staph saprophyticus

141
Q

2 organisms in UTI that would indicate renal tract abnormalities

A

proteus mirabilis
klebsiella

142
Q

buzzword for proteus mirabilis

A

struvite stones ** key
alkaline urine

143
Q

what organism causes sterile pyruia

A

TB ** key
STIs - chlamydia

144
Q

Tx of lower UTI

A

nitrofurantoin
trimethoprim
cephalexin

145
Q

Tx course of lower UTI in complicated / uncomplicated

A

uncomplicated = 3d
complicated in male = 7d

146
Q

when can you not give trimpethoprim / nitrofurantoin

A

can’t give trimethoprim in 1st trimester
can’t give nitrofurantoin in 3rd trimester

147
Q

drug interaction of trimethoprim

A

methotrexate (folate antagonist)

148
Q

Tx for pyelonephritis

A

admit pt
IV co-amoxiclav + gentamicin

149
Q

organisms that cause surgical site infections, from most to least common

A

staph aureus
e.coli
strep spp.
pseudomonas
**EMQ Q

150
Q

organisms that cause osteomyelitis or septic arthritis from most to least common

A

staph aureus
strep spp.
e.coli
** EMQ Q

151
Q

organism that causes osteomyelitis or septic arthritis in sickle cell disease

A

salmonella

152
Q

organisms that cause prosthetic joint infection from most to least common

A

staph epidermidis
staph aureus
strep spp.
e.coli
** EMQ Q

153
Q

when is staph epidermidis the most common organism to cause prosthetic joint infection

A

ONLY IN FIRST 2 MONTHS POST OP
- after that, its staph aureus –> strep –> e.coli

154
Q

34M 2/7 fever and menigism.
LP - clear, lymphocytosis, high protein / glucose
Dx?

A

viral meningitis

155
Q

sites of CNS infection

A

meningitis - bacterial / viral / fungal
encephalitis - usually viral
brain abscess - infective collection in parenchyma

156
Q

what can cause meningism that isn’t meningitis

A

SAH

157
Q

causes of bacterial meningitis in neonates

A

GBS
listeria monocytogenes
e.coli

158
Q

causes of bacterial meningitis in adults

A

neisseria meningitides
strep pneumoniae

159
Q

causes of bacterial meningitis in elderly

A

GBS
listeria monocytogenes
adult ones too

160
Q

causes of bacterial meningitis in immunocompromised ppl

A

TB

161
Q

viral causes of mengitis

A

enteroviruses
HSV2
HIV seroconversion can present with meningitis

162
Q

fungal causes of menigitis in HIV / immunocompetent

A

cryptococcus neoformans in HIV
cryptococcus gattii in immunocompetent

163
Q

why can LP in raised ICP be a problem

A

raised ICP due to SOL –> worried about coning

164
Q

indications for CT before LP

A

(rule out SOL)
focal neurology
seizures
reduced GCS
papilloedema

165
Q

when should LP be done ideally

A

before ABx but don’t hold ABx off for this

166
Q

buzzword for cryptococcus stain in LP

A

india ink stain

167
Q

Ix in CSF analysis for ?meningitis

A

biochemical analysis
gram stain for bacteria
PCR viruses
Ziehl Neelson stain for TB
india ink stain for cryptococcus

168
Q

CSF in viral meningitis
- colour
- WCC
- predominant WC
- protein
- glucose (CSF:blood)
- opening CSF pressure

A

clear
slightly high
lymphocytes
normal / slightly high
normal
normal / slightly high

169
Q

CSF in bacterial meningitis
- colour
- WCC
- predominant WC
- protein
- glucose (CSF:blood)
- opening CSF pressure

A

cloudy / turbid
very high
neutrophils
very high
low
high

170
Q

CSF in fungal meningitis
- colour
- WCC
- predominant WC
- protein
- glucose (CSF:blood)
- opening CSF pressure

A

fibrin web
normal / slightly high
lymphocytes
normal / slightly high
normal / slightly low
high / very high

171
Q

CSF in TB meningitis
- colour
- WCC
- predominant WC
- protein
- glucose (CSF:blood)
- opening CSF pressure

A

cloudy and viscous
slightly high
lymphocytes
very high
very low
high

172
Q

Tx of meningitis in GP

A

IM benzylpenecillin
999

173
Q

Tx of meningitis in hospital

A

empirical IV ceftriaxone / cefotaxime
+ ampicillin if <3 months / >55y/o

174
Q

2 other medications that can be added to meningitis ABx and why

A

dexamethasone if strep / h.influenzae
aciclovir if encephalitis can’t be excluded

175
Q

most common HHV cause of encephalitis

A

HSV1

176
Q

who gets arbovirus encephalitis

A

travellers - no 1 cause worldwide

177
Q

unvaccinated. measles as a child, now 10 years later has encephalitis. Dx?
(** measles = buzzword)

A

SSPE
subacute sclerosing panencephalitis

178
Q

HIV + on monoclonal treatment, now has encephalitis. cause?

A

JC virus
** buzzword with HIV

179
Q

what syndrome does JC virus cause

A

PML - progressive multifocal leucoencephalopathy
**buzzword with HIV

180
Q

Tx of encephalitis

A

empirically treat with aciclovir

181
Q

Ix for encephalitis

A

MRI
LP / CSF PCR

182
Q

what kind of growth pattern is seen in brain abscess

A

mixed growth !! strep / staph + anaerobes

183
Q

pt with HIV and brain abscess. Dx?

A

toxoplasmosis
** buzzword with HIV

184
Q

Ix and result of brain abscess

A

MRI > CT
ring enhancing lesion

185
Q

Mx of brain abscess

A

ABx - wide spectrum and anaerobic cover
surgical drainage
+/- steroids +/- anti seizures

186
Q

23M Hx of STIs. PC fevers, pustular rash, red swollen knee and wrist. Organism?

A

neisseria gonorrhoea

187
Q

most common STI

A

chlamydia

188
Q

5 different PCs of chlamydia

A

often asymptomatic
STI Sx - pain passing urine, discharge change, PID
reactive arthritis
serovars L1-3 –> lymphogranuloma venereum
opthalmia neonatorum, 1-2wks of life

189
Q

PC of lymphogranuloma venereum

A

proctitis
obviously, painful inguinal lymph nodes

190
Q

who gets lymphogranuloma venereum

A

MSM

191
Q

what is opthalmia neonatorum

A

neonatal conjunctivitis

192
Q

ix of chalmydia

A

NAAT
NOT culture

193
Q

tx of chlamydia

A

doxycycline >azithromycin

194
Q

reactive arthritis features of chlamydia

A

keratoderma blenorrhagica (brown rash)
balanitis

195
Q

4 different PCs of gonorrhoea

A

asymptomatic
STI Sx –> PID
disseminated gonococcal infection
opthalmia neonatorum

196
Q

PC of disseminated gonoccoal infection

A

fever
migratory arthritis - painful knee –> wrist
pustular rash
tendonitis

197
Q

how does opthalmia neonatorum differ in chlamydia and gonorrhoea

A

chlamydia = after first 1-2 weeks of life
gonorrhoea = after first few days of life

198
Q

Ix of gonorrhoea

A

gold standard = culture
usually diagnosed with NAAT

199
Q

Tx of gonorrhoea

A

IM ceftriaxone

200
Q

cause of syphilis

A

treponema pallidum

201
Q

stages of syphilis with Sx & buzzword for each

A

primary = painless chancre (ulcer)
secondary = unwell, condyloma lata, lymphadenopathy, maculopapular rash
latent = nothing
tertiary = gummatous disease, aortitis, neurosyphilis, tabes dorsalis

202
Q

what are conyloma lata

A

greyish, painless, wart like lesions in genitals or mouth
** buzzword for secondary syphillis

203
Q

what is gummatois disease

A

erosion through cartilage in mouth

204
Q

classic buzzword sign of neurosyphilis

A

argyll robertson pupils
(accomodation but not constriction)

205
Q

what is tabes dorsalis

A

degeneration of spinal cord

206
Q

Tx of syphillis

A

IM benzylpenecillin

207
Q

what reaction can occur upon Tx of syphillis and why

A

Jarish - Herxheimer reaction **buzzword
- killing of bacteria releases toxins that make pt feverish / unwell for a few days

208
Q

where does the rash of secondary syphillus affect

A

palms and soles of feet

209
Q

testing in primary syphillis

A

darkfield microscopy of chancre sample (** buzzword) and look under microscope
if not possible:
- non treponemal - VDRL, RPR
- treponemal - TPHA, TP-EIA

210
Q

cons of non treponemal tests for primary syphillis

A

not specific for syphilis, can react to like HIV etc

211
Q

cons on treponemal tests for syphilis

A

stay positive even after primary syphillis treated - can cause confusion in latent

212
Q

how is adequate treatment of syphillis confirmed

A

4x reduction in non treponemal titre

213
Q

organism causing chancroid

A

haemophilus ducreyi

214
Q

buzzword for chancroid

A

painful ulcers
lymphadenopathy
tropical regions

215
Q

organism causing donovanosis / granuloma inguinale

A

klebsiella granulomatis

216
Q

buzzwords for donovanosis

A

painless beefy red ulcers
tropical regions
donovan bodies on histology

217
Q

buzzwords for TV

A

yellow-green discharge
strawberry cervix

218
Q

cause of genital warts

A

HPV

219
Q

PC of HSV

A

painful ulcers with NO lymph nodes

MedEd Path (10 decks)

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