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Nimna's Flash Cards > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

Biggest risk factor for invasive mould infections

A

Graft vs Host Disease.

severe grade 3-4(C-D)
GVHD which is classified as:
erythroderma + bilirubin 100
-300 +severe diarrhoea

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2
Q

Encapsulated organisms

A

S. pneumoniae
N. Meningiditis
H. Influenzae

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3
Q

Organisms that are silver stain positive

A

Bacteria - Pseudomonas, Legionella, H. pylori, Bartonella and Treponema,
fungal - Pneumocystis, Cryptococcus, and Candida.

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4
Q

Quantiferon gold negative in HIV patient. Develops lymphadenopathy after starting treatment. ?Cause.

A

TB - due to IRIS.

Quantiferron gold can be negative in HIV

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5
Q

Treatment of c.diff

A
  1. Vancomycin or fidaxomicin

2. Faecal transplant

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6
Q

Treatment for ventilator associated enterococcus

A

Linezolid

Daptomycin is inactivated by surfactant

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7
Q

Difference between E. Faecium and E. Faecalis.

A 
Faecium = monster. High resistance. 
Faecalis = less resistance
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8
Q

MOA of Gentamicin

A

Inhibition of protein synthesis by binding to 30S subunit

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9
Q

CNS infection with high opening pressure

A

TB

Cryptococcus

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10
Q

Type of meningitis which steroids are contraindicated

A

Cryptococcal meningitis

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11
Q

Reasons to delay anti-retro viral therapy in HIV

A

TB meningitis
Cryptococcal meningitis

Treat for at least 6 weeks

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12
Q

CMV treatment in D+/R- renal transplant

A

Oral valganciclovir

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13
Q

Type of malaria that causes hypoglycaemia

A

M. Falciparum

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14
Q

Penicillin’s do not easily cross the BBB. Why are penicillin’s used in the treatment of meningitis?

A

Inflammation on the meninges causes increased permeability of the BBB

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15
Q

For plasmodium ovale and Vivax, which agent needs to be used to prevent recurrence and why?

A

Primaquine - to eliminate liver hypnozites of ovale and vivax.

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16
Q

Alcohol rub is not effective in killing which pathogen

A

C.diff

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17
Q

Cephalosporin active against pseudomonas

A

Cefepime

Ceftazidime

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18
Q

Cephalosporin active against MRSA

A

Ceftaroline

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19
Q

NAP1 strain of C.diff

A

produces a binary toxin

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20
Q

Order of pneumovax post splenectomy

A
  1. conjugate

2. Polysaccharide

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21
Q

HIV testing in pregnant women requires what type of test

A

Western blot

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22
Q

How does VRE form.

A

Vancomycin works on Enterococcus by binding to cell wall precursor molecules.
VRE forms by changing the structure of the cell wall precursor proteins to ones that Vancomycin cant bind to.

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23
Q

Extensively drug resistant TB

A

Resistant to:

  • Rifampicin
  • Isoniazid
  • Moxifloxacin
  • Amikacin
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24
Q

Antibiotic inactivated with surfactant

A

Daptomycin

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25
Q

oral agent for MRSA

A

Bactrim

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26
Q

Management of HIV in pregnancy

A

Start ART
Give additional zidovudine IV in 3rd trimester if viral load >1000.
Post exposure prophylaxis for baby after birth

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27
Q

Cause of TB reactivation in Anti-TNF therapy

A

reduced macrophages and lymphocytes in lungs.

maintenance of TB granulomas

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28
Q

E.coli producing shiga toxin gene

A

O157:H7

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29
Q

Recurrent meningitis cause

A

HSV2

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30
Q

Gentamicin efficacy pharmacodynamics

A

Cmax/MIC

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31
Q

Empiric therapy for GPC meningitis

A

4g Ceftriaxone + Vancomycin + dexamethasone

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32
Q

Mx of anaerobic aspiration pneumonia

A

Clindamycin

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33
Q

What is Panton-Valentine leukocidin

A

A toxic produced by Staph Aureus that causes pyodermic infections (pus).
Works by leukocyte destruction and tissue necrosis

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34
Q

Staph aureus toxin that allows pulmonary infection

A

alpha- haemolysin

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35
Q

Live vaccines

A 
Varicella/ VZV 
Japanese encephalitis 
MMR 
BCG 
oral typhoid 
Rotavirus 
yellow fever
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36
Q

EBV infects which cell type

A

B cells

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37
Q

Bacteria which can be found intracellularly

A 
Listeria
Mycobacteria
Brucella
rickettsia 
chlamydia
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38
Q

Endotoxins are produced by what type of bacteria

A

Gram negative bacteria + Listeria

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39
Q

Treatment for Listeria

A

Ampicillin/Ben Pen

- resistant to Cephalosporins

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40
Q

Cell type affected in PML

A

Oligodendrocyte

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41
Q

Pathophysiology of Toxic shock and super antigens

A

Super antigen - eg staph aureus.

The toxin has direct activation of MHC2 which activates a variable part of the T-cell beta chain, causing activation of a very high number of T cells.

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42
Q

MOA of tetanus toxin

A

sustained excitatory discharge of alpha motor neurons

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43
Q

Toxin associated with HCC

A

aspergillus toxin

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44
Q

Management for genital warts (HPV)

A

Imiquimod

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45
Q

Management for Pediculosis Pubis (pubic lice) and scabies.

A

Permethrin

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46
Q

Management for Syphilis

A

Benzathine Penicillin

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47
Q

Management for Chlamydia

A

STAT Azithromycin or 1 week Doxycycline

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48
Q

Management for gonorrhoea

A

STAT Ceftriaxone + Azithromycin or 1 week doxycycline.

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49
Q

Management for Lymphogranuloma venereum

A

doxycycline

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50
Q

Presentation of Lymphogranuloma venereum (type of chlamydia)

A

lymphangitis, areas of necrosis occur within the nodes, followed by abscess formation

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51
Q

Symptoms of HIV myelopathy

A

A vacuolar myopathy, seen in AIDS.
spastic paraparesis is accompanied by loss of vibration and position sense and urinary frequency, urgency, and incontinence. Upper-extremity function is usually normal.

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52
Q

HIV drug causing lipoatrophy

A

zidovudine

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53
Q

Sign of c.diff on colonoscopy

A

pseudomembranous colitis

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54
Q

Infection unique to sickle cell anaemia

A

Salmonella Osteomyelitis

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55
Q

Management of meningococcal exposure

A

Cipro or Ceftriaxone + Meningococcal vaccination.

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56
Q

Meningococcal vaccine available

A

Conjugate vaccine - Meningococcal C + tetanus toxin
Combo vaccine - Haemophillus influenzae B + Meningococcal C + tetanus toxin
Combination Vaccine - Meningococcal A, C, W, Y
Meningococcal B vaccine

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57
Q

treatment of strongyloides

A

ivermectin

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58
Q

Syphilis screening test

A

EIA

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59
Q

Syphilis monitoring tests

A

RPR, VDRL

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60
Q

Test for Cryptococcus

A

Latex agglutination test (good for detecting Cryptococcus, bad for detecting meningococcus)
ELISA

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61
Q

hole punch brain

A

neurocysticercosis

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62
Q

Jarisch-Herxheimer reaction

A

Occurs when Abx are given in Syphilis - causes release of endotoxins resulting in flu like symptoms

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63
Q

Mechanism of Penicillin resistance

A

Cleavage of the β-lactamring by β-lactamases (penicillinases)
PBP mutations

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64
Q

Carbapenem side effects

A

Secondary fungal infections [11]
CNS toxicity: can lower seizure threshold at high serum concentrations
Highest risk: imipenem
Lowest risk: meropenem

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65
Q

Bezlotoxumab MOA

A

is a human IgG1 monoclonal antibody which binds to C. difficile toxin B

66
Q

Mx of Schiotosomiasis

A

Praziquantel

67
Q

Polyenes (Amphotericin) MOA

A

Binds to ergosterol in the fungal cell wall forming pores.

68
Q

Polyenes (Amphotericin) SE

A 
Arrhythmias 
Hearing loss 
Infusion reactions 
Nephrotoxicity 
Neurotoxicity
69
Q

Azoles MOA

A

Reduces activity of fungal cytochrome P450, reducing ergosterol formation

70
Q

Azoles SE

A 
Hepatotoxicity 
Gynaecomastia 
Long QT 
Hypokalemia 
Visual changes - voriconazole
71
Q

Echinocandins MOA

A

Inhibit Beta-glucan synthesis in cell wall

72
Q

Echinocandins SE

A

Hepatotoxic
Flushing
Hypotension
Fever

73
Q

Drug used in invasive aspergillosis

A

Voriconazole

74
Q

Mx of systemic candidiasis

A
  • IV Amphotericin B
  • ECHO
  • Ophthalmoscopy
75
Q

Mx Cryptococcus

A

first 2 weeks - Amphotericin B + flucytosine

Ongoing - Oral fluconazole

76
Q

Post exposure prophylaxis of varicella

A
  • varicella vaccine -> IF significant exposure within the last five days. (not pregnant or immunocomprimised)
  • If unable to have vaccine –> varicella immune globulin (Varizig) if it can be given within 10 days of exposure.
  • For sufficient immunity in immunocomprimised patients, they must have adequate IgG titres AND Hx of vaccination/ exposure.
77
Q

Most common pathogen in febrile neutropenia

A

Staph Epidermidis

78
Q

Most common cause of travellers diarrhoea

A

E.coli

79
Q

Management of Staph prosthetic joint infections.

A

MSSA - Fluclox
MRSA - Vanc

For patients with S. aureus PJI and residual hardware following surgery - adjunctive use of rifampin + Ciprofloxacin - for BIOFILM.

80
Q

Cause of false positive HIV test

A

CAR-T therapy

81
Q

Empirical Mx of septic arthritis/ Osteomyelitis

A
  • surgical drainage

- IV fluclox 4-6 hourly

82
Q

In hospital Mx of Malaria

A

IV Artesunate
IV Ceftriaxone
Paracetamol

83
Q

Rifaximin increases the risk of what infection.

A

Increases risk of MRSA

84
Q

Empirical therapy for Candida Auris

A

Echinocandins (Micafungin)

85
Q

Most common cause of portal hypertension worldwide

A

Schistosomiasis

86
Q

Incubation and symptoms of Leptospirosis

A

Incubation 7-30days

Sympt: Conjunctival haemorrhage, GIT symptoms, aseptic meningitis.

87
Q

Long term Rifaximin use (used for hepatic encephalopathy) can lead to resistance of what organism?

A

Staph aureus

88
Q

HIV testing method

A

Test ELISA antigen and antibody

89
Q

Treatment of Listeria

A

Penicillin’s - usually ampicillin

90
Q

Management of animal bite

A

Prophylaxis - Augmentin DF or Doxy/Cipro with Metro/Clinda for anaerobes.

91
Q

Organisms with low ID50

A

Shigella, coxiella burnetti, EHEC, M bovis, TB, Rickettsia

92
Q

Diseases caused by Human T lymphocyte virus 1.

A

Adult T cell leukemia-lymphoma (ATL) and HTLV-I-associated myelopathy (HAM), also known as tropical spastic paraparesis (TSP)

93
Q

When is tetanus immunoglobulin required?

A

When the wound is deep/contaminated and patient has had <3 tetanus doses.

94
Q

Infections needing droplet precautions

A 
B - Bordatella pertussis
I - Influenza/ Cold viruses
R - Rhinovirus 
D - Diptheria
M - Mumps
A - adenovirus 
N- Neisseria Meningitis
95
Q

Infections needing airborne precautions

A

T -Tuberculosis
E
M - Measles
P - Pox - chicken pox, small pox.

96
Q

Reason why Ceftriaxone and Paracetamol are given in Malaria treatment

A

Ceftriaxone - high risk of bacterial co-infection

Paracetamol - reduces risk of haemorrhagic AKI

97
Q

Reasons to add Vancomycin in neutropenic sepsis

A
  • suspected catheter‐related infections
  • known colonisation or recent positive blood culture with a resistant organism.
  • haemodynamic instability
  • recently taken cipro or Bactrim
98
Q

Timing for pneumococcal vaccinations in splenectomy

A

Vaccines to be given 8 weeks apart - first the conjugate vaccine then the polysaccharide.
Vaccines to be given atleast 14 days before or 7 days after splenectomy.

99
Q

Pneumococcal conjugate vaccine is conjugated to which protein

A

diphtheria toxin like protein.

100
Q

Risk of vertical transmission of HIV in UNTREATED patient.

A

perinatal period - 25%
breast feeding - 15%

If treated with suppressed viral load <1%

101
Q

MOA of Aertemisinins in malaria therapy

A

Artemisinins appear to act by binding iron, breaking down peroxide bridges, leading to the generation of free radicals that damage parasite proteins.

102
Q

Why are Aertemisinins used in combination only?

A

To prevent rapid formation of resistance

103
Q

Most common infectious agent in post influenza pneumonia

A

Staph aureus

104
Q

Most common bug causing empyema

A

Strep pneumonia

105
Q

N. meningitidis gram stain

A

Gram negative diplococci.

Associated with petechial rash

106
Q

Method of diagnosing culture negative endocarditis

A

16S RNA PCR

107
Q

Features of “severe” c.diff

A
  • Shock/hypotension
  • Ileus
  • megacolon
  • WCC >15

Abx therapy - non-severe 10 days

108
Q

Most common organisms in chronic granulomatous disease.

A
  1. aspergillus
  2. staph aureus
  3. Pseudomonas
  4. Serratia
  5. Nocardia
109
Q

Most common organism in viral meningitis

A

Enterovirus

110
Q

Increased risk of which organism causing meningitis on TNFa inhibitors

A

Listeria meningitis

111
Q

Which type of meningococcal does the vaccine not cover?

A

meningococcal B

112
Q

Treatment for HSV 1 meningitis

A

Aciclovir

113
Q

Teratment for HSV 6 meningitis

A

Gancyclovir

114
Q

EEG pattern in HSV encephalitis

A

periodic lateralising epileptiform discharges

115
Q

Gene in CJD

A

PRNP gene

116
Q

Treatment of TB meningitis

A

Rifampicin
Isoniazid
Pyrazinamide
Streptomycin/ Moxifloxacin

Replace ethambutol as it has poor CNS penetration

117
Q

HRZE side effects

A

R - drug interactions
I - B6 deficiency causing peripheral neuropathy, Hepatitis
P - hyperuricemia, GI upset, hepatitis
E - optic neuritis

118
Q

Mx for ABPA

A

Itraconazole + steroids

119
Q

Ix for aspergillus

A

galactomannan, beta D glucan

120
Q

In which disease do you see elementary and reticulate bodies?

A

Chlamydia

121
Q

STI causing rash on palms and soles

A

Syphilis

122
Q

Definition of “severe” malaria

A

Neuro - GCS <11 , Generalised weakness preventing movement , > 2 convulsions in 24hrs

Haem - Hb <50, Jaundice (from haemolysis), Significant bleeding.

Parasitaemia >10%

Shock related - Acidosis , Hypoglycaemia , AKI, APO.

123
Q

Travel bug with long incubation

A

malaria

124
Q

Least severe form of malaria

A

F. malariae

125
Q

Malaria prophylaxis and duration

A

Hydroxychloroquine - start 2 weeks before and continue 4 weeks after.

Doxycycline - start 2 days before and continue 4 weeks after.

126
Q

Differentiating features of Typhoid

A

Rose spots
Constipation
Intestinal haemorrhage/ perforation.

127
Q

Management of typhoid (ABx)

A

Ceftriaxone

Ciprofloxacin

128
Q

Gram stain of Typhoid

A

gram negative bacillus

129
Q

Gram stain and management of Rickettsia

A

GNB, treat with doxycycline.

130
Q

Management for Campylobacter (Abx)

A

Azithromycin

131
Q

Management for shigella (Abx)

A

Ciprofloxacin

132
Q

frequency of HIV testing for patients on PrEP

A

3 monthly

133
Q

HIV drug causing neural tube defects

A

Dolutegravir

134
Q

When is dolutegravir + TDF preferred over dolutegravir + lamivudine

A

Based on the results of two large, randomized controlled trials that showed that a two-drug regimen of DTG plus lamivudine (DTG/3TC) was noninferior to DTG plus tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC)

except for individuals:

  1. With pre-treatment HIV RNA >500,000 copies/mL;
  2. Who are known to have active hepatitis B virus (HBV) coinfection; or
  3. Who will initiate ART before results of HIV genotype testing for reverse transcriptase or HBV testing are available.
135
Q

What to do if household contact of immunocompromised patient develops a rash post varicella vax

A

Cover rash
Avoid immunocompromised pt for duration of rash
No immunoglobulin required as disease will be mild

136
Q

HIV infection prophylaxis by CD4 count

A

CD4 <200 - Bactrim for PJP/ Toxo

CD4 < 50 - Azithromycin for MAC

137
Q

High risk areas for melioidosis

A

Thailand

Northern Territory

138
Q

Melioidosis gram stain and appearance

A

a Gram-negative rod with a characteristic “safety pin” appearance (bipolar staining).

139
Q

Presentation of Melioidosis

A

Pneumonia + abscesses in spleen and prostate

140
Q

Melioidosis treatment

A

Ceftazidime or Meropenem

141
Q

“booster” HIV drugs

A

cobicistat and ritonavir

142
Q

Testing required before Abacavir therapy

A

HLA-B5701

143
Q

Types of DNA transfer of bacteria (3)

A

Transformation - bacteria take up free DNA in the environment
Transduction - transfer of DNA between bacteria by a virus (bacteriophage)
Conjugation - bacteria TF DNA via plasmids

144
Q

Treatment of SBP

A

Ceftriaxone or Cefotaxime

145
Q

SBP prevention

A

Bactrim or Norflox

146
Q

New NEJM trial treatment for multi and extensively drug resistant TB

A

bedaquiline, pretomanid, and linezolid

147
Q

Which organisms does Bactrim cover

A 
PJP 
Toxoplasmosis 
MRSA
Nocardia 
Listeria
148
Q

When to add Gentamycin in feberile neutropenia

A

Sepsis

149
Q

Febrile neutropenia prophylactic agents

A
  • posaconazole
  • valaciclovir
  • ciprofloxacin
150
Q

Opportunistic infection commonly seen in heart lung transplants

A

Toxoplasmosis - treat with Bactrim

151
Q

Endocarditis treatment

  • Staph
  • Strep
  • Enterococcus
  • HACEK (slow growing)
  • Emperical
A
  • Staph - Flucloxacillin or Cephazolin. Vancomycin if MRSA or penicillin allergy.
  • Strep - Ben Pen + Gent or Ben Pen + Ceft
  • Enterococcus - Ben Pen + Gent or Vanc + Gent if penicillin allergy
  • HACEK (slow growing) - Ben Pen if penicillin sensitive, Ceftriaxone if not.
  • Emperical - Ben Pen + Fluclox + Gent.
152
Q

Post exposure prophylaxis for Meningococcal

A

Rifampicin/ Cipro/ Ceftriaxone

153
Q

Post exposure prophylaxis for Haemophilus influenza B

A

Rifampicin/ Ceftriaxone

154
Q

2nd line therapy for CMV

A

Foscarnet

155
Q

Supplement which helps recovery in measles

A

Vit A

156
Q

Antigen to test for in dengue

A

NS1

157
Q

complication of zika virus in pregnancy

A

microcephaly

158
Q

HLA protective in HIV

A

HLA-B5701

159
Q

SE Ritonavir

A

GI side effects

metabolic syndrome

160
Q

Which TB drugs are most hepatotoxic

A
  1. Pyrazinamide

2. Isoniazid

161
Q

MOA of Oseltamivir

A

Is a neuraminidase inhibitor - stops the new virus budding off the host cell.

Nimna's Flash Cards (15 decks)

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