Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

taz- year 3 med > infectious diseases > Flashcards

infectious diseases Flashcards

(93 cards)

Start Studying
1
Q

what are some common bacteria that can cause soft tissue/skin infections

A

Staphylococci – Staph. aureus

Streptococci (e.g. Group A Strep)

MRSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what abx would you use for a staph or a strep skin infection? what would you use if you had an allergy

A

Staphylococci- Flucloxacillin

Streptococci- Benzylpenicillin / Fluclox

If Penicillin allergy:

  • Tetracycline (doxycycline)
  • Carbapenem(eg meropenem)
  • Cephalosporin(eg ceftriaxone)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what abx would you use for a MRSA skin infection

A

Glycopeptide (eg vancomycin, teicoplanin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are some common respiartory disease causing bacteria and what abx would you use for them

A

Streptococci (S. pneumoniae)- Penicillin (Amoxicillin) Macrolide (eg erythromycin, clarithromycin)

H. influenzae- Co-amoxiclav (amox + clavulinic acid)

“Atypical” (Legionella, Mycoplasma)- Doxycycline Fluroquinolone/FQ (eg levofloxacin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what abx do you use for Salmonella spp. (S. typhi /paratyphi)

A

Ceftriaxone/azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what abx do you use for C. difficile

A

PO Metronidazole/Vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what abx would you use for Visceral infection/peritonitis (Usually Enterobacteriacae)

and how would you add aerobic cover

what would you give if there was a penicillin allergy

A

Co-amox OR cipro OR aminoglycoside (eg gentamicin)

Metronidazole / Co-amox
for Anaerobic cover

Carbapenem If severe infection / penicillin allergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what abx would you use for Gonorrhoea (N. gonorrhoea)

A

IM/IV Ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what abx would you use for Chlamydia trachomatis

A

Azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what abx would you use for Neisseria (N. meningitidis)

A

Ceftriaxone/Cefotaxime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what medication would you use for Herpes simplex virus (encephalitis)

A

IV Aciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are some common conditions for fever in returning travellers

A

malaria, dengue fever, and typhoid (enteric) fever.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how would you investigate fever in returning travellers

A
  • Exclude malaria in all travelers from the tropics
  • Exclude HIV in all
  • Most travellers have self limiting illnesses that could have been acquired in the UK. Look for tropical infection but font forget your usual differentials.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what differentials should you consider for fever in returning travlers in these time frames

  • 0-10d:
  • 10-21d:
  • > 21d:
A

0-10d: Dengue, rickettsia, viral (incl infectious mononucleosis), gastrointestinal (bacterial/amoebea)

10-21d: Malaria, typhoid, primary HIV infection

> 21d: Malaria, chronic bacterial infections (eg brucellosis, Coxiella, endocarditis, bone and joint infections); TB, parasitic infections (helminths/ Protozoa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is a fever in returning trailer till proven otherwise

A

Malaria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how is malaria spread

A

Transmission occurs through the bit of an infected Anopheles mosquito. Only female mosquitoes transmit Plasmodium as only females require a blood meal for egg development. Transmission in the absence if a mosquito is rare; vertical (congenital transfer from mother to child), transfusion, rogan transplantation, needle sharing.
• P. Falciparum results in the most serious illness. Approx 90% of malaria cases originate in africa. Other common species: P.vivax, P.ovale (most SE Asia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the clinical features of malaria

A

consider in anyone with a fever which has previously visited a malarial area.
• presentation: abrupt onset of rigours followed by high fevers, malaise, severe headache and myalgia, vague abdominal pain, nausea and vomiting, diarrhoea may occur in up to 25% of pt.
• Examination: fever, otherwise unremarkable. If diagnosis is delayed or severe disease then may present with jaundice, confusion, seizures, pallor due to anaemia and hepatosplenomegaly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how does malaria present

A
  • travel history to area of high humidity, rural location, cheap accom, outdoors at night roughly 2 weeks ago
  • non specific symptoms: fever, chills, headaches, cough, myalgia, GI upset
  • signs: hepatomegaly, jaundice, abdo tenderness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are features of late/ severe malaria?

A

Impaired consciousness, SOB, bleeding, fits, hypovolaemia, hypoglycaemia, AKI, resp distress syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 3 causative organisms of malaria and what are their incubations?

A

Plasmodium falciparum: 7-14 days (most common in africa)
Plasmodium vivax: 12-17 days w/ relapses common due to dormant parasites in liver
Plasmodium ovale: 15-18 days, also relapsing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How should suspected malaria be investigated?

A
  • 3x thick and thin blood films with giemsa stain
  • rapid antigen test
  • FBC, U&E, LFT, G6PD activity (prior to giving primaquine), blood glucose, gases, clotting, lactate (if severe)
  • head CT
  • CXR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How is p. falciparum treated?

A

IV quinine initially (needs ECG monitoring) then oral quinine and doxy for 7 days when they can swallow.
Supportive treatment also

Sulphate and Doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is p vivax and ovale malaria treated?

A

Cholorquine (3-4 days) and primaquine (14 days)

Supportive treatment also

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are some complications of malaria

A
  • Disseminated Intravascular Coagulation
  • Cerebral malaria confusion, fits, coma
  • ARDS
  • Blackwater Fever (IV Haemolysis dark urine) -> Renal failure + Lactic acidosis
  • Hypoglycaemia (<2.2)
  • Shock – rarely occurs in malaria (‘Algid Malaria’) should prompt suspicion of concurrent sepsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
how is Typhoid fever (also known as enteric fever) transmitted
Typhoid fever is a potentially fatal multisystem illness caused primary by Salmonella typhi and paratyphi. It is transmitted by the faecal-oral route.
26
How does typhoid present? What is the relevance of their tongue?
Gradually increasing fever, malaise, headache, dry cough, abdo pain, diarrhoea, furred tongue with red edges and tip, bradycardia
27
What organism causes thyphoid, what is incubation period and how does it spread?
Salmonella typhi Incubation period is 10-20 days for S typhi and 1-10 days for S paratyphi Spreads through contaminated water and food
28
How is typhoid investigated?
- Blood cultures (gram neg bacillus) - FBC, U&E, LFT - blood films for malaria
29
How is typhoid managed? (4)
- IV ceftriaxone or azithromycin - steroids in severe disease - supportive - side room, PPE, careful handwashing and faeces disposal - surgery if bowl perforates
30
Give 3 signs characteristic of Typhoid Fever
Faget's Sign (Bradycardia and Fever) Rose Spots Hepatosplenomegaly
31
Define Pyrexia of Unknown Origin
Temperature more than 38 degrees on more than one occasion Illness>3 weeks duration No diagnosis despite 1 weeks worth of inpatient
32
Categories of causes of PUO include Infective/Autoimmune/Neoplastic and Other. Give 2 examples of each.
Infective - TB, Brucellosis (slow growing) Autoimmune - Temporal Arteritis, Wegener's Granulomatosis Neoplastic - Leukaemia, Lymphoma Other - Thromboembolism, Hyperthyroidism
33
How is TB spread?
Aerosol inhalation causing pulmonary infection and subsequent haematogenous spread
34
What is the Quantiferon test?
Assesses the amount of interferon gamma released from T cells when exposed to mycobacterium CANNOT differentiate between active and latent
35
What is the T Spot test?
Same principle as Quantiferon test but tests an individual T lymphocyte (good for immunosupressed patients)
36
How is latent TB treated?
Not treated if over 35 usually (high risk of hepatotoxicity) | 3 months Rifampicin and Isoniazid OR 6 months isoniazid
37
Give 4 symptoms of active TB
Non resolving cough Weight loss Night sweats Haemoptysis
38
Describe 3 features seen on a TB XRay
Mediastinal lymphadenopathy Cavitating Pneumonia Pleural Effusion
39
What would be seen on a CT scan of TB?
Lymphadenopathy (often with central necrosis)
40
How would you aim to take a biopsy from a suspected pulmonary TB patient?
FIrst try a sputum sample If the sputum sample is negative then proceed to bronchoscopy/EBUS to take sample from pulmonary lymph nodes (caseating granulomatous inflammation)
41
What would you see on the lumbar puncture of meningeal TB?
Inreased lymphocytes HIGH protein Low glucose
42
What is the paradoxical reaction in TB?
As bacteria die there is an increase in inflammation causing worsening symptoms Steroids are initiated if this is in a place where an increase in inflammation would not be tolerable (eg CNS)
43
Describe the treatment plan for Active TB
2 months of Rifampicin/Isoniazid/Pyrazinamide/Ethabutol along with Pyridoxine 4 months of Rifampicin/Isoniazid plus Pyridoxine
44
Name 2 side effects of Rifampicin
Orange Urine | Drug induced hepatitis
45
Name 3 side effects of Isoniazid
Peripheral Neuropathy (vit B deficiency) Colour Blindness Drug induced hepatitis
46
Name a side effect of Pyrazinamide
Drug induced hepatitis
47
Name a side effect of Ethambutol
Reduced visual acuity
48
Give three features of infection control in TB
Contact tracing Nursed in a side room until they've had atleast two weeks of treatment Wear a mask if giving aerosol treatment such as nebuliser
49
What extra is needed to treat TB if there is pericardial, meningeal or spinal involvement?
steroids- the start of the anti TB meds will cause bacteria death and inflammation which will be bad in these places
50
How should suspected HIV be investigated?
- HIV test (antigen and antibody testing, positive a few weeks after infection and get results on same day) - CD4 count - HIV viral load (PCR) - HIV resistance profile - syphillis and hep abc serology - routine bloods - taxoplasma, measles, varicella and rubellla IgG - TB cultures often
51
Name 4 conditions and infections associated with severe HIV infection?
- kaposi sarcome - TB - PCP (pneumocystis jiroveci pneumonia) - taxoplasmosis - CMV - lymphoma - herpes - candida - cryptococcal meningitis
52
How is HIV managed?
Nucleoside receptor transcriptase inhibitor x2 (tenofovir, lamivudine) + non NRTI or protease inhibitor or integrase inihbitor or CCR5 (entry) inhibitor AND hep B, pneumococcal and flu vaccines AND co trimoxazole for PCP prophylaxis if your CD4 is <200 AND opthalmology assesment for CMV retinitis if your CD4 count is <50 Also education about condoms etc is important
53
Describe the pathophysiology of HIV in four steps
1) HIV binds to CD4 receptors on T cells 2) HIV uses reverse transcriptase to bind to host DNA 3) DNA replication 4) Causes inflammation and spreads to other tissues
54
How is HIV transmitted
bodily fluids
55
Give 5 symptoms of primary HIV
``` Flu like Maculopapular Rash Myalgia Lymphadenopathy Weight Loss ```
56
Describe the 5 stages of HIV in terms of CD4
``` Primary - Normal CD4 Stage 1 - >500 CD4 Stage 2 - <500 CD4 Stage 3 - <350 CD4 Stage 4 - <200 CD4 (AIDs Defining) ```
57
How is meningitis investigated?
- lumbar puncture if no signs of raised ICP (ZN stain, cytology, virology, glucose, protein, culture PCR) - FBC, CRP, coag, culture, glucose, gases, U&E, lactate, meningococcal and pneumococcal PCR - throat swabs - sometimes a CT scan
58
How is meningitis without signs of shock, severe sepsis or signs suggesting brain shift managed?
- dexamethoasone 10mg IV - ceftriaxone IV - careful fluid restriction - Follow SEPSIS6
59
What signs suggest raised ICP and so you should delay Lumbar puncture in meningitis?
- severe sepsis or rapidly evolving rash - severe resp/ cardiac compromise - focal neurological signs - papillodema - continuous or uncontrollable seizures - GCS<13
60
List 5 potential complications of meningitis
septic shock, DIC, septic arthritis, haemolytic anaemia, pericardial effusion, subdural effusion, SIADH, seizures, hearing loss, cranial nerve dysfunction
61
Describe the pathophysiology of Meningitis
Inflammation of the leptomeninges (arachnoid and pia) by virus/bacteria/non infective causes
62
Give four risk factors for Meningitis
Young Age Immunosupression Crowding Spinal Procedures
63
Name the causative organisms of bacterial meningitis in neonates
Group B Strep | E.Coli
64
Name the causative organisms of bacterial meningitis in adults
Haemophilus Influenza Strep Pneumoniae Neisseria Meningitidis
65
Name the causative organisms of bacterial meningitis in the elderly
Strep Pneumoniae
66
What is Aseptic Meningitis? Give 4 examples
When no bacteria can be cultured | Viral Infections, Fungal Infections, TB, Partially treated meningitis
67
Give 4 causes of non infective Meningitis
Malignant Cells (Leukaemias, Lymphomas) Medication (NSAIDs, Trimethoprim) Sarcoidosis SLE
68
Give 5 symptoms of Meningitis
``` Fever Nausea Headache Nuchal Rigidity Photophobia ```
69
Describe the management of viral Meningitis
Supportive | IV Aciclovir if Herpes Simplex Virus is suspected
70
Describe the management of bacterial Meningitis
Supportive | IV Ceftriaxone AND Dexamethasone
71
How does dengue fever present?
- abrupt onset high fever, severe headache behind eyes, myalgia, N+V, abdo pain - macropapular blanching trunchal rash - signs of bleeding, organ failure, hypovolaemia in severe disease
72
What countries is dengue common in and how long is the incubation period?
africa/ thailand/ americas 4-10 day incubation carried by day biting mosquito
73
How is dengue investigated?
- FBC (high PCV, low platelets, leukopenia), clotting studies (prolongs APTT and PT), U&Es, LFTs - Serum IgM and IgG antibody detection by ELISA - CXR if pleural effusion suspected - blood cultures - malaria film
74
How is dengue managed?
- All supportive: - Fever control w/ paracetamol/ tepid sponge/ fans - Iv fluid resus and fluid balance monitoring - haemorrhage and shock require FFP, platelets and sometimes infusion - severe dengue may need ITU
75
Hep A is an RNA virus, how is it spread? What is the incubation period?
Faecal - Oral spread or by shellfish | Incubation period is 2-6 weeks
76
Name four risk factors for Hepatitis
Personal contact IVDU MSM Health workers
77
Give 5 symptoms of Hepatitis A
``` Nausea Malaise Arthralgia Jaundice Pale Stools/Dark Urine ```
78
What investigations would you do for Hepatitis A, and what would they show?
Immunoglobulins (raised IgG for acute infection) LFTs (ALT raised, potential damage to synthetic function) USS to exclude other diagnoses
79
How is Hepatitis A managed?
``` Supportive Avoid alcohol Vaccine available (works for one year or twenty with booster) ```
80
Hep B is a DNA virus, how is it spread? What is it's incubation period?
Spread by blood products, sexual contact or vertically | Incubation is 1-6 months
81
Give 6 symptoms of Hep B
``` Nausea Malaise Arthralgia Urticaria Jaundice RUQ Ache ```
82
Describe the following Hep B Serology: HbsAg, HbeAg, Antibodies to core antigen, Antibodies to surface antigen
HbsAg - present 1-6 months after exposure (if persists past 6 months then it is chronic) HbeAg - present 1.5-3 months after exposure (implies high infectivity) Antibodies to core antigen imply past infection Antibodies to surface antigen imply vaccination
83
Describe the management of Hep B
Supportive Immunise sexual contacts Any signs of chronic liver inflammation - 48/52 of retrovirals such as Peginterferon Alfa-2a
84
State two complications of Hep B
Cirrhosis | Hepatocellular Carcinoma
85
Hep C is a RNA virus, how is it spread? What is its incubation period?
Spread is via IVDU, Blood Transfusions and Sexual | Incubation is 6-9 weeks
86
How would acute Hep C present?
Often asymptomatic, may just be jaundiced
87
How would chronic Hep C present?
Over 80% of cases are chronic | Malaise, Weakness, Anorexia
88
Name three possible investigations for Hep C
LFTs PCR of the virus to confirm ongoing infectivity If PCR +ve then do a liver biopsy to assess damage
89
Describe the management of Hep C
Stop alcohol/smoking Start anti-virals NO VACCINE AVAILABLE
90
What is Hep D?
A co - infection for Hep B (as it is an incomplete RNA virus)
91
How would you investigate Hep D?
You would test for Anti Hep B antibody, and then if that was positive, proceed to do the Anti Hep D antibody
92
How would you manage Hep D?
Peginterferon Alfa-2a has limited success so a liver transplant may be required
93
Describe three features of Hep E's pathophysiology/epidemiology
RNA virus similar to Hep A Common in Indochina Associated with pigs

taz- year 3 med (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions