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Year 3 Medicine > Infectious Disease > Flashcards

Infectious Disease Flashcards

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1
Q

How should you take blood cultures from a patient with suspected endocarditis?

A

Three cultures from at least three different sites

To be taken before antibiotics commenced

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2
Q

What is sepsis?

A

life-threatening organ dysfunction caused by a

dysregulated host response to infection

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3
Q

What is the sepsis 6?

A 
Give O2 
Give IV fluids
Give IV Abx
Take blood cultures 
Measure lactate 
Measure urine output
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4
Q

What are the common organisms that cause soft skin infections?

A

Staphylococcus aureus
Streptococci
MRSA

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5
Q

What organisms can cause MSK infections?

A

Staphylococcus aureus
Streptococci
MRSA
TB

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6
Q

What organisms commonly causes respiratory infections?

A

Streptococci pneumoniae
Haemophilus influenzae
Atypical: legionella, mycoplasma
Rhinovirus/adenovirus/enterovirus/influenza

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7
Q

What organisms commonly cause GI infections?

A 
Rotavirus, adenovirus
Campylobacter
Shigella
E.Coli
Salmonella typhi/paratyphi
Enterobacteriacae (visceral infection/peritonitis)
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8
Q

What organisms typically cause GU infections?

A 
Enterobacteriacae (e.g. e.coli, klebisella sp, proteous sp.)
Pseudomonas arogenosa
ESBL/resistant organisims 
Neisseria gonorrhoeae
Chlamydia trachomatis
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9
Q

What organisms commonly cause CNS infections?

A 
Streptococci pneumoniae
Neisseria meningitidis
Listeria
TB
Herpes simplex virus
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10
Q

What organisms typically cause endocarditis?

A

Streptococci viridans group
Enterococci faecalis/faecium
Staphlococcus aureus
MRSA

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11
Q

What organisms typcially cause line infections?

A

Staphylococcus aureus
Streptococci
MRSA

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12
Q

What is the first line antibiotic to treat suspected sepsis?

A

Meropenem stat dose

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13
Q

What organisms typically cause hospital aquired infections?

A

Enterobacteriacae (E.coli, Klebsiella spp.)
Pseudomonas spp.
C. difficile
Staph. aureus (pneumonia)

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14
Q

What is the 10 point approach to a patient with an infection?

A
  1. What is the evidence for infection
  2. Severity
  3. Patient factors to consider
  4. Body system/organ affected
  5. What is the likely organism involved?
  6. And therefore what is the best antimicrobial therapy?
  7. Which route of administration is best?
  8. Is any other treatment needed?
  9. Is there any risk of transmission to others?
  10. What planning is required for follow-up and discharge?
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15
Q

What travel-related illness signs/symptoms do patients most commonly present with?

A 
Diarrhoea
Vommiting
Jaundice
Lymphadenopathy
Hepatosplenomegaly
Cough
SOB
Rash
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16
Q

What should be asked when taking a history from a patient where travel-related infection is suspected?

A 
Geographic region of travel within the last 12-18 months
ANY previous travel to the tropics
Dates of travel and duration of stay
Time and onset of signs and symptoms
Rural vs urban stays - accomidation
Recreational activities and exposures
Food and water
Sexual exposures
PMH and predisposition to infection
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17
Q

What kind of infection is likely to present 0-10 days after travel

A 
Dengue
Rickettesa (insects)
Viral
Bacteria
Amoeba
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18
Q

What type of infection is likely to present 10-21 days after returning from travel?

A

Malaria
Typhoid
Primary HIV infection

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19
Q

What type of travel-related infection is likely to present after 21 days?

A

Malaria
Chronic bacterial infections (brucella, coxiella, endocarditis, bone and joint infections)
TB
Parasitic infections

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20
Q

What infections can cause splenomegaly?

A 
Mononucleosis 
Malaria
Visceral leishmaniasis
Thyphoid fever
Brucellosis
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21
Q

What infections may present with a maculopapular rash?

A 
Dengue fever
Leptospirosis
Rickettsia
EBV
CMV
Rubella
Parovirus 19
Primary HIV infection
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22
Q

What travel-related infections can cause meningo-encephalitis?

A

Cerebral maleria
Japanese enchephalitis
West nile virus encephalitis
(+common causes) N.meningitis/STrep penumonia/ HSV

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23
Q

What is the most common species of malaria that causes serious illness?

A

Plasmodium falciparum

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24
Q

What is the most common species of malaria?

A

Plasmodium vivax

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25
How does malaria present?
``` Abrupt onset rigors High fevers Malaise Severe headache Myalgia Vague abdo pain N&V Diarrhea (25%) Jaundice Hepatoslenomegaly Anaemia, thromovytopenia, leukopenia, abnormal LFTs(chronic illness) Untreated p. falciparum: hypoglycemia, renal failure, pulmonary odema, neurologic deterioration ```
26
Where is typhoid fever prevalent?
South east Asia | Southern and Centeral America
27
How does Thypoid Fever present?
``` Sustained fever Anorexia Malaise Vague abdominal discomfort Constipation or diarrhea Dry cough Hepatospleonmegaly Rose spots Pule-temperature dissociation Leucopenia, lymphopenia, raised CRP ```
28
How is typhoid fever diagnosed?
Isolation of organism in cultures of blood, stool, urine, bone marrow, duodenal aspirates
29
How is suspected Typhoid fever treated empirically?
IV Ceftriaxone
30
What is used to treat Typhoid once sensitivites known?
Ciprofloxacin or Azithromycin
31
What is the definition of Pyrexia of Unknown Origin?
Temperature > 38 degrees on multiple ocassion Illness > 3 weeks duration No diagnosis despite > 1 week inpatient stay
32
Causes of PUOs?
Infective - TB, abscesses, infective endocarditis, brucellosis Autoimmune/connective tissue adult onset Still's disease, temporal arteritis, Wegner's granulomatosis Neoplastic - leukaemias, lymphomas, renal cell carcinoma Other - drugs, thromboembolism, hyperthroidsim, adrenal insufficiency
33
Key parts of examination when reviewing a pt with PUO
Lymph nodes Stigmatat of endocarditis Evidence of weight loss Joint abnormalities
34
What is the lifetime reactivation risk of TB?
10-15% usually due to immunosupression, HIV, increasing age
35
What screening is used to identify latent TB?
quantiFERON or T-spot - measurement of interferon gamma | CXR
36
Who should be screened for latent TB?
Immigrants from high prevalence countries Healthcare workers HIV positive patients Patient starting on immunosupression
37
What drugs are used to treat latent TB?
3 MONTHS RIFAMPICIN + ISONIAZID or 6 MONTHS RIFAMPICIN
38
Active TB symptoms
Non-resolving cough Unexplained persistent fever (low or high grade) Drenching night sweats Weight loss
39
What clinical signs may be present in a patient with TB?
``` Clubbing Cachexia Lymphadenopathy Hepato/splenomegaly Erythema Nodosum Crepitations Bronchial breathing Pericardial rub ```
40
What imaging may be used for TB?
CXR - pulmonary TB CT - Lymphadenopathy, nodes with central necrosis, lesions in viscera MRI - can show leptomeningeal enhancement in TB meningitis
41
What may be seen on the CXR of a patient with pulmonary TB?
Mediastinal lymphadenopathy Cavitating pneumonia Pleural effusion
42
What is the gold standard for diagnosing TB?
Bacterial culture Ideally taken before treatment commenced But do not need to wait to start therapy as may take up to 6 weeks
43
What is smear positive TB?
TB can be seen on a sample using single microscopy | High bacterial load and high infectivity
44
In smear negative pulmonary TB what investigation is done next?
Bronchoscopy +/- endobronchial guided biopsy of pulmonary lymph nodes
45
How is meningeal TB diagnosed?
Lumbar puncture for TB culture and PCR
46
How is lymph node TB diagnosed?
Core biopsy of lymph node
47
How is pericardial TB diagnosed?
If practical (often not) pericardiocentesis
48
How is GI TB diagnosed?
Colonoscopy and bowel biopsy/US guided omentum biopsy
49
What is seen on TB histology?
Caseating/necrotising granulomatous inflammation
50
When should steroids be given alongside ATT?
When TB is affecting sites that cannot tolerate swelling e.g. meningial/spinal/pericardial Steroids given at the start of treatment
51
Why do many patients feel worse at the start of TB treatment?
Increase in inflammation as bacteria die causing worsening symptoms
52
What complications may result from pericardial TB? What signs might be seen?
Pericardial Effusion Tamponade Pericardial rub Kussmaul's sign
53
When should ATT be started in patients with MIliary TB?
As soon as it is determined whether or not there is a CNS involvement, using CT/MRI head, should not be delayed whilst awaiting biopsies
54
Where can Miliary TB be found?
``` Widespread Lung CNS Bone marrow Pericardium ```
55
What precautions should be taken in terms of infection control for patients with MDR TB
Negative pressure room | Staff to wear masks and PPE
56
What is the Standard ATT (used for all sites but CNS)
``` 2 months: Rifampicin Isoniazid Ethambutol Pyrazinamide (Pyridoxine) 4 months Rifampicin Isoniazid (Pyridoxine) ```
57
Side effects of Rifampicin?
Turns urine/tears orange | Hepatitis
58
Side effects of Isoniazid?
Peripheral nueropathy Colour blindness Hepatitis
59
Ethambutol side effects?
Optic neuropathy | Reduced visual acuity
60
Which drug used in ATT is most likely to cause hepatitis?
Pyrazinamide
61
What monitoring is required before commencing ATT?
Baseline LFTs | Ethambutol - visual acuity
62
What must be monitored throughout ATT?
LFTs
63
For how long must a patient with TB be isolated?
Until they have been treated for 2 weeks
64
How can NAATS be performed when screening for chlamydia trachomatis or neisseria gonorrhoeae?
first pass urine (men) vulvo-vaginal swab pharyngeal swab rectal swab
65
Where should a vaginal discharge swab be taken from when testing for trichomonas vaginals and candida?
Posterior fornix | Charcoal swab
66
Where should a vaginal discharge swab be taken from when testing for Gonococcal culture?
Cervical os | Charcol swab
67
What kind of swab should be used for Gonococcal cultures?
Charcol
68
What viruses should be tested for in patients with genital and oral ulcers?
HSV 1 | HSV 2
69
What infections may cause anal discharge?
Gonorrhea | HSV
70
What baseline investigations should be carried out on patients newly diagnosed with HIV?
Confirmatory HIV test CD4 count HIV viral load HIV resistance profile HLA B*5701 status Serology for syphillis, hepatitis B, hep C, heP A Toxoplasma IgG measles IgG varicella IgG rubella IgG FBC U&Es LFTs bone profile lipid profile Schistosoma serology (if spent >1 month in sub-Saharan Africa) Women should have annual cervical cytology
71
What serology should be conducted for Hep B?
sAg cAb sAb
72
Below which CD4 count should HIV patients be perscribed prophylactic antibiotics against PCP?
CD4 < 200
73
Below what CD4 is considered AIDs?
CD4 < 200
74
What vaccinations should be given to patients with HIV?
Hep B Pneumococcus Annual Influenza
75
After what time period following ingestion does Bacillus cereus infection present?
Within 6 hours
76
What food most commonly causes Bacillus cereus?
Rice
77
What symptoms does Bacillus Cereus infection cause?
Vomiting | Diarrhoea
78
How does Heamophillus Influenzae present on gram stain?
Gram negative cocci
79
What drugs can be used to treat VRE?
Linezolid | Teicoplanin
80
What is the gold standard in diagnosis of malaria?
Thick and thin blood films Thin: identification of species Thick: estimation of parasite density
81
What is the most common cause of food poisoning in the UK?
Campylobacter jejuni
82
What kind of diarrhoea does campulobacter jejuni cause?
Dysenteric (blood+mucus) due to bacterial invasion of the intestinal mucosa
83
What is the investigation of choice for chlamydia?
NAATs | Nuclear acid amplification test
84
How does HSV typically present
Painful ulcers
85
How does syphillis normaly present?
Painless ulcers
86
What kind of bacterium is chlamydia trachomatis?
Obligate intracellular
87
What kind of bacterium is N.gonorrhoea - intracellular or extracellular?
Extracellular
88
How is chlamydia managed?
7 days doxycycline | Azithromycin if not tolerated or in pregnancy
89
What can predispose patients with parovirus B19 to aplastic aneamia?
Patients with a background of haemolytic aneamia
90
What virus can cause a characteristic slapped cheek rash, particularly in children?
Parovirus 19/fifth disease
91
Parovirus 19 can cross the placenta, before what gestation should a pregnant woman seek advice if exposed?
20 weeks
92
What is Lemieere's syndrome?
Thrombophlebitis of the internal jugular vein following an anaerobic oropharangeal infection (e.g. tonsillitis)
93
How long after transmission does hep A present? How is it often transmitted?
2-4 weeks | Undercooked meat/unclean water consumed in developing countries
94
Why should bacteria in the urine of a pregnant woman be treated, regardless of symptoms?
Risk factor for low birth weight, pyelonephritis, premature delivery
95
At what point in a pregnancy is trimethoprim tetragenic?
First trimester
96
When shout nitrofurantonin be avoided during pregnancy?
At term - may produce neonatal haemolysis
97
What are the main caustive organisms for cellulitis?
Staphylococcus aureus | Streptococcus pyogens
98
Antibiotic of choice for cellulitis?
Flucloxacillin | Clarithromycin if pen allergic
99
What is the treatment of choice for Neisseria gonorrhoeae infection
intramuscular antibiotic injection of ceftriaxone
100
Which antibiotic class can cause defective desquamation of the filiform papillae of the younger, leading to a black, hairy tongue
Tetracyclines (doxycycline, tetracycline)
101
What is the drug of choice to treat Schistosoma mansoni?
praziquantel
102
What is the treatment for PID?
Doxycycline + metronidazole + ceftriaxone
103
What is the antibiotic of choice for extensive otitis externa?
Flucloxacillin
104
What should be used to treat an outbreak of genital herpes?
Oral aciclovir
105
How many doses of tetnus vaccination is suitable for long term protection?
5
106
What vaccinations are routinely offered to women who are pregnant?
Influenza | Pertussis
107
How does BV (gardnerella vaginalis) infection present?
``` Offensive vaginal discharge Fishy smell - positive whiff test when potassium hydroxide added Clue cells Grey in colour Vaginal pH > 4.5 ```
108
How does a vaginal canddida albicans infection typically present?
White 'curdy' vaginal discharge | pH < 4.5
109
How to trichomonas vaginalis infections typicall present?
Vulvovaginitis acoompinied by offensive, yellow-green frothy discharge
110
What drug is used to treat both BV and trichomonas
Metronidazole
111
WHat is the latest time HIV PEP can be given?
72 hours after exposure
112
What antibiotic should be given to treat an atypical pneumonia?
Clarithromycin
113
What antibiotic should be used to treat a lower urinary tract infection?
Trimethoprim Nitrofurantonin Amoxicillin Cephalosporin
114
What antibiotic should be added in the treatment of penumonia secondary to influenza?
Flucloxacillin
115
What is the first-line antibiotic threapy for campylobacter infection?
Clarithromycin
116
What organism causes Q fever and what is its natural resevoir?
Coxiella burnetti | Cattle and sheep
117
What organism causes Q fever and what is its natural resevoir?
Coxiella burnetti | Cattle and sheep
118
Common local complication of gonorrhoea in men?
Urethral stricture
119
How does Neisseria Meningitidis appear on gram stain?
Gram negative diplococci
120
How does E coli appear on gram stain?
Gram negative rods
121
How does Staph aureus appear on gram stain?
Gram positive cocci - grape like
122
How does staph epidermis appear on gram stain?
Gram positive cocci - grape like
123
How does staph pyogenes appear on gram stain?
Gram positive cocci chains | GROUP A are B HAEMOLYTIC
123
How does staph pyogenes appear on gram stain?
Gram positive cocci chains | GROUP A are B HAEMOLYTIC
124
How does C. difficile appear on gram stain?
Gram positive rod
125
How does step pneumoniae appear on gram stain?
Gram positive cossus (usually diplococci)
126
How does viridans streptococci appear on gram stain?
Gram positive cocci in chains
127
How does haemophilus influenzae appear on gram stain?
Gram negative coccobacilli
128
How does salmonella typhi appear on gram stain?
Gram negative bacilli with flagella
129
How does legionella pneumophillia look on gram stain?
Gram negative bacilli
130
What kind of virus is EBV?
dsDNA envoloped virus
131
How does EBV appear on a FBC?
Elevated lymphocytes, on microscopy atypical lympocytes will be seen
132
What kind of virus is Varicella Zoster?
Enveloped DNA virus
133
Where does latent infection of varicella zoster lie?
Dorsal root ganglia
134
What kind of rash does varicella zoster cause?
Vesicular rash
135
How can varicella zoster be treated?
Acyclovir
136
What kind of virus is HIV?
ssRNA, enbeloped retrovirus
137
Name opportunistic infections that can be found in patients with HIV?
Oral candidiasis - candida albicans Kaposis sarcoma - HHV8 Pneumonocystis pneumonia - pneumonocystis
138
How is P.Falciarum treated
Quinine Doxyclcyline Can use chloroquinine but do G6PDH testing first
139
How is candida albicans treated?
Nystatin CLotrimazole IV fluconazole
140
How is aspirgillous infection treated?
Amphotericin B
141
What antibiotic is used to treat Neisseria Meningitdes infection?
Ceftriaxone (good activity in CSF) in sepsis
142
Best antibiotic for e-coli UTI?
Trimethoprim
143
What antibiotic is used to treat staph epidermis infection?
Flucloxacillin
144
What antibiotic is used to treat strep pyogenes infection?
Penicillin V | Clarithromycin if resistant
145
What antibiotic is used to treat c.diff infection?
Vancomycin
146
What antibiotic is used to treat strep pneumoniae infection?
MILD Amoxicillin/doxycyline MODERATE (amoxicillin) + doxycycline SEVERE: CO amoxiclav/meropenem and Doxycycline
147
What antibiotic is used to treat haemophilus influenzae infection?
Amoxicillin
148
What antibiotic is used to treat salmonella thyphi infection?
3rd gen cephalosporin (cefixime)
149
What is used to treat legionella pneumophila
CLarithromycin or fluroquinolones
150
In hepatitis B which antibody will be positive in vaccinated patients?
Anti HbsAb
151
How is Hep C treated?
Ribovarin and interferon (8-12 weeks)
152
How is HIV treated?
2 Nucleoside inhibitors + 1 non-nucleoside reverse transcriptase inhibitor / 1 protease inhibitor / 1 intergrase inhibitor
153
What is the most common caustive ogranism of bacterial tonsilitis?
Streptococcus pyogenes
154
What is used to treat bacterial tonsillitis?
Penicillin V
155
Most common causes of pharangitis?
EBV Adenovirus Steptococcus pyogenes
156
How may schitosomiosis infection present?
``` Hepatospleonmegaly Eosinophillia Katayama fever Helminth eggs in stools and urine Liver/bladder fibrosis ```
157
What is the diagnostic test for mumps?
Salivary IgM testing
158
Mode of transmission for measles?
Resp droplets
159
What are the white spots inside a patients cheek that are called found in children with measels?
Koplik
160
What test can quickly identify streptococcus pneumonia?
Urinary antigen testing
161
Risk factors for brucellosis?
Abatoir work Unpasturised milk consumption Transmission through resp droplets between farmers
162
Incubation of brucellosis
5-30 days
163
What CSF findings are found in bacterial meningitis?
Macroscopically purulent Neutrophillic leukocytosis Low glucose High protein
164
What often causes a tertian pattern (every two days) fever?
Plasmodium vivax or ovale species
165
What is used to treat schistosomiasis?
Corticosteroids | Praziquantel
166
Whats the first line treatment for c diff?
Oral vancomycin
167
How does leprosy present?
Hypopigmented, hypoesthetic skin lesions Leonine facial appearence Neuorpathy with thickening of the peripheral nerves
168
Best investigation to diagnose BV?
Gram stain
169
Most common bacterial causes of gastroenteritis?
Staphylococcus aureus: usually found in cooked meats and cream products Bacillus cerus: mainly found in reheated rice CLostridium perfringes E.coli Salmonella Shigella
170
What clinical exmaination test is ussed to differentiate gastroenteritis from Dengue?
Torniquet test
171
What is a positive torniquet test?
BP cuff inflated to midway between systolic and diastolic for five mins If 10 or petechiae per square inch, positive
172
Treatment for athletes foot?
Topical terbinafine?
173
What ATT is most likely to cause hepatotoxicity?
Isoniazid
174
What is given in bacterial meningitis to reduce morbiditiy and mortality?
IV Dexamethasone
175
What should be used with caution in patients with a history of penicilin anaphylaxis?
1st gen cephalosporins such as ceftazadime
176
What is the Argyll Robertson pupil and what is it associated with?
The pupil is constricted and does not react to light but does react to the accomidation reflex Tertiary syphillis or neurosyphillis
177
What is the first line in suspected bacterial meningitis in the primary care setting?
Benzylpenicillin
178
What is a chancre?
A painless ulcer, appears in syphillis, typically with central slough and rolled edge
179
What is a clinincal sign pathonogenic for Lymes disease?
Erthema migrans | Rash with red centre and red circle surrounding
180
Which patients may suffer from pneumocystis jirovecci infection (fungal)?
Immunocompromised patients, usually with HIV
181
How is pneumocystis jirovecii treated?
Co-trimoxazole
182
What type of pneumonia does klebsiella pneumoniae cause?
Cavitating pneumonia
183
How does klebsiella pneumoniae appear on gram stain?
Gram negative rods
184
Where is pseudomonas usually aquired?
Hospital - contaminated ventilator
185
How is Legionella pneumophilia treated?
Macrolides: erythromycin, roxithromycin, azithromycin and clarithromycin
186
What blood test abnormalities may be present in legionella?
hyponatraemia and lymphopenia
187
What is erythema migrans pathognomic of?
Lyme disease
188
What causes lyme disease?
Borrellla burgdoferi (tick borne)
189
How does stahpylococcal scalded skin syndrome present?
``` Red tender blistering skin Positive Nikolsky (the very thin top layer of skin will shear off, leaving skin pink and moist, and usually very tender) A prodome of sore throat or conjunctivitis may occur ```
190
What CSF results are typical of bacterial meningitis?
A cell count of 90-1000+ mm3 Predominantly consisting of polymorphs CSF glucose < 1/2 plasma glucose CSF protein of over 1.5g/L
191
What is bordetella pertussis?
Whooping cough | Symptoms, worse at night: cold, a runny nose, red and watery eyes, a sore throat, and a slightly raised temperature
192
What triad does pneumocystis jirovecii?
Shortness of breath Cough Fever Presents in Immunocompremised states such as HIV
193
What is the gold standard investigation for TB?
Culture in Lowenstein-Jensen media
194
What is schistosomiasis?
Infection from a trematode (fluke) of the genus Schistosoma Indemic in many countries in sub-sahran africa Leading cause of portal-HTN in those endemic areas (ascities, caput medusae) Can cause genitourinary symptoms: frquency, haematuria, urinary tract obstruction) GI symtpoms: GI bleed, diarrhoea, abdominal pain
195
How does Mycoplasma penumonia infection present
Preceding flu like lillness, dry cough, erthema mutiforme (target shaped lesions), eveidence of anaemia (SOB and low Hb) Common cause of atypical pneumonia
196
What is erythema multiforme?
Target shaped lesions
197
First line treatment for ESBL-producing organisms?
Cabapenums e.g. meropenem
198
Treatment of MRSA?
Glycopeptides such as Teicoplanin Vancomycin
199
Treatment for pseudomonas?
IV Ciprofloxacin
200
1st line treatment for haemophilius influenzae?
Amoxicillin | Doxycycline if pen allergic
201
1st line treatment for pseudomonas aeruginosa?
Ciprofloxacin
202
What rare side effect of Ciprofloxacin should patients be conselled about?
Achillies tendinitis
203
Common causative organisims of reactive arthritis?
Chlamydia trachomatis Chlamydia pneumoniae Campylobacter spp. Neisseria gonorrhoeae
204
Which oral antibiotic is most suitable for a dog bite?
Co-amoxiclav
205
Treatment of choice for severe cellulitis?
IV benzylpenicillin and IV flucloxacillin
206
What blood tests may be derranged in in legionella pneumophila?
LFT FBC U&E - hyponatremia
207
Other than on FBC, how might legionella pneumophilla cause derranged blood tests?
LFTs deranged | U&Es - hyponatraemia
208
What are fluroquinolones?
Fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin etc.) are commonly used antibiotics for conditions such as infectious diarrhoea, pyelonephritis, otitis externa, pseudomonal infections and many other medical problems. Notable side effects include gastric distress, QT interval prolongation, tendonitis and tendon rupture. They are contraindicated in pregnant women.
209
In patients with suspected infection without evidence of erythema migrans, NICE guidelines recommend what?
ELISA - enzyme linked immunosorbant assay
210
What organism stains with india ink?
Cryptococcus neoformans
211
Rash associated with rheumatic fever?
erythema marginatum
212
Features associated with cholera diagnosis?
DIahorrea | Hypoglycemia
213
Causes of genital ulcers?
painful: herpes much more common than chancroid painless: syphilis more common than lymphogranuloma venereum
214
Prophylaxis against animal bites?
co amoxiclav
215
W
A risk higher than 3% (as is the case with this patient) indicates that the patient should undergo PCI within 72 hours of hospital admission
216
Preceding influenza predisposes to which organism?
staph aureus pneumonia
217
menigococcal meningitis prophylaxis
Oral ciprofloxacin or rifampicin is used as prophylaxis for contacts of patients with meningococcal meningitis
218
A recurrent episode of C. difficile within 12 weeks of symptom resolution should be treated with what?
A recurrent episode of C. difficile within 12 weeks of symptom resolution should be treated with oral fidaxomicin
219
Gas gangrene?
There are multiple causes of gas gangrene but often clostrida species, particularly clostridium perfringens are implicated. Key features often begin with pain and then become systemic (fever, dehydration). This progresses on to skin changes, which are often seen as blisters which can burst produced a foul smelling discharge. Often crepitus can be heard on movement.
220
pH glucose and LDL in empyema?
Empyema: Turbid effusion with pH<7.2, Low glucose, High LDH
221
Causes of false negative mantoux test?
``` TB AIDS Long-term steroid use Lymphoma Sarcoidosis Extremes of age Fever Hypoalbuminaemia Anaemia ```
222
What travel related infection gets better and the worse again over a short duration?
Yellow fever has an incubation period of 2 to 14 days
223
Special considerations in MENINGOCOCCAL SEPTICAEMIA? (VS classic bacterial meningitis)
DO NOT GIVE DEXAMETHASONE DO NOT DO LUMBAR PUNCTURE DO give cefotaxime
224
Gastroenteritis within 12 hours?
Staph aureus | Bacillus cereus
225
Bloody diahorrea
Salmonella Shigella Campylobacter (flu-like)
226
Non bloody diahorrea most likely
E Coli
227
Giardiasis vs amoebiasis?
G: bleeding, bloating, abdominal pain, flatulence, non-bloody diarroea A:: non-bloody, liver absess
228
What can vitamin A def cause?
Immune deficiency | Loss of nighttime vision
229
Most common gram pos cause of CAP
Strep pneumonia
230
Most common gram neg cause of CAP
H Influenzae
231
Mechanism of action of amoxicillin?
Inhibits bacterial cell wall synthesis
232
Clarithromycin mechanism of action?
Inhibits protein synthesis
233
Mechanism of action of doxycycline?
Inhibits protein synthesis
234
Pneumocystis jiroveci penumonia is treated withwhat?
Pneumocystis jiroveci penumonia is treated with co-trimoxazole, which is a mix of trimethoprim and sulfamethoxazole
235
Post-HIV exposure screening?
p24 antigen and antibody testing in 4 weeks time and in 3 months time
236
What organism that often causes infection in patients with HIV may manifest as newfound breatjlessness?
The classic sign of PCP is a lowering of oxygen saturations on exercise. This would manifest as newfound breathlessness in patients recently infected Pneumocystis Pneumonia (PCP) is an infection with the fungus Pneumocystis Jiroveci. It is a common presentation associated with individuals with HIV who are noncompliant with their cART regimens or antibiotic prophylaxis.

Year 3 Medicine (8 decks)

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