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Infectious diseases 2 Flashcards

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1
Q

What tests should be done into TB?

A

Bloods:

  • FBC
  • CRP
  • U&Es
  • LFTS

**HIV test

Orifices:

  • sputum smear - Ziehl Neelsen stain
  • 3 samples
  • Early morning
  • Acid fast Bacilli *if positive should start treatment
  • Sputum Culture
  • 1-3 weeks to grow

X-ray:
- CXR

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2
Q

Complications of TB?

A

Massive haemoptysis
Cor Pulmonale
Bronchiectasis

Enteritis
Pericarditis
Pott’s disease
Anorectal disease - due to swallowed sputum

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3
Q

After a diagnosis of TB - who should be contacted?

A

Public health - TB is a notifiable disease

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4
Q

What are some of the complications of Malaria?

A

Severe anaemia

Intracerebral anaemia

Shock
- AKI

Hypoglycaemia

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5
Q

What would you expect the bloods to be in malaria?

A

Anaemia
Thrombocytopenic
Parasitaemia
Deranged coagulation

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6
Q

What are the symptoms for croup and how is it managed?

A

*caused by parainfluenza virus

Barking cough
Difficulty breathing
Hoarse voice
Males

Treatment:

  • Steroids
  • Supportive

Severe:

  • Nebulised Adrenaline
  • Oxygen therapy
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7
Q

What are the symptoms of viral pharyngitis?

A 
Sore throat 
Hyperaemia of adenoids 
Coryzal symptoms 
Hoarseness to voice 
Dysphagia
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8
Q

What is the management for epiglottitis?

A

Caused by: H.Influenza

FBC
Blood Cultures
laryngoscope

Treatment:

  • oxygen
  • IV Ceftriaxone + Clindamycin
  • Nebulised Adrenaline
  • Inhaled corticosteroids
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9
Q

What are the antibiotics given for Necrotising Fasciitis?

A 
Benzylpenicillin
Flucloxacillin
Gentamicin 
Metronidazole 
Clindamycin
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10
Q

How is the urine sample collected for STI from men?

A

First void urine

- which is then sent for NAAT

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11
Q

What are the symptoms of chlamydia in women?

A 
Dysuria 
Clear discharge from the vagina 
Bleeding between periods 
Dyspareunia
Prostatitis
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12
Q

What are the symptoms of chlamydia in men?

A

Dysuria
Watery discharge of penis
Pain in the testicles

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13
Q

What are some of the complications of gonorrhea?

A

Septic arthritis

Gonococcal conjunctivitis

Pelvic inflammatory disorder

Urethral strictures

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14
Q

What are the complications of TB:

A

Cervical lymphadenopathy

TB meningitis

Intestinal TB

Adrenal TB - hypoadrenalism

Kidney TB
- sterile pyuria

Peritoneal - TB ascites

Testicular infiltration
- infertility

Aspergilloma formation
- invades into the TB cavity

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15
Q

What are the diagnostic tests for TB?

A

Ziehl Neelsen Stain

Cultures
- 10 weeks

Liquid media Based radiometric assays
- picks up the metabolic activity of TB

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16
Q

What drug must be given with isoniazid?

A

Vitamin B6

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17
Q

If you are giving Rifampicin and patient is on warfarin, what do to do?

A

Rifampicin is an Inducer and thus will break down warfarin

- higher doses are needed

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18
Q

Which TB drug can cause vision defects including vision colour changes?

A

Ethambutol

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19
Q

What radiological signs may you see on x-ray of pneumonia?

A

Consolidation

Air-bronchograms (where the bronchi passess throughthe aveoli with high amount of fluid in them)

Pleural effusions

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20
Q

What are the types of pneumonia?

A

CAP
HAP
Aspiration
Ventilator associated

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21
Q

What are the risk factors for pneumonia?

A 
Influenza 
Alcoholics
Smokers 
<5 years old, >65 years 
Previous pneumonia 
Chronic lung disease 
Neurological pneumonia
Immunosuppressed
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22
Q

What are the systemic signs of pneumonia?

A 
Fever 
Herpes labias - known to reactivate 
Shock 
Central cyanosis 
AF
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23
Q

Whilst monitoring a patient with pneumonia, they are not improving, what should you do?

A

• Repeat Chest x-ray
• Tap any pleural effusions
• Re-culture for resistance organisms
- Reconsider diagnosis

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24
Q

Following a pneumonia and a patient deteriorates again what things may have caused the complication?

A

Empyema

Cellulitis
- from where the IV line was in

C. Diff

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25
What is a differential for cellulitis?
Erysipelas
26
What are some complications of cellulitis?
Sepsis Endocarditis Necrotizing fasciitis
27
What are some complications of Infectious mononucleosis?
Splenic rupture Malignancy - Lymphoma Encephalitis
28
What type of vaccine is the BCG and who is it offered to?
Live attenuated vaccine with M. Bovis Offered to those at risk: - children with positive mantoux parents It doesn't prevent pulmonary TB but prevents extrapulmonary and meningitis
29
When taking a history from a patient with a fever after traveling, what questions do you want to ask?
Location - risk of certain infections Travel dates - malaria etc usually presents 1 month later Activities while away - out in the open? - water? Prophylactic medication prior - use of nets - DDT Past medical history Viral hemorrhagic risk
30
What are the varying types of necrotizing fasciitis?
Type I: polymicrobial Type II: haemolytica Step A Type III: Marine Type IV: Fungi
31
What are some complications of HSV-1?
Herpetic Keratitis - eye ulceration Encephalitis Bell's palsy Herpetic whitlow
32
What are the complications of chickenpox?
Pneumonia - 1-6 days after infection Bacterial super-infection of the skin Dissemination and spread to internal organs - especially in immunocompromised host Encephalitis *risk to pregnant women
33
How is VZV tested for and how is it treated?
Tzanck test PCR testing Serology Treatment: - Aciclovir >16 years old + IgG immunoglobulins (zoster Immunoglobulins) - for immunocompromised Pregnancy: <20 weeks: IgG immunoglobulins >20 weeks: Aciclovir *must be given 7 days after exposure
34
What is the classic triad of symptoms of EBV?
Headache Malasia Sore throat Lymphadenopathy + Palatal Petechiae Macular rash (usually due to penicillin use)
35
Complications of EBV:
Guillain Barre syndrome Splenic rupture Encephalitis Lymphoma
36
What is the recommended antibiotic for enteric fever?
Ciprofloxacin
37
How many a child have a positive HIV antibody but not be HIV infected?
IgG antibodies from the mother can cross the placenta
38
List some AIDs defining illnesses:
Candidiasis of esophagus/ Bronchi CMV Kaposi's sarcoma Primary lymphoma - especially of brain Disseminated TB Pneumocystis Jiroveci
39
List some effects of HIV:
Neurological: - AIDS Dementia Complex - Neuropathies Mucocutaneous Manifestations: - maculopapular rash - Puritiis Haematological: - Lymphopenia - isolated thrombocytopenia G.I: - malabsorption Renal: - HIV nephropathy - Nephrotic syndrome Cardio: - cardiomyopathy
40
What is the natural history of HIV?
Initial infection: usually asymptomatic Seroconversion: - fever - maculopapular rash etc Asymptomatic phase: - usually have persistent generalised lymphadenopathy AIDs related Complex - prodromal features: weight loss, night sweats, HSV AIDs - AIDS defining features - CD <200
41
Name a nucleotide reverse transcriptase inhibitor and non nucleotide reverse transcriptase inhibitor
Truvada (combination) Efavirenz
42
What can cause a false positive for HIV test and how is it confirmed?
Lupus Syphilis Western blot can confirm diagnosis
43
What screening test can be done into HIV?
Rapid HIV testing - needs follow up with ELSIA testing ELSIA involves: - p24 - HIV antibody
44
What is the confirmatory test done for HIV?
Western Blot test
45
Practical points in the Anti-retroviral drugs for HIV:
Must be taken as prescribed Should not be stopped suddenly Can be compromised by other drugs such as inducers and herbal medicines - Rifampicin - St John's wort Associated with adverse drug reactions May exacerbate comorbidities
46
Complications of HAART therapy?
Allergic reactions Lipodystrophy and metabolic syndrome Mitochondrial
47
How is pneumocystis Jiroveci diagnosed?
High resolution CT conformation: - Bronchoalveolar lavage - Blood test for PCR of pathogen DNA
48
What are some specific illnesses to complicate HIV?
Pneumocystis Jiroveci CMV - retinitis Toxoplasmosis Cryptococcal meningitis - headache - papilloedema Progressive multifocal leukoencephalopathy - JC virus Kaposi sarcoma - HHV8
49
What are some complications of Gonorrhoea?
``` Prostatitis Epididymitis Reactive arthritis Septic arthritis PID ```
50
How is syphilis diagnosed?
Serology for antigens - Group Specific: TPHA - Non specific: Cardiolipin, VDRL, RPR *group specific always positive, non-specific should go down with treatment. Dark Field microscopy
51
What are some differentials for malaria?
Dengue fever Yellow fever Pneumonia Enteric Fever
52
What is the granuloma called in TB and what is it called when the lymph node is attached? and what is it called when its scared over?
Ghon focus Ghon Complex Ranke Complex
53
What are the treatment options for Flu and how are they delivered?
Oseltamivir - Oral - 5 days Zanamivir - Nasal spray - 5 days
54
What are some of the complications of flu?
Febrile seizures - in children Secondary bacterial pneumonia Viral pneumonia Encephalitis Croup
55
What are some common causes of a fever of unknown origin:
Usually defined as >38C for >3 weeks Infections Cancer - leukemia Autoimmune/ vasculitis * Adult's still disease - this is a disease of exclusion and characterised by: - myalgia - lymphadenopathy - splenomegaly
56
List some causes of a fever:
``` Infection Cancer Drug abuse - amphetamines VTE Trauma/ Surgery Heat stroke Epilepsy ```
57
What are the differentials for meningitis?
Migraine SAH Dengue fever Malaria Encephalitis
58
What should you do when doing an LP during meningitis?
Record opening pressures. | - they will be elevated
59
What are some poor prognostics of bacterial meningitis?
Pneumococcal Lowered GCS >60 years old Focal neurological signs
60
What further test should be conducted on those who suffered from meningitis after the infection has settled?
Pure tone Audiometry test
61
What are some of the signs seen on MRI of toxoplasmosis infection?
Enhancing ring lesions patients present with: - headache - focal neurological - confusion
62
What is the pathogen which causes cholera? and list some complications:
Vibro Cholera Dehydration Electrolyte disturbance Replaced needs: - fluids - sodium correction - K+ - glucose
63
List some specific intracerebral complications associated with HIV infection:
Toxoplasmosis Gondi - most common cause and will present with raised intracranial pressure Crytococcal Mengitis HIV encephalopathy Progressive Multifocal leukoencephalopathy - caused by the JC virus
64
What are the complications of Hepatitis B?
Hepatocellular carcinoma Fulminant disease Polyarteritis nodosa Chronic Hep B
65
List some features present in trichomonas vaginalis to help distinguish it from bacterial vaginosis:
Frothy yellow discharge Strawberry cervix Vulvovaginitis
66
Which set of infections present in a very similar way to EBV infection?
``` CMV Toxoplasmosis HIV - pharyngitis - lymphadenopathy - splenomegaly - fever ```
67
What does Entamoeba histolytica cause and why may it cause shoulder tip pain or fullness?
Causes Amoebiasis - can cause liver abscess formation which leads to liver enlargement causing diaphragmatic irritation * require US and biopsy of cysts
68
Schistosomiasis:
Infection caused by swimming infected water. Presents: 1. Swimmers wash - pruritic rash initially 2. 4 weeks later: - Asthma like fevers - Diarrhoea - Eosinophilia - Hepatomegaly - urticaria Diagnosis: - urine sample for ova - serology Treatment: - Praziquantel Complication: - bladder cancer - squamous type

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