Common infections AB

Question 1

What is the incubation period of Influenza?

Answer 1

1-3 days

Question 2

Antigenic shift - what does this cause in a population?

Answer 2

Pandemic

Question 3

Antigenic drift - what does this cause in a population?

Answer 3

Annual epidemic

Question 4

What are some extra-pulmonary sequelae of influenza?

Answer 4

MyositisGBSEncephalitisReye syndrome- mostly influenza B + aspirin

Question 5

Meningococcal meningitis - what is the treatment?

Answer 5

IV Benpen 1.8g 4 hourly (short course)Cipro if type 1 penicillin hypersensitivity

Question 6

Meningococcal meningitis - what is the mortality?

Answer 6

7% (on treatment)

Question 7

N meningitidis - what is the microbiology?

Answer 7

Gram negative diplococci(neiserria = negative)

Question 8

Meningococcal meningitis - what is the incubation period?

Answer 8

2-10 days

Question 9

Pneumococcal meningitis - what is the treatment?

Answer 9

Empiric - Ceph + VancLow MIC (

Question 10

L monocytogenes meningitis - what is the incubation?

Answer 10

Long - up to 6 weeks

Question 11

L monocytogenes meningitis - what is the treatment?

Answer 11

Benpen (resistant to Ceph)Resistant: TMP/SMX

Question 12

Cryptococcal meningitis - what is the treatment?

Answer 12

Induction: Amphoterecin B + FlucytosineConsolidation: FluconazoleMinimum 10 weeks therapy

Question 13

Hib meningitis - what is the treatment?

Answer 13

Ceftriaxone for 7 days(+ Benpen for 7 days if susceptible)

Question 14

Steroids - what is the proven efficacy in meningitis?

Answer 14

Hib - hearing loss in childrenPneumococcus - mortality benefitNo benefit in meningococcal.

Question 15

Diffuse erythematous rash - what are some infective causes?

Answer 15

Scarlet fever (strep)Toxic shock syndrome (staph or strep)Staph scalded skin syndromeDengueEnterovirus

Question 16

Purpuric rash - what are some infective causes?

Answer 16

MeningococcusGonococcusStaph sepsisDengueHBVEnterovirusRickettsial infection

Question 17

Cellulitis - what are the associated exposures with:- Dog/cat bite- Fresh water- Sea water- Immunocompromised- Shell fish- Other water exposure

Answer 17

• Dog/cat bite - pasturella- Fresh water - aeromonas (esp males with cirrosis/cancer)- Sea water - vibrio- Immunocompromised - clostridia- Shell fish - erisepelothrix- Other water exposure - mycobacterium marinum

Question 18

Necrotising fasciitis - what is empiric therapy?

Answer 18

MeropenemPenicillinClindamycin

Question 19

Hyposplenism - name some causes

Answer 19

Haematologic disorders- CLL, sickle cell, lymphomaSplenic irradiationhigh dose steroidsCoeliac diseaseBone marrow transplant- Especially if GvHD

Question 20

Name 4 encapsulated organisms

Answer 20

St pneumoniaeN meningitidisH influenzaeCapnocytophaga carimorus

Question 21

Toxoplasmosis - what is the treatment?

Answer 21

Pyrimethamine/folinic acid and sulfadiazine or clindamycinc

Question 22

Zygomycosis - what is the treatment?

Answer 22

Debridement and amphotericin (lipid formulations)

Question 23

Varicella - what is the incubation period?

Answer 23

10-21 days

Question 24

Schistosomiasis - which organism infects the urinary tract?

Answer 24

S haematobium

Question 25

Schistosomiasis - which organisms infect the bowel?

Answer 25

S masonii, S japonicum, S intercalatum

Question 26

Schistosomiasis - what is the typical clinical picture?

Answer 26

Days: pruritic rashWeeks later: febrile illnessMonths/years later: fibrotic response in urinary tract or gut Chronic infection: colitis, portal HT, urolithiasis, SCC bladder

Question 27

Schistosomiasis - what is the management?

Answer 27

Praziquantel

Question 28

Ascariasis - what sort of organism?

Answer 28

Helminthic (most common human)

Question 29

Ascariasis - what is the management?

Answer 29

Mebendazole, pyrantel pamoate

Question 30

Melioidosis - what is the organism?

Answer 30

Burkholderia pseudomallei

Question 31

Melioidosis - what are the risk factors for infection?

Answer 31

DMEtOH

Question 32

Melioidosis - what are the clinical manifestations?

Answer 32

PneumoniaAbscesses (spleen, prostate)Osteomyelitis, septic arthritisSkin and soft tissue infectionHigh mortality if sepsis

Question 33

Melioidosis - what is the management?

Answer 33

Ceftazadime, Carbapenem(GCSF in sepsis)

Question 34

H pylori and gastric adenocarcinoma - which molecules/genes are involved?

Answer 34

CagA geneVacuolating cytotoxin (vacA)

Question 35

HPV - which strains are most likely to cause cervical cancer?

Answer 35

16 and 18

Question 36

EBV and Burkitt's lymphoma - which chromosome is affected?

Answer 36

Chromosome 8 translocation - deregulation of c-MYC oncogene

Question 37

EBV - what are the associated malignancies?

Answer 37

Burkitt's lymphomaHodgkin's lymphomaNHL in immunocompromisedNasopharyngeal carcinoma

Question 38

HHV-8 - what are the associated malignancies?

Answer 38

Kaposi sarcomaPrimary effusion lymphomaMulti-centric Castleman's disease

Question 39

Schistosomiasis - what is the associated malignancy?

Answer 39

SCC of the bladder

Question 40

What is the Jarish-Herxheimer reaction?

Answer 40

Fever and transient exacerbation of constitutional symptoms from sudden release of bacterial products from injured or killed bacteriaSeen with tertiary syphilis, brucellosis, enteric fever, schistosomiasis.