Case 17- Questions Flashcards

1
Q

How are Leishmania parasites transmitted

A

They are transmitted by phlebotomine sandflies

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2
Q

Define stigma and health conditions particularly at risk of it

A

Stigma arises when an adverse social judgement is made about a group or person which leads to rejection, blame, social exclusion or devaluation:

1) HIV/Sexually transmitted diseases
2) Mental health disease
3) Learning disabilities
4) Physical/Visible disabilities

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3
Q

Two possible clinical features that could trigger screening for CMV in infants

A

1) Growth retardation
2) Encephalitis
3) Calcification on cranial ultrasound
4) Congenital cataracts
5) Failed neonatal hearing screen
6) Petechiae or purpura in the newborn
7) Hepatosplenomegaly
8) Prolonged jaundice
9) Unexplained thrombocytopaenia
10) Premature birth

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4
Q

Briefly explain the most common causes, types of infections and treatment of antibody immunodeficiency

A

Cause - bacterial infection (eg Pneumococcus & H. influenzae)
Types of infection - one from: Otitis, Pneumonia, Sinusitis, GI tract disturbances, Autoimmunity
Therapy: Immunoglobulin replacement

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5
Q

Function of Amphotericin B- antifungal agent

A

Puncture of the cell membrane by binding ergosterol

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6
Q

The best description of antigen presentation by MHC molecules

A

A MHC class 1 molecules binds with a peptide in the endoplasmic reticulum

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7
Q

What AIDs defining condition is associated with a CD4+ count of <100/mm^3

A

Disseminated Mycobacterium avium complex

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8
Q

What antibody class is able to cross the placenta and protect the newborn infant

A

IgG

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9
Q

What is the antiviral combination most commonly used across the world

A

Nucleoside/nucleotide reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors

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10
Q

What is the most common cause of fungal infection in the general population

A

Candida sp

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11
Q

Where do CD8 positive T cells recognise foreign sntigens

A

On the surface of any nucleated cell type

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12
Q

The organ responsible for the negative selection for self-recognising T lymphocytes.

A

Thymus

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13
Q

The protein that downregulates a T-cell mediated response (a checkpoint inhibitor), loss of which can lead to autoimmunity.

A

PD-1

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14
Q

A process involved in T cell independent B cell activation

A

It only occurs if B cell receptors have been crosslinked

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15
Q

A process involved in T cell independent B cell activation

A

It only occurs if B cell receptors have been crosslinked

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16
Q

How is antibody diversity generated

A

V, D and J gene segments are brought together by a somatic recombination process

17
Q

How is antibody diversity generated

A

V, D and J gene segments are brought together by a somatic recombination process

18
Q

What cell type is predominantly used against Helminths

A

IgE

19
Q

What do non-nucleoside inhibitors target

A

Reverse transcription

20
Q

The Nucleotide analog reverse-transcriptase inhibitor (NtRTI) that is a component of some PrEP candidates in clinical trials.

A

Tenofovir

21
Q

What causes blood in urine

A

Malaria

22
Q

What causes a maculopapular rash and fluid in the lungs

A

Dengue

23
Q

What causes conjunctivitis

A

Zika virus

24
Q

Initial managment of dengue

A

Initial fluid bolts over 10 to 15 minutes

25
Q

Advice on how to reduce the risk of a communicable disease- malaria

A

1) Make sure all routine vaccinations are up-to-date
2) Explanation of need for travel insurance
3) Advise that the risk of contracting an infectious disease abroad depends upon context of visit: For example, region being visited, time of year/season, type of activity…urban or rural etc

26
Q

Give an explanation about how a patients culture may influence their beliefs that pharmacological intervention is bad?

A

Religion = A belief that health is determined by a deity and thus this deity will heal them or that they are being punished and that here should be no intervention

Education = Pharmacological intervention is perceived to be harmful/drug companies out to exploit patients/conspiracy theories surounding use of pharmacotherapy etc

Friends/Family = Patient has been told of serious side effects of drugs/family member/friend bad experience of medication influences perception and beliefs of surrounding pharmacological intervention

27
Q

Considering the cultural iceberg- state two cultural factors that influence patients behaviour

A

1) Religious beliefs
2) Life experience
3) Sexual orientation
4) Education
5) Values
6) Attitudes

28
Q

What does OM stand for

A

Once daily in the morning

29
Q

Type A reactions

A

Exaggerated effects of the medication when given at normal therapeutic doses. Can cause respiratory depression in excess

30
Q

The antimalaria drug which is used to prevent relapse from Plasmodium vivax and Plasmodium ovale

A

Primaquine- effective against hypnozoites dormant in the liver

31
Q

What are the Filarial nematodes and Trypansoma species transmitted

A

Filarial nematodes- transmitted by mosquitos

Trypanosoma- transmitted by Tsetse fly vectors

32
Q

What information is legally required on the prescription

A

Prescriber address

33
Q

Select the parasite that has gene cassettes of variable surface glycoproteins which continue to switch, enabling the organism to escape antibody detection and continue to replicate.

A

Trypanosome

34
Q

What parisitic infection can be aquired by migration of larvae through bare feet

A

Hookworm infection

35
Q

What is it when a patient follows the written instructions provided by their GP

A

Compliance- passive role where the patient is following instructions

36
Q

What organism is most likely to cause haematuria- bathing in water

A

Schistoma Haematobium

Schistosoma Mansoni- causes disease of the bowel and liver. It does not typically cause urinary symptoms

37
Q

The purpose of the BNF

A

Facilitates cost-effective, safe prescribing

38
Q

The stage of the Plasmodium life cycle where they can infect Anopholes mosquito vectors

A

Gametocytes