infectious diseases Flashcards by jane smith

needlestick injury whilst taking blood from a patient who is known to be HIV positive

mx?

oral antiretroviral therapy for 4 weeks

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58-year-old farmer
high fever, sweating profusely
several black blisters which produce foul smelling discharge.

bug?

dx: Gas gangrene

clostridium perfringens

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rash is most often seen in early Lyme disease?

Erythema chronicum migrans (‘bulls-eye’)

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seen in?

Rheumatic fever

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UTI in pregnancy

tx?

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Campylobacter jejuni.
tx? when to tx?
complications?

Campylobacter infection is often self-limiting but if severe then treatment with clarithromycin may be indicated

if more then 8 bowel movements needs abx

Guillain-Barre syndrome may follow Campylobacter jejuni infections
reactive arthritis
septicaemia, endocarditis, arthritis

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Human bite abx

CO-AMOXICLAV

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Bacterial vaginosis in pregnancy

Bacterial vaginosis: oral metronidazole 400mg 5 days

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What is the most effective method for limiting the spread of norovirus?

wash hands with soap and water

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34-year-old man presents with a widespread maculopapular rash and mouth ulcers.
Two months ago he reports developing a painless penile ulcer.

bug?

secondary syphilis
Treponema pallidum

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MSRA tx?

Nasal mupirocin + chlorhexidine for the skin

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involved in a fight
rusty knife
has all the tetnas jabs

tetanus risk?

If a patient has had 5 doses of tetanus vaccine, with the last dose < 10 years ago, they don’t require a booster vaccine nor immunoglobulins, regardless of how severe the wound is

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which abx plus alcohol can cause a disulfiram-like reaction (flushing)

metronidazole
Cefoperazone, a cephalosporin,

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DnV after meal within 30 mins to 8 hours, bug?

Staphylococcus aureus gastroenteritis is characterised by a short incubation period and severe vomiting

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bug with clue cells?

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Kaposi’s sarcoma - caused by

HHV-8 (human herpes virus 8)

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pregnant woman is found to have tested positive syphilis, tx?

IM benzathine penicillin G

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flu vaccine in children
administration route?
first dose?
vaccine live or dead?

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non-productive cough, dullness to percussion on the right upper lobe,, previous TB. X-ray is taken which shows a target-shaped lesion in the right upper lobe with air crescent sign present.

dx?

An aspergilloma may arise in a lung cavity that developed secondary to previous tuberculosis

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immigrant 12-year-old boy advised to get BCG for TB. what do you do?

it is important that a tuberculin skin test is performed (to exclude past exposure to tuberculosis) prior to giving the vaccine.

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pregnant women more likely to get listeria?

pregnant women are almost 20 times more likely to develop listeriosis compared with the rest of the population due to changes in the immune system

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make up of bug causing this?

Streptococcus pyogenes, a beta-haemolytic group A streptococci

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purulent discharge, Gram-negative diplococci.

bug? tx?

intramuscular ceftriaxone (ALONE) is the treatment of choice for Gonorrhoea

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purulent discharge, Gram-negative diplococci.

bug? tx?

intramuscular ceftriaxone (ALONE) is the treatment of choice for Gonorrhoea

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most commonly diagnosed sexually transmitted infection in the UK?

chlamydia

Stereotypical features of ....?....... include flu-like symptoms and a dry cough, relative bradycardia and confusion. Blood tests may show hyponatraemia

Legionella

Stereotypical features of ....?....... include flu-like symptoms and a dry cough, relative bradycardia and confusion. Blood tests may show hyponatraemia

Legionella

Animal bites tx for wound after abx?

Thorough washout and dressing only

which TB meds cause urine to go bright colour?

Rifampicin can cause orange tears/urine

tx for chlamydia? if preggo?

Chlamydia - treat with doxycycline if pregnant then azithromycin, erythromycin or amoxicillin may be used

What is the most effective single step to reduce the incidence of MRSA?

HAND HYGIENE

multiple painful ulcers on the shaft of his penis.

herpes simplex

rose spots on her abdomen.

Salmonella typhi

34-year-old man is diagnosed as being HIV positive. what point should anti-retroviral therapy be started?

Anti-retroviral therapy for HIV is now started at the time of diagnosis, rather than waiting for the CD4 count to drop to a particular level

39-year-old man SOB flu like symptoms non-productive cough chest x-ray shows bilateral consolidation and examination reveals erythematous lesions on his limbs and trunk. dx?

lu-like symptoms, bilateral consolidation and erythema multiforme point to a diagnosis of Mycoplasma. The most appropriate diagnostic test is Mycoplasma serology

virus that is capable of producing pancytopenia in patients with a predisposing haematological disease?

Parvovirus B19 Erythema infectiosum (also known as fifth disease or 'slapped-cheek syndrome')

19 yo boy in thailand, has a rabies vaccine, gets bitten by dog tx?

if an individual is already immunised then 2 further doses of vaccine should be given plus possible abx if not previously immunised then human rabies immunoglobulin (HRIG) should be given along with a full course of vaccination. If possible, the dose should be administered locally around the wound

Pneumocystis jiroveci penumonia is treated with

co-trimoxazole, which is a mix of trimethoprim and sulfamethoxazole

following antibiotics should be avoided in the first trimester of pregnancy to tx uti?

trimethoprim

URTI symptoms + amoxicillin → rash dx?

A rash develops in around 99% of patients who take amoxicillin whilst they have infectious mononucleosis.

painful deep ulcer with a ragged border is seen on the shaft of the penis.

Chancroid causes painful genital ulcers side note: Herpes simplex is another sexually transmitted cause of painful genital ulceration however usually presents as multiple, superficial, vesicular lesions. Additionally, inguinal lymphadenopathy is more classical of chancroid rather than herpes simplex.

50 yo with flu symptoms- the nhas a chest cough. what bug?

Preceding influenza predisposes to Staphylococcus aureus pneumonia

live attenuated vaccines

bacterial vaginosis bug make up?

Gram-positive and negative bacteria

Atypical pneumonia tx?

Clarithromycin

Should be added in the treatment of pneumonia if secondary to influenza

Flucloxacillin

appropriate investigation to test for Lyme disease?

ELISA

suspected prostatitis should immediately be started on antibiotic therapy. tx?

cipro

genitourinary medicine clinic due to four fleshy, protuberant lesions on her vulva which are slightly pigmented. dx and tx?

Malaria: prophylaxis avoided if the patient has a history of epilepsy

Chloroquine

Can be stopped just one week after returning from a malarial zone

Atovaquone + proguanil

Malaria: prophylaxis Is taken weekly

Chloroquine

inactivated preparation of influenza?

intramuscular

Mycoplasma is associated with....?...type of rash

erythema multiforme

bloating, watery diarrhoea, floating stools. returned from pakistan 4 days ago

Giardia lamblia Malabsorption can be caused by chronic Giardia infection

21-year-old man 2 week history of burning when he urinates, worse in the morning itching around his penis. urine dip and find that it is leukocyte positive. cause?

Urethritis due to a sexually transmitted infection urethritis in young men is most commonly due to a sexually transmitted infection (STI).

active TB tx?

man had sex with a girl who has now tested positive for chlamydia. how do you mx him?

Offer Chlamydia testing and antibiotic treatment immediately without waiting for the results 46%

deep-ish cut with garden tool- not aware if tetnus jab given mx?

Patients with an uncertain tetanus vaccination history should be given a booster vaccine + immunoglobulin, unless the wound is very minor and < 6 hours old

First line treatment for early Lyme disease is

a 14-21 day course of oral doxycycline

44-year-old farmer headache, fever and muscle aches Subconjunctival haemorrhages dx?

Leptospirosis

.....?..... doses of the tetanus vaccine are given over the course of the routine immunisation schedule

gastro diarrhea bugs which has the longest vs shortest incubation period?

longest: Giardiasis shortest: bacillus cereus

primary genital herpes What is the most appropriate management?

oral aciclovir

anti malarial: associated with photosensitivity avoided if the patient has a history of depression

doxy MEFLOQUINE

UTI tx length of time in man vs woman?

woman- nitro for 3 days man- nitro for 7 days

diagnosis and screening of HIV

HIV p24 antigen and HIV antibody

Genital warts - 90% are caused by HPV ...?....

6 & 11

dry cough and target rash present on both her lower limbs, chest x-ray shows reticulo-nodular shadowing of the right lung. dx?

The dry cough, erythema multiforme (symmetrical target shaped rash with a central blister) and the radiological findings point to a diagnosis of Mycoplasma.

prodrome: 3 days of feeling generally unwell now 1 day of bloody diarrhoea went to a bbq what bug?

Campylobacter infection is characterised by a prodrome, abdominal pain and bloody diarrhoea

needle stick injury, man has hep b, shes in the process of getting the vaccines what to do do avoid hep b?

Give an accelerated course of the hepatitis B vaccine + hepatitis B immune globulin

Mastitis during breast-feeding abx?

Flucloxacillin

Dental abscess ax?

Amoxicillin

what abx interacts with methotrexate?

trimethoprim

who should get the BCG vaccine?

children born in areas where tuberculosis (TB) is prevalent, or if their parents or grandparents are from areas with a high rate of TB. It is also given to people who have a high risk of occupational exposure to TB -who are under the age of 35. The BCG vaccine is not given to anyone over the age of 35, as there is no evidence that it works for people of this age group.

prophylaxis for contacts of patients with meningococcal meningitis i.e flat mate has it

oral cipro

complaining of severe pain in his perineum and scrotum purple rash with bullae present covering the entire perineum and extending up the scrotum BP 110/90mmHg, heart rate 109bpm, respiration rate 21/minute, temperature 38.1ºC, and oxygen saturation 98%

Necrotising fasciitis: most commonly affected site is the perineum side note- t2dm increases risk

Pelvic inflammatory disease abx?

Doxycycline + metronidazole + ceftriaxone MDC PID

Extensive otitis externa

FLUCLOX

TB drugs RIPE s/e? rifampicin isoniazid pyrazinamide ethambutol

Salmonella typhi presentation? What is the best treatment?

constipated more common- but can cause the runs, bloated, temperature, sparse macular rash- rose spots ciprofloxacin

HIV positive presents with a 2 day history of diarrhoea. What is the most likely cause of his diarrhoea?

Cryptosporidium

Bacterial vaginosis - overgrowth of predominately?

Gardnerella vaginalis

painful eruption of spots around her vaginal area dx?

Painful vesicles in the genital area are usually symptomatic of Herpes simplex infection.

A 14-month-old boy who has a barking cough which is worse at night. dx ? bug? tx?

Parainfluenza virus croup tx dexamethasone

HIV positive man with cough and dyspnoea. Auscultation of his chest is unremarkable but he is noted to desaturate on exertion.

Pneumocystis jiroveci

alternative to treat early Lyme disease if doxycycline is contraindicated such as in pregnancy?

Amoxicillin

latent TB tx?

Common cold bug?

Rhinovirus

45-year-old smoker who develops pneumonia Mycoplasma pneumoniae bug?

Streptococcus pneumoniae

6-month-old who is 'chesty', has rhinitis and is off her feeds. Auscultation of her chest reveals bibasal crackles and an expiratory wheeze.

RSV

Infective exacerbation of COPD ABX?

Amoxicillin or tetracycline or clarithromycin

Acute pyelonephritis ABX?

Broad-spectrum cephalosporin or quinolone

38 wk preggo and uti mx?

cefalexin or amoxicillin

When should a test of cure (TOC) be performedcin pregnnat women? when treating sti clamydia?

6 weeks

healthy person with toxoplasmosis tx?

Immunocompetent patients with toxoplasmosis don't usually require treatment

viruses is associated with nasopharyngeal carcinoma?

EPV

SEX WORKER neck stiffness and and mild photophobia and as such a lumbar puncture is performed. lumbar puncture show a yeast and a capsule in the CSF stained with India ink.

Cryptococcus neoformans meningitis

painful genital and oral ulceration.

Behcet's disease The classic triad in Behcet's is oral ulcers, genital ulcers and uveitis. Venous thromboembolism is also seen.

addition of what meds (not abx) improves outcomes (by reducing neurological sequelae) in the treatment of bacterial meningitis

dexamethasone

infectious diseases Flashcards

(100 cards)