INFECTION Flashcards

Question

What are granulocytes?

Answer 1

Types of white blood cell which are professional phagocytes and have granular cytoplasm

Answer 2

Basophils Neutrophils Eosinophils

Answer 3

Neutrophils

Answer 4

Multi-lobed nucleus Granules in cytoplasm

Answer 5

Phagocytosis Release of antimicrobial substances Neutrophil Extracellular Traps Chemotaxis

Answer 6

Recognise pathogen via PAMP/DAMP, extend cells membrane around pathogen, engulf pathogen into vesicle, vesicle fuses with a lysosome to break it down

Answer 7

Myeloperoxidase Collagenase Lysozyme Reactive oxygen species Nitric oxide

Answer 8

Neutrophils can release their DNA and proteins to form sticky webs that trap pathogens making it easier for other immune cells to destroy them

Answer 9

Chemotactic signals from activated macrophages, peptide fragments of cleaved complement proteins and some PAMPs

Answer 10

Phagocytosis Immune response activation, they present antigens to T-cells Wound healing Cytokine production

Answer 11

Macrophages

Answer 12

multi-lobed

Answer 13

Parasite defence Allergic reactions Asthma

Answer 14

Dead neutrophils/pathogens

Answer 15

Check if cells have appropriate immune recognition cells on surface. If not they are likely cancerous or infected so they are persuaded to commit apoptosis

Answer 16

Pain Redness Heat Swelling

Answer 17

Blood vessels dilate, leading to local swelling and the accumulation of components of the immune system

Answer 18

In mucosal tissues, not in circulation

Answer 19

Tetrameric, with four polypeptide chains 2 identical heavy chains (H) and two identical light chains (L), held together by covalent disulphide bonds at the hinge and between H and L chains

Answer 20

IgG IgM IgD IgA IgE

Answer 21

Free in blood plasma

Answer 22

Surface of B cell In blood plasma

Answer 23

Surface of B cell

Answer 24

Saliva Tears Milk Other body secretions

Answer 25

Secreted by plasma cells in skin and tissues surrounding GI and respiratory tracts

Answer 26

Bone marrow

Answer 27

help the immune system distinguish between self and non-self and determine whether to attack or leave a cell alone.

Answer 28

All nucleated cells

Answer 29

Some immune cells such as macrophages, dendritic cells and B cells

Answer 30

T-helper (CD4+) T-regulatory (CD4+) T-cytotoxic (CD8+)

Answer 31

A biological response to harmful stimuli, characterized by symptoms such as pain, redness, heat, and swelling.

Answer 32

Dilation of blood vessels and accumulation of immune system components.

Answer 33

Cytokines, including chemokines that attract neutrophils.

Answer 34

* TNF-α * Prostaglandins * Leukotrienes * Platelet activating factor * C5a

Answer 35

A persistent inflammatory response caused by factors such as pathogens, tumors, autoimmunity, and tissue damage.

Answer 36

* Pathogen * Tumours * Autoimmunity * Atherosclerosis * Heart disease * Obesity

Answer 37

A condition including Ulcerative colitis and Crohn’s disease, characterized by an immune reaction to gut microbiota.

Answer 38

An inflammatory condition where macrophages recruit TH1 cells.

Answer 39

An autoimmune disease mediated by CD4+ T cells leading to B cell activation and IgA release.

Answer 40

An autoimmune disease causing chronic inflammation of the joints, affecting multiple body systems.

Answer 41

The Fc region of IgG.

Answer 42

They are deposited in joints and activate the complement cascade, causing type III hypersensitivity reaction.

Answer 43

* Primary Lymphoid Organs * Secondary Lymphoid Organs * Tertiary Lymphoid Organs

Answer 44

The breaking of self tolerance leading to response to self antigens.

Answer 45

Self reactive cells are inactivated or undergo death.

Answer 46

* Central tolerance * Peripheral tolerance

Answer 47

Infection can break self-tolerance.

Answer 48

Cytotoxic, antibody-dependent disease.

Answer 49

They either prevent endogenous ligand binding or mimic ligand effects.

Answer 50

Hyperthyroidism.

Answer 51

Progressive muscle paralysis.

Answer 52

Immune complex disease where antibodies bind to soluble antigens.

Answer 53

Rheumatoid Arthritis (RA).

Answer 54

Joint destruction and chronic disability.

Answer 55

They produce autoantibodies known as Rheumatoid Factor.

Answer 56

Found in ~80% of RA patients.

Answer 57

* TNFα * TNF-like molecules * IL-6

Answer 58

Delayed type hypersensitivity.

Answer 59

T-lymphocytes.

Answer 60

A type IV hypersensitivity.

Answer 61

An immune response to the food allergen gluten.

Answer 62

Loss of intestinal villi and severe inflammation of the intestine wall.

Answer 63

Suppression of the immune system increases susceptibility to infections.

Answer 64

Macrophages stimulate the proliferation of CD4+ T cells.

Answer 65

They destroy target cells on contact.

Answer 66

They initiate local inflammatory reactions.

Answer 67

The MHC receptor that binds peptides with glutamic acid.

Answer 68

It presents a serious socio-economic burden.

Answer 69

Individuals between the ages of 25-35.

Answer 70

An inappropriate immune response to harmless antigens or self-antigens.

Answer 71

Type I, Type II, Type III, and Type IV hypersensitivity.

Answer 72

Production of an IgE response to an innocuous antigen.

Answer 73

Mast cells and basophils.

Answer 74

A predisposition to develop allergic reactions.

Answer 75

Clearing worm infections.

Answer 76

Hygiene hypothesis, modified as counter-regulation hypothesis.

Answer 77

A form of eczema characterized by itchy, red, dry, and cracked skin.

Answer 78

10% to 20% in the first decade of life.

Answer 79

Cracked, sore, and bleeding skin.

Answer 80

Anaphylaxis.

Answer 81

A severe allergic reaction that can lead to catastrophic loss of blood pressure.

Answer 82

Some drugs, e.g., penicillin.

Answer 83

The drug binds to RBCs, inducing an antibody response and causing anemia.

Answer 84

Reactions that arise from stimulation with soluble antigens causing immune complex disease.

Answer 85

Serum sickness.

Answer 86

Antigen specific effector T cells of TH1 or CD8+ subtypes.

Answer 87

Coeliac disease.

Answer 88

Urticaria.

Answer 89

Anaphylactic shock.

Answer 90

Peanut allergy.

Answer 91

Suppressing TH2 cytokine production.

Answer 92

Reduced production of Treg cells, leading to increased atopy.

Answer 93

IgE ## Footnote Type I reactions are mediated by Immunoglobulin E (IgE) antibodies.

Answer 94

Soluble ## Footnote Type I reactions typically involve soluble allergens.

Answer 95

Mast cell degranulation ## Footnote This leads to the release of histamines and other mediators.

Answer 96

* Allergic rhinitis * Asthma * Anaphylaxis ## Footnote These conditions are common manifestations of Type I hypersensitivity.

Answer 97

IgG or IgM ## Footnote Type II reactions are mediated by Immunoglobulin G (IgG) or Immunoglobulin M (IgM) antibodies.

Answer 98

Cellular ## Footnote Type II reactions typically involve cellular antigens.

Answer 99

Complement activation and cell lysis ## Footnote This can lead to the destruction of target cells.

Answer 100

* Hemolytic anemia * Goodpasture syndrome * Graves' disease ## Footnote These conditions exemplify Type II hypersensitivity reactions.

Answer 101

IgG ## Footnote Type III reactions are primarily mediated by Immunoglobulin G (IgG) antibodies.

Answer 102

Soluble ## Footnote Type III reactions involve soluble immune complexes.

Answer 103

Inflammation and tissue damage ## Footnote This occurs due to the deposition of immune complexes.

Answer 104

* Systemic lupus erythematosus * Rheumatoid arthritis * Serum sickness ## Footnote These are examples of conditions associated with Type III hypersensitivity.

Answer 105

T cells ## Footnote Type IV reactions are mediated by T lymphocytes (T cells).

Answer 106

Cellular ## Footnote Type IV reactions involve cellular antigens.

Answer 107

Delayed-type hypersensitivity response ## Footnote This leads to inflammation and tissue damage over time.

Answer 108

* Contact dermatitis * Tuberculin skin test * Graft-versus-host disease ## Footnote These conditions represent Type IV hypersensitivity reactions.

Answer 109

A network of vessels and nodes that conveys lymph, returning plasma-derived interstitial fluids to the bloodstream and integrating the immune system.

Answer 110

* Defend the body against pathogens * Develop body immunity * Remove excess fluids * Absorb and transport fats * Produce immune cells

Answer 111

In the primary lymphoid organs.

Answer 112

* Bone marrow * Thymus

Answer 113

They reside in the bone marrow and are responsible for blood formation (haematopoiesis).

Answer 114

T-lymphocytes complete maturation in the thymus.

Answer 115

A method to treat certain types of cancer, including leukemia and lymphoma, often referred to as stem cell transplants.

Answer 116

Organs where the immune response is initiated, including lymph nodes, spleen, and mucosa-associated lymphoid tissue (MALT).

Answer 117

Organizes the immune response against blood-borne pathogens.

Answer 118

* Cortex * Follicle * Para-cortex * Medulla

Answer 119

Tissue that organizes responses to antigens entering mucosal tissues, including tonsils and Peyer's patches.

Answer 120

* Dolor: pain * Rubor: redness * Calor: heat * Turgor: swelling

Answer 121

They recognize, engulf, and destroy foreign invaders and inform other immune cells about the invaders.

Answer 122

Signaling molecules secreted by immune system cells that mediate inflammation and immunity.

Answer 123

Innate immunity is activated by chemical characterization of the antigen, while adaptive immunity is antigen-specific.

Answer 124

An autoimmune disease characterized by chronic inflammation of the joints and can affect other systems.

Answer 125

* Pathogen * Tumours * Autoimmunity * Atherosclerosis * Heart disease * Obesity

Answer 126

An intrinsic body defense during acute illnesses involving changes in the production of blood proteins.

Answer 127

* TNF-α * Chemokines * Prostaglandins * Leukotrienes * Platelet activating factor * C5a

Answer 128

1. Atopic Eczema 2. Seborrhoeic Eczema 3. Nappy Rash 4. Contact Dermatitis 5. Dyshidrotic Eczema 6. Stasis Dermatitis 7. Neurodermatitis

Answer 129

An immune system induced condition that is more common in children and often develops before their first birthday

Answer 130

Mild: dry, scaly, red, itchy Severe: weeping, crusting, bleeding

Answer 131

* Soap and detergents * Skin infection * House-dust mites * Animal dander * Pollens * Overheating * Rough clothing

Answer 132

Moisturising treatments applied topically to soothe, smooth, protect, and hydrate the skin

Answer 133

A way of keeping skin moisturised by using a combination of products liberally and frequently

Answer 134

At least 3-4 times a day

Answer 135

Can cause skin reactions such as stinging, burning, itching, and redness in some patients

Answer 136

Discontinue treatment and try an alternative emollient that does not contain SLS

Answer 137

* Mild * Moderate * Potent * Very potent

Answer 138

Applied thinly to affected areas only, no more than twice a day

Answer 139

To reduce inflammation and irritation during flare-ups

Answer 140

Cradle cap

Answer 141

Greasy, yellow or brown scaly patches that appear on the scalps of young babies

Answer 142

Do not pick at the scales as it may prompt an infection

Answer 143

Prolonged exposure to urine and/or faeces

Answer 144

Marked redness with exudate, and vesicular and pustular lesions

Answer 145

Antifungal cream, such as Clotrimazole

Answer 146

If it spreads to other areas or worsens despite treatment

Answer 147

Apply in a downward motion, following the direction of the hairs

Answer 148

To hydrate the skin, reduce itching/scratching, and prevent secondary infections

Answer 149

Length of cream/ointment from the tip of an adult index finger to the crease

Answer 150

Apply emollient up to 20 minutes before to hydrate the skin

Answer 151

Clotrimazole ## Footnote Clotrimazole is commonly used to treat fungal infections.

Answer 152

After the candidal infection has settled.

Answer 153

Bacterial and Fungal.

Answer 154

If it is spreading to other areas, getting worse or not responding to treatment, bacterial infection is present or suspected, fungal infection coexists with oral thrush, or systemic symptoms like fever occur.

Answer 155

Factors include: * Readily available * Selectively toxic against a range of organisms * Site of infection * Mode of administration * Chemically stable * Metabolism and excretion * Duration of treatment * Toxicity * Cost * Local rates of resistance ## Footnote These factors help determine the most effective antibiotic for a patient.

Answer 156

Characteristics include: * Appropriate spectrum of activity * No toxicity to the host * Low propensity for resistance development * No hypersensitivities induced * Rapid and extensive tissue distribution * Relatively long half-life * Free of drug interactions * Convenient administration * Relatively inexpensive * Chemically stable ## Footnote An ideal antibiotic should effectively treat infections without harming the patient.

Answer 157

Examples include: * Bacillus subtilis: Bacitracin * Bacillus polymyxa: Polymyxin ## Footnote These microbes are known for their antibiotic production.

Answer 158

An antibiotic is a substance produced by a microorganism that inhibits the growth of another microbe in low concentrations. ## Footnote Antibiotics can be derived from natural sources, semi-synthetic, or synthetic.

Answer 159

Antibacterials are relatively easy to develop due to the differences between prokaryotic and eukaryotic cells. ## Footnote This allows for low toxicity in antibacterial drugs.

Answer 160

Antivirals are the most difficult to develop because viruses use host cell enzymes and machinery for reproduction. ## Footnote This complicates targeting the virus without affecting the host.

Answer 161

The key is selective toxicity. ## Footnote This means that the drug should target the pathogen without harming the host.

Answer 162

MIC is the minimum concentration of antibiotic required to inhibit the growth of the test organism. ## Footnote It is a crucial measurement in determining antibiotic effectiveness.

Answer 163

Bacteriostatic inhibits growth, while bactericidal kills the organism. ## Footnote Understanding this difference is important for selecting appropriate treatments.

Answer 164

Targets include: * Inhibit cell wall production * Inhibit protein synthesis * Inhibit nucleic acid synthesis * Block biosynthetic pathways * Disrupt bacterial membranes ## Footnote These targets help disrupt essential functions of pathogens.

Answer 165

Antibiotic resistance is the inability to kill or inhibit the organism with clinically achievable drug concentrations. ## Footnote Resistance can be innate or acquired through mutation or foreign DNA.

Answer 166

Factors include: * Inadequate antibiotic levels * Short duration of treatment * Overwhelming numbers of organisms * Overuse/misuse of antibiotics ## Footnote These factors can lead to increased resistance in microbial populations.

Answer 167

Biosafety levels include: * BSL-1: No disease in healthy humans * BSL-2: Moderately hazardous agents * BSL-3: Microbes in safety cabinets * BSL-4: Severe or fatal disease agents ## Footnote These levels dictate the safety protocols in laboratory settings.

Answer 168

An autoclave is used for moist heat sterilization. ## Footnote It is an effective method for sterilizing equipment and materials.

Answer 169

Lyophilization is used for the long-term preservation of microbial cultures. ## Footnote It prevents the formation of damaging ice crystals.

Answer 170

Refrigeration decreases microbial metabolism, growth, and reproduction. ## Footnote It slows down chemical reactions and limits available liquid water.

Answer 171

Incineration is the ultimate means of sterilization. ## Footnote It effectively destroys all forms of microbial life.

Answer 172

[inexpensive, fast-acting, stable during storage, harmless to humans] ## Footnote These characteristics enhance the effectiveness and safety of antimicrobial agents.

Answer 173

Prokaryotes lack a nucleus and membrane-bound organelles, while eukaryotes have a nucleus and membrane-bound organelles.

Answer 174

* Fungi * Protozoa * Algae * Helminths

Answer 175

Gram positive bacteria have a thick peptidoglycan layer and retain the crystal violet stain, while Gram negative bacteria have a thin peptidoglycan layer and do not retain the stain.

Answer 176

* Streptococcus pyogenes * Epstein-Barr virus * Adenovirus

Answer 177

* Neisseria meningitidis * Streptococcus pneumoniae * Haemophilus influenzae

Answer 178

* Nucleic acid (DNA or RNA) * Protein coat (capsid) * Lipid envelope (in some viruses)

Answer 179

* Inhibiting cell wall synthesis * Inhibiting protein synthesis * Inhibiting nucleic acid synthesis * Disrupting metabolic pathways

Answer 180

* Inhibiting cell wall synthesis * Disrupting cell membrane function * Inhibiting nucleic acid synthesis

Answer 181

The life cycle includes eggs being ingested, larvae hatching in the intestine, and adult worms residing in the colon.

Answer 182

* Commensalism: a relationship where one organism benefits and the other is neither helped nor harmed. * Parasitism: a relationship where one organism benefits at the expense of the other.

Answer 183

A prokaryotic cell is a simple, unicellular organism that lacks a nucleus and membrane-bound organelles.

Answer 184

Flagella are long, whip-like structures that aid in the movement of prokaryotic cells.

Answer 185

Pilus is a hair-like structure on the surface of prokaryotic cells that helps in adhesion and conjugation.

Answer 186

Prokaryotic cells lack a nucleus and membrane-bound organelles, whereas eukaryotic cells have both.

Answer 187

We have more antibiotics because bacteria are easier to target with specific mechanisms compared to viruses and fungi.

Answer 188

The main targets for antibiotics include: * Cell wall synthesis * Protein synthesis * Nucleic acid synthesis * Metabolic pathways

Answer 189

Penicillin inhibits cell wall synthesis in bacteria, leading to cell lysis.

Answer 190

Tetracycline inhibits protein synthesis by blocking the attachment of tRNA to the ribosome.

Answer 191

Rifampin inhibits RNA synthesis by binding to bacterial RNA polymerase.

Answer 192

Main causes of antibiotic resistance include: * Overuse of antibiotics * Misuse in agriculture * Incomplete courses of treatment To control resistance, we need to: * Promote appropriate antibiotic use * Enhance infection prevention * Invest in new antibiotic research

Answer 193

Bacteria can be grown on selective media, incubated at specific temperatures, and identified using biochemical tests.

Answer 194

Other mechanisms include: * Disinfectants * Heat sterilization * UV radiation * Chemical agents

Answer 195

Conjunctivitis is an inflammation of the conjunctiva that can be caused by bacteria, leading to redness, swelling, and discharge.

Answer 196

Whooping cough is a highly contagious bacterial infection characterized by severe coughing fits and is caused by Bordetella pertussis.

Answer 197

Impetigo is a superficial bacterial skin infection that causes red sores, commonly seen in children.

Answer 198

Main considerations include: * Correct antibiotic choice * Patient allergies * Susceptibility testing * Potential side effects

Answer 199

A molecular machine responsible for protein synthesis ## Footnote Ribosomes are found in all living cells and translate messenger RNA into polypeptides.

Answer 200

In prokaryotic cells, it contains the genetic material ## Footnote The nucleoid is not membrane-bound and is typically located in the cytoplasm.

Answer 201

Provides protection and helps in adherence to surfaces ## Footnote It is a sticky layer composed of polysaccharides and proteins.

Answer 202

Flagellum ## Footnote Flagella are long whip-like appendages that enable movement.

Answer 203

Single-celled eukaryotes, similar to animals in nutrient needs and structure ## Footnote They can reproduce asexually or sexually and are capable of locomotion.

Answer 204

Asexual reproduction ## Footnote Some protozoa also reproduce sexually.

Answer 205

Small amounts of DNA or RNA and a protein coat ## Footnote They are acellular and require a host to replicate.

Answer 206

Prokaryotes lack a nucleus and membrane-bound organelles ## Footnote They are typically smaller and have a simpler structure.

Answer 207

Algae, protozoa, fungi, animals, and plants ## Footnote Eukaryotes have a nucleus and are generally larger and more complex than prokaryotes.

Answer 208

Bacteria and Archaea ## Footnote Both are unicellular and lack nuclei.

Answer 209

Peptidoglycan ## Footnote This structure provides strength and rigidity to the cell wall.

Answer 210

Molds are multicellular; yeasts are unicellular ## Footnote Molds reproduce by spores, while yeasts reproduce by budding.

Answer 211

smaller ## Footnote Prokaryotic cells are generally about 1.0 µm in diameter.

Answer 212

False ## Footnote Viruses require electron microscopy for visualization.

Answer 213

1 µm ## Footnote This size is characteristic for many species of bacteria.

Answer 214

Pigmentation, storage products, and composition of the cell wall ## Footnote These factors help in the classification of different algal species.

Answer 215

Multi-celled organisms ## Footnote They can range in size from microscopic forms to large tapeworms.

Answer 216

Modification and transport of proteins ## Footnote It plays a crucial role in the post-translational modification of proteins.

Answer 217

* Mutualism * Commensalism * Parasitism ## Footnote Mutualism benefits both organisms, commensalism benefits one without harming the other, and parasitism benefits one while harming the other.

Answer 218

A normal microbiota that can cause disease under unusual circumstances. ## Footnote This can occur due to immune suppression or changes in normal microbiota.

Answer 219

* Skin * Mucous membranes * Placenta * Parenteral route ## Footnote Parenteral route includes punctures or breaks in the skin.

Answer 220

* Staphylococcus spp. * Streptococcus spp. ## Footnote These are commonly associated with opportunistic infections.

Answer 221

Triggers fever, vasodilation, inflammation, shock, and blood clots. ## Footnote Lipid A is a component of the outer membrane of Gram-negative bacterial cell walls.

Answer 222

* Neisseria meningitidis * Streptococcus pneumoniae * Haemophilus influenzae * Listeria monocytogenes * Streptococcus agalactiae ## Footnote These species account for 90% of bacterial meningitis cases.

Answer 223

* Staphylococcus spp. * Streptococcus spp. * Haemophilus influenzae * Neisseria gonorrhoeae * Moraxella spp. ## Footnote Conjunctivitis is mostly viral but can be bacterial if pus is produced.

Answer 224

Impetigo ## Footnote Impetigo is often caused by Staphylococcus aureus or Streptococcus pyogenes.

Answer 225

False ## Footnote Otitis media is common in children.

Answer 226

Bordetella pertussis ## Footnote This pathogen produces numerous virulence factors that contribute to the disease.

Answer 227

Intravenous antimicrobial drugs ## Footnote Vaccines are available for some causative agents.

Answer 228

Sore throat and difficulty swallowing ## Footnote May progress to scarlet or rheumatic fever.

Answer 229

* Escherichia coli * Serratia marcescens ## Footnote These belong to the Enterobacteriaceae family.

Answer 230

* Incubation * Catarrhal * Paroxysmal * Convalescent ## Footnote Each phase has distinct symptoms and implications for treatment.

Answer 231

Presence of vesicles ## Footnote Treatment includes penicillin and careful cleaning of infected areas.

Answer 232

Vaccines are available for key pathogens like S. pneumoniae, H. influenzae type b, and N. meningitidis. ## Footnote Vaccination helps reduce the incidence of these infections.

Answer 233

True ## Footnote Topical antibiotics may be needed if symptoms persist or if specific pathogens are suspected.

Answer 234

Amoxicillin ## Footnote 90% of cases clear without treatment after 7-9 days.

Answer 235

Mainly composed of peptidoglycan with β-lactam bonds

Answer 236

Mycoplasma pneumoniae

Answer 237

Archaea have no peptidoglycan

Answer 238

A chain of four amino acids

Answer 239

Lipid bilayer and absence of sterols

Answer 240

Protection against digestion and desiccation

Answer 241

Generally polysaccharide

Answer 242

Formed when bacteria are under stress and are highly resistant

Answer 243

* Ribosome * Cytoplasm * Nucleoid * Glycocalyx * Cell wall * Cytoplasmic membrane * Inclusions * Flagellum

Answer 244

Single chromosome, circular DNA

Answer 245

Circular, normally short, often multiple copies of DNA

Answer 246

* Fimbria - adhere to host surfaces * Pilus - structure for sexual reproduction

Answer 247

Allows movement

Answer 248

A method of bacterial reproduction

Answer 249

* Temperature * Pressure * Nutrients * Oxygen * pH

Answer 250

Organisms that thrive at high temperatures

Answer 251

Organisms that thrive in high salt concentrations

Answer 252

* Archaea * Bacteria

Answer 253

Classification of prokaryotes

Answer 254

At least 28 phyla (2 archaea, 26+ bacteria)

Answer 255

Stain pink with Gram stain but often lack a cell wall

Answer 256

* Bacillus * Listeria * Lactobacillus * Streptococcus * Staphylococcus

Answer 257

Organisms that convert CO2, H2, and organic acids to methane

Answer 258

Organisms that require extreme conditions to survive

Answer 259

Proteobacteria

Answer 260

Help in buoyancy and flotation

Answer 261

Minuscule, acellular infectious agents having either DNA or RNA, cannot carry out metabolic pathways, neither grow nor respond to the environment, cannot reproduce independently, and recruit the cell’s metabolic pathways to increase their numbers.

Answer 262

The complete virus particle, including its genetic material and protective protein coat.

Answer 263

* DNA * RNA ## Footnote Viruses may have single-stranded or double-stranded forms of these nucleic acids.

Answer 264

* Helical * Polyhedral * Complex

Answer 265

Provides protection for viral nucleic acid and acts as a means of attachment to host cells.

Answer 266

A phospholipid bilayer and proteins, often including virally coded glycoproteins.

Answer 267

* Morphology * Serology * Genetic material * Baltimore classification system

Answer 268

The form of genetic material and the method of replication.

Answer 269

* Class 1: dsDNA * Class 2: ssDNA * Class 3: dsRNA * Class 4: ssRNA (Positive Sense) * Class 5: ssRNA (Negative Sense) * Class 6: ssRNA (Positive Sense with Reverse Transcription) * Class 7: Partially dsDNA

Answer 270

* Attachment * Entry * Uncoating * Replication * Assembly and release

Answer 271

Lytic replication usually results in the death and lysis of the host cell, while lysogeny allows infected cells to grow and reproduce normally for generations before they lyse.

Answer 272

An inactive phage that integrates into the chromosome of a host bacterium.

Answer 273

Viruses cause 20–25% of human cancers by carrying copies of oncogenes, promoting existing oncogenes, or interfering with tumor suppression.

Answer 274

False; some consider them complex pathogenic chemicals, while others view them as the least complex living entities.

Answer 275

[humans, animals, plants, bacteria]

Answer 276

The protein subunits that make up a viral capsid.

Answer 277

Itchy eyes, tearing, redness, discharge, light sensitivity ## Footnote Most cases are caused by adenovirus but can be caused by many others, with Herpes Simplex virus being the most problematic.

Answer 278

Adenovirus ## Footnote Herpes Simplex virus is also a significant cause.

Answer 279

Yes, it is highly contagious and self-limiting.

Answer 280

Topical antivirals such as idoxuridine, vidarabine, and trifluridine.

Answer 281

Symptoms are generally used, but further investigation may be required in severe cases.

Answer 282

Avoid touching the eye, use separate towels and linen, stay at home.

Answer 283

Severe pain in the ears.

Answer 284

Adenoviruses.

Answer 285

Viruses in the pharynx spread to the sinuses via the throat.

Answer 286

No known treatment is effective.

Answer 287

Similar to those of bacterial meningitis, usually milder.

Answer 288

90% of cases are caused by viruses in the genus Enterovirus.

Answer 289

By characteristic signs and symptoms in the absence of bacteria in the CSF.

Answer 290

No specific treatment exists.

Answer 291

Slow spreading skin lesions, recurrence of lesions is common.

Answer 292

Human herpes viruses 1 and 2.

Answer 293

Painful lesions caused by inflammation and cell death, causing fusion of cells to form syncytia.

Answer 294

Trigeminal (V) nerve ganglion, brachial ganglia, sacral ganglia.

Answer 295

Spread between mucous membranes of mouth and genitals.

Answer 296

Presence of characteristic lesions and immunoassay revealing viral antigens.

Answer 297

Cold-like symptoms, loss of appetite, mild fever, non-itchy red rash with bumps or fluid-filled sacs, painful mouth ulcers.

Answer 298

Coxsackie virus A16, A6, A10, and Enterovirus 71.

Answer 299

By oral-oral or fecal-oral route.

Answer 300

No vaccine exists; prevention is through good hand hygiene.

Answer 301

Fever, runny nose, coughing in babies or immunocompromised individuals, mild cold-like symptoms in older children and adults.

Answer 302

Respiratory syncytial virus (RSV).

Answer 303

Virus causes syncytia to form in the lungs, immune response further damages the lungs.

Answer 304

Via close contact with infected persons.

Answer 305

Diagnosis made by immunoassay.

Answer 306

Selective toxicity.

Answer 307

* Inhibition of pathogen’s attachment to host * Inhibition of DNA or RNA synthesis * Inhibition of protein synthesis * Prevention of virus attachment.

Answer 308

Interfere with an enzyme HIV needs in its replication cycle.

Answer 309

Interfere with the function of nucleic acids and prevent further replication, transcription, or translation.

Answer 310

Act against an enzyme HIV uses in its replication cycle and do not harm people.

Answer 311

Eukaryotes ## Footnote Eukaryotes have a nuclear membrane, 80S ribosomes, and organelles.

Answer 312

Non-motile under any conditions; grow towards food

Answer 313

* Multicellular * Unicellular (e.g., yeasts)

Answer 314

Favorable conditions

Answer 315

25 – 37 °C

Answer 316

Heterotrophic organisms

Answer 317

* Saprotrophic (decaying matter) * Parasitic (living matter) * Mutualistic relationships

Answer 318

Fungi and cyanobacteria

Answer 319

* Asexual (mitosis, binary fission) * Sexual (meiosis, schizogony)

Answer 320

A structure that releases spores

Answer 321

1.5 million species

Answer 322

Division Zygomycota

Answer 323

Fungi that cause superficial infections

Answer 324

Athlete's foot

Answer 325

Mucosal membrane infections

Answer 326

Sporothrix schenckii

Answer 327

Invasive/systemic infections

Answer 328

Toxins produced by fungi under certain conditions

Answer 329

Tissue sample

Answer 330

Selective toxicity

Answer 331

Synthesis of glucan in cell walls

Answer 332

Ergosterol synthesis

Answer 333

Attaches to ergosterol in fungal membranes

Answer 334

False ## Footnote All animal species are affected.

Answer 335

Heterotrophic

Answer 336

A cell with two genetically distinct nuclei (n + n)

Answer 337

Division Ascomycota

Answer 338

* Sporotrichosis * Mycetoma

Answer 339

Antigen presentation, Helper T cell differentiation, Clonal expansion, Self-stimulation

Answer 340

Associated with body secretions

Answer 341

Involved in response to parasitic infections and allergies

Answer 342

Exact function is not known

Answer 343

Activation of complement and inflammation, Neutralization, Opsonization, Killing by oxidation, Agglutination, Antibody-dependent cellular cytotoxicity (ADCC)

Answer 344

Immunoglobulins similar to BCRs, Secreted by activated B cells called plasma cells

Answer 345

Heavy chain, Light chain, Epitope, Antigen-binding sites, Variable region

Answer 346

Each B cell generates a single BCR that recognizes only one epitope

Answer 347

In the red bone marrow

Answer 348

The secretion of antibodies

Answer 349

Exogenous antigens

Answer 350

Produced in the red bone marrow and mature in the thymus

Answer 351

Cytotoxic T lymphocyte, Helper T lymphocyte, Regulatory T lymphocyte

Answer 352

Directly kills other cells

Answer 353

Helps regulate the activities of B cells and cytotoxic T cells

Answer 354

Repress adaptive immune responses

Answer 355

Persist for months or years and are immediately functional upon subsequent contacts with epitope

Answer 356

T-independent humoral immunity, T-dependent humoral immunity

Answer 357

Originally meant protection against Smallpox; led to significant reduction in mortality

Answer 358

Lady Mary Wortley Montague

Answer 359

First vaccination using cowpox to protect against Smallpox

Answer 360

Molecules the body recognizes as foreign and worthy of attack

Answer 361

Three-dimensional regions recognized by the immune system as part of antigens

Answer 362

Specificity, Inducibility, Clonality, Unresponsiveness to self, Memory

Answer 363

The initial immune response to a specific pathogen

Answer 364

The enhanced immune response upon re-exposure to the same pathogen

Answer 365

Anthrax and Rabies vaccines

Answer 366

Vaccines ## Footnote Vaccines are widely recognized for their role in public health and disease prevention.

Answer 367

Edward Jenner ## Footnote Jenner is known for developing the smallpox vaccine.

Answer 368

The process of stimulating the immune system to produce a response against a specific pathogen.

Answer 369

The administration of pre-formed antibodies to provide immediate immunity.

Answer 370

* Triggers an immune response that creates memory * Requires only one administration * No risk of infection * No side effects * Effective against 100% of infections

Answer 371

* Type of infection * Pathogenicity of the pathogen * Determination of the antigen

Answer 372

* Attenuated (modified live) vaccines * Inactivated vaccines * Subunit vaccines * Toxoid vaccines * Recombinant vaccines * DNA/RNA vaccines

Answer 373

Active organisms that have lost their virulence.

Answer 374

Not suitable for immunocompromised patients or pregnant women.

Answer 375

Vaccines containing whole agents killed by heat or formaldehyde.

Answer 376

The vaccine can revert to wild type within the host, leading to disease.

Answer 377

Vaccines that use antigenic fragments of the pathogen.

Answer 378

To attach polysaccharides to an inactivated toxin to enhance immune response.

Answer 379

It covers 13 serotypes and triggers mucosal immunity.

Answer 380

Vaccines created by inactivating toxins from bacteria using formaldehyde.

Answer 381

Hepatitis B Vaccine ## Footnote Developed by Pablo Valenzuela in 1986.

Answer 382

Plasmids containing genes encoding an antigen are injected into host cells.

Answer 383

They use messenger RNA to encode the antigen of choice.

Answer 384

95% effective.

Answer 385

They can be quickly designed and produced after identifying a novel virus.

Answer 386

60-90% depending on dosage.

Answer 387

Vaccines ## Footnote Vaccines are considered a primary method for disease prevention due to their effectiveness and accessibility.

Answer 388

Edward Jenner ## Footnote Jenner developed the smallpox vaccine, which was the first successful vaccine.

Answer 389

Administration of antiserum containing preformed antibodies ## Footnote This provides immediate protection against recent infections or ongoing diseases.

Answer 390

Antisera have several limitations, including: * Containing antibodies against many antigens * Can trigger allergic reactions (serum sickness) * Potential contamination with viral pathogens * Antibodies degrade relatively quickly

Answer 391

One advantage is its role in breast-feeding ## Footnote Breast milk provides antibodies that help protect infants.

Answer 392

Group B Streptococcus ## Footnote This bacterium can cause serious infections in infants.

Answer 393

Early onset and late onset ## Footnote Early onset occurs within 0-7 days, while late onset occurs between 7-90 days.

Answer 394

Intramuscular ## Footnote This method is commonly used for most vaccines.

Answer 395

Alternative methods include: * Cutaneous (skin patch) * Subcutaneous * Mucosal membrane * Oral

Answer 396

Substance required to enhance immune response ## Footnote Commonly used with toxoids or subunit vaccines.

Answer 397

It is commonly used as an adjuvant to enhance immune response ## Footnote It stimulates cytokine production and enhances phagocytosis.

Answer 398

2-8 °C ## Footnote Proper storage is crucial to maintain vaccine efficacy.

Answer 399

The system ensuring vaccines are kept at the required temperature throughout storage and transport ## Footnote This includes using designated refrigerators and cool boxes.

Answer 400

They may cause disease or spread to immunocompromised individuals ## Footnote Caution is required when administering these vaccines.

Answer 401

6 in 1 – DTaP/IPV/Hib/HepB, MenB, Rotavirus vaccine ## Footnote This schedule includes vaccines for various diseases.

Answer 402

Hib/Men C, MMR, Pneumococcal vaccine, Meningitis B ## Footnote This age is critical for several vaccinations.

Answer 403

Hepatitis A, Typhoid, Cholera, Yellow fever ## Footnote These vaccines are necessary for specific travel destinations.

Answer 404

Vaccines cause Autism ## Footnote This claim has been widely debunked and is based on flawed research.

Answer 405

Concerns include: * Mercury and formaldehyde in vaccines * Potential for illness post-vaccination * Belief that unvaccinated children do not affect vaccinated ones

Answer 406

use by date

Answer 407

Flu vaccine, Pneumococcal Vaccine (PPV) ## Footnote Vaccination is important to prevent diseases in older adults.

Answer 408

Whooping cough vaccine ## Footnote This helps protect both the mother and the baby.

Answer 409

Otitis media is caused by inflammation and infection of the middle ear.

Answer 410

Common symptoms include ear pain, irritability, difficulty sleeping, and fever.

Answer 411

Factors include exposure to secondhand smoke, allergies, and frequent upper respiratory infections.

Answer 412

Treatment may include pain management and antibiotics if bacterial infection is suspected.

Answer 413

Amoxicillin is commonly recommended.

Answer 414

Advice includes breastfeeding infants, avoiding smoke exposure, and ensuring vaccinations are up to date.

Answer 415

Complications may include hearing loss, speech delays, and the spread of infection.

Answer 416

The face and limbs are commonly affected; symptoms include red sores that can burst and ooze.

Answer 417

Bullous impetigo typically affects the trunk and extremities; symptoms include larger blisters filled with clear fluid.

Answer 418

Treatment includes topical antibiotics; advise keeping the sores clean and covered.

Answer 419

Oral antibiotics include cephalexin; topical options include mupirocin for 7 days.

Answer 420

Tonsillitis is caused by viral or bacterial infections.

Answer 421

Main symptoms include sore throat, difficulty swallowing, and swollen tonsils.

Answer 422

Symptoms include severe sore throat, fever, and white patches on the tonsils.

Answer 423

Advice includes practicing good hygiene and avoiding close contact with infected individuals.

Answer 424

Advice includes staying hydrated, using throat lozenges, and taking pain relievers.

Answer 425

Ringworm is caused by fungal infections and can affect the skin, scalp, and nails.

Answer 426

Symptoms include red, itchy, and scaly patches of skin.

Answer 427

At-risk groups include children, athletes, and those with weakened immune systems.

Answer 428

Advice includes maintaining good hygiene, avoiding sharing personal items, and keeping skin dry.

Answer 429

Oral antifungals such as griseofulvin are used.

Answer 430

Topical antifungals such as clotrimazole or terbinafine are used.

Answer 431

Topical antifungals like miconazole or oral antifungals may be prescribed.

Answer 432

Topical antifungals such as ketoconazole are typically used.

Answer 433

Oral antifungals such as terbinafine or itraconazole are used.

Answer 434

Non-bullous impetigo and Bullous impetigo ## Footnote Non-bullous impetigo is more common and characterized by honey-colored crusts, while bullous impetigo presents with painless, fluid-filled blisters.

Answer 435

Crusts, usually honey-coloured, form and the skin heals without scarring unless scratched deeply ## Footnote The infection can spread to other body areas, making treatment important.

Answer 436

Painless, fluid-filled blisters without redness on surrounding skin ## Footnote It is less common than non-bullous impetigo.

Answer 437

Strep. pneumoniae, Haemophilus influenzae, Moraxella catarrhalis ## Footnote These bacteria are normally broad-spectrum.

Answer 438

No, absolute benefits are small and clinical significance is questionable ## Footnote Benefits must be weighed against potential harms like allergic reactions or antibiotic-associated diarrhea.

Answer 439

Amoxicillin (broad spectrum) ## Footnote It is effective against the three common pathogens.

Answer 440

125 mg 3 times a day ## Footnote Doses vary for different age groups.

Answer 441

* Crowded conditions * Skin-to-skin contact * Warm weather * Contact sports * Broken skin * Immuno-suppressed patients ## Footnote These factors increase the chances of spreading and developing the infection.

Answer 442

Children ## Footnote Adults with itchy skin conditions like eczema are also at risk.

Answer 443

Ecthyma ## Footnote Ecthyma is a more serious infection that develops deeper into the skin, leading to painful blisters and potential scarring.

Answer 444

2.8% ## Footnote The incidence lowers to 1.6% for children over 4 years.

Answer 445

* Ear ache * Pulling and rubbing on the ear * Cough and runny nose * Red/yellow or cloudy eardrum ## Footnote Occasionally, the eardrum may be bulging.

Answer 446

* Skin rash * Diarrhea * Nausea ## Footnote These side effects occur in approximately 1 in 100 patients.

Answer 447

VD is 0.2-0.4L/kg, peak plasma concentrations at 2 hrs, T½ = 1 hr ## Footnote It crosses the placenta and has very little presence in breast milk.

Answer 448

Inflammation of the ear ## Footnote It is often associated with infections like acute otitis media.

Answer 449

It is shorter in children than adults, allowing easy entry of bacteria and viruses ## Footnote This facilitates direct extension of infections from the nasopharynx.

Answer 450

3 to 10 days depending on the severity ## Footnote Treatment duration can vary based on clinical judgment.

Answer 451

* Passive smoking * Breastfeeding less than 4 months * Recent upper respiratory infections * Drinking while lying down ## Footnote These factors can contribute to higher recurrence rates.

Answer 452

7 to 14 days ## Footnote Some cases may take 2 to 3 weeks or more.

Answer 453

* Adenoviruses * Rubella virus * Rubeola (measles) virus * Herpes viruses (simplex and Epstein Barr) ## Footnote Adenoviruses are one of the most common causes.

Answer 454

Most common form in outpatient settings ## Footnote Common agents include Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pneumoniae.

Answer 455

Bacterial conjunctivitis typically has a purulent exudate.

Answer 456

A severe type that develops rapidly, can lead to corneal perforation, and is often caused by Neisseria gonorrhoeae.

Answer 457

Chloramphenicol ## Footnote It is a broad-spectrum bacteriostatic antibiotic.

Answer 458

Binds to bacterial ribosomes and inhibits bacterial protein synthesis.

Answer 459

Often accompanied by eyelid swelling and itching.

Answer 460

Infection from mothers with Chlamydia trachomatis.

Answer 461

Typically unilateral with hyperemia and purulent discharge.

Answer 462

Hypersensitivity reactions, including anaphylaxis.

Answer 463

Inhibits peptidoglycan synthesis and is effective against Staphylococcus aureus.

Answer 464

Not longer than 10 days.

Answer 465

False ## Footnote It is bacteriostatic and inhibits replication.

Answer 466

Using it for longer than 10 days.

Answer 467

* Viruses * Bacteria * Allergens * Contact lens use * Chemicals * Fungi * Certain diseases (e.g., chlamydia, gonorrhea)

Answer 468

Topical and/or oral antibiotics.

Answer 469

Symptom of pain at the back of the throat

Answer 470

Inflammation of the orthopharynx

Answer 471

6% (120 people per 2000 patients/GP/year)

Answer 472

More common in children/young adults

Answer 473

Viral or bacterial infection ## Footnote Less commonly, non-infectious causes

Answer 474

* Rhinovirus * Coronavirus * Parainfluenza * Influenza (4%)

Answer 475

Streptococcus pyogenes (GABHS)

Answer 476

* Sore throat * Fever * Lymphadenopathy

Answer 477

Amoxicillin or Ampicillin

Answer 478

* Irritation * Hayfever (rare) * Adverse drug reactions

Answer 479

* Otitis media * Sinusitis * Quinsy (Peri-tonsillar abscess)

Answer 480

A collection of pus beside the tonsil in the peritonsillar space

Answer 481

Self-limiting, 3 - 7 days in most people

Answer 482

* Presence of tonsillar exudate * Presence of tender anterior cervical lymphadenopathy * History of fever * Absence of cough

Answer 483

40-60% chance of GABHS and may benefit from antibiotics treatment

Answer 484

Refer to A&E

Answer 485

* Avoid contact with others * Paracetamol or ibuprofen * Adequate fluid intake * Medicated lozenges

Answer 486

Phenoxymethylpenicillin

Answer 487

Increased risk of Clostridium difficile

Answer 488

Reduction of 1 day's illness

Answer 489

Antibiotics are unnecessary for most patients with sore throat

Answer 490

Fungi that live off keratin found in skin, nails, and hair

Answer 491

* Very young or very old * African-Caribbean (for scalp ringworm) * Type 1 diabetes * Weakened immune system

Answer 492

* Topical clotrimazole * Miconazole

Answer 493

Topical application of ketoconazole and systemic itraconazole or terbinafine

Answer 494

* Fungistatic (inhibition of sterol synthesis) * Fungicidal at higher concentrations

Answer 495

Consider oral antifungals

Answer 496

Pink, flat, ring-shaped lesions

Answer 497

Otitis media is caused by inflammation and infection of the middle ear.

Answer 498

Common symptoms include ear pain, irritability, difficulty sleeping, and fever.

Answer 499

Factors include exposure to secondhand smoke, allergies, and frequent upper respiratory infections.

Answer 500

Treatment may include pain management and antibiotics if bacterial infection is suspected.

Answer 501

Amoxicillin is commonly recommended.

Answer 502

Advice includes breastfeeding infants, avoiding smoke exposure, and ensuring vaccinations are up to date.

Answer 503

Complications may include hearing loss, speech delays, and the spread of infection.

Answer 504

The face and limbs are commonly affected; symptoms include red sores that can burst and ooze.

Answer 505

Bullous impetigo typically affects the trunk and extremities; symptoms include larger blisters filled with clear fluid.

Answer 506

Treatment includes topical antibiotics; advise keeping the sores clean and covered.

Answer 507

Oral antibiotics include cephalexin; topical options include mupirocin for 7 days.

Answer 508

Tonsillitis is caused by viral or bacterial infections.

Answer 509

Main symptoms include sore throat, difficulty swallowing, and swollen tonsils.

Answer 510

Symptoms include severe sore throat, fever, and white patches on the tonsils.

Answer 511

Advice includes practicing good hygiene and avoiding close contact with infected individuals.

Answer 512

Advice includes staying hydrated, using throat lozenges, and taking pain relievers.

Answer 513

Ringworm is caused by fungal infections and can affect the skin, scalp, and nails.

Answer 514

Symptoms include red, itchy, and scaly patches of skin.

Answer 515

At-risk groups include children, athletes, and those with weakened immune systems.

Answer 516

Advice includes maintaining good hygiene, avoiding sharing personal items, and keeping skin dry.

Answer 517

Oral antifungals such as griseofulvin are used.

Answer 518

Topical antifungals such as clotrimazole or terbinafine are used.

Answer 519

Topical antifungals like miconazole or oral antifungals may be prescribed.

Answer 520

Topical antifungals such as ketoconazole are typically used.

Answer 521

Oral antifungals such as terbinafine or itraconazole are used.

Answer 522

A branch of Science that deals with the Parasites and the infections they cause.

Answer 523

An organism that is dependent on another organism in all stages of its life cycle.

Answer 524

An organism which holds the parasite.

Answer 525

A relation in which both the parasite and host are totally dependent on each other.

Answer 526

A relation in which the parasite only is dependent and does not harm the host.

Answer 527

A relation where parasite benefits from the host and can’t live independently, while the host suffers.

Answer 528

* Ecto-parasite * Endo-parasite * Erratic or Aberrant Parasite * Free-living parasite

Answer 529

An organism that lives on the surface of another organism (host).

Answer 530

An organism which lives in another organism inside the host body.

Answer 531

An organism which wanders from its usual site of infection.

Answer 532

An organism which is capable of living in the environment and leading a non-parasitic existence.

Answer 533

A host that holds the adult stage where sexual reproduction of a parasite takes place.

Answer 534

A host that harbours some developmental stages of the parasite before transferring it to another host.

Answer 535

A host that harbours the parasite not at a developmental stage.

Answer 536

Whole period of life parasitism.

Answer 537

Opportunistic parasite when opportunity arises.

Answer 538

Relation with unusual host.

Answer 539

* Blockage of blood vessels * Producing toxins * Deficiency of nutrients or fluids

Answer 540

* Immunological reaction of the host * Propagation of certain tissues due to parasite invasion * Tissue damage

Answer 541

Classification follows the same rules of zoological nomenclature: Phylum, Subphylum, Class, Order, Family, Genus, Species.

Answer 542

* Protozoa * Helminthes * Arthropods

Answer 543

* Eukaryotic * Unicellular * Lack a cell wall

Answer 544

* Trophozoites * Dormant cysts

Answer 545

The active, feeding, multiplying stage of protozoa usually associated with pathogenesis.

Answer 546

The conversion of a trophozoite to cyst form.

Answer 547

The process of transforming back into a trophozoite.

Answer 548

Classified by their method of locomotion: Flagella, Cilia, Pseudopodia.

Answer 549

Multicellular, bilaterally symmetrical animals that have three germ layers.

Answer 550

* Cestodes * Trematodes * Nematodes

Answer 551

Tape worms that are dorsoventrally flattened with flat segmented, ribbon shape.

Answer 552

Round worms with size ranging from 2mm to 1m, with males being smaller than females.

Answer 553

Nematodes that are long, thin, unsegmented, cylindrical helminths.

Answer 554

* Peri-anal itching * Irritability * Decreased appetite

Answer 555

Caused by Enterobius vermicularis.

Answer 556

Self-limited or treated with pyrantel pamoate or mebendazole.

Answer 557

Flukes, flat, leaf-shaped worms with two suckers for food and attachment.

Answer 558

They affect human health by being direct agents or intermediate hosts for parasites.

Answer 559

* Crustacia * Arachnida * Insecta

Answer 560

Inhibit various biological processes in helminths.

Answer 561

* Benzimidazole * Iodoquinol * Ivermectin * Praziquantel

Answer 562

* Permethrin * Phenothrin * Malathion * Dimeticone

Answer 563

Ability to cause disease ## Footnote Pathogenicity involves characteristics like invasiveness, infectivity, and toxigenicity.

Answer 564

* Invasiveness * Infectivity * Pathogenic potential * Toxigenicity

Answer 565

* Host to host (sneezing, etc.) * Contamination of inanimate objects * Food sources * Environmental contamination

Answer 566

Specialized molecules or structures on the pathogen's cell surface to bind complementary receptor sites on the host cell surface ## Footnote Examples include filamentous hemagglutinin, fimbrae, glycocalyx, lectin, pili, S-layer, teichoic and lipoteichoic acids.

Answer 567

Through various mechanisms like sneezing, coughing, or other bodily fluids.

Answer 568

Among the most lethal substances known, associated with specific diseases and highly immunogenic.

Answer 569

LPS bound to the host, toxic in high doses, and weakly immunogenic.

Answer 570

The ability of a pathogen to produce toxins that can damage the host.

Answer 571

Substances produced by some pathogens that cause degranulation of lysosomes.

Answer 572

Intracellular pathogen

Answer 573

* Elementary bodies (EB) * Reticulate bodies (RB)

Answer 574

Infective form that attaches to host cells and is resistant to environmental extremes.

Answer 575

* Unusual vaginal discharge * Pain when urinating * Low abdominal pain * Bleeding between periods * Pain during or bleeding after sex

Answer 576

* White/cloudy watery discharge * Pain or burning sensation when urinating * Testicular pain or swelling

Answer 577

* Azithromycin (single dose) * Doxycycline (7 days) * Erythromycin (14 days)

Answer 578

Gram negative diplococci and the microbe responsible for gonorrhoea.

Answer 579

* Acute inflammation * Painful urination * Purulent discharge

Answer 580

* Ceftriaxone (single intra-muscular injection) * Azithromycin (single oral dose)

Answer 581

Human herpes virus (HHV)

Answer 582

* Double stranded DNA * Icosahedral capsid * Enveloped

Answer 583

Painful lesions on the genitalia.

Answer 584

* Acyclovir * Valaciclovir * Vododeoxyuridine

Answer 585

Human Papillomavirus (HPV)

Answer 586

* Retrovirus * Enveloped * Positive sense single-stranded RNA * Reverse transcriptase

Answer 587

* Fever * Fatigue * Weight loss * Diarrhoea * Body aches

Answer 588

Anti-retroviral therapy (ART) involving a cocktail of 3-4 different antiviral drugs.

Answer 589

Acquired immunodeficiency syndrome, characterized by a decline in CD4 cells and increased susceptibility to infections.

Answer 590

Primary, secondary, latent, and tertiary.

Answer 591

* Painful/burning sensation when urinating * Irritation and soreness at the tip of the penis * White/cloudy discharge

Answer 592

Pelvic Inflammatory Disease

Answer 593

Transcribes RNA into DNA, allowing the virus to integrate into the host's genome.

Answer 594

immunogenic

Answer 595

PCR of RNA

Answer 596

Anti-retroviral therapy (ART)

Answer 597

3-4 different antiviral drugs

Answer 598

Antiviral drugs used in ART

Answer 599

Integrase inhibitors

Answer 600

Inhibit the protease enzyme in HIV

Answer 601

Stop the replication of HIV

Answer 602

HIV is highly mutable

Answer 603

IgA and T-lymphocytes

Answer 604

IgG-virus complex binds to B cells and virus remains infective

Answer 605

By forming multinucleated giant cells

Answer 606

Macrophages, dendritic cells, and Helper T cells

Answer 607

Sexual contact

Answer 608

Use condoms and engage in safe sex practices

Answer 609

Pthirus pubis

Answer 610

Itching and rash in the infected area

Answer 611

Through sexual contact and close personal contact

Answer 612

Topical insecticides

Answer 613

Adult females deposit 2-3 eggs per day

Answer 614

Immune response to mites, saliva, eggs, and feces

Answer 615

Microscopic observation of skin scrapings

Answer 616

Topical permethrin or oral ivermectin

Answer 617

Exclusively via sex

Answer 618

Purulent, odorous discharge; vaginal and cervical lesions

Answer 619

Inflammation of the urethra and bladder

Answer 620

Nitroimidazole drugs

Answer 621

STIs such as Chlamydia, Gonorrhoea, Syphilis, and others

Answer 622

Non-specific urethritis

Answer 623

Chlamydia, Gonorrhoea, Syphilis, Trichomoniasis, Genital Herpes, HIV/AIDS, Pubic Lice

Answer 624

* Penicillins * Cephalosporins * Macrolides * Nitroimidazoles * Antiviral agents * Antiretrovirals * Insecticides

Answer 625

Any compound that kills or inhibits microorganisms

Answer 626

A substance produced by one microorganism, which inhibits the growth of other microorganisms

Answer 627

The principle that antimicrobials inhibit or kill microorganisms with minimal or no adverse effects on host cells/tissues

Answer 628

* Inhibition of bacterial cell wall synthesis * Inhibition of bacterial protein synthesis * Inhibition of folate synthesis * Inhibition of transcription of bacterial RNA * Inhibition of bacterial DNA gyrase and topoisomerase IV

Answer 629

* Beta-lactam antibiotics * Glycopeptides

Answer 630

Mammalian cells do not have cell walls

Answer 631

A macromolecule composed of sugar chains cross-linked with peptide bridges, accounting for the shape, strength, and integrity of bacterial cells

Answer 632

Diarrhoea, hypersensitivity reactions

Answer 633

Inhibition of bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs)

Answer 634

Active against many Gram-positive organisms and some Gram-negative cocci

Answer 635

penicillin nucleus

Answer 636

They can inactivate penicillins, leading to treatment failure

Answer 637

Na and K salts of penicillins are very soluble but hydrolyzed in solution, affecting oral administration

Answer 638

Antibacterial agents

Answer 639

Inhibition of bacterial protein synthesis

Answer 640

* Take before food (except Amoxycillin) * Monitor for hypersensitivity reactions * Consider renal function for dosing

Answer 641

Orally on an empty stomach, except for Amoxycillin ## Footnote Amoxycillin can be taken with food.

Answer 642

The beta-lactam ring of penicillins ## Footnote Beta-lactamases are enzymes that provide resistance to certain antibiotics.

Answer 643

Destruction of many penicillins, leading to antibiotic resistance ## Footnote Certain bacteria, like some Staphylococcus strains, produce beta-lactamases.

Answer 644

Clavulanate and Tazobactam ## Footnote These inhibitors help restore the effectiveness of penicillins against beta-lactamase-producing bacteria.

Answer 645

About 10% ## Footnote Anaphylaxis occurs in approximately 0.01% of patients.

Answer 646

5-10% with other penicillins, cephalosporins, and carbapenems ## Footnote This can complicate treatment options for allergic patients.

Answer 647

Absorption is impaired by food, except for Amoxycillin ## Footnote This means that penicillins should generally be taken on an empty stomach.

Answer 648

Intravenous (IV) ## Footnote Intramuscular (IM) injection can be painful, with exceptions for Procaine and Benzathine penicillins.

Answer 649

Diarrhea, nausea, rash, superinfection ## Footnote Rare side effects include anaphylactic shock and Stevens-Johnson syndrome.

Answer 650

Natural Penicillins, Aminopenicillins, Antistaphylococcal penicillins, Antipseudomonal penicillins ## Footnote Each group differs in spectrum, stability, route of administration, side effects, and cost.

Answer 651

Benzylpenicillin (Penicillin G), Phenoxymethylpenicillin (Penicillin V) ## Footnote These are mainly effective against Gram-positive organisms and some Gram-negative cocci.

Answer 652

Bacterial endocarditis, meningitis, aspiration pneumonia, syphilis ## Footnote It is inactive orally and must be given parenterally.

Answer 653

Cefazolin, Cefalotin, Cefalexin ## Footnote They are characterized by their effectiveness against Gram-positive bacteria.

Answer 654

Bactericidal, binding to penicillin-binding proteins (PBPs) in bacterial membranes ## Footnote They are generally more stable to beta-lactamases than penicillins.

Answer 655

Generally well-tolerated, but can cause rash and nephrotoxicity ## Footnote Cross-hypersensitivity with penicillins is also a concern.

Answer 656

Cefotaxime, Ceftriaxone, Cefepime ## Footnote These have increased activity against Gram-negative organisms.

Answer 657

Aminoglycosides, Macrolides, Lincosamides, Tetracyclines, Chloramphenicol, Oxazolidinones ## Footnote These can be either bactericidal or bacteriostatic.

Answer 658

Composed of a 30S and a 50S subunit forming a 70S ribosome ## Footnote Human ribosomes are larger, composed of 40S and 60S subunits.

Answer 659

Bacteriostatic, inhibit protein synthesis by binding to the 50S ribosomal subunit ## Footnote Examples include Erythromycin, Azithromycin, and Clarithromycin.

Answer 660

Broad spectrum against Gram-positive and some Gram-negative bacteria ## Footnote They are alternatives for patients allergic to penicillins.

Answer 661

Broad spectrum against Gram + and some Gram - bacteria. Also active against H.pylori, M.pneumoniae, Treponema pallidum, Bordetella pertussis, Chlamydia, Legionella, and Campylobacter. Not active against enterococci. ## Footnote Used as alternatives in patients allergic to penicillins or cephalosporins.

Answer 662

Treatment and prophylaxis of Mycobacterium avium complex (MAC) and pertussis. ## Footnote Erythromycin is the drug of choice for several infections, including Legionnaire’s disease.

Answer 663

* Nausea * Vomiting * Rashes * Diarrhoea * Abdominal pain and cramps * Candidal infections ## Footnote Rare effects include anaphylaxis, acute respiratory distress, and Stevens-Johnson syndrome.

Answer 664

Erythromycin > Clarithromycin > Roxithromycin > Azithromycin ## Footnote Macrolides inhibit CYP3A4, leading to clinically significant drug interactions.

Answer 665

* Community-acquired pneumonia * Trachoma * Chlamydial genital infections * Gonorrhoea * Prophylaxis and treatment of MAC infections ## Footnote Azithromycin is the main macrolide used in STIs.

Answer 666

Bacteriostatic, reversibly bind to 30S subunit of ribosome. ## Footnote Active against Rickettsia spp, Mycoplasma, Chlamydia, some Gram + and Gram - bacteria.

Answer 667

* Sinusitis * Infection exacerbations of COPD * Pneumonia * Acne * Q fever * Syphilis * Malaria prophylaxis ## Footnote Demeclocycline is used to treat SIADH but not as an antibiotic.

Answer 668

Chelation with Calcium, Magnesium, Aluminium, Iron can affect absorption. ## Footnote Tetracycline is poorly absorbed from GIT and should be given in high doses.

Answer 669

* Nausea * Diarrhoea * Metallic taste * Thrombophlebitis (IV use) ## Footnote Rare effects include pancreatitis, hepatitis, peripheral neuropathy, and CNS toxicity.

Answer 670

Antibacterial and antiprotozoal, active against obligate anaerobic bacteria and protozoa by undergoing intracellular chemical reduction to active metabolites. ## Footnote These metabolites are cytotoxic and interact with DNA, causing cell death.

Answer 671

Doxycycline 100mg BD for 7 days OR Azithromycin 1g oral stat. ## Footnote Especially if pregnant or if adherence could be problematic.

Answer 672

Penicillin. ## Footnote Rates of Syphilis are increasing globally, especially in low to middle-income countries.

Answer 673

* Adsorption * Penetration * Uncoating * Synthesis * Assembly * Release ## Footnote The sequence of events that follows can be divided into these 6 main stages.

Answer 674

* Aciclovir: Herpes simplex and shingles * Famciclovir: Herpes simplex and shingles * Valaciclovir: Herpes simplex, shingles, and CMV * Ganciclovir: CMV * Valganciclovir: CMV ## Footnote Converted by viral and cellular enzymes to nucleotides which inhibit viral DNA polymerase.

Answer 675

* Oseltamivir * Zanamivir ## Footnote They are used for treating Influenza A and B.

Answer 676

False. ## Footnote Azithromycin is also effective against Gram - bacteria and various STIs.

Answer 677

Treatment and suppression of episodes of genital herpes simplex, shingles, and H.simplex encephalitis ## Footnote Aciclovir is an antiviral medication that is effective in treating infections caused by certain types of viruses.

Answer 678

CMV retinitis, CMV infection in bone marrow and organ transplant patients, prevention of CMV disease following solid organ transplant ## Footnote Ganciclovir is particularly used in immunocompromised patients.

Answer 679

Severe disseminated infections, pneumonia, encephalitis, hepatitis, or retinitis ## Footnote CMV can affect any organ but is most often associated with these conditions.

Answer 680

Multiple daily dosing and the requirement for adequate hydration to prevent renal complications ## Footnote Aciclovir crystals can form in renal tubules if hydration is not maintained.

Answer 681

Within 48 hours of onset of symptoms ## Footnote Starting treatment beyond 72 hours offers little benefit unless the patient is immunocompromised.

Answer 682

Valaciclovir is a pro-drug that is converted to aciclovir in the liver, providing better oral bioavailability ## Footnote This means that Valaciclovir requires fewer doses compared to Aciclovir.

Answer 683

Famciclovir and Valaciclovir ## Footnote These agents are preferred due to better oral bioavailability and less frequent dosing.

Answer 684

400 mg Q8H for 10 days ## Footnote Alternative treatments include Famciclovir or Valaciclovir at specified dosages.

Answer 685

Restoration and preservation of immune function, improving quality of life, and reducing HIV-related disease progression ## Footnote Antiretroviral therapy cannot cure HIV but aims to manage the infection effectively.

Answer 686

* Nucleoside reverse transcriptase inhibitors (NRTI) * Non-nucleoside reverse transcriptase inhibitors (NNRTI) * Protease inhibitors (PI) ## Footnote Each class works through different mechanisms to suppress HIV replication.

Answer 687

Highly Active Antiretroviral Therapy ## Footnote HAART typically involves using three or more antiretrovirals from different classes to effectively suppress HIV replication.

Answer 688

* Lipodystrophy * Hyperglycaemia * Dyslipidaemia * Hepatotoxicity * Bone density changes * Rash ## Footnote The incidence of adverse drug reactions can vary significantly between different antiretroviral groups.

Answer 689

T4 lymphocytes, but also glial cells, monocytes, and macrophages ## Footnote The binding of HIV to CD4 antigens leads to immunosuppression.

Answer 690

Occurs 2-4 weeks after HIV infection, presenting with fever, headache, pharyngitis, nausea, CNS symptoms, mucocutaneous ulcers, rashes ## Footnote It is experienced by 5-70% of patients.

Answer 691

Reduction in HIV-associated morbidity and mortality, prevention of HIV transmission ## Footnote Treatment has shown to reduce transmission risk significantly, especially in serodiscordant couples.

Answer 692

In all pregnant women with HIV, patients with HIV and chronic Hepatitis B requiring treatment, asymptomatic patients with CD4 count <500 cells/microlitre ## Footnote There are specific recommendations for different CD4 count thresholds.

Answer 693

Two NRTI/NtRTIs plus either one NNRTI or one PI ## Footnote An example of a regimen includes Emtricitabine and Tenofovir with Efavirenz.

Answer 694

Two NRTI/NtRTIs (Emtricitabine and Tenofovir) plus either one NNRTI (Efavirenz) or one PI (Atanzavir) or one Integrase inhibitor (Dolutegravir or Elvitegravir + cobicistat or Raltegravir) ## Footnote Emtricitabine and Tenofovir are available in combination as Truvada®, while Efavirenz + Emtricitabine + Tenofovir is available as Atripla®.

Answer 695

Comprehensive counselling regarding the nature of disease, treatment implications, and importance of compliance (>90% compliance required for best results) ## Footnote Assessment of cardiovascular risk, diabetes, general health, CD4 counts, viral load, opportunistic infections, hepatitis, and other STIs is also necessary.

Answer 696

Initially 2-4 weeks after starting therapy and then every 3-4 months if stable, with a review extended to 6 months if stable for >2 years ## Footnote Monitoring should include clinical status, compliance, HIV viral load, and CD4 cell count.

Answer 697

Viral load should fall at least 10-fold within 4-6 weeks and to <50 copies/ml after 3-6 months in all patients ## Footnote CD4 count usually increases by 100-200 cells/microliter after 12 months.

Answer 698

Blood counts, electrolytes, LFTs, and RFTs ## Footnote Cardiovascular risk factors such as smoking, diet, exercise, BP, weight, BSL, and serum lipids should also be assessed.

Answer 699

Nystatin or Miconazole for minor infections; systemic antifungals like Fluconazole or Itraconazole for severe cases ## Footnote Fluconazole is given at 50-100mg daily for 10-14 days.

Answer 700

Co-trimoxazole either orally or IV for 21 days ## Footnote Monitoring of full blood counts and renal and liver function is required twice-weekly.

Answer 701

Trimethoprim + Sulfamethoxazole or Dapsone or Atovaquone or Pentamidine ## Footnote Options are listed in order of preference.

Answer 702

If CD4 count is <200 cells/microliter or CD4 cell % <14% or if the patient suffers from oropharyngeal candidiasis ## Footnote This is to prevent the onset of PCP.

Answer 703

Ethambutol plus either Clarithromycin or Azithromycin, with or without Rifabutin ## Footnote Primary prophylaxis should start when CD4 count is <50 cells/microliter.

Answer 704

Ganciclovir, Valganciclovir, Foscarnet, Cidofovir ## Footnote Valganciclovir is often preferred for outpatient treatment due to its oral administration.

Answer 705

Bone marrow suppression and cytotoxic precautions required in preparation ## Footnote It is related in structure and mechanism of action to aciclovir but is effective against CMV.

Answer 706

* Cryptococcus neoformans * Cryptosporidium parvum * Hepatitis B and C viruses * Herpes simplex virus (HSV) * Isospora belli * Mycobacterium tuberculosis * Toxoplasma gondii * Treponema pallidum * Varicella-zoster virus (VZV) ## Footnote HIV/AIDS patients are also at greater risk of certain malignancies such as Kaposi’s sarcoma and malignant melanoma.

Answer 707

Approximately 0.3% ## Footnote Mucocutaneous exposure has a risk of <0.1%.

Answer 708

Wash the site of exposure with soap and water without scrubbing ## Footnote Allow free bleeding but do not squeeze or suck the wound.

Answer 709

Post Exposure Prophylaxis ## Footnote PEP is a medical treatment to prevent HIV infection after potential exposure.

Answer 710

* Breast milk * CSF * Amniotic fluid * Any visibly blood stained fluid ## Footnote CSF stands for cerebrospinal fluid.

Answer 711

* Wash the site with soap and water without scrubbing * Allow free bleeding but do not squeeze or suck the wound * Irrigate affected mucous membranes with water

Answer 712

If the source is HIV antibody/antigen negative and unlikely to be in the window period, no follow-up is required.

Answer 713

* Nature of the exposure * Likelihood that the source is HIV positive * Other factors associated with the source and exposed person

Answer 714

As soon as possible after exposure and within 72 hours.

Answer 715

* Emtricitabine + Tenofovir (Truvada®) 200+300mg oral daily for 4 weeks * Lamivudine + Zidovudine (Combivir®) 150+300mg oral BD for 4 weeks

Answer 716

* Lopinavir + Ritonavir (Kaletra®) 400+100mg oral BD for 4 weeks * Raltegravir 400mg oral BD for 4 weeks

Answer 717

Pre-Exposure Prophylaxis ## Footnote PrEP is the use of antiretrovirals by HIV-negative individuals to reduce the risk of HIV exposure.

Answer 718

PrEP offers no protection for other STIs.

Answer 719

Men who have sex with men.

Answer 720

* Use Maldison or permethrin applications * Consider shaving pubic and body hair * Wash underwear and bedding

Answer 721

Apply a layer of white soft paraffin twice daily for 8 days.

Answer 722

Complement is at the centre of the development of inflammatory reactions. It is a heat labile component of the serum comprising 16 plasma proteins that constitute 10% of total serum proteins.

Answer 723

* Triggering and amplification of inflammatory reactions * Attraction of phagocytes by chemotaxis * Clearance of immune complexes * Cellular activation * Direct microbial killing * Important role in the development of antibody responses

Answer 724

Individuals lacking specific complement components, such as C3, are subject to overwhelming bacterial infections.

Answer 725

* Lectin Pathway * Classical Pathway * Alternative Pathway

Answer 726

The terminal pathway is the final stage that all three complement activation pathways lead to.

Answer 727

C3 is the most abundant and important of the complement proteins, involved in all three activation pathways.

Answer 728

Complement proteins are named in the order of discovery, not the order of function (C1, C4, C3, C5, C6, C7, C8, C9).

Answer 729

Opsonization is primarily mediated by C3b and C4b, which bind covalently to pathogen surfaces, allowing phagocytes to recognize and engulf them.

Answer 730

Anaphylatoxins, primarily C3a and C5a, are important inflammatory activators that induce vascular permeability and recruit phagocytes.

Answer 731

C5b binds to the target surface, recruits C6 and C7, and forms a complex that inserts into the lipid bilayer, leading to cell lysis.

Answer 732

C4b and C3b covalently bind to immune complexes, which are recognized by CR1 complement receptors on red blood cells for transport to the liver and spleen.

Answer 733

A pseudoallergic response occurs without prior sensitization and can manifest as acute allergic reactions, especially with liposome or polymeric nanoparticle infusion.

Answer 734

Liposome-induced pseudoallergic responses are strongly correlated with complement activation, leading to rapid production of anaphylatoxins.

Answer 735

In a study, 13 out of 29 cancer patients experienced acute allergic reactions, with complement activation detected in 72% of patients.

Answer 736

PEGylation appears to induce cardiopulmonary distress due to complement activation related pseudoallergic responses.

Answer 737

* Increase in C4 and SC5b levels suggests Lectin pathway * No activation with C4 depleted serum indicates dependence on C4b2a * No factor B split products (Bb) rules out Alternative Pathway * Activation in C1q depleted serum confirms Classical Pathway not involved

Answer 738

Adverse reactions include ataxia, restlessness, trembling, respiratory abnormalities, and even death in livestock.

Answer 739

PEG has been perceived as immunologically safe but may lead to unexplained adverse reactions similar to those observed in veterinary settings.

Answer 740

PEGs with molecular weights below 10nm activate exclusively through the C4 pathway, while those above 10nm activate through both the lectin and alternative pathways.

Answer 741

sCR1 inhibits complement activation and suppresses liposome-induced cardiopulmonary changes.

Answer 742

PEG anatomically seals membranes of damaged axons through fusion, restoring neuronal excitability.

Answer 743

More common in women (50% at some stage) but more serious in men (complicated UTIs).

Answer 744

* Upper urinary tract infections - pyelonephritis * Lower UTIs - cystitis, urethritis, prostatitis

Answer 745

A common infection of the bladder.

Answer 746

Usually sexually transmitted.

Answer 747

* Increased urinary frequency * Dysuria * Haematuria * Fever * Confusion * Flank pain (pyelonephritis)

Answer 748

An enzyme released by WBCs indicating infection.

Answer 749

Healthy adult, non-pregnant woman with no fever, loin or flank pain.

Answer 750

3 days of antibiotic treatment.

Answer 751

Nitrofurantoin 100mg m/r bd.

Answer 752

If eGFR is less than 45mL per min.

Answer 753

Trimethoprim 200mg bd.

Answer 754

Extended-spectrum beta-lactamases.

Answer 755

* Escherichia coli (E. coli) * Klebsiella species

Answer 756

Urinary tract infections that can progress to blood poisoning.

Answer 757

Increase in resistance.

Answer 758

Pivmecillinam 400mg STAT then 200mg tds after sensitivity testing.

Answer 759

* 1st line: Nitrofurantoin 100mg m/r bd for 7 days * 2nd line: Amoxicillin 500mg tds * 3rd line: Cefalexin 500mg bd

Answer 760

More than 3 infections a year.

Answer 761

Rule out red flag factors.

Answer 762

Trimethoprim 100mg nocte or nitrofurantoin 50-100mg nocte for 6 months.

Answer 763

An infection that can occur at any age, unlike BPH and prostate cancer.

Answer 764

4-week course, usually with quinolone.

Answer 765

* Septic shock * Chronic pyelonephritis * Chronic renal insufficiency

Answer 766

* Urinary urgency * Urinary frequency * Burning sensation * Haematuria * Nocturia * Dysuria * Cloudy urine * Fever * Chills * Nausea * Flank pain * Poor appetite * Low back pain * Fatigue

Answer 767

Ciprofloxacin 500mg bd for 7 days.

Answer 768

Pivmecillinam 400mg tds for 7 days.

Answer 769

Skin ## Footnote Skin accounts for 15% of the total adult body weight.

Answer 770

Protection against external influences, prevention of dehydration (thermoregulation) ## Footnote Skin acts as a barrier to physical, chemical, and biological agents.

Answer 771

Epidermis, dermis, subcutaneous tissue

Answer 772

Keratinocytes

Answer 773

Synthesize keratin, a threadlike protein

Answer 774

Basal cell layer (stratum germinativum), squamous cell layer (stratum spinosum), granular cell layer (stratum granulosum), cornified or horny cell layer (stratum corneum)

Answer 775

The differentiation process of keratinocytes as they move from the basal layer to the skin surface

Answer 776

Active cell division and proliferation of basal cells

Answer 777

Pigment-synthesizing cells that produce melanin

Answer 778

T-cell responses and phagocytosis

Answer 779

Mechanoreceptors that increase tactile resolution and sensitivity

Answer 780

stratified, squamous

Answer 781

Protein and low in lipid content

Answer 782

Cellular signaling molecules (hormones, growth factors, cytokines)

Answer 783

Conditions such as psoriasis and skin tumors

Answer 784

Provide resistance to physical stresses

Answer 785

Involved in the synthesis and modification of keratins

Answer 786

They convert into protective corneocytes through apoptosis

Answer 787

Maintenance of post-natal structure and function

Answer 788

Stimulates an increase in melanin production and transfer to keratinocytes

Answer 789

Desmosomal junctions

Answer 790

They are large, flat, and considered dead cells

Answer 791

2%–8% ## Footnote These cells maintain constant numbers and distributions in specific areas of the body.

Answer 792

Hemi-desmosomes ## Footnote These structures distribute shearing forces through the epithelium.

Answer 793

Provides support, developmental signals, directs cytoskeleton organization, and functions as a semi-permeable barrier ## Footnote It allows the exchange of fluid between the epidermis and dermis.

Answer 794

Ectoderm ## Footnote This includes eccrine and apocrine glands, ducts, and pilo-sebaceous units.

Answer 795

Thermal regulation ## Footnote Eccrine sweat glands are particularly plentiful on the soles of the feet.

Answer 796

* Intra-epidermal spiral duct * Straight dermal portion * Coiled secretory duct

Answer 797

Axillae and perineum ## Footnote They are involved in scent release and do not open to the skin surface directly.

Answer 798

* Protection from environmental elements * Distribution of sweat-gland secretions * Psychosocial role in society

Answer 799

Inheritance ## Footnote The phenotype of hair is expressed early during embryonic development.

Answer 800

* Hair cone * Cuticle * Inner root sheaths

Answer 801

Produce inner and outer root sheaths and the hair shaft ## Footnote These cells are involved in hair growth.

Answer 802

Distribution of melanosomes in the hair shaft ## Footnote Aging leads to loss of melanocytes and greying of hair.

Answer 803

* Anagen * Catagen * Telogen

Answer 804

Fingernails grow at 0.1 mm per day, 2-3 times faster than toenails ## Footnote The slow growth rate of toenails can indicate past toxic exposure.

Answer 805

Collagen ## Footnote Collagen provides flexibility, elasticity, and strength to the skin.

Answer 806

* Sub-papillary superficial plexus * Deeper plexus

Answer 807

Active role in allergy, atherosclerosis, parasitic diseases, malignancy, pulmonary fibrosis, arthritis, and asthma ## Footnote They are concentrated in the papillary dermis.

Answer 808

Causes hair follicles to contract and pull into a vertical position ## Footnote This results in 'gooseflesh' skin.

Answer 809

Pain, temperature, and itch sensations ## Footnote These fibers end around hair follicles and in the papillary dermis.

Answer 810

Allergy, atherosclerosis, parasitic diseases, malignancy, pulmonary fibrosis, arthritis, asthma.

Answer 811

In the subcutaneous tissue.

Answer 812

Fibrous septa made up of collagen and large blood vessels.

Answer 813

Energy storage and hormone conversion.

Answer 814

* Acne * Alopecia areata * Basal cell carcinoma * Bowen's disease * Contact dermatitis * Eczema (atopic eczema) * Melanoma * Psoriasis * Scabies * Vitiligo.

Answer 815

* Basal cell carcinoma * Squamous cell carcinoma * Melanoma.

Answer 816

Hydroquinone (2-4%).

Answer 817

Triluma (4% hydroquinone, tretinoin, and a corticosteroid).

Answer 818

Hydroquinone.

Answer 819

tyrosinase inhibitor.

Answer 820

Wet combing or dimeticone 4% lotion ## Footnote Dimeticone is preferred for young children aged 6 months to 2 years and individuals with asthma or eczema.

Answer 821

Shampoos are diluted too much and have insufficient contact time to kill eggs.

Answer 822

Miconazole oral gel ## Footnote Unlicensed for use in children younger than 4 months, or 5-6 months for pre-term infants.

Answer 823

The child should be sent for investigation to eliminate the possibility of underlying disease.

Answer 824

Coxsackieviruses ## Footnote The most common is coxsackie virus A16.

Answer 825

General hygiene measures.

Answer 826

It can be highly distressing.

Answer 827

It depends on the specific case.

Answer 828

Common infestation of the skin caused by tiny mites that burrow into the skin.

Answer 829

Between family members.

Answer 830

Tiny and very itchy spots all over the body, including soles of the feet, armpits, and genital area.

Answer 831

Creams that kill the scabies mite need to be given to the whole family at the same time.

Answer 832

A common illness that mainly affects children and causes an itchy, spotty rash.

Answer 833

One to three weeks after becoming infected.

Answer 834

Yes, until all the blisters have scabbed over.

Answer 835

A common fungal skin infection that causes a ring-like red rash almost anywhere on the body.

Answer 836

Using non-prescription creams.

Answer 837

* Pain in the muscles, joints, or limbs * Unusually cold hands and feet or shivering * Pale or blotchy skin and blue lips * Severe headache * Fever * Vomiting * Feeling generally unwell

Answer 838

A body temperature of 38ºC (100.4ºF) or above.

Answer 839

* Drowsiness * Confusion * Seizures or fits * Unable to tolerate bright lights (photophobia) * Stiff neck * Rapid breathing rate * Blotchy red rash that does not fade with pressure

Answer 840

* Loss of appetite * > 24hrs without wet nappy * Loss of weight * Persistent raised temperature * Breathing problems * Significant earache * Discharge from one nostril only * Temperature and sore throat * Persistent night cough * Blood loss from any orifice * Neck stiffness * Photophobia * Rash which does not blanch on pressure

Answer 841

A raised, itchy rash that appears on the skin, also known as hives, weals, or welts.

Answer 842

High levels of histamine and other chemical messengers released in the skin due to triggers.

Answer 843

* Allergic reactions (e.g., food allergy, insect bites) * Cold or heat exposure * Infections (e.g., cold) * Certain medications (e.g., NSAIDs, antibiotics)

Answer 844

A severe allergic reaction that can be life-threatening.

Answer 845

* Swollen eyes, lips, tongue, hands, and feet * Feeling lightheaded or faint * Narrowing of the airways * Abdominal pain, nausea, and vomiting * Collapsing and becoming unconscious

Answer 846

Pimples that develop on a baby's cheeks, nose, and forehead within a month of birth.

Answer 847

Washing the baby's face with water and a mild moisturiser.

Answer 848

A viral infection that causes a rash, often referred to as slapped cheek syndrome.

Answer 849

A common viral illness causing a blistery rash on hands and feet, and ulcers in the mouth.

Answer 850

A highly contagious bacterial infection of the surface layers of the skin causing sores and blisters.

Answer 851

With antibiotics (oral or topical).

Answer 852

A viral infection causing a bright red rash on both cheeks and a fever, common in children.

Answer 853

* Daily baths * Cut fingernails to prevent secondary infection * Paracetamol/ibuprofen for fever * Calamine or virasoothe for itchiness * Stay off school until last spot crusts over

Answer 854

This could indicate a serious condition and should be evaluated by a GP.

Answer 855

Describe skin structure & function, understand types of eczema affecting children and their management, understand general management of emollients and corticosteroids in childhood dermatological conditions.

Answer 856

7 types of eczema.

Answer 857

* Atopic Eczema * Seborrhoeic Eczema * Nappy rash (Contact dermatitis)

Answer 858

Immune system induced eczema.

Answer 859

Cradle cap or dandruff.

Answer 860

Contact dermatitis.

Answer 861

* Provides barrier * Reduces water and electrolyte loss * Prevents entry of micro-organisms * Temperature regulation * Sensation (touch, pain, temperature, itch)

Answer 862

Often develops before their first birthday.

Answer 863

1 in 5 children.

Answer 864

Dry, scaly, red, itchy.

Answer 865

* Soap and detergents * Skin infection * House-dust mites * Animal dander * Pollens * Overheating * Rough clothing

Answer 866

Moisturising treatments applied topically to soothe, smooth, protect, and hydrate the skin.

Answer 867

A regimen to keep skin moisturized by using a combination of products liberally and frequently.

Answer 868

Discontinue treatment and try an alternative emollient that does not contain SLS.

Answer 869

At least 3-4 times a day.

Answer 870

Do not rub; apply in a downward motion.

Answer 871

To reduce inflammation and irritation in flare-ups of eczema.

Answer 872

* Creams * Lotions * Gels * Mousses/Foams * Ointments * Tapes

Answer 873

* Mild * Moderate * Potent * Very Potent

Answer 874

Once or twice a day for 1-2 weeks.

Answer 875

Length of cream/ointment from a tube squeezed from the tip of an adult index finger to the crease.

Answer 876

Cradle cap.

Answer 877

Greasy, yellow or brown scaly patches on the scalp.

Answer 878

Use greasy emollients or soap substitutes.

Answer 879

Prolonged exposure to urine and/or faeces.

Answer 880

Advise about skin care, apply barrier preparation, and refer to a doctor.

Answer 881

If it spreads, worsens, or if there are systemic symptoms.

Answer 882

Clotrimazole ## Footnote Clotrimazole is commonly used to treat fungal infections.

Answer 883

After the candidal infection has settled ## Footnote This ensures that the barrier can effectively protect the skin.

Answer 884

Bacterial and Fungal ## Footnote Both types can cause complications in nappy rash.

Answer 885

Spreading to other areas, getting worse or not responding to treatment, bacterial infection present or suspected, fungal infection co-existing with oral thrush, systemic symptoms (fever) ## Footnote These signs indicate potential complications that require medical evaluation.

Answer 886

Basic skin structure & function ## Footnote Understanding skin anatomy is essential for assessing and treating dermatological issues.

Answer 887

Types of eczema ## Footnote Knowledge of different eczema types is crucial for effective management.

Answer 888

Emollients and corticosteroids ## Footnote These are commonly used to manage various skin conditions in children.

Answer 889

IgE ## Footnote IgE is crucial in mediating allergic reactions.

Answer 890

Immunoglobulin E (IgE)-mediated allergy and Non-Immunoglobulin E (Non-IgE)-mediated allergy ## Footnote These classifications help in understanding the mechanisms behind food allergies.

Answer 891

Acute and rapid onset ## Footnote These reactions can lead to severe symptoms shortly after exposure.

Answer 892

Non-acute and delayed onset ## Footnote Symptoms may take hours or even days to appear.

Answer 893

Skin prick test or blood test ## Footnote These tests measure specific IgE antibodies.

Answer 894

Elimination diet ## Footnote The suspected allergen is avoided for 2-6 weeks before being reintroduced slowly.

Answer 895

False ## Footnote These methods are not recognized as valid diagnostic tools.

Answer 896

* Family history of allergy-related conditions * Other allergies * Age ## Footnote These factors can increase the likelihood of developing food allergies.

Answer 897

A true food allergy causes an immune system reaction, while food intolerance symptoms are generally less serious and often limited to digestive problems. ## Footnote Allergies can be life-threatening, whereas intolerances usually are not.

Answer 898

* Skin reactions (red itchy rash, swelling) * Digestive problems (stomach ache, vomiting, colic) * Hay fever-like symptoms * Eczema that doesn't improve ## Footnote Symptoms can vary widely among individuals.

Answer 899

* Securing the airway * Restoration of BP * Administration of adrenaline injection * High flow oxygen and rehydration * IV corticosteroid + IV/IM antihistamine ## Footnote Prompt treatment is crucial for survival.

Answer 900

It has an anti-inflammatory and immunosuppressive effect with a delayed onset of action to prevent further deterioration. ## Footnote It is used in severe allergic reactions.

Answer 901

It is used for immediate self-administration in allergic emergencies, with a dose of 0.3mg intramuscularly. ## Footnote Pediatric dosage is 0.01mg/kg.

Answer 902

* Strong vasoconstrictor action * Bronchial smooth muscle relaxation * Alleviates pruritis, urticaria, and angioedema ## Footnote Adrenaline counteracts the life-threatening effects of anaphylaxis.

Answer 903

A condition where individuals have difficulty digesting lactose, leading to gastrointestinal discomfort. ## Footnote It can be triggered by the consumption of dairy products.

Answer 904

elimination ## Footnote This diet helps identify food intolerances or allergies.

Answer 905

days ## Footnote This delayed reaction is a hallmark of food intolerance.

Answer 906

Prednisolone should be stopped after the course is completed (e.g. three days) ## Footnote Prednisolone is a corticosteroid used to reduce inflammation and suppress the immune system.

Answer 907

Be careful if driving or operating machinery ## Footnote Sedating antihistamines can cause drowsiness, impacting the ability to perform tasks that require alertness.

Answer 908

Specify the brand to be dispensed to ensure patients receive the device they have been trained to use ## Footnote Different brands may have specific injection techniques that the patient needs to be familiar with.

Answer 909

Always keep the self-injectable adrenaline with them and inform friends about its location and use ## Footnote This ensures that help can be provided quickly in case of an anaphylactic reaction.

Answer 910

Wear a necklace or bracelet identifying their severe allergy ## Footnote This helps medical responders quickly understand the patient's allergy status in emergencies.

Answer 911

Regularly check the expiry date of the EpiPen ## Footnote Expired EpiPens may not work effectively in an emergency.

Answer 912

Always seek medical help immediately after using the EpiPen ## Footnote This is important even if symptoms appear to be improving.

Answer 913

History of hypersensitivity to eggs, chicken proteins, or any other component of the vaccine ## Footnote This is important for preventing allergic reactions in susceptible individuals.

Answer 914

Know what happens physiologically during a food allergy reaction ## Footnote Understanding the body's response is essential for managing and treating food allergies.

Answer 915

Know how food allergies are assessed and diagnosed ## Footnote Accurate diagnosis is critical for effective management and avoidance of allergens.

Answer 916

Genetic predisposition, environmental factors, early exposure to allergens ## Footnote Understanding these factors can help in prevention strategies.

Answer 917

Hives, swelling, difficulty breathing, gastrointestinal symptoms ## Footnote Recognizing these symptoms can lead to prompt treatment and management.

Answer 918

Food allergy involves an immune response, while food intolerance does not ## Footnote This distinction is important for diagnosis and treatment.

Answer 919

* Mutualism * Commensalism * Parasitism ## Footnote Mutualism benefits both organisms, commensalism benefits one without harming the other, and parasitism benefits one while harming the other.

Answer 920

Normal Microbiota ## Footnote Normal microbiota usually do not cause disease but can become pathogenic under certain conditions.

Answer 921

* Skin * Mucous membranes * Placenta * Parenteral route ## Footnote Parenteral route includes punctures or breaks in the skin.

Answer 922

* Staphylococcus spp. * Streptococcus spp. * Bacillus spp. * Clostridium spp. * Mycoplasma spp. * Corynebacterium spp. * Mycobacterium spp. * Propionebacterium spp. * Nocardia spp. * Actinomyces spp. ## Footnote These bacteria have a thick peptidoglycan layer and stain positively in Gram staining.

Answer 923

* Gram positive cocci * Cluster in grapelike arrangements * Facultatively anaerobic * Non-motile * Low G+C ## Footnote Staphylococcus aureus and Staphylococcus epidermidis are notable examples.

Answer 924

* Food poisoning * Impetigo * Scalded skin syndrome * Conjunctivitis * Folliculitis * Toxic shock syndrome * Bacteremia ## Footnote Staphylococcus aureus can produce multiple toxins leading to these conditions.

Answer 925

* Gram positive cocci * Arranged in pairs or chains * Facultatively anaerobic * Non-motile * Low G+C ## Footnote Examples include Streptococcus pyogenes and Streptococcus pneumoniae.

Answer 926

* Meningitis * Pneumonia * Otitis media * Scarlet fever * Pharyngitis * Tonsillitis ## Footnote Streptococcus pneumoniae is a major cause of respiratory infections.

Answer 927

Lipid A in the outer membrane ## Footnote Lipid A is an endotoxin that can cause severe systemic reactions.

Answer 928

* Neisseria gonorrhoeae * Neisseria meningitidis ## Footnote These bacteria are known for causing serious infections like gonorrhea and meningitis.

Answer 929

* Neisseria meningitidis * Streptococcus pneumoniae * Haemophilus influenzae * Listeria monocytogenes * Streptococcus agalactiae ## Footnote These pathogens are responsible for the majority of bacterial meningitis cases.

Answer 930

Penicillin and careful cleaning of infected areas ## Footnote Proper hygiene is also crucial for prevention.

Answer 931

Severe pain in the ears ## Footnote Otitis media is common in children and can result from bacteria spreading from the pharynx.

Answer 932

Bordetella pertussis ## Footnote This bacterium produces several virulence factors that contribute to its pathogenicity.

Answer 933

Incubation

Answer 934

False ## Footnote Many cases are viral, but bacterial infections can occur and are often indicated by pus production.

Answer 935

DTaP vaccine ## Footnote Vaccination is crucial for preventing this highly contagious disease.

Answer 936

Peptidoglycan with β-lactam bonds

Answer 937

Mycoplasma pneumoniae

Answer 938

Archaea do not contain peptidoglycan

Answer 939

A chain of four amino acids

Answer 940

Lipid bilayer, similar to eukaryotes but without sterols

Answer 941

Porins and lipopolysaccharides

Answer 942

Protection against digestion and desiccation

Answer 943

Polysaccharides

Answer 944

It allows biofilm formation

Answer 945

Glycogen and polysaccharides

Answer 946

Highly resistant structures formed by bacteria under stress

Answer 947

Single chromosome, circular DNA without a membrane

Answer 948

Circular DNA, normally short, often multiple copies

Answer 949

Adhering to host surfaces and sexual reproduction

Answer 950

30 to 120 minutes

Answer 951

Temperature, pressure, nutrients, oxygen, pH

Answer 952

Types of bacteria classified by temperature preference

Answer 953

Autotrophs produce their own food; heterotrophs consume others

Answer 954

Obligate anaerobes cannot survive in oxygen; facultative can

Answer 955

Archaea, Gram positive, Gram negative

Answer 956

They include nitrogen fixers and sulfur reducers

Answer 957

They have a thick peptidoglycan layer

Answer 958

Archaea that convert CO2, H2, and organic acids to methane

Answer 959

Organisms that require extreme conditions to survive

Answer 960

A classification system for prokaryotes

Answer 961

They stain pink and are often without a cell wall

Answer 962

Oxygenic and anoxygenic bacteria

Answer 963

Chlamydias, Spirochetes, Cyanobacteria

Answer 964

Minuscule, acellular infectious agents having either DNA or RNA ## Footnote Causes many infections in humans, animals, plants, and bacteria

Answer 965

Cannot carry out any metabolic pathway ## Footnote Neither grow nor respond to the environment

Answer 966

Cannot reproduce independently; recruit the cell’s metabolic pathways to increase their numbers

Answer 967

The complete virus particle, containing genetic material and a protein coat

Answer 968

May be DNA or RNA, but never both ## Footnote Types include dsDNA, ssDNA, dsRNA, ssRNA

Answer 969

Three basic shapes: * Helical * Polyhedral * Complex

Answer 970

Acquired from host cell during viral replication or release; composed of phospholipid bilayer and proteins

Answer 971

Envelope’s proteins and glycoproteins often play a role in host recognition

Answer 972

A method to classify viruses based on their type of genetic material and replication strategy

Answer 973

* Double stranded DNA * Double stranded RNA * Single stranded DNA * Single stranded RNA

Answer 974

* Produce copies of the viral genome * Produce mRNA which is translated into viral proteins

Answer 975

Replication cycle usually results in death and lysis of the host cell

Answer 976

Modified replication cycle where infected host cells grow and reproduce normally before they lyse

Answer 977

They can integrate their genetic material into the host genome as prophages

Answer 978

* Burkitt’s lymphoma * Hodgkin’s disease * Kaposi’s sarcoma * Cervical cancer

Answer 979

Some consider them complex pathogenic chemicals; others consider them the least complex living entities

Answer 980

Multiple pathways possible, specific details not provided

Answer 981

Provide protection for viral nucleic acid and means of attachment to host’s cells

Answer 982

Composed of proteinaceous subunits that make up the capsid

Answer 983

Itchy eyes, tearing, redness, discharge, light sensitivity ## Footnote Most cases are caused by adenovirus but can also be due to other viruses.

Answer 984

Herpes Simplex virus ## Footnote This virus can lead to more severe symptoms and complications.

Answer 985

No treatment unless caused by HSV; topical antivirals like Idoxuridine, vidarabine, or trifluridine can be used ## Footnote Treatment is not necessary for non-HSV cases.

Answer 986

Self-limiting disease, highly contagious ## Footnote It can spread easily in crowded environments.

Answer 987

Severe pain in the ears ## Footnote This condition is common in children.

Answer 988

Adenoviruses ## Footnote These viruses can lead to inflammation and pain.

Answer 989

Symptoms often diagnostic; no effective treatment exists ## Footnote There is no known way to prevent otitis media.

Answer 990

Similar to bacterial meningitis but usually milder ## Footnote Symptoms may include fever, headache, and stiff neck.

Answer 991

Viruses in the genus Enterovirus ## Footnote These viruses are commonly found in the environment.

Answer 992

By characteristic signs and symptoms in absence of bacteria in the CSF ## Footnote This is crucial for differentiating it from bacterial meningitis.

Answer 993

Painful lesions caused by inflammation and cell death, cause fusion of cells to form syncytia ## Footnote The lesions are typically slow spreading.

Answer 994

Trigeminal (V) nerve ganglion, brachial ganglia, sacral ganglia ## Footnote These sites allow the virus to remain dormant in the host.

Answer 995

Spread between mucous membranes of mouth and genitals ## Footnote This can occur through direct contact.

Answer 996

Cold-like symptoms, loss of appetite, mild fever, non-itchy red rash, painful mouth ulcers ## Footnote Symptoms can vary in severity.

Answer 997

Coxsackie virus A16, A6, A10, Enterovirus 71 ## Footnote Enterovirus 71 can cause more complications.

Answer 998

By symptoms ## Footnote There is no specific treatment or vaccine available.

Answer 999

Respiratory Syncytial Virus (RSV) ## Footnote It affects infants and immunocompromised individuals severely.

Answer 1000

Fever, runny nose, coughing in babies; mild cold-like symptoms in older children and adults ## Footnote Symptoms can escalate quickly in vulnerable populations.

Answer 1001

Made by immunoassay ## Footnote This helps confirm the presence of the virus.

Answer 1002

Prevent viral uncoating or interfere with replication enzymes ## Footnote Examples include amantadine and protease inhibitors.

Answer 1003

Interfere with function of nucleic acids, distorting their shapes ## Footnote These are often used against viruses and rapidly dividing cancer cells.

Answer 1004

Attachment antagonists block viral attachment or receptor proteins ## Footnote This is a new area of antimicrobial drug development.

Answer 1005

Nuclear membrane, 80S ribosome, organelles ## Footnote Eukaryotes include organisms like fungi, plants, and animals.

Answer 1006

Thallus ## Footnote The thallus is the non-fruiting part of the fungus.

Answer 1007

Non-motile under any conditions ## Footnote Fungi grow towards food but do not move themselves.

Answer 1008

Chitin ## Footnote Chitin is a polymer that provides structural support.

Answer 1009

Heterotrophic organisms ## Footnote Fungi absorb organic matter for nutrition.

Answer 1010

Multicellular and unicellular ## Footnote Yeasts are an example of unicellular fungi.

Answer 1011

25 – 37 °C ## Footnote This range is optimal for fungal growth.

Answer 1012

Asexual and Sexual ## Footnote Asexual reproduction involves mitosis, while sexual reproduction involves meiosis.

Answer 1013

Budding ## Footnote Other methods include fragmentation and spore production.

Answer 1014

Superficial/Cutaneous infections ## Footnote Common examples include ringworm and athlete’s foot.

Answer 1015

Candida Spp. ## Footnote Candida can cause infections in humans and animals.

Answer 1016

Zygomycota ## Footnote Zygomycota includes fungi such as Rhizopus.

Answer 1017

Superficial infections ## Footnote They often affect keratinized layers of the skin.

Answer 1018

Ringworm of the scalp ## Footnote It is a type of dermatophyte infection.

Answer 1019

Tropical or subtropical environments ## Footnote Walking barefoot increases the risk for localized infections.

Answer 1020

Toxins produced by fungi under certain conditions ## Footnote Affects all animal species and can cause various symptoms.

Answer 1021

Inhibit the synthesis of glucan in cell walls ## Footnote They are considered a penicillin of antifungals.

Answer 1022

Disrupt ergosterol synthesis ## Footnote This leads to cell membrane disruption in fungi.

Answer 1023

True ## Footnote Most fungi require oxygen for growth, although yeasts can be facultative anaerobes.

Answer 1024

Tissue sample required ## Footnote This can be challenging due to the nature of fungal growth.

Answer 1025

It refers to a cell with two distinct nuclei (n + n) ## Footnote Dikaryons are formed during sexual reproduction.

Answer 1026

Cryptococcus ## Footnote Cryptococcus neoformans is a significant pathogen.

Answer 1027

Large molecules made using living cells, usually by genetically modifying cells.

Answer 1028

Biologic drugs are often 200 to 1,000 times the size of small-molecule drugs.

Answer 1029

A less costly imitation of biologics that is not an exact copy.

Answer 1030

More than 50%.

Answer 1031

62 biologics.

Answer 1032

$299 billion.

Answer 1033

* Vaccines * Blood and blood components * Somatic cells * Gene therapy * Tissues * Recombinant therapeutic proteins

Answer 1034

Products applicable to the prevention, treatment, or cure of disease or condition of human beings, including blood-derived products, vaccines, and most protein products.

Answer 1035

* Monoclonal antibodies * Cytokines * Enzymes * Immunomodulators

Answer 1036

Antibodies that have been artificially produced against a specific antigen.

Answer 1037

* Block the action of specific molecules * Target specific cells * Function as signaling molecules

Answer 1038

* Complexity * Price * Administration * Immunogenicity * Formulation and stability

Answer 1039

Biologics are biotechnology products with high molecular weight and complex structures.

Answer 1040

environment.

Answer 1041

The ability of a substance to provoke an immune response.

Answer 1042

Therapeutic agents that combine monoclonal antibodies with cytotoxic drugs for targeted delivery.

Answer 1043

To create less immunogenic versions of monoclonal antibodies for therapeutic use.

Answer 1044

Due to their complex makeup, biosimilars cannot be exact copies of the biologic reference product.

Answer 1045

Demonstration of high similarity to an FDA-approved biological product with no clinically meaningful differences.

Answer 1046

* Human growth hormone * Erythropoietin (EPO) * Insulin * Etanercept * Pegfilgrastim

Answer 1047

They can significantly impact the quality, safety, or effectiveness of the product.

Answer 1048

To produce a cell line capable of producing a specific type of antibody indefinitely.

Answer 1049

They are the predominant host used to produce therapeutic proteins.

Answer 1050

Type of cell and environments used to manufacture ## Footnote The modifications can affect the quality, safety, or effectiveness of the product.

Answer 1051

No, biosimilars cannot and are not required to be exactly like the biologic reference product ## Footnote This is in contrast to generics, which can be identical to a small molecule reference product.

Answer 1052

Manufacturers generally need to generate lab, non-clinical, and clinical data ## Footnote This data must show that the product provides the same therapeutic benefit and risks to patients as the reference product.

Answer 1053

Drugs in the same class as existing, approved biologics but are not identical to the original ## Footnote Biobetters are engineered with improvements.

Answer 1054

Biobetters are considered completely new and benefit from patent and market protection ## Footnote Unlike biosimilars, which are less costly imitations.

Answer 1055

Rituxan (Rituximab) ## Footnote This is a first-generation monoclonal antibody.

Answer 1056

Reditux ## Footnote It is a biosimilar of Rituxan (Rituximab).

Answer 1057

Gazyva (Obinutuzumab) ## Footnote Gazyva is considered a biobetter compared to existing biologics.

Answer 1058

Big, complex, and sensitive molecules with a complicated production process ## Footnote They offer unparalleled target specificity and therapeutic potential.

Answer 1059

Delivery, stability, and cost issues ## Footnote These challenges impact their use and accessibility.

Answer 1060

Biosimilars are not exact copies of biologics ## Footnote Unlike generics, which can be identical to small molecule reference products.

Answer 1061

Less costly ## Footnote This characteristic makes biosimilars an attractive option in the market.

Answer 1062

False ## Footnote Biobetters are engineered with improvements and are not identical.

Answer 1063

Gastrointestinal Tract

Answer 1064

* Abdominal pain & discomfort * Nausea * Vomiting * Diarrhoea * Constipation * Blood in stools * Weight changes * Bloating

Answer 1065

* Site * Onset * Character * Radiation * Associated symptoms * Timing * Exacerbating and relieving factors * Severity

Answer 1066

Usually a symptom of a more serious condition

Answer 1067

* Food * Trauma

Answer 1068

Pain that comes and goes, associated with conditions like appendicitis, biliary and renal colic, and intestinal obstruction

Answer 1069

* Nausea * Vomiting * Weight loss * Melaena (black stools) * Altered bowel habits * Haematemesis

Answer 1070

Irritable Bowel Syndrome, a functional bowel disorder affecting 10-20% of the adult population in the western world

Answer 1071

* Abdominal pain and discomfort in the LLQ * Symptoms relieved on defecation * Altered bowel habits (diarrhoea/constipation) * Bloating

Answer 1072

* Blood in stools * Fever * Nausea/vomiting * Severe abdominal pain * Changes in bowel habits in patients over 45

Answer 1073

Identify and avoid food triggers, such as FODMAPs

Answer 1074

The passage of three or more loose or liquid stools per day

Answer 1075

* Acute diarrhoea (lasting less than 14 days) * Persistent diarrhoea (lasting more than 14 days) * Chronic diarrhoea (lasting more than 4 weeks)

Answer 1076

* Viruses (e.g., norovirus) * Bacteria (e.g., food poisoning) * Parasitic causes * Drugs (e.g., laxatives, metformin) * IBS * IBD * Coeliac disease

Answer 1077

A chronic immune-mediated systemic disorder triggered by dietary gluten in genetically predisposed individuals

Answer 1078

* Bloating * Diarrhoea * Nausea * Flatulence * Constipation * Tiredness * Headaches * Sudden weight loss * Hair loss * Anaemia * Osteoporosis * Rash (Dermatitis herpetiformis) * Neurological disorders

Answer 1079

Adherence to a gluten-free diet

Answer 1080

Low dose tricyclic antidepressants

Answer 1081

It helps reduce the frequency of diarrhoea

Answer 1082

Fatty foods

Answer 1083

Chronic inflammatory intestinal disease and autoimmune disease

Answer 1084

Induced by gluten, referred to as true gluten intolerance

Answer 1085

Affects 1 in 100 people

Answer 1086

* Bloating * Diarrhoea * Nausea * Flatulence * Constipation * Tiredness * Headaches * Sudden weight loss * Hair loss * Anaemia * Osteoporosis * Rash (Dermatitis herpetiformis) * Neurological disorders

Answer 1087

* Kidney and liver disease * Malignancies (lymphomas) * Higher mortality (factor of 1.9-3.8)

Answer 1088

* Gliadin (most studied) * Glutenin * Hordeins (in barley) * Secalins (in rye)

Answer 1089

20 parts per million

Answer 1090

T-cell mediated (CD4+), involving MHC Class II molecules and cytokines like Interferon-γ and IL-15

Answer 1091

* HLA-DQ2 (90% of cases) * HLA-DQ8 (10% of cases)

Answer 1092

Deamidates gluten, allowing it to bind to MHC II molecules with high affinity

Answer 1093

* Serum analysis for anti-gliadin/Transglutaminase antibodies * ELISA * Biopsy of the intestine * HLA Typing

Answer 1094

Gluten-free diet

Answer 1095

Less than 20 ppm gluten

Answer 1096

* Genetically modified gluten * Zonulin inhibitors * Therapeutic vaccine * Probiotics * Tissue transglutaminase inhibitors

Answer 1097

Conflicting evidence on efficacy and potential for probiotic bacteremia

Answer 1098

* Calcium * Iron * Folate * Magnesium * Fat-soluble vitamins

Answer 1099

Coeliac disease patients carry higher numbers of enterobacteriaceae, which can cause disease

Answer 1100

osteoporosis, infertility, autoimmune disorders, malignant disease

Answer 1101

A long tube open at both ends for the transit of food during processing.

Answer 1102

* Esophagus * Stomach * Small intestine * Large intestine * Rectum

Answer 1103

Structures that contribute to food processing but are not part of the GI tract.

Answer 1104

* Teeth * Tongue * Salivary glands * Liver * Gallbladder * Pancreas

Answer 1105

Four layers.

Answer 1106

Facilitates peristalsis, producing rhythmic waves to move food through the gut.

Answer 1107

* Submucosal plexus * Myenteric plexus

Answer 1108

Regulates digestive processes via parasympathetic and sympathetic divisions.

Answer 1109

The physical breakdown of food, such as chewing.

Answer 1110

The enzymatic breakdown of food into smaller molecules.

Answer 1111

disaccharides.

Answer 1112

* Oral Phase * Pharyngeal Phase * Oesophageal Phase

Answer 1113

Food is prepared into a pellet (food bolus) for easy passage.

Answer 1114

* Trigeminal * Facial * Hypoglossal

Answer 1115

Closes the larynx to prevent food from entering the trachea.

Answer 1116

Transports food to the stomach via rhythmic contractions.

Answer 1117

* Upper esophageal sphincter * Lower esophageal sphincter

Answer 1118

J-shaped enlargement of the GI tract.

Answer 1119

The release of gastric acid (HCl) in the stomach.

Answer 1120

In the small intestine.

Answer 1121

Increase surface area for digestion and absorption.

Answer 1122

Provides a vehicle for absorption of substances from chyme.

Answer 1123

* Enzymes that digest carbohydrates, proteins, fats, and nucleic acids * Sodium bicarbonate to buffer stomach acid

Answer 1124

Emulsifies fats for digestion.

Answer 1125

Stores bile until needed.

Answer 1126

It drives the sodium/amino acid symporter to move sodium and amino acids in the same direction.

Answer 1127

Absorption of water and electrolytes, and formation of feces.

Answer 1128

The colon is responsible for the absorption of water, electrolytes, and some vitamins, and it also plays a role in feces formation. ## Footnote The colon's functions are crucial for maintaining fluid balance in the body.

Answer 1129

Feces consist of: * Water * Inorganic salts * Sloughed-off epithelial cells * Bacteria * Products of bacterial decomposition * Undigested portions of food ## Footnote The composition of feces reflects the processes of digestion and absorption occurring in the colon.

Answer 1130

Bacteria in the colon are involved in: * Breaking down substances * Synthesizing some vitamins ## Footnote The bacterial action is essential for the final stages of digestion.

Answer 1131

The defecation reflex is triggered when the rectal wall distends, sending sensory nerve impulses to the sacral spinal cord. ## Footnote This reflex involves coordinated motor impulses that lead to the contraction of rectal muscles and the opening of the anal sphincter.

Answer 1132

The cephalic phase stimulates gastric secretion and motility. ## Footnote This phase is initiated by the sight, smell, or thought of food.

Answer 1133

The gastric phase involves neural and hormonal mechanisms that regulate gastric juice pH and gastric motility. ## Footnote This phase is crucial for the digestion of food in the stomach.

Answer 1134

The intestinal phase of digestion involves neural and hormonal mechanisms that regulate digestive processes in the intestines. ## Footnote This phase ensures the proper digestion and absorption of nutrients in the small intestine.

Answer 1135

[water] ## Footnote The absorption of water is essential for maintaining hydration and electrolyte balance in the body.

Answer 1136

False ## Footnote Feces also contain water, bacteria, and other components resulting from digestion.

Answer 1137

Defecation occurs, and the feces are expelled. ## Footnote This process is part of the defecation reflex facilitated by the contraction of rectal muscles.

Answer 1138

Stretch receptors send sensory nerve impulses to the sacral spinal cord when the rectal wall distends. ## Footnote These impulses initiate the motor responses necessary for defecation.

Answer 1139

Immune-mediated chronic intestinal condition ## Footnote IBD includes two major types: Ulcerative Colitis and Crohn’s Disease.

Answer 1140

* Ulcerative Colitis * Crohn’s Disease

Answer 1141

Routine in patients with lower abdominal symptoms or in cases of diarrhoea ## Footnote Normal mucosa appears shiny with superficial vessels and no contact bleeding.

Answer 1142

* Reflex oesophagitis * Gastritis * Ulcers * Cancer

Answer 1143

Transmural inflammation ## Footnote It can occur anywhere along the gastrointestinal tract.

Answer 1144

* Fatty liver * Renal stones * Adhesions * Gallstones * Perianal and internal fistulae * Strictures * Eyes * Joints * Spine

Answer 1145

Blood, mucus, pus, urgency, nocturnal defecation, tenesmus, pre-defecation pain relieved by passing stool

Answer 1146

Rectum, spreads to colon

Answer 1147

* Treat and reduce intestinal inflammation * Promote mucosal healing * Reduce risk of colorectal cancer * Control and relieve symptoms * Treat complications * Minimise toxicity * Maintain remission * Address psychosocial issues * Replenish nutritional deficits * Improve QoL

Answer 1148

* Corticosteroids * Aminosalicylates * Thiopurines * Biologics

Answer 1149

Inhibits leukotriene and prostanoid formation, scavenges free radicals, decreases neutrophil chemotaxis

Answer 1150

To assess the risk of pancreatitis

Answer 1151

Worsens the condition

Answer 1152

Classification of Crohn’s Disease

Answer 1153

A scoring system used to assess the severity of Crohn’s Disease

Answer 1154

terminal ileum and ascending colon

Answer 1155

Both Crohn’s Disease and Ulcerative Colitis

Answer 1156

* Eye effects * Mucocutaneous lesions * Skin effects * Weight loss * Anaemia

Answer 1157

Targeted treatment depending on disease extent ## Footnote Includes suppositories, foam, and enemas.

Answer 1158

Appendectomy appears protective

Answer 1159

A polymer used in pharmaceuticals and food applications ## Footnote Ethylcellulose is often used as a thickening agent and film-forming agent.

Answer 1160

To monitor for potential complications or cancers in patients with IBD ## Footnote Regular surveillance helps in early detection of colorectal cancer in IBD patients.

Answer 1161

A condition of lower than normal bone density ## Footnote Osteopenia increases the risk of fractures.

Answer 1162

Crohn's Disease ## Footnote It classifies the disease based on location, behavior, and age of onset.

Answer 1163

A scoring system to assess the severity of Crohn's Disease ## Footnote The CDAI helps in evaluating treatment effectiveness.

Answer 1164

The clinical activity of Crohn's Disease ## Footnote It is a simplified version of CDAI focusing on fewer parameters.

Answer 1165

The severity of Ulcerative Colitis ## Footnote It categorizes the disease based on symptoms and clinical findings.

Answer 1166

To assess disease activity in children with Ulcerative Colitis ## Footnote This index considers age-specific symptoms and health status.

Answer 1167

Poor response to long-term medical treatment, emergency situations, cancer, abscesses, fistulas, strictures ## Footnote Surgery may be necessary when conservative treatments fail.

Answer 1168

Surgical removal of the rectum and colon with creation of an ileostomy ## Footnote This procedure is performed for both Crohn's Disease and Ulcerative Colitis.

Answer 1169

May affect drug absorption due to altered intestinal anatomy ## Footnote Drugs absorbed in the upper small intestine may not be adequately absorbed post-surgery.

Answer 1170

Herniation of colonic mucosa through areas of weakness in the colon ## Footnote Diverticulae can be found incidentally during imaging studies.

Answer 1171

Presence of diverticula without inflammation ## Footnote It may lead to changes in bowel habits and abdominal pain.

Answer 1172

Acute inflammation of diverticula ## Footnote Diverticulitis can present with severe abdominal pain and fever.

Answer 1173

Crohn’s Disease Activity Index (CDAI)

Answer 1174

False ## Footnote A colostomy is less likely to significantly impact drug absorption compared to an ileostomy.

Answer 1175

Travel Health is a relatively new medical specialty that addresses the health, safety, and welfare needs of travelers.

Answer 1176

Travel Health is important because travelers are at greater risk of disease or death compared to non-travelers, especially when visiting developing countries.

Answer 1177

* Pre-travel health assessments and advice * Prescription and recommendation of medicines * Provision of specialist travel first aid kits * Vaccinations and preventative measures * Management of health problems in returning travelers

Answer 1178

For every 100,000 travelers visiting a developing country for 1 month, approximately 50,000 will develop some health problem.

Answer 1179

False. Only 1-4% of travel-related deaths are caused by infectious diseases.

Answer 1180

* Ischaemic heart disease (35%) * Trauma (25%) * Malaria

Answer 1181

Traveller's Diarrhoea, with 25-90% of travelers experiencing symptoms in the first 2 weeks of travel.

Answer 1182

Health Information for International Travel.

Answer 1183

NaTHNaC aims to protect British travelers and is commissioned by Public Health England.

Answer 1184

75% of travelers to developing countries develop health problems while overseas.

Answer 1185

Influenza.

Answer 1186

* Driving on the opposite side of the road * Taking greater risks while overseas * Involvement of alcohol and/or drugs

Answer 1187

Emporiatrics is another term for Travel Health, reflecting its multidisciplinary nature.

Answer 1188

* Up to 20% of travelers practice casual sex * 50% do not use condoms * Up to 25% of European cases of syphilis and gonorrhea are acquired overseas

Answer 1189

* Malaria * Dengue * Yellow Fever

Answer 1190

Pharmacists play a key role in the provision of specialist travel first aid kits and advising on medications.

Answer 1191

300 times greater than when in the UK.

Answer 1192

* NaTHNaC * CDC Yellow Book * British National Formulary

Answer 1193

* Traveller's Diarrhoea * Respiratory tract infections * Influenza

Answer 1194

It marked the beginning of systematic studies of tropical diseases encountered by Europeans.

Answer 1195

To prevent illnesses and injuries occurring to travelers going abroad and manage problems arising in travelers returning from abroad.

Answer 1196

25% may require some alteration of travel plans.

Answer 1197

Up to 25% ## Footnote Conservative estimates suggest significant transmission of STIs through international travel.

Answer 1198

300x greater ## Footnote This highlights the increased risk for UK travelers in certain regions.

Answer 1199

30-40% ## Footnote This reflects attitudes towards sexual health among travelers.

Answer 1200

Alcohol/drugs ## Footnote Substance use can impair judgment and lead to unsafe sexual practices.

Answer 1201

Sex tourism ## Footnote This issue involves complex social dynamics and health risks.

Answer 1202

50% or greater ## Footnote This statistic underscores the vulnerability of sex workers to STIs.

Answer 1203

Increased incidence ## Footnote This trend poses challenges for treatment and public health.

Answer 1204

No ## Footnote While male sex tourism is more common, female tourists also engage in such practices.

Answer 1205

They can significantly affect the spread of infectious diseases ## Footnote Examples include the spread of SARS and COVID-19.

Answer 1206

4.8% ## Footnote This contrasts with developed countries, which had a lower growth rate.

Answer 1207

1.6 billion ## Footnote This figure illustrates the scale of global travel.

Answer 1208

>10% ## Footnote This indicates a significant portion of Australians engage in international travel.

Answer 1209

Travelers are increasingly visiting higher risk destinations ## Footnote This shift requires greater awareness of health risks.

Answer 1210

They are decreasing ## Footnote What was once considered risky is now seen as more mundane.

Answer 1211

Leisure travelers (52%) ## Footnote This highlights the dominant purpose of travel among individuals.

Answer 1212

Growth in business travel ## Footnote This reflects economic changes and globalization.

Answer 1213

They spend more time in close proximity with local populations ## Footnote This increases their exposure to local health risks.

Answer 1214

36-52% ## Footnote This indicates a gap in health preparedness among travelers.

Answer 1215

Prevent and/or minimize health risks associated with travel ## Footnote This includes individualized risk assessments.

Answer 1216

Assessment of the traveller’s baseline health and destination risks ## Footnote This helps tailor health advice to individual needs.

Answer 1217

4-8 weeks before travel ## Footnote This allows adequate time for vaccinations and health preparations.

Answer 1218

Itinerary-related data ## Footnote Includes countries and regions being visited, planned activities, and potential disease exposure.

Answer 1219

Age and gender, vaccination history, full medical, allergy and medication history, pregnancy/breastfeeding status, planned medical care or surgery, attitudes/traits of traveller, budget ## Footnote Important for determining higher risk travellers.

Answer 1220

* Required vaccines * Routine vaccines * Recommended vaccines

Answer 1221

Yellow fever ## Footnote Required for travellers returning from endemic areas.

Answer 1222

Increasingly, children are not vaccinated and/or adults have not had recent boosters.

Answer 1223

* Cholera * Typhoid * Japanese encephalitis * Rabies

Answer 1224

Plan an appropriate vaccination program requiring adequate time.

Answer 1225

Tailored, prioritized, and individualized to meet the needs of the traveler ## Footnote Includes obligatory counselling on health risks.

Answer 1226

* Altitude * Marine and diving-associated diseases * Heat or cold * Motion sickness

Answer 1227

3 loose or watery stools in a 24 hour period with/without one or more of: abdominal pain, nausea, vomiting, fever, cramps, blood or mucus in stools, faecal urgency.

Answer 1228

Bacterial infections ## Footnote 50-75% of cases are due to bacteria.

Answer 1229

* Adventurous behaviour * Particular destinations * Length of stay * Consumption of unclean water or food

Answer 1230

Be careful of what and where they eat, and gradually introduce local foods.

Answer 1231

* Moist foods served at room temperature * Raw fruits and vegetables that cannot be peeled * Food from street vendors unless freshly prepared

Answer 1232

Avoid tap water, ice cubes, ice blocks, and milk products if suspected to be unsafe.

Answer 1233

Regular handwashing, even in extreme conditions, and using alcoholic hand rub.

Answer 1234

traveller’s diarrhoea

Answer 1235

Dry foods like bread without spreads ## Footnote Considered safer than moist foods.

Answer 1236

12-15 days

Answer 1237

24-48 hours

Answer 1238

Better presentation may involve greater handling, increasing contamination risk.

Answer 1239

Tap water should be avoided if suspected to be hazardous, as well as ice cubes, ice blocks, and milk products. ## Footnote This applies to both developing and some developed countries.

Answer 1240

No, swimming pool water is not sterile and should not be drunk. ## Footnote It is chlorinated but still poses health risks.

Answer 1241

Travelers should avoid swimming in and drinking water from areas where schistosomiasis is a known risk.

Answer 1242

Only drink bottled water from bottles with intact seals and that do not appear tampered with. ## Footnote Street vendors may refill bottles with tap water.

Answer 1243

Soft drinks, carbonated water, wine, and bottled beers are generally considered safe if opened at the table.

Answer 1244

Fruit juices and cordials may have been prepared with contaminated water.

Answer 1245

Boiling water for 3-5 minutes is the most common method.

Answer 1246

Water boils at a lower temperature at altitude, necessitating a longer boiling time.

Answer 1247

Avoid iodine in pregnancy, thyroid disease, or if allergic to iodine.

Answer 1248

Newer cholera vaccines provide some protection against certain strains of ETEC, but only about 50% of ETEC strains express the enterotoxin.

Answer 1249

Pepto-Bismol results in a 60% reduction of travelers' diarrhea risk.

Answer 1250

The goals are to avoid dehydration, reduce severity and duration of symptoms, and prevent interruption of planned activities.

Answer 1251

Loperamide is the antimotility agent of choice.

Answer 1252

Seek medical attention if blood is present in stools or symptoms are severe.

Answer 1253

The average incubation period for Plasmodium falciparum is 7-14 days.

Answer 1254

P. falciparum can cause a severe, rapidly progressive, and frequently fatal form of malaria.

Answer 1255

Migrants residing in non-endemic areas returning to visit relatives in endemic areas are a key risk group.

Answer 1256

Malaria is very dangerous in pregnancy and may cause spontaneous abortion and stillbirth.

Answer 1257

Early symptoms of malaria are often described as 'flu-like'.

Answer 1258

Artemether and lumefantrine is the first-line treatment.

Answer 1259

Consider carrying Ciprofloxacin and Metronidazole for severe symptoms during long trips to remote locations.

Answer 1260

The average incubation period for P. vivax is 12-17 days.

Answer 1261

P. vivax remains sensitive to chloroquine, although resistance is developing.

Answer 1262

Treat empirically for Giardia if there is no clear diagnosis.

Answer 1263

Every 48 hours.

Answer 1264

Every 72 hours.

Answer 1265

Fevers are irregular, with coma and death occurring within as little as 24 hours after initial symptoms.

Answer 1266

* Fever * Myalgia * Arthralgia * Diarrhoea * Headache * Nausea * Vomiting * Malaise

Answer 1267

High risk of complications.

Answer 1268

The surface is altered, causing them to adhere to blood vessel walls, potentially leading to cerebral malaria.

Answer 1269

* Thrombocytopenia * Renal insufficiency * Hypoglycaemia * Splenomegaly

Answer 1270

* Destination country and area * Time of year * Rural or urban * Activities at destination * Accommodation and style of travel * Presence of contraindications (age, pregnancy, medical history) * Presence of P.falciparum resistance

Answer 1271

Artemether with lumefantrine.

Answer 1272

Artesunate.

Answer 1273

Eradication of liver stages of malaria to prevent relapse.

Answer 1274

300mg base per week.

Answer 1275

* Fatal cardiac arrhythmia in overdose * Nausea * Vomiting * Chronic retinopathy * Itching * Tinnitus

Answer 1276

Do not use in pregnancy or children under 8 years.

Answer 1277

1 week before.

Answer 1278

2-3 weeks.

Answer 1279

Treatment prescribed for travellers to take on expeditions to start treatment if malaria is suspected.

Answer 1280

Symptoms of malaria.

Answer 1281

Apply insect repellents to the skin.

Answer 1282

75-95% effective.

Answer 1283

* Acidosis * Hypoglycaemia * Pulmonary oedema

Answer 1284

Nighttime exposure for Anopheles and daytime exposure for Aedes mosquitoes.

Answer 1285

4 tablets at time 0, 8, 24, 36, 48, and 60 hours.

Answer 1286

Perfumes and aftershave lotion ## Footnote These can attract mosquitoes.

Answer 1287

Malaria is more likely to be severe in pregnancy, with increased risks of acidosis, hypoglycaemia, and pulmonary oedema ## Footnote It can also lead to low birth weight and foetal death.

Answer 1288

Doxycycline after the first 18 weeks and mefloquine throughout pregnancy ## Footnote Chloroquine and proguanil can be used.

Answer 1289

Required, Routine, and Recommended ## Footnote Vaccines may vary depending on legal requirements and travel destinations.

Answer 1290

Hepatitis A ## Footnote It is transmitted via the faecal/oral route.

Answer 1291

Apprehension, headache, fever, sensory changes, excitability, hallucinations, hydrophobia, delirium, convulsions ## Footnote Rabies is invariably fatal without treatment.

Answer 1292

Deep vein thrombosis (DVT) occurring in long-haul flights due to lack of mobility and cramped conditions ## Footnote It can lead to pulmonary embolism (PE).

Answer 1293

* Lower partial pressure of oxygen at altitude * Consumption of alcohol or caffeine leading to dehydration ## Footnote These can affect circulation.

Answer 1294

* Traveller’s immune status * Medical history * History of allergy * Destinations visited * Length of stay * Type of travel * Traveller’s age * Time from consultation to departure * Intended activities at destination

Answer 1295

True ## Footnote Hepatitis B has a case fatality rate of 2% compared to Hepatitis A's 0.1%.

Answer 1296

High in rural areas of Africa, Asia, Europe, North and South America, particularly in Asia where 90% of rabies deaths occur ## Footnote Risk increases with length of stay in rabies-endemic countries.

Answer 1297

Apprehension, headache, fever, sensory changes ## Footnote Advanced symptoms include excitability and hydrophobia.

Answer 1298

Cost of pre-exposure vaccination versus risk of exposure ## Footnote Availability of rabies immunoglobulin and vaccine for post-exposure treatment.

Answer 1299

3000-6000 per month ## Footnote Case fatality rate is 0.1%.

Answer 1300

Yellow fever vaccine ## Footnote Required in specific countries in South America and Africa.

Answer 1301

Economy Class Syndrome ## Footnote This term reflects the increased risk of deep vein thrombosis during long flights.

Answer 1302

* Previous history of DVT or PE * Flights greater than 12 hours * Older age groups (greater than 50 years) * Overweight or obese people * Being very tall in height * Smoking * Reduced mobility * Dehydration * Trauma * Recent surgery * Pregnancy or recent childbirth * Medications (combined oral contraceptives, hormone replacement therapy, hypnotics) * Chronic diseases (heart disease, malignancy, ulcerative colitis, varicose veins) * Hypercoagulability

Answer 1303

Avoid excessive alcohol and caffeine ## Footnote Staying hydrated can help reduce the risk of DVT.

Answer 1304

desynchronisation

Answer 1305

* Difficulty sleeping * Fatigue * Confusion * Irritability * Digestive disorders * Joint stiffness * Headache

Answer 1306

* Direction of travel * Age * Number of time zones crossed * Napping * Previous bad travel experiences * Sleep deprivation prior to journey * Dehydration and excessive alcohol consumption * Stress * Poor diet and overeating

Answer 1307

To reduce the effects of jet lag ## Footnote Its use remains controversial, with inconsistent trial results.

Answer 1308

* Be well rested prior to the journey * Choose flights with transits to arrive at normal sleeping times * Avoid planning critical tasks immediately on arrival

Answer 1309

* Avoid sleep deprivation * Set watches to destination time * Plan sleep during the journey * Drink plenty of fluid * Avoid alcohol and caffeine

Answer 1310

* Spread of diseases in crowded environments * Vectorborne diseases from port visits * Need for ship's medical facilities * Various illnesses on-board (respiratory illness, seasickness, GI illness)

Answer 1311

Norovirus ## Footnote It accounts for over 90% of GI outbreaks with a confirmed cause.

Answer 1312

* Keep away from children * Carry written instructions and a letter of authorization * Package medicines appropriately to prevent misunderstandings at customs

Answer 1313

* Varying legal status of medicines between countries * Potential problems with controlled drugs

Answer 1314

* Use solid dosage forms packaged in blister packs * Keep medicines cool * Pack in at least two caches in case baggage is lost

Answer 1315

An adequate supply of their regular medication plus some overage in case of delays. ## Footnote This includes medicines that may be used infrequently at home but required during travel.

Answer 1316

Examples include: * Stimulant sinus medications (e.g., pseudoephedrine) * Vicks inhalers * Some natural products and vitamins. ## Footnote These restrictions can vary by country.

Answer 1317

Have a letter of authorisation. ## Footnote This letter can help clarify the purpose of the medication to border officials.

Answer 1318

Reasons may include: * Saving space in luggage * Saving money * Lost or forgotten medications * Treating unexpected travel-related conditions * Usurping pricing arrangements in their own country. ## Footnote These reasons may lead to potential risks.

Answer 1319

Considerations include: * Communication issues * Identification of medications * Availability of medicines * Quality of medicines. ## Footnote These factors significantly impact the safety and efficacy of medications obtained abroad.

Answer 1320

The problem of counterfeit pharmaceuticals. ## Footnote Counterfeit medicines can affect therapeutic response and may contain harmful excipients.

Answer 1321

Factors include: * Itinerary * Size of the group * Size of the kit * Chronic diseases and regular medicines * Packaging * Stability of medications. ## Footnote These factors ensure the kit meets the traveller's specific needs.

Answer 1322

Keep medications appropriately packaged and labelled. ## Footnote Additionally, carry a doctor’s letter or copies of prescriptions.

Answer 1323

Items include: * Analgesics (e.g., Ibuprofen, Acetaminophen) * Antihistamines/Decongestants (e.g., Benadryl) * Wound care supplies (e.g., adhesive bandages) * Gastrointestinal medications (e.g., Antacid) * Miscellaneous items (e.g., water purification tablets). ## Footnote A well-stocked medical kit can address a variety of health issues during travel.

Answer 1324

A chronic systemic inflammatory (autoimmune) condition characterized by persistent symmetric polyarthritis (synovitis) affecting hands and feet ## Footnote RA may also affect extraarticular tissues/organs such as skin, lungs, heart, and eyes.

Answer 1325

* Persistent symmetric polyarthritis (synovitis) of hands and feet * Progressive articular deterioration * Difficulty performing activities of daily living (ADLs) * Constitutional symptoms * Common sites of involvement: upper and lower extremities ## Footnote Common joints include metacarpophalangeal joints, wrists, knees, and hips.

Answer 1326

3 cases per 10,000 population with 1% prevalence ## Footnote RA peaks in prevalence between ages 35-50 years.

Answer 1327

Women are three times more affected than men; the difference diminishes with older ages ## Footnote First-degree relatives of RA patients have a 2-3 fold increase in risk.

Answer 1328

HLA-DR4 allele increases severity and development of RA ## Footnote This indicates a genetic predisposition to the disease.

Answer 1329

* Increased smoking duration * Red meat intake * Vitamin D deficiency * Excessive coffee consumption * High salt intake ## Footnote Hormonal factors, particularly prolactin levels, also play a role.

Answer 1330

* Phase I - Interaction of genetic and environmental risk factors * Phase II - Production of RA autoantibodies (e.g., RF, anti-CCP) * Phase III - Begin arthralgia or joint stiffness * Phase IV - Development of arthritis * Phase V - Established RA

Answer 1331

B-cells and T-cells inappropriately enter the joint, releasing cytokines that cause the synovium to release proteolytic enzymes, destroying bone and cartilage ## Footnote Key cytokines include TNF-α, IL-1, IL-6, IL-8, TGF-ß, FGF, and PDGF.

Answer 1332

* History * Symptoms * Blood tests * X-ray ## Footnote The process involves differentiating RA from other conditions with similar signs or symptoms.

Answer 1333

* Joint involvement * Serology * Acute-phase reactants * Duration of symptoms

Answer 1334

* ESR * CRP * IgM-RF (present in 80% of RA patients) * Anti-CCP (useful for early detection) ## Footnote ANA can help differentiate types of disease.

Answer 1335

A measure that counts the number of swollen and tender joints, and includes ESR or CRP and a global health score ## Footnote DAS-28 > 5.1 indicates active disease, while < 2.6 indicates remission.

Answer 1336

* Reduce symptoms * Slow/limit joint damage * Preserve/improve function * Achieve/maintain disease remission ## Footnote There is currently no cure for RA.

Answer 1337

* Physiotherapy * Exercise * Diet * Psychological education * Stress reduction * Surgical interventions

Answer 1338

* NSAIDs * Glucocorticoids * DMARDs * Biologicals ## Footnote NSAIDs can worsen cardiovascular risks associated with RA.

Answer 1339

Short-term treatment with glucocorticoids to rapidly decrease inflammation ## Footnote Long-term use should be discussed with patients due to potential complications.

Answer 1340

Fully discussed and all other treatment options have been offered ## Footnote Long-term use of glucocorticoids can lead to various complications including osteoporosis, diabetes, and cardiovascular issues.

Answer 1341

60mg/day gradually reduced to 7.5mg over 7 weeks ## Footnote This tapering schedule is important to minimize withdrawal symptoms and side effects.

Answer 1342

120mg intramuscularly on a PRN basis ## Footnote PRN means 'as needed', indicating that the medication is not given on a regular schedule.

Answer 1343

Gold, Ciclosporin, and Penicillamine ## Footnote These older DMARDs have largely been replaced by more effective treatments with better safety profiles.

Answer 1344

Methotrexate ## Footnote Methotrexate is widely recognized for its efficacy in managing RA but has associated risks.

Answer 1345

* Liver impairment * Neutropenia * Anaemia * Pneumonitis * Nausea ## Footnote Monitoring of blood counts and liver function is essential during treatment.

Answer 1346

Pro-drug activated in the colon with anti-RA effects due to the inhibition of transcription factors ## Footnote It is important to monitor patients for side effects such as cough, diarrhea, and fever.

Answer 1347

Diarrhea ## Footnote Leflunomide is an effective DMARD that requires monitoring for gastrointestinal side effects.

Answer 1348

Interferes with antigen presentation and activation of the immune response ## Footnote Hydroxychloroquine is also used for malaria and lupus, with ocular toxicity as a serious side effect.

Answer 1349

cDMARD monotherapy ideally within three months of diagnosis ## Footnote This includes Methotrexate, Leflunomide, or Sulfasalazine.

Answer 1350

Their mechanism of action ## Footnote This includes classifications such as Anti-TNF-alpha inhibitors, CD20 inhibitors, and Janus Kinase inhibitors.

Answer 1351

Infliximab ## Footnote Infliximab has paved the way for subsequent biologic therapies.

Answer 1352

* Adalimumab * Etanercept * Infliximab * Certolizumab pegol * Golimumab * Tocilizumab * Abatacept ## Footnote These are recommended only if the disease is severe and has not responded to intensive therapy with DMARDs.

Answer 1353

When methotrexate is contraindicated or intolerant, and the criteria for severity are met ## Footnote Monotherapy is considered when the patient cannot tolerate DMARDs.

Answer 1354

No more frequently than every 6 months ## Footnote Rituximab is given in combination with Methotrexate for better efficacy.

Answer 1355

An improvement in DAS28 of 1.2 points or more ## Footnote The DAS28 score is a measure of disease activity in rheumatoid arthritis.

Answer 1356

* Initiation with analgesia/NSAIDs * Referred to a rheumatology specialist * If RA is confirmed, treatment with DMARDs starts * If DAS-28 remains above 5.2 after six months, biologic treatment may start ## Footnote This pathway ensures timely and effective management of RA.

Answer 1357

Involves viral entry, replication, and immune response leading to symptoms and potential complications ## Footnote Pathophysiology refers to the functional changes associated with or resulting from disease or injury.

Answer 1358

Focus on clinical assessment, testing, antiviral therapy referral, and patient education ## Footnote NICE stands for the National Institute for Health and Care Excellence.

Answer 1359

* Increasing age * Male sex * Co-morbidities (e.g., hypertension, diabetes) * Health and social care workers * Black and Asian ethnic groups * Lower socioeconomic groups

Answer 1360

* Clinical assessment * Lateral flow testing * PCR testing * Blood tests (Serology and generic tests) * COVID Oximetry at Home Monitoring

Answer 1361

* Progressively worsening breathlessness * Haemoptysis * Cyanosis * Collapse or syncope * New confusion * Drowsiness * Reduced urine output * Hypoxia

Answer 1362

False ## Footnote Referral is based on the severity of symptoms.

Answer 1363

* Stay at home * Self-manage symptoms * Get vaccinated * Ensure adequate ventilation and hygiene * Access mental health support

Answer 1364

Patients with risk factors for severe illness such as: * Down syndrome * Solid cancers * Respiratory conditions (COPD & Asthma) * Immune deficiencies

Answer 1365

To evaluate antiviral treatments for COVID-19 in community settings, particularly among high-risk, vaccinated populations

Answer 1366

Inhibits the SARS-CoV-2 main protease (Mpro), stopping viral replication ## Footnote Nirmatrelvir is used in combination with ritonavir.

Answer 1367

* Altered taste * Diarrhoea * Headache * Muscle aches

Answer 1368

Binds to the spike protein of SARS-CoV-2, blocking the virus from entering human cells

Answer 1369

200mg IV on day 1, followed by 100mg IV on days 2 and 3 for non-hospitalised patients ## Footnote For hospitalised patients, it is given for 5-10 days.

Answer 1370

Do not prescribe antibiotics to prevent secondary bacterial pneumonia; start for suspected or confirmed secondary infections ## Footnote Antibiotics are ineffective against viral infections.

Answer 1371

* Acute respiratory distress syndrome * Venous thromboembolism * Acute myocardial injury * Acute kidney injury * Sepsis

Answer 1372

* Volume depletion * Haemodynamic changes * Viral infection causing tubular injury * Thrombotic vascular processes * Glomerular pathology

Answer 1373

Haematuria, proteinuria, and abnormal serum electrolyte levels

Answer 1374

Targets SARS-CoV-2 RNA-dependent RNA polymerase and introduces errors into the viral RNA during replication

Answer 1375

* Diarrhoea * Nausea * Dizziness * Headache

Answer 1376

Dexamethasone is first-line; suppresses immune response and reduces inflammation ## Footnote Important for managing cytokine storms.

Answer 1377

Remdesivir ## Footnote Risk factors for AKI include treatments for pre-existing conditions such as ACE inhibitors and NSAIDs.

Answer 1378

Fever and increased respiratory rate

Answer 1379

Direct damage, systemic inflammation, endothelial dysfunction, hypoxia ## Footnote Direct damage occurs via ACE2 receptor interaction; systemic inflammation leads to myocarditis; endothelial dysfunction triggers a hypercoagulable state.

Answer 1380

ECG, Troponin, NT-proBNP

Answer 1381

Endothelial dysfunction, hypercoagulable state, immobility

Answer 1382

A validated risk assessment tool

Answer 1383

Oxygen supply needs and bleeding risk

Answer 1384

Common cold, respiratory syncytial virus, parainfluenza virus, strep pharyngitis, meningitis, bacterial pneumonia, glandular fever, whooping cough, malaria

Answer 1385

Acute bronchitis, asthma exacerbations, otitis media, pneumonia

Answer 1386

Myocarditis, pericarditis, febrile convulsions, myalgia, neurological complications ## Footnote Includes conditions like Reyes syndrome and toxic shock syndrome.

Answer 1387

Potential issues with treatment efficacy due to timing

Answer 1388

Maintain hydration and plenty of rest

Answer 1389

Influenza must be circulating as per national surveillance

Answer 1390

Over 65 years, children under 6 months, pregnant women, and individuals with chronic conditions

Answer 1391

Inhibit the enzyme neuraminidase, preventing viral replication and spread

Answer 1392

Oral oseltamivir

Answer 1393

Oral, BD dosing based on age and weight

Answer 1394

Nausea and vomiting

Answer 1395

Inhaled via Diskhaler, OD

Answer 1396

Throat irritation and cough

Answer 1397

Manage antiviral treatments and patient education

Answer 1398

Prevent viral infections

Answer 1399

Composition and mechanism of action

Answer 1400

Targeted outreach and education

INFECTION Flashcards

(1487 cards)