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MSRA > Infectious Disease 2 > Flashcards

Infectious Disease 2 Flashcards

1
Q

Cutaneous larva migrans

Mx

A

Albendazole or Ivermectin

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2
Q

Rose spots and constipation
Caused by
Type of organism (-ve/+ve)

A

Typhoid
Salmonella
Gram-negative rods

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3
Q

HIV diarrhoea most common cause

A
  1. Cryptosporidium + other protozoa (most common)
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4
Q

Who should be given prophylaxis for PJP?

Common complication of PJP?

A

CD4 count < 20 should receive PCP/ PJP prophylaxis

Pneumothorax

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5
Q 
Name three extrapulmonary manifestations in PJP
Mx PJP (2)
A

hepatosplenomegaly
lymphadenopathy
choroid lesions

co-trimoxazole
IV pentamidine in severe cases

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6
Q

HPV
Which causes warts?
Which causes cervical cancer?

A

6&11

16&18

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7
Q

Age group for cervical cancer screening

Who else should be offered vaccine and why?

A

25-49 every 3 years
50-64 every 5 years
Boys and girls aged 12-13yo
Men who have sex with men under the age of 45 to protect against anal, throat and penile cancers

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8
Q

bilateral interstitial pulmonary infiltrates =

A

PJP

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9
Q

Listeria monocytogenes
+ve/-ve shape
dx
Mx

A

Gram-positive bacillus
Contaminated food unpasteurised dairy products
blood cultures
amoxicillin/ampicillin

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10
Q

Animals
‘scabby’ lesions around the mouth and nose

Humans
generally affects the hands and arms
initially small, raised, red-blue papules
later may increase in size to 2-3 cm and become flat-topped and haemorrhagic

A

Orf

condition found in sheep and goats although it can be transmitted to humans. It is caused by the parapox virus.

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11
Q

PEP

Hepatitis A

A

Human Normal Immunoglobulin (HNIG) or hepatitis A vaccine

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12
Q

PEP

Hepatitis B

A

If known responder to HBV vaccine then for booster dose

If non responder for HBIG + vaccine

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13
Q

PEP

Hep C

A

monthly PCR - if seroconversion then interferon +/- ribavirin

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14
Q

PEP

HIV

A

Combi of antiretrovirals ASAP - can be started up to 72 hrs post exposure for 4 weeks
Serological testing at 12 weeks

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15
Q

PEP

Varicella

A

VZIG for IgG negative pregnant women/immunosuppressed

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16
Q

Sepsis scoring system

A

qSOFA >=2 = greater risk of mortality
Respiratory rate > 22/min
Altered mentation
Systolic blood pressure < 100 mm Hg

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17
Q

papulovesicular lesions where the skin has been penetrated by infective larvae e.g. soles of feet and buttocks
larva currens: pruritic, linear, urticarial rash
if the larvae migrate to the lungs a pneumonitis similar to Loeffler’s syndrome may be triggered

=

A

Strongyloides stercoralis

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18
Q

Strongyloides stercoralis
What is it?
Rx

A

human parasitic nematode worm
larvae are present in soil and gain access to the body by penetrating the skin
Rx ivermectin and albendazole

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19
Q

Sulfonamides

Example

A

sulfamethoxazole

co-trimoxazole

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20
Q

multiple painful ulcers =

A

genital herpes HSV 2

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21
Q

Haemophilus ducreyi. =

painful genital ulcers associated with unilateral, painful inguinal lymph node enlargemen

A

Chancroid

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22
Q

Lymphogranuloma venereum (LGV) is caused by

A

chlamydia

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23
Q

What it Lymphogranuloma venereum (LGV)?

Rx

A

stage 1: small painless pustule which later forms an ulcer
stage 2: painful inguinal lymphadenopathy
stage 3: proctocolitis
doxycycline

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24
Q

questions referring to sewage workers, farmers, vets or people who work in an abattoir =
Mx

A

Leptospirosis

high-dose benzylpenicillin or doxycycline

25
Q

Influenza children
How is it given
When is it first given?
Live or inactive?

A

it is given intranasally
the first dose is given at 2-3 years, then annually after that
it is a live vaccine

26
Q

CI for flu vaccine in kids

A

immunocompromised
aged < 2 years
current febrile illness or blocked nose/rhinorrhoea
current wheeze (e.g. ongoing viral-induced wheeze/asthma) or history of severe asthma (BTS step 4)
egg allergy
pregnancy/breastfeeding
if the child is taking aspirin (e.g. for Kawasaki disease) due to a risk of Reye’s syndrome

27
Q

SE fluc vaccine kids

A

blocked-nose/rhinorrhoea
headache
anorexia

28
Q

Types of influenza and most common

A

three types of influenza virus; A, B and C. Types A and B account for the majority of clinical disease.

29
Q

Who is given the influenza vaccine?

A

> 65yo
Healthcare professionals
Comorbidities
Pregnant

30
Q

CI for flu vaccine in adults

A

hypersensitivity to egg protein

31
Q

Drowsiness with meningitis symptoms could indicate?

Mx

A

Meningoencephalitis

IV ceftriaxone and aciclovir

32
Q

What is the most common cause of non-falciparum malaria?

Cyclical fever every how many hrs for each case?

A

Plasmodium vivax

Plasmodium ovale and Plasmodium malariae accounting for the other cases.

33
Q

Mx plasmodium ovale and vivax (2)

A

Acute treatment = chloroquine

primaquine to be given alongside it to prevent relapse

34
Q 
Most common malaria
Prophylaxis meds (4)
A

Plasmodium falciparum

  1. Malarone (proguanil + atovaquone)
  2. Chloroquine
  3. Doxy
  4. Lariam (mefloquine)
35
Q

swimmers’ itch =
RF for which condition
Mx
Which organ is impacted? (three features)

A

schisto
squamous cell bladder cancer
single oral dose of praziquantel
Bladder - therefore haematuria, increased frequency, bladder calcification

36
Q

doxy SE (2)

A
  1. photosensitivity

2. oesophagitis

37
Q

Lumbar puncture show a yeast and a capsule in the CSF stained with India ink =

A

cryptococcal meningitis

38
Q

Faget’s sign =

A

Slow pulse + temperature seen in Yellow fever

39
Q

Yellow fever typical acute symptoms (4)

A

fever
muscle pain
loss of appetite
N&V

40
Q

Riverfisherman
Haemturia
Jaundice

=

A

Weil’s disease

41
Q

Floaters, visual field defects in a HIV +ve pt =

A

CMV retinitis

42
Q

Giardia mx

A

metro

43
Q

Rocky mountain spotted fever =

Gram +ve/-ve

A

ricketssia ricketsii

Gram -ve

44
Q

Life long scar formation =

A

Lieshmoniasis

45
Q

River blindness

A

onchocherciasis

46
Q

Paul Bunnel test =

A

Mono

47
Q

Mx agitation and confusion in palliative patients

A
  1. Haloperidol

2. chlorpromazine, levomepromazine

48
Q

Management of hiccups in palliative care (3)

A
  1. chlorpromazine
  2. haloperidol, gabapentin
  3. dexamethasone is also used, particularly if there are hepatic lesions
49
Q 
Palliative care pain
First line
what should be prescribed with it 
what can be prescribed with it 
breakthrough pain how to work out the dose?
percentage increase when stepping up
A
  1. MR or IR morphine
    - 20-30mg of MR a day with 5mg for breakthrough pain
    - must be prescribed laxatives with it
    - +/- anti-emetic
    1/6th total dose
    30-50%
50
Q

Palliative care pain

If renal disease which pain relief?

A

mild - mod Oxycodone

severe - lfentanil, buprenorphine and fentanyl

51
Q

Metastatic bone pain management (3)

A
  1. strong opioids
  2. bisphosphonates
  3. radiotherapy
52
Q 
Conversions
Oral morphine to Oral oxycodone
Oral tramadol	to Oral morphine
Oral codeine to Oral morphine
oral morphine to subcutaneous morphine
A

/ 1.5-2
/10
/10
/2

53
Q 
Carcinogens 
Nitrosamines
Aniline dyes
Aflatoxin
Bleomycin
A

Gastric + oesophageal
TCC
HCC
can cause pulmonary fibrosis

54
Q

Mx congenital toxoplasmosis

Rx for infected mother during pregnancy =

A

spiramycin

55
Q

Listeria in pregnancy

Mx

A

amoxi and gent

56
Q 
Recent trip abroad 
Presenting symptom = headache 
Diurnal variation with fever 
Giemsa stained thick and thin peripheral blood smears 
= ?
A

Malaria

57
Q

Week 1: diffuse AP, constipation, inflamed Peyer Patches, blanching, truncal maculopapules
Week 2: splenomegaly, bradycardia
Week 3: pea soup diarrhoea, bowel perf, abdo distension
Blood and bone marrow cultures for diagnosis?

A

Typhoid

58
Q

Fever, facial flushing, myalgia, haemorrhagic manifestations
Thrombocytopenia, leucopenia
=

A

dengue

MSRA (22 decks)

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