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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
Q

Extra hepatic C/P of HCV

A

Cryoglobulinemia, Lichen planus, and membranoproferative GN

26
Q

TENOFAVIR

A

Chronic HBV TTT
Most potent viral suppresion
Associated with osteopenia

27
Q

Telbivudine

A

Chronic hbv treatment
Safe in pregnancy
High incidence of resistance

28
Q

Entecavir

A

Acute and chronic ttt hbv infection
Oral, potent, low side effect but expensive

29
Q

Safe chronic hbv ttt in pregnancy

A

Lamivudine (least expensive)
Telbuvidine

30
Q

Locally invasive collitis with uncommom bacterimia

A

Shigellosis

31
Q

Shedding of bacteria in shigellosis

A

Lasts for 1 to 2 weeks after they are ill

32
Q

C/P of shigallosis

A

Abd cramp 1-5 days after infec
Bloody + mucus diarrhea
Diarrhea 30times/day
Resolves 5-7days ( with exceptions)

33
Q

Rieter’s syndrome

A

Cant see, cant pee, cant climb a treaa
Conjunctivitis, urethritis, arthritis post infection (shigallosis)

34
Q

Shigallosis complications

A
  1. Toxic megacolon
  2. Perforation
  3. Hyponateremia and convulsions
  4. Protien losing enteropathy
  5. HUS
  6. Rieter’s syndrome
35
Q

Antibiotics for shigella

A

Ampicillin, TMP-SMX , Nalidixic acid, Fluoroquinolone

36
Q

Antibiotic with Ecoli O157 ??

A

Not used, only supportive therapy. Increase the risk for HUS
Same for antidiarrheal like Lomdium

37
Q

Infants and Traveler’s diarrhea

38
Q

Voluminous watery diarrhea up to 10times a day

A

ETEC
Lasts about 5 days with anorexia vomiting and abd cramps

39
Q

ETEC treatment

A

Fluid+ electrolytes mainstay
Antibiotics shorten duration= fluoroquinolone and azithromycin

40
Q

Profuse watery diarrhea with hypotension

41
Q

V. Cholera selective culture media

A

TVBS Thiosulfate citrate bile salt sucrose

42
Q

Risk factor for C difficile

A

Old age
Healthcare environment
Broad spectrum antibiotics
Acid suppression medication

43
Q

First line ttt for c difficile

A

Vancomycin
If not: metronidazole

44
Q

Leading cause of Life threatening diarrheal ds amongest children

A

Rota virus

45
Q

Diarrhea defined as

A

Passing stool weight > 200gm or volume > 200ml per 24hrs
Increase in the frequency, liquidity or volume of stool

46
Q

GI TB commonest site

A

Jejeno-ileal or ileo-cecal

47
Q

C/p of GI TB

A

IBS with Abd pain and diarrhea, hematochezia and onstruction
Mimics appendicitis
Ulceration and fistulas

48
Q

TB meningitis in endemic areas

A

Common from birth -5yrs

49
Q

Commonest geniturinary TB infection site in men

A

Epididymis

50
Q

Sterile pyuria and s/s of pyelonephritis

A

Think of genitourinary TB

51
Q

Miliary TB is most common among

A

Chimdren <4 yrs
Elderly
Immunocompromised

52
Q

TB of bone and joints mostly

A

Axial > peripheral
LL > UL

53
Q

False negative tuberclin test

A
  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
Q

Pyrazinamide precautions

A

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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