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1
Q

BV

  1. Cause
  2. Symptoms
A
  1. Mixture of bacteria, occurs when normal vaginal flora is disrupted
  2. ASYMPTOMATIC
    - Fishy thin discharge, esp after sex
    - May have irritation (not itchy)
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2
Q

BV

  1. Investigations
  2. Treatment
A
  1. Microscopy - CLUE CELLS. Positive AMINE test

4. METRONIDAZOLE

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3
Q

Gonorrhoea

  1. Cause
  2. Symptoms
A
  1. Gram -ve diplococcus Neisseria gonorrohoeae

2. 50% asymptomatic, inc/altered discharge, lower abdo pain, dysuria WITHOUT frequency

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4
Q

Gonorrhoea

  1. Investigations
  2. Treatment
A
  1. Culture

4. CEFTRIAXONE 500mg stat (IM) + AZITHROMYCIN 1g stat (PO)

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5
Q

Trichomonas Vaginalis

  1. Cause
  2. Symptoms
A
  1. Parasite Trichomonas vaginalis. Usually sexually acquired
    • Yellow/green, thin, frothy, offensive discharge
    • Irritation
    • Dyspareunia
    • Dysuria WITHOUT frequency
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6
Q

Trichomonas Vaginalis

  1. Investigations
  2. Treatment
A
  1. STRAWBERRY CERVIX & culture
  2. METRONIDAZOLE 400mg BD 5/7

N.B. send to GUM as often has another STD

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7
Q

Fragile X Syndrome

  1. Cause
  2. Presentation
A
  1. Mutated FMR1 gene on X chromosome
  2. LARGE TESTICLES & LONG FACE
    - Hyperextensible fingers, soft skin, hypotonia
    - Delayed milestones
    - Learning difficulties, IQ <70
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8
Q

Williams Syndrome

  1. Cause
  2. Presentation
A
  1. Deleted gene from chromosome 7 - autosomal DOMINANT
  2. “Elfin” appearance
    - Short
    - Learning disability
    - Friendly & extroverted
    - Transient neonatal hypercalcaemia
    - Aortic stenosis
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9
Q

Edwards Syndrome

  1. Cause
  2. Presentation
A
  1. Trisomy 18

2.

  • Rocker bottom feet
  • Microcephaly
  • Low set ears, micrognathia, cleft lip/palate
  • Overlapping fingers
  • Clenched hands & underdeveloped thumns/nails
  • Absent radius

N.B 80% cases are FEMALE

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10
Q

Patau Syndrome

  1. Cause
  2. Presentation
A
  1. Trisomy 13
    • Congenital heart defects (80%)
    • Microcephaly
    • Midline facial defect
    • Cleft lip/palate, small eyes, micropthalmia
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11
Q

Noonan Syndrome

  1. Cause
  2. Presentation
A
  1. Genetic - autosomal DOMINANT
    • Webbed neck
    • Pectus excavatum
    • Short
    • Pulmonary stenosis
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12
Q

Pierre-Robin Syndrome

  1. Cause
  2. Presentation
A
  1. DNA mutation near SOX9 gene
    • Micrognathia
    • Posterior tognue displacement –> upper airway obstruction
    • Cleft palate
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13
Q

Prader-Willi Syndrome

  1. Cause
  2. Presentation
A
  1. Loss of function of genes on chromosome 15

2. Hypotonia, hypogonadism, obesity

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14
Q

Cri du chat Syndrome

  1. Cause
  2. Presentation
A
  1. Chromosome 5p deletion
  2. Characteristic cry
    - Feeding difficulties
    - Poor weight gain
    - Learning difficulties
    - Microcephaly
    - Micrognathism
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15
Q

Hypersensitivity reaction
- Mediator & mechanism

Type 1 e.g. atopy
Type 2 e.g. blood transfusion
Type 3 e.g. erythema nodosum
Type 4 e.g. allergic contact dermatitis
Type 5 e.g neonatal hyperthyroid
Type 6 e.g. tumour rejection
A
  1. IgE - RAPID (30 mins) reaction to specific antigens
  2. IgG & IgM - intravascular reaction
  3. Immune complex - activate complement to cause local tissue damage
  4. Lymphocytes - secondary cellular response, appears 48-72hrs after exposure
  5. IgG - directed towards cell surface antigens
  6. Killer cells - lyse target cells coated by antibody
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16
Q

Malaria

  1. Presentation
  2. Investigations
  3. Treatment
A

Manifests weeks after leaving endemic area

  1. HEADACHE
    - Flu-like illness
    - Fever is REMITTING (diurnal variation)
    - Diarrhoea/GI sx

Severe –> splenic rupture, cerebral malaria, anaemia, renal failure & pulmonary oedema

  1. Giemsa-stained thick & thin peripheral blood smears
  2. Artemsinin combo therapy (ACT), quinine
17
Q

Typhoid

  1. Cause
  2. Presentation
  3. Investigation
A
  1. Salmonella typhi

Typhoid fever begins 7-14 days after ingestion

  1. RISING TEMP over course of each day
    - 1st week: GI sx, blanching rash
    - 2nd week: splenomegaly, bradycardia
    - 3rd week: abdo distension, “pea soup” diarrhoea, bowel perf + peritonitis
    - 4th week: slow improvement
  2. Culture
18
Q

Dengue

  1. Cause
  2. Presentation
  3. Investigation
A
  1. Dengue VIRUS (mosquitoes)
  2. HIGH FEVER (>40) & FACIAL FLUSHING
    - Red skin mottling
    - Headache, N+V, myalgia, arthralgia
    - Haemorrhagic sx
    - Abdo pain
    - Cardiomyopathy
  3. Serology - rise in ANTIBODY titre in IgG/IgM
19
Q

Schistosomiasis

  1. Cause
  2. Presentation
A
  1. Flatworm (5 species) that live in fresh water
    • Acute: “swimmer’s itch” & Katayama syndrome (mimics generic acute illness)
    • Chronic depends on type, can involve most organs
20
Q

Amoebiasis

  1. Cause
  2. Presentation
A
  1. Entamoeba histolytica transmitted via ingestion of cystic protozoa
  2. LIVER ABSCESS
    - Dysentery
    - Colitis sx
21
Q

Toxoplasmosis

  1. Cause
  2. Presentation
    - Adults
    - Fetus/immunocompromised
A
  1. Toxoplasma gondii parasite (CATS)

2.
- Self-limiting flu-like illness

  • CNS involvement (encephalitis, hemiparesis, speech changes, neuropsych)
  • Pneumonitis
  • Ocular (pain + loss of visual acuity)
22
Q

Chlamydia

  1. Cause
  2. Presentation
  3. Complications
A
  1. Gram-negative bacteria
  2. ASYMPTOMATIC
    - Tracoma (ocular)
    - GU infections
    - Lymphogranuloma venereum (painLESS genital ulcers + lymph nodes)
  3. PID, ectopic pregnancy, tubal infertility, epidydimo-orchitis
23
Q

Chlamydia

  1. Investigation
  2. Treatment
A
  1. Nucleic acid amplification tests (NAATs)
    - Men first void urine
    - Women swab or urine
  2. Azithromycin 1x dose (or doxy BD for 7/7)

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