Infectious disease

Question 1

Treatment for Pneumocystis jiroveci pneumonia

Answer 1

co-trimoxazole

Question 2

Common causes for post operative fever

Day 1-2
Say 3-5
Days 5-7
Day 5+

Answer 2

Day 1-2: ‘Wind’ - Pneumonia, aspiration, pulmonary embolism
Day 3-5: ‘Water’ - Urinary tract infection (especially if the patient was catheterised)
Day 5-7: ‘Wound’ - Infection at the surgical site or abscess formation
Day 5+: ‘Walking’ - Deep vein thrombosis or pulmonary embolism
Any time: Drugs, transfusion reactions, sepsis, line contamination.

Question 3

Risk factors for oral candidiasis

Answer 3

HIV infection 
advanced malignancy 
chemo / radiotherapy 
immunosuppressive therapy 
Antibiotic therapy 
Inhaled corticosteroids 
Diabetes

Question 4

Systemic antifungal treatment for candidiasis (severe disease)

Answer 4

fluconazole

Question 5

Topical antifungal for candidiasis

Answer 5

clotrimazole oropharyngeal / nystatin

Question 6

Inflammation with a candida infection of the skin, prescribe what?

Answer 6

corticosteroid cream

Question 7

who are at risk of vaginal candidiasis

Answer 7

pregnancy
diabetes
hormonal contraceptives immunosuppressed
recently taken antibiotics

Question 8

first line treatment in systemic candidiasis

Answer 8

Echinocandins (caspofungin) or fluconazole are first-line choices

Question 9

Virus causing measles

Answer 9

Paramyxovirus

Question 10

Presentation of malaria

Answer 10

fever 
malaise 
myalgia 
headache 
NandV 
Anaemia 
Jaundice 
Splenomegaly

Question 11

Diagnosis of malaria - specific test

Answer 11

Blood film

Question 12

Treatment of malaria

Answer 12

Chloroquinine

Doxycycline

Question 13

the first sign of lyme disease is usually?

Answer 13

erythema migrans

Question 14

general symptoms of lyme disease

Answer 14

fever 
malaise 
headache
muscle aches
joint pain 
lymphadenopathhy

Question 15

Treatment of lyme disease

Answer 15

Doxycycline - 14 to 21 days

Question 16

Which lobe of the lung does TB usually affect

Answer 16

Upper

Question 17

Name for TB which has spread to the blood

Answer 17

Miliary

Question 18

First area of granulomatous inflammation in TB

Answer 18

ghon focus

Question 19

Risk factors for TB

Answer 19

immunocompromised 
young / old 
socially deprived 
immigrants 
alcoholics 
HIV

Question 20

Primary TB presentation

Answer 20

Normally asymptomatic

May have a mild fever

Question 21

Presentation of progressive TB

Answer 21

Cough 
Fever 
Night sweats 
Haemoptysis 
Weight loss 
Sputum 
Malaise 
Cervical lymphadenopathy

Question 22

Bedside investigations in TB

Answer 22

Rapid sputum identification test

Culture sputum

Question 23

4 Medications used to treat TB

Answer 23

RIPE

Rifampicin

Isoniazid

Pyrazinamide

Ethambutol

RIPE - 2 months
RI - 4 months

Question 24

SE of Rifampicin

Answer 24

Orange urine

hepatitis

Question 25

SE of Isoniazid

Answer 25

Peripheral neuropathy Psychosis Hepatitis

Question 26

SE of pyrazinamide

Answer 26

Gout

Question 27

SE of Ethambutol

Answer 27

Optic neuritis

Question 28

What must be done when TB is diagnosed

Answer 28

Notifiable disease | Screen contacts

Question 29

90% of causes of glandular fever

Answer 29

EBV

Question 30

Classic triad of infectious mononucleosis

Answer 30

Sore throat Anterior and posterior triangle lymphadenopathy Pyrexia

Question 31

Primary features of syphilis

Answer 31

Chancre - painless ulcer on the site of sexual contact | Local non tender lymphadenopathy

Question 32

Secondary features of syphilis

Answer 32

Fever Lymphadenopathy Rash one trunk, palms and soles Buccal ulcers

Question 33

Treatment of syphilis

Answer 33

IM benzathine penicillin for 10 days or doxy for 14 days

Question 34

How is Mumps virus spread

Answer 34

droplets

Question 35

clinical features of Mumps

Answer 35

Fever Malaise Muscle pain Parotitis - earache / pain on eating

Question 36

Important to do what when diagnose mumps

Answer 36

notifiable disease

Question 37

Causes for HSV recurrence

Answer 37

Stress Fever Tissue damage Immunocompromise

Question 38

HSV genital ulcer presentation

Answer 38

Macules, papules and ulcers lasting >3 weeks

Question 39

Expectant mothers with HSV infection should be offered?

Answer 39

C-section

Question 40

Treatment for HSV

Answer 40

Aciclovir

Question 41

Gonorrhoea and Chlamydia bacteria is gram?

Answer 41

-ve

Question 42

Presentation of gonorrhoea

Answer 42

``` Purulent discharge Perianal or anal discharge Urethritis Dysuria Homosexual men - pruritus ani and pain ```

Question 43

Treatment for gonococcal urethritis

Answer 43

Cefixime or ceftriaxone - single dose + oral azithromycin

Question 44

Treatment for neonatal conjunctivitis

Answer 44

Erythromycin

Question 45

Presentation of chlamydia

Answer 45

can be asymptomatic discharge - not usually purulent urethritis women - post coital or intermestrual bleeding

Question 46

Treatment of chlamydia

Answer 46

Azithromycin one dose or doxy od for 7 days

Question 47

live vaccines

Answer 47

``` Live attenuated vaccines BCG MMR oral polio yellow fever oral typhoid ```

Question 48

how does mycoplasma pneumonia present?

Answer 48

dry cough erythema multiforme chest x-ray shows reticulo-nodular shadowing of the lung (s)