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clinical Flashcards

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1
Q

Diarrhoea symptoms and signs

A

Pain, fever, watery stools

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2
Q

diarrhoea investigations

A

Hydration, temperature, raised WCC, BP, pulse

stool culture, blood culture, renal function, FBC, x-ray/CT if indicated

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3
Q

diarrhoea treatment

A

rehydration

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4
Q

differentials for diarrhoea

A

Inflammatory bowel disease
spurious diarrhoea secondary to constipation
carcinoma
sepsis outside the gut

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5
Q

protozoa symptoms

A

Diarrhoea, gas, malabsorption, failure to thrive

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6
Q

protozoa investigations

A

Stool microscopy

serology

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7
Q

protozoa Tx

A

Metronidazole

+/- luminal agent

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8
Q

CDI causes

A

Cephalosporins, co-amoxiclav, clindamycin, ciprofloxacin

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9
Q

CDI symptoms

A

Mild diarrhoea, severe colitis

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10
Q

CDI tx

A 
Metronidazole 
oral vancomycin
fidaxomicin
stool transplants
surgery. Stop offending antibiotics.
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11
Q

influenza symptoms

A

Abrupt fever lasts 3 days
2 or more; cough, myalgia, sore throat, rinorrhoea, headache, malaise. Maybe nausea, vomiting, diarrhoea. Aches, joint pain, loss of appetite.

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12
Q

influenza diagnosis

A

Viral nose and throat swabs, CXR, blood culture, pulse oximetry, respiratory rate, U+E’s, FBC, CRP

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13
Q

influenza treatment

A

Neuraminidase inhibitors
within 48hours
oseltamivir, zanamivir.

vaccination!

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14
Q

influenza complications

A

Acute bronchitis, secondary bacterial pneumonia, myocarditis, transverse myelitis, encephalitis lethargica

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15
Q

secondary bacterial pneumonia symptoms

A

Flu and fever > 4 days. confusion, tachyopnoea

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16
Q

secondary bacterial pneumonia investigations

A

CXR

urea, RR, blood pressure

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17
Q

candidiasis signs

A

Neutropenia, low CD4+, impaired IL-17 immunity

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18
Q

candidiasis investigations

A

Blood culture
Beta-d-glucan high NPV
PCR

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19
Q

candidiasis treatment

A

Amphotericin B

Echinocandins and fluconazole

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20
Q

candidiasis prophylaxis

A

prophylaxis use of itraconazole and posaconazole

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21
Q

Acute invasive pulmonary aspergillosis symptoms and signs

A

Acute invasive pulmonary aspergillosis
Rapid extensive hyphal growth
thrombosis and haemorrhage
absent or nonspecific clinical signs

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22
Q

sub-acute invasive pulmonary aspergillosis symptoms

A

limited growth, tissue necrosis, excessive inflammation

presentation often outside of lungs e.g. bones, spine, brain, abdominal

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23
Q

chronic pulmonary aspergillosis symptoms

A

lung function decline, exacerbations not responding to antibiotics, cough, dyspnoea

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24
Q

allergic bronchopulmonary aspergillosis symptoms

A

sub-acute decreased lung function

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25
Aspergillus and Aspergillosis investigations
``` Sputum culture X-ray biopsy CT PCR and galactomannan ```
26
allergic bronchopulmonary aspergillosis specific investigations
positive specific IgG and IgE
27
Tx for Aspergillus and Aspergillosis
Intubation influenza then oseltamivir, corticosteroids, antibiotics. Amphotericin B Voriconazole and isavuconazole
28
prophylaxis for Aspergillus and Aspergillosis
prophylaxis use of itraconazole and posaconazole
29
Cryptococcus and cryptococcosis symptoms
Headache, confusion, altered behaviour, visual disturbance
30
Cryptococcus and cryptococcosis investigations
CSF Indian ink preparation, culture, high protein low glucose, antigen, blood culture
31
Cryptococcus and cryptococcosis treatment
Amphotericin B | +flucytosine followed by fluconazole for maintenance
32
Cryptococcus and cryptococcosis prophylaxis
prophylaxis use of itraconazole and posaconazole
33
HIV signs and symptoms
``` CD4 count lymphadenopathy weight loss mucocutaneous manifestations herpes zoster recurrent respiratory infections chronic diarrhoea febrile illness, fever, malaise, lethargy, toxic exanthema, pharyngitis ```
34
HIV Tx
Nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase, protease inhibitors, integrase inhibitors PrEP prophylaxis
35
Pneumocystis Jiroveci pneumonia symptoms
insidious onset, Breathlessness over weeks, dry cough
36
PJP investigation
CXR, Sputum PCR
37
PJP treatment
Cotrimoxazole | Pentamidine
38
Sepsis qSOFA
hypotension <100mmHg systolic B.P. altered mental status tachypnoea RR>22/min
39
sepsis symptoms
fever, chills, rigors, flushes, cold sweats, night sweats, hypothermia, tachycardia, tachyopnoea, altered mental status, hyperglycaemia
40
sepsis signs
altered consciousness reduced platelets, albumin, Protein C oliguria, anuria, tachycardia, jaundice, high lactate, skin mottling, reduced peripheral perfusion increased liver enzymes, PT, creatinine, D dimer
41
sepsis investigations
WCC, platelets, LFT, U+E’s, glucose, CXR/AXR, INR, lactate, blood culture, urine output
42
sepsis treatment
Amoxicillin, Gentamicin, metronidazole IV fluid challenge oxygen 30ml/Kg fluid
43
S. aureus investigations
Microscopy multiple blood cultures biopsy imaging X-Ray, CT, MRI, radionuclide imaging, ECHO
44
S. aureus tx
``` Antibiotics therapy, surgical intervention. flucloxacillin vancomycin teicoplanin Linezolid daptomycin ```
45
impetigo symptoms
superficial skin infection, multiple vesicular lesions on an erythematous base, golden crust
46
impetigo Tx
Topical antibiotics, flucloxacillin.
47
erysipelas symptoms
Painful red area, fever, regional lymphadenopathy, elevated borders
48
cellulitis symptoms
Diffuse, presents spreading erythema, fever, regional lymphadenopathy and lymphangitis
49
folliculitis symptoms
Circumscribed pustular infection of hair follicle. Presents as small red papules found in head, back and buttocks
50
furunculosis symptoms
Boils, moist hairy friction areas affected.
51
carbuncle symptoms
Back of neck, posterior trunk of thigh, multiseptated abcesses
52
necrotising fasciitis symptoms
Rapid onset, erythema, extensive oedema, haemorrhagic bullae, skin necrosis, crepitus, fever, hypotension, tachycardia, delirium, multiorgan failure, anaesthesia at site.
53
necrotising fasciitis tx
Flucloxacillin, gentamicin, clindamycin
54
pyomyositis symptoms
Purulent infection deep within striated muscle often manifesting as abcess, fever, pain, woody induration of affected muscle
55
pyomyositis investigation
Gram cultures, Ct, MRI, screen for TB and fungus
56
septic bursitis symptoms
Swelling and warmth, fever and pain, peri bursal cellulitis
57
septic bursitis investigation
Aspiration of the fluid
58
infectious tenosynovitis symptoms
Erythematous fusiform swelling of finger, semiflexed, tenderness and pain with extension
59
staph toxic shock syndrome
Fever, hypotension, diffuse macular rash, live,r blood, renal GI, CNS, muscular,
60
staph toxic shock syndrome treatment
Urgent surgical debridement of the infected tissues, I.V. fluids, inotropes, antibiotics, I.V. immunogloblins
61
malaria symptoms
Fever, rigors, aching bones, abdo pain, headache, dysuria, frequency, sore throat, cough, none, splenmegaly, hepatomegaly, mild jaundice
62
malaria treatment
Quinine, artemisinins, malarone, riamet if complicated then IV quinine
63
malaria investigations
Thick and thin blood films, quantitative buffy coat, rapid antigen tests, glucose, haemoglobin, U+E
64
typhoid symptoms
Fever headache, abdo discomfort, constipation, dry cough, relative bradycardia, neutrophilia, confusion, rose spots, diarrhoea, tachycardia, neutropenia, intestinal bleeding, perforation, peritonism
65
typhoid investigations
Culture blood, urine and stool, culture bone marrow
66
typhoid Tx
Oral azithromycin, IV ceftriaxone
67
Dengue fever symptoms
Sudden fever, severe headache, retro-orbital pain, severe myaga, arthralgia, macular rash, haemorrhagic signs, thrombocytopenia, leukopenia, elevated transaminases
68
Dengue fever investigations
PCR, serology
69
dengue fever treatment
IV fluids, fresh frozen plasma, platelets avoid bites
70
schistosomiasis symptoms
Swimmer’s itch, cough, abdo discomfort, splenomegaly eosinophilia, prostrate, fever, urticaria, lymphadenopathy, splenomegaly, diarrhoea, eosinophilia
71
schistosomiasis investigations
Clinical diagnosis, antibody test, ova in stools and urine, rectal snip
72
schistosomiasis treatment
Praziquantel, prednisolone if severe
73
rickettsiosis symptoms
Abrupt onset swinging fever, headache, confusion, endovasculitis, rash, bleeding
74
rickettsiosis Tx
tetracycline
75
zika symptoms
Headache, asymptomatic, rash, fever, malaise, conjunctivitis, joint pains

infections (3 decks)

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