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Infectious diseases Flashcards

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1
Q

What is the management of cutaneous leishmaniasis in Africa/India?

A

Supportive treatment

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2
Q

Management of cutaneous leishmaniasis acquired in South or Central America?

A

Treat due to risk of mucocutaneous leishmaniasis caused by Leishmania braziliensis

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3
Q

Plasmodium vivax treatment to kill hypnozoites after finishing acute course?

A

Primaquine

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4
Q

Treatment of schistosomiasis?

A

Praziquantel

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5
Q

Sexually active patient + genital chlamydia (painless anal ulcer) + bowel symptoms (tenesmus, rectal pain and bleeding) =

A

Lymphogranuloma venereum secondary to chlamydia

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6
Q

Malaise + low-grade temperatuer + painful mouth ulcers + cervical lymphadenopathy =

A

Herpes simplex virus infection

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7
Q

Short incubation period + severe vomiting = what organism?

A

Staphylococcus aureus

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8
Q

How to diagnose Lyme disease?

A
  • If erythma migrans is present = diagnosis and an indication to start ABx
  • ELISA to Borrelia burgdorferi antibodies should be done - if negative and Lyme disease still suspected in patients tested 4 weeks form symptom onset, repeat ELISA 5-6 weeks after the first one.
  • If symptoms are still ongoing after 12 weeks, do immunoblot test
  • if positive or equivocal, do immunoblot test
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9
Q

ABX in Lyme disease?

A

Doxycycline first-line
Amoxicillin in pregnant women
Ceftriaxone in disseminated disease
Jarisch-Herxheimer reaction possible

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10
Q

Bacterial vaginosis treatment, and when to treat?

A

If asymptomatic, don’t treat.
If symptomatic, treat with Metronidazole for 5-7 days, or 2g stat if concerns about adherence.
If pregnant + asymptomatic = discuss with OBGYN
If symtomatic, treat with 5-7 days of Metronidazole orally, or topical.

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11
Q

Fever + severe joint pain without swelling + headache, malaise and fatigue + Asia/Africa/India =

A

Chikungunya (Alphavirus transmitted by mosquitoes)

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12
Q

Urinary infection in women in early to mid preganancy?

A

1st line = Nitrofurantoin (MSU should be sent)
2nd-line = amoxicillin and cefixin

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13
Q

Prophylactic ATB in HIV patients with CD4<200?

A

Co-trimoxazole

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14
Q

Treatment of Strongyloides infection?

A

Ivermectin or albendazole

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15
Q

Treatment of Pneumocystis jirovecii pneumonia?

A

Co-trimoxazole

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16
Q

Treatment of giardiasis diarrhoea?

A

Metronidazole

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17
Q

Treatment of cryptosporidium diarrhoea?

A

Supportive treatment

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18
Q

Treatment of Amoebiasis diarrhoea?

A

Metronidazole

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19
Q

Treatment of Campylobacter jejuni diarrhoea?

A

Fluids + clarithromycin

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20
Q

What organism is responsible for Kaposi’s sarcoma?

A

Human Herpes Virus 8

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21
Q

Treatment in case of symptomatic tetanus?

A

Tetanus immunoglobulins + diazepam for muscle spasms +/- ventilation support

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22
Q

Treatment of Melioidosis?

A

IV Ceftazidime, imipenem, meropenem for 10-14 days
Followed by eradication therapy: oral TMP/SMX (plus doxycycline) for 3-6 months

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23
Q

Pneumonia + red cell agglutination on blood smear =

A

Mycoplasma pneumoniae

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24
Q

Diphteria’s complication?

A

Heart block - neuritis (cranial nerves)

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25
Treatment of Diphteria?
IM penicillin - Diphteria antitoxins
26
Mechanism of action of aciclovir?
Inhibits the viral DNA polymerase - Aciclovir is a guanosine analog, phosphorylated by thymidine kinase
27
Viral CSF picture with low glucose?
Mumps virus
28
Most common cause of erysipelas?
Staphylococcus pyogenes
29
Treatment of meningococcal meningitis (N. meningitidis) if allergic to penicillin?
Chloramphenicol
30
Management of multiple painful genital ulcers (primary genital herpes)?
Oral aciclovir
31
Most likely pathogen to cause pharyngitis?
Streptococcus pyogenes (B haemolytic, group A)
32
Treatment of cutaneous anthrax?
Ciprofloxacin
33
What antibiotics facilitate acquisition of MRSA?
Quinolones (Ciprofloxacin)
34
Management of genital warts?
Single keratinized wart = cryotherapy Multiple warts = topical podophyllum
35
Treatment of aspergilloma?
Voriconazole
36
Vulvivaginitis + frothy yellow/green offensive discharge + strawberry cervix + mobile trophozoites on wet mount = ?
Trichomonas vaginalis
37
Management of Trichomonas vaginalis?
5-7 days of metronidazole or 2g metronidazole one-off
38
Mechanism of action or clarithromycin?
Inhibits bacterial protein synthesis through binding to the 50S subunit
39
Treatment of Varicella pneumonia in adults?
IV Aciclovir
40
Why should Zanamivir (Relenza) prescribed for Influenza, be prescribed with caution?
It causes exacerbation of asthma and COPD because of increased bronchoconstriction
41
Returning traveller with fever/flu-like symptoms + anaemia-jaundice-thrombocytopaenia-renal impairment =?
Falciparum malaria
42
TTT for hospital-acquired pneumonia within 5 days of admission?
Co-amoxiclav OR Cefuroxime
43
TTT for hospital-acquired pneumonia more than 5 days of admission?
Piperacillin-Tazobactam OR Broad-spectrum Cephalosporin (Ceftazidime) OR Quinolones (Ciprofloxacin)
44
TTT of pneumonia caused by atypical organisms?
Clarithromycin
45
TTT of exacerbation of chronic bronchitis?
Amoxicillin or Tetracyclin or Clarithromycin
46
TTT of latent TB (+ Mantoux and + Gamma interferon assay)?
Isoniazide + pyridoxine for 6 months Rifampicin + Iso + pyridoxine for 3 months
47
Diagnosis of infectious mononucleosis?
Heterophile antibodies test
48
Bloody diarrhea + incubation of 1-6 days + unpasteurized milk or undercooked poultry =
Campylobacter jejuni - Treat with Clarithromycin
49
Fever, hypotension and a rash that desquamates?
Staphylococcal Toxic Shock Syndrome
50
Management of African Trypanosomiasis?
Acute phase: IV Pentamidine or Suramin Chronic or CNS involvment: IV Melarsoprol
51
Management of American Trypanosomiasis (Chagas' disease)?
Benznidazole or Nifurtimox
52
What vaccines to give post-splenectomy?
- Pneumococcal, HiB, Menigococcus C two weeks before or after splenectomy - Meningococcus ACWY one month later - Annual influenza vaccine in winer or autumn
53
Antibiotics that inhibit DNA synthesis?
- Quinolones (Ciprofloxacin) - Metronidazole - Trimethoprim - Sulphonamides
54
Antibiotics that inhibit RNA synthesis?
Rifampicin
55
Antibiotics that inhibit cell wall formation?
B-lactams : Penicillin (binds transpeptidase blocking cross-linking of peptidoglycan cell walls) and cephalosporins
56
Antibiotics that inhibit protein synthesis?
(these ATB are bacteriostatic) - Aminoglycosides (cause misreading of mRNA) - Chloramphenicol - Macrolides (e.g. erythromycin) - Tetracyclines - Fusidic acid
57
Maculopapular rash + flu-like illness in traveller/businessman = ?
HIV seroconversion
58
Immediate complication of measles?
Pneumonia - also most common cause of death
59
Most common complication of measles ?
Otitis media
60
Features of severe malaria?
- schizonts on a blood film - parasitaemia > 2% - hypoglycaemia - acidosis - temperature > 39 °C - severe anaemia - complications (acute renal failure aka Blackwater fever, ARDS, cerebral malaria, disseminated intravascular coagulation)
61
Vaccines contraindicated in HIV-positive patients ?
Oral polio-intranasal influenza- BCG-cholera CVD103-HgR (other live attenuated vaccines in general are contraindicated when CD4<200 like MMR, yellow fever, varicella)
62
Best way to monitor Hepatitis C treatment efficacy?
Viral load, or HCV RNA levels
63
Cause of culture-negative endocarditis?
Coxiella burnetti causing Q fever (abattoir, cattle, sheep, or inhaled from infected dust)
64
Treatment of Q fever?
Doxycycline
65
Transmission rate of HCV from mother to baby?
<10%
66
Side-effects of tetracyclines?
Photosensitivity (rash) Discolouration of teeth Angioedema Black hairy tongue
67
Second-line for cellulitis if penicillins are ineffective?
Clindamycin (covers MRSA and has additional anti-inflammatory action) Oral vancomycin is not used orally as it has poor oral bioavailability
68
Causes of false positive TPHA-VDRL test? (Neg TPHA pos VDRL)
Pregnancy - Anti-Phospholipid syndrom - SLE - HIV - Tuberculosis - Malaria - Leprosy
69
TTT of anthrax?
Ciprofloxacin
70
What type of staining should be applied to brochoalveolar lavage to reveal Pneumocystis jirovecii?
Silver stain, shows characteristic cysts
71
TTT of severe Legionella disease? (signs of meningism/renal failure)
IV Benzylpenicillin
72
TTT of bacterial meningitis in patients <60? and >60?
<60: IV Ceftriaxone >60: IV Ceftriaxone + Amoxicillin
73
What staining is used to detect Bartonella hanselae (cat scratch disease)?
Warthin-Starry staining
74
How long to wait between 2 live vaccine administrations?
4 weeks, to avoid immunological interference (live vaccines can either be given on the same day, or 4 weeks apart)
75
TTT of UTI in patient taking Methotrexate?
Nitrofurantoin (Trimethoprim and co-trimoxazole are CI with Methotrexate as they cause life-threatening myelosupression)
76
Which anti-retroviral drug is associated with nephrolithiasis?
Indinavir
77
MOA of Telbivudine/Zidovudine/Stavudine?
Thymidine NUCLEOSIDE ANALOGUE that inhibits the replication of hepatitis B
78
Diagnosis of Brucellosis?
- Rose Bengal plate is a rapid screening tool but not diagnostic - BRUCELLA SEROLOGY is mainstay of diagnosis - Blood/bone considered in some patients
79
TTT of Brucellosis?
-DOXYCYCLINE 6 weeks + RIFAMPICIN 6 weeks - Doxycycline (6 weeks) + streptomycin (for first 2–3 weeks) if rifampicin is unsuitable
80
Stain to reveal Cryptosporidium?
Ziehl-Neelsen stain
81
TTT of Cysticercosis?
Bendazoles
82
Prophylaxis of malaria in pregnant women?
- Chloroquine - Proguanil but folate supplementation must be given - Malarone-Proguanil should be avoided, but if necessary, give folate
83
Management of genital herpes in pregnancy?
Risk transmission is low - Elective caesarean if episode occurs at >28weeks Supressive therapy with Aciclovir in recurrent herpes
84
MOA of Oseltamivir?
Neuraminidase inhibitor
85

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