RPA infectious diseases Flashcards
dengue virus
RNA
what is the basis of community diagnostic assays for dengue
detection of NS1 antigen
Risk factors for severe disease in dengue
young age, female sex, high body-mass index, virus strain, and genetic variants of MHC class I–related sequence B and phospholipase C epsilon 1 genes
Previous infection with different serotype
diagnosis of dengue shock syndrome
pulse pressure narrows to 20 mm Hg or less, accompanied by signs of peripheral vascular collapse
sustained virological response rate for hepatitis C treated with sofosbuvir and ledipasvir or glecaprevir and pibrentasvir
95%
Both pangenotypic regimens
Sofosbuvir = NS5B inhibitor
velpatasvir = NS5A inhibitor
Glecaprevir = NS3/4A protease inhibitor
Pibrentasvir = NS5A inhibitor
When to give tetanus vaccination and tetanus immunoglobulin after possible tetanus exposure
Vaccination: last tetanus vaccination >5yr
Immunoglobulin: only if immunosuppressed
how to calculate maintainence dose rate
maintenance dose rate (mg/hr) = target concentration (mg/L) x clearance
MOA of clindamycin
Inhibits 50S subunit of bacterial ribosomes
and inhibits exotoxin production
What opportunistic infection can cause autoinfection and hyperinfection in renal transplant recipients
Strongyloides
What prophylaxis does kidney transplant patients require?
CMV: if donor or receipient positive then valgan for 3 months
UTI: Bactrim ~6mo
Pneumocystic jirovecii: bactrim for 3-6 months
Candida spp: mystatin/oral clotrimator in “early transplant period”
If present..
TB: isoniazid for 9 mo for latent TB
Hep B positive recipients: tenofovir, entecavir, lamivudine
Fanconi syndrome biochem
Acidosis, hypophosphataemia. glycosuria, proteinuria, hypokalaemia
Due to losing things in the proximal tubules!
Type 2 RTA
Due to inadequate reabsorption in the proximal renal tubules - decreased absorption of glucose, amino acids, uric acid, phosphate and biarb
What HIV medication can cause Fanconi syndrome?
Tenofovir
What vaccines should splenectomy patients receive
Pneumococcus, meningococcus, haemophilus influenzae, influenzae
What precautions does meningococcal require?
Droplet
What precautions does influenzae require?
Droplet precautions
What precautions does varicella zoster and measles require?
Airborne precautions
Rheumatic fever diagnosis criteria
2 major or 1 major and 2 minor criteria with evidence of a preceding group A strep infection
Major criteria: carditis (including valvulitis), polyarthritis, chorea, erythema marginatum, subcutaneous nodules
Minor criteria: monoarthralgia, fever, ESR >30, prolonged PR on ECG
Secondary prophylaxis for rheumatic fever
Duration: minimum 10 years after most recent episode of ARF or until age 21 (whichever is longer)
benzathine benzylpenicillin 1.2 million units every 21 or 28 days
what malaria species have hypnozoites
P. vivax and P ovale
what stage of malaria does primaquine act upon?
hypnozoites
what do you need to test for before giving primaquine?
G6PD
when to add anaerobic cover for aspiration pneumonia
if failing to improve after 48hr and concerns regarding anaerobic organisms (lung absess, poor dentition, putrid sputum)
what antibiotics can prolong QTc
quinolones and macrolides
what antibiotic causes a disulfiram effect when taken with alcohol
metronidazole
(accumulation of acetaldehyde)
Worst antibiotics for myasthenia gravis
aminoglycosides
ketolides
quinolones
MOA maraviroc
chemokine antagonist in HIV
what antibiotic is associated with achilles tendon rupture
cipro
Treatment for uncomplicated malaria
artemether+lumefantrine oral therapy 3 days
Treatment for secere P falciparum
IV/IM artesunate then 3 days of oral ACT
Ddx of painful genital ulcers
HSC
Chancroid
Ddx of painless genital ulcers
syphilis
LGV
Donovanosis
Renal transplant, what is the msot likely o rganism to cause a bacterial meningitis
strep pneumoniae
What is the galactomannan assay specific for in testing for fungal disease
aspergillosis
Recurrent neisseria meningitis infections - what immunodeficiency
complement deficiency
What is the optimal timing for pre-op cephazolin administration
60 min prior to surgery
(same for other abx except vancomycin which should be started 30-120 min before insertion)
what organisms don’t produce nitrates on urinalysis
enterococci, staphylococci (Staphylococcus saprophyticus), Acinetobacter, or adenovirus
