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MedEd Path > Microbiology 2 - TB, Respiratory Infections, STIs, GI Infections, HAI, Wound, bone and joint fection, Urinary infection, CNS infection, Antimicrobials, Endocarditis > Flashcards

Microbiology 2 - TB, Respiratory Infections, STIs, GI Infections, HAI, Wound, bone and joint fection, Urinary infection, CNS infection, Antimicrobials, Endocarditis Flashcards

1
Q

What does PET stand for?

A

Positron electron tomography

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2
Q

What is used in PET?

A

Radio transparent - glucose

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3
Q

What % of TB pts get drug induced liver injury?

A

5-10%

1% life threatening - hepatic necrosis, may require liver transplant.

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4
Q

Patient being treated for TB comes in with severe vomiting, diagnosis?

A

Drug induced liver injury

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5
Q

How long are TB patients infectious?

A

Infectious until they have done 2 full weeks of Tb treatment. Can do sputum sample to check.

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6
Q

What should you exclude if or presents with liver abscess?

A

Immunodeficiency - HIV

Bowel Cancer - cancer breaks the basement membrane, makes a hole bacteria can escape from in blood —> goes to liver —> abscess

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7
Q

80 year old known COPD patient presents with SOB, wheeze, cough and fever. give features of organism too i.e. gram stain and shape.

A

Haemophilus Influenzae - most common respiratory organism in smokers
Gram negative coccobacilli

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8
Q

70 year old lady presents with SOB and cough productive of rusty brown sputum give features of organism too i.e. gram stain and shape.

A

Streptococcus pneumoniae - rusty brown sputum

Gram positive cocci (in groups of two/diplococci)

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9
Q

45 year old man presents to ED stating he feels very unwell with a dry cough, fever, rhinorrhea and muscle aches. Observations are within normal limits. Bloods show CRP 12, WCC 9. No past medical history. give features of organism too i.e. gram stain and shape.

A

Influenza virus - the flu

Virus - no shape

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10
Q

65 year old alcoholic presents with SOB, productive cough, haemoptysis and feeling hot and cold. give features of organism too i.e. gram stain and shape.

A

Klebsiella - haemoptysis (cavitating lesion)

Gram negative bacilli

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11
Q

Most likely respiratory organism in a smoker?

A

Haemophilus influenzae

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12
Q

Pneumonia after an illness

A

Usually staph aureus

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13
Q

Alcoholic person with bloody sputum

A

Klebsiella

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14
Q

What is an important thing to consider in COPD pneumonia?

A

They get atypical pneumonia

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15
Q

45 year old man presents to ED stating he feels “very unwell”, with a dry cough, fever, rhinorrhea and muscle aches. Observations are within normal limits. Bloods show CRP 12, WCC 9. No past medical history.
treat

A

Encourage oral intake and give discharge advice

influenza virus

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16
Q

65 year old alcoholic presents to ED with SOB, productive cough, haemoptysis and feeling hot and cold. Temp 38.5, HR 110. Inflammatory markers are raised.

A

IV Co-amoxiclav + clarithromycin

signs of systemic illness

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17
Q

Pathagnomonic for Bacterial Meningitis

A

Polymorphs on LP

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18
Q

What acronym for managing infection in COPD patients?

A

ABC
Antibiotics
Bronchodilators
Corticosteroids

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19
Q

How to manage mild and moderate - severe IECOPD?

A

Mild = doxycycline + inhalers + prednisolone + supportive

Mod-severe (sepsis/respiratory compromise) = IV abx + nebulisers + hydrocortisone STAT + supportive

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20
Q

50 year old has ben recovering well on the ward after elective bowel resection when he develops a cough. CXR shows pneumonia. Routine MRSA swabs are negative. treat

A

IV Tazocin (piperacillin + tazobactam)

HAI - hospital acquired pneumonia: first line in IV Tazocin

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21
Q

70 year old lady presents to GP with cough productive of rusty brown sputum for one week. Observations are within normal limits.

treat

A

PO Amoxicillin

strep pneumoniae

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22
Q

How do manage CAP?

A

Community acquired pneumonia:

classic: mild-moderate: penicillin, moderate-severe: penicillin + macrolide (co-amoxiclav + clarithromycin)
atypical: chlaemydia, mycoplasma: use protein synthesis abx: macrolide/tetracycline

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23
Q

hotel

A

legionella pneumoniae

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24
Q

nigerian man - which organism

A

Pneumocystis jirovecii

after HIV

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25
Q

A businesswoman has recently returned from a hotel conference with a cough and fever. Bloods show Cr 65, K+ 4.0, Na+ 129 which organism

A

Legionella pneumoniae

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26
Q

A 35 year old Nigerian man presents with a dry cough. On examination, she is cachectic and has multiple purple skin lesions on his face and torso.

A

Pneumocystis jirovecii

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27
Q

A 45 year-old keen birdkeeper presents feeling unwell for 2 weeks with fever, muscle aches, cough and SOB.
which organism?

A

Chlamydia psitacci

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28
Q

pneumonia and Bone Marrow Treatment which organism:

A

Aspergillius + CMV

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29
Q

pneumonia and Splenectomy - which organism

A

Encapsulated organisms - H. influenza, S. pneumonia, N. meningitidis

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30
Q

Poor response to abx - which pneumonia organism

A

TB

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31
Q

Joint pain and erythema multiforme (target lesion rash)

A

Mycoplasma pneumonia

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32
Q

HIV pneumonia organisms

A

Pneumocystis jirovecii

Cryptococcus neoformans

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33
Q

What are the time frames different types of meningitis develop over and which type is associated with each?

A

Hours - Bacterial

Days (3-7) - Viral

Weeks to Months - TB

Weeks to Months - Fungal

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34
Q

20 year old woman presents with sudden, severe, persistent headache, fever and neck stiffness. On examination, GCS 15/15, she is very irritable and is sitting in the dark. CT head normal. Lumbar puncture shows cloudy CSF with WCC 100, protein level is high, glucose is 1.5mmol/L. Serum glucose is 6 mmol/L.
diagnose

A

Bacterial meningitis

bacterial as v. sudden onset high WCC

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35
Q

A 40 year old man who was treated for TB in Bangladesh several years ago presents with an acute onset right flank pain radiating to the right groin. PMH: chronic back pain. On examination the abdomen is soft, he is unable to flex his right hip. Observations: T 38.6, HR 105, BP 130/80, RR 20, O2 98%. Urine dip is normal.

A

Spinal TB

previous TB - latent TB has activated
could be primary psoas abscess

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36
Q

Treatment for TB

A 
RIPE
Rifampicin
Isoniazid
Pyraminazine
Ethambutol

all for 2 months, first 2 for 4 more.

extrapulmonary TB is given for 12 months
latent TB usually treated with only Isoniazid 6-9 months

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37
Q

A 50 year old man presents with a rash on the soles of his feet and palms of his hands. His only previous history is a painless ulcer on his penis that healed itself. VDRL test is positive.

diagnose and organism

A

Syphilis

Treponema pallidum

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38
Q

A 30 year old man presents with a painful ulcer on his penis. Swabs grown on chocolate agar demonstrate the responsible microbe.

diagnose and organism

A

Chancroid

Haemophilus ducreyi

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39
Q

A 21 year old man presents for a routine sexual health check with no symptoms. Urinary NAAT test reveals a positive result.

diagnose and organism

A

Chlamydia

most common STI in UK, also most common with no symptoms

Chlamydia trachomatis

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40
Q

A 40 year old man presents with a 4 day history of swollen right testis. On examination there is swelling and a tender mass palpable separate to the testis. He has also noted some blood in his semen. Temperature is 38.4

diagnose and organism

A

Epididymitis

Neisseria gonorrhoae

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41
Q

VDRL Test Positive

A

Syphillis

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42
Q

Chocolate Agar

A

Chancroid

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43
Q

most common STI uk

A

chlamydia

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44
Q

2 common presentations for gonorrhoea

A

asymptomatic, urethral discharge

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45
Q

2 common presentations for chlamydia

A

asymptomatic, urethral discharge

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46
Q

A 30 year old vegan presents with offensive smelling vaginal discharge. Microscopy reveals clue cells. Whiff test is positive.

diagnose and managment

A

Bacterial vaginosis

Metronidazole

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47
Q

A 30 year old woman presents with vulval pruritus and a thin white discharge. Microscopy reveals the presence of a flagellated protozoan.

diagnose and managment

A

Trichomoniasis

Metronidazole

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48
Q

A 30 year old woman presents with vulval pruritus and a thick white discharge she describes as “like cottage cheese”.

diagnose and managment

A

Candidiasis

Fluconazole + clotrimazole cream

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49
Q

A 30 year old woman presents with abdominal pain and vaginal discharge. Examination reveals generalised tenderness and pain on cervical motion. She does not use contraception. Pregnancy test is negative.

diagnose and managment

A

Pelvic inflammatory disease

IM Ceftriaxone 500mg single dose followed by oral doxycycline 100mg twice daily plus Metronidazole 400mg twice daily for 14 days

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50
Q

Treatment genital warts

A

podophyllin cream, cryotherapy

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51
Q

most common vulval pathology worldwide

A

Trichomonas vaginalis

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52
Q

vulval parasite

A

Trichomonas vaginalis

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53
Q

treatment for PID

A

IM ceftriaxone 500mg single dose, oral doxycyline 100mg BD 2/52, oral metronidazole 400mg BD 2/52

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54
Q

20 year old man has just returned from Thailand, he has been having non-bloody diarrhoea 5 times/day for 5 days associated with crampy abdo pain.

A

salmonella entiridis

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55
Q

20 year old man has just returned from Thailand, he has been having non-bloody diarrhoea 5 times/day for 5 days associated with crampy abdo pain.

A

E Coli

most common cause of Traveller’s diarrhoea

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56
Q

20 year old man present to the OOH GP at midnight, he woke in the night with vomiting, abdominal pain and profuse diarrhoea. He recalls reheating a Chinese takeaway a few hours prior.

A

Bacilius cereus

Found in rice, symptoms develop in 4-8 hours hours

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57
Q

Whilst camping in rural Peru, a 30 year old woman becomes unwell with a one week history of abdo pain, vomiting and bloody diarrhoea 10x day

A

Shigella

bloody diarrhoea + VOMITING

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58
Q

Whilst camping in rural Peru, a 30 year old woman becomes unwell with a one week history of abdominal pain and watery diarrhoea 10x day. The stool is described as rice-water.

A

Vibrio cholerae

rice water stool

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59
Q

A 30 year old woman presents with diarrhoea and abdo pain. She recalls attending a barbecue 3 days ago where chicken was served.

A

Salmonella enteritidis

non-bloody diarrhoea and chicken
gastroenteritis salmonella

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60
Q

A 30 year old woman presents with bloody diarrhoea and abdo pain. She recalls attending a barbecue 3 days ago where chicken was served.

A

Campylobacter

bloody diarrhoea and chicken

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61
Q

A 55 year old man on long-term antibiotics for a chronic joint infection begins to suffer with severe diarrhoea, abdominal pain and feeling unwell.

A

C. diff

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62
Q

A hospital ward has been shut due to an epidemic of diarrhoea and vomiting, leaving many patients dehydrated.

A

Norovirus

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63
Q

mobile trophozoites

A

Entamoeba histolytica

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64
Q

mnemonic for causes of bloody diarrhoea

A 
CHES
Campylobacter
Haemorrhagic E coli
Entamoeba histolytica
Shigella
Salmonella - rarely/causes non-bloody
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65
Q

fever, abdo pain, diarrhoea, headache, rash on torso, low heart rate, enlarged liver.
dx and rx

A

typhoid fever

ciprofloxacin

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66
Q

40 year old woman presents with diarrhoea, large amounts of offensive flatulence and abdominal pain. Stool microscopy reveals mobile trophozoites.

A

Entamoeba histolytica

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67
Q

A 60 year old renal transplant patient presents to ED with severe diarrhoea. Kinyoun acid fast stain of stool reveals oocysts.

A

Cryptosporidia

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68
Q

A 55 year old man on long-term antibiotics for a chronic joint infection begins to suffer with severe diarrhoea, abdominal pain and feeling unwell.

A

C. Difficile

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69
Q

A 30 year old has recently returned from El Salvador presenting with fever and abdominal pain. On examination splenomegaly is noted. Bloods show WCC 3.0.

A

Salmonella typhi

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70
Q

A hospital ward has been shut due to an epidemic of diarrhoea and vomiting, leaving many patients dehydrated.

A

Norovirus

71
Q

pathagnomonic for entamoeba histolytica

A

mobile trophozoites

72
Q

what is entamoeba histolytica

A

an anaerobic parasitic amoebozoan

73
Q

pathagnomonic for cryptosporidium

A

acid fast stain reveals oocysts

74
Q

list 3 protozoa and one key symptom of each

A

entamoeba histolytica - excessive flatulence w/diarrhoea
giardiasis lamblia - v. foul smelling diarrhoea
cryptosporidium - diarrhoea

75
Q

list types of salmonella and brief effects of each

A

Salmonella enteritidis = gastroenteritis
Salmonella typhi = typhoid fever
Salmonella paratyphi = paratyphoid fever

76
Q

Rose spots - causative organism - disease

A

Salmonella typhi - typhoid fever

77
Q

Ricewater Stools

A

Cholera

78
Q

c diff rx 1st and 2nd line

A

PO metronidazole, 2nd line PO vancomycin.

79
Q

MRSA rx

A

vancomycin

80
Q

A diabetic with long-standing infected uclers on his right ankle complains of persistent pain. MRI shows bone marrow oedema of the distal tibia.

A

Osteomyelitis

81
Q

A 50 year old man presents with with an acutely swollen, red, painful left knee fixed at 10 degrees flexion. He is unable to weight bear. He is known to have a total knee replacement on that side. He has recently been treated for CAP.

A

Septic arthritis

82
Q

elderly patient has new confusion

A

dip the urine - check for UTI

83
Q

A 60 year old has recently had a Hartmann’s procedure for CRC. The stoma site is not yet fully healed, with surrounding erythema and yellow discharge. Inflammatory markers are raised.

A

Wound infection

84
Q

Why is septic arthritis common in children?

A

Very high blood supply to the bones

85
Q

Why are prosthetic joints a common site for septic arthritis?

A

They have no immune system!

86
Q

Why do children hold their hip out in a flexed externally rotate position in septic arthritis?

A

it makes the joint capsule space as large as possible

87
Q

What is prosthetic joint failure?

A

When there is a mechanical failure of the joint

88
Q

most likely organism of (superficial) wound infection and tx

A

staph. aureus

treat w/ flucloxacillin

89
Q

what is superficial and deep wound infection?

give respective treatments

A

superficial = infection of skin and subcutaeneous tissue, cellulitis. S.aureus most likely organism. Tx = flucloxacillin

deep = infection down to fascial and muscle layers or beyond into organ spaces, failure of healing. Rx = Broad spectrum antibiotics as per guidelines for organ systems involved.

90
Q

Rx = IV antibiotics and surgery (arthroscopic washout)

condition?

A

Septic Arthritis

91
Q

Most common pathogen causing UTI

A

Escherichia coli

92
Q

2nd most common pathogen causing UTI, frequently seen in young women

A

Staphlyococcus saprophyticus

93
Q

Pathogen associated with recurrent UTI and staghorn calculi

A

Proteus Mirabilis

94
Q

Sign most associated with coliform infection on urine dipstick testing

BONUS: what does coliform mean?

A

Nitrate positive

coliform: rod-shaped Gram-negative non-spore forming and motile or non-motile bacteria which can ferment lactose with the production of acid and gas

95
Q

20 year old man presents with right iliac fossa pain. On examination there is RIF tenderness and guarding. WCC 16, CRP 120

dx and tx

A

Appendicitis – urgent surgery

96
Q

A 5 year old child presents unwell with a painful hip, unable to weight bear. On examination the hip is held in flexed externally rotated position. Temperature 39.5. WCC 18 CRP 150.

A

Septic arthritis

97
Q

70 year old woman presents with confusion and suprapubic tenderness. Urine dipstick is positive for leukocytes and nitrates. WCC 12, CRP 20

A

UTI – trimethoprim

98
Q

40 year old woman presents with abdominal pain and dysuria. On examination there was right renal angle tenderness. Pregnancy test negative. Pyuria is present.

A

Pyelonephritis – co-amoxiclav + gentamicin

99
Q

Renal angle tenderness on examination

A

pyelonephritis

100
Q

sudden severe loin to groin pain. 10/10. Worse on any movement.

give name and treatment

A

renal colic - renal stones

conservative/lithotripsy/PCNL
percutaneous nephrolithotomy - surgical removal of stones

101
Q

30 year old woman presents with headache, neck stiffness and fever. Lumbar puncture shows low glucose, high protein and WCC 100 with 90% polymorphs.

A

Bacterial meningitis

102
Q

30 year old woman presents with headache, neck stiffness and fever progressive over 5 days. Lumbar puncture shows normal glucose, normal protein with WCC 100 90% lymphocytic infiltrate.

A

Viral meningitis

103
Q

A 30 year old Somalian woman presents with headache, worsening fever and neck stiffness. Lumbar puncture shows high levels of glucose, protein and white cells, with a lymphocytic predominance.

A

TB meningitis

104
Q

A 30 year old woman presents checks in to ED complaining of headache, fever and neck stiffness. The receptionist calls you to the waiting room urgently, the patient is seizing. Once stable, she tells you she had been unwell with the flu recently

A

Viral Encephalitis

Seizing is far more common in encephalitis

Preceding prodromal illness is more common in encephalitis

105
Q

LOW GLUCOSE LP

A

BACTERIAL

106
Q

List time frames to consider to distinguish types of meningitis

A

hours

days

weeks to months

107
Q

30 year old man from Swaziland presents with persistent cough, feeling hot and night sweats. He occasionally brings up blood. He has lost 10kg in the last 6 months. He is a smoker.

A

TB (respiratory) highest in swaziland

108
Q

How does glucose vary for the different types of meningitis on LP?

A

Low Glucose - Bacterial (bacteria uses it)

Low Glucose - TB

Normal (similar to plasma) Glucose - Viral

109
Q

How do white cells vary for the different types of meningitis on LP?

A

Polymorphs - Bacterial

Lymphocytes - Viral, TB

110
Q

How does protein content vary for the different types of meningitis on LP?

A

High protein - Bacterial

High protein - TB

Low protein - Viral (small small amounts of protein in viruses)

111
Q

Why do we do CT Head in meningitis?

A

Exclude any other causes of symptoms, to reassure us.

112
Q

80 year old known COPD patient presents to ED with SOB, wheeze, cough and fever. O2 82% RA, RR 28.
treat

A

IV Co-amoxiclav + clarithromycin, IV hydrocortisone, salbutamol and ipratropium nebuliser
(need to improve lung function as well as treat infection)

113
Q

72 year old woman diagnosed with meningitis. CSF culture shows gram positive rods with tumbling motility.
dx and mx?

A

Listeria

IV ceftriaxone + ampicillin

114
Q

Newborn baby is diagnosed with meningitis. Gram negative rods are seen in the CSF
dx and mx?

A

E. coli

IV ceftriaxone

115
Q

18 year old is diagnosed with meningitis.

dx and mx?

A

N. meningitidis

IV ceftriaxone

116
Q

50 year old man is diagnosed with meningitis. Ziehl-Nielsen stain reveals the organism responsible.
dx and mx?

A

Mycobacterium tuberculosis

Rifampicin + isoniazid + pyrazinamide + dexamethasone

117
Q

Gram positive rods with tumbling motility have caused a meningitis - causative organism?
tx?

A

Listeria

IV ceftriaxone + ampicillin

118
Q

meningitis: Gram -ve bacilli in a newborn

A

E coli

119
Q

meningitis: Gram +ve cocci in a newborn

A

Group B Strep

120
Q

meningitis: Gram +ve diplococci in a teenager

A

Neisseria meningitis

121
Q

meningitis: gram positive bacilli + motility in elderly and newborns

A

Listeria

122
Q

meningitis: Gram –ve coccobacilli in newborns and children

A

Haemophilus influenzae

123
Q

Which antimicrobial class inhibits protein synthesis?

A

Aminoglycosides

AMINO

124
Q

Which antimicrobial class inhibits cell wall synthesis?

A

Beta-lactams

125
Q

Which antimicrobial class inhibits DNA synthesis?

A

Fluoroquinolones

fluoro-uracil

126
Q

Which antimicrobial class inhibits folate metabolism?

A

Sulfonamides

sulFO
FOlate

127
Q

Give a Beta-lactam

Ceftriaxone
Vancomycin
Doxycycline
Ciprofloxacin
Colistin
Erythromycin
Linezolid
Gentamicin
Trimethoprim
A

Ceftriaxone

128
Q

Give an example of Fluoroquinolones

Ceftriaxone
Vancomycin
Doxycycline
Ciprofloxacin
Colistin
Erythromycin
Linezolid
Gentamicin
Trimethoprim
A

Ciprofloxacin

129
Q

Give an example of Glycopeptide

Ceftriaxone
Vancomycin
Doxycycline
Ciprofloxacin
Colistin
Erythromycin
Linezolid
Gentamicin
Trimethoprim
A

Vancomycin

130
Q

Give an example of Aminoglycoside

Ceftriaxone
Vancomycin
Doxycycline
Ciprofloxacin
Colistin
Erythromycin
Linezolid
Gentamicin
Trimethoprim
A

Gentamicin

131
Q

Give an example of Macrolide

Vancomycin
Doxycycline
Ciprofloxacin
Colistin
Erythromycin
Linezolid
Gentamicin
Trimethoprim
A

Erythromycin

132
Q

Give an example of Diaminopyrimidines

Ceftriaxone
Vancomycin
Doxycycline
Ciprofloxacin
Colistin
Erythromycin
Linezolid
Gentamicin
Trimethoprim
A

Trimethoprim

133
Q

Give an example of Oxazolidinones

Ceftriaxone
Vancomycin
Doxycycline
Ciprofloxacin
Colistin
Erythromycin
Linezolid
Gentamicin
Trimethoprim
A

Linezolid

134
Q

Give 3 types of beta-lactams?

A

Penicillins,
cephalosporins,
carbapenems

135
Q

Where does Tb originate?

A

Cow..

136
Q

Factors inducing transmission of Tb

A

Sputum status of index case (can you see Tb down microscope)
Proximity
Time in high risk area
Susceptibility of exposed person (e.g. PPI lowers stomach acid more likely to get salmonella)

137
Q

Who is at risk of disseminated Tb?

A

Young and the immunocompromised

138
Q

Where does Tb usually enter?

A

Lung

Sometimes pharynx and lymph nodes

139
Q

What compound keeps Tb latent?

A

Anti-TNF

140
Q

Gold standard of diagnosing Tb?

A

Culture
Takes 20 days - 8 weeks

Thus we have a lot of empirical therapy before dx confirmed

141
Q

How sensitive is TB PCR?

A

60-65% lymph node

40% CSF (Tb meningitis)

142
Q

How to tell if a granuloma is a TB?

A

Pus coming out of a granuloma, perhaps in the wall of an abscess

143
Q

What does whole genome sequencing save time on in Tb Ix?

A

After culturing Tb you can find the sensitivity by mapping the 4000 genes of it. This saves several weeks as normally you would reculture the positive culture with all the different Abx.
Future of Ix

144
Q

What are Mantoux test and IGRA for Tb equivalent to?

A

Equivalent to IgG for Tb.
All it shows is past immune response to Tb.

Note: IGRA misses 1 in 5 cases (low sensitivity)

145
Q

Definition of Latent Tb.

A

Positive Mantoux test or IGRA test with no clinical symptoms.

146
Q

How many cases and deaths of Tb each year?

A

1.4 million deaths
10 million cases
Ten times less funding than HIV

147
Q

Features of military Tb?

CXR?

A

No cough, feeling rotten

Tiny spots all over, apical sparing

148
Q

How to differentiate pleural Tb and malignancy?

A

Drain the fluid - lots of lymphocytes, no malignant cells

149
Q

Where are mediastinal lymph nodes on CXR?

A

Around the hilae

150
Q

Cold abscess?

A

Abscess in lymph node with Tb

It is called cold because if it was staph aureus it would be very hot

151
Q

How does spinal Tb work?

A

Starts in bones, destroy, press into the spinal cord

Or

Starts in brain and then spreads to cord. Can become paraplegic.

152
Q

How to treat CNS and Spinal Tb?

A

Normal treatment with HIGH dexamethasone.
(Look up in BNF)

High immunosuppression can foster Tb to spread to spinal Tb. It can also mask symptoms until progressed Tb.

May often find meningitis if spreading through cord.

153
Q

When must you give steroids in Tb?

A 
Spinal Tb
Pericarditis Tb (lower inflammation that causes scarring and strangles the heart)

Can give for symptoms

154
Q

Why multi drug treatment for Tb?

A

Speed killing

Combat resistance

155
Q

Who gets longer Tb treatment”

A

Spinal Tb- 12 months

Intolerant - 1st line - rif and iso for 9 months

Missed doses - if totals 2 weeks must start from beginning

Drug-resistant Tb - long time

156
Q

How treat latent Tb?

Screen the significantly immunocompromised, especially high steroids

A

3 months RI

Or 6 months I

157
Q

Which Tb drug has most interactions?

A

Rifampicin

158
Q

What can be given alongside Tb therapy if some symptoms arise?

A

Vitamin B6

159
Q

Signs of URTI

A

Cervical lymph nodes

Coryza

160
Q

What to do if Pt ill just have exposed camels

A

MERS - put mask on and isolate

161
Q

Key point if history in fever in returning traveller

A

Focus or no focus

162
Q

Ddx for fever with no focus

A

Bacterial - typhoid

Parasites - malaria (must be ruled out 3 tests) (low platelets)

Viral - arbovirus (mosquitoes)(dengue common, chikingunya, zika)

163
Q

Low platelets, returning traveler, fever, no focus

A

Malaria

Viral

164
Q

Which disease in fever returning traveller no focus has unusual FBC result.

A

Typhoid no neutrophilia

165
Q

Why does Tb not usually present in returning traveller?

A

Very variable incubation time. Could be 6 months could be 3 years after exposure

166
Q

Man returned from Delhi, puo

A

Amoebic liver abscess

167
Q

What is the difference between thin and thick blood film?

A

Thin is one cell thick
Thick is many cells

Thin is a blob spread out so one cell thick
Thick is one blob not spread

168
Q

What is the appearance of malaria blood cells in falciparum malaria

A

Earphones or signet rings in cells

169
Q

How to treat typhoid

A

Ceftriaxone

170
Q

How to treat malaria

A

Artesunate

171
Q

Mortality of Ebola in tropic

Mortality of Lassa

A

50-70%

Very variable

172
Q

What disease is around the entire tropics?

A

Zika virus

173
Q

How to prevent congenital zika

A

No babies for 6 months if Male

No babies for 2 months if female

MedEd Path (5 decks)

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