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MRCP > MRCP Infectious diseases/STI > Flashcards

MRCP Infectious diseases/STI Flashcards

1
Q

How long after HIV infection does seroconversion occur?

A

2-4 weeks

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2
Q

Describe symptoms of HIV seroconversion

A

Viral illness similar to glandular fever:

fever, myalgia, pharyngitis, erythematous maculopapular rash

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3
Q

Diagnosing HIV serovoncersion

A

HIV RNA (viral load) & p24 antigen (ELISA)

Investigation of choice for HIV infection: HIV antibody serology (3 month window from infection to this test becoming positive -> false negative. hence seroconversion do the above tests)

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4
Q

Markers of infection activity in HIV

A

Viral load (RNA) & CD4 count

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5
Q

Post-splenectomy sepsis common organisms

A 
Encapsulated organisms:
- H influenza type b
- S pneumoniae (most concerning)
- N meningitidis 
Receive vaccines for the above
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6
Q

Multiple painful genital ulcers & tender lymphadenopathy

A

Herpes simples virus

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7
Q

First-line investigation suspected meningococcal infection

A

If no rash/raised ICP: LP & CSF microscopy.

If rash/raised ICP/uncooperative: Blood cultures & PCR

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8
Q

Cream coloured retina, overlying haemorrhages. ‘pizza pie appearance’

A

CMV retinitis

Occurs in up to 25% of untreated AIDS

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9
Q

Test for latent TB (irrespective of vaccination status)

asymptomatic, contact with TB positive

A

Mantoux test

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10
Q

Symptoms of primary TB infection

A

Often asymptomatic ;)

Cough/wheeze/erythema nodosum. Reactivation presents with typical symptoms.

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11
Q

Most severe malaria species

A

Plasmodium falciparum

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12
Q

Malaria species which have ‘hypnozoite’ stage - parasites remain dormant in liver and can cause relapse months or years later

A

P ovale, P vivax

Give primaquine as well as chloroquine to cure hynozoites

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13
Q

Gold-standard investigation for malaria

A

Malaria blood film (microscopy)

  • x3 thick and thin blood films over 24-48h
  • thick identifies parasite, thin identifies parasite load
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14
Q

Treatment for severe falciparum malaria

A

IV artesunate

2nd line: IV quinine (5 days) then second agent eg doxycycline for 7 days

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15
Q

What vaccination is never indicated in HIV positive people? (irrespective of CD4 count)

A

BCG

Risk of developing clinical TB

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16
Q

List the live-attenuated vaccines (8)

A 
BCG, MMR
oral polio, oral typhoid, oral rotavirus
intranasal influenza
yellow fever
shingles & chickenpox
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17
Q

Malignancies associated with EBV infection (5)

A
  • Burkitt’s lymphoma
  • Hodgkin’s lymphoma
  • Nasopharyngeal carcinoma
  • HIV-associated CNS lymphomas
  • Gastric cancer
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18
Q

Jarisch-Herxheimer reaction as associated with which conditions?

A

Spirochete infections:

  • Syphilis
  • Lyme disease
  • Leptospirosis
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19
Q

Describe Jarisch-Herxheimer reaction

A

Fever, tachycardia, hypotension & rash after first dose of antibiotics, within 24h.
Likely due to toxin release following rapid bacterial death

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20
Q

CSF staining with India ink

A

Cryptococcal meningitis

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21
Q

Sabouraud dextrose agar

A

Sporothrix schenckii infection

  • fungal, enters via cut in skin
  • non-tender maculopapular lesion, progressive increase in number along lymphatic lines
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22
Q

How is coxiella burnetii spread?

A

Between animals via infected ticks

Animal to human by inhalation of infected dusts and aerosols, and unpasteurised milk of infected cows

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23
Q

Treatment for trichomonas vaginalis

A

PO metronidazole

24
Q

Anti-HBe antibodies implies what?

A

Active hep B infection

25
Q

Generally unwell, febrile illness, relative bradycardia despite sepsis, constipation

A

Typhoid

26
Q

Treatment for gonorrhoea

A

IM ceftriaxone 500mg & PO azithromycin 1g

27
Q

Cardiac/renal/neuro complications due to diphtheria are caused by what?

A

Bacterial exotoxin

28
Q

Flu-like illness & conjunctivitis, progressing to hepatic & renal failure, possibly meningitis.
May work in sewer or row/canoe

A

Leptospirosis
Spread by rat urine

Rx: benpen/doxy

29
Q

Drug regime for treatment of TB:

  • Pulmonary/lymph node
  • CNS
A

(Rifampicin, Isoniazid, Pyrazinamide, Ethambutol)
Pulm/LN: RIPE for 2 months, R&I for a further 4 months
CNS: RIPE for 2 months, R&I for a further 10 months

30
Q

Treatment of epididymo-orchitis

A

<35 yrs/risk STI: Ceftriaxone

>35/low risk STI: Ofloxacin

31
Q

Skin rash associated with Lyme disease

A

Erythema migrans

target appearance

32
Q

Biliary & hepatic cysts, eosinophilia

A

Hydatid cysts - Echinococcus granulosus

33
Q

First line therapy for non life threatening c diff

A

oral metronidazole 10-14 days

34
Q

Therapy for life-threatening c diff

A

oral vancomycin & IV metronidazole

35
Q

Yellow-grey mouth ulcers & vesicular rash hands & feet

A

Hand foot & mouth disease

  • Coxsackie virus
  • Commonly A16
  • Supportive treatment
36
Q

Commonest cause of post-STI reactive arthritis

A

Chlamydia

37
Q

Treatment of CMV encephalitis

A

Ganciclovir

38
Q

Presentation of CMV in immunocompetent hosts

A

Similar to EBV: fever, lymphadenopathy, splenomegaly, rarely hepatitis

39
Q

Common SE of tenofovir

A

Renal tubular damage

Esp in elderly/HTN/diabetes

40
Q

Treatment of Lyme disease

A

Doxycycline

Amox if doxy CI eg pregnancy

41
Q

At what CD4 count does PCP prophylaxis need to be commenced in HIV +ve patients?

A

<200 cells/mm3

42
Q

Lymphogranuloma venereum LGV) organism

A

Chlamydia (L1, L2, L3)

43
Q

Possible rabies exposure (eg bat bite) management

  • no immunisation
  • previously immunised
A
  • no immunisation –> rabies vaccine course & immunoglobulin
  • prev immunised –> rabies vaccine course only
44
Q

Earache, external ear red hot & swollen, & facial nerve palsy

A

Malignant otitis externa

  • often diabetics
  • pseudomonas aeruginosa
45
Q

Prosthetic joint infection many years following arthroplasty (organism)

A

Propionibacterium acnes (slow growing gram positive bacterium with poor virulence)

46
Q

Treatment of Legionnaire’s disease (pneumonia)

A

Macrolides eg clarithromycin, azithromycin

47
Q

Pneumonia with coldsores (organism)

A

Streptococcus pneumoniae

48
Q

Flu like illness 6-60 days following renal transplant

A

CMV infection

treat with IV ganciclovir

49
Q

Management of hish-risk rabies bite in a previously vaccinated person

A

Vaccination on the day and day 3

50
Q

Pneumonia following flu-like illness/influenza

A

Staph aureus

51
Q

Pneumonia associated with herpes labialis infection

A

Streptococcus pneumoniae

52
Q

Dapsone, rifampicin and clofazimine is the treatment for what?

A

Leprosy

53
Q

Presentation of Yersinia enterocolitica infection?

A

Pseudoappendicitis secondary to mesenteric adenitis

54
Q

Medical therapy for entamoebia?

A

Metronidazole

55
Q

Treatment of chlamydia in pregnancy?

A

Azithromycin

MRCP (14 decks)

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