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Focused 3 > Infection/Haem > Flashcards

Infection/Haem Flashcards

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1
Q

Listeriosis - tx
Listeriosis meningitis - to

A

Amox or ampicillin
If meningitis - add gentamicin

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2
Q

Syphilis tx

A

Benzathine benzylpenicillin

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3
Q

Congenital toxoplasmosis - tx

A

Spiramycin for infection in pregnant mum

pyrimethmine and sulfadiazine for infected foetus

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4
Q

Cause of hand foot and mouth disease

A

Coxsackie virus A

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5
Q

Cause of fifth disease aka erythema infantiosum

A

Slapped cheek rash
Parvovirus b19

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6
Q

tx of giardiasis

A

metronidazole

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7
Q

when can you get shingles vaccination?

A

age 70-79

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8
Q

tx of neisseria gonorrhoea

A

IM ceftriaxone

OR ciprofloxacin OR tetracycline

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9
Q

investigation for chlamydia

tx of chlamydia

A

Ix: NAAT

1st line: doxycycline 7/7
2nd line: azithromycin 3/7

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10
Q

tx of bacterial vaginosis and trichomoniasis

A

BV: metronidazole (PO/TOP) or clindamycin
Trichomoniasis: metronidazole

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11
Q

tx of syphillis

A

benzylpenicillin

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12
Q

which organism causes fungal meningitis for west africa patient?
PC: fever, headache, diarrhoea, weight loss

A

cryptococcus neoformans

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13
Q

what level of CD4 count must you aim with anti-retroviral tx?

A

> 350

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14
Q

abx prophylaxis for meningococcal patients-contacts

A

ciprofloxacin
rifampicin - 2nd line

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15
Q

prophylaxis for malaria

A

1st line: doxycycline
2nd line: atovaquone/proguanil

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16
Q

HIV positive with recent travel to tropics and severe diarrhoea ? organism

A

cryptosporidium

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17
Q

what causes hand, foot and mouth disease?

A

Coxsackie virus A type 16

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18
Q

contraindication to doing LP

A

raised ICP signs (GCS<9, drop in GCS of 3, relative bradycardia and HTN, focal neurological signs, abnormal posturing, anisocoria/unequal pupils, papilloedema, tense or bulging frontonelle)
haemodynamic instability
extensive or spreading purpura
seizures ongoing
coagulation abnormalities (platelet<100)
infection at site of LP
respiratory compromise

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19
Q

?diagnosis - homeless person, initial scab on face, itchy and increase swelling, pyrexia and cannot open eye due to swelling

A

erysipelas
organism: Group A strep (strep pyogenes)
tx: penicillin

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20
Q

swimming in lake malawi. urinary symptoms. ?organism

A

schistosomia haematobium (look for ovum in microscopy)

Tax: praziquantel

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21
Q

differences in the plasmodiums

A

falciparum:

malariae: fever recur every 3 days, less severe than falciparum/vivax, found in Africa only.

vivax: fever recur every 2 days, can lie dormant for years -> leading to recurrence. found in latin America and Asia.

Treatment depends on chloroquine sensitivity/resistance. But you can use artemisin-drugs for both. Eg lumefantrine, mefloquine, amodiaquine, sulfadoxine/pyrimethamine, piperaquine and chlorproguanil/dapsone

P.ovale and vivas should be given primaquine to ensure that liver hypnozoites are destroyed.

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22
Q

rose spots - ?organism

A

salmonella
(can cause splenomegaly, constipation earlier on then diarrhoea)
Ix: blood culture
tx: ciprofloxacin

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23
Q

return from south africa - high swinging fever with diarrhoea and tenderness in RUQ ? organism

A

likely liver abscess
amoebiosis

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24
Q

difference in number of cells in LP for:
viral, bacterial, TB, cryptococcal meningitis

A

viral: 5-1000, lymphocyte
bacterial: >100, neutrophil
TB: 5-100, lymphocyte
cryptococcal: 5-100, lymphocyte

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25
rose-pink maculopapular rash before the rash - conjunctivitis, pain on eye movement, sore throat, general malaise, low grade fever Forchheimer sign (pinpoint or larger petechiae) ?diagnosis
rubella
26
organism causing mumps
rubulavirus
27
organism causing scarlet fever
Group A beta-hameolytic streptococcus
28
farm worker. headache, fever, severe myalgia, petechial rash, jaundiced, raised urea ?diagnosis
leptospirosis AKA weil's disease Tax: benzylpenicillin/doxy
29
strawberry cervix ?diagnosis
trichomoniasis (but only visible for 1-2% of cases under colposcopy)
30
tx of CMV colitis in HIV patients
IV gaciclovir
31
salmon-pink rash on trunk
adult still's disease aka juvenile idiopathic arthritis
32
clue cells - what is it?
vaginal epithelial cells covered with gram negative rods found in bacterial vaginosis
33
HIV nephropathy - how is it different to nephrotic syndrome?
in nephrotic syndrome - high cholesterol in HIV nephropathy - normal/low cholesterol and no HTN. renal USS will reveal large echogenic kidneys
34
abx post-dog bite
co-amoxiclav
35
tx of cryptococcal meningitis
amphotericin tx followed by long-term prophylactic fluconazole
36
which abx works best intracellularly?
macrolides quinolones ketolides
37
tx of lyme disease
doxycycline
38
strawberry tongue
kawasaki disease
39
difference between TRALI and TACO
blood pressure! TRALI- hypo TACO- hyper
40
APTT vs PT
APTT tests for intrinsic and common pathways - factor 8, 9,11,12 PT tests for extrinsic and common pathways - factor 2,5,7,10
41
what is SCID?
recurrent infections, diarrhoea, dermatitis, failure to thrive compromise in number and function of T-cells, B-cells and natural killer cells
42
treatment/prophylaxis for C1 inhibitor deficinecy
tx: C1-INH concentrate of FFP (during acute attack) prophylaxis: androgens (danazol) increase production of C1-INH, fibrinolysis inhibitors (tranexamic acid)
43
works as a vet and notice large right axillary lymph node which was fluctuant and tender ?diagnosis
cat scratch disease - Bartonella henselae - infection affeting the lymph nodes that drain the sites of inoculation form a cat scratch/bitec tx: paracetamol, local heat to relieve pain of enlarged lymph nodes, trimethoprim-suxamethoxazole, ,ciprofloxacin, azithromycin
44
warm VS cold autoimmune haemolytic anaemia
warm: idipathic, SLE, lymphoma, CLL, Evan's syndrome cold: paroxysmal cold haemaglobinuria, mycoplasma pneumoniae, lymphoma, glandular fever
45
pel-ebstein fever - what is it? what disease associated with it?
temperature is high for one week and then low for another week associated with hodgkin's lymphoma
46
fever that rises each day and drops by next morning. also has maculopapular rash. - 1st week: abdo pain, constipation - 2nd week: splenomegaly and bradycardia - 3rd week: abdo distension, pea-soup diarrhoea, can also have bowel perforation and peritonitis - 4th week: fever, confusion and abdo distension improves. ?diagnosis
typhoid ix: blood culture
47
high fever begins in day 3 and lasts 5-7 days. preceded by chills, erythematous skin mottling, facial flushing. for children: fever abates for a day and then returns (saddleback fever) also complain of myalgia, arthralgias , haemorrhagic manifestations, abdo pain
48
lymphadenopathy, splenomegaly, weight loss, fatigue, night sweats ?diagnosis
non-hodgkin's lymphoma
49
what type of anaemia does a patient with pica has?
microcytic anaemia
50
anti-cardiolipin antibodies can be found in which conditions?
antiphospholipid syndrome SLE ITP RA Psoriatic arthritis Sjogren syndrome
51
sudden coldness then followed by rigor and then fever and sweating ?diagnosis
malaria
52
how long must the patient stay in A&E after anaphylaxis reaction?
6 hours - recurrence of smptoms can occur
53
what is the mode of inheritance for 'hairy ears'?
Y-chromosome linked
54
abdominal pain, ascites and hepatomegaly for patient with polycythaemia ?what has happened
Budd CHiari syndrome - occlusion of hepatic veins that drain the liver
55
for patient with polycythaemai - if they also complain of tenderness of the sternum, what complication is arising?
acute myeloid leukaemia
56
patient has egg allergy, which vaccine should they NOT take?
influenza tick-borne encepahalitis yellow fever
57
low MCV and normal ferritin ?diagnosis
thalassemia
58
what is the summary of these HIV complications: - cryptosporidiosis - cryptococcosis - coccidiodomycosis
cryptosporidiosis: protozoan. watery diarrhoea with abdo cramps, loss of appetite, low fever, n&v.self-limiting. Tx: nitazoxanide for >1yo or antiretroviral tx for CD40>100. cryptococcosis: fungal infection. any organ affected - but usually lungs, menigitoencephalitis. tx: oral fluconazole 1st line. severe disease/CNW: amphotericin B and flucytosine. coccidiodomycosis: fungal infection. via inhalation. if CD40<350cells/mm3. mild to severe pneumonia. extrapulmonary infection of skin, soft tissues, skeletal or CNS. fever, headache, dry cough, myalgia, arthralgia, rash. Tx: azoles.
59
examples of encapsulated bacteria
SHiN SKiS Strep pneumoniae Haem influenza type B Neisseria meningitidis Group B strep Klebsiella pneumoniae Salmonella typhi
60
scromboid food poisoning
ingestion of fresh, canned or smoked fish with hihg histamine levels due to improper processing/storage. flushing, rash, urticaria, palpitations, headacem difccuje
61
most common organism for meningitis in: - adults - neonates
adults: strep pneumoniae. others: neisseria, haem influenza neonates: strep agalactiae, e.coli, strep pneumonia and listeria

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