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Final year Medicine > Infectious disease > Flashcards

Infectious disease Flashcards

1
Q 
Constipation
Bradycardia
rose spots 
Aerobic gram - rods
hepatosplenomegaly
A

Salmonella typhi

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2
Q

Complications of salmonella

A 
Osteomyelitis
GI bleed/perf
meningitis
cholecystitis
chronic
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3
Q

Pregnant woman with UTI tx

A

Nitrofurantoin (not if term)

amoxicillin, cefalexin

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4
Q

Rapidly growing painful skin rash
temp 38.2
t2dm
Perineum

A

Necrotising fasciitis
(fourniers gangrene)

type1: anaerobes/aerobes
DM/ post surgery

type2: strep pyogenes

Mx: urgent surgical debridement.
IV abx

mortality 20%

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5
Q

painless ulcer on penis

local non tender LN

A

Syphillis

treponema pallidum

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6
Q

Secondary syphiliis features

A 
6 weeks after
Fevers, LNs
Rash on trunk, palmas, soles.
buccal snail track ulcers
condylomata lata - painless warts genitals
tertiary features
- gummas, 
-ascending aortic aneursyms
-tabes dorsalis
argll robertson pupil 
congenital 
-blunt incisors
-rhagades- scars mouth
-keratitis
saber shins
saddle nose
deaf
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7
Q

IV quinine moniroting

A

cardiac- arrythmias

BMs - hypoglycaemia

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8
Q

Follow up for f.malaria

p vivax/ovale

A

IV artenusate -> oral artemisinin

viv/ov -> primaquine prevent relapse due to hepatic hypnoozites.

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9
Q

Meningitis public health actions

A

Side room - droplet precautions until 24h antibiotics.
Masks and face protection for intubation.
Masks all <3ft.

Inform infection control
Inform local Health protection consultant by phone, even if OOHs.

treat close contacts w prophylactic abx, assisted by Health protection agency.

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10
Q

Purpura fulminans

A

meningococcal, pneumococcal, staphylococcal sepsis(if hyposplenism)

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11
Q

meningitis mx

A

IV ceftriaxone 2g every 12h
Chloramphenicol if pen allergic.
IV Dexamethasone 8.3mg every 6h. up until 12h after first abx dose. for 4 days.

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12
Q

Ix PCP

A 
WCC
LFTs
HIV serology 
ABG
Blood culture

CXR
CT

BAL
Pulmonary function tests

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13
Q

Mx PCP

A

2L o2 via nasal specs
IV Co trimoxazole

pO2 <9.5 -> systemic steroids.

Patient consent counselling

Prophylactic cotrimoxazole when CD4 <200.

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14
Q

bacteria of cellulitis

A

s. aureus

Strep pyogenes

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15
Q

Classification of cellulitis

A

Class 1: no systemic signs or symptoms
Class 2: Comorbid affects recovery
Class 3: + limb threatening conditions/confusion
Class 4: life threatening infection or sepsis

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16
Q

Mx Cellulitis

A

Class 1: Oral fluclox as outpatient
Class 2: Oral/IV abx in opd.
Class 3: admit + IV abx
Class 4: urgent admit, intensive multiple therapy and specialist consultation.

Follow up:
Clinical review in 2 days.
Elevate leg.
moisturise. 
Analgesia.
17
Q

Causes of lymphopenia

A 
Chronic Leukaemia
HIV
Marrow infiltration by cancer
Renal failure
Steroid therapy
18
Q

Ix HIV meningism (e.g. toxo)

A 
differential CD4 count
toxo serology
Viral hepatitis serology
Blood cultures
CXR
CT/MRI head - ring enhancing lesions + perilesional oedema

cervical LN biopsy
counselling and HIV testing

19
Q

Causes of ring enhancing lesions

A 
Atypical infection (toxoplasma gondii)
Bacterial cerebral abscess
Cerebral glioma
Cerebral lymphoma
Cerebral metastases
20
Q

Mx Toxoplasmosis

A

Sulphadiazine
Pyrimethamine
- serial MRI monitoring.
Folic acid supplementation.

21
Q

features of toxo

A 
Paranoid psychosis
chorioretinitis. 
Meningism. 
focal neurology
headache
22
Q

Septic shock definition

A

sepsis with refractory hypotension

raised lactate despite adequate fluid resus.

23
Q

indications for CT in meningitis

A

GCS <15
signs of Raised ICP
no c.i.s to LP

24
Q

Ix Meningitis

A 
bacterial throat swab
blood cultures
Clotting screen
EDTA for bacterial PCR
plasma glucose
LP (if icp not raised/GCS 15)
25
Q

Complications of bacterial meningitis

A

Cerebral oedema
venous sinus thrombosis
hearing loss
long term neuro damage.

26
Q

Hep A phases

A
  1. Prodrome flu 3-10 days. can have RUQ pain.

2. Jaundice 1-3weeks

27
Q

transmission of hep A

A

faeco oral

sexual contact

28
Q

Ix Hep A

A 
LFTs
Serum hep A igM,
(positive for 6m)
igG can be from vaccine, stays lifelong.
Clotting screen.
(PT >5s = decompensation)

USS if LFts abnormal.
Screen for Hep B/C

29
Q

Mx Hep A

A

Mild/mod - mx as OPt.
Fluids for dehydration.
avoid food handling, avoid unprotected sex.
for 2 weeks before, 1w after jaundice.
inform sexual partners/household contacts.
inform public health.

Severe: vomiting, profound dehydation, hepatic decompensation
- urgent

Final year Medicine (18 decks)

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