Infectious Disease Flashcards

1
Q

What is HIV and when was it first recognised?

A

Human immunodeficiency virus

1984

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2
Q

When has treatment for HIV been available since?

A

1996

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3
Q

How many people are living with HIV now worldwide?

A

37 million people

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4
Q

How many people are living with HIV in the UK now? How many are undiagnosed?

A

100 000

18000 undiagnosed

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5
Q

How many new diagnoses of HIV are made each year in the uk?

A

6000 a year, mainly 20-39 year olds

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6
Q

What is the mortality of HIV if diagnosed late when CD4 count is less than 100?

A

8% at 1 year

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7
Q

What is the mortality rate of HIV when diagnosed early, when CD4 count is more than 200?

A

0.5% mortality at 1 year

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8
Q

What is normal CD4+ T cell levels and what is it when opportunistic infections arise?

A

500+ normal

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9
Q

When should you be tested again for HIV if risk of exposure?

A

Test when exposed and 3 months after

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10
Q

Who should be routinely tested for HIV?

A
Men who have sex with men
IV drug users
Pregnant women
Anyone with another STI/partner has STI
From a country of high prevalence or partner from that country
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11
Q

Indicators for HIV testing?

A
Any opportunistic infection
Pneumonia
Blood disorders
Weight loss
Shingles
Lymphadenopathy
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12
Q

Name the 5 most common opportunistic infections

A
Seroconversion illness 
Pneumocystis jirroveci pneumonia (PCP)
Toxoplasmosis gondii
Kaposi's sarcoma
Tuberculosis
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13
Q

What is seroconversion illness also called?

A

Acute HIV syndrome
Similar to glandular fever
Can drop CD4+ counts low enough to get infections

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14
Q

What is the commonest opportunistic infection in the UK?

A

Pneumocystis Jirroveci pneumonia

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15
Q

Signs and symptoms of PCP pneumonia? Treatment?

A

Subacute insidious onset of breathlessness, fever, cough
Progressive hypoxia
Treatment= co-trimoxazole +/- steroids

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16
Q

Toxoplasmosis gondii

A

Protozoan parasite
May be latent and reactivated when immunocompromised
Space occupying lesion in brain
Treated with sulfadiazine and pyrimethamine

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17
Q

Kaposi’s sarcoma

A

AIDS associated cancer
Vascular tumour of spindle cells -> dark red pigmented lesions
Skin and viscera
Driven by co-infection with HHV-8

18
Q

What is the most common complication of HIV worldwide?

A

TB

19
Q

Who should be giver ART?

A

All people with HIV at any CD4+ count

-> prevents onward transmission, extends life and improve health

20
Q

What is PrEP and who should be on it?

A

Pre-exposure prophylaxis
Anyone at substantial risk of HIV
(serodiscordant couples, sex workers, injecting drug users, men who have sex with men/transgender women, transgender people, prisoners)

21
Q

What is a community acquired infection?

A

An infection contracted outside of a healthcare setting, or present

22
Q

Why is it important to know if an infection is community or hospital acquired?

A

Different organisms and resistance patterns

Community cases are a potential marker for developing outbreaks

23
Q

What is the most common community and hospital acquired cause for pneumonia?

A

Comm: Strep pneumonia
Hosp: Gram -ve E.coli/Klebsiella

24
Q

What is the most common community and hospital acquired cause for meningitis?

A

Comm: Strep pneumonia
Hosp: Gram -ve E.Coli/Klebsiella

25
Q

What is the most common community and hospital acquired cause for UTI?

A

Comm: E.coli
Hosp: E. coli

26
Q

What are the main infective organisms for hospital acquired infections?

A

Gram -ve E.coli and Klebsiella
Pseudomonas
Staph aureus

27
Q

What are the 2 main infective organisms for community acquired infections?

A

Strep pneumoniae

Haemophilus influenzae

28
Q

Signs and symptoms of meningitis

A
Headache, neck stiffness, photophobia
CSF raised WCC and raised protein
Meningeal enhancement on CT
Sepsis?
Rash (in neisseria meningitis)
29
Q

What is the most common cause of meningitis in the young versus old

A

Viral in young

meningococcal if older

30
Q

Why is travel history useful in meningitis presentation?

A

Tick borne encephalitis
West nile virus
Lyme’s disease

31
Q

Treatment of meningitis?

A
Stabilise airway, breathing, circulation
Intensive care? Senior review?
GCS documented
Blood cultures and nasopharyngeal swab
LP if not shock or sever sepsis
Start treatment (antibiotics) 
Fluid resus if septic
32
Q

If CSF us cloudy/purulent, what is likely?

A

Bacterial meningitis

33
Q

If CSF is viscous and clear/opaque what is likely?

A

TB meningitis

34
Q

If CSF is clear, what is likely?

A

Viral meningitis

35
Q

If CSF >90% neutrophils present and low protein, what is likely?

A

Bacterial meningitis

36
Q

If CSF has few neutrophils plus low protein what is likely?

A

Viral meningitis

37
Q

if CSF has high protein and low glucose, what is likely?

A

TB meningitis

38
Q

What antibiotics usually treat bacterial meningitis?

A

Ceftriaxone/Cefoxione IV

39
Q

If meningitis is penicillin resistant pneumococci?

A

Add vancomycin IV

40
Q

Complication of meningitis infection?

A

Subdural empyema
Seizures
Hydrocephalus
Central venous sinus thrombosis