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Infectious Diseases > MKSAP > Flashcards

MKSAP Flashcards

1
Q

Which RIPE Tb drug can cause hyperuricaemia ?

A

Pyrixinamide. Contraindicated in active hour - caution in chronic gout. Also causes hepatitis and GI upset

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2
Q

Blastomycosis

A

Yeast。 up to 40% get extra pulmonary manifestation e.g skin lesion. Use itraconazole if mild. Amphterocin if severe pulmonary disseminated disease

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3
Q

Tuberculous pericarditis?

A

Prednisone + RIPE

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4
Q

Treatment of cervicitis?

A

Single ceftriaxone and doxycycline for 14 days

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5
Q

Toxoplamosis? Findings on MRI?

A

Ring enhancing lesions in immunocompromised AIDS patients CD4 <100. Use pyrimethamine & sulfadiazine. If no improvement in 2 weeeks involve neurosx for biopsy

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6
Q

HIV/AIDS CD4 166 with fever headache. CT mildly increased ventricular size

A

Cryptocccus neoformans = amphotericin B followed by long term oral fluconazole.

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7
Q

CMV encephalitis CD count threshhold?

A

<100. MRI shows periventricular involvement

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8
Q

Tacrolimus toxicity

A

Acute rise in creatinine and urea. Hypertension, hyperglycaemia, hyperkalaemia, hypomagnesaemia. Increased toxicity with macrolide
Tremors

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9
Q

Vibrio Vilnius is

A

Can cause necrotising fasciitis - exposure to shellfish in warm months Gulf of Mexico. Haemachromatosis patients more susceptible

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10
Q

Capnocytophaga canimorsus

A

Gram-negative rod causing overwhelming sepsis in cat /dog bite - particularly asplenic patients

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11
Q

Cat scratch

A 
Bartonella henslae. 
Azithromycin 
Doxycycline
Bactrim 
Ciprofloxacin
Clarithryomycin
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12
Q

Cat bite

A

Pastuerella.

Consider augmentin or clindamycin

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13
Q

Preventing varicella infection in immunocompromised

A

Varicella immunoglobulin. Cannot do live vaccine

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14
Q

Best screen TB in patient with BCG vaccine?

A

IGRA

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15
Q

Shigella

A

Ciprofloxacin

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16
Q

Campylobacter

A

Azithromycin

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17
Q

Life threatening candidaemia

A

Echinocandin agent - anidulafungin, caspofungin, micafungin

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18
Q

Blastocystis diarrhoea

A

Treat with metronidazole or Bactrim. If asymptomatic no requirement to treat

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19
Q

Cavitatitory CAP severe

A

Ceftriaxone, azithromycin + additional vanc due to cavitation

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20
Q

Botulism

A

Foodborne transmission
1-5 days onset. Symmetric descending flaccid paralysis prominent bulbar palsy, normal GCS. Afebrile.
4Ds - diplopia, dysarthria, dysphonia, dysphagia

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21
Q

Paralytic shellfish poisoning

A

Tingling of lips and tongue - parathesia of hands & feet

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22
Q

Oesophageal candidiasis

A

Fluconazole oral. Prophylaxis if CD count <100

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23
Q

Empiric treatment of life threatening diabetic osteomyelitis

A

Meropenem and vancomycin

Bone biopsy most sensitive - MRI not definitive and growth on swabs no reliable unless staph a

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24
Q

HIV pregnancy

A

Behind ART regardless of CD 4 count, viral load, or symptoms. Zidovudine, lamivudine, lopinavir-ritonavir safe in pregnancy.
Efavirenz is contraindicated in pregnant

25
Q

Fever, headache, myalgia, lower back pain, rash on trunk + lower extremities, thrombocytopenia

A 
Dengue fever 
Break bone fever 
Frontal and retro-orbital pain 
Rash sparing palms and soles 
Neutropenia 
Thrombocytopenia
AST>ALT

Aedes aegypti mosquito

26
Q

Interpret TST in IVDU

A

If<10mm = negative
High risk groups who need CXR include HIV, evidence of old TB, contact with active TB, organ transplant, immunosuppressed

27
Q

CMV rejection

A

Fevers, myalgia, hepatitis
Valganciclovor oral or IV ganciclovir

Or foscarnet
Can give cytotoxic T lymphocytes

28
Q

BK virus

A

Late term complication of kidney transplant. Nephropathy, organ rejection, urethral strictures.
Decoy cells in urine
Mx: reduce inmunsuppression

29
Q

EBV PTLD

A

Reduce immunosuppression

In severe disease, also give rituximab

30
Q

Gram negative rod respiratory

A

Pseudomonas auruginosa
Cefepime/mero/tazocin
Plus ciprofloxacin/levofloxacin
Or beta lactam + aminoglycoside + azithromycin

Aztreonam alternative antipseudomonal agent for severe beta lactam allergy

31
Q

HSV encephalitis

A

IV aciclovir as oral does not give good brain penetration for 14-21 days. MRI 90% abnormal - temporal lobe inflammation.
If negative CSF HSV PCR and normal MRI brain, cease IV aciclovir.

32
Q

PCP

A

Dry cough; dyspnoea. CXR diffuse interstitial disease in immunocompromised.
Treat with bactrim. If pO2 < 70, add prednisone

33
Q

Mucormycosis

A

Sinusitis, rhino-orbital infection , Black eschar

Need to debride and use IV amphotericin B. Step down to posaconazole.

34
Q

HIV treatment failure

A

Remain in treatment whilst doing resistance testing. No role in stopping ART

35
Q

Bipolar gran negative bacillus

A

Closed safety pin appearance - yersinia pestis

Bubonic plague!

36
Q

Typhoid fever

A

Rose colored rash, diarrhoea, abdominal pain
Thrombocytopenia, leucopenia, raised bilirubin
Vaccine not completely effective

37
Q

Leishmaniasis

A

Protozoal disease, female sandfly vector

Hypergammaglobulinemia, weight loss, fever, hepatosplenomegaly

38
Q

Brucellosis

A

Zoonotic , fever, bone pain, joint pain neuro

39
Q

Gonorrhoea

A

Intracellular gram negative diplococci

Ceftriaxone and azithromycin

40
Q

Allergic diseases

A

C1 inhibitor deficiency - recurrent angioedena, family hx (AD), abdo pain, laryngeal oedema

Selective IgA deficiency - chronic LRTI, autoimmune & atopic disorder, gastrointestinal and uti post blood transfusion

Terminal C5-9 deficiency - autosomal co dominant - susceptible to neisseria meningococcal disease

41
Q

Which abx not effective in pneumonia ?

A

Daptomycin

Keflex

42
Q

Which drug cannot be used as mono therapy due to resistance?

A

Rifampicin

43
Q

Which malaria prophylaxis good for pregnant women?

A

Mefloquine.

Chloroquine not used because of high resistance rates
Doxycycline and atovoquone-proguanil not good for pregnancy

44
Q

Which prophylaxis most effective against travelers diarrhoea in IBD on immunosuppresion?

A

Rifaxamin

45
Q

Familial Mediterranean fever

A

Recurrent fevers. Joint pain, rash on lower torso, usually manifests <20
Neutrophilix leucocytosis

46
Q

Sweets syndrome

A

Erythrodermic neutrophilic leucocytosis.
Usually on face, arms and chest.
Can be associated with haem malignancy

47
Q

Foul smelling diarrhoea with bloating

A

Giardia

48
Q

Syphillis

A

Primary - chancre
Secondary
Tertiary neurosyphillis

Single IM penicillin G

49
Q

Risk of cyclosporine toxicity ?

A

Itraconazole, voriconazole. Not fluconazole. Features are hirsutism, gingival hyperplasia

50
Q

Adenovirus

A

Cidofivir

51
Q 
Which of the following findings would virtually exclude a partially treated bacterial meningitis?
A. negative gram stain
B. negative culture 
C. CSF glucose 45% of serum glucose
D. Negative Kernigs
E. CSF WCC 3
A

E. A CSF white count of 3 (normal) makes bacterial meningitis extremely unlikely

52
Q

Management of tetanus?

A

Prior to wound debridement, it is crucial to give human tetanus immunoglobulin. This is because of the risk that debridement may precipitate further release of tetanus toxin into the systemic circulation. Penicillins have been dissapointing but are recommended as 1st line antibiotics.

53
Q

Beware of extensive oesphageal candidiasis even with use of steroid inhaler.

A

Consider HIV

54
Q

Pox virus in HIV/AIDs (molluscum contagiosum)

A

Multiple painless umbilicated papular lesions

55
Q

CMV retinitis

A

Brushfure lesion with large white fluffly lesion mixed with retinal haemorrhage
Ocular histoplasmosis and syphilitic choroiditis would give a fundus picture of multiple whitish lesions.
Syphilitic neuroretinitis would normally give a picture of a macular star exudation.

56
Q

Which one of the following measures would be most effective in reducing transmission of E. coli O157:H7 during an outbreak of diarrhoea caused by this organism?
A. Hand washing
B. Ensuring meat products fully cooked
C. Isolation of individuals with diarrhoea
D. Drinking only boiled water

A

B. Cattle are a major reservoir of Escherichia coli O157:H7 and contaminated meat is the most commonly implicated source of outbreaks.

57
Q

EBV spot test can be negative in 25% in the 1st week of symptoms.

A

If atypical lymphocytes, more likely EBV anyway

58
Q

if disseminated gonococal infection reactive arthritis, need to give IV ceftriaxone for minimum 48 hours, with oral cipro

A

Rather than single ceft + azithro

59
Q

Gram positive filament with nodule in immunosuppression?

A

Nocardia

Bactrim

Infectious Diseases (4 decks)

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