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Tropical Flashcards

1
Q

Most common cestode infec

A

Hymnolepis Nana

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2
Q

Tenea solium

A

Undercooked pork

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3
Q

4 key findings in fasciola infection

A

Fever
Jaundice
Hepatomegaly
Hyperesinophilia

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4
Q

Water lily sign

A

U/S separation of germinal membrane of hydatid cyst

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5
Q

Complications of hydatid cyst rupture

A
  1. Anaphylaxis and allergy
  2. Dissamination
  3. Cholangitis
  4. Hemoptysis and secondary infection if bronchial
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6
Q

What is PAIR in percutanous drainage of Hydatid cyst larger than 5cm?

A

Done if pt is inoperable:

  1. Puncture
  2. Aspiration
  3. Installation of cysticidal then hypertonic saline/ ethanol for 5-10min
  4. Re-aspirate
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7
Q

Hydatid medical treatment

A

Albendazole 400mg x 2/day
If <5 cm for 6 months
As per drugs.com
28days cycle then 14days drug free interval, for a total of 3 cycles

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8
Q

Pyogenic liver abcess commonly caused by?

A

Polymicrobial most commonly Ecoli and K. Pneumonea

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9
Q

Diration of medical therapy after PAIR hydated

A

1 month albendazole and 4 days before

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10
Q

Most common site of pyogenic liver abcess

A

Biliary tract

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11
Q

Anchovy sauce

A

Amoebic liver abscess acellular debris

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12
Q

Infective stage of amoeba

A

Cyst

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13
Q

TTT pyogenic liver abcess

A

Medical ( 6 to 12 weeks) and surgical (or drain)

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14
Q

Mainstay of diagnosis in invasive amoebiasis

A

Detection of Ab (serology)

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15
Q

TTT of amoeba

A

Luminal:
1. Paromomycin 25mg/kg x 3/day for 10days, diloxanide 500mgx3x10

Tissue;
Metronidazole 800mgx3x10 (is luminal as well.
Tinidazole 2gm for 3 days

Abscess up to 10cm can be cured with metronidazole without drainage

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16
Q

Surgical indication for Amoebic liver abscess

A
  1. Possible pyogenic liver abscess
  2. Not responding to metronidazole 4days
  3. Large left sided abcess
  4. Severely ill patient
  5. Empyema from rupture
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17
Q

U/S for liver amoebiasis

A

Sensitive but not specific

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18
Q

Flask shaped ulcer

A

Intestinal amobiases

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19
Q

Serology in liver abscess

A

Mainstay Diagnostic but could have false negative in 1st week

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20
Q

Non infectious causes of chronic hepatitis

A

NASH
Alcoholic
Metabolic: hemosidrosis..
Drug induced: phenytoin INH Methyldopa macrodantin

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21
Q

Viral hepatitis in which fever fail to subside with icetric phase?

A

CMV

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22
Q

Complications of Acute hepatitis A infec

A

1 acute fulminant hepatits
2. Cholestatic hepatitis
3. Nephrotic syndrome
4. Relapsing hepatits

23
Q

Screening for HCC done by

A

Abd U/S
Alfa feto protien

24
Q

Extra hepatic C/P of HBV

A

Aplastic anemia and membranous GN

25
Extra hepatic C/P of HCV
Cryoglobulinemia, Lichen planus, and membranoproferative GN
26
TENOFAVIR
Chronic HBV TTT Most potent viral suppresion Associated with osteopenia
27
Telbivudine
Chronic hbv treatment Safe in pregnancy High incidence of resistance
28
Entecavir
Acute and chronic ttt hbv infection Oral, potent, low side effect but expensive
29
Safe chronic hbv ttt in pregnancy
Lamivudine (least expensive) Telbuvidine
30
Locally invasive collitis with uncommom bacterimia
Shigellosis
31
Shedding of bacteria in shigellosis
Lasts for 1 to 2 weeks after they are ill
32
C/P of shigallosis
Abd cramp 1-5 days after infec Bloody + mucus diarrhea Diarrhea 30times/day Resolves 5-7days ( with exceptions)
33
Rieter’s syndrome
Cant see, cant pee, cant climb a treaa Conjunctivitis, urethritis, arthritis post infection (shigallosis)
34
Shigallosis complications
1. Toxic megacolon 2. Perforation 3. Hyponateremia and convulsions 4. Protien losing enteropathy 5. HUS 6. Rieter’s syndrome
35
Antibiotics for shigella
Ampicillin, TMP-SMX , Nalidixic acid, Fluoroquinolone
36
Antibiotic with Ecoli O157 ??
Not used, only supportive therapy. Increase the risk for HUS Same for antidiarrheal like Lomdium
37
Infants and Traveler’s diarrhea
ETEC
38
Voluminous watery diarrhea up to 10times a day
ETEC Lasts about 5 days with anorexia vomiting and abd cramps
39
ETEC treatment
Fluid+ electrolytes mainstay Antibiotics shorten duration= fluoroquinolone and azithromycin
40
Profuse watery diarrhea with hypotension
Cholera
41
V. Cholera selective culture media
TVBS Thiosulfate citrate bile salt sucrose
42
Risk factor for C difficile
Old age Healthcare environment Broad spectrum antibiotics Acid suppression medication
43
First line ttt for c difficile
Vancomycin If not: metronidazole
44
Leading cause of Life threatening diarrheal ds amongest children
Rota virus
45
Diarrhea defined as
Passing stool weight > 200gm or volume > 200ml per 24hrs Increase in the frequency, liquidity or volume of stool
46
GI TB commonest site
Jejeno-ileal or ileo-cecal
47
C/p of GI TB
IBS with Abd pain and diarrhea, hematochezia and onstruction Mimics appendicitis Ulceration and fistulas
48
TB meningitis in endemic areas
Common from birth -5yrs
49
Commonest geniturinary TB infection site in men
Epididymis
50
Sterile pyuria and s/s of pyelonephritis
Think of genitourinary TB
51
Miliary TB is most common among
Chimdren <4 yrs Elderly Immunocompromised
52
TB of bone and joints mostly
Axial > peripheral LL > UL
53
False negative tuberclin test
1. Very recent infection 2. Very old infection 3. Very young infant <6mo 4. Cutanous anergy 5. Severe Tb ds 6. Recent live virus vaccine (measles small pox
54
Pyrazinamide precautions
DM : gluc level liable Incr gout Renal failure take it 3 times a week not daily Porphyria Hepatitis

Clinical Flashcards (10 decks)

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