Infectious Diseases Flashcards
(222 cards)
1
Q
Which antibiotics have anti-anaerobic activity
A
Penicillins, cephalosporins (except ceftazidime), erythromycin, tetracycline, metronidazole
2
Q
Which antibiotics have no anti-anaerobic activity
A
Ceftazidime, ciprofloxacin, gentamycin
3
Q
What is the MOA of rifampicin
A
Prevents transcription of DNA to mRNA
4
Q
What is the MOA of isoniazid
A
Inhibits mycolic acid synthesis
5
Q
What is the MOA of pyrazinamide
A
Inhibits fatty acid synthase
6
Q
What is the MOA of ethambutol
A
Inhibits arabinosyl transferase
7
Q
What are the types of gram positive rods
A
Actinomyces, bacillus anthracis, clostridium, diphtheria, listeria
8
Q
Which antibiotics inhibit cell wall formation
A
Penicillins, cephalosporins, isoniazid, vancomycin
9
Q
Which antibiotic targets the 50s subunit of the ribosome
A
Macrolides (erythromycin, clarithromycin, azithromycin)
10
Q
What is the MOA of tetracyclines
A
Inhibits 30s subunit of ribosome, thereby inhibiting protein synthesis
11
Q
What drug must be stopped when macrolides are started
A
Statins
12
Q
Which antibiotics inhibit DNA gyrase
A
Quinolones (ciprofloxacin, levofloxacin)
13
Q
Which organism is responsible for most central line infections
A
Staph epidermis
14
Q
Which organism is classified as group A beta-haemolytic streptococcus
A
Strep pyogenes
15
Q
What is the diagnostic criteria for toxic shock syndrome
A
Temp >38.9, hypotension BP <90, diffuse erythematous rash, desquamation of palms and soles, >2 organs involved
16
Q
What is the main organism that causes osteomyelitis in sickle cell patients
A
Salmonella
17
Q
What is the main organism that causes necrotising fasciitis
A
Strep pyogenes
18
Q
What is the treatment of anthrax
A
Ciprofloxacin
19
Q
What are the main 3 organisms responsible for meningitis in adults
A
Neisseria meningitidis
Streptococcus pneumoniae
Listeria monocytogenes
20
Q
Which organism spread by unpasteurised dairy can present with hemiparesis and ataxia
A
Listeria monocytogenes
21
Q
What is the treatment of Lyme disease presenting with bulls eye lesions but no disseminated disease
A
Doxycycline 2-3 weeks
22
Q
Which organism spread by infected rat urine causes renal failure in 50% and hepatic failure in 10% of cases
A
Leptospirosis
23
Q
What is the gold standard investigation for diagnosing Brucellosis
A
Bone marrow aspiration and culture
24
Q
How many mm is considered positive in Mantoux test
A
6mm
25
Name 5 causes of false negatives in Mantoux test
Miliary TB, HIV, sarcoid, immunosuppression, steroids
26
What is the treatment of TB meningitis
1 year TB treatment + steroids
27
What organism caught from fresh water produces ‘fish tank granulomas’
Mycobacterium marinum
28
What is the treatment of seizures caused by isoniazid
Vitamin B6 (pyridoxine)
29
How many strands of RNA are present in a HIV cell
2 copies of single stranded RNA
30
What are the envelope proteins present on HIV cells
GP120, GP41
31
What 3 main enzymes do HIV genes encode
Reverse transcriptase, integrase, protease
32
What does GP120 bind to on T cells to allow HIV to enter
CD4 and CXCR4
33
What does GP120 bind to on macrophages to allow HIV to enter
CD4, CCR5
34
What happens to IL-2 production in progressive HIV
IL-2 production decreases
35
Which vaccines are contraindicated in HIV
Cholera, intranasal influenza, oral polio, TB
36
What are the common suffixes to remember ARTs
Proteinase inhibitors = -navir
| Integrase inhibitors = -gravir
37
Name 3 common NRTIs used for HIV treatment
Abacavir, tenofovir, zidovudine
38
What are the side effects of protease inhibitors
Diabetes, hyperlipidaemia, buffalo hump, central obesity, P450 inhibitors
39
What is the treatment of PJP
IV co-trimoxazole + IV methylprednisolone
40
What is the commonest causative organism of diarrhoea in HIV
Cryptosporidium
41
Which organism shows red rounded oocysts against blue-green background on acid-fast (Ziehl-Neelsen) stain of stool
Cryptosporidium
42
What two things cause Addison’s disease in HIV patients
CMV-Adenitis, TB
43
What is the most common fungal infection of the CNS in HIV
Cryptococcus
44
How is histoplasmosis diagnosed
Adrenal biopsy with groccott stain
45
What is the treatment of histoplasmosis
Itraconazole 3-6 months
46
How does the clostridium tetani neurotoxin act to cause lockjaw
Blocks release of GABA
47
What does the exotoxin produced by clostridium botulinum do to cause flaccid paralysis
Blocks ACh release
48
What does the shiga toxin act on
Inactivates 60S ribosome
49
Which bacteria release endotoxins
Gram negative e.g. Neisseria Meningitidis
50
Which virus can cause haemoptysis in HIV patients
HHV-8 (Kaposi’s sarcoma)
51
What is the most common cause of blindness in HIV
CMV retinitis
52
What is the MOA of acyclovir
Inhibits viral DNA polymerase
53
Which antiviral is used to treat CMV
Gancyclovir
54
Which antiviral used to treat chronic HCV interferes with capping of viral mRNA
Ribavarin
55
Which two conditions is amantadine used to treat
Influenza, Parkinson’s
56
What are the side effects of Foscarnet - an antiviral used to treat CMV and HSV
Nephrotoxic, low calcium, low magnesium
57
What is the MOA of interferon alpha in the treatment of HBV, HCV and hairy cell leukaemia
Inhibits synthesis of mRNA
58
Which virus in neonates causes skin scarring, eye defects, limb hypoplasia and microcephaly
VZV
59
When should Ramsay hunt syndrome be referred urgently to opthalmology
Vesicles on nasolabial folds or tip of nose
60
What is seen on blood film in EBV
At least 10% atypical lymphocytes
61
Which virus causes oral hairy leukoplakia
EBV
62
Which virus can lead to subacute sclerosing panencephalitis 5-10 years after exposure
Measles
63
Which virus causes Koplik spots
Measles
64
Which virus can cause aplastic crisis in sickle cell anaemia
Parvovirus B19
65
What condition is associated with aspirin exposure in children
Reye’s syndrome
66
What test is used to diagnose chlamydia
Nuclear acid amplification tests (NAAT)
67
What is the incubation of chlamydia
7-21 days
68
What is the treatment of chlamydia
Doxycycline
69
What is the incubation of gonorrhoea
2-5 days
70
What is the treatment of gonorrhoea
Ceftriaxone 1g IM single dose
71
What is the most likely organism seen in urethritis with purulent discharge
Gonorrhoea
72
Which condition presents with rash on trunk, palms and soles and buccal ‘snail track’ ulcers
Secondary syphillis
73
What are the symptoms of tertiary syphillis
Gummas (ulcerating skin lesions)
Aortic aneurysms, AR
Neurosyphillis
74
What are the symptoms of congenital syphillis
Blunted upper incisor teeth, saddle nose, deafness
75
Which organism causes Q fever
Coxiella burnetti
76
Which condition presents similarly to syphillis but is not sexually transmitted
Yaws
77
What is the name of the disease caused by haemophilus ducreyi that presents with painful ulcers
Chancroid
78
Which HPV is responsible for genital warts
6&11
79
Which condition is associated with clue cells
Bacterial vaginosis
80
Which STI is associated with strawberry cervix and raised vaginal pH
Trichomonas
81
What is seen on bloods in plasmodium falciparum
```
Schizonts on blood film
Parasitaemia >2%
Severe anaemia <50
Hypoglycaemia
Metabolic acidosis
Lactate >5
```
82
Which types of malaria cause a cyclical fever every 48 hours
Vivax and ovale
83
What is the most common type of malaria other than falciparum
Plasmodium vivax
84
What is the treatment of non-falciparum malaria
Chloroquine (+primaquine in ovale and vivax)
85
Which cancer is more likely to develop after schistosomiasis infection
Squamous cell bladder cancer
86
Which disease is spread by sand flies and causes grey skin in it’s visceral form
Leishmaniasis
87
Which organism causes mucocutaneous leishmaniasis (involving mucosa of nose and pharynx)
L. Brasiliensis
88
Which condition does the tsetse fly spread
African trypanosomiasis (sleeping sickness)
89
Which systems does trypanosoma cruzi affect
Chaga’s disease: cardiac (myositis), GI (dysphagia)
90
What intra-abdominal pathology can arise from tapeworm infection
Liver cysts leading to obstructive jaundice
91
What causes itching in scabies
Type IV hypersensitivity reaction to mites/eggs after 30 days
92
What is the treatment of scabies
Permethrin to patient and contacts
93
What organism causes cat scratch disease
Bartonella henselae
94
What is the treatment of pyogenic liver abscess
Amoxicillin + ciprofloxacin + metronidazole
95
What are the symptoms of tetanus
Jaw spasm, risus sardonicus, arched back, hyperextended neck, dysphagia
96
Which organism presents with fever, bradycardia, constipation and salmon-coloured rose spots
Salmonella typhi (typhoid)
97
What is the treatment of complicated Salmonella (Typhoid)
Ceftriaxone
98
How is giardia diagnosed
Duodenal aspirates or string tests
99
Which condition causes profuse rice water diarrhoea
Cholera
100
Which condition causes black spots on forearms/thighs and fever
African Tick Typhus (Rickettsiae)
101
Which illness spread by ticks causes fever followed by a rash on palms and soles 6 days later
Rocky Mountain spotted fever
102
What are the symptoms of dengue fever
Retro-orbital pains, back pains, myalgia (break bone fever), high grade pyrexia, rash, facial flushing
103
Which tick-bourne disease causes haemolytic anaemia, haemoglobinuria and polyclonal hypergammaglobulinaemia
Babesiosis
104
What is the post exposure prophylaxis for HCV
Monthly PCR tests
105
What is the management of botulism
ITU for intubation and antitoxin
106
What causes encephalopathy in measles and VZV
Post-infectious encephalopathy- brain swelling cause by immune response to infection
107
What is the presentation of histoplasmosis
South USA - Erythema nodosum, BHL, cavitating lesions on CXR
108
Which organism causes swimmers ear
Pseudomonas aeruginosa
109
Which organism causes cervical lymphadenopathy and an adherent greyish pharyngeal membrane
Diphtheria
110
What endotoxin is responsible for toxic shock syndrome in staph aureus infection
TSST-1 superantigen
111
Which exotoxins increase cAMP levels
Pertussis toxin, Cholera A toxin, Heat labile E. coli toxin
112
What is the MOA of amantadine
Inhibits uncoating of virus in the cell
113
Which organism is responsible for pharyngitis
Streptococcus pyogenes
114
What is the treatment of Listeria Meningitis
Amoxicillin + gentamicin (cephalosporins usually inadequate)
115
What are the symptoms of Legionella
Fever, dry cough, bradycardia, confusion, lymphopenia, hyponatraemia
116
What condition causes flu-like illness, then a brief remission, followed by jaundice and haematemesis
Yellow fever
117
What is the treatment of cerebral toxoplasmosis in HIV
Pyrimethamine + sulphadiazine for 6 weeks
118
Which opportunistic infection presents with exercise-induced desaturation and very few chest signs
PJP
119
Which class of antibiotics promotes MRSA along with beta-lactams
Quinolones
120
Which organism usually acquired from eggs in dog faeces causes visceral larva migrans
Toxocara canis (nematode)
121
What is the first step in chickenpox exposure in pregnancy
Check VZV Abs in the mother
122
What is the management of pubic lice
Permethrin or malathion cream applied to all body hair, reapplied after 3-7 days
123
How is Lassa fever spread
From infected rats or person-to-person
124
What are the 3 criteria for VZV Ig
1. Significant exposure
2. Clinical condition that increases risk (pregnancy, long term steroids, neonates)
3. No antibodies to VZV
125
What prophylaxis is given to close contacts of a patient with pneumococcal meningitis
None - carriage is extremely common
126
What is the treatment of severe campylobacter
Clarithromycin
127
Which organisms are the most common cause of viral meningitis
Enteroviruses (coxakie, echovirus)
128
What is the best investigation for PJP
Bronchoalveolar lavage
129
What is the treatment of mycobacterium avium infection in HIV patients
Rifabutin + ethambutol + clarithromycin
130
What is the immediate management of meningitis in a patient with allergy to penicillins/cephalosporins
Chloramphenicol
131
What are the symptoms of chikungunya
Severe joint pain, high fever - africa, Asia, Indian subcontinent
132
What is the treatment of invasive amoebiasis
7 days metronidazole followed by 10 days diloxanide furoate
133
Which vaccines are live-attenuated
BCG, MMR, influenza (intranasal), oral rotavirus, oral polio, yellow fever, typhoid
134
What is the next step in a patient with suspected Lyme disease but no erythema migrans
ELISA antibody testing and start doxycycline
135
What is the treatment of cryptosporidium in immunocompromised patients
Nitazoxanide
136
Which hepatitis carries significant mortality in pregnancy
Hepatitis E
137
Which organism causes filariasis (lymphatic obstruction)
Wuchereria Bancrofti
138
What is the treatment of non-specific urethritis
Doxycycline 1 week
139
Which bacteria is responsible for bacterial vaginosis
Gardnerella vaginalis
140
Which type of leprosy is associated with hair loss
Tuberculoid leprosy
141
Which bacterial chest infection is associated with cavitating lesions and is seen after influenza infection
Staph aureus
142
Which viral meningitis is associated with unusually low glucose
Mumps
143
What is the MOA of telbuvudine in the treatment of HBV
Synthetic thymidine nucleoside analogue
144
What is the clinical picture of botulinum toxin
Afebrile, descending flaccid paralysis, slurred speech, diplopia, ptosis
145
What is first line treatment of hydatid disease (dog tapeworm Echinococcus granulosus)
Albendazole
146
Which bacteria is found in unpasteurised dairy and causes sweating with a ‘wet hay’ smell
Brucella melitensis
147
Which antibiotics are bacteriostatic
Chloramphenicol, macrolides, tetracyclines, sulphonamides, trimethoprim
148
Which virus is associated with nasopharyngeal carcinoma
EBV
149
Which vaccines cannot be used in egg anaphylaxis
Yellow fever, MMR
150
Which condition describes an infectious thrombophlebitis of the internal jugular vein
Lemierre’s syndrome
151
What are the most common viral organisms that cause meningitis
Coxsackie, echovirus
152
What drugs act as CCR5 fusion inhibitors in HIV treatment
Maraviroc, enfuviritide
153
Which vaccines are absolutely contraindicated in HIV-infected adults
Cholera, intranasal influenza, poliomyelitis, tuberculosis
154
Which complication of malaria can cause haemoglobinuria, AKI and anaemia
Blackwater fever
155
What is first line investigation for chlamydia
Women: vulvovaginal swab Men: urine test
156
What is second line treatment for genital warts after topics podophyllum
Topical imiquimod
157
What does thick film look for in malaria
Parasite burden
158
What does thin film look for in malaria
Species of malaria
159
What is the management of VZV exposure in >20 weeks pregnancy and not immune
Either VZIG or antivirals after day 7-14 of exposure
160
Which antiretroviral is an enzyme inducer
Nevirapine
161
What are the symptoms of HIV seroconversion
Like EBV (sore throat, lymphadenopathy, malaise, diarrhoea) with rash, mouth ulcers
162
What are the features of leptospirosis
```
Early: fever, flu, conjunctival erythema
Immune phase (Weil’s disease): AKI, hepatitis, aseptic meningitis
```
163
What is the investigation of choice for leptospirosis
Serology for leptospira Abs
164
What is the causative organism of Rocky Mountain spotted fever
Rickettsia rickettsii
165
What is toxoplasmosis caused by
Toxoplasma gondii - intracellular protozoan (parasite)
166
What should be checked before and during ethambutol treatment
Visual acuity (causes optic neuritis)
167
How should recurrent HSV outbreaks in pregnancy be managed
Suppressive treatment with aciclovir from 36 weeks gestation
168
Which infection is transmitted through rabbit/beaver bites and produces ulcerating regional lymphadenopathy
Tularaemia
169
Which organism causes ring enhancing lesions on CT head in patients with HIV
Toxoplasmosis
170
What is the treatment of pseudomonas ear infection
Gentamicin drops
171
What contributes to the rapid progression of necrotising fasciitis
M protein
172
Which organism causes melioidosis
Burkholderia pseudomallei
173
What is the difference between oral hairy leukoplakia and oral candidiasis
Leukoplakia cannot be scratched off/dislodged
174
What is the most important cause of mortality in diphtheria
Myocarditis
175
What is the treatment of choice for severe leptospirosis
IV penicillin
176
What is first line treatment of syphillis
Benzylpenicillin IM
177
What is the first line treatment of uncomplicated chlamydia
7 days doxycycline
178
What is the best treatment for chlamydia in pregnancy
Oral azithromycin
179
What is the standard treatment of genital herpes
Oral aciclovir
180
What is the treatment of toxoplasma gondii brain abscess
Sulphadiazine and pyrimethamine
181
Which organism causes a tick bite eschar
Rickettsia conorii
182
What is the treatment of cryptosporidium in immunocompromised patients
Supportive therapy + nitazoxanide
183
Which infection associated with cattle farming causes back pain, hepatosplenomegaly and low platelets
Brucellosis
184
What is the treatment of brucellosis
6 weeks doxycycline + streptomycin/rifampicin
185
What bacteria is spiral shaped on EM
Campylobacter
186
What does the nematode Loa loa (loiasis) cause
Filariasis
187
What is the most common side effect of lamivudine
Bone marrow suppression
188
What spreads dengue fever
Aedes mosquito
189
What presents 6-60 days after renal transplant with flu like symptoms and fever
CMV infection
190
What is the treatment of CMV infection in renal transplant
IV ganciclovir
191
What is the MOA of oseltamivir
Neuraminidase inhibitor
192
What is the incubation period of salmonella gastroenteritis
6-72 hours
193
Which organism causes African river blindness
Onchocerca volvulus (most common cause of infective blindness worldwide)
194
Which organism causes a murmur and hepatitis after exposure in a farm in France
Coxiella (Q fever endocarditis)
195
What is the antibiotic of choice for nocardia/actinomycete chest infection in immunocompromised
Sulphonamides - sulphadiazine
196
Which HIV ART is associated with fat redistribution and an insulin resistant phenotype
Zidovudine
197
What is the most common cause of PID
Chlamydia trachomatis
198
What is the causative organism of cysticercosis
T.solium (pork tapeworm)
199
What is the most specific investigation for diagnosing neurocysticerosis
Fundoscopic examination to directly visualise subretinal parasites
200
What remains positive throughout life and only indicates previous syphillis infection
TPHA
201
Which form of leprosy is systemic with symmetrical distribution and more severe
Lepromatous leprosy
202
What is the treatment of strongyloides nematode infection
Ivermectin (albendazole if concurrent AIDS)
203
What investigation should be performed in adults diagnosed with molluscum contagiosum
HIV antigen test
204
Which vaccines are safe in HIV patients with low CD4 count
Help A, Hep B, flu, pneumococcal
205
What is the treatment of symptomatic shigella
Oral azithromycin
206
What causes gas gangrene
Clostridium perfringens (treat with benzylpenicillin + clindamycin)
207
What is the treatment of Coxiella infection
Doxycycline
208
What is the investigation for hydatid liver disease
ELISA testing for echinococcus
209
What is the treatment for latent TB whilst taking HAART
Isoniazid mono therapy 6-9 months
210
What test confirms the diagnosis of leprosy
Skin biopsy
211
What is the treatment of chancroid
Single dose IM ceftriaxone
212
What classification of bacteria is pertussis
Gram-negative coccobacillus
213
What presents with a painless penile ulcer and significant inguinal lymph node enlargement
Lymphogranuloma venereum
214
Which NRTI is associated with myocarditis/cardiomyopathy
Zidovudine
215
What is used to diagnose cryptococcus meningitis
India ink test
216
What are the features of severe malaria
- Hb <50
- BM <2.2
- pH <7.30
- Lactate >5
217
Which paramyxovirus infection presents with parotid swelling and raised amylase level
Mumps
218
Which STI is most likely to cause an acute hepatitis
Hepatitis B
219
What is the most common hepatitis to be transmitted via homosexual anal intercourse
Hepatitis B
220
What is the most important risk factor for spread of Hep C
IVDU
221
What is the treatment of systemic primary VZV infection in an immunocompromised patient
IV aciclovir
222
Which infections have an incubation period of 1-2 weeks
Measles
Malaria
Typhoid
Dengue
