Infectious disease

Question 1

Which hepatitis viruses can be faeco-orally transmitted?

Answer 1

fAEco-oral
Hep A
Hep E

Question 2

What is the triad of symptoms seen in acute viral hepatitis?

Answer 2

Jaundice
RUQ pain
Fever
nb. Is same as Charcot’s triad for cholangitis

Question 3

Which type of hepatitis is associated with polyarteritis nodosa?

Answer 3

Hep B

Question 4

How is Hep B transmitted?

Answer 4

Vertically, sex, blood products

Question 5

Recall the HBV antibodies that will be positive in current, past and vaccinated Hep B

Answer 5

Current: sAg, cAb
Past: cAb, sAb
Vaccinated: sAb

Question 6

Which hepatitis viruses are associated with hepatocellular carcinoma?

Answer 6

HBV and HCV

Question 7

What are the signs and symptoms of hep D infection?

Answer 7

Fulminant acute hepatitis

Question 8

What is the most common form of hepatitis virus in the UK?

Answer 8

Hep E

Question 9

What is the standard pulmonary TB therapy?

Answer 9

Rifampicin, isoniazid, pyrizinamide and ethambutol for 2 months
then
Rifampicin and isoniazid for 4 more months

Question 10

Recall the side effects of each TB medication

Answer 10

ONLY 
rifampicin --> Orange secretions 
isoniazid --> Neuropathy (peripheral) 
pyrizinamide --> Liver (hepatotoxicity) 
ethambutol --> eYes (visual disturbance)

Question 11

Which of the TB drugs is a CYP450 inducer?

Answer 11

Rifampicin

Question 12

What are the classical symptoms of primary syphillis?

Answer 12

Painless ulcer and painless lymphadenopathy

Question 13

What are the classical symptoms of lymphgranuloma venereum?

Answer 13

Painless ulcer and painFUL lymphadenopathy

Question 14

What is the causative organism in lymphgranuloma venereum?

Answer 14

C trachomatis

Question 15

What are the typical symptoms of chancroid?

Answer 15

Painful ulcer and painful lymphadenopathy

Question 16

What is the causative organism in chancroid?

Answer 16

Haemophilus ducreyi

Question 17

Which 2 streptococcal species are alpha haemolytic?

Answer 17

Strep pneumoniae

Strep viridans

Question 18

Recall 5 conditions that are most commonly caused by Strep pyogenes (GAS)

Answer 18

Erysipelas
Impetigo 
Cellulitis 
T2 necrotising fasciitis 
Pharyngitis/tonsilitis

Question 19

Recall 2 haematological abnormalities that are seen in malaria

Answer 19

Thrombocytopaenia

Anaemia

Question 20

How should malaria be investigated?

Answer 20

3 thick and think blood films

Question 21

What drug is used as malaria prophylaxis?

Answer 21

Quinine

Question 22

What is the first line treatment for falciparum anaemia?

Answer 22

IV artesunate

Question 23

Recall 4 possible complications of typhoid fever

Answer 23

GI perforation
Myocarditis
Hepatitis
Nephritis

Question 24

What are the key signs and symptoms of typhoid?

Answer 24

Fever
Bradycardia
Anorexia
Diarrhoea OR constipation

Question 25

What is Sphygmothermic dissociation / Faget’s sign?

Answer 25

Unusual pairing of fever and bradycardia that can be seen in typhoid fever

Question 26

What is the 1st line treatment for typhoid fever?

Answer 26

IV ceftriaxone

Question 27

Recall 3 abnormalities on an FBC in degue fever

Answer 27

Low WCC low plts low Hb

Question 28

What are the key signs and symptoms of dengue fever?

Answer 28

Headache (retro-orbital) Sunburn-like rash High fever and myalgia

Question 29

What is the most helpful intervention in dengue haemorrhagic fever?

Answer 29

Fluid resuscitation

Question 30

What is the gold-standard investigation for dengue fever?

Answer 30

PCR viral antigen | Serology IgM

Question 31

What is the causative pathogen in Q fever?

Answer 31

Coxiella burnetti

Question 32

What is the typical natural history of Lyme disease?

Answer 32

Rash --> malaise, carditis, meningitis --> CNS signs

Question 33

What is the proper term for sleeping sickness?

Answer 33

Trypanosoma

Question 34

How long after primary infection does seroconversion occur in HIV?

Answer 34

3-12 weeks

Question 35

How long after exposure can you do an HIV test?

Answer 35

At 4 weeks offer a test, if negative offer a repeat test at 12w as 99% of people will have antibodies at 12w

Question 36

Recall some ways you can differentiate between toxoplasmosis and primary CNS lymphoma

Answer 36

Toxoplasmosis: multiple lesions, ring enhancement | CNS lymphoma: single lesion, homogeous enhancement

Question 37

What 2 drugs are used to treat CNS toxoplasmosis?

Answer 37

Sulfadiazine | Pyrimethamine

Question 38

What is the investigation of choice for encephalitis?

Answer 38

CT (oedematous brain)

Question 39

Recall 2 investigations that can be used for cryptococcus

Answer 39

CSF: india ink test positive CT: cerebral oedema, meningeal enhancement