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Infectious diseases Flashcards

(56 cards)

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1
Q

Gram positive bacteria (peptidoglycan cell wall staining)

A

Streptococci
Staphylococci
Enterococci
Clostridium

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2
Q

Gram negative bacteria

A 
Neisseria 
H. pylori
Escherichia coli 
Shigella, Salmonella, Campylobacter
Haem influenzae
Bordetella pertussis
Cholerae
Yersinia pestis
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3
Q

Cocci shape

A

Round

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4
Q

Bacilli

A

Rod shaped

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5
Q

Risk factors for latent TB reactivation

A 
Immunosuppression 
Organ transplant
New infection 
HIV
Malnutrition
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6
Q

Testing times for HIV

A

Most should be picked up 4-6 weeks after exposure (p24 antigen from 1-4 weeks)
Testing again at 12 weeks will confidently exclude the diagnosis (99% have HIV antibodies at 12 weeks)

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7
Q

Treatment of pneumocystis jiroveci

A

Co-trimoxazole

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8
Q

Chancroid features

A

Painful genital ulcers associated with unilateral painful inguinal lymphadenopathy
Ulcers have sharp jagged borders

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9
Q

Causes of genital ulcers

A 
Herpes simplex (type 2)
Syphilis
Chancroid
Lymphogranuloma venereum- chlamydia trachomatis 
Behcet's disease
Carcinoma
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10
Q

Antibiotics for acute pylonephritis

A

Broad spectrum cephalosporin or quinolone (ciprofloxacin)

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11
Q

Antibiotics for acute prostatitis

A

Quinolone or trimethoprim

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12
Q

Treatment for throat infections and acute sinusitis

A

Phenoxymethylpenicillin

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13
Q

Antibiotics for otitis media

A

Amoxicillin (or erythromycin)

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14
Q

Antibiotics for otitis externa

A

Flucloxacillin (or erythromycin)

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15
Q

Antibiotics for gonorrhoea

A

Stat dose of IM ceftriaxone

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16
Q

Antibiotics for chlamydia

A

Doxycycline or azithromycin

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17
Q

What is carcinoembryonic antigen CEA used for?

A

Tumour marker for several cancers

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18
Q

Clinical features of trichomonas vaginalis

A 
pH>4.5
Frothy green discharge
Strawberry cervix
Vulvovaginitis 
Asymptomatic or urethritis in men
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19
Q

Meningitis causing organisms from 0-3 months

A

Group B strep
E. coli
Listeria monocytogenes

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20
Q

Meningitis causing organisms from 3 months-6 years

A

Neisseria meningitides
Strep pneumoniae
Haemophilus influenza B

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21
Q

Meningitis causing organisms from 6-60

A

Neisseria meningitides

Strep pneumoniae

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22
Q

Meningitis causing organisms from 60+

A

Neisseria meningitides
Strep pneumoniae
Listeria monocytogenes

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23
Q

Most likely organism to cause central line infections

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A

Staphylococcus epidermis

24
Q

First line antibiotic for campylobacter jejuni if severe or patient is immunocompromised

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A

Clarithromycin

25
Klebsiella pneumoniae is classically seen in
Alcoholics
26
Prophylaxis for contacts of meningococcal meningitis
Ciprofloxacin or rifampicin
27
Diagnostic tests for latent TB
Tuberculin skin testing- Mantoux test- intradermal injection of purified protein leading to skin induration, size dependent on the positivity Interferon gamma release assays
28
Active pulmonary TB diagnostic tests
CXR- calcification, cavitation, typically upper lobe, miliary disease, effusion, lymphadenopathy Sputum smear- stained for acid-fast bacilli, early morning samply needed Sputum culture more sensitive but takes longer- can assess drug sensitvity NAAT
29
Treatment for TB
RIPE 2 months intensive with rifampicin, isoniazid, pyrazinamide and ethambutol 4 months continuation with rifampicin and isoniazid
30
Antivirals for influenza if high risk or complicated
Inhibitors of influenza neuraminidase Oseltamivir- first line Zanamivir
31
Prevention of HIV transmission
Sexual transmission- barrier methods PrEP and PEP- short term use of antiviral therapy before and after sexual or occupational exposure- can be given up to 72 hours after ART from 24 weeks gestation Neonatal PEP given from 4 weeks
32
Presentation of primary HIV infection
Typically 2-4 weeks after infection- acute retroviral syndrome/ seroconversion illness Fever, rash, myalgia, pharyngitis, mucosal ulceration, lymphadenopathy, headache, aseptic meningitis Persistent generalised lymphadenopathy
33
Treatment for pneumocystis jirovecii
Co-trimoxazole 21 day course
34
Complications of HIV
PCP pneumocystis jirovecii Candidiasis Cryptococcus neoformans (commonest systemic fungal infection in HIV) Toxoplasma gondii abscesses (commonest cause of intracranial lesions when CD4 count <200) CMV Cryptosporidium- chronic diarrhoea Kaposi's sarcoma- most common tumour in HIV and AIDS Lymphoma- non-Hodgkin's
35
Presentation of toxoplasmosis abscesses
Focal neurological signs and seizures, headache and vomiting if raised ICP Ring enhanced lesions on MRI
36
Presentation of Kaposi's sarcoma
Cutaneous or mucosal lesions- patch, plaque or nodular
37
Herpes encephalitis
Transfer of virus from the peripheries to the brain via neuronal transmission Fever, malaise, headache, nausea and then encephalopathy
38
Treatment for herpes simplex
Aciclovir | Will not prevent latent HS infection
39
When is VZV vaccine given?
70 to prevent shingles reactivation
40
Treatment of VZV
Aciclovir within 48hrs of rash | IV if pregnant, immunosuppressed or disseminated disease
41
Presentation of EBV
Infectious mononucleosis in 50% of infections in adults Fever, sore throat, anorexia, lymphadenopathy, palatal petechiae, hepatosplenomegaly, jaundice, malaise Resolution of symptoms usually within 2 weeks
42
Diagnosis of EBV
Blood film- lymphocytosis Monospot test- heterophile antibody test Serology- IgM to EBV viral capsid antigen, IgG if past infection
43
What is a nosocomial infection?
Healthcare associated
44
Three stages of syphilis
1) Painless chancre with central slough with defined rolled edges 2) Dissemination after chancre, maculopapular rash on soles and palms, mucous patches, fever, headache, myalgia, lymphadenopathy, hepatitis 3) 20-40yrs after infection, neurosyphilis, aseptic meningitis, focal neurology, seizures, psychiatric, Argyl Robertson pupil, gummatous syphilis, cardiovascular
45
Treatment of syphilis
IM Benzylpenicillin
46
Cause of lymphogranuloma venerum
Chlamydia trachomatis
47
What are vaginal triple swabs?
Endocervical NAAT swab Endocervical charcoal swab High vaginal charcoal swab
48
Treatment for genital candidiasis
Topical clotrimazole (or other) Pessary if possible, cream if vulval symptoms Oral if severe
49
Tropical fresh water infections
Leptospirosis | Schistosomiasis
50
Fever in the returning traveller investigations
``` Guided by exposure and travel history Full examination Malaria film/ rapid diagnostic testing HIV test FBC, LFT Blood culture Consider specific serology ```
51
Typhoidal enteric fever classic history
Marked fever rising stepwise, progressing throughout the day Salmonella typhi pea-soup diarrhoea
52
Malaria differential diagnoses
Dengue fever, typhoid, hepatitis, meningitis, viral haemorrhagic fever
53
Treatment for uncomplicated malaria
Artemisinin combination therapies (ACT)
54
Presentation of dengue fever
``` 3-14 day incubation period Fever N+V Headache Retroorbital pain Arthralgia ```
55
Yellow fever classic course
Fever, headache, myalgia, anorexia Remission Severe symptoms 48 hours later Epigastric pain, AKI, jaundice, cardiac instability
56
Features of Legionella infection
``` Flu like symptoms Dry cough Relative bradycardia Confusion Lymphopenia Hyponatraemia Deranged LFTs Pleural effusion ```

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