Infectious disease/ skin Flashcards
Common cx pneumonia in alcoholics
Klibsielal
Pneumonia with influenza predispsoses to?
Staphj aureus pneumonia
flu-like symptoms, bilateral consolidation and erythema multiforme, painful vesicles in ear, renal impairment, low platelets
Mycoplasma - to serology. TX: doxycycline/ erythromycine/ clindamycin
Derranged LFts, flu like SX, cough, bradycardia, lymphopenia, confusion low sodium
Legionella - erythromycin/ clarithromycin. confirm urinary antigen
fishy smell’ down below. Microscopy reveals the presence of clue cells.
Gardnerella vaginalis - 5 days metronidazole 400mg BD
fever, malaise, and myalgia, which may precede the appearance of painful vesicular eruptions in the genital area.
Herpes Simplex
Campylobacter enteritis TX
Clarithromycin
Salmonella/ shigella TX
Ciprofloxacin
Pelvic inflammatory disease TX
Oral ofloxacin + oral metronidazole or intramuscular ceftriaxone + oral doxycycline + oral metronidazole
Animal or human bite TX abx
Co-amox (allergy - doxy and metronidazole)
Mastitis during breast feeding?
Fluclox
Meningitis tx summary: if
meningoccocal?
if <3m or 50+
if listeria suspected?
when to start dexamethasone?
What to give contacts?
when to delay LP?
what could suggest cryptococcal meningitis?
IV cefotaxime, if <3 months or 50+ add amoxicillin (or ampicillin).
If meningococcal - ben pen or cefotaxime.
listeria give IV amoxicillin and gent.
IV dex before abx, avoid in septic shock, in sus pneumococcal meningitis in adults
contact: Oral ciprofloxacin or rifampicin for 7 days
delay LP: GCS<12, focal neuro sx, papilloaedema, seizures continued
cryptococal meng - high opening pressure LP, sex worker, AIDS, yeast and capsule in CSF stained with india ink
Painless genital ulcers causes?
Syphilis (single) - Treponema pallidum.
Lymphogranuloma venereum (LGV) - cuased by chlamydia, tx doxycycline.
donovanosis (granuloma inguinal)
multiple - HPV warts
Unilateral, painful inguinal lymph node enlargement. with single painful genital ulcer? sharp, jagged border
Chancroid - Haemophilus ducreyi (painful, patients do cry)
Tetanus vaccine uk?
2, 3, 4 months
3-5 yrs,
13-18 yrs
Cellulitis TX
flucloxacillin,
allergy - macrolide such as clarithromycin or erythromycin or another medication such as doxycycline.
UTI TX in pregnancy women
tx asap 7 days first-line: nitrofurantoin (should be avoided near term)
second-line: amoxicillin or cefalexin
trimethoprim is teratogenic in the first trimester and should be avoided during pregnancy
GE with short intubation period and severe vomitting no diarrhoea
Staphylococcus aureus
GE incubation period of 3-4 days and causes diarrhoea that usually becomes bloody, lasting up to a week.
E-coli
48-72 hrs GE A flu-like prodrome, crampy abdominal pains, fever and diarrhoea which may be bloody
May mimic appendicitis
Complications include Guillain-Barre syndrome
Campylobacter - tx clarithromycin
HIV patient, hepatospenlomegaly, pneumonia signs, clear chest. cx?
tx?
Pneumocystitis jiroveci. Need broncheolar lavage, TX co-trimoxazole. Risk pneumothorax. need proph abx if cd4 <200.
tx: co-trimoxazole. consider steroids if hypoxic
lymes disease progression? early (in 30 days. late?
and tx?
first line test?
early: erythema migrans 1-4 weeks after, painless, malaise, arthralgia.
later: heart block, peri/myocarditis. :neurological:
facial nerve palsy,radicular pain,meningitis.
TX:
doxycycline / amoxicillin - in pregnancy/allergy as doxy is CI./ if disseminated - ceftriaxone
IX: ELISA antibody to borrelia burgdorferi. if neg and still sus, do in 4-6 weeks after
Flu sx, raised, red painful rash on legs and face?
erysipelas- Flucloxacillin* (clarithromycin, erythromycin or doxycycline if penicillin-allergic)
ID cx: difficulty in breathing and swallowing. A grey coating surrounding the tonsils, fever, and cervical lymphadenopathy, travel to india
Diptheria - can present with cranial nerve sydfunction. IM penicillin
pneumonia cx: worsening flu-like symptoms and a dry cough. Erythema multiforme is noted on examination. Infective changes on CXR
Mycoplasma pneumoninae
URTI SX, given amoxicillin then got rash? DX? lymphadenopathy, raised ALT,
EBV/ glandular fever. do monospot test, do FBC and LFT (lymphocytosis, raised ALT, haemolytic anaemia)
Fishy discharge, clue cells. allergic to penicillin
Metronidazole if not allergic/
topical clindamycin for BV
Cellulitis - abx for pregnant and pen allergy?
pregnant - erythromycin
Pen allergy - clarithromycin
Syphillis stages?
6-10 weeks after?
tx?
painless chancre on penis, local painless LN, men / or lesion on cervix
6-10 weeks: fevers, LN, snail track buccal ulcers, condulomata lata (painless warty lesions on genitalia, rash on trunk and arms
risks: aortic aneurysms, gummas, tabes dosalis - neuro issues/ bladder issues/ muscle wasting, argyll-robertson pupil
Normal: IM benzathine penicillin
or doxyclycine (not in pregnancy)
Common reaction - fever, tachy, fever no wheeze. (jarisch herxheimer reaction)
Non-bloody diarrhoea, fatty stools, 15 days after exposure, bloating, flatulent
Giardiasis is caused by the flagellate protozoan Giardia lamblia. Swimming anal sex etc. chronic - risk of low vitamins, malnoutrition
purple papules or plaques on the skin or mucosa (e.g. gastrointestinal and respiratory tract)
Kaposi’s sarcoma - radiotherapy/ resection. Caused by HHV 8.
malaise,headache and mild abdominal pain. Constipation, bloated, sparse, macular rash on chest. CX of GE?
what are other complications?
common risk in sickle cell disease?
Salmonella typhi - enteric fever (constipation and rose spots), low HR
risks: osteomyelitis (esp sickle cell), GIB, meng, cholecystitis,
single painless ulcer with small lymphadenopathy/ then 2 months later widespread maculopapular rash and ulcers in mouth, systemic features
Stages of syphillis, trepenoma pallidum.
t2DM on SGLT2 - dapagliflozin, painful and numb to touch in perineum, purple rash with bullae
Necrotising fascitis / fournier’s gangrene (in perineum)
other type - t1DM post op
what are the live vaccines? (MY BOOTI)
MMR, yellow fever, BCG, ORal polio, oral rotavirus, typhoid, intranasal influenza
Tx for toxoplasmosis in immunocompromised ppl?
Pyrimethamine and sulphadiazine are management options for immunocompromised patients. complications: chorioretiinits, seziures, anaemia
multiple painful blisters and ulcers around her labia. She has been feeling like she has the flu for the past five days. It is extremely painful when she urinates.
Herpes simplex
oral ulcers, genital ulcers and uveitis. Venous thromboembolism is also seen.
Small cell vasculitis, behcet’s
Chlamydia treatment? pregnant ?
Doxycycline 7 days, if pregnancy - erythromycin, azithromycin,