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Infectious disease Flashcards

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1
Q

What is the most common cause of gastroenteritis?

A

Viral: rotavirus, norovirus, adenovirus

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2
Q

What is the spread of E.coli?

A

Infected faeces, unwashed salad, water

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3
Q

What is the incubation time of campylobacter jejuni?

A

2-5 days

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4
Q

What is the spread of campylobacter jejuni?

A

Raw poultry, untreated water, unpasteurised milk

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5
Q

What are the symptoms of campylobacter jejuni gastroenteritis?

A
  • Cramps
  • bloody diarrhoea
  • fever
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6
Q

What is the incubation time of shigella?

A

1-2 days

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7
Q

What is the spread of shigella?

A

Contaminated water and food

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8
Q

What are the symptoms of shigella?

A
  • abdominal cramps
  • bloody diarrhoea
  • fever
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9
Q

What is the incubation time of salmonella?

A

12 hours to 3 days

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10
Q

What is the spread of salmonella?

A
  • raw egg/poultry
  • contaminated food
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11
Q

What are the symptoms of salmonella?

A
  • watery diarrhoea ± blood/mucus
  • abdominal pain
  • vomiting
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12
Q

What is haemolytic uraemic syndrome?

A
  • Shiga toxin produced by EHEC and sometimes shigella and strep pneumoniae
  • Triad of: microangiopathic anameia, thrombocytopenia and AKI
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13
Q

What should be avoided in haemolytic uraemic syndrome?

A
  • Antibiotics
  • anti-motility agents
  • NSAIDs
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14
Q

What bacteria can cause bloody diarrhoea?

A
  • Campylocbater jejuni
  • shigella
  • EHEC
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15
Q

What bacteria can cause watery diarrhoea?

A
  • Salmonella
  • ETEC, EPEC
  • Bacillus cereus
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16
Q

What is the incubation time for bacillus cereus?

A

5 hours

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17
Q

What is the most common cause of the common cold?

A

Rhinovirus

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18
Q

What are complications of the common cold?

A
  • otitis media
  • sinusitis
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19
Q

What is the presentation of pharyngitis?

A
  • sore throat
  • fever
  • pharyngeal inflammation
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20
Q

In a patient presenting with pharyngitis and mouth vesicles, what is the most likely cause?

A

Enterovirus

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21
Q

What is the peak age of croup infection?

A

2 years old

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22
Q

What are the symptoms of croup?

A
  • fever
  • rhinorrhoea
  • harsh seal like cough
  • tachypnoea
  • subglottic obstruction
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23
Q

What is the cause of croup?

A

Parainfluenza viruses 1-4

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24
Q

What are the symptoms of influenza?

A
  • fever
  • fatigue
  • anorexia
  • muscle aches
  • headache
  • dry cough
  • sore throat
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25
What is the diagnosis of influenza?
Viral nasal/throat swab -> PCR
26
Who should get the vaccine for influenza?
- >65 - Young children - pregnant women - chronic health conditions - healthcare workers
27
What is the treatment for influenza?
Oral oseltamivir 75mg twice daily for 5 days if at risk of complications but must be within 49 hours
28
What are the complications of influenza?
- otitis media - sinusitis - bronchitis - viral pneumonia - worsening of health conditions
29
What type of bacteria is klebsiella?
Gram positive ros
30
What is the marker of a klebsiella respiratory infection?
Red currant jelly sputum
31
Which patient groups is klebsiella more common in?
Diabetics and alcoholics
32
What is the most common cause of pneumonia?
Streptococcus pneumonia
33
What is the most common cause of pneumonia following an influenza infection?
Staphylococcus aureus
34
What is mycoplasma pneumoniae associated with?
Erythema multiforme and cold autoimmune haemolytic anaemia
35
What should you treat mycoplasma pneumoniae with
Macrolide
36
What is MRSA resistant to?
- beta lactams - cephalosporins
37
What is the treatment of MRSA bacteraemia
IV vancomycin
38
What is the treatment of MRSA pneumonia?
IV vancomycin
39
What is the treatment of MRSA UTI?
Trimethoprim
40
What type of bacteria is clostridium difficile?
Gram positive rod
41
What is the presentation of c. diff infection?
- diarrhoea - abdominal pain - raised white cell count
42
What is the diagnosis of c diff
- c.diff toxin in the stool - c.diff antigen only shows exposure to the bacteria
43
What is the management of first presentation of c diff infection?
oral vancomycin for 10 days
44
What is the management of recurrent c diff?
oral Fidaxomicin for 10 days
45
What is the management of life threatening c diff?
Oral vancomycin and IV metronidazole
46
Which antibiotics are associated with C diff?
- Cephalosporins - clindamycin - ciprofloxacin (fluoroquinolones)
47
What are the complications of c diff?
- ileus - toxic megacolon - perforation and peritonitis
48
What are the causes of viral meningitis?
- Enteroviruses - HSV - mumps - Varicella zoster virus - WEst nile - HIV
49
CSF in viral meningitis
- clear - White blood cell 50-100 - Protein >50
50
What is the treatment of viral meningitis?
- supportive care - analgesia - anti-emetic - IV fluids
51
What are the causes of bacterial meningitis?
- Streptococcus pneumoniae - Neisseria meningitidis - Haemophilus influenzae
52
CSF in bacterial meningitis
- Cloudy and turbid - WBC >100 - Low glucose - Increased protein - increased opening pressure (>25cm H2O)
53
Empirical antibiotics in bacterial meningitis
Ceftriaxone IV
54
What are the causes of fungal meningitis?
Cryptococcus species
55
CSF in fungal meningitis
- clear/cloudy - increased opening pressure - white cell count 10-100 - low glucose - increased protein
56
What is the most common cause of bacterial meningitis in 0-3 month olds?
Group B strep
57
What is the most common cause of bacterial meningitis in 3mth to 6 year olds?
N.meningitidis, strep pneumoniae, haemophilus influenzae
58
What is the most common cause of bacterial meningitis in 6 to 60 year olds
N. meningitidis, streptococcus pneumoniae
59
What is the most common cause of bacterial meningitis in immunosuppressed
Listeria monocytogenes
60
What is the prophylaxis for meningitis and when does it need to be offered?
Oral ciprafloxacin or rifampicin, if they have had close contact with the patient within 7 days of symptom onset
61
What is the presentation of herpes simplex virus?
- prodrome (may experience tingling) - genital ulcer - oral ulcer - dysuria
62
Investigation for herpes simplex virus
Viral PCR swab
63
What is the treatment for HSV?
1st episode: aciclovir 200mg 5 a day for 7-10 days
64
How can you decrease the transmission of HSV?
aciclovir 400mg PO twice a day for 12 months
65
What is the presentation of TB?
- cough - fever - anorexia - weight loss - malaise - night sweats
66
What are the risk factors of TB?
- immunosuppression - HIV - Asia/latin america/africa
67
What is the investigation for TB?
- sputum acid-fast bacilli smear and culture - CXR: fibronodular opacities in the upper lobes - Full blood count: increased WCC and decreased Hb
68
What is the treatment of TB?
For four months: - Isoniazid - Rifampicin - Pyrazinamide - Ethambutol For a further 2 months: - Isoniazid - rifampicin
69
What is the treatment of latent TB?
Isoniazid monotherapy
70
What is HIV?
A retrovirus that destorys CD4 cells
71
What are the risk factors for HIV?
- IVDU - Men who have sex with men
72
What is the presentation of HIV?
- Fever and night sweats - Weight loss - Oral ulcers - angular chelitis - oral thrush - recent admission due to infection - generalised lymphadenopathy
73
What is the investigation for HIV?
- ELISA serum HIV enzyme-linked immmunisorbent assay - serum p24 antigen - test asymptomatic patients at 4 weeks after possible exposure
74
What CD4 count is considered end stage HIV/AIDS
<200
75
What is the antiretroviral therapy for HIV?
- 2x NTRIs and protease inhibitor or non nucleoside reverse transcriptase - Start as soon as diagnosed
76
What is the management of HIV?
- Co-trimoxazole if CD4<200 to protect agaisnt pneumocystis jiroveci pneumonia - yearly cervical smears - vaccination: influenza, pneumococcal, Hep A+B, tetanus, diptheria and polio
77
What is post exposure prophylaxis for HIV?
- <72 hours - Truvada (emtricitabine/tenofovir) and raltegravir for 28 days
78
What is meant by undetectable in HIV?
Viral load/no. of HIV RNA per ml blood (50-100)
79
What are the AIDS defining illnesses?
- kaposi's sarcoma - Pneumocystis jirovecii pneumonia - cytomegalovirus - candidiasis - lymphoma - tuberculosis
80
SIRS
- sweats - chills/rigors - tachypnoea - tachycardia - hypotentsion
81
Sepsis
Evidence of infection plus organ dysfunction: ≥2 of: hypotension, confusion, or tachypnoea (≥22)
82
What is neutropenic sepsis?
Neutrophil count of <0.5 or 1 if recent chemo and fever or hypothermia or SIRS or sepsis/septic shock
83
What is septic shock?
Sepsis induced hypotension requiring inotropic support or hypotension which is not responsive to adequate fluid resuscitation
84
What are the risk factors for staphylococcus bacteraemia?
- intravascular and other invasive devices - skin and soft tissue infection - surgical site infection - IVDU
85
Treatment of staph aureus bacteraemia
IV flucloxacillin 2 grams 6 hourly
86
Presentation of chlamydia
- asymptomatic - cloudy/yellow discharge, post coital or intermenstrual bleeding in women - mucoid discharge in men - dysuria in men and women
87
Investigation for chlamydia
- NAAT: vulvovaginal in women, urine for men - testing should be carried out two weeks after exposure
88
What is the management of chlamydia?
- doxycycline 7 days
89
Presentation of gonorrhoea
- mucopurulent cervicitis - urethral discharge in men
90
Investigation for gonorrhoea
- NAAT - culture
91
Management gonorrhoea
- ceftriaxone IM 1g
92
Presentation of syphilis
Primary: - chancre: painless ulcer - local, non tender lymphadenopathy Secondary: - systemic symptoms - rash on trunk, palms and soles - buccal 'snail track' ulcers - condylomata lata (painless warty lesions on genitals Territory: - Gummas - Neurosyphilis - aortitis, aortic valve disease, aortic aneurysm
93
Treatment of syphilis
Benzathine penicillin IM
94
Presentation of trichomonas vaginalis
- offensive yellow/green and frothy discharge - vulvovaginitis - strawberry cervix - pH>4.5 - usually asymptomatic in men but may cause urethritis
95
Treatment trichomonas vaginalis
Oral metronidazole for 5-7 days
96
What species of plasmodium cause malaria?
- falciparum - ovale - vivax - malariae
97
What causes severe malaria
falciparum
98
What are the features of severe malaria?
- schizonts on a blood film - parasitaemia >2% - hypoglycaemia - acidosis - temperature >39 - severe anaemia
99
What are the features of non-falciparum malaria
- fever - headache - splenomegaly - vivax/ovale: cyclical fever every 48 hours, malariae: 72 hours - malariae is associated with nephrotic syndrome
100
investigation for malaria
- blood film: thick/thin - antigen testing - FBC
101
What causes infectious mononucleosis?
Epstein barr virus
102
What is the presentation of infectious mononucleosis?
- sore throat - pyrexia - lymphadenopathy - malaise, anorexia, headache - palatal petechiae
103
What are the investigations for infectious mononucleosis?
- FBC: lymphocytosis (at least 10% atypical0 - monospot test (heterophil antibody test)
104
What is the presentation of dengue fever?
- Fever - headache - myalgia, bone pain, arthralgia - pleuritic chest pain - facial flushing - maculopapular rash
105
Severe dengue
- Haemorrhagic fever - thrombocytopenia and spontaneous bleeding
106
Investigation for dengue
- FBC: leukopenia, thrombocytopenia, raised aminotransferases - Serology/NAAT
107
What are the causes of enteric fever?
- S.typhi - S.paratyphi
108
Presentation of enteric fever
- HEadache, fever, arthralgia - Relative bradycardia - Abdominal pain and distension - Constipation - Rose spots
109
What are the investigations for enteric fever?
- blood and stool culture
110
What is schistosomiasis?
Parasitic flatworm infection
111
What is the presentation of schistosomiasis ?
- Swimmer's itch - Acute schistosomiasis syndrome: fever, urticaria, arthralgia, cough, diarrhoea
112
Treatment of schistosomiasis
Praziquantel
113
What is the most common cause of community acquired pneumonia?
Streptococcus pneumoniae
114
What is the treatment of choice for non falciparum malaria?
Chloroquine
115
What is the spread of hepatitis A?
Faecal-oral
116
What is the spread of hepatitis C?
Parenteral, sex, vertical transmission
117
What is the spread of Hep B?
Parenteral, sex, vertical transmission
118
What is e coli
Gram negative rod
119
Rice
Bacillus cereus
120
What is the spread of Hepatitis E?
Faecal-oral
121
What is haemophilus influenzae?
Gram negative rod
122
Rusty sputum
Strep pneumoniae
123
What causes syphilis?
Treponema pallidum
124
Which vaccines are live attenuated?
- MMR - BCG - influenza (intranasal) - polio - typhoid - yellow fever - Oral rotavirus
125
India ink positive
Cryptococcus
126
clue cell
Bacterial vaginosis
127
What is the most common cause of diarrhoea in those with HIV?
Cryptosporidium
128
What is the management of hospital acquired pneumonia?
Within 5 days of admission: co-amoxiclav or cefuroxime More than 5 days after admission: piperacillin with tazobactam OR a broad-spectrum cephalosporin (e.g. ceftazidime) OR a quinolone (e.g. ciprofloxacin)
129
What is the length of post exposure prophylaxis?
28 days

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