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Medicine Finals > Infectious Diseases & Antibiotics > Flashcards

Infectious Diseases & Antibiotics Flashcards

(140 cards)

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1
Q

Which causes of gastroenteritis are relate to uncooked poultry?

A

Salmonella (non-typhoid)

Campylobacter

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2
Q

What is the most common bacterial cause of gastroenteritis?

A

Campylobacter

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3
Q

What is the most common infective cause of bloody diarrhoea without fever?

A

E. coli

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4
Q

What is the main complication of E. coli? What does it consist of?

A

Haemolytic uraemic syndrome - triad of

Haemolytic anaemia

Acute kidney injury

Thrombocytopenia (low platelets)

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5
Q

What is the name of the toxin produced by E. coli?

A

Shiga toxin

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6
Q

How does typhoid fever present?

A

Systemic upset – headache fever Arthralgia

Relative bradycardia (pulse is lower than expected for temperature)

Abdominal pain and distension

Constipation or diarrhoea (pea soup diarrhoea)

Rose spots (more common in paratyphoid)

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7
Q

How is typhoid fever treated?

A

Ciprofloxacin

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8
Q

How is Shigella transmitted?

A

Faeces contaminated water/food

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9
Q

How does shigella present?

A

Bloody diarrhoea
Abdominal cramps

Fever

Vomiting

Can cause haemolytic uraemic syndrome - AKI, haemolytic anaemia, low platelets

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10
Q

How is shigella infection treated?

A

Management is mostly supportive

If severe azithromycin/ciprofloxacin can be used

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11
Q

How does dengue fever present?

A

Retro-orbital headache
Facial flushing
Maculopapular rash

Fever
Myalgia
Arthralgia
Pleuritic pain
Lymphadenopathy
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12
Q

How is dengue fever treated?

A

Supportive treatment with fluids and potentially blood transfusions

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13
Q

What is giardiasis?

A

A parasitic infection caused by the protozoa giardia lamblia

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14
Q

How is Giardiasis transmitted?

A

Faeco-oral

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15
Q

How does Giardiasis infection present?

A

Long-lasting diarrhoea with associated weight loss due to malabsorption

Steatorrhoea

Associated with lactose intolerance - this may continue beyond treatment

Abdominal pain and excess flatulence

Vomiting and fever are uncommon

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16
Q

How is Giardiasis treated?

A

Metronidazole

Note: After treatment there can be transient lactose intolerance

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17
Q

What antibiotic is used for rheumatic fever?

A

Stat dose IV Benzylpenicillin

Oral Penicillin V

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18
Q

What antibiotics are used for the initial management of IE (no culture)?

A

Native valve -> Amoxicillin

Prosthetic valve -> Vancomycin + Rifampicin + Gentamicin

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19
Q

What antibiotics are used for IE which has been confirmed to be caused by a staph infection?

A

Native valve -> Flucloxacillin

Prosthetic valve -> Flucloxacillin + Rifampicin + Gentamicin

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20
Q

What organism causes cellulitis and which antibiotics are used?

A

Most common organism = staph aureus

1st line = Flucloxacillin (Clarithromycin/Erythromycin if pen allergic)

If severe = Co-amoxiclav or a cephalosporin

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21
Q

What organism causes Erysipelas and what antibiotic is used?

A

Usually caused by strep pyogenes

First line is Fluclox

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22
Q

What is the first and second line treatment for impetigo? What about if it’s widespread?

A
  1. Hydrogen peroxide cream
  2. Topical fusidic acid
  3. Oral flucloxacillin
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23
Q

What organism most commonly causes acute otitis media and wha is the antibiotic of choice?

A

Organism = strep pneumoniae/haem influenzae

Abx = Amoxicillin (or Clarithromycin)

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24
Q

What are indications for Abx in acute otitis media?

A

Symptoms lasting more than 4 days

Systemically unwell

Immunocompromised

Under 2 years with bilateral otitis media

Perforation/discharge

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25
What is the most common organism that causes otitis externa and what is the antibiotic of choice?
Organism = Pseudomonas and staph aureus Abx = topical Neomycin + Dexamethasone If tympanic membrane is perforated = Ciprofloxacin + Dexamethasone
26
How is malignant otitis external managed?
IV Ciprofloxacin
27
What is the most common organism that causes tonsillitis and what is the antibiotic of choice?
Organism = strep pyogenes Abx = Penicillin V (or Clarithromycin)
28
What is the triple eradication therapy for H.pylori?
PPI + Amoxicillin + Clarithromycin/Metronidazole If pen allergic - PPI + Clarithromycin + Metronidazole
29
What antibiotic is used for diverticulitis?
Oral co-amoxiclav If no improvement -> IV Ceftriaxone + metronidazole
30
What is the most common organism that causes peritonitis and what is the antibiotic of choice?
Organism = E.coli Abx = IV Cefotaxime / Tazocin
31
What prophylaxis do patients who have had an episode of spontaneous bacterial peritonitis require?
Oral Ciprofloxacin
32
What is the first line management for C.diff? What if it is life-threatening? What indicates a life-threatening infection?
First line = oral Vancomycin Life-threatening = oral Vancomycin + IV Metronidazole Life-threatening = hypotensive
33
What antibiotics are used for neutropenic sepsis?
IV Tazocin
34
What is used to treat encephalitis?
IV Aciclovir
35
What is the most common cause of meningitis and how is it treated?
Organism = Neisseria meningitidis <3 months = IV Cefotaxime + Amoxicillin 3m-50 years = IV Cefotaxime >50 years = IV Cefotaxime + Amoxicillin Ceftriaxone is an alternative to Cefotaxime Not Cefuroxime
36
What prophylaxis are close contacts of someone with diagnosed meningitis given?
Oral ciprofloxacin or rifampicin
37
What is the antibiotic used for intrapartum prophylaxis of Group B strep?
IV Benzylpenicillin
38
What is the causative organism of UTI and what is the antibiotic of choice?
Nitrofurantoin/Trimethoprim 1st and 2nd trimester = Avoid trimethoprim At term = Avoid nitrofurantoin
39
What is the causative organism and treatment for osteomyelitis?
Organism = staph aureus Abx = 6 weeks fluclox IV (or clindamycin)
40
What is the causative organism and antibiotic of choice for septic arthritis?
Organism = staph aureus Abx = flucloxacillin + rifampicin
41
What is the antibiotic of choice for BV?
Metronidazole
42
What is the antibiotic of choice for Trichamonas?
Metronidazole
43
What is the antibiotic of choice for Chlamydia?
Doxycycline In pregnancy = Azithromycin/erythromycin
44
What is the antibiotic of choice for Gonorrhoea?
IM Ceftriaxone
45
What is the antibiotic of choice for Syphilis?
IM Benzathine Benzylpenicillin
46
What antibiotic is used for COPD exacerbations?
Amoxicillin / Doxycycline / Clarithromycin
47
What is the most common organism which causes COPD exacerbations?
Haemophilus influenzae
48
What antibiotic can be used for acute bronchitis and when is it used?
Doxycycline If raised CRP >100 / systemically unwell / co-morbidities (asthma/COPD)
49
What antibiotics are used for community-acquired pneumonia?
CURB-65 score 0/1 -> Amoxicillin 2 -> Amoxicillin + Clarithromycin (admission) 3-5 -> IV Co-Amoxiclav + Clarithromycin (admission)
50
What antibiotic is used for hospital-acquired pneumonia?
Co-amoxiclav If severe -> Tazocin
51
Which antibiotics are used for aspiration pneumonia?
IV Cephalosporin + Metronidazole
52
Which antibiotics are used for TB?
Isoniazid 6m Rifampicin 6m Pyrazinamide 2m Ethambutol 2m
53
What antibiotic is first line for campylobacter? When should it be given?
Clarithromycin, if immunocompromied
54
What are complications of camylobacter infection?
Guillan barre syndrome Reactive arthritis
55
Which type of pneumonia is predisposed by a preceding influenza infection?
Staph aureus
56
Which type of pneumonia is classically in alcoholics?
Klebsiella
57
Which pneumonia classically causes a bilateral consolidation and potentially haemolytic anaemia/erythema multiforme (target lesions?
Mycoplasma pneumoniae
58
Which bacteria is most commonly associated with eating undercooked rice?
Bacillus cereus
59
Pneumonia symptoms + pain in extremities?
Mycoplasma pneumoniae | Due to autoimmune haemolytic anaemia
60
What is the most common type of Malaria?
Plasmodium Falciparum
61
How does Malaria typically present?
``` Returning traveller High fever Malaise Myalgia Headache Jaundice ```
62
What are complications of malaria?
Hypoglycaemia Cerebral malaria (seizures) ARDS Acute renal failure DIC
63
How is malaria diagnosed?
Schizonts on blood film
64
How can malaria be excluded?
Need at least 3 blood samples on 3 different days
65
What are signs of malaria?
Haemolytic anaemia Hepatosplenomegaly Jaundice Low platelets
66
What is the most common non-falciparum malaria?
Plasmodium vivax
67
Malaria with cyclical fever every 48 hours?
Plasmodium vivax / plasmodium ovale
68
How is malaria treated?
Chloroquine Patients with ovale/vivax need Primaquien following acute treatment
69
How does amoebiasis present?
Can be asymptomatic, present with amoebic dysentry or liver abscessess Amoebic dysentry = Profuse bloody diarrhoea If amoebiasis liver abscess - fever, RUQ pain
70
How does Cholera present?
Traveller's diarrhoea Profusely watery diarrhoea Abdominal cramps Patient will be severely dehydrated
71
How does leprosy present? How is it treated?
Patches of hypopigmented skin with sensory loss over the patches Triple therapy - Rifampicin/Dapsone/Clofazimine
72
What is leptospirosis? Who does it occur in and how does it present?
Infection which is spread by infected rat urine In sewage workers/farmers/vets Fever, flu-like symptoms Red eyes AKI Hepatitis
73
What is the causative organism of Lyme disease?
Borrelia Burgdorferi
74
How does Lyme disease present?
Early features = Erythema migrans (bulls-eye rash) Usually 1-4 weeks after bite PAINLESS May be systemic features - headache, lethargy, fever Late features = Heart block/pericarditis/facial nerve palsy/meningitis
75
How is Lyme disease diagnosed?
Usually can be diagnosed clinically with erythema migrans
76
How is Lyme disease treated?
Doxycycline Amoxicillin if Doxy is CI
77
What is the usual carrier of Toxoplasmosis?
Cat
78
How does Toxoplasmosis present?
Resembles mononucleosis Fever Malaise Lymphadenopathy
79
How can Toxoplasmosis affect patients with HIV?
Can cause CNS symptoms - headache/confusion/drowsiness Will present on CT as ring-enhancing lesions
80
How is Toxoplasmosis treated?
Pyrimethamine + Sulphadiazine
81
What are the two causes of pneumonia + deranged LFTs?
Legionella Mycoplasma
82
How does legionella pneumonia present?
Dry cough Deranged LFTs Low lymphocytes Low sodium
83
How is legionella diagnosed?
Urinary antigen
84
How is mycoplasma diagnosed?
serology
85
How does mycoplasma pneumonia present?
Flu like symptoms Dry cough Bilateral consolidation Cold autoimmune haemolytic anaemia Erythema multiforme
86
How is Legionalla + Mycoplasma treated?
Macrolide
87
What is the first line treatment for MRSA?
Vancomycin
88
What pathogen causes TB?
Mycobacterium tuberculosis
89
How is primary TB seen on a CXR?
Ghon focus (caseating granuloma)
90
How is TB meningitis seen on lumbar puncture?
Raised protein Low glucose Raised lymphocytes
91
How is latent TB diagnosed?
Mantoux test or Interferon-gamma blood test
92
How is active TB diagnosed?
Sputum culture = gold standard but this can take a long time Ziehl-Neelsen stain is often used
93
What are options for malaria prophylaxis?
Doxycycline Mefloquine Proguanil + Atovaquone
94
Which types of hepatitis are spread faeco-orally?
Hepatitis A Hepatitis E
95
Which types of hepatitis are spread bloodbourne?
Hepatitis B Hepatitis C Hepatitis D
96
Hepatitis B antibodies: HbsAb(Anti-HbS) positive
Immunised
97
Hepatitis B antibodies: HBcAb and HBsAb
Previous infection and now resolved
98
Hepatitis B antibodies: HBsAg and HBcAb
Chronic infection
99
How to manage a neonate whose mother has Hepatitis B?
HBIG within 24 hours of birth Full course of vaccinations
100
How is HIV monitored?
CD4 T-cell count HIV viral load
101
What is the progression of HIV?
Acute primary infection (seroconversion) = fever, malaise, lymphadenopathy Usually 2-4 weeks post exposure Asymptomatic phase - progressive loss of CD4 T cells Early symptomatic phase AIDS
102
What are AIDS defining illnesses?
``` Kaposi's sarcoma Pneumocystis pneumonia CMV infection Oesophageal/bronchial candidiasis Lymphoma TB ```
103
How is HIV diagnosed?
p24 antigen Antibody (takes longer to become positive) PCR
104
How is HIV treated?
Triple antiretroviral therapy - NRTI/NNRTI/Protease inhibitor
105
What is Kaposi's sarcoma?
AIDS defining illness Caused by HHV8 Papules/macules/nodules across body
106
How is PCP treated?
Co-trixomazole
107
Who needs PCP prophylaxis?
HIV with CD4 count <200
108
What antibiotic should be given in the case of an animal or human bite?
Oral co-amoxiclav
109
What is the most common cause of viral meningitis?
Enteroviruses e.g. Coxsackie
110
What is seen on lumbar puncture in viral meningitis?
Lymphocyte predominant Normal glucose Raised protein ???
111
What is the most common cause of necrotising fasciitis?
Strep pyrogenes
112
How is necrotising fasciitis treated?
IV Abx + urgent surgical debridement
113
What is seen on CXR in PCP?
Interstitial pulmonary infiltrates
114
What might make you suspect meningococcal meningitis?
Non-blanching rash
115
How is meningococcal meningitis treated in hospital?
Prior to admission = IM benzylpenciilln In hospital = IV Benzylpenicillin or IV Ceftriaxone If sensitivity to penicillin and cephalosporins = Chloramphenicol
116
How is bacterial meningitis (aetiology unknown) treated in hospital?
3yrs-50 years = Cefotaxime/Ceftriaxone >50 years = Ceftriaxone/Cefotaxime + Amoxicillin
117
How long is HIV Post-exposure prophylaxis?
4 weeks
118
What are side effects of tetracyclines?
``` Discolouration of teeth Photosensitivity Black hairy tongue Angioedema IIH ```
119
Which types of gastroenteritis present within hours of eating the contaminated food?
Staph aureus | Bacillus cereus
120
What is the incubation period of Salmonella?
24-48 hrs
121
What is the incubation period of E.coli?
24-48 hours
122
Which causes of gastroenteritis have an incubation period of more than 7 days?
Giardiasis | Amoebiasis
123
Which macrolides are safe in pregnancy?
Erythromycin or Azithromycin | NOT Clarithromycin
124
Which malignancies are associated with EBV?
Burkitt's Lymphoma Hodgkin's Lymphoma Nasopharyngeal carcinoma
125
What is the most severe complication of Chagas disease?
Cardiomyopathy
126
What is the most common cause of pneumonia in patients who have CF?
Pseudomonas
127
What should be tested for in everyone diagnosed with TB?
HIV
128
What can cause a false negative Mantoux test in a patient with TB?
``` Sarcoidosis Immunosuppression - AIDS, steroids Lymphoma Fever Hypoalbuminaemia Anaemia ```
129
What can cause a false positive Mantoux test in a patient who does not have TB?
BCG vaccination
130
HIV + Neuro symptoms -- How can you tell the diagnosis from MRI head?
Multiple ring enhancing lesions = Toxoplasmosis Single homogenous enhanced lesion = Lymphoma
131
Chancroid vs. Syphilis Chancre vs Lymphogranuloma vereneum?
Painless ulcer and painless lymphadenopathy = Syphilis (Chancre) Painless ulcer and painful lymphadenopathy = LGV Painful ulcer and painful lymphadenopathy = Chancroid
132
Which bacteria stains with India ink?
Cryptococcus
133
How does cryptococcosis present on LP?
High opening pressure | India ink staining positive
134
Which types of hepatitis have an increased risk of developing hepatocellular carcinoma?
``` Hepatitis C (Most common) Chronic hepatitis B ```
135
How is hep A managed?
Self limiting
136
Which drug should be given alongside isoniazid?
Pyridoxine (Vitamin B6)
137
What is used to treat cytomegalovirus retinitis?
IV Ganciclovir
138
Which antibiotic used for whooping cough?
Clarithromycin
139
What is schistosomiasis and how does it present?
Parasitic flatworm infection Enters from water - from freshwater swimming Initially presents with a swimmer's itch Can then lead to hepatosplenomegaly, RUQ pain Chronic = haematuria + dysuria
140
How is schistosomiasis treated?
Praziquantel

Medicine Finals (32 decks)

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