Miscellaneous infections

Question 1

Clostridium tetani is found in

Answer 1

animal faeces, contaminated soil

Question 2

Clostridium tetani: ↓ involvement of nervous system– _____ causes sustained excitation of motor neurons, causing _____

Answer 2

toxin; motor spasms

Question 3

S&S of Clostridium tetani

Answer 3

• stiffness
• lockjaw
• sardonic grin (sneering grin)
• opisthotonus (extreme arching of the back)

Question 4

Is Burkholderia psedomallei fatal?

Answer 4

Yes

Question 5

Toxoplasmosis is a serious health implication in these people:

Answer 5

• pregnant women

- immunocompromised

Question 6

S&S of toxoplasmosis

Answer 6

• Usually asymptomatic or mild
• Some may have flu-like symptoms, lymphadenopathy, myalgia, ocular toxoplasmosis (blurred vision, photophobia, redness of eye)

Question 7

Test for parasites

Answer 7

ova, cysts and parasite (OCP) test in stool

Question 8

Transmission of scabies

Answer 8

spread by prolonged skin-to-skin contact with a person who has scabies.

Question 9

When are signs of infection shown in scabies?

1st time:
Reinfection:

Answer 9

1st time: symptoms usually do NOT appear for up to 2 months

Reinfection: symptoms appear 1-4 days after exposure

Question 10

Scabies: when can worker go back to work?

Answer 10

In general, a person diagnosed with scabies could return to work once treatment is begun

Question 11

Are norwegian scabies diff from ‘normal’ scabies?

Answer 11

Yes, different.

Norwegian scabies are highly contagious due to the higher no. of mites

Question 12

Bacteraemia vs Septicaemia

Answer 12

Bacteremia is the simple presence of bacteria in the blood

Septicemia is the presence and multiplication of bacteria in the blood, and thus showing signs of being unwell

Question 13

Consequences of septicaemia

Answer 13

mortality, metastatic infection

Question 14

Vitals of SIRS:

• HR
• RR
• Temp
• WBC

Answer 14

• HR >90/min
• RR >20/min
• Pyrexia or hypothermia
• Raised WBC >12000 or leukopenia WBC<4000

Question 15

To detect bacteraemia/septicamia (not line associated)

Answer 15

• 2 sets of blood cultures

- 10 ml in EACH bottle to maximise yield of detecting bacteria or Candida

Question 16

To detect bacteraemia/septicamia (central like associated)

Answer 16

blood cultures taken from the line & peripheral vein in the same setting

Question 17

Concern of line-associated infections

Answer 17

severe infections can result in

• septic shock (collapse of blood pressure due to infection)
• organ damage or failure
• abnormal blood clotting and death

Question 18

What is the importance of ‘source’ control?

Answer 18

Eliminate source of infections (not just going for antibiotics)

Question 19

What are the complications in toxoplasmosis?

Answer 19

a) pregnant women
- risk of miscarriage & stillborn child
- child born with signs of toxoplasmosis (eg.jaundice)

b) immunocompromised
- HIV patient if infected with Toxoplasma for 1st time, at risk of having severe primary infection
- HIV patients who have Toxoplasma in the past may develop reactivation of the infection

Question 20

Management of tetanus

Answer 20

• ICU care– paralyse patient, mechanical ventilation
• HTIG– human tetanus immunoglobulin
• Wound exploration & debridement
• Antibiotics

Question 21

Prevention of tetanus

Answer 21

• Tetanus toxoid immunisation

- Tetanus toxoid booster

Question 22

Burkholderia psedomallei- is a gram tve or -ve organism?

Answer 22

gram -ve

Question 23

Burkholderia psedomallei is found in

Answer 23

soil and water in endemic regions