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ICSM Year 6 + edits > 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

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31
Q

What is the causative pathogen in Q fever?

A

Coxiella burnetti

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32
Q

What is the typical natural history of Lyme disease?

A

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

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33
Q

What is the proper term for sleeping sickness?

A

Trypanosoma

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34
Q

How long after primary infection does seroconversion occur in HIV?

A

3-12 weeks

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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

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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

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37
Q

What 2 drugs are used to treat CNS toxoplasmosis?

A

Sulfadiazine

Pyrimethamine

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38
Q

What is the investigation of choice for encephalitis?

A

CT (oedematous brain)

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39
Q

Recall 2 investigations that can be used for cryptococcus

A

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

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40
Q

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

A

Ceftriaxone

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41
Q

In HIV+ patients, when should PCP prophylaxis begin?

A

When CD4 <200

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42
Q

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

A

Plasma glucose

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43
Q

What is the most common complication of bacterial meningitis?

A

Sensorineural deafness

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44
Q

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

A

IV ceftriaxone

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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)

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46
Q

Which form of HSV typically causes meningitis vs encephalitis?

A 
Meningitis = HSV2
Enephalitis = HSV1
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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

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48
Q

Which antibiotic is known to have an antabuse effect?

A

Metronidazole

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49
Q

In what 2 ways should vancomycin be monitored?

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

2. Monitor renal function

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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)

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51
Q

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

A

Staph epidermidis

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52
Q

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

A

Debridement of affected tissues

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53
Q

Following rabies exposure, what should be done?

A

Give rabies immunoglobulin + full course of vaccination

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54
Q

Which antibiotics are used to treat legionella pneumonia?

A

Macrolides eg clarithromycin

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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

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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

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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

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58
Q

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

A

Cephalosporins (due to cross reactivity)

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59
Q

Which population group is most at risk of leptospirosis?

A

Sewage workers (due to exposure to rat urine)

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60
Q

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

A

Echo to look for endocarditis

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61
Q

What is the investigation of choice for genital herpes?

A

NAAT

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62
Q

How should toxoplasmosis be managed?

A

Immunocompetent patients: no treatment

Immunocompromised patients: pyrimethamine and sulfadiazine

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63
Q

Which tropical disease can cause lactose intolerance?

A

Giardia

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64
Q

What is the first line treatment for amoebiasis?

A

Metronidazole

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65
Q

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

A

E coli

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66
Q

Which organism causes gas gangrene?

A

Clostridium perfringens

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67
Q

What is the antibiotic regime of choice in neutropenic sepsis?

A

IV Tazocin

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68
Q

What should be conducted at time of HIV diagnosis?

A

Full STI, Hep C & TB screen

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69
Q

What CD4 count is required for AIDS?

A

CD4 < 200cells/ml

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70
Q

What are the HIV complications by CD4 count?

A

500 - hodgkin’s, cervical cancer
400 - TB, Oropharyngeal candida, seborrhoeic dermatitis, fungal infections (lymphadenopathy, sweats)
300 - oral hairy leukoplakia, shingles, pneumocystis pneumonia, persistent herpes complex - non hodgkin’s, weight loss
200 - oesophageal candida, cerebral toxoplasmosis, cryptococcal meningitis, cryptosporidiosis, kaposi’s sarcoma, diarrhoea, wasting
100 - primary cerebral lymphoma, cmv infection, atypical mycobacterial infection - dementia

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71
Q

Type of virus HIV is?

A

retrovirus
HIV 1 = common
HIV 2 = west africa

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72
Q

Papilloedema, meningism, neurological signs in the context of HIV

A

Cryptococcal meningitis
serum cryptococcal antigen (CrAg)
rasied opening pressure on LP

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73
Q

Acute worsening of infection after starting ART

A

Immune Reconstitution Inflammatory Syndrome (IRIS) - worsening of infection

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74
Q

What drugs are given to treat HIV?

A

2 NRTI + one more agent

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75
Q

Side effects of ART

A

Hypersensitivity Lipodystrophy
Lipoatrophy
T2DM
Hyperlipidaemia

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76
Q

HIV: reduced visual acuity and perivascular infilitrates

A

CMV retintis

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77
Q

HIV: odonophagia and white mucoasl plaques at endoscopy

A

Oesophageal candidiasis

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78
Q

HIV: Violaceous plaques and HHV8

A

Kaposi’s sarcoma

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79
Q

First line Ix for HIV

A

HIV antibodies + p24 antigen
- repeat to confirm if +ve in 12 weeks and commence AV therapy
- repeat in 12 weeks if -ve

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80
Q

What causes Syphilis?

A

Treponema pallidum

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81
Q

Why CSF and CXR in syphilis?

A

csf - neurosyphilis - csf vdrl
CxR - aortic aneurysm / calcification

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82
Q

What are the signs of neurosyphilis?

A

visual disturbance, tabes dorsalis, gneral paresis

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83
Q

How is neurosyphilis treated?

A

IV aqueous Benzylpenicillin

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84
Q

How is latent +ve and -ve syphilis treated?

A

IM benzathine benzylpenicillin (+ve) - once
-ve = three doses over two weeks

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85
Q

What is a Jarisch-Herxheimer reaction?

A

acute febrile illness within 24 hrs of starting syphilis treatment

acute fever, headache, myalgia

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86
Q

How does syphilis present under microscopy?

A

Coiled spirochaete bacterium with corkscrew appearance and motility

only use if lesion present, if not then do trep serology - check HIV

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87
Q

Treatment for CNS involvement with TB

A

12 months (extra 4 month now 10) + 4-8 weeks po steroids

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88
Q

What patients with TB should be managed by a MDT

A

HIV
Diabetes
CKD 4-5
Severe Liver Disease
Pregnancy

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89
Q

Patients with latent TB should be tested for what?

A

HIV, Hep B/C

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90
Q

If latent TB comes back +ve after IGRA

A

3 months R/I

or

6 months I/P

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91
Q

CSF low glucose, high protein and lymphocytes

A

TB Meningitis

92
Q

First line for active TB

A

CXR & Sputum

93
Q

What type of organism is C.difficile

A

Gram +ve spore forming anaerobic bacillus

94
Q

What are the main drugs C.Difficile is associated with?

A

Cephalosporins
Quinolones
Penicillins

95
Q

RF for C.Difficile

A

Older age 65
AB treatment & PPI
Prolonged hospitalisation
previous history

96
Q

When is relapse defined?

A

<12 weeks

97
Q

How are mild - moderate C.Difficle treated?

A

mild - supportive + PO Vancomycin 10-14 days
moderate - 3-5 stools - fidaxomicin if vanco fails - relapse

98
Q

What are associated features of Severe and life threatening C.Difficile?

A

Severe - AKi, Temp >38.5, severe colitis, WBC >15
LT - Colitis, HTN, Ileus, Toxic Megacolon

99
Q

How is LT C.Difficile treated?

A

PO / NG Vancomycin (PR if Ileus) + IV Metronidazole + Surgery

100
Q

Poly-arthralgia, conjunctivitis, mucosal ulcers

A

Reactive arthritis

101
Q

Chronic abdo pain, altered bowel habit with no identifiable cause

A

Post-infectious IBS

102
Q

Do you need to wait to treat c.difficile if clinically suspected?

A

No

103
Q

Incubation periods for all types of Malaria?

A

Falciparum - 12-14
Vivax & Ovale - 14, could occur months after due to hypzonite reactivation
Malariae = 18 days - low grade fever for yrs tho

104
Q

Sign of severe Malaria

A

Hyperparasitaemia > 10%

105
Q

List some complications of Malaria

A

CNS - low glucose csf, cerebral oedema
liver - jaundice
Haem - bleeding, DIC
Pulmonary oedema, ARDS
Shock

106
Q

What organism causes Dengue? Incubation period?

A

Aedes aegypti
3-14 days

107
Q

Main test for Infectious mononucleosis

A

monospot test

108
Q

Main sign of rocky mountain spotted fever

A

tick bite - treat with doxycycline

109
Q

General malaise, relative bradycardia, rose spots

A

Salmonella typhi

110
Q

Bulls eye rash

A

Erythema chronicum migrans
Lyme disease

111
Q

Main signs and investigations for cryptococcal meningitis + treatment

A

high opening pressure with CNS signs
India ink stain
Amphotercin B + Flucytosine

112
Q

Main investigation finding of TB Meningitis

A

High lymphocyte count, high protein and low glucose

113
Q

Sign of brain imaging for progressive multifocal leukoencephalopathy

A

demyelination, no mass effect and no contrast enhancement on MRI

treat with ART

114
Q

CXR signs of PJP

A

diffuse bilteral interstitial infiltrates

treat with trimethoprim + sulfamethoxazole

115
Q

Main complication of ETEC

A

reactive arthritis

116
Q

Campylobacter complications

A

bacteraemia
colitis
reactive arthritis
GBS
GI perforation

azithromycin in severe

117
Q

How is Shigella treated

A

fluoroquinolones

118
Q

How is salmonella treated?

A

Ciprofloxacin

119
Q

How is Giardia treated?

A

Tinidazole

120
Q

What is a Treponema Pallidum specific test?

A

TP - EIA

121
Q

Causes of false +ve non-treponemal tests

A

Pregnancy
SLE, anti-phospholipid
TB
Leprosy
Malaria
HIV

how if -ve with +ve speific test = successfully treated syphilis

122
Q

What AB can be used to treat MRSA?

A

Vancomycin
Teicoplanin
Linezolid

123
Q

Organisms that cause post splenectomy sepsis

A

Strep Pneumoniae
Haemophilus Influenzae
Meingococci

treat with vaccines + PenV 500mg or Amox 250mg

decrease phagocutosis and complement activation

124
Q

Flaccid paralysis, complex ophtalmoplegia, IVDU

A

Botulism

c. botulinum - antitoxin

125
Q

Chlamydia treatment

A

7d - Doxycycline
Macrolides secondary - pregnant = first

126
Q

Adverse effects of Metronidazole

A

Disulfiram reaction with alcohol
Increases the anticoagulant effect of warfarin

127
Q

Dysentery, liver abscesses, colonic abscesses, inflammatory masses in colon

A

Entamoeba histolytica

trophozoites, oral metronidazole + luminal agent diloxanide furoate

128
Q

What is the organism for Bacterial Vaginalis?

A

Gardnerella vaginalis

use clinda if metronidazole cannot be used

oral met 5 - 7 days for treatment, alkaline, stippled, whiff

129
Q

Causes of acute food poisoning

A

staph (severe, short incubation), bacillus (rice), clostridium perfringens

130
Q

How is legionella pneumophilia best diagnosed

A

Urinary antigen

questions hint at air conditioning or foreign holidays

131
Q

Features of legionella

A

dry cough
relative bradycardia
confusion
lymphopaenia
hyponatraemia
deranged liver function tests
pleural effusion: seen in around 30% of patients

132
Q

CXR signs of legionella

A

mid to lower zone predominance of patchy consolidation

133
Q

How is legionella treated?

A

Erythromycin / clarithromycin

134
Q

Gold standard investigation for TB

A

sputum culture

NAAT = rapid diagnosis but less sensitive

135
Q

What decreases the sensitivity of sputum smear in TB

A

decreased in individuals with HIV

50 to 20%

136
Q

What is a classical finding of reactivated TB

A

upper lobe cavitation

137
Q

What does mantoux test? What causes false negatives?

A

latent Tb
FN:
miliary TB
sarcoidosis
HIV
lymphoma
very young age (e.g. < 6 months)

138
Q

Uti in third trimester

A

7 days amoxicillin / cefalexin

139
Q

Adverse effects of tetracycline

A

discolouration of teeth
photosensitivity
angioedema
black hairy tongue

140
Q

When is staph the most common cause of pneumonia

A

After the influenza infection

141
Q

what is a specific feature of pneumococcal pneumonia

A

herpes labialis

cold sores

142
Q

Name local complications to gonorrhoea

A

urethral strictures, epididymitis, inferility

143
Q

Treatment order for gonorrhoea

A

IM ceftriaxone 1g
oral ciprofloxacin 500mg
needle phobic:
- oral cefixime 400mg + oral azithromycin 2g

144
Q

Key features of DGI

A

tenosynovitis
migratory polyarthritis
dermatitis

145
Q

What organism is associated with oral herpes

A

HSV-1

146
Q

What is a calcified ghon complex a sign of?

A

Latent TB

147
Q

RF for developing active TB from latent TB

A

silicosis
chronic renal failure
HIV positive
solid organ transplantation with immunosuppression
intravenous drug use
haematological malignancy
anti-TNF treatment
previous gastrectomy

148
Q

First line for borrelia burgdorferi Ix

A

ELISA

149
Q

How to treat tic bites

A

remove it is using fine-tipped tweezers, grasping the tick as close to the skin as possible and pulling upwards firmly. The area should be washed following

150
Q

Causes of viral meningitis

A

non-polio enteroviruses e.g. coxsackie virus, echovirus
mumps
herpes simplex virus (HSV), cytomegalovirus (CMV), herpes zoster viruses
HIV
measles

151
Q

key findings of viral meningitis on LP

A

lymphocytes
normal glucose
raised wbC
normal protein

152
Q

What are the features of yellow fever?

A

sudden onset high fever, rigors, nausea and vomiting
bradycardia
jaundice
haematemesis
oligouria
councilman bodies - inclusion bodies - hepatocytes

153
Q

Features seen in behcet disease

A

oral ulcer, genital, uveitis
VTE

154
Q

Features of bacterial meningitis

A

cloudy
low glucose
high protein
raised wcc

155
Q

atypical lymphocytes on blood film

A

infectious mononucleosis

156
Q

Complications of Hep B infection

A

chronic hepatitis (5-10%). ‘Ground-glass’ hepatocytes may be seen on light microscopy
fulminant liver failure (1%)
hepatocellular carcinoma
glomerulonephritis
polyarteritis nodosa
cryoglobulinaemia

157
Q

main treatment for hep B

A

pegylated interferon alpha

158
Q

Features of Mycoplasma pneumoniae

A

prolonged and gradual onset disease
flu-like precede a dry cough
bilateral consolidation

159
Q

Complications of Mycoplasma pneumoniae

A

cold agglutins (IgM): may cause an haemolytic anaemia, thrombocytopenia
erythema multiforme, erythema nodosum
meningoencephalitis, Guillain-Barre syndrome and other immune-mediated neurological diseases
bullous myringitis: painful vesicles on the tympanic membrane
pericarditis/myocarditis
gastrointestinal: hepatitis, pancreatitis
renal: acute glomerulonephritis

160
Q

Ix for Mycoplasma pneumoniae

A

serology
+ve cold agglutination - smear show red blood cell agglutination

treat with doxy / macrolide

161
Q

Ongoing diarrhoea, lethargy, bloating, flatulence, steatorrhoea, weight loss with recent travel

A

giardiasis

metronidazole treatment

162
Q

Indications for delayed lumbar puncture

A

signs of severe sepsis or a rapidly evolving rash
severe respiratory/cardiac compromise
significant bleeding risk
signs of raised intracranial pressure
focal neurological signs
papilloedema
continuous or uncontrolled seizures
GCS ≤ 12

163
Q

why is dexamethasone given with treatment of meningitis

A

improves outcomes by reducing neurological sequelae

164
Q

If above 50 what ABs should be given for bacterial meningitis

A

cefotaxime + amoxicillin

gentamicin if listeria

165
Q

Young adult with sore throat, fever, lethargy, cervical lymphadenopathy persisting > 1 week

A

Infectious mononucleosis

166
Q

acute pyelonephritis treatment

A

broad spec cephalosporin + quinolone

167
Q

Risk factors for Invasive aspergillosis

A

HIV, leukaemia, BS antibiotics

168
Q

Who should be vaccinated for Hep A

A
  • people travelling to or going to reside in areas of high or intermediate prevalence, if aged > 1 year old
  • people with chronic liver disease
  • patients with haemophilia
  • men who have sex with men
  • injecting drug users
  • individuals at occupational risk: laboratory worker; staff of large residential institutions; sewage workers; people who work with primates
169
Q

What are genital warts and how are they treated?

A

Small fleshy protuberances pigmented

topical podophyllum
imiquimod second line

caused by HPV 6 & 11

170
Q

What bacteria has the shortest incubation period

A

Bacillus
Staph aureus

171
Q

How is Jarisch_herxheimer reaction treated

A

supportively - IV paracetemol

172
Q

Drug to treat patient with pencillin allergy that gets cellulitis

A

erythromycin

173
Q

Indications to send urine culture in non pregnant women

A

aged 65<
visible or non visible haematuria

only 3 day course of Ab

174
Q

What is the alternative for doxycycline in CT treatment with a pregnant lady

A

azithromycin

risk of dental discolouration and enamel hypoplasia

175
Q

Flagellated protozoa name and treatment

A

trichomonas vaginalis
metronidazole

176
Q

What condition does self limiting toxo mimic

A

infectious mononucleosis

177
Q

What are common side effects of amoxicillin

A

diarrhoea and nausea

178
Q

what is this?

A

Kaposi’s sarcoma

179
Q

alternative to lumber puncture on diagnosing meningitis

A

whole blood pcr and blood cultures

180
Q

Features of cholra and mx

A

Profuse rice water diarrhoea
dehydration
hypoglycaemia

oral rehydration therapy and doxy / cipro

181
Q

cellulitis near the eye treatment

A

amoxicillin + clavulanic acid aka co-amoxiclav

182
Q

Patients with uncertain tetanus vaccine should get what

A

Vaccine + Ig (if severe wound or > 6 hrs)

if more than 10 yrs ago just vaccine, if high risk add Ig

183
Q

Post treatment for UTI in pregnancy what should be done

A

Urine culture

risk of pyelonephritis

184
Q

Target shaped lesion in lung

A

Aspergilloma

185
Q

Which patients should be avoided with dexamethasone in Meingitis treatment?

A

septic
meningococcal
post surgery
immunocompromised

186
Q

Asymptomatic BV

A

No treatment

unless pregnant - oral metronidazole

187
Q

What is atypical pneumonia treated with

A

Clarithromycin

188
Q

What should be added to treat pneumonia if secondary to influenza

A

flucloxacillin

189
Q

HIV, diarrhoea, Ziehl-Neelsen stain showing protozoa

A

Cryptosporidium parvum

190
Q

If a gram +ve organism coccus is resistant to penicillin what is it

A

MRSA

vanco, teico, linezolid

191
Q

How does diptheria present

A
  • recent visitors to Eastern Europe/Russia/Asia
  • sore throat with a ‘diphtheric membrane’ - grey, pseudomembrane on the posterior pharyngeal wall
  • bulky cervical lymphadenopathy
  • may result in a ‘bull neck’ appearanace
  • neuritis e.g. cranial nerves
  • heart block

IM pen / dip anti-toxin

192
Q

Best way to assess response for treatment to Hep C

A

Viral Load / HCV RNA level

193
Q

What is a common complication of administering rapid intravenous infusion vancomycin

A

red man syndrome - vanco activates mast cells

stop, then re start at slower rate

194
Q

Renal transplant + infection

A

CMV pneumonitis

195
Q

What test for any mycobacteria

A

Acid fast bacilli

196
Q

6 - 60 yrs bacterial meningitis causes

A

NM
Strep Pneumoniae

197
Q

HIV, diarrhoea, Ziehl-Neelsen stain showing protozoa

A

Cryptosporidium Parvum

198
Q

Main affects of chronic chagas disease

A

myocarditis leading to dilated cardiomyopathy

GI features - megaoesophagus, megacolon

treat complications and azole

199
Q

Persistent PUO and lymphadenopathy with high WCC

A

lymphoma

lymph node biopsy

200
Q

Sinusitis treatment

A

Phenoxymethylpenicillin

201
Q

Acute prostatitis treatment

A

14 day of ciprofloxacin

202
Q

Live attenuated vaccines

A

BCG
MMR
oral polio
yellow fever
oral typhoid

203
Q

what is the incubation period of yellow fever

A

7 to 21 days

204
Q

how many ulcers does chancroid present with

A

single

if multiple with same symptoms think genital ulcers

205
Q

Which Hepatitis out of A and B has the shorter incubation period?

A

A - 15 to 50 days
B much longer

206
Q

Lab features of pseudomonas aeruginosa

A

Gram-negative rod
non-lactose fermenting
oxidase positive

207
Q

Late onset HAP should be treated how?

A

piperacillin with tazobactam OR a broad-spectrum cephalosporin (e.g. ceftazidime) OR a quinolone (e.g. ciprofloxacin)

208
Q

Severe campylobacter infection should be treated with what

A

clarithromycin - macrolide

209
Q

Negative non-treponemal test + positive treponemal test

A

Successfully treated syphilis

210
Q

Positive non-treponemal test + negative treponemal test

A

consistent with a false-positive syphilis result e.g. due to pregnancy or SLE

211
Q

Patient has had a full course of tetanus vaccines, with the last dose < 10 years ago

A

no vaccine nor tetanus immunoglobulin is required, regardless of the wound severity

212
Q

Patient has had a full course of tetanus vaccines, with the last dose > 10 years ago

A

if tetanus prone wound: reinforcing dose of vaccine
high-risk wounds (e.g. compound fractures, delayed surgical intervention, significant degree of devitalised tissue): reinforcing dose of vaccine + tetanus immunoglobulin

213
Q

How does pseudomonas present as a wound infection?

A

wet with a pale green slough over it and smells damp and offensive

214
Q

Adverse effects of trimethoprim

A

myelosuppression
rise in creatinine, inhibits tubular secretion, blocks ENaC channel in distal nephron - hyperkalaemic distal TA

215
Q

Extensive otitis externa treatment

A

Flucloxacillin

216
Q

Fever on alternating days

A

Malaria

217
Q

Mechanism of ritonavir

A

protease inhibitor

navir - navir tease a pro

zidovudine = NRTI, raltegravir = integrase inhibitor

218
Q

large, keratinised genital wart treatment

A

cryotherapy

multiple = topical podophyllum

219
Q

Long incubation period with dysentery

A

Amoebiasis

oral metronidazole

220
Q

BCG in children protects against what

A

TB meningitis

221
Q

Spinal epidural abscess Ix

A

full spine MRI to check for skip lesions

222
Q

Most common cause of dysphagia and odynophagia with HIV disease

A

Oesophageal candidiasis

223
Q

Signs of leptospirosis

A

commonly preceded by flu-like symptoms, associated with subconjunctival suffusion and is a cause of hepatorenal failure

flood, sewage based areas

224
Q

Signs of chronic schisto

A

frequency, haematuria, bladder calcification

225
Q

What is the normal dose of metronidazole for BV

A

400mg bd for 7 days

226
Q

Treatment for erysipelas

A

flucloxacillin

227
Q

Most common pathogen during anal sex

A

Hepatitis A

ICSM Year 6 + edits (28 decks)

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