MEDgems 2

Question 1

argyll robertson pupil

Answer 1

accomadating but not reactive pupil

Question 2

Farmer flu like illness with jaundice, abnormal U&Es, headache, subconjunctival haemorrhage and muscle pains

Answer 2

leptospirosis
> common in farmers
> liver and kidney damage

Question 3

syphilis causing organism?

Answer 3

treponema phallidum

Question 4

gram +
tumbling motility

Answer 4

listeria monocytogenes

Question 5

acyclovir commonly used against?

Answer 5

DNA virus
HSV
varicella zoster - chicken pox and shingles

Question 5

antiviral which covers for CMV, HHV-6?

Answer 5

ganciclovir
vanciclovir

Question 6

Hepatitis B specific antiviral?

Answer 6

tenofovir

Question 7

ritonavir

Answer 7

sars-cov2

Question 8

Jarisch Herxheimer reaction

Answer 8

when treating syphilis with abx can commonly occur

spirochete
fever
muscle ache
headache

Question 9

what is tabes dorsalis?

Answer 9

slow degeneration of nerve cells and nerve fibres
can occur as part of tertiary syphilis

Neurosyphilis

Question 10

types of 3^ Syphilis?

Answer 10

gummatous - skin/bone granuloma (spirocheates scanty)

CVD- aortitis, ++++spirochaetes, ++++inflamatory

Neurosyphilis: dementia, tabes dorsalis, Arg-Robert pupil
spirochaetes in CSF

Question 11

how to diagnose syphilis?

Answer 11

PCR - dark ground microscopy

treponemal test
abs against specific antigens

Question 12

sinusitis mx

Answer 12

phenoxymethylpenicillin

Question 13

before starting terbinafine

Answer 13

LFT
hepatotoxic

Question 14

brazil massive splenomegaly
normocytic anaemia

Answer 14

visceral leishmaniasis

parasite moves to LIVER< SPLEEN< BM

Question 15

kaposi sarcoma?

Answer 15

Human gammaherpesvirus 8,

Question 16

meningitis gram - diplococci

Answer 16

neisseria meningitidis

Question 17

reheated rice in microwave
profuse diarrhoea

Answer 17

bacillus cereus

Question 18

duration of abx for HAP?

Answer 18

5 days

Question 19

what abx covers for MRSA

Answer 19

doxycycline
linezolid
vancomycin

Question 20

pseudomonas cover?

Answer 20

piperacillin- tazobactem
carbapanem

Question 21

CJD most forms are due to mutation in what?

Answer 21

CD230

Question 22

most common form of prion disease?

Answer 22

sporadic CJD

Question 23

variant CJD

Answer 23

bovine
spongiform encephalopathy

Question 24

HAP - mx?

Answer 24

piperacillin tazobactem

Question 25

complicated malaria - Kids? what is diff to adults?

Answer 25

>2% resp distress inability to stand/sit

Question 26

what is a prion disease?

Answer 26

infectious disease caused by infectious protein > abdnormal form of protein cd230 >major prion protein > protease resistant > codon 129 polymorphism

Question 27

commensal bacteria may cause UTI and carries risk of postnatal sepsis?

Answer 27

Group B streptococcus

Question 28

C diff investigations

Answer 28

CT abdo and pelvis with contrast blood test PCR test - + for pathogen and toxin

Question 29

1st line for c diff?

Answer 29

oral vancomycin po/Iv metronidazole /fidaxomicin 10-14 days

Question 30

non abx which increase risk of c difficile

Answer 30

PPI inhibitor - omeprazole

Question 31

most common organism that causes an aseptic meningitis

Answer 31

enterovirus > coxsackie

Question 32

investigation for prion disease?

Answer 32

brain biopsy

Question 33

beta haemolytic streptococcus

Answer 33

pyogenes agalactiae

Question 34

what bacteria causes scarlet fever

Answer 34

strep pyogenes beta haeolytic lancefield grooup A group A streptococcus = streptococcus pyogenes

Question 35

non modifiable risk factor for c diff?

Answer 35

age co morbid prolonged nursing home stay