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Infectious Diseases Flashcards

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1
Q

C. diff:

A

> 70 years, past C. diff, use of abx, antiperistaltic drugs

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2
Q

Staph aureus:

A

food, 1-6 hours after eating, last less than 12 hours

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3
Q

Vibrio cholera:

A

rice water diarrhoea, poor sanitation, shock

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4
Q

E. coli:

A

leafy vegetables

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5
Q

Bacillus cereus:

A

reheated rice, can cause cerebral abscess

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6
Q

Salmonella:

A

eggs, might also have constipation, multiplies in Payer’s patches of the intestine

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7
Q

Organisms which can cause diarrhoea and dysentry

A

salmonella, campylobater, c diff, Eoli (haemorrhagic or non)

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8
Q

Diarrhoea only

A

Staph A, Vibro Cholera, E coli, Bacillus Cereus

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9
Q

Campylobacter:

A

uncooked poultry

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10
Q

(Haemorrhagic) E. coli:

A

leafy vegetables

bloody diarrhoea followed by haemolytic uraemic syndrome then it is EHEC

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11
Q

Entamoeba histolytica:

A

poor sanitation, tropical places, MSM(direct or indirect oral anal contact)

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12
Q

Shigella:

A

person-to-person contact, travel in areas with poor sanitation, MSM

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13
Q

Polymorphs seen

most commonly neutrophils

A

Campylobacter
E. coli
Shigella

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14
Q

No polymorphs

A

Salmonella
E. coli
C. difficile

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15
Q

Antivirals (oseltamivir) if

A 
>65
Pregnant
Diabetes
Immunosuppressed
>40 BMI
Chronic disease
*prophylaxis
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16
Q

Malaria Px

A

Presentation
Fever paroxysms
Cold stage (<1h) – shivering, feeling cold
Hot stage (2-6h) – 41C, flushed, dry skin, N&V, headache
Sweats (3h) – as temperature falls

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17
Q

pattern to fever spikes, especially initially

A

Falciparium Malarium

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18
Q

Ix for malaria

A 
Serial thin &amp; thick blood films
Rapid stick tests are available if microscopy cannot be performed
Others
FBC – anaemia, thrombocytopenia
Clotting
Glucose
ABG – lactic acidosis
U&amp;E – renal failure 
Urine analysis – haemoglobinuria, proteinuria, casts
Blood culture – rule out septicaemia
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19
Q

Tx for malaria

A

Treatment
Chloroquinine 1st choice
Resistance is spreading
Prophylaxis good, but not full protection

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20
Q

Varicella Zoster Virus is which HSV and what does it cause?

A

HSV III

chicken pox and shingles

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21
Q

How contagious is chicken pox

Study These Flashcards
A

Incubation – 11-21 days

Infectious period – 4 days before rash till all lesions scabbed

22
Q

Px of chicken pox

Study These Flashcards
A

Prodrome of nausea, myalgia, anorexia
On examination
Fever
Rash: small erythamatous macules which progress to papules in 12-14 hours. Crusts develop after 5 days, and crusts fall off 1-2 weeks
Common in children
In adults the fever is prolonged and the rash more widespread

23
Q

When do you manage chicken pox

Study These Flashcards
A

Oral aciclovir for an immunocompetent adult or adolescent

24
Q

Complications of chicken pox

Study These Flashcards
A

Complications
DIC
Pneumonitis
Ataxia

25
Shingles presentation
Prodrome of abnormal sensation and pain in dermatomal distribution, maybe headache, malaise, fever Characterised by unilateral rash – vesicular lesions in same dermatomal distribution (normally T1 – L2). Crust in 7-10 days, heal in 2-4 weeks Neuritis – neuralgic pain over the same area
26
Tx of shingles
Information & advice Start oral aciclovir within 72 hours of rash onset for people aged >50, or who are immunocompromised, non-truncal involvement, or moderate pain/rash Treat pain – paracetamol
27
How does bacterial meningitis cause death?
Cerebral Odema Raised intracranial pressure Death
28
Most common bacterial meningitis
Step Pneumoniae | Neisseria Meningitidis
29
Meningitis Buzz Words | Streptococcus pneumonia
G+ve cocci, elderly
30
Meningitis Buzz Words | Neisseria meningitides:
G-ve diplococci
31
``` Meningitis Buzz Words Listeria monocytogenes (neonates/elderly): ```
Cheese/unpasteurised milk, alcoholics
32
``` Meningitis Buzz Words Haemophilus influenzae (children): ```
Unvaccinated children
33
Meningitis Buzz Words | Group B streptococcus (neonates):
Extended labour, infection in prev. pregnancy
34
Meningitis Buzz Words | Mycobacterium tuberculosis:
Chronic infection. Also, results of CSF sample.
35
``` Meningitis Buzz Words Escherichia coli (neonates): ```
Late neonatal infection
36
Kernig’s sign:
with the patient supine and the thigh flexed to a 90° right angle, attempts to straighten or extend the leg are met with resistance
37
Brudzinski's signs:
flexion of the neck causes involuntary flexion of the knees and hips, or passive flexion of the leg on one side causes contralateral flexion of the opposite leg.
38
Non blanching pupuric Rash
Bacterial Meningitis: Classically due to meningococcal septicaemia. N. meningitides releases an endotoxin which initiates the clotting cascade leading to disseminated intravascular coagulation. Clotting factors are used up, there will be bleeding, and this leads to the purpuric rash. Eventually there will be signs of shock, and then death. If there is a non-blanching rash, this is an emergency.
39
Viral causes of meningitis
Commonly enterovirus, influenza and HSV | Enterovirus can also give non blanching rash
40
What to ask for in an LP for meningitis
``` Cell count and differential Protein concentration Glucose concentration Culture and gram stain TB PCR (if TB is suspected) Cryptococcal/histoplasmosis antigen test (if fungi suspected) ```
41
When are lumbar punctures contraindicated?
Signs of raised intracranial pressure (seizures, frequent vomiting, papilloedema Superficial infection at the LP site Coagulation abnormalities This includes meningococcal septicaemia
42
What tests to do if LP is contraindicated in meningitis?
CT scan – Perform is raised intracranial pressure is suspected For example, if there are seizures Bloods – Perform if there is coagulation, or LP will be delayed. FBC/CRP– Perform to confirm infection Meningococcal PCR – Perform to exclude meningococcal sepsis. Culture
43
Tx of meningitis:
For older children and adults the initial broad spectrum antibiotics regimen is: Ceftriaxone with or without dexamethasone
44
CSF: turbid Glucose: decreased WCC: neutrophils Protien: increased lots
Bacterial
45
CSF: clear/cloudy Glucose: normal WCC: lymphocytes Protien: increased
Viral
46
CSF: clear/cloudy Glucose: decreased WCC: lymphocytes Protien: increased
TB/Fungal
47
HIV Ix
Investigations - CD4 count - HIV RNA - HIV antibodies - FBC - U&E - LFT
48
Candida Albicans Px
1. Oral candidiasis, dysphagia Tx – Nystatin suspension (1mL swill and swallow) 2. Pneumonia 3. Infective endocarditis 4. Vaginal candidiasis (thrush) – discharge, vagina may be red, fissured, sore Risks – pregnancy, immunodeficiency, diabetes, Abx Tx – Clotrimazole vaginal pessary + cream for vulva 5. Urethritis 6. Systemic candidiasis, sepsis Consider this with PUO, candida UTI in DM Tx – Fluconazole
49
CT – characteristic multiple ring-shaped contrast enhancing lesions
Toxoplamsmosis | Most common cause of intracranial mass in HIV
50
HHV 8
Causes Kaposi’s sarcoma in immunocompromised Px : papules or plaques on skin and mucosa (any organ) Metastasizes to lymph nodes Visceral KS can be aggressive – lung (dyspnoea, haemoptysis), bowel (nausea, abdominal pain), rarely CNS, eye, breast, biopsy sites Tx : optimise HAART, cryotherapy, chemotherapy, radiotherapy
51
EBV – Infectious mononucleosis O/`E
Presentation: Sore throat, fever, fatigue, headache, malaise, anorexia, sweating, abdominal pain Examination Inflamed tonsils with exudates Cervical lymphadenopathy Splenomegaly, hepatomegaly (jaundice)
52
EBV Ix and Tx
Investigations Monospot test – heterophile antibodies Throat swab IgM or IgG EBV viral capsid antigen – present during clinical illness IgG against EBNA – appear 6-12 weeks after onset of symptoms FBC, U&E, LFT Management: Rest, paracetamol, NSAIDs

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