Infection and immunology

Question 1

Patient has oral ulcers, genital ulcers, and anterior uveitis. Has erythema nodosum. Gets a DVT. What test is suggestive of the condition?

Answer 1

Pathergy test - pustule following needle prick

Behcet’s

Question 2

Patient has blueberry muffin skin lesions, hepatosplenomegaly, and seizures. What’s the treatment?

Answer 2

IV ganciclovir (for CMV)

Question 3

First treatment for uncomplicated falciparum malaria

Answer 3

Arthemether-lumefantrine

Question 4

Treatment for severe falciparum malaria

Answer 4

IV artesunate

Question 5

Main cause of neutropenic sepsis

Answer 5

Staph epidermis

Question 6

Neutropenic sepsis prophylaxis

Answer 6

Fluoroquinolone e.g. ciprofloxacin

Question 7

Neutropenic sepsis treatment

Answer 7

Piperacillin with tazobactam (tazocin)

Question 8

Which test is not specific for syphilis and when does it become negative?

Answer 8

Non-treponemal
- RPR
- VDRL

Negative after treatment (months to couple of years)

Question 9

Which test is specific for syphilis and when does it become negative?

Answer 9

Treponemal
- TP-EIA
- TPHA

Positive forever

Question 10

When does type 1 necrotising fasciitis often occur?

Answer 10

Post-surgery in diabetics (caused by mixed anaerobes and aerobes)

Question 11

What causes type 2 necrotising fasciitis?

Answer 11

Strep pyogenes

Question 12

Which drug in diabetics is associated with necrotising fasciitis?

Answer 12

SGLT-2 inhibitors e.g. dapagliflozin

Question 13

Most common site of necrotising fasciitis?

Answer 13

Perineum (Fournier’s gangrene)

Question 14

Initial features of necrotising fasciitis?

Answer 14

Rapidly worsening cellulitis and really bad pain to light touch

Question 15

Necrotising fasciitis management

Answer 15

Urgent surgical debridement referral
IV abx

Question 16

Patient has red face, small aphthous ulcers on his left buccal mucosa. He also has a maculopapular erythematous rash on his upper trunk, red hands and folliculitis on his chest. His liver and spleen are just palpable and he has mild neck stiffness. What is the condition?

Answer 16

HIV seroconversion

Question 17

Condition with macular rash over his body, including palms, soles and scalp, a few palpable lymph nodes in the groin and a small papular lesion on the glans of his penis.

Answer 17

Secondary syphilis

Question 18

Gonorrhoea management

Answer 18

1) Single dose IM ceftriaxone (or single oral ciprofloxacin if sensitive)
2) Oral cefixime + oral azithromycin

Question 19

Chlamydia management

Answer 19

7 days doxycycline

Question 20

Tests for chlamydia and gonorrohoea in women: endocervical or vulvovaginal?

Answer 20

Vulvovaginal