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1
Q

CD4 count below 200 what opportunistic infections could occur in hiv

A

candidiasis - white coating on tongue and pain on swelling

penumocytisi penumonia - pneumocystisi hireovecii

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2
Q

CD4 count below 100 what opportunistic infections could occur in hiv

A

Cryptococcal meningitis:

Headache, fever, fatigue, LP has a high opening pressure

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3
Q

CD4 count below 50 what opportunistic infections could occur in hiv

A

Progressive multifocal leukoencephalopathy (PML)
Cognitive impairment, focal neurological signs, MRI shows hyperdense lesions

Cerebral toxoplasmosis : Headache, fever, confusion, focal neurological signs, seizures, imaging shows multiple ring enhancing lesions

Disseminated MAC: fever, night sweats, weight loss, diarrhoea, abdo pain, hepatosplenomegaly

CMV retinitis: floaters, visual field defects, painless visual loss, pizza pie fundus

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4
Q

CD4 count below 500 what opportunistic infections could occur in hiv- anything

A

TB:

Fever, chills, night sweats, weight loss, haemoptysis, lymphadenopathy, CXR- consolidation/cavities/nodules

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5
Q

HIV pneumonia causative organism

A

Pneumocystis carnii (jirovecii)

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6
Q

CAP causative organism

A

strep pneumoniae

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7
Q

HAP causative organism

A

staph

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8
Q

COPD pneumonia

A

haemophiliac influenzae

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9
Q

CF or ventilated patents causative organism for pneumonia

A

pseudomonas

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10
Q

immunocomprimsed pneumonia

A

aspergillus

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11
Q

post operative pneumonia causative organism

A

e.coli

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12
Q

Aids defining malignancies

A

Kaposi’s sarcoma- purple nodular lesions on back
High grade B cell non-Hodgkin’s lymphoma
Invasive cervical cancer

Non-AIDS defining malignancies include Hodgkin’s lymphoma and HIV related anal cancer

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13
Q

what is the difference between candida ( under cd4 200) and oral hairy leukoplakia ( under 500)

A

candid you can scape off tongue leading it to be red

. white patches on leukoplakia does not come off

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14
Q

what to treat candida

A

oral fluconazole

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15
Q

what to treat hair leukoplakia

A

self resolving maybe acyclovir

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16
Q

PCP - pneumocystis jiroveci
symptoms
treatment

A

dry cough, SOB, reduced effort tolerance and fever

trimethoprim , sulfamethoxazle with steroids if severe

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17
Q

what to treat mycobacterium tb

A

RIPE - rifampicin, isoniazid , pyrazinamide

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18
Q

symptoms of cryptococcal meningitis - below 100

A

headache fever and malice with neck stiffness , photophobia and fever and signs of raised ICP

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19
Q

treatment of cryptococcal meningitis

A

IV amphoctericin B + PO flu cytosine then fluconazole

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20
Q

cytomegalovirus symptoms and management

A

below 50
blind spots and visual floaters , peripheral field defects and painless visual loss
retinal haemorrhages and heard exudates

gancicclovir

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21
Q

difference between chlamydia and gonorrhoea

A

c - clear or white discharge and
G- green or yellow discharge

men in C need to have first catch urine sample and women vulvo-vaginal swab whereas in G men urethral swab and women endodermal-cervical swab

docyclicine for C
gonorrhoea - culture and ciprofloaxicn or cefratriaxone

22
Q

Herpes = blisters which form painful ulcers

treatment ?

A

oral acyclovir

23
Q

Lymphogranuloma venerum = painless ulcers + painful inguinal lymphadenopathy

treatment same as chlamydia

A

doxycycline - for 7 day

or one tablet of arthromycin

24
Q

Lymphogranuloma venerum = painless ulcers + painful inguinal lymphadenopathy

treatment same as chlamydia

A

doxycycline - for 7 day
or one tablet of arthromycin
\

Stage 1 Syphilis = painless ulcers
Treatment- HIV and HIV testing + referral

25
thrush caused by what and what treatment
hrush (candida albicans)- present in normal flora (overgrowth is causes by stress, antibiotics or immunosuppression) Cottage cheese like discharge, often sore. Give Canesten cream and/or fluconazole
26
bacterial vaginosis - overgrowth of anaerobes like gardnerella clue cells on microscopy ]]symptoms and treatment
smelly fishy discharge no pain metronidazole Genital psoriasis- dry and scaly skin. Often itchy. Give steroid cream.
27
common joints affected by RA
MCP and PIP swan neck deformity -MCP flexion, PIP hyperextension, DIP hyperflexion). Boutonniere finger deformity (PIP flexion, DIP hyperextension). Ulnar deviation of proximal phalanges. Z-shaped thumb.
28
treatment for RA
NSAIDS and physiology DMARDs - methotrexate and hydorxycloroquine ( continued through ores as contains folate) biologics - anti-TNF
29
antibodies seen for SLE
anti ds DNA , anti sm and ANA get skin rashes plus small joints oh hands with weight change
30
treatment for SLE
Hydroxychloroquine(all)+ prednisolone(sx relief)+ Methotrexate/Azithioprine if needed Cyclophosphamide as a rescue therapy
31
OA is asymmetrical swelling on knees, hips and hands affecting DIP worsening with activity what findings
Serology negative, ESR and CRP normal
32
UTI treat
Nitrofurantoin or Trimethoprim
33
cellulitis
flucloacilin
34
orbital cellulitis
co-amoxiccilin
35
tonsilitis
1st line is pencillin - phenoxy | 2nd line is erythromycin or clarithromycin
36
CAP pneumonia antibiotics
amoxicillin and if atypical clarithromycin
37
prostate drains to what nodes
iliac lymph nodes
38
chicken pox cause symptoms and treat
varicella zoster widespread papule that blister into vesicles and scab - parities and fever treat with supportive fluids and if adults acyclovir school exclusion until lesion have crusted over
39
hand foot and mouth cause symtposm treat
coxsackie virus A16 vescicale rash on hands and feet and painful oral ulcers and low grade fever treat - supportive fluids and simple analgesics - oral lidocaine used for fluids no exclusion from school
40
impetigo cause symtposm
staph aureus red sores, blisters round the mouth that burst and crust over forming Honey coloured crust treat with 1st line topical hydrogen peroxide 2nd line fusidic acid and 3rd if spread flucloaxillin school exclusion until lesion cursed and healed or 48hr after antibiotics commenced
41
erythema infectious -slap cheek cause symtposm treat
parvovirus B19 red cheeks and pink rash on limbs aplastic anaemia supportive analgesics - no exclusion from school
42
scarlet fever cause symtposm treat
group A strep sore throat, fever and sick with GI upset sandpaper like rash and tender cervical adenopathy and strawberry tongue with pharyngeal erythema amoxicillin return after 24 hr of antibiotics
43
Kawasaki disease cause symtpom treat
- N/A acute vasculitis dever , sandpaper rash on palms and soles , tender lymphadenopathy and strawberry tongue IV immunoglobulin and aspirin no exclusion
44
shingles cause symptoms treat
varicella zoster papules blister into vesicles and scab over into dermatomal distribution acyclovir and analgesia - school exclusion until lesion have all crusted over
45
in hiv what do you need to make sure during pregnancy
avoid breastfeeding vertical transmission unlikely with undetectable viral load below 0.1 % - continue ART treatment and deliver via c section if viral load detectable - ART 4 weeks for baby
46
treat for HIV
Treatment Start ASAP Backbone of two NRTI’s plus NNRTI or PI or INI Post exposure prophylaxis= course of HIV therapy for 28 days. Post-exposure prophylaxis Should be given within 72 hours Receptive anal sex – recommended regardless of HIV status Everything in between Oral sex without ejaculation- not recommended
47
stages HIV
Stages 1 Seroconversion/ primary infection: triad of fever, rash and pharyngitis (only in 60% and usually mild) 2 Chronic/latent phase 3 AIDs (severe opportunistic infections and tumours)
48
Ophthalmia neonatorum simply means infection of the newborn eye. Responsible organisms include
Chlamydia trachomatis Neisseria gonorrhoeae Suspected ophthalmia neonatorum should be referred for same-day ophthalmology/paediatric assessment.
49
what is subcostal plane
The subcostal plane is a transverse plane which bisects the body at the level of the 10th costal margin and the vertebral body L3.
50
``` Pylorus stomach Left kidney hilum (L1- left one!) Right hilum of the kidney (1.5cm lower than the left) Fundus of the gallbladder Neck of pancreas Duodenojejunal flexure Superior mesenteric artery Portal vein Left and right colic flexure Root of the transverse mesocolon 2nd part of the duodenum Upper part of conus medullaris Spleen ``` are all at what level of the body
L1- transpyloric
51
hairy leukopenia causes by what organism
EBV
52
trimethoprim inhibits bacteria DHFR but methotrexate a chemotherapy agent inhibits
mammalian DHFR

Host defence (10 decks)

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