Infectious Diseases

Question 1

What is Sepsis?

Answer 1

large immune response in response to infection which causes systemic inflammation and affects organ function

Question 2

What is disseminated intravascular coagulopathy?

Answer 2

During sepsis, deposistion of fibrin throughout blood circulation forming clots. This uses up all the platelets and clotting factors leading to thrombocytopenia and bleeding

Question 3

How do you diagnose septic shock?

Answer 3

Systolic <90
Lactate >4mmol/L

Question 4

What is the sepsis six?

Answer 4

Take
blood lactate
blood cultures
urine output

give
oxygen
ABX
IV Fluids

Question 5

What is the usual sorce of infection in UTI?

Answer 5

From faeces or urinary catheters

Question 6

How do lower urinary tract infections present?

Answer 6

Dysuria
frequency
incontinence
suprapubic pain

Question 7

How does pyelonephritis present?

Answer 7

Fever
Loin, suprapubic or back pain
unwell
vomiting
loss of appetite
haematuria

Question 8

What should you look for on urine dipstick which suggests infection?

Answer 8

Nitrites

Question 9

How do you investigate a UTI?

Answer 9

Dipstick looking for nitrites and leaukocytes

then Mid streem urine for cultute and sensitvity testing

Question 10

What is the most common bacteria involved in UTIs?

Answer 10

E.COLI

Question 11

What are antibiotics of choice for UTI (usually)?

Answer 11

Trimethoprim
Nitrofurantoin

Question 12

How long should patients get antibiotics for in UTIs?

Answer 12

3 days for woman
5-10 days for immonosuppresed woman
7 days for men or people with catheters

Question 13

What do you do if you find a UTI in pregnant woman?

Answer 13

if 1st trimester - 7 Days Nitrofurantoin

if 3rd trimester - 7 days Trimethoprim

Question 14

What are the most common bacteria in a skin or soft tissue infection?

Answer 14

Staphylococcus aureus
Group A streptococcus
Group B strep

Question 15

What is the go to abx in skin or soft tissue infections and why?

Answer 15

Flucloxacillin as it treats both staphaureus and streptococal infections

Question 16

What is the most common cause of bacterial tonsilitis?

Answer 16

group A streptococcus

Question 17

What is the score system for bacterial tonsilits and how do you use it

Answer 17

Fever
Tonsillar exudates
No cough
tender anterior cervical nodes

If 3 points then 50% chance its bacterial - give abx

Question 18

What is the treatment for bacterial tonsilitis?

Answer 18

Penicillin V - Phenoxymethypenicillin for 10 days

Question 19

What should you consider when prescribing abx in bacterial tonsilitis?

Answer 19

Consider using a delayed perscription

Question 20

What is the abx for otitis media?

Answer 20

Oral amoxcicillin

Question 21

What is the treatment for sinusitis?

Answer 21

<10 days - nothing
>10 days - 2 weeks high dose nasal spray or penicillin V

Question 22

What does metronidazole do?

Answer 22

Good cover for anaerobic bacteria

Question 23

What does gentamicin do?

Answer 23

kills gram negative bacteria

Question 24

What is the common cause of a septic joint?

Answer 24

staphylococcus aureus

Question 25

What are the differntial diagonsis of a septic joint?

Answer 25

Gout pseudogout reactive arthritis haemarthrosis

Question 26

How do you manage a septic joint

Answer 26

Follow local "hot joint" policy aspirate joint and culture for abx treatment check crystal microscopy too

Question 27

How do you investigate suspected influenza?

Answer 27

viral nasal and throat swab for PCR

Question 28

How do you treat influenza in someone at risk?

Answer 28

oseltamivir oral zanamivir inhaled

Question 29

What is acute gastritis?

Answer 29

inflammation of the stomach

Question 30

How does gastritis present and how does enteritis present?

Answer 30

Gastritis = nausea and vomiting enteritits = diarrohea

Question 31

what are the most common causes of viral gastroenteritis?

Answer 31

Rotavirus Norovirus Adenovirus

Question 32

How does ecoli 0157 present and what do you need to remember about it

Answer 32

it produce shiga toxin which causes cramps, diarrhoea and vomititng Shiga toxin destroys blood cells causeing haemolytic ureamic syndrome

Question 33

What is improtant to remember about ecoli?

Answer 33

Shiga toxin, risk of heamolytic ureamic syndrome. Avoid antibiotics

Question 34

What causes travelers diarrohea?

Answer 34

camplyobacter jejuni

Question 35

How does camplyobacter present?

Answer 35

After 2-5 days of incubation you get 3-6 days of abdominal cramps, diarrhoea with blood, vomiting and fever

Question 36

What diseases causes haemolytic ureamic syndrome?

Answer 36

Ecoli Shigella they both produce shiga toxin

Question 37

What is the incubation and symptoms of salmonella ?

Answer 37

incubation 1 - 3 days and lasts for 1 week

Question 38

What are the features of bacillus cereus

Answer 38

immediated vomiting, followed by diahrroea after 12 hours with full recover in 2 days

Question 39

What are the two immediate vomiting bacteria?

Answer 39

bacillus cereus staphylococcus aureus toxin

Question 40

How do you investigate food poinsing ?

Answer 40

stool sample for microscopy, culture and sensitvities

Question 41

What should you advise people with gastroenteritis?

Answer 41

plenty fluid small trial meals remain off work for 48 hours after symptom resolution isolate

Question 42

What are the layers of the meingies?

Answer 42

Dura matter arachnoid matter arachnoid space pia matter

Question 43

What causes the classic non blanching rash?

Answer 43

meningococcal septiceamia

Question 44

What does the meningitis non blanching rash occour?

Answer 44

due to disseminated intravascular coagulopathy

Question 45

How does menegitis present in adults?

Answer 45

fever neck stiffness photophobia headache vomiting altered consciousness

Question 46

When should babies get lumbar punctures?

Answer 46

<1 month with fever <3 monts with fever and unwell <1 year with unexplained feature

Question 47

What two physical examination techniques can you use in babies with suspected meningitis?

Answer 47

Kernig's test. Straighten leg when riased Brudzinski's test lay patient on bed and lift head and neck towards chest

Question 48

How do you treat children with suspected meningitis?

Answer 48

If non blanching rash then benzylpenicillin injection immediatly then transfer to hospital

Question 49

How is meningitis treated in the hospital?

Answer 49

lumbar puncture with meningococal PCR, viral PCR and culture then Ceftriaxone and possible steroids inform public health

Question 50

Where do you do a lumbar puncture

Answer 50

between L3-L4 (line connecting iliac crests)

Question 51

What are the complications of a lumbar puncture?

Answer 51

hearing loss seizure focal neurological deficiets

Question 52

what are the buzzwords for tuberculosis

Answer 52

acid-fastness Zeihl-Neelsen stain

Question 53

What is the test for TB?

Answer 53

Mantoux test (skin injection)

Question 54

Who gets the BCG vaccine?

Answer 54

People with TB exposure risk

Question 55

what are the symptoms of tuberculosis?

Answer 55

lethargy night sweats weight loss cough

Question 56

How do you managed TB?

Answer 56

test contacts infrom public health isolate