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ICSM Year 6 > Medicine - Infectious disease > Flashcards

Medicine - Infectious disease Flashcards

1
Q

Which hepatitis viruses can be faeco-orally transmitted?

A

fAEco-oral
Hep A
Hep E

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2
Q

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

A

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

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3
Q

Which type of hepatitis is associated with polyarteritis nodosa?

A

Hep B

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4
Q

How is Hep B transmitted?

A

Vertically, sex, blood products

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5
Q

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

A

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

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6
Q

Which hepatitis viruses are associated with hepatocellular carcinoma?

A

HBV and HCV

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7
Q

What are the signs and symptoms of hep D infection?

A

Fulminant acute hepatitis

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8
Q

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

A

Hep E

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9
Q

What is the standard pulmonary TB therapy?

A

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

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10
Q

Recall the side effects of each TB medication

A 
ONLY 
rifampicin --> Orange secretions 
isoniazid --> Neuropathy (peripheral) 
pyrizinamide --> Liver (hepatotoxicity) 
ethambutol --> eYes (visual disturbance)
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11
Q

Which of the TB drugs is a CYP450 inducer?

A

Rifampicin

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12
Q

What are the classical symptoms of primary syphillis?

A

Painless ulcer and painless lymphadenopathy

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13
Q

What are the classical symptoms of lymphgranuloma venereum?

A

Painless ulcer and painFUL lymphadenopathy

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14
Q

What is the causative organism in lymphgranuloma venereum?

A

C trachomatis

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15
Q

What are the typical symptoms of chancroid?

A

Painful ulcer and painful lymphadenopathy

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16
Q

What is the causative organism in chancroid?

A

Haemophilus ducreyi

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17
Q

Which 2 streptococcal species are alpha haemolytic?

A

Strep pneumoniae

Strep viridans

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18
Q

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

A 
Erysipelas
Impetigo 
Cellulitis 
T2 necrotising fasciitis 
Pharyngitis/tonsilitis
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19
Q

Recall 2 haematological abnormalities that are seen in malaria

A

Thrombocytopaenia

Anaemia

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20
Q

How should malaria be investigated?

A

3 thick and think blood films

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21
Q

What drug is used as malaria prophylaxis?

A

Quinine

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22
Q

What is the first line treatment for falciparum malaria?

A

IV artesunate

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23
Q

Recall 4 possible complications of typhoid fever

A

GI perforation
Myocarditis
Hepatitis
Nephritis

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24
Q

What are the key signs and symptoms of typhoid?

A

Fever
Bradycardia
Anorexia
Diarrhoea OR constipation

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25
Q

What is Sphygmothermic dissociation / Faget’s sign?

A

Unusual pairing of fever and bradycardia that can be seen in typhoid fever

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26
Q

What is the 1st line treatment for typhoid fever?

A

IV ceftriaxone

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27
Q

Recall 3 abnormalities on an FBC in degue fever

A

Low WCC
low plts
low Hb

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28
Q

What are the key signs and symptoms of dengue fever?

A

Headache (retro-orbital)
Sunburn-like rash
High fever and myalgia

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29
Q

What is the most helpful intervention in dengue haemorrhagic fever?

A

Fluid resuscitation

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30
Q

What is the gold-standard investigation for dengue fever?

A

PCR viral antigen

Serology IgM

31
Q

What is the causative pathogen in Q fever?

A

Coxiella burnetti

32
Q

What is the typical natural history of Lyme disease?

A

Rash –> malaise, carditis, meningitis –> CNS signs

33
Q

What is the proper term for sleeping sickness?

A

Trypanosoma

34
Q

How long after primary infection does seroconversion occur in HIV?

A

3-12 weeks

35
Q

How long after exposure can you do an HIV test?

A

At 4 weeks offer a test, if negative offer a repeat test at 12w as 99% of people will have antibodies at 12w

36
Q

Recall some ways you can differentiate between toxoplasmosis and primary CNS lymphoma

A

Toxoplasmosis: multiple lesions, ring enhancement

CNS lymphoma: single lesion, homogeous enhancement

37
Q

What 2 drugs are used to treat CNS toxoplasmosis?

A

Sulfadiazine

Pyrimethamine

38
Q

What is the investigation of choice for encephalitis?

A

CT (oedematous brain)

39
Q

Recall 2 investigations that can be used for cryptococcus

A

CSF: india ink test positive
CT: cerebral oedema, meningeal enhancement

40
Q

How should meningococcal sepsis patients be treated if they are penicillin-allergic?

A

Ceftriaxone

41
Q

In HIV+ patients, when should PCP prophylaxis begin?

A

When CD4 <200

42
Q

What extra piece of information do you always need to interpret CSF results following an LP?

A

Plasma glucose

43
Q

What is the most common complication of bacterial meningitis?

A

Sensorineural deafness

44
Q

What is the antibiotic of choice for bacterial meningitis in hospital (if the organism has not yet been isolated)?

A

IV ceftriaxone

45
Q

What antibiotic is used as chemoprophylaxis of meningococcal sepsis for close contacts of people with meningococcal disease?

A

Rifampicin (or ciprofloxacin as alternative)

46
Q

Which form of HSV typically causes meningitis vs encephalitis?

A 
Meningitis = HSV2
Enephalitis = HSV1
47
Q

What is the likely cause of meningitis if the patient has a swollen face?

A

Mumps - as this is likely due to parotitis

48
Q

Which antibiotic is known to have an antabuse effect?

A

Metronidazole

49
Q

In what 2 ways should vancomycin be monitored?

A
  1. Check trough levels, aim for 15-20

2. Monitor renal function

50
Q

What are the 3 components of the qSOFA score, and what is it used for?

A

GCS <15
SBP <100
RR >22
Used to judge likellihood of someone needing ITU (eg in sepsis)

51
Q

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

A

Staph epidermidis

52
Q

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

A

Debridement of affected tissues

53
Q

Following rabies exposure, what should be done?

A

Give rabies immunoglobulin + full course of vaccination

54
Q

Which antibiotics are used to treat legionella pneumonia?

A

Macrolides eg clarithromycin

55
Q

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?

A

Vaccine booster dose

56
Q

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

A

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

57
Q

How should a tick bite be treated?

A

If asymptomatic - reassure and safety net

If symptomatic for Lyme disease –> single dose of doxycycline

58
Q

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

A

Cephalosporins (due to cross reactivity)

59
Q

Which population group is most at risk of leptospirosis?

A

Sewage workers (due to exposure to rat urine)

60
Q

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

A

Echo to look for endocarditis

61
Q

What is the investigation of choice for genital herpes?

A

NAAT

62
Q

How should toxoplasmosis be managed?

A

Immunocompetent patients: no treatment

Immunocompromised patients: pyrimethamine and sulfadiazine

63
Q

Which tropical disease can cause lactose intolerance?

A

Giardia

64
Q

What is the first line treatment for amoebiasis?

A

Metronidazole

65
Q

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

A

E coli

66
Q

Which organism causes gas gangrene?

A

Clostridium perfringens

67
Q

What is the antibiotic regime of choice in neutropenic sepsis?

A

IV Tazocin

68
Q

What is the treatment of BV?

A

Oral metronidazole, 400mg BD for 5 days

69
Q

Greasy stools would point towards which GI infection?

A

Giardia lamblia (due to fat malabsorption)

70
Q

What is the standard for diagnosis and screening of HIV?

A

HIV p24 antigen and HIV antibodies

71
Q

Why should trimethoprim be avoided in the treatment of a UTI in the first trimester of pregnancy?

A

It is an anti-folate agent so should not be used during first trimester as this is when the spinal cord is developing so increases the risk of spina bfida

72
Q

When should Abx be given without an LP first?

A

An LP should be done before IV antibiotics, unless:
* Cannot be done within 1 hour
* Signs of severe sepsis or a rapidly evolving rash
* Significant bleeding risk
* Signs of raised intracranial pressure

73
Q

What is the standard post-exposure Tx for HIV?

A

4 weeks of antiretroviral therapy

ICSM Year 6 (21 decks)

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