micro mash up Flashcards
(88 cards)
1
Q
what diagnostic is used to detect HSV1/2/3
A
tzanck smear
2
Q
what is the incubation period of VZV
A
2-3 weeks (10-21 days)
3
Q
what is the infectious period of VZV
A
48 hours before rash and up to 5 days after or until all the vesicles have crusted over
4
Q
where does the VZV remain latent in
A
dorsal root ganglion +/- trigeminal ganglion
5
Q
what are the common complications of all the HHVs in immunocompromised patients
A
disseminated disease - affecting all part of the body (pneumonitis, oesophagitis, colitis, enephalitis**)
6
Q
treatment of HSV-1/2
A
IV ACV
7
Q
neonatal varicella typically presenting when
A
within first month
8
Q
what is the characteristic presentation of shingles
A
prodromal parasthesia/burning pain
dermatomal rash, usually unilaterally
post herpetic neuralgia persisting 3 months
9
Q
CNS complications of VZV and time it happens
A
encephalitis (10 days)
cerebellar ataxia (2-3 weeks)
10
Q
IPC for VZV
A
- Airbourne precautions
- NEGATIVE pressure isolation room
11
Q
IPC for Shingles
A
- Contact and airbourne precautions (if disseminated or immunocompromised)
- Contact precautions, covering lesions (if immunocompetent)
12
Q
Prevention of VZV and Shngles
A
vaccinations
VZV: VZV Ig (post exposure, <96h) - paassive and Varicella vaccine (> 12 months, cpox)
Shingles: Zostavax (live, attenuated), Shingrix
13
Q
what is disseminated cutanoues herpes zoster (shingles) defined by
A
> 20 extradermatomal lesinos
3 dermatomal involvment
+/- visceral organ involvment
14
Q
what would raise suspicion of neonatal varicella
A
skin, eye and mouth lesions
first month in life
not responsive to abx
15
Q
EBV incubation period
A
1-2 months
16
Q
EBV linked to what pathologies
A
INFECTIOUS MONONUCLEOSIS
oral hairy leukoplakia
Burkitt’s lymphoma
post transplant lymphoproliferative disease (PTLD - detected by histopathology)
17
Q
tx of EBV
A
supportive only
18
Q
inclusion bodies on biopsy, what do u think it is?
A
CMV
19
Q
CMV tx
A
valgancyclovir (tx, prophylaxis)
20
Q
HHV-6/7/8 associated with what disease
A
6/7: Roseola infantum (high fever for 3-5 days then disappear and rose-pink maculopapular rash appear for 1-2 days)
8: Kaposi’s sarcome (low grade vascular tumour) - in patients with new and untreated HIV with low CD4 count
21
Q
types of large vessel arteririts
A
- takayasu
- giant cell (temporal) arteritis
22
Q
overwhelming post-splenectomy infection (OPSI) / sepsis (OPSS) - which is the most comon bacterial cause
A
s. pneumoniae
23
Q
overwhelming post-splenectomy infection (OPSI) / sepsis (OPSS) - prevention and prophylaxis regimes
A
- prevention: vaccination against Hib, pnemococcal, meningococca, influenxa
- prophylaxis - PO penicillin
- patient awarenss + Amox if symptpms develop
24
Q
prevetion of infections in solid organ transplant
A
- pre-transplant screenig for latent infections
- removing the foci for finfectios
- abx prophylaxis for surgery
25
neutropenia treamtent and presentation
high risk of bacterial infections - almost always fever, but not always signs of inflammation
- PROMPT antibiotics to be administered (+ broad spectrum with activity aginst P. aeruginosa)
26
most likely risk factor for hepatitis C in ireland
IVDu
27
how long do maternal antibodies in the neonate last for
12 months
can interact with active vaccination courses
28
which vasculitis is assocaited with Hep B
polyarteritis nodos (30% cases)
29
types of medium vessel vasculitis
polyarteritis nodosoa and kawasaki disease
30
what are some examples of encapsulated bacteria and their significance
Increased risk of infection by encapsulated bacteria (N. meningitidis, H. influenzae and S. pneumoniae)
31
what is the main apthogen ffor OPSI/OPSS
Mostly S. pneumoniae
32
what are mothers screened for in pregnancy (unless they choose to opt out)
rubella, syphilis, HIV, hep B , VZV
1. Serological screening
Universal “opt-out”: rubella immunity, syphilis, HIV, hepatitis B, varicella
Selective groups based on risk factors: hepatitis C (e.g. IV drug users)
Patient specific: TORCH infections
33
should u treat asymptomatic bacteriuria in pregnant women
Asymptomatic bacteriuria: 5-10% of all pregnant women, defined by > 100,000 of a single organism per ml of MSU, and **TREAT asymptomatic bacteriuria if pregnant (normal don’t)
34
what is the msot common cause of post-partum sepsis / bacteraemia
E. coli
35
what is hte most common cause of death from post-partum sepsis / bacteraemia
GAS
36
pathogen associated with postpartum mastitis
S. aureus, Sporadic during W2/3 after delivery
37
what is the triad of symptoms in congenital toxo
1. hydrocephalus
2. chorioretinitis
3. intracranial calcifications
Almost all infected foetuses have / will develop defects, more severe with T1 infections.
Asymptomatic babies often to develop ocular manifestations later in life
38
what does TORCH stand for
T- toxoplasmosis
O- other (VZV, T. pallidum, Zika, Parvovirus, Listeria)
R- rubella
C - CMV
H - HSV
39
what is blueberry muffin rash associated with
congenital rubella infection
40
what virus is asociatied wih slapped cheek syndrome
parvovirus b19
41
what is the msot common congenital infectino
CMV
42
which vaccines are live and should not be adminstered during pregnancy
rubella
vzc
43
what is the infectious period for measles
4 days before and after rash
44
what is the infectious period for rubella
7 days before and after rash
45
common complications of vzv. measles and rubella
encephalitis (~10d)
vzv: cerebellar ataxia (2-3 weeks)
measles: subacute sclerosing panencephalitis (chronic measles) and bacterial superinfection (otitis media, pneumonia)
rubella: athralgia, suboccipital lymphadenopathy, in utero (congenital rubella): skin, eye (cataracts), ear (deafness), cardiac abnormalities and hepatosplenomegaly
46
prevention of measles / rublela
Prevention: VACCINATION; live attenuated MMR vaccine
Need 95% vaccination rates to stop spread, outbreaks occur when coverage decreases
47
Dusky red, florid maculopapular rash
1-3d before rash: Koplik spots (enanthem of the buccal mucosa)
Measles
48
Pink, non-confluent maculopapular rash spreading from head (esp behind the years) extending to the trunk and extremities but sparing palms and soles
Suboccipital lymphadenopathy
Arthralgia
Rubella
49
Rash on cheeks (slapped cheek appearance) and later lace-like reticular rash on trunk spreading to extremities
Erythema infectiosum (Parvovirus B19)
50
causative agent for scarlet fever
GAS, e.g. S. pyogenes
51
CXR - bilateral reticular marking
CT - diffuse, bilateral ground glass opacities
Silver stain - coffee bean appearance
waht does this suggest
Pneumocystis jirovecii
52
what are the 3 cryptococcus manifestatios
1. pulmonary
2. skin infections
3. meningitits
53
which fungal infections are AIDs defining
- Oesophageal candidiasis
- Cryptococcus (pneumonia, skin and meningitis)
- Pneuocystis jirovecii pneumonia
54
which is part of the critical list by WHO
- asp
- candida
- cryptococcua
- mucorales
- pneumocystis jirovecii
Critical priority: Cryptococcus, Aspergillus, Candida
55
Acid-fast on ZN stain
TB (Distinguishing factor: cell wall of mycobacterium has high lipid and mycolic acid ⇒ Acid fast bacilli (Ziehl-Neelsen stain)
56
spiderweb clotting found in CSF sample
suspect TB meningitis
low glucose high protein, lymphocytic pleocytosis, possible spider web clotting
57
what animal associated with mycobacterium leprae (causingleprosy)
armadillo
58
what is used to treat Polyarthritic patient with anaerobic component in infection
Metronidazole
59
bone and joint infection: what is used to treat G+ bacteria (e.g. S. aureus)
Flucloxacillin (pena allergy = vancomycin)
coag neg staph = linezolid
60
bone and joint infection: what is used to treat G- bacteria (e.g. gonococcal, e. coli, pseudomonas)
gonococcal = ceftriaxone + azithromycin / doxy
E. coli / pseudomonas: tazocin
61
what is differnece btwn septic arthritis and bursitis
arthritis
Inflammatory reaction of joint space caused by an infectious agent.
bursitis
Infection and inflammation of the bursa. Commonly affecting the SC olecranon, pre- and infra-paerllar bursae.
62
most common causative agent in septic arthritis (bacterial)
s. aureus
63
classic triad of septic arthritis
1. fever
2. joint pain
3. decreased ROM
64
what is the plan of investigatinos in septic arthritis
1. microscopy (gram staining) and cell count
- if WCC > 50,000, suggestive of septic arthritis
- G stain: bacteria usu not present in joint space, if found need action
. G stain can be negative, so then
- microscopy tro gout
2. culture
3. PCR (if culture negative, can detect the pathogen DNA)
65
what is the triad of presentatino of disseminated gonoccocal infection.
1. dermatitis
2. polyarticular arthritis
3. tenosynovitis
66
which bones are most affected in osteomyelitis
children: metaphysis of long bone
adults; spine
67
which bone infection has sinus tract formation
osteomyelitis (esp in chronic, > 6 weeks)
68
some causative agents for viral arthritis
parvovirus B19, chikugunya
69
what is potts disease
spinal TB - hematogenous dissemination from an primary site
- affecting thoracic / lumbar does it
70
what side of the heart is affected in endocaditis in ivdu
** Endocarditis in IV drug users are often RIGHT sided. But IE usually involves the aortic or mitral valve (LEFT sided)
71
what is the most common cause of infective endocarditis (native valve)
GPB. s. aureus
72
which strep is associated with colonic cancer
strep gallolyticus
73
which group of people get coag neg staph endocarditis
skin-based (opportunitstc), prostetic valve endocarditis, from IV line (**in native valve is s. aurues)
74
which organism is in IVDU endocarditis
pseudomonas aeruginose
75
when to suspect IE
1. fever
2. new heart murmur
FROM JANE
- fever, roth spots, osler's nodes, murmurs,
janeway lesions, anaemia, nail bed haemorrhages and emboli
76
which criteria is used to diagnose infective endocarditis
Duke's criteria
77
what is Duke's criteria
Diagnosis: use Duke’s criteria
Major criteria
Microbiological evidence of typical organism from > 2 blood cultures > 12h apart, without other causes of infections. If Coxiella, only 1 blood culture needed.
Evidence of endocardial involvement on imaging (TOE): vegetatino, abscess, dehiscence of prosthetic valve.
Minor criteria
Predisposing heart condition or IVDU
Fever > 38 deg
Vascular phenomena (e.g. arterial embolism)
Immunological phenomena (e.g. Osler’s nodes)
Microbiological evidence that does not fall under the major criteria (e.g. serology)
Definite IE is the presence of
2 Major or
1 Major + 3 Minor or
5 Minor
Possible IE is the presence of
1 Major or
3 Minor
78
in the treatment of IE, which antibiotics should you monitor
Rifampicin to monitors the LFTs
Cephalosporins to monitor the C. diff infection
79
what is subacute / indolent presentation bacterial endocarditis and what is the most common causation
low-grade fever, insidious onset
mostly caused nyb strep viridans
80
what is the cardiac manifestatino of SLE
Libman-sacks endocarditis (sterile plaques on valves from immune complex depositsion)
81
what is the most commoon cause of viral myo and pericarditis
Coxsackievirus type B3
82
what drugs is TB resistant to in MDR TB
MDR-TB (Isoniazid and Rifampicin resistance)
Pre-XDR-TB (MDR + fluoroquinolones)
XDR-TB (MDR + fluoroquinolones + linezolid and/or bedaquiline)
RR (Rifampicin resistance)
83
PCR test on the stool for bacterial exotoxin gene in the case of nosocomial diarrhoea
C. diff
84
strap cells
embryonal rhabdomyosarcoma
85
alveolar pattern on histology
alveolar rhabdonyosarcome
86
Hürthle cells (oncocytes)
Lymphoid follicles infulctration, destruction of thyroid follicule and replacement fibrosis
hashimoto's
87
painful goitre
de quervain's
88
