Revision Session

Question 1

Most common organisms in dog/ cat bites

Answer 1

-Pasteurella multocida
-Capnocytophaga canimorsus
-Staph aureus
-Strep pyogenes
-Coliforms
-Anaerobes

Question 2

Management of domestic pet bite/ scratch

Answer 2

-Discussion with orthopaedics to assess need for surgical debridement
-Sepsis 6
-Tetanus toxoid booster
-Consider rabies risk assessment
-Co-amoxiclav/ doxy + metronidazole

Question 3

Presentation of infectious mononucleosis

Answer 3

-Fever
-Lymphadenopathy (bilateral posterior cervical)
-Severe sore throat (tonsil enlargement. White exudate, palatal petechiae)
-Malaise
-Chills
-Myalgia
-Sweats
-Anorexia
-Retro-orbital headache
-Rash
-Splenomegaly
-Hepatomegaly

Question 4

Investigation of IM

Answer 4

-Younger than 12= EBV viral serology
-FBC (WCC, monospot test)
-LFT

Question 5

Management of IM

Answer 5

-Analgesia
-No contact sports to reduce risk of splenic rupture

Question 6

Presentation of HSV

Answer 6

-Severe gingivostomatitis
=Fever
=Malaise
=Sore throat
=Lymphadenopathy
=Excess salivation
=Painful vesicles
-Cold sores
-Painful genital ulceration.
-Prodrome of pain, burning tingling, itching, paraesthesia preceding lesions.

Question 7

Management of HSV

Answer 7

-Oral Aciclovir (also for genital herpes) and chlorhexidine mouthwash for gingivostomatitis, topical acyclovir for cold sores

Question 8

Presentation of varicella zoster

Answer 8

-Prodrome (nausea, myalgia, anorexia, headache)
-Malaise
-Loss of appetite
-Feeding problems
-Rash (small, erythematous macules appear on scalp, trunk, proximal limbs which progress over 12-14 hours to papules, clear vesicles which are intensely itchy and pustules, can occur on palms, soles, and mucous membranes, crusting)

Question 9

Management of varicella zoster

Answer 9

-Calamine lotion
-School exclusion
-Immunocompromised patients and new-borns receive varicella zoster immunoglobulin
-IV Aciclovir.
-Complications: pneumonia, encephalitis, disseminated haemorrhagic chickenpox, arthritis.

Question 10

Presentation of mumps

Answer 10

-Fever
-Malaise
-Muscular pain
-Parotitis (earache, pain on eating, unilateral initially then becomes bilateral)
-Lethargy
-Reduced appetite
-Headache
-Dry mouth

Question 11

Investigation and management of mumps

Answer 11

-PCR testing on saliva swab (IgM), blood antibodies
-Management: rest, paracetamol for high fever, notifiable.