Medicine - Infectious disease Flashcards by B M

Which hepatitis viruses can be faeco-orally transmitted?

fAEco-oral
Hep A
Hep E

How well did you know this?

Not at all

Perfectly

What is the triad of symptoms seen in acute viral hepatitis?

Jaundice
RUQ pain
Fever
nb. Is same as Charcot’s triad for cholangitis

How well did you know this?

Not at all

Perfectly

Which type of hepatitis is associated with polyarteritis nodosa?

Hep B

How well did you know this?

Not at all

Perfectly

How is Hep B transmitted?

Vertically, sex, blood products

How well did you know this?

Not at all

Perfectly

Recall the HBV antibodies that will be positive in current, past and vaccinated Hep B

Current: sAg, cAb
Past: cAb, sAb
Vaccinated: sAb

How well did you know this?

Not at all

Perfectly

Which hepatitis viruses are associated with hepatocellular carcinoma?

HBV and HCV

How well did you know this?

Not at all

Perfectly

What are the signs and symptoms of hep D infection?

Fulminant acute hepatitis

How well did you know this?

Not at all

Perfectly

What is the most common form of hepatitis virus in the UK?

Hep E

How well did you know this?

Not at all

Perfectly

What is the standard pulmonary TB therapy?

Rifampicin, isoniazid, pyrizinamide and ethambutol for 2 months
then
Rifampicin and isoniazid for 4 more months

How well did you know this?

Not at all

Perfectly

Recall the side effects of each TB medication

ONLY
rifampicin –> Orange secretions
isoniazid –> Neuropathy (peripheral)
pyrizinamide –> Liver (hepatotoxicity)
ethambutol –> eYes (visual disturbance)

How well did you know this?

Not at all

Perfectly

Which of the TB drugs is a CYP450 inducer?

Rifampicin

How well did you know this?

Not at all

Perfectly

What are the classical symptoms of primary syphillis?

Painless ulcer and painless lymphadenopathy

How well did you know this?

Not at all

Perfectly

What are the classical symptoms of lymphgranuloma venereum?

Painless ulcer and painFUL lymphadenopathy

How well did you know this?

Not at all

Perfectly

What is the causative organism in lymphgranuloma venereum?

C trachomatis

How well did you know this?

Not at all

Perfectly

What are the typical symptoms of chancroid?

Painful ulcer and painful lymphadenopathy

How well did you know this?

Not at all

Perfectly

What is the causative organism in chancroid?

Haemophilus ducreyi

How well did you know this?

Not at all

Perfectly

Which 2 streptococcal species are alpha haemolytic?

Strep pneumoniae
Strep viridans

How well did you know this?

Not at all

Perfectly

Recall 5 conditions that are most commonly caused by Strep pyogenes (GAS)

Erysipelas
Impetigo
Cellulitis
T2 necrotising fasciitis
Pharyngitis/tonsilitis

How well did you know this?

Not at all

Perfectly

Recall 2 haematological abnormalities that are seen in malaria

Thrombocytopaenia
Anaemia

How well did you know this?

Not at all

Perfectly

How should malaria be investigated?

3 thick and think blood films

How well did you know this?

Not at all

Perfectly

What drug is used as malaria prophylaxis?

Quinine

How well did you know this?

Not at all

Perfectly

What is the first line treatment for falciparum malaria?

IV artesunate

How well did you know this?

Not at all

Perfectly

Recall 4 possible complications of typhoid fever

GI perforation
Myocarditis
Hepatitis
Nephritis

How well did you know this?

Not at all

Perfectly

What are the key signs and symptoms of typhoid?

Fever
Bradycardia
Anorexia
Diarrhoea OR constipation

How well did you know this?

Not at all

Perfectly

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-allergic?

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?

1. 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)

What is the most common pathogen to infect a central line?

Staph epidermidis

What is the most important initial step in managing necrotising fasciitis?

Debridement of affected tissues

Following rabies exposure, what should be done?

Give rabies immunoglobulin + full course of vaccination

Which antibiotics are used to treat legionella pneumonia?

Macrolides eg clarithromycin

What is the post-exposure prophylaxis for Hep B in a person who has had a full course of Hep B vaccination and was a known responder?

Vaccine booster dose

When should antibiotics be given for an animal bite, and which antibiotics should be chosen?

Give abx when: - A human bite that has drawn blood or broken the skin in a high-risk individual - A cat bite that has drawn blood or appears to be deep - A dog bite that has caused considerable tissue damage or is contaminated Abx = Co-amoxiclav

How should a tick bite be treated?

If asymptomatic - reassure and safety net If symptomatic for Lyme disease --> single dose of doxycycline

If a patient is penicillin-allergic, what other class of antibiotic should you avoid giving?

Cephalosporins (due to cross reactivity)

Which population group is most at risk of leptospirosis?

Sewage workers (due to exposure to rat urine)

If discitis is due to staphylococcus, what extra investigation must be done?

Echo to look for endocarditis

What is the investigation of choice for genital herpes?

NAAT

How should toxoplasmosis be managed?

Immunocompetent patients: no treatment Immunocompromised patients: pyrimethamine and sulfadiazine

Which tropical disease can cause lactose intolerance?

Giardia

What is the first line treatment for amoebiasis?

Metronidazole

What is the most common cause of traveller's diarrhoea?

E coli

Which organism causes gas gangrene?

Clostridium perfringens

What is the antibiotic regime of choice in neutropenic sepsis?

IV Tazocin