ID Flashcards
1
Q
What is an effective way of reducing transmission of HIV from mother to baby when pregnant?
A
Postnatal administration of zidovudine to the baby
2
Q
What is the most common bacterial infection of industrialised countries?
A
Campylobacter enteritis
3
Q
What meat often gives campylobacter infection?
A
Chicken
4
Q
What does the parasite entameoba histolytica cause
A
Intestinal sx (usually bloody diarrhoea)
extra intestinal manifestations (usually liver abscess)
5
Q
Treatment of tapeworm
A
Niclosamide
6
Q
What causes cholera
A
Vibrio cholerae
7
Q
Presentation of cholera
A
Abrupt onset of voluminous watery diarrhoea
Hypoglycaemia
No blood in stool
8
Q
Treatment of cholera
A
Rehydration
Doxycycline or co-trimoxazole
9
Q
What foodstuffs can you get cholera
A
Shellfish
10
Q
Presentation of salmonella enteritiis
A
Significant abdo pain
Blood and mucus in stool
11
Q
Test for lymes disease
A
ELISA test
12
Q
causative organism of lymes disease
A
Borrelia Burgdorferi
13
Q
Which hepatitis virus relies on conceurrent hep B infection for replication?
A
Hep D
14
Q
WHat does a positive HAV-IgM and positive HAV-IgG mean?
A
Acute hep A is likely
15
Q
What does a positive HAV-IgG and negative HAV-IgM indicate?
A
Past Hep A or immunity from previous vaccination
16
Q
WHat serological test rises in current Hep B infection?
A
HbsAg (surface antigen)
17
Q
WHat indicates the progression to chronic hep B (serologically)
A
HBsAg, HBeAg, HBVDNA
18
Q
What indicated Hep B infection in the last 6 months
A
IgM anti-HBc
19
Q
What does IgG anti-Hbc indicate?
A
persists for life and indicates past infection
20
Q
what does anti-HBs without anti-HBC indicate?
A
Immunisation
21
Q
What serological test confirms exposure of Hep C
A
anti-HCV antibodies
22
Q
What serological test confirms ongoing Hep C infection
A
HCV-PCR
23
Q
WHat is granuloma inguinae and how does it present
A
Caused by Klebsiella granulomatis
Reproduces in neutrophils plasma cells and histocytes
Primary painless indurated nodule
Progresses to a healed up ulcer
24
Q
WHat does granuloma inguinae contain
A
Donovan bodies
25
Treatment of granuloma inguinae
Doxycycline or co-trim
26
Serology of aspergillosis
Aspergillus RAST
IgE
Beta glucan
Galactomannan
27
What is on a CXR when you have histoplasmosis?
Diffuse reinonodular changes (no change in 40-50%)
28
Treatment of cryptococcal meningitis
Amphotericin B
29
investigation for gonnorhoea in women
Endocervical swabs and NAAT
30
Quinine in malaria and insulin
Quinine stimulates insulin release due to extreme catabolism of the burden of malaria infection
These two factors together when given IV quinine can cause severe hypoglycaemia
31
Treatment of toxoplasmosis in immunocompromised individuals
pyrimethamine with sulfadiazine and folinic acid
32
Presentation of leprosy
Nodular rash
Gradual scarring of peripheral nerves results in sensory loss
33
Initial treatment of leprosy
Rifampicin, dapsone and clodazimine
34
Skin biopsy of nodules in leprosy shows what?
AFB (acid fast bacilli)
35
What is the hallmark sign of systemic meningococcal disease?
haemorrhagic skin lesions
36
Features of plasmodium vivax and plasmodium ovale compared to other species of malaria
Have an additional life cycle stage during which hypnozoites form in the liver
Can reactivate months to years after infection
37
Treatment of plasmodium vivax and ovale
Artemther-lumefantrine or chloroquine
then
Primaquine (eradicates hypnozoite stage of disease)
38
Presentation of measles
Koplicks spots
Fever
Malaise
Conjunctivitis
Cough
Coryzal sx
Then maculopapular rash develops
spreading from behind ears to face and migrates caudally
Lymphadenopathy and high fever
Cough up to 3 weeks
39
What can indicate PCP / pneumocistis jiroverci
Elevated 1,3 beta-D glucan levels
40
What is potts disease
Those with TB
Spondyolitis (especially of lower thoracic spine)
Paraspinous TB abscesses
Psoas abscess
Cord compression
Marked acute phase response with lymphocytosis
41
How long is reommended treatment for patients with TB treatment to the bone
12 months
42
How long does mycobacterium tuberculosis take to multiply
18-24 hours
much slower than other organisms
43
What does bone marrow biopsy showed Hodgkins lymphoma
Reed Sternberg cells
44
What usually preceeds the rash in measles
Flu like symptoms
Conjunctivitis
45
How does NAC work in paracetomal overdose?
Conjugation with the toxic metabolite as an exogenous gluthione source
46
What is whipples disease
A rare chronic multisystem condition caused by the combination of
- infection with gram positive actinobacteria (tropheryma whipellei)
- abnormal response of cell mediated immunity
47
Presentation of whipples disease
GI Sx
- abdo pain
- diarrhoea
- abdo distension
- steatorrhoea
- anorexia
Lymphadenopathy
Arthropathy
Cough
Intermittent pyrexia
As condition progresses; may be
- cardiac, neurological or resp involvement
48
Treatment of whipples
Long term Abx therapy (1-2 years)
e.g. 14 days ceftriaxone or benpen
followed by a years maintenance therapy of TMP
49
Risk factors for whipples disease
Working in agricultural environment
Sewage plant workers
50
Diagnosis of whipples disease
Jejunal biopsy
- deposition of macrophages containing PAS-positive granules within the villi
51
What is visceral leishmaniasis caused by
protozoa of Leishmana species
Vectored by the sand fly
52
Presentation of visceral leishmaniasis
Prolonged chronic deterioration
fevers
night sweats
epistaxis
dry cough
proceeding to weight loss, and further decline
Hepatosplenomegaly
Lymphadenopathy
53
Diagnosis of visceral leishmaniasis
Microscopy and culture
- of either a lymph node aspirate, splenic biopsy or bone marrow aspirate
54
Skin manifestations of typhoid
Maculopapular rose spots which blanch on pressing
55
Presentation of typhoid
Diarrhoea or constipation at onset
Fever
Malaise
Headache
Cough
Anorexia
Maculopapular rose spots
56
Blood findings of typhoid
Raised transaminases
Neutropenia
57
Causative organism of typhoid
Salmonella typhi
58
Treatment of PJP
Co-trimoxazole
59
Presentation of leptospirosis
Fever
Maliase
Conjunctiviits
Flu like symptoms
Progresses to
- jaundice
- hepatomegaly
- AKI
- aseptic meningitis (Weils disease)
60
Treatment of leptospirosis
IV penicillin
61
Where do you commonly catch brucellosis
Middle east
62
Who is at risk of leptospirosis
Infected animal urine (usually rats) / contaminated water
Contact with animals
Sewage workers
Farmers
Canoeists/rowers
63
Treatment of strongylodiasis infection
Albendazole for 3 days, can be repeated after 3 weeks if required
Ivermectin
64
Treatment of giardiasis
Tinidazole
65
What is strongylodiasis
Parasitic roundworm
66
How is strongylodiasis caught
Contact between bare skin and soil
67
Presentation of strongylodiasis
Can be asymptomatic
Abdo pain
Intermittent diarrhoea
Malabsorption
Weight loss
Loffler syndrome - pneumonitis if the larve migrate to the lungs
68
What does strongylodiasis cause on blood tests
Marked eosinophilia
69
Which serological marker shows vaccination success after Hep B immunisation
Anti-HBs antibodies
70
Diarrhoea of cholera is often described as what
Rice water stools
71
What is rocky mountain spotted fever and where is it seen
USA and south america
Caused by Rickettsia rickettsii, spread by ticks
72
Presentation of rocky mountain spotted fever
Non generalised headaches
Fever
Distinctive erythematous macular rash on palms and soles that moves centripetaly and after days may become petechial
73
Treatment of rocky moutnain spotted fever
Doxycycline
If pregnant - chloramphenicol
74
What should all individuals be screened for before treatment with primaquine
G6PD
75
Which type of malaria causes the most severe form of the disease
Plasmodium falciparum
76
Diagnostic tests of malaria
Serial thick and thin malaria blood films
77
Treatment of uncomplicated falciiparum malaria
Artemesinin combination therapy for at least 3 days
78
Treatment of severe falciuparum malaria
IV artesunate
2nd line - 5 day course IV quinine followed by second agent (e.g. doxy) for 7 days
79
What is regarded as a positive mantoux test
>5mm regardless of previous BCG
80
What HPV viruses are most assosiated with cervical cancers
HPV-16 and HPV-18
81
WHat is thrichomonas vaginalis
Sexually transmitted protozoal infection
82
Presentation of thrichomonas vaginalis
Frothy vaginal discharge
Strawberry cervix O/E
83
Treatment of trichomonas vaginals
Metronidazole
84
What is an argyll robertson pupil and where is this seen as a complication of
Accomodates but does not react
Tertirary syphillis
85
Stool specimen analysis in cholera
Comma-shaped gram negative bacilli
86
What skin manifestation is assosiated with mycoplasma pneumonia
Erythema multiforme
87
How is dengue fever transmitted
Female mosquitos
- Aedes ageypti
- adedes albopictus
88
Presentation of dengue fever
Fever
Headache
Pain behind the eyes
Muscle and joint pains
Nausea and vomiting
Swollen glands
Rash
89
Diagnosis of dengue fever
Serum RT-PCR
Serum NS1
Serum ELISA
90
What is seen on ELISA test in dengue fever
IgM detectable after 1 week up until 12 weeks
IgG indicative of past infection and can remain in blood for many years
91
Treatment of dengue fever
Symptomatic
92
What is hydatid disease
Caused by dog tapeworm Echinococcus granulosis
Immediate host agricultural animal e.g. sheep
93
Presentation of hydatid disease
Cysts form in liver and lungs - leading to compesssive symptoms (slow growing)
- haemoptysis
- abdominal pain
- hepatomegaly
94
WHat is toxic shock syndrome
Acute, severe, multisystem inflammatory response secondary to streptococcal and staphylococcal bacterial toxin release
95
Most common causes of toxic shock syndrome
Staph A
Strep pyogenes
96
Presentation of toxic shock syndrome
Viral type symptoms
Pyreixa
Shock (hypotension)
Rash with potential future desquamation
Circulatory collapse
Potential for organ failure
97
Common antibiotic regime of TSS
IV clinda + IV fluclox/vancomycin
98
Most common cayses of necrotising fascitis
1. Strep pyogenes (group A)
2. Klebsiella, Clostridium, E coli, Staph A
99
Chalymydia and staining
Chalymudia organisms too small to see on staining - cannot grow on any free media
100
Common cause of keratitis with dendritic ulceration of the cornea
HSV
101
Presentation of HSV keratitis
Acute onset of pain
Blurred vision
Conjunctival injection
Dendritic ulceration of the cornea
102
Is propphylaxis required for pneumonoccoal meningitis
No
103
What does infection with shigella cause
Shigellosis
104
Presentation of shigellosis
Dysentery
- inflammation of the colon resulting in severe abdo pain and diarrhoea
105
Transmission of shigellosis
Faecal oral
Sexual
106
What is the most common cause of dysentry in the UK
Shigella
107
Treatment of shigellosis
Usually self limiting and resolves in 3-7 days
More severe cases - penicillin and cephalospoirins, macrolides and quinololones
108
Diagnossis of EBV
Heterophile antibody test / monospot test
109
What infection is EBV most commonly assosiated with
Infectious mononucleosis
110
WHat other manifestiation can EBV cause
Splenomegaly
111
Treatment of infectious mononucleosis
Supportive
112
What should patients with EBV avoid
Contact sports - due to risk of splenic rupture
113
What commonly is assosiated with reactive arthritis
Chalymydia
Gonorrhoea
Campylobacter
Salmonella
114
Triad of reactive arthritis
Arthritis (often asymmetrical and of the lower limbs)
Urethritis
Conjunctivitis
115
HLA assosiation of reactive arthritis
HLA-B27
116
What is the most common CNS infection in HIV positive individuals with CD4 counts < 200
Cerebral toxoplasmosis (toxoplasma gondii)
117
CT scan of brain in cerebral toxoplasmosis
Ring enhancing lesions
- typically multiple but may be single
Surrounding oedema
118
Treatment of cerebral toxoplasmosis
Sulfadiazine and pyrimethamine
119
HIV patients with a CD4 < 200 should have prophylaxis to what with what?
PJP
Co-trim
120
What is present on examination on 50% of paitents with nec fasc
Subcutaneous gas or crepitations
121
Where do healthcare staff commonly transport MRSA
Nose
122
Investigation to dignose norcardia spp.
Paraffin bait
123
Test to screen for lymes disease
Borrelia IgG
124
What causes botulinism
Clostridium botulinum
125
How to catch botulinism
Food - improperly preserved or canned
Open wounds / IV drug users
126
Presentation of botulinism
Initial presentation - visual, speech or swallowing disutrbances
Descending flaccid paralysis involving motor and autonomic symptoms
No sensory change
No loss of consciousness
127
Treatment of botulinism and when should this be given
Botulinium antitoxin
Should be administered immediately on clinical suspecision - do not wait for laboratory confirmation
128
Presentation of tetanus
Trismus
Spasms
Rigidity
129
What causes epidemic typhus
Rickettsia Prowazekki
130
How is infection of epidemis typhus spread
Faeces of the human body louse - pediculus humanus humanus
Can spread rapidly in where people live in crowded conditions with poor hygiene
131
Presentation of epidemus typhus
Headache
Conjunctivitis
Orbital pain
Measles like eruption on 5th day after onset of symptoms
- get bigger until eventurally purpuric
At end of first week
- signs of meningoencephalitis/stupor/coma/extrapyramidal symptoms
132
Treatment of epidemic typhus
Doxycycline or azithromycin
133
What causes Q fever
Coxiella Burnetti
134
Skin manifestation of secondary syphillis
Condylomata
135
What are koplicks spots and what condition do you see them in
Rash in mouth - red spots with a blue/white centre
Measles
136
When does symptoms after infection with salmonella occur
12-48 hours after ingestion
137
Incubation period of staph A toxin
Very short - 1 - 6 hours
138
How do you catch Q fever (C burnetti)
Spread between domestic animals by ticks, transmission to humans if of inhalation of infected dust and aerosols, and drinking unpasturised milk
139
What organism in south america can burrow but not go any further than under the skin, and causes an intense itchy rash along the path of their travel
Ancylostoma braziliense (hookworm)
140
What is the most opportunistic eye disease in patients with HIV
CMV retinitis
(only when CD4 counts < 50)
141
Presentation of CMV retinitis
Unilaterally or bilaterally
Floaters
Blurred vision
Visual loss
142
Retinal appearance of CMV retinitis
Pizza pie or cottage cheese and ketchup fundus
143
Presentation of diffuse infiltrative lymphocytic syndrome
Presents like sjogrens syndrome but extra glandular manifestations are common
Hx of HIV
Peripheral motor neuropathy / weakness
Parotid gland involvement
Exertional dyspnoea
Aseptic meningitis
Cranial nerve palsies
Rare to have auto antibodies
144
What is the most serious complication of diffuse infiltrative lymphocytic syndrome
Lymphocytic interstitial pneumonitis
145
What is chancroid caused by
Haemophilus ducreyi
146
Presentation of chancroid
Tender ulcer with a ragged edge
Readily bleeds on contact
Multiple ulcers can occur
Lymphadenopathy
147
Treatment of chancroid
Azithromycin stat dose or
Ceftriaxone one dose IM or
cipro for 3 days or
erythromycin for 7 days
148
What does hantavirus cause
Haemorrhagic fever with renal syndrome
149
What is the medical term and organism that causes "jock itch"
Fungus T Rubrum
Tinea curis
150
Presentation of tinea curis / jock itch
Similar to ringworm
Scaley, erythematous border that gradually spreads down the inner thigh
Extremely itchy
151
Presentation of cutaenous leishmaniasis
Nodule 1-2 months post infection/sandfly bite
Gradually ulcerates
Thick fibrous crust over the surface
152
Presentation of Q fever
Atypical pnuemonia
Incubation 14-26 days
Flu like illness - headaches, malaise, fever, dry cough
Hepatosplenomegaly and transaminitis
Endocarditis
153
Investigation of Q fever
Serology testing for Coxiella
154
Treatment of Q fever
Doxycycline
155
What causes diptheria
Corynebacteriim diptheriae
156
Presentation of diptheria
Fever
Non specific prodrome
Followed by
- membraneous pharingitis with thick, grey membranes seen on examination
- cervical lymphadenopathy and oedema leading to the characteristic "bull neck"
Rarely
- myocarditis
- heart block
157
Treatment of diptheria
Diptheria anti-toxin
Antibiotics
Diptheria toxoid immunisation (following acute infection)
158
Where is diptheria common
Russia
159
How to quantify viral load in HIV
PCR
160
Testing for HIV
ELISA
161
Causative organism of malignant otitis externa
Pseudomonas aeruingosa
162
What does malignant otitis externa involve
Invasion of the temporal bone and base of the skill
Can be rapidly progressive and life threatning
Facial swelling
Facial nerve involvement
163
Who does malignant otitis extrna almost always occur in
Diabetic patients
164
What is topical sprue
A cause of chronic diarrhoea and malabsorption assosiated with travel to the tropics (including india and SE asia)
Exact aietology unclear
Can present months or years after travel
165
Presentation of topical sprue
Diarrhoea
Steatorrohoea
Weight loss
Malabsorption symptoms
166
What should HIV anti retroviral therapy consist of
two nucleoside reverse transcriptase inhibitors and one other agent
e.g.
efaivranez/emtirictabine/tenfovir
167
What organism is most likely to be found in the sputum of an HIV positive individual
Cryptococcus spp.
168
How does cryptococcus generally present
Meningitis in immunocompromised individuals
Though pulmonary and disseminated infections may occur
169
Treatment of cryptococcal meningitis
IV amphotericin B
in combination with flucytosine or fluconazole
170
What does mefloquine (malaria prophylaxis) toxicity present as
Acute psychosis
171
Presentation of infection with the nermatoid Loa Loa (african eye worm)
slow passage across eye - can be sensed by patient
skin lesions confined to extemeties i.e. arms and legs
Lesions knwon as calabar swellings
Can be asymptomatic
Severe itching
Myalgia
Arthralgia
Tiredness
Urticaria
172
What is medetiranian spotted fever caused by
Rickettsia conorrii
173
How do you establish medeterianian spotted fever from other vector borne infections
Skin lesions eschar
- blackened centre of tick bite
174
What is enteric fever and what causes them
The collective term for typhoid and paratyphoid fevers
Salmonella typhi or salmonella paratyphi
175
Presentation of enteric fever
High fever and flu like symptoms
Abdomainal pain / constipation / diarrhoea may be present
Relative bradycardia
Blanching rash (rose spots)
Splenomegaly
176
What is seen in blood cultures in enteric fever
gram neg rods (salmonella species)
177
Key feature of mumps
Parotitis
178
WHat happens in 10% of patients with mumps and the treatment
Viral meningitis
Resolves spontaenously
Orchitis
Specialist review
179
Is mumps a notifiable disease
Yes
180
Mechanism of action of vancomycin
Prevents synthesis of polymers for the bacterial cell wall
181
What is IRIS (immune reconstitution inflammatory syndrome) and how does it present
Seen in HIV positive patients after commencing antiretrovirals
Presents as a paradoxical worsening of other infections
Tends to occur in patients with a very low CD4 count
182
Which anti retroviral used in HIV is commonly assosiated with a rash
Nevirapine
183
What do the questions commonly use as an antibiotic for cellulitis if someone is allergic to penciillin
Clindamycin
184
What should be suspected in every case of fever in a returning traveller, despite prophyaxis
Malaria
185
What can occur in assosiated with P falciparum infection
Blackwater fever
Intravascular haemolysis
Characteristic dark urine
186
Treatment of severe / cerebral malaria
IV artesunate
IV quinine if above not available
187
PEP post needlestick injury from higher risk patient
3 anti retroviral agents for 1 month
188
What causes paragonimiasis
Trematode fluke - paragonimus westermani
(ingested from an infected crustacean)
189
Features of paragonimiasis
Penetrate gut wall, peritoneum and the lungs
Cellular reaction, eosinophilia and haemorrhage
Granulomatous response
190
Treatment of african tick typhus
Doxy
191
Is yellow fever a live vaccine
Yes
192
What causes a viral meningitis caused by the mumps virus
Paramyoxvirus
193
Treatment of schistosomiasis
Praziquantel
194
Treatment of Loa loa / loiasis
Diethylcarbamazine (DEC)
195
Treatment of diardiasis
Tinidazole
196
Key features of strongylodies infection
Urticarial rash
Abdominal symptoms
Peripheral blood oesinophilia
197
Treatment of storngylodies infection
Ivermetcin or albendazole
198
Which part of the life cycle occurs in P vivax but not P falciparum
Hypnozoites
199
What are hypnozoites
Represent the dormant liver stage of p vivax and ovale
can cause late relapses after treatment
Not in p falciparum
200
Common pathogens causing bacterial meningitis in the immunocompromised
Strep pneumoniae
Neiserria meningitis
Listeria monocytogenes
Aerobic gram neg bacilli
201
Which organism is most likely to cause a culture negative endocarditis
Coxiella burnetti (Q fever)
202
Causes of culture negative endocarditis
Prev antibiotic administration
Brucells
Bartonella
Corxiella burnetti
Fungal causes
Malignancy
SLE
203
Virus causing kapsois sarcoma
Human herpesvirus 8
204
Prophylaxis for meningococcal B
Cirpofloxacin
205
Treatment of CMV encephalitis in HIV patients
Ganciclovir
206
What transmits epidemic typhus
Human body louse
207
Commonest cause of epididymo-orthitis in < and > 35s
< - STIs
> - gram neg enteric bacteria
208
Treatment of epidiymo orchiritis if NOT suspecting an STI
Ofloxacin
209
What causes yellow fever
Flavivirus
210
Presentation of yellow fever
Can be mild
Severe flu like illness
Pyrexia up to 40C
Epigastric pain
Vomiting
Bradycardia (fagets sign) on 2nd day of the illness
Recovery phase
Severe fever again
Jaundiced
Hepatomegaly
Bleeding from gums / bruising / haematemesis / melena
211
Treatment of yellow fever
Supporitve
212
Investigation for group A strep
Anti-streptolysin O titre
213
WHat can a high eosinophil count indicate
Helminth infection
214
Treatment of decomp liver failure in the context of chronic hep B
Entecavir
215
When is delayed initiation of ART considered
When CD4 count < 50
216
50% of patients have what
Pleural effusion
217
WHat organism causes cat stratch disease
Bartonella Heneslae
218
Pathology of bacterial vaginosis
Healthy microbiota of female GU tract (lactobacillus, L crispatus, L jensii and Liners ) are replaced by predominantely anaerobic micro organisms, such as gardenerlla vaginalis or prevotella, peptosteptococcus and bacteriodes spp.
219
WHat type of mosquites vector all malaria
Anopheles
220
What type of diseases do the aedes mosquito vector
Dengue
Yellow fever
Zika
221
Which type of malaria has the shortest incubation
Falciparum
222
What is PML caused by
JC virus
223
Presentation of PML
Focal, progressive neurology due to white matter demhyelination
Occurs weeks to months
224
Guidelines for travel for patients with active TB
IF
- have evidence of drug susceptible disease or no signs of drug resistance AND
- Do not have a clinical or public health need for admission to hospital
Can travel two weeks after starting therapy
Different if HIV positive or immunosuppressed
225
Malaria types capable of true dormancy
Vivax and ovale
226
Where can you catch p. ovale
only in sub saharan africa
227
Fundoscopy of HSV keratitis
Cornea - dendritic ulcer
Ulcer with linear blanching pattern
Terminal bulbs
Swollen epithelial borders
Central ulceration through the basement membrane
228
What serological tests would indicate if someone had previously had Hep B but has now completely cleared the infection
Postivie for both core and surface antibodies
Negative surface antigen
229
WHat is the marker of infection serologically for Hep B
Surface Antigen
230
Organisms that cause bloody diarrhoea
Salmonella
Shigella
Enterohaemorrhagic E coli
Entamoeba histolytica (slower course of disease)
231
S/E ethambutol
Ocular complications / optic neutritis
232
S/E of isoniazid
Drug induced hepatitis
Peripheral neuropathy
233
S/E Pyrazinamide
hepatotoxic
234
S/E rifampicin
Pink/orange secretions
Drug induced hepatitis
Interacts with alot of other medications
235
Which anti-malarial agent is affective against liver hypnozoites
Primaquine
236
Is streptococcus gram negative or positive
positive
237
Is neisseria meningitidis gram negative or positive
negative
238
What is trachoma and what is it caused by
Chronic keratoconjunctivitis
Chlamydia trachomatis
239
Patients with advanced HIV infection and CD4 counts < 50 are at high risk of what
Disseminated mycobacterium avium complex (MAC) infection
240
In questions . sitting near a river might indicate what
Possibility of exposure to rats urine (leptospirosis)
241
Causative organism of prosthetic joint infections that are chronic
Staphlococcus epidermi
242
Is chicken pox a live vaccine
yeS
243
What kind of bacteria is legionella
gram negative rod
244
Treatment for leprosy and for how long
Dapsone, clofazimine, rifampicin
At least 2 years
245
What bacteria can you get consuming soft cheeses
Listeria
246
What is the concern after a bat bite in the UK
Rabies
247
Treatment of high risk exposure to rabies in a non immune patient
Both rabies immunoglobulin and vaccine
248
Treatment of low risk exposure to rabies / someone who has been previously vaccinated
Vaccine course only
249
What kind of bacteria is gonorrrhoea
Gram negative diplococci
250
What is an indium labelled leukocyte study for
Detecting occult abcesses in patients of PUO whos conventional scans have failed to detect a source of infection
251
When does the jarish Herxheimer (JH) typically occur
Sphirochete infections e.g. lymes disease
Syphillis
Leptospirosis
Symptoms follow the first dose of antibioticd
252
What should be avoided in a pregnant patient with HIV
Foetal blood sampling
253
Treatment of chronic hep C infection of genotypes 1 or 4, with or without compensated cirrhosis
Daclatasvir and sofosbuvir
254
Treatment of genital warts secondary to HPV
Topical podophyllotoxin
255
What virus causes kaposis sarcoma
HHV-8
256
What virus causes hand foot and mouth disease
Coxsackie virus
257
Presentation of HFM disease
incubation 3-5 days
Followed by flu like symptoms
Yellow grey ulcers in mouth
Vesicular rash on hands and feet
Episodes often self limiting but can have complications - myocarditis, meningitis, encephalitis
258
Treatment of HFM disease
Supportive
259
How does s. schnekkii infect humans
Lives on soil and plant matter
Enters skin through cut or scrape
260
Treatment of s. schnekki infections
Reddish, non tender, maculopapular lesion at the site of innoculation (10 weeks after)
Over next several weeks. similar nodules form along proximal lymphatic channels
These break down and form a row of ulcers
261
Diagnosis of s. schnekki infections
Culture of biopsy samples on Sabouraud dextrose agar
262
Treatment of s. schnekki infection
Itraconazole
More severe / immunocompromised - IV amphotericin B
263
Which adults should receive aciclovir for chicken pox
If rash < 72 hours of onset and
- immunocompromised or
- non truncal parts of body or
- mod - severe pain or
- severe rash
264
What renal problem can secondary syphilis cause
Acute glomerulonephritis
265
Bacteria that are gram positive cocci
Staph
Strep
Enterococci
266
Bacteria that are gram positive rods
Actinomyces
Bacillus
Clostridium
Diptheria
Listeria monocytogenes
267
Bacteria that are gram negative cocci
Neisseria
Moraxella
Brucella
268
Bacteria that are gram negative rods
Legionella
Campylobacter
E coli
Pseudomonas
Proteus
Salmonella
269
What is the procedure if someone has a needle stick injury from someone who is positive for Hep C
Hep C virus ribonucleic acid monthly surviellance
If signs of seroconversion - treatment with antivirals can be initiayed
270
What abdominal symptom does giardiasis present with whihc the mechanism of which is not fully understood
Malabsorptions symptoms
271
How to differentiate between the 3 causative organisms of asthelets foot
Trichophyton - multiple small microconidia
Microsporum - produce single microconidia or multiseptate macronconidia
Epidermophyton - do not produce conidia
272
What is the CD4
T-helper cell
273
Cancer assosiations of EBV
Gastric cancer
Nasopharyngeal carcinoma
274
Definition of treatment failure in TB
Positive cultures after 4 months of therapy
275
What causes chancroid
Haemophilus ducreyi
276
Presentation of chancroid
Incubation 4 - 7 days
Erythematous papule forms
Subsequently breaks down into a painful ulcer
Painful inguinal lymphadenopathy develops, unusually unilaterally, which can suppurate
Several ulcers can merge to form giant serpiginous lesions
277
Diagnosis of chancroid
Isolating the organism from swabs taken from the lesion and cultured on chocolate based media
278
Treatment of chancroid
Single dose azithromycin
IM cef
3 day course erythromycin
279
When should oropharyngeal anthrax be considered
Patients who present with fever, severe pharyngitis and neck oedema
Particularly if there is consumption of raw or undercooked meat
280
Which vaccine can HIV positive patients not have
BCG
281
WHat can be used to cover for listeria in meningitis in patients with a penicillin allergy
Co-trimoxazole (instead of amoxicillin)
282
Treatment of falciparum malaria
Artemether with lumefantrine
283
Who is oral hairy leukoplakia seen in
HIV positive patients
284
Causative organism of ora hairy leukoplakia
EBV (in HIV positive patients)
285
Presentation of oral hairy leukoplakia
Similar appearance to candida
Irregular white patches on tongue and oral mucosa
Covered in tiny hair like projections occuring along the folds
Cannot be dislodged with scraping
286
Treatment of oral hairy leukoplakia
Managing underlying cause
287
WHat CD4 count do you need to have to get a live vaccination with HIV
> 200
288
What causes impetigo
Staph aureus
Occassionally strep pyogenes
289
Treatment of impetigo
Topical fusidic acid
290
What causes schistocytes on a blood film
Acute haemolytic anaemia
291
Presentation of congenital varicella syndrome
LBW
Characteristic abnormalities of the skin arms, legs, hands and extremeties, brain and eyes
Symptoms may vary depedning on timing of infection
292
Which ART is known to cause renal stones in 10% of patients who take it
Indinavir
293
Usual firm line treatment for ESBL
Meropenem
294
Infection period of chickenpox
1-2 days before the rash until all of the lesions are crusted and dry
295
Statin lowering drug that is preferred in HIV patients
Pravastatin
296
What causes bacterial vaginosis
Garnderella vaginalis
297
What causes the weakness in botulism
Exotoxin release
298
What suggests lupus vulgaris
A chronic progressive irregular plaque like lesion with central scarring from an invidual from an endemic area
299
What is the lupus vulgaris the most common manifestiation of
cutaneous tuberculosis
300
Malaria prophylaxis in patients with epilepsy
Doxycycline
Atovaquone with proguanil hydrochloride (Malarone)
301
WHat does an increasing PR interval in a patient with IE indicate
Aortic root abscess / sign of uncontrolled infection
302
Commonest cause of encephalitis in the UK
HSV
303
Which ARVs have the S/Es of hyperlipidaemia
Ritonavir
Lopinavir
304
Mechanism of action of mebendazole
Inhibitor of tubulin polymerisation
305
What does poor HIV control and middle/lower third oesophageal ulcers indicate
CMV infection
306
Treament of CMV in HIV individuals
Valganciclovir
307
Causative organism of BV
Gardnerella vaginalis
308
What to do if a pregnant lady is exposed to chicken pox
1. Varicella zoster antibody testing
- if positive - no further intervention required
- if negative - VARICELLA ZOSTER IMMUNE GLOBULIN
If develops symptoms (aciclovir within 24 hours of onset)
309
What is the fancy name of the worm seen in the UK
Enterobius vermicularis
310
Investigation of leptospirosis
Microscopic agglutination test
311
Treatment of C diff
1. Vanc
2. Metronidazole
312
Most common adverse effect of immunoglobulin infusions
Headache
313
Treatment of cellulitis in a DIABETIC patient
co-amoxiclav
314
What causative organism would you think of if someone has pharyngitis, and develops a non blanching maculopapular rash around 48 hours of commencement of antibiottics treatment
EBV
315
Treatment of syphillis in a penicillin allergic patient
Doxycycline
316
Treatment of UTI in a breastfeeding woman who is pen allergic
Cefixime
317
Ascitic / abdominal involement TB - treatment duration
6 months
318
Investigation of cutaneous leishmaniasis
Punch biopsy from edge of an ulcer
319
Prophylaxis of close contacts of patients diagnosed with meningococcal meningitis
Single dose of ciprofloxacin
320
Common cause of insect bites infection
Strep pyogenes
321
Susceptibility to PJP can be associated with high levels of what
IgM
322
