Infectious diseases Flashcards

1
Q

IE organisms from

Urological procedure

GI tract

Prosthetic valve surgery

A

Uro - E. faecalis

GI - Strep. bovis

Prosthetic valve - Staph. epidermidis, S. aureus

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2
Q

Brain abscess + sinusitis

Organism

A

S. milleri

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3
Q

IVDU + pan-systolic murmur + CXR pulmonary cavitations

A

Tricuspid valve endocarditis

+ septic embolisation

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4
Q

Group A strep (pyogenes) + shock

A

Streptococcal toxic shock syndrome

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5
Q

Rifampicin SE

A

orange secretions
deranged LFTs
CP450 inducer

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6
Q

Isoniazid SE

A
peripheral neuropathy (give pyridoxine/B6)
hepatotoxicity
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7
Q

Pyrazinamide SE

A

hepatotoxicity

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8
Q

Ethambutol SE

A

retrobulbar neuritis

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9
Q

M tuberculosis resistance to Rifampicin MOA

A

alteration DNA dependent RNA transcriptase

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10
Q

E. coli resistance MOA

A

ESBL

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11
Q

S pneumoniae resistance to penicillin MOA

A

alter penicillin binding proteins

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12
Q

Scrombotoxin source

A

fish

-> food poisoning

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13
Q

S aureus and C perfringens source food poisoning

A

meat

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14
Q

Yersinia source food poisoning

A

milk

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15
Q

Pregnant woman exposed to rash

Which test?

A

Parvovirus B19

if + then intrauterine transfusion + doppler for hydrops faetalis

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16
Q

Enteric fever Ix

A

malaria blood film

BC (S typhi and S paratyphi)

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17
Q

Syphilis testing

A
Treponema test (TPPA, EIA) 
 - detects treponemal Ag and Ab even after Tx 

Non treponemal test (VDRL, RPR)
- detects Abs to cardiolipin, monitors response to Tx

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18
Q

Disease prevalent south america/ africa but NOT Asia

Disease prevalent in asia

A

Yellow fever - africa/ south america

Japanese B encephalitis - south-east Asia.

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19
Q

Yellow fever

A

RNA virus transmitted by female mosquitoes

results in an acute haemorrhagic disease

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20
Q

commonest cause of viral meningitis in the adult population

A

Enterovirus meningitis

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21
Q

Clear, fishy smelling discharge

no itching or irritation

A

bacterial vaginosis

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22
Q

Haemorrhagic lesions of the temporal lobe

A

Herpes simplex virus

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23
Q

Empirical treatment of uncomplicated MRSA skin infections should be with

A

oral doxycycline

or fusidic acid/trimethoprim + rifampicin

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24
Q

What makes TB pt infectious

A

untreated smear-positive pulmonary TB is likely to be infectious

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25
Q

Oesophageal candidiasis + young woman with fever

Ix?

A

HIV test

oesophageal candidiasis is an AIDS-defining illness but oral candidiasis is not.

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26
Q

weakness of both legs and double incontinence.

CSF - inc. protein and neutrophils + normal glucose.

A

CMV polyradiculopathy

Guillain Bare would have normal CSF

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27
Q

Pityriasis versicolor

Cause?

Rx?

A

skin lesion
caused by a fungus called Malassezia furfur

The treatment is topical selenium sulphide.

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28
Q

diarrhoeal illness

subtle ‘rose spots’ on the abdomen.

A

Typhoid fever

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29
Q

Organism most associated with meningitis in children

A

Haemophilus influenzae

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30
Q

Length duration Rx for TB

Bone
meningitis
drug resistant TB

A

bone TB - 9 months
meningitis - 1 year
drug resistance - 2 years

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31
Q

Travel

headaches and retro-orbital pain

severe musculoskeletal pain + maculopapular rash

A

Dengue fever (Flavivirus)

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32
Q

prophylactic treatment of healthcare workers during flu epidemics

A

Oseltamivir (Tamiflu)

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33
Q

Types of herpes simplex virus that can cause encephalitis

MRI changes

Rx

A

type 1 and type 2

Type 1 - older children/adults
Type 2 - neonates who acquire the virus during delivery

MRi shows temporal lobe changes

Rx = aciclovir if HSV encephalitis is suspected

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34
Q

Multiple painless umbilicated papular lesions

A

molluscum contagiosum

caused by pox virus

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35
Q

Chronic lymphocytic leukaemia (CLL)associated with what immunodeficiency

A

panhypogammaglobulinaemia (low IgG)

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36
Q

Saccharopolyspora rectivirgula organism

What disease?

A

(found in moldy hay/straw)

farmer’s lung

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37
Q

Salmonella typhi

Who is carrier?

Where is reservoir for infection that can cause recurrent infection after ABx?

A

Females are carriers

Gallbladder can be reservoir of infection and cause relapse in individuals treated with antibiotics. Cholecystectomy may be indicated.

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38
Q

Painless ulcer on nose after travel to south america

A

Cutaneous leishmaniasis

Leishmania braziliensis, spread by sandfly bites

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39
Q

painful, shallow ulcer

Travel to tropical area

A

Fusobacterium

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40
Q

Aciclovir MOA

A

synthetic purine nucleotide analogue

DNA polymerase inhibitor

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41
Q

oseltamavir MOA

A

Neuramidase inhibitors

42
Q

Ritonavir MOA

A

Protease inhibitors

43
Q

tenofovir MOA

A

Reverse transciptase

44
Q

Raltegravir MOA

A

Integrase inhibitors

45
Q

severe pharyngitis
travel to eastern Europe

Cause?

A

diphtheria

Exotoxins produced by the organism may cause myocarditis or neurological defects.

46
Q

SE of IV quinine therapy

A

Hypoglycaemia

47
Q

Organism causing cutaneous anthrax?

Cause?

Gram stain?

Appearance?

Cutaneous anthrax is associated with a

A

Bacillus anthracis

direct contact of the bacteria into an open wound

Gram positive rod

Painless black eschar without pus + widespread oedema.

48
Q

ulcer + travel

amastigotes on a thin smear of dermal scrapings

Giemsa stain

A

cutaneous leishmaniasis

49
Q

Bacterial vaginosis vs. T vaginalis

A

bacterial vaginosis = fishy odour + NO soreness or irritation

Trichomoniasis vaginalis = yellow discharge + vulval irritation

50
Q

recurrent painless haematuria and sensorineural deafness

A

Alport’s syndrome

mutations on collagen type 4 in kidneys/ eyes

51
Q

Haemolytic anaemia + Heinz bodies

Cause?

Precipitants?

A

G-6-PD

X-linked inheritance

Precipitants e.g. antimalarials and broad beans

52
Q

Fever, sore throat, cervical lymphadenopathy and an adherent, greyish pharyngeal membrane

A

Pharyngeal diphtheria

53
Q

C3 deficiency associated with which infection

A

N. meningitidis + encapsulated organisms

54
Q

first-line treatment for mild-to-moderate infections f/ dog, cat, or human bite.

A

Co-amoxiclav i

55
Q

severe egg allergy

Avoid which vaccine?

A

Yellow fever vaccine

56
Q

C1qrs, C2, and C4 deficiency associated with

A

SLE

57
Q

C5 deficiency

A

Leiner’s disease

syndrome of recurrent diarrhoea, wasting, and generalised seborrhoeic dermatitis presenting in infants.

58
Q

commonest cause viral meningitis

A

enterovirus

mumps

59
Q

Cephalic tetanus causes

A

severe dysphagia

60
Q

Abx given to household contacts of HiB meningitis

A

Rifampicin

Also vaccinate individuals if not already done so

61
Q

Paul-Bunnel test for

A

EBV (infectious mononucleosis)

62
Q

Rx PCP pneumonia

A

Trimethoprim-sulfamethoxazole

63
Q

HIV + CD4 150

upper lobe infiltrates

Cause

A

PCP (commonly see UL infiltrates)§

64
Q

positive India ink test

A

cryptococcal meningitis

65
Q

gonorrhoea treatment

A

ceftriaxone 500 mg intramuscularly

66
Q

DDx HIV pt ring enhancing lesion on CT head

A

cerebral toxoplasmosis
abscesses
metastases
atypical CNS lymphoma.

67
Q

Giargia lamblia:

type of organism
how is it spread?

Symptoms

Diagnosis

Rx

A

parasite

faeco-oral route (cysts ingested)

diarrhoea, steatorrhoea, abdominal pain, and nausea
carriers can excrete cysts and are asymptomatic

stool microscopy
- if negative, then duodenal aspirates or biopsy

metronidazole

68
Q

Chlamydia trachomatis urethritis Rx

A

Doxycycline

69
Q

19M
severe pharyngitis
atypical lymphocytes on blood film,
modest rise in CRP

Likely cause?

A

EBV

NB. EBV test 25% false negative in first week infection

NB. S. pyogenes would have higher CRP rise and no atypical lymphocytes on blood film

70
Q

Mycobacterium subtype that is opportunistic infection

Features?

A

Mycobacterium avium

typically when CD4 count is less than 50

fatigue, weight loss and fevers
Typically BM infiltration -> anaemic and/or pancytopaenic

71
Q

Koplik spots diagnostic of

A

measles

blue-grey spots in buccal mucosa

72
Q

maculopapular rash after takign amoxicillin

Cause?

A

Glandular fever

73
Q

Rx tetanus

A

anti-tetanus Ig

Metronidazole/benpen

+/- diazepam, neuromuscular blockade, intubation

74
Q

DDx cavitating mass on CXR

A
lung abscess
TB 
malignancy
fungal (hstoplasmosis, coccidiodomycosis)
RA 
Wegener's
75
Q
49M alcoholic
night sweats
10kg wt loss 
CXR nodular pattern throughout liung 
giant cells on transbronchial biopsy

Cause?

A

TB

76
Q

How do T cells recognise antigens?

A

Recognise Ag only when presented on (self) MHC molecules on an APC

77
Q

Diagnostic test for anaphylaxis

A

Mast cell tryptase

Anaphylaxis = Type I hypersensitivity, IgE mediated

78
Q

CJD Ix

rapid decline in young person

A

EEG - can show abnormalities

79
Q

Oseltamivir (Tamiflu)

MOA

Use

A

neuraminidase inhibitor

Used for influenza prophylaxis

80
Q

Blood type more susceptible to Cholera

A

Blood type O

81
Q

Streptococcus bovis IE

What Ix? Why?

A

Colonoscopy

a/w strep bovis and colonic neoplasia

82
Q

Likely causative organism prosthetic valve endocarditis

A

Staphylococcus (epidermidis)

83
Q

ABx associated with QT prolongation

A

Macrolides e.g. erythromycin

84
Q

Meningism signs/Sx. Gram negative organism. Older Adult

A

N. meningitidis (meningococcus)

85
Q

Gram positive cocci. Meningism. What organism? (older adult)

A

Streptococcus pneumoniae

86
Q

Complication of streptococcus pneumoniae in 50% of patients

A

Deafness

87
Q

Newborns bacterial causes meningitis

A

Group B strep
S pneumonia
Listeria monocytogenes
E Coli

88
Q

Babies bacterial causes meningitis

A

S pneumoniae, N meningitidis, H influenza, Group B Strep, TB

89
Q

Young adults bacterial causes meningitis

A

Strep pneumoniae

Neisseria meningitidis

90
Q

Lyme disease causative organism

A

Borrelia burgdorferi

Transmitted by ticks

91
Q

Initial manifestation lyme disease

A

Erythema migrans at site of bite within 1-2 weeks
Signs/Sx Lyme disease
Constitutional - fever, headaches, myalgia, fatigue
Affects neurological, cardiac, MSK (arthritis)

92
Q

27M fever, arthralgia, urethritis, swollen ankle w/pustular rash. Likely cause?

A

Disseminated gonorrhoea

93
Q

Salmonella ABx

A

Ciprofloxacin

94
Q

Define chronic diarrhoea

A

3+ stools/day for >4 weeks

95
Q

Shigella ABx

A

Ampicillin or ciprofloxacin

96
Q

Campylobacter ABx

A

Erythromycin

97
Q

C diff Rx

A

Metronidazole, vancomycin

98
Q

Yersinia ABx

A

Tetracycline

99
Q

Abdominal bloating, intermittent diarrhoea, strong farts

A

Giardiasis

100
Q

Gonorrhoea Rx

Chlamydia Rx

A

Gonorrhoea - CEFTRIAXONE/ CEFIXIME

Chlamydia - AZITHROMYCIN/ DOXYCYCLINE