Infectious Diseases / GUM Flashcards
(129 cards)
1
Q
Legionella pneumophilia is best diagnosed by ?
A
Urinary Antigens
2
Q
Management of Legionella
A
Erythromycin/clarithromycin
3
Q
Chagas disease - organism?
A
Trypanosoma cruzi
4
Q
Syphilis - organism?
A
Spirochaete - Treponema pallidum
Infection is characterised by primary, secondary and tertiary stages
5
Q
Primary features of Syphilis
A
Chancre - painless ulcer at the site of sexual contact
Local non-tender lymphadenopathy
6
Q
Secondary feature of Syphilis
A
Occurs 6-10 weeks after primary infection
Systemic symptoms: fevers, lymphadenopathy
Rash on trunk, palms and soles
Buccal ‘snail track’ ulcers
Condylomata lata (painless, warty lesions on the genitalia )
7
Q
Treponema pallidum particle agglutination assay (TPPA)
A
Indirect agglutination assay used for detection and titration of antibodies against Treponema pallidum.
IgG antibodies to syphilis can remain elevated
8
Q
Candidiasis in immunocompromised patients - treatment?
A
High dose fluconazole
9
Q
VDRL + and TPHA +
A
Active infection
10
Q
VDRL - and TPHA +
A
Past infection
11
Q
VDRL + and TPHA -
A
False positive
SLE, malaria, HIV, TB
12
Q
Chancroid
A
STI caused by Haemophilus ducreyi.
Painful ulcers
Painful lymphadenopathy
13
Q
Lymphogranuloma venereum
A
Chlamydia trachomatis
14
Q
Leprosy - define
A
Granulomatous disease - peripheral nerves and skin
Mycobacterium leprae
15
Q
Management of Leprosy
A
Triple therapy
Rifampicin
Dapsone
Clofazimine
16
Q
Leptospirosis - define
A
Spirochaete - Leptospira interrogans
Classically being spread by contact with infected rat urine.
17
Q
Investigation for Leptospirosis
A
Serology: antibodies to Leptospira develop after about 7 days
PCR
Culture
18
Q
Coagulase-positive
Causes skin infections, abscesses, osteomyelitis, toxic shock syndrome
A
Staphylococcus aureus
19
Q
Coagulase-negative
Cause of central line infections and infective endocarditis
A
Staphylococcus epidermidis
20
Q
Tick-borne encephalitis
A
Flavivirus
Supportive management
21
Q
Risk of vertical transmission for hepatitis C
A
6%
22
Q
Retro-orbital headache, fever, facial flushing, rash, thrombocytopenia in returning traveller
A
Dengue
23
Q
Severe dengue (dengue haemorrhagic fever)
A
Form of disseminated intravascular coagulation (DIC) resulting in:
Thrombocytopenia
Spontaneous bleeding
24
Q
Periodic acid-schiff staining
A
Used on jejunal biopsy specimens to diagnose Whipples disease
25
Silver staining
Pneumocystis jiroveci on sputum samples
26
Ziehl-Neelsen stain (acid-fast stain) of the stool
Red cysts of Cryptosporidium
27
Relative bradycardia
Abdominal pain, distension
constipation/diarrhoea
Rose spots: present on the trunk
Typhoid fever - Salmonella enterica
28
Management of PCP
Co-trimoxazole
IV pentamidine in serious cases
Aerosolized pentamidine - risk of pneumothorax
29
Norovirus - investigation
Faecal/Vomitus Viral PCR
30
Chikungunya
Alphavirus disease caused by infected mosquitoes
Africa, Asia and Indian subcontinent
Severe joint pain and abrupt onset of high fever
31
HIV, once stable, should be monitored with ?
Viral load every six months
CD4 counts annually
32
Management of Typus
Doxycycline
33
Infectious mononucleosis
Epstein-Barr virus
Sore throat
Pyrexia
Lymphadenopathy
34
Infectious mononucleosis - investigation
Heterophil antibody test (Monospot test)
35
Other features of Infectious Mononucleosis
Palatal petechiae
Splenomegaly
Hepatitis, transient rise in ALT
lymphocytosis: presence of 50% lymphocytes with at least 10% atypical lymphocytes
Haemolytic anaemia secondary to cold agglutins (IgM)
36
Loiasis - define
Filarial infection caused by Loa Loa
Pruritus / Urticaria
Calabar swellings: transient, non-erythematous, hot swelling of soft-tissue around joints
'Eye worm'
37
Treatment for Loa Loa
Ivermectin
38
Giardiasis - treatment
Metronidazole
39
Giardiasis - bloody or non-bloody
Non-bloody
40
Yellow fever - define
Type of viral haemorrhagic fever (also dengue fever, Lassa fever, Ebola)
Zoonotic infection: spread by Aedes mosquitos
41
The biopsy results show the presence of inclusion bodies in the colonic mucosa - what organism and treatment?
CMV colitis - IV Ganciclovir
42
Cerebral Toxoplasmosis - treatment
Sulfadiazine and pyrimethamine
43
Treatment of strongyloidiasis
Ivermectin + Albendazole
44
Most common fungal CNS infection in patients with HIV
Cryptococcal meningitis
India ink test positive
45
Q fever - define + features
Coxiella burnetii
Fever, malaise
Transaminitis
Atypical pneumonia
Endocarditis (culture-negative)
46
Q fever - management
Doxycycline
47
Amoebiasis - define
Entamoeba histolytica - spread by the faecal-oral route
48
Amoebic dysentery
Pofuse, bloody diarrhoea
There may be a long incubation period
Oral metronidazole - 'luminal agent' (to eliminate intraluminal cysts) is recommended usually as well e.g. diloxanide furoate
49
Amoebic liver abscess - treatment
Oral metronidazole
A 'luminal agent' (to eliminate intraluminal cysts) is recommended usually as well e.g. diloxanide furoate
50
Lyme disease - define
Spirochaete - Borrelia burgdorferi
51
Features of Lyme disease
Headache, lethargy, fever, arthralgia
Erythema migrans
Heart block
52
Treatment of Lyme Disease
Doxycycline if early disease.
Amoxicillin is an alternative if doxycycline is contraindicated (e.g. pregnancy)
Ceftriaxone if disseminated disease
53
Meningitis: causes
0-3 months
Group B Streptococcus (most common cause in neonates)
E. coli
Listeria monocytogenes
54
Treatment of Typhoid
Quinolones
Ciprofloxacin
55
Main technique used to screen for latent tuberculosis
Mantoux
56
Management fo Cytomegalovirus retinitis
IV ganciclovir
57
Herpes simplex virus (HSV) in pregnancy - treatment?
Oral Aciclovir
58
Treatment of choice for MRSA septicaemia
IV Vancomycin
Vancomycin
Teicoplanin
Linezolid
59
Severe hepatitis in a pregnant woman
Hepatitis E
60
Type 1 Necrotising fasciitis
Mixed anaerobes and aerobes
61
Type 2 Necrotising fasciitis
Streptococcus pyogenes
62
Gonorrhoea - organism
Gram-negative diplococcus
Neisseria gonorrhoeae
63
Gonorrhoea - treatment
Single dose of IM ceftriaxone 1g
64
Treatment for Chlamydia
Doxycycline
65
Treatment for Trichomonas vaginalis
Metronidazole
66
Treatment for Gardnerella vaginalis
Metronidazole
67
Investigation of choice for Chlamydia
Nucleic Acid Amplification Test (NAAT)
68
Cutaneous leishmaniasis is typically diagnosed using?
Punch Biopsy
69
Leishmaniasis - vectors
Sandflies
70
First line treatment for early Lyme disease
14-21 day course of oral doxycycline
71
Q fever
Coxiella burnetii
Fever, malaise
Pyrexia of unknown origin
Transaminitis
Atypical pneumonia
Endocarditis (culture-negative)
72
Treatment for Q Fever
Doxycycline
73
Plasmodium vivax - where
Central America and the Indian Subcontinent
74
Plasmodium ovale - where
Africa
75
Cyclical fever every 48 hours
Plasmodium vivax/ovale
76
Cyclical fever every 72 hours
Plasmodium malariae
77
Relapse with Malaria - subtypes?
Plasmodium Vivax/Ovale
Should be given primaquine following acute treatment with chloroquine to destroy liver hypnozoites and prevent relapse
78
Brucellosis - define
Zoonosis - Middle East and in farmers, vets and abattoir workers
79
Features of Brucellosis
Fever, malaise
Hepatosplenomegaly
Sacroiliitis
Osteomyelitis, infective endocarditis, meningoencephalitis, orchitis
leukopenia often seen
80
Treatment for Brucellosis
Doxycycline and streptomycin
81
Investigation for Brucellosis
Brucella serology is the best test for diagnosis
Rose Bengal plate test can be used for screening
82
Drug of choice for contact prophylaxis - bacterial meningitis
Within 7 days of contact
Ciprofloxacin - Single dose
83
HHV-8
Kaposi's sarcoma
84
Nucleoside analogue reverse transcriptase inhibitors (NRTIs)
Lamivudine, Abacavir and Zidovudine
85
Gram-positive bacilli (or rods)
ABCDL
Actinomyces
Bacillus anthracis
Clostridium, Corynebacterium
Diphtheria
Listeria monocytogenes
86
Gram positive cocci
Streptococci
Staphylococci
87
Gram-negative cocci
NNM
Neisseria (Neisseria meningitides, Neisseria gonorrhoea)
Moraxella
88
Vancomycin Resistant Enterococcus (VRE) can be treated with
Linezolid, daptomycin and tigecycline
89
Investigations for Mycoplasma pneumoniae
Mycoplasma serology
Positive cold agglutination test → peripheral blood smear may show red blood cell agglutination
90
Management of Mycoplasma pneumoniae
Doxycycline
or
Macrolide (e.g. erythromycin/clarithromycin)
91
Management of Leprosy
Triple therapy:
Rifampicin, dapsone and clofazimine
92
Confirmatory investigation of TB
Multiple respiratory samples
(3 deep cough sputum samples, preferably including 1 early morning sample)
for TB microscopy and culture
93
Two choices for treating latent tuberculosis:
3 months of isoniazid (with pyridoxine) and rifampicin
or
6 months of isoniazid (with pyridoxine)
94
Diagnosis of PCP
Bronchoalveolar lavage (BAL)
Silver stain shows characteristic cysts
95
Extended Spectrum Beta-Lactamases (ESBL) - Treatment
Carbapenems - Meropenem
96
Mucocutaneous leishmaniasis - organism
Leishmania braziliensis
97
Most common complication of mumps in post-pubertal males.
Orchitis
98
Gold standard for diagnosis - Visceral leishmaniasis (kala-azar)
Bone marrow or splenic aspirate
99
Most common cause of epilepsy worldwide
Neurocysticercosis
Management is with praziquantel or albendazole and prednisolone.
100
Which Hepatitis carries a significant mortality during pregnancy?
Hepatitis E
101
Amoebiasis - organism
Entamoeba histolytica
102
Treatment of Amoebiasis
Oral metronidazole
A 'luminal agent' (to eliminate intraluminal cysts) e.g. (diloxanide furoate)
103
Treatment of Cutaneous larva migrans
Anthelmintic agents:
Ivermectin or albendazole
104
Treatment of non-typhoidal Salmonella gastroenteritis.
Ciprofloxacin
105
Treatment of Legionnaires
Macrolides or fluoroquinolones (such as levofloxacin)
106
Management of Influenza
First line: oseltamivir
Second line: zanamivir
107
Management of PCP in someone who is hypoxic
Co-trimoxazole + steroids
108
Vancomycin - class
Glycopeptide antibiotic
Treatment of Gram-positive infections, particularly MRSA
109
Mantoux test (6-15)mm indicates:
1.Prior BCG vaccination
2.Latent TB
3.Previous history of TB
110
Treatment of Chlamydia
Doxycycline
111
Most common cause of necrotising fasciitis is
Type 1 : polymicrobial infection
112
Type 2 necrotising fasciitis - most commonly caused by:
Streptococcus pyogenes
113
Candidiasis in immunocompromised patients - treatment?
High dose fluconazole
114
Treatment of paragonimiasis (lung fluke infection)?
Praziquantel
115
Treatment of Mycoplasma pneumoniae
Doxycycline or a macrolide
116
Bed bugs - organism
Cimex lectularius
117
Management of Typhus
Doxycycline
118
Treatment of Staphylococcus aureus bacteraemia
IV Flucloxacillin 2 weeks
119
Treatment of Visceral leishmaniasis
Sodium stibogluconate
2nd line - Amphotericin B
120
Human herpes virus 5 (HHV 5)
Cytomegalovirus (CMV)
121
Drug of choice for lymphatic filariasis
Diethylcarbamazine
122
Treatment for Cryptosporidiosis
Supportive for immunocompetent patients
Nitazoxanide/Rifaximin - immunocompromised
123
Main/Serious complications of Typhoid
Bowel perforation and haemorrhage
124
Syphilis: management
Intramuscular benzathine penicillin
2nd line: doxycycline
125
Treatment of choice for tropical trypanosomiasis
Benznidazole
126
Treatment of Botulism
Botulism antitoxin and supportive care
127
Risk of infection following splenectomy:
Streptococcus pneumoniae. Haemophilus influenzae type B, Neisseria meningitidis
128
What type of feeding is recommended in the UK to all babies with HIV +ve mothers
Formula feeding
129
CIprofloxacin is used to treat which GI infections?
Salmonella
Shigella
Campylobacter
