Medicine - Infectious disease Flashcards
Which hepatitis viruses can be faeco-orally transmitted?
fAEco-oral
Hep A
Hep E
What is the triad of symptoms seen in acute viral hepatitis?
Jaundice
RUQ pain
Fever
nb. Is same as Charcot’s triad for cholangitis
Which type of hepatitis is associated with polyarteritis nodosa?
Hep B
How is Hep B transmitted?
Vertically, sex, blood products
Recall the HBV antibodies that will be positive in current, past and vaccinated Hep B
Current: sAg, cAb
Past: cAb, sAb
Vaccinated: sAb
Which hepatitis viruses are associated with hepatocellular carcinoma?
HBV and HCV
What are the signs and symptoms of hep D infection?
Fulminant acute hepatitis
What is the most common form of hepatitis virus in the UK?
Hep E
What is the standard pulmonary TB therapy?
Rifampicin, isoniazid, pyrizinamide and ethambutol for 2 months
then
Rifampicin and isoniazid for 4 more months
Recall the side effects of each TB medication
ONLY rifampicin --> Orange secretions isoniazid --> Neuropathy (peripheral) pyrizinamide --> Liver (hepatotoxicity) ethambutol --> eYes (visual disturbance)
Which of the TB drugs is a CYP450 inducer?
Rifampicin
What are the classical symptoms of primary syphillis?
Painless ulcer and painless lymphadenopathy
What are the classical symptoms of lymphgranuloma venereum?
Painless ulcer and painFUL lymphadenopathy
What is the causative organism in lymphgranuloma venereum?
C trachomatis
What are the typical symptoms of chancroid?
Painful ulcer and painful lymphadenopathy
What is the causative organism in chancroid?
Haemophilus ducreyi
Which 2 streptococcal species are alpha haemolytic?
Strep pneumoniae
Strep viridans
Recall 5 conditions that are most commonly caused by Strep pyogenes (GAS)
Erysipelas Impetigo Cellulitis T2 necrotising fasciitis Pharyngitis/tonsilitis
Recall 2 haematological abnormalities that are seen in malaria
Thrombocytopaenia
Anaemia
How should malaria be investigated?
3 thick and think blood films
What drug is used as malaria prophylaxis?
Quinine
What is the first line treatment for falciparum anaemia?
IV artesunate
Recall 4 possible complications of typhoid fever
GI perforation
Myocarditis
Hepatitis
Nephritis
What are the key signs and symptoms of typhoid?
Fever
Bradycardia
Anorexia
Diarrhoea OR constipation
What is Sphygmothermic dissociation / Faget’s sign?
Unusual pairing of fever and bradycardia that can be seen in typhoid fever
What is the 1st line treatment for typhoid fever?
IV ceftriaxone
Recall 3 abnormalities on an FBC in degue fever
Low WCC
low plts
low Hb
What are the key signs and symptoms of dengue fever?
Headache (retro-orbital)
Sunburn-like rash
High fever and myalgia
What is the most helpful intervention in dengue haemorrhagic fever?
Fluid resuscitation
What is the gold-standard investigation for dengue fever?
PCR viral antigen
Serology IgM
What is the causative pathogen in Q fever?
Coxiella burnetti
What is the typical natural history of Lyme disease?
Rash –> malaise, carditis, meningitis –> CNS signs
What is the proper term for sleeping sickness?
Trypanosoma
How long after primary infection does seroconversion occur in HIV?
3-12 weeks
How long after exposure can you do an HIV test?
At 4 weeks offer a test, if negative offer a repeat test at 12w as 99% of people will have antibodies at 12w
Recall some ways you can differentiate between toxoplasmosis and primary CNS lymphoma
Toxoplasmosis: multiple lesions, ring enhancement
CNS lymphoma: single lesion, homogeous enhancement
What 2 drugs are used to treat CNS toxoplasmosis?
Sulfadiazine
Pyrimethamine
What is the investigation of choice for encephalitis?
CT (oedematous brain)
Recall 2 investigations that can be used for cryptococcus
CSF: india ink test positive
CT: cerebral oedema, meningeal enhancement
How should meningococcal sepsis patients be treated if they are penicillin-allerguc?
Ceftriaxone
In HIV+ patients, when should PCP prophylaxis begin?
When CD4 <200
What extra piece of information do you always need to interpret CSF results following an LP?
Plasma glucose
What is the most common complication of bacterial meningitis?
Sensorineural deafness
What is the antibiotic of choice for bacterial meningitis in hospital (if the organism has not yet been isolated)?
IV ceftriaxone
What antibiotic is used as chemoprophylaxis of meningococcal sepsis for close contacts of people with meningococcal disease?
Rifampicin (or ciprofloxacin as alternative)
Which form of HSV typically causes meningitis vs encephalitis?
Meningitis = HSV2 Enephalitis = HSV1
What is the likely cause of meningitis if the patient has a swollen face?
Mumps - as this is likely due to parotitis
Which antibiotic is known to have an antabuse effect?
Metronidazole
In what 2 ways should vancomycin be monitored?
- Check trough levels, aim for 15-20
2. Monitor renal function
What are the 3 components of the qSOFA score, and what is it used for?
GCS <15
SBP <100
RR >22
Used to judge likellihood of someone needing ITU (eg in sepsis)
