Infectious Diseases Flashcards
(208 cards)
1
Q
What is the role of Folic Acid
A
Synthesis and regulation of DNA within bacteria
2
Q
What does gram negative bacteria mean
A
They do not have a cell wall
3
Q
How to treat MRSA
A
Teciplanin or vancomycin
4
Q
Name three beta lactams (antibiotics that inhibit cell wall synthesis)
A
Penicillin
Carbapenems (meropenem)
Cephalosporins
5
Q
Name two antibiotics that inhibit wall synthesis but are not beta lactams
A
Vancomycin
Teicoplanin
6
Q
What antibiotic inhibits folic acid metabolism
A
Trimethoprim
7
Q
Why is tazocin typically added after co-moxiclav
A
To cover pseudomonas (co amoxiclav does not cover atypical bacteria)
8
Q
Describe the stepwise approach of escalating antibiotic treatment in a hospital patient
A
- Amoxicillin
- Co-Amoxiclav
- Tazocin
- Meropenem to cover ESBLs
- Teicoplanin to cover MRSA
- Clarithromycin
9
Q
What is the pathological consequence that leads to raised blood lactate in the body
A
Cause hypoperfusion of the tissues = anaeraobic respiration
10
Q
First line management of septic shock
A
IV Fluids
if IV fluids does not improve BP, switch to inotropes (noradrenaline)
11
Q
At what level of lactate should sepsis be suspected
A
> 2 mmol/L
12
Q
What medications can cause neutropenic sepsis
A
Clozapine Hydrocychloroquine (RA) Methotrexate (RA) Sulfsalazine (RA) Carbimazole Quinine Infliximab Rituximab
Chemotherapy
13
Q
Treatment of neutropenic sepsis
A
IMMEDIATE IV Pipperacillin with Tazobactam
14
Q
First line management of UTIs in pregnancy
A
Nitrofurantoin 7 days
Then Cefalexin
15
Q
What antibiotic should be avoided in the first trimester for UTIs
A
Trimethoprinm
16
Q
What antibiotic should be avoided in the third trimester for UTIs
A
Nitrofurantoin
17
Q
First line management of Pyelonephritis
A
Cefalexin for 7-10 days
18
Q
What classification is used to grade Cellulitis
A
Eron
19
Q
What antibiotic is given for cellulitis
A
Flucloxacillin
20
Q
First line management of sinusitis
A
Phenoxymethylpenicillin for a 5 day course
Second line: Co-Amoxiclav
21
Q
Management of intra-abdominal infections
A
Co-Amoxiclav
or
Amoxicillin + Gentamycin + Metronidazole
22
Q
First line management of spontaneous bacterial peritonitis
A
Tazocin
23
Q
What disease is spontaneous bacterial peritonitis seen in
A
Liver Failure
24
Q
Diagnosis of influenza
A
Viral nasal swabs -> PCR
25
Management of influenza
Oral Oseltamivir 75mg twice daily for 5 days
within 48 hours to reduce risk of complication
26
What post-exposure prophylaxis is given for influenza
Oral Oseltamivir
27
What species is the most comon cause of traveller's diarrhoea
Campylobacter jejuni
28
How does campylobacter jejuni spread
Raw poultry
| Unpasteurised milk
29
Incubatino period of campylobacter jejuni
2-5 days
30
Antiibtiotcs for campylobacter jejuni infection
Azithromycin
31
Treatment of shigella
Azithromycin
32
What species causes diarrhoea from leftover fried rice left at room temperature
Bacillus Cereus
33
Management of bacillus cereus infection
leave for 24 hours
34
Treatment of giardiasis
Metronidazole
35
What is meningococcal septicaemia
Where the meningococcus bacterial infection spreads in the blood
This causes the classic non-blanching rash from DIC
36
What is meningococcal meningitis
Bacteria infetcing the meninges and CSF around the brain and spinal cord
37
What is the most common cause of bacterial meningitis in neonates
Group B strep
38
What is the criteria for lumbar puncture in children
<1 month with fever
1-3 months with fever and are unwell
<1 year with unexplained fever + other features of serious illness
39
What is the kernig's test
Lie on back, flex one hip at 90 degrees and slowly straighten (causes pain)
40
What is the Brudzinski's test
Lying the patient flat on their back and gently using your hands to lift their head and neck off the bed (cause involuntary flexing of their hips and knees)
41
Management of meningitis in the community
IM Benzylpenecillin
42
Management of meningitis <3 months
Cefotaxime + Amoxicillin
43
Management of meningitis >3 months
Ceftriaxone
44
At what age can dexamethasone be given to children with meningitis
>3 months
45
Post-exposure prophylaxis for meningitis
Ciprofloxacin
46
Most common cause of viral meningitis
HSV
47
Management of Viral Meningitis
Aciclovir
48
Glucose levels in Bacterial vs Viral meningitis
Low vs High
49
Appearance of CSF fludi in bacterial vs virus
Cloudy vs clear
50
Protein levels in bacterial vs viral meningitis
High vs Normal
51
Appearance of disseminated miliary TB on a chest X-rAy
Millet seeds uniformly distributed across the lung fileds
52
In what lobes in reactivated TB found in
Upper Zones of the lungs
53
Management of latent TB (those at risk of re-activation)
Isoniazide + Rifampicin for 3 months
Then
Isoniazid for 6 months
54
Management of Acute Pulmonary TB
RIPE
R + I for 6 months
P + E for 2 months
55
Side-effect of isoniazid
Peripheral neuropathy
56
How to prevent peripheral neuropathy from isoniazid
Prescribe B6
57
Side-effect of Pyrazinamide
Hyperuricaemia
58
Side-effect of Ethambutol
Colour Blindness
59
What is the problem with antibocyd testing in HIV
Can be negative for up to 3 months
60
Three ways we can test for HIV
Antibody testing
p24 antigen testing
PCR tetsing for HIV RNA to get viral load
61
How to monitor HIV progression
CD4 count
62
What is the normal CD4 count
500 +
63
When is a virla load referred to as undetectable
<100
64
Treatment of HIv
2 NRTIs (Tenofovir and emricitabine) + third agent
65
Management of Pneumocytis jirovecii pneumonia
Co-Tramoxazole
66
How does birth change in women with a viral load
Require C-Sections
67
WHat is post-exposure prophylaxis given for HIV
Truvada + Reltegravir for 28 days
68
What is the most dangerous species of malaria
Plasmodium Flaciparum
69
Which species of malaria lie dormant in the liver (as hypnozoites) for years
P. vivax
P. Ovale
70
IN which organ to malarial species mature in
Liver
71
Where do merozoites move to after maturing in the liver
RBCs where they reproduce and destroy the cells = haemolytic anaemia
72
Describe the pattern of fevers in malaria
High fever spikes every 48 hours as that' show long it takes for meroxoites to reproduce inside RBCs
73
Incubation period of malaria
1-4 weeks
74
Diagnosis of Malaria
Blood film (EDTA bottle) - 3 samples over 3 days
75
Management of uncomplicated malaria (orally treatable)
Artemether with lumefantrine
Proguanil + Atovaquone
Quinine
76
IV Management of severe malaria
Artesunate
or
Quinine Dihydrochloride
77
What prophylaxis can be given for malaria
Proguanil + Atovaquone
second line:
Mefloquine (but can cause bad dreams)
78
What antibody in Heb B implies past or current infection
HBcAb
79
What antibody indicates vaccination or precious infection in Hep B
HBsAb
80
What does a CT scan show for toxoplasmosis gondii infections
Multiple ring enhancing lesions
81
What does a CT scan show for Primary CNS lymphoma
Single lesion
82
What does a CT show for HIV caused encephalitis
Oedematous brain
83
Most common fungal infection of the CNS
Cryptococcus
84
What stain is used to check for cryptococcus infections
India ink staining
85
Symptoms of progressive multifocal leukoencephalopathy
Widespread demyelination
Behavioural changes, speech, motor and visual impairment
86
What does an MRI show for PML
Widespread demyelination
87
What does stool microscopy show for amoebiasis
Trophozoites
88
Treatment for amoebiasis
Oral metronidazole
89
What causes yellow fever
Aedes mosquitos (zoonotic infections)
90
Symptoms of yellow fever
Sudden onset fever, rigors, nausea and vomiting
Then remission
Then jaundice and oliguria
91
What is seen under microscopy for yellow fever
Concilman bodies
92
Management of encephalitis
Ceftriaxone and acyclovir
93
Clinical features of trypanosomiasis
Painless subcutaneous nodule at site of infection + fever
then get sleepiness and headaches later on
94
Management of trypanosomiasis
IV pentamidine
Late IV melarsoprol (CNS involvement)
95
What type of microbe is toxoplasmosis
Protozoan
96
If someone's received a full 5 dose of the tetanus vaccine in the past 10 years, should they receive another at A&E?
No. Over 10 = yes
97
Clinical features of schistosomiasis
Swimmer' itch
Fever, cough and diarrhoea
98
Why does schistosomiasis cause bladder cancer
Deposit eggs in the bladder causing inflammation
99
Investigation for schistosomiasis
Asymptomatic: Serum schistosome antibodies
Symptomatic: Urine or stool microscopy
100
Complications of rubella
Thrombocytopaenia
Arthritis of small hands
Encephalitis
Myocarditis
101
Management of p oval and vivax infections
Chloroquine and THEN primaquine to destroy liver hypnozoites - prevents relapse
102
Management of leptospirosis
Benzylpenicillin
103
What species causes leprosy
Mycobacterium leprae
104
Clinical features of leprosy
Patches of hypo pigmented skin affecting the buttocks, face and extensors
Sensory loss
105
What typiclaly causes acute pyelonephritis
E.coli
106
What type of bacteria is entamoeba histolytica
Protozoan
107
Symptoms of amoebiasis
Profuse and bloody diarrhoea
Long incubation period
108
Investigation for suspected amoebiasis
stool microscopy - hot stool + trophozoites
109
Management of amoebiasis
Metronidazole
110
Management of liiver amoebic abscess
Metronidazole (usually a singular mass in the liver)
111
Features of anthrax
Painless black eschar (pus)
Oedema
GI Bleeding
112
Management of Anthrax
Ciprofloxacin
113
How is anthrax spread
Infected carcasses
114
Management of PID
Oral Ofloxacin + Metronidazole
Ceftriaxone + doxycycline + Metronidazole
115
Management of c.diff
Oral vancomycin
second line: Fidaxomicin
116
Antibiotic given for salmonella and shigella
Ciprofloxacin
117
What antibiotic typically results in c.diff infections
Clindamycin
118
Name two conditions that can predispose someone to aspergilliosus
TB
Lung cancer
CF
119
Management of botulism
Botulism antitoxin and supportive care
120
How do people get boutlism toxins
From food that has not been preserved well
121
Incubation of campylobacter infections
6 days
122
What species causes cat scratch disease
Bartonella Henslae
123
Criteria for IV antibiotics in cellulitis
Class III or IV cellulitis on the eron scale
Rapidly deteriorating
<1 years old
Immunocompromisd
Facial cellulitis
124
Management of cellulitis in pregnancy
Erythromycin
125
Management of Class III + Cellulitis
IV co amoxiclav
126
What species causes a chancroid
Haemophilus ducreyi
127
Mangement of cholera
Oral Rehdyration therapy first
Doxycycline
128
How is the cholera vaccine given
Orally
129
What species causes pseudomembranous colitis
C.diff
130
What type of species is cryptosporidium
Protozoal
131
Symptoms of cryptosporridium infection
Wstery diarrhoea
Abdominal cramps
132
Stool sample results in cryptosporidium infections
Red cysts on ziehl-neelsen stain
133
Management of cryptosporridium infection
Supoprtive
Rifaximin if severe symptoms
134
Microscopy in CMV infections
Owl's eye
135
Three symptoms of CMV infection
1. Slow growth
2. Blueberry muffin rash
3. Microcephaly
136
Management of CMV retinitis
IV Ganciclovir
(has pizza retina)
137
What mosquito typically carry dengue
Aedes Aegypti mosquito
138
Symptoms of dengue fever
Fever
Bone pain
Haemorrhages
Warning signs: Hepatosplenomegaly + ascites
139
Complication of dengue
DIC
Shock
140
Diagnostic test of dengue
NAAT
Serology
141
Management of dengue
Supportive
142
What bacteria causes diptheria
Gram positive: Cornyebacterium diptheriae
143
Presentation of diptehria
Greying of the posterior pharyngeal wall
Cervical lymphadenopathy (causes bulky neck)
Heart block
144
Invetsiation of diptheria
Throat swab
145
Management of diptheria
IM penecillin + antitoxin
146
What virus is the only one that is single stranded
Parvovirus
147
What species causes ebola
Filoviridae
148
How is ebola spread
Througgh direct contact (secretions etc)
149
Incubation period of ebola
2-21 days
150
What species causes typhod
Salmonella
151
Features of typhoid
Bradycardia
Constipation (even though salmonella usually causes diarrhoea)
Rose spots on trunk
152
What species causes osteomyelitis in SCA
Salmonella
153
Name two types of lymphomas associated with EBV
Burkitt's lymphoma
HOdgkin's lymphoma
154
What diarrhoeeal infection has appendicitis type symptoms
Campylobacter infections
155
What is the most common cause of infective diarrhoea in HIV +ve patients
Cryptosporidium infections
156
What species causes Kaposi's sarcoma
Human Herpes Virus 8
157
Management of Kaposi's sarcoma
Radiotherapy + Resection
158
Management of HIV
Two NRTIs + PI or NNRTI
159
What virus is associated with Primary CNS lymphoma
EBV
160
A patient presents with headache, fever and malaise - india ink stain is positive. What species has caused this invasion of the CNS
Cryptococcus
161
Management of oesophageal candidiasis
FLuconazole + Itraconazole
162
What species causes hairy leukoplakia
EBV
163
Under what CD4 count should all HIV patients recieve PCP prophylaxis
<200
164
COmplication of PCP
Pneumothorax
165
What examination finding is consistent with PCP
Excercise-induced desaturation
166
What is diagnostic of PCP
Bronchoalveolar lavage - silver stain shows cysts
167
Management of PCP
Co-trimoxazole
or
IV pentamidine
168
When should steroids be given in PCP
pO2 < 9.3kPa
169
What factor in HIV diagnosis correlates to poor long term prognosis
Symptom severity
170
When should a repeat test be offered in asymptomatic patients for HIV
4 weeks after exposure
Tehn 12 weeks after
171
When do HIV antibodies get detected in the blood
4-6 weeks after infection
172
What HPV strains are linked to cervical cancer
16 and 18
173
What is the triad seen in infectious mononucleosis
Sore throat
Pyrexia
Lymphadenopathy
Splenomegaly
174
When should the monospot test be conducted
2nd week of illness
175
How is the influenza vaccine given to children
INtranasally (live vaccine)
176
Contradinications to the influenza vaccine
People taking aspirin for kawasaki
Egg allergy
Pregnancy
Asthma
<2 years
177
Diganosis of legionella pneumophilia
Urinary antigen
178
Management of legionella
Erythromycin
179
How is leishmaniasis spread
Sandflies bites
180
Signs of a leishmaniasis bite
Underlying red ulcer
181
How is leishmaniasis diagnosed
Punch biopsy
182
Where is leishmaniasis spread
South america
183
What is a positive mantoux test
Erythema > 10mm = previous exposure including BCG
184
Signs of false negative mantoux test
Sarcoidosis
Lymphoma
Fevers
185
How does IV antibiotics change for managing meningitis 3 months - 50 years and > 50 years
3 months - 50 years: IV Cefotaxime
50 + : IV cefotaxime + Amoxiccillin
186
Side-effects of metronidazole
Increases anticoagulant effects of warfarin
Causes bad experiences with alcohol intake
187
Management of MRSA
Vancomycin
188
Triad for congenital toxoplasmosis
Cerebral calcification
Hydrocephalus
Chorioretinitis
189
Management of latent TB
3 months of isoniazid (with pyridoxine) + rifampicin
6 months of isoniazid (with pyridoxine)
190
Management of TB
First 2 motnhs: RIPE
Next 4 months: RI
191
Side effect of pyrazinamide
GOUT
192
What is yellow fever
It is a viral haeemorhagic fever from aedes mosquitos
193
What strain of HIV is common in the world
HIV-1
194
Name trhee cells that carry CD4+ cells
T-helper cells
Macrophages
Dendritic cells
195
Describe how HIV molecules get into cells
Bind to CD4 cells by GP120 receptors on their cell surface
Then GP120 binds to CXCR4 co receptor
Has to bind to both to get in
196
WHat enzyme causes the RNA HIV virus to be turned into DNA
Reverse transcriptase enzymes
Basically: whenever you get an infection in the body, these immune cells try and replicate but the viral DNA gets replicated instead - producing more HIV cells by accident!
197
What causes the acute stage of HIV
The dentritic cells just chill in the epithelium - then migrate to the lymph nodes to elsewhere in the body. High concentrtaion of immune cells means HIV has a field day and infects all the other cells
198
Symptoms of teh acute phase of HIV
Flu like symptoms:
By 12 weeks, the HIV virus reaches almost zero.
Then we enter the chronic phase
199
What happens in the chronic phase
Some HIV strains carry an X4 receptor that SPECFICIALLY targets T-cells. It hides in the lymphoid tissues and attacks the T4 cells causing them to deceline.
HIV count goes up
200
Symptoms of HIV at 200-500 T cells
Swollen lymph nodes
Hairy leukoplakia (EBV)
Oral candidiasis
201
Name four AIDS defining illnesses
Kaposi's lymphoma
Pneumocystis pneumonia
Candidiasis of oesophagus
Primary CNS lymphoma
Progressive multifocal leucoencepholopathy
Toxoplasma gondii infection
202
Name two conditions that are protective against amalria
SCA
Thalassamia
G6PD deficiency
203
Where do the sporozoites in malaria develop
IN the liver - form merozoites
204
Name two species that go dormant in the liver
p.vivax
p.ovale
called hypnozoites at this point
205
How does malaria cause haemolysis
The merozoites invade the blood stream and bind to RBCs
(p.vivax typically only infects reticulocytes)
Then reproduce inside the RBCs to form trophozoites
They eat up haemoglobin from inside the cells: Schizont (they are differentiated)
Burst the RBCs and go into the blood
206
What species causes the worts malarial infections
p.falciparum
207
Complication of p.falciparum infections
Blocks up blood vessels
Blocks blood supply to spleen
Blocks blood supply to the brain (seizures)
BLocks blood supply to the liver.
Causes RBCs to clump together
208
Diagnosis of malaria
Blood smear
