Broadly what the causes of pyrexia of unknown origin (PUO)?
Infection - 30% Malignancy - 30% AI - 30% Undiagnosed - 10%
2 or more of:
- Temp <36 or >38
- HR >90bpm
- RR >20bpm or PaCO2
- <4 or >12x10(9) cells/L (or 'left shift' >10% immature neutrophils)
SIRS + definitive infection
Severe sepsis =
Sepsis + organ dysfunction
Septic shock =
Severe sepsis + hypotension (<90mmHg)
What is the CD4 threshold for AIDS?
Start treatment at 350 in UK. In USA and Europe start at 500.
MDR TB definition
Resistant to Rifampcin and Isoniazid
XDR TB definition
MDR + resistant to fluoroquinolones and at least one injectable agent (amikacin, kanamycin, capreomycin)
What are the 5 groups of TB medications? Give an example of each.
Group 1 = RHZE (aka RIPE) Group 2 = Injectables: amikacin, kanamycin, capreomycin Group 3 = certain fluoroquinolones: moxifloxacin Group 4 = bacteriostatics: prothioamide, cycloserine Group 5 = Experimental of unknown efficacy: linezolid
Doxycycline Contra-indicated in pregnancy due to teratogenicity. Therefore, use azithromycin or erythromycin.
Classical presentation of molluscum contagiosum.
Umbilical herniated papules. Occurs commonly in childhood. In adults, associated with immunosuppression. Caused by pox virus.
Aciclovir 200mg 5 times/day for 5/7
Daily wash with salt water, reduces adhesions.
Pee in warm bath. Painful to pee as urine hits ulcers. Reflex inhibition. In extreme catheterise.
M = meningo-encephalitis
A = Arthritis
O = orchitis (& oophoritis)
M = myocarditis
P = pancreatitis
S = sensorineural deafness
TB treatment: RIPE common side effects
R + I + P RIP through your liver = hepatotoxicity esp. P
R - reddy/orange secretions
I - 'Ingling: peripheral neuropathy (give pyridoxine)
P - pain (gout) and pruritus
E - eyes: colour blindness
Classes of HIV drugs with an example of each
1. Entry inhibitors
- fusion inhibitor - enfuviritide
- CCR5 inhibitor - maraviroc
2. Nucleoside RT inhibitors (NRTI)
- zidovudine, lamivudine
- abacavir, tenofovir
3. Non-nucleoside RT inhibitors (NNRTI)
4. Integrase inhibitors
5. Protease inhibitors
- Ritonavir, Indinavir
What is an isotope?
An element with equal