ID

Question 1

why are Abx not often given with EHEC?

Answer 1

Increase risk of HUS

Question 2

EHEC management?

Answer 2

Rehydrate, supportive therapy, notify PH

Question 3

commonest cause of HAIs?

Answer 3

Blood-stream infections
pneumonias including VAPs
UTIs
Surgical site infections
(S.AUREUS)

Question 4

Student S. America returns 1 week before return, bloody, mucous diarrhoea, febrile, abdo pain - likely cause?

Answer 4

salmonella typhi

Question 5

foul smelling discharge - BV - clue cells - Rx?
(Gardnerella vaginalis)

Answer 5

Metronidazole

PO>topical and stat. 400mg BD 7/7

Question 6

Gonorrhoea Rx:

Answer 6

stat dose IM CRO

Question 7

lower abdo pain, dyspareunia, PV discharge - chlamydia + - Rx?

Answer 7

7/7 doxycycline

azithro if preg, br feeding/allergy

Question 8

CIs to LP in child suspected of bacterial meningitis:

Answer 8

Sx raised ICP
haemodynamic instability
Extensive/spreading purpura
multiple seizures - until stabilised
Plt <100
Infection at LP site
respiratory compromise
GCS <9 or drop grater than 3
relative bradycardia + HTN

Question 9

Mastitis abx of choice in breastfeeding?

Answer 9

Flucloxacillin

Question 10

Lyme (Borellia) Abx?

Answer 10

Doxycycline

Question 11

?Meningococcal septicaemia abx of choice?

Answer 11

IM Benpen stat then get to ED

Question 12

Dx rabies?

Answer 12

clinical or PCR

Question 13

20M returns S America, headache, fever, rash, meningism, deafness - dx and key Ix?

Answer 13

Typhys (Rickettsia). Serology.

Question 14

Schisto Ix?

Answer 14

Urine microscopy (…)

Question 15

steroids for COPD and new dysphagia?

Answer 15

oropharyngeal candidiasis

Question 16

change PV discharge, thin, fishy, clue cells -

Answer 16

BV

Question 17

UTI men abx and length?

Answer 17

Nitro/trim = 7/7

Question 18

B. Burgdorferi Ix?

Answer 18

Anti-Borrelia burgdorferi titre
hard to culture

Question 19

which step in HIV converts viral RNA into DNA?

Answer 19

Reverse transcriptase

Question 20

acute epiglottitis caused by?

Answer 20

Hib

Question 21

Ringworm Rx?

Answer 21

Miconazole

Question 22

ringworm rash - describe?

Answer 22

annular spreading appearance
also dermatophytosis

Question 23

aims of ART:

Answer 23

VL<50
CD4>350
reduce transmission
improve QOL while reducing SFx

Question 24

transmission and incubation HAV?

Answer 24

FOT
2-6 weeks

Question 25

who should not receive oral aciclovir for shingles?

Answer 25

otherwise F+W children - self-limiting pregnancy - low risk IC - IV needed

Question 26

STI intracellular diplococci?

Answer 26

N. Gonorrhoeae

Question 27

Abx for giardia?

Answer 27

metronidazole

Question 28

STI 1st line ix?

Answer 28

NAAT

Question 29

ix giardiasis?

Answer 29

if <14 days - stool mc+s if >14/7 - send 2-3 stools

Question 30

Ghana, painless rash on trunk, scaly, pale patches, 1-3cm diameter ?

Answer 30

Pityriasis Vesicolor Malasezzia furfur - yeast. skin scrapings mc+s

Question 31

amox 2/7 ago, rash, lymphocytosis - dx?

Answer 31

EBV/Mono

Question 32

hand foot and mouth =

Answer 32

coxackie A virus vesicles rash on hands and feet and grey ulcers on mucosa

Question 33

36F yellow-green d/c. swollen and erythematous vagina -

Answer 33

thrichomoniasis strawberry cervix

Question 34

42M W Africa, 2/52 headaches, fever. intermittent diarrhoea, weight loss over last year. only abnormality is fever OE. dx?

Answer 34

fungal men (due to weight loss and diarrhoea...) tbf, OP would be higher in TBM

Question 35

70M T2DM L swelling face, extending. facial nerve palsy. green purulent d/c ear. includes forehead - causative pathogen?

Answer 35

pseudomonas aeruginosa (malignant otitis externa 2 to DM)

Question 36

Leigonella - micro, e- abnormality, abx?

Answer 36

G- rods hyponatraemia macrolides/quinalones

Question 37

herald patch few days before widespread itchy rash indicates?

Answer 37

Pityriasis Rosea Viral - Herpes 6/7 viruses

Question 38

prophylaxis for meningitis contact?

Answer 38

ciprofloxacin

Question 39

commonest cause nosocomial skin infection?

Answer 39

hand hygiene (lack of)

Question 40

commonest cause of bacterial food poisoning in UK?

Answer 40

campylobacter jejuni FOT 2-5 days inc

Question 41

bacillus cereus incubation?

Answer 41

2-12 hours

Question 42

commonest cause of vaginal ulceration UK/USA?

Answer 42

herpes

Question 43

chancroid caused by?

Answer 43

Haemophylus ducreyi

Question 44

important notifiable disease UK ?

Answer 44

malaria

Question 45

norovirus vs c.diff based on symptoms?

Answer 45

c.diff less likely to have nausea, vomiting, more severe diarrhoea

Question 46

offensive yellow frothy discharge from vagina, erythema of mucosa -

Answer 46

trichomonas vaginalis (flagellated protozoa) - strawberry cervix

Question 47

HIV commonest opportunistic diahhroeal cause?

Answer 47

cryptosporidium

Question 48

screening of latent TB in high risk groups - ix?

Answer 48

mantoux test

Question 49

sporozoites produced where?

Answer 49

in liver during exoerythrocytic cycle

Question 50

50M farmer tick bite 2 weeks ago fever, flu-sx, dry cough, LZ creps, HSM Dx?

Answer 50

Q fever - coxiella burnetti

Question 51

50M recurrent fevers, Saudi return, arthralgia, weight loss, epididymo-orchitis, sacroiliitis?

Answer 51

Brucellosis

Question 52

hepatitis returning from India, student, no sexual/IV ect. =

Answer 52

Hep A

Question 53

CMV retinitis?

Answer 53

Pizza-pie appearance large multiple cotton wool spots

Question 54

CMV leads to?

Answer 54

GI ulceration Hepatitis Retinitis Pneumonitis Encephalitis Rx - galvanciclovir

Question 55

BV ix?

Answer 55

vaginal pH

Question 56

HBV - which serology test would be positive in vaccination?

Answer 56

HBSAb

Question 57

Weil's disease?

Answer 57

severe acute leptospirosis

Question 58

EBV sx?

Answer 58

abnormal LFTs sore throat severe cervical LN

Question 59

rose spots and relative bradycardia =

Answer 59

salmonella sp - blood culture

Question 60

S. Africa, return, high swinging fever 5 days, RUQ tender - dx ix

Answer 60

liver abscess, USS, aspirate

Question 61

Vietnam return then generally unwell 2 weeks later - ix, dx

Answer 61

malaria, T&T

Question 62

abx tomnsilitis requiring abx?

Answer 62

penicillin

Question 63

abx post-splenectomy?

Answer 63

penicillin

Question 64

Abx Gas gangrene?

Answer 64

vancomycin

Question 65

Abx PMC colitis?

Answer 65

vancomycin (PMC is caused by c.diff!!!)

Question 66

what is unusual about children presenting with UTIs?

Answer 66

diarrhoea common

Question 67

Hx N.Meningitidis, new meningitis sounding picture - likely overall deficiency?

Answer 67

MAC formation deficiency