MICRO: Zoonoses and tropical diseases

Question 1

What does cyst + calcification on brain CT suggest?

Answer 1

Taenia solium cystocercosis

Question 2

What 2 tapeworms can cause intestinal infection in humans?

Answer 2

T. solium

T. saginata

Question 3

Can vegetarians get pork tapeworm?

Answer 3

Not if they don’t eat measly pork infected with it BUT they can get cysticercosis as this is spread from faeces of other humans where there are eggs

Question 4

What sites for cysticercosis affect?

Answer 4

All - including heart and muscle

Question 5

What is happening if you are getting symptoms with cysticercosis?

Answer 5

Cyst degeneration –> eosinophilic influx

Question 6

Name 2 cestocidal drugs.

Answer 6

Albendazole

Praziquantel

Question 7

What do RBCs look like in falciparum malaria?

Answer 7

Like there are “headphones” inside the cell - 2 parasites

Question 8

20% parasitaemia, what is the treatment?

Answer 8

IV artesunate

Question 9

Name 3 malaria prophylaxis tx.

Answer 9

Docycyline. malorone, mefloquine

Question 10

What metabolic abnormality in malaria?

Answer 10

Metabolic acidosis

Question 11

What does 1 schizont indicate?

Answer 11

Even 1 is severe disease - multiple parasites in 1 RBC

Question 12

What % parasitaemia is used for tx in UK?

Answer 12

2%

Question 13

Which stains for malaria?

Answer 13

Giemsa and Fields

Question 14

How many thick and thin blood smears for malaria?

Answer 14

3

Question 15

What is the tx for mild-mod falciparum malaria?

Answer 15

Riamet (artemether-lumefantrine) OR malarone

Question 16

What is the tx for all non-falciparum malaria?

Answer 16

Chloroquine + primaquine (check G6PD)

Question 17

What does ACT consist of?

Answer 17

Artemisin combination therapy:
Riamet - artemisin&lumefantrine
Quinine TDS
Doxycycline 1 week

Question 18

What is a side effect of IV quinine vs artesunate?

Answer 18

Artesunate side effects: delayed haemolysis

Quinine side effects: cinchonism, arrhythmias, hyperinsulinaemia

Question 19

SE Asia traveller, retro-orbital headache, arthralgia, conjunctival injection + thrombocytopenia, leukopenia + erythrodermic rash = ?

Answer 19

Dengue

Question 20

Dengue vector?

Answer 20

Aedes mosquito, flavivirus (Aedes aegypti is usually urban)

Question 21

What FBC findings mean high risk dengue?

Answer 21

High Hct, low platelets

Question 22

What is the dengue prophylaxis?

Answer 22

DEET + long sleeves

in endemic areas: dengvaxia vaccine, mosquito control etc

Question 23

What diagnostic is preferred for dengue?

Answer 23

PCR (abs can cross react with those for JE and YF)

Question 24

Himalayan peaks fever = ?

Answer 24

Typhoid sphygmothermic dissociation

Question 25

Complications of typhoids?

Answer 25

GI bleed/perforation | Encephalopathy

Question 26

What is the treatment for typhoid?

Answer 26

Ceftriaxone empirical then azithromycin 7 days

Question 27

Curved gram -ve rod in kittens?

Answer 27

Bartonella henselae

Question 28

Two diseases caused by Bartonella?

Answer 28

``` Cat scratch fever (immunocompetent)-> self limiting Bacillary angiomatosis (immunocompromised) -> fatal ```

Question 29

Name 2 main abx used for Bartonella.

Answer 29

Erythromycin, doxycycline (+ rifampicin in BA)

Question 30

What dye is used for toxoplasma?

Answer 30

Sabin Feldman Dye test - blue if no anti-toxo antibodies

Question 31

What is the tx of a mother with toxo?

Answer 31

Spiramycin 3 weeks - prevents vertical transmission

Question 32

What is the tx of an infant with toxo?

Answer 32

Pyrimethamine + sulfadiazine for 1 YEAR

Question 33

What localised infections can brucella cause?

Answer 33

Orchitis Abscess e.g. psoas Back pain

Question 34

What medium is Brucella grown in?

Answer 34

Castaneda medium

Question 35

What is the tx for Brucella?

Answer 35

Doxycycline + gentamycin/rifampicin for 6 weeks

Question 36

What is a common source of Coxiella burnetti?

Answer 36

Goats

Question 37

Does coxiella spread between people?

Answer 37

Usually not(?)

Question 38

What causes rabies?

Answer 38

LYSSA virus

Question 39

What causes rat bite fever?

Answer 39

Sterptobacillus monoliformis OR spirillum minus

Question 40

Zoonotic infection causing polyarthralgia progressing to purpuric rash = ?

Answer 40

rat bite fever

Question 41

What tx for rat bite fever?

Answer 41

Penicillin

Question 42

Bayou virus?

Answer 42

Rice rat

Question 43

Black canal virus?

Answer 43

Cotton rat

Question 44

Sin Nombre virus?

Answer 44

Deer mouse and white-footed mouse

Question 45

Name 2 bat viruses causing VHF.

Answer 45

Ebola and Marburg

Question 46

Name a rat virus causing VHF.

Answer 46

Lassa virus

Question 47

Name a tick virus causing VHF.

Answer 47

Congo-Crimean haemorrhagic fever

Question 48

Most important first investigation in brucella?

Answer 48

Blood culture