Mercy Juma Flashcards
Clinical presentation of acute hepatitis
Acute hepatitis can be asymptomatic, muscle and joint pain, fever, nausea and vomiting, fatigue, malaise, anorexia, abdominal pain, dark urine, pale, grey-coloured poo, itchy skin, jaundice.
Clinical presentation of chronic hepatitis
splenomegaly, spider angiomas in skin, redness of palms, abdominal ascites, coagulopathy, jaundice, hepatic encephalopathy.
5 ddx for ejection systolic murmur
o Problem with blood flow- thyrotoxicosis, pregnancy, anaemia o Aortic stenosis o Pulmonary stenosis o Aortic coarctation (narrowing) o Hypertrophic cardiomyopathy
How is HIV detected in patients
o ELISA test followed by a western blot- works best at identifying chronic HIV infection. False negatives in the weeks to months after initial infection as antibodies aren’t produced quickly.
o Viral load: blood test, used in monitoring or to detect early HIV infection. RT-PCR, then branched DNA assay to amplify the signal, then nucleic acid sequence based amplification assay are the 3 steps.
5 types of malaria
falciparum, vivax, malariae, ovale, knowlesi
describe the temp variation between the types of malaria parasite
o Vivax and ovale you get a temperature spike every 36h
o Falciparum random fevers
o Malariae fever occurs every 72hrs
o Knowlesi fever spikes every 48h
3 types of parasite
protozoa
helminths
ectoparasites
MOA and side effects of lumefantrine
MOA: lumefantrine inhibits the formation of beta-hematin by forming a complex with hemin and inhibits nucleic acid and protein synthesis.
Side effects: abdominal pain, appetite decrease, cough, diarrhoea, dizziness, abnormal gait, headache, nausea, palpitations, QT interval prolongation, skin reactions, drowsiness, angioedema, toxicity in animal pregnancy studies, avoid breast feeding for 1 week after last dose.
MOA of artemether
Interacts with heme or ferrous ions in the parasitic vacuole resulting in the generation of cytotoxic radials.
5 options for prophylaxis of malaria
Atovaquone + proguanil Chloroquine doxycycline mefloquine primaquine
What is AIDs?
o Acquired immunodeficiency syndrome
o CD4<200cells/mm and development of certain opportunistic infections
Px of TB
cough, sputum, malaise, weight loss, night sweats, pleurisy, haemoptysis, plural effusion
Px of cryptococcal meningitis
fever, headache, altered sensorium neck stiffness
Tx of TB
isoniazid
azithromicin
Tx of cryptococcal meningitis
amphotericin then fluconazole
Px of toxoplasmosis
flu-like symptoms e.g. high temp, aching muscles, tiredness, nausea, sore throat, swollen glands
Tx of toxoplasmosis
pyrimethamine then sulfadiazine and leucovorin
Px of PCP
fever, cough, difficulty breathing, chest pain, chills, fatigue, SOB on exertion
Tx of PCP
co-trimoxazole or pentamidine isethionate or prednisolone
5 clinical features of HIV infection
o Raised temperature o Sore throat o Body rash o Tiredness o Joint pain o Muscle pain o Lymphadenopathy o Weight loss o Chronic diarrhoea o Night sweats o Skin problems o Recurrent infections o Serious life-threatening illness
Principles of antiretroviral therapy
2x NRTIs + 1 NNRTI, protease inhibitor or integrase inhibitors
3 examples of NRTIs
tenofovir
emtricitabine
zidovudine
abacavir
example of NNRTI
doravirine
example of protease inhibitor
atazanavir
example of integrase inhibitor
raltegravir
2 drugs involved in PrEP
tenofovir and emtricitabine
3 drugs in PEP
Emcitrabine, tenofovir and raltegravir.
MOA of co-trimoxazle
sulfamethoxzole- inhibits bacterial dihydrofolic acid synthesis which is necessary for the production of purines and pyramidines. Trimethoprim- reversible inhibitor of dihydrofolate reductase, necessary for the biosynthesis of bacterial nucleic acids, thus having bactericidal activity.
Co-trimoxazole side effects
diarrhoea, electrolyte imbalance, fungal overgrowth, headache, nausea, skin reactions, vomiting, dyspnoea, fever, haemolytic anaemia, SLE
