Week 1 Flashcards by prion alpha

which gender gets infective endocarditis more

male

How well did you know this?

Not at all

Perfectly

most common bacterial cause of infective endocarditis

streptococcus viridans

How well did you know this?

Not at all

Perfectly

what is infective endocarditis

inflammation of the endocardium due to bacterial colonisation, commonly on valves with vegetation

How well did you know this?

Not at all

Perfectly

why are valves more prone to bacterial colonisation

poor blood supply

How well did you know this?

Not at all

Perfectly

which valve is most prone to infective endocarditis

mitral valve

How well did you know this?

Not at all

Perfectly

who gets right sided infective endocarditis

IVDU

How well did you know this?

Not at all

Perfectly

3 most common bacterial causes of infective endocarditis

streptococcus viridans
strptococcus faecalis
staph aureus

How well did you know this?

Not at all

Perfectly

who are more prone to getting infective endocarditis caused by the HACEK organisms

IVDU
poor dental hygiene
pre-existing valvular disease

How well did you know this?

Not at all

Perfectly

what fungal causes of infective endocarditis are there

candida albicans

aspergillus

How well did you know this?

Not at all

Perfectly

what are 4 bacterial causes of infective endocarditis that will not culture

mycoplasma
brucella
legionella
chalmydia

How well did you know this?

Not at all

Perfectly

risk factors of infective endocarditis

immunocompromised
artificial heart valves
valvular conditions
hx of infective endocarditis
IVDU
people at risk of bacteraemia

How well did you know this?

Not at all

Perfectly

why is prior dental procedure a risk factor for infective endocarditis

because streptococcus viridans lives in the mouth and throat and procedures can cause skin punctures and introduction of bacteria into the blood

How well did you know this?

Not at all

Perfectly

systemic symptoms of infective endocarditis

fever
flu like illness
night sweats
rigors
weight loss
malaise 
fatigue

How well did you know this?

Not at all

Perfectly

signs of infective endocarditis

murmur
finger clubbing
splenomegaly

How well did you know this?

Not at all

Perfectly

what does FROM JANE stand for

Fever
Roth’s spots
Osler’s Nodes
Murmur

Janeway lesions
Anaemia
Nail haemorrhages
Embolus

How well did you know this?

Not at all

Perfectly

what 2 types of symptoms are found in infective endocarditis

vasculitic symptoms and immunologic symptoms

How well did you know this?

Not at all

Perfectly

describe janeway lesions and oslers nodes

oslers nodes are painful, found on finger and toes

janeway lesions are not painful, found on palms and soles of feet

How well did you know this?

Not at all

Perfectly

why is haematuria a sign of infective endocarditis

immunologic symptom of infective endocarditis causing glomerulonephritis

How well did you know this?

Not at all

Perfectly

investigations of infective endocarditis

ECG, urine dipstick
Bloods and culture
imaging - CXR and ECHO

How well did you know this?

Not at all

Perfectly

how should blood cultures be taken in infective endocarditis

3 cultures 6 hours apart

How well did you know this?

Not at all

Perfectly

what is the diagnostic requirement for Dukes criteria

2 major
1 major 3 minor
5 minor

How well did you know this?

Not at all

Perfectly

what are the major criteria in dukes criteria

blood culture findings

echo findings

How well did you know this?

Not at all

Perfectly

what are the minor criteria in dukes criteria

Fever
Echo findings (not major)
Vasculitic symptoms
Evidence from microbiology
Risk factors

How well did you know this?

Not at all

Perfectly

important questions to ask in suspected malaria case

travel history
malaria prophylaxis compliance
past history of malaria

How well did you know this?

Not at all

Perfectly

symptoms of malaria

``` fever night sweats rigors headache fatigue splenomegaly ```

complications of malaria

``` renal dysfunction iron deficiency hypoglycaemia hypotension jaundice hepatosplonomegaly shock ```

difference between thick and thin blood films in malaria investigation

thick tells you if there is a parasite thin tells you the species

ABCD of malaria prevention

awareness bite prevention chemoprophylaxis Diagnosis

what are some typical malarial chemoprophylaxis

doxycyline chloroquine malarone

treatment for malaria

quinine doxycycline artemisinin combination therapy

what is dengue fever caused by

Flavivirus - RNA virus with 5 subtypes

which mosquito transmits malaria

anopheles

which mosquito transmits dengue

aedes egptyi

what time of the day are the malaria and dengue mosquitoes most active

malaria - morning/night dengue - day time

symptoms of dengue fever

``` fever rash arthralgia retroorbital pain photophobia lymphadenopathy ```

what can dengue fever progress to

dengue haemorrhagic fever or dengue shock syndrome

treatment for dengue fever

supportive, fluids, blood

causative organism of typhoid?

salmonella typhii

transmission route of typhid

faecal oral, food

most common areas in the world affected by typhoid

india, SEA, africa

clinical features of typhoid

malaise, aches, anorexia abdominal pain bloody diarrhea rashes

FBC features of typhoid

neutrophillia, leukopaenia, thrombocytopaenia

typhoid can be a chronic carrier status - T or F

true - treat with 28 days ciprofloxacin

5 'P's of sexual history taking

``` sexual practices partners past sti history protection pregnancy ```

when to examine a person with suspected STI

only if symptomatic

what position should a female be in an STI examination

lithotomy position

4 major complaints of STI presentations

urethritis/discharge ulcers lumps and bumps vaginal discharge

what STIs can cause urethritis

``` gonorrhea chlamydia HSV trichomonas vaginalis mycoplasma genitalium ```

what is the 2nd most common STI in UK

gonorrhea

which group of the population have the highest incidence of gonorrhea

males 20-24

clinical features of gonorrhea

``` purulent discharge urethritis inflammation at contact point depending on sexual practice systemic sysmptoms (fever sweats) ```

2 possible male complications of gonorrhea

epididymo-orchitis | prostatits

2 possible female complications of gonorrhea

PID | bartholinits

what can neonates get in vertical gonorrhea infections

gonococcal conjunctivities

investigation of gonorrhea

microscopy | blood cultures

what would gonorrhea look like on a microscope

gram negative intracellular diplococci

there is only 1 strain of chlamydia - T or F

F serotypes D-K are most common of chlamydial STIs

most chlamydia infections are asymptomatic - T or F

true

clinical features of chlamydia

urethritis cervicitis proctitis

what STIs can cause genital ulceration

HSV sphillis scabies tropical STIs like chancroid LGV

where does HSV1 and HSV2 usually infect

HSV1 usually mouth | HSV2 usually genitals

which group of the population have the highest rates of HSV infections

females 20-24

stages of HSV STI

primary infection latent phase reactivation

how does primary infection of HSV present

itchy, painful ulcerate genitalia vesicles regional painful lymphadenopathy systemic features - fever, headache myalgia

where does the HS virus remain latent

dorsal ganglia

how does HSV reactivation look like

genital cold sores

how to diagnosis HSV STI

clinical appearance

blood tests are useful in HSV investigation - T or F

F - many people are asymptomatic carriers

treatment for HSV STI

aciclovir

which strains of HPV are most responsible for genital warts

6 and 11

how does HPV warts look like

painless genital warts

what is the primary causative organism of bacterial vaginosis

gardenerella vaginalis

which 2 groups of females are more prone to bacterial vaginalis

IUCD and WSW

symptoms of bacterial vaginalis

discharge | foul smelling - like fish

describe the discharge in bacterial vaginalis

thin, homogenous grey vaginal discharge (NOT purulent)

how to diagnose bacterial vaginosis

wet film, gram smear | look for clue cells and mixed flora

symptoms of candidiasis

itchy, dry yeasty smell vaginal discharge

microscopy features of candidiasis

spores and pseudohyphae

what causes trichomoniasis

bacteria - trichomoniasis vaginalis

symptoms of trichominiasis

offensive vaginal discharge - green or yellow

microscopy features of trichomoniasis

motile trichomonads

what route is hepatitis A spread by

faecal oral

symptoms of hepatitis A

systemic - fever, malaise, ruq pain, anorexia, arthralgia jaundice

complications of hepatitis A

fuliminant liver failuer | encephalopathy

investigations of hepatitis A

``` FBC - lymphocytic LFTs - hepatitic piture Clotting - raised PT Bilirubin - raised if jaundiced ESR: raised ```

which viral hepatitis infections have vaccines

Hep A and B

transmission of hepatitis B via?

blood, bodily fluids

symptoms of Hepatitis B

generalised malaise, arthralgia, anorexia, mild fever, RUQ pain, jaundice

what are the different possibilities after infection with Hepatitis B virus

``` active infection resolution chronic hepatits B infection fulminant liver failure hepatocellular carcinoma ```

which blood protein is sensitive for hepatocellular carcinoma

alpha-fetoprotein

6 types of serological markers in hepatitis B

``` HBsAg HBeAG antiHB C IgM antiHB C IgG HBe AB HBs AB ```

serological markers in hepatitis B of active infection

HBs Ag HBe Ag HBC IgM HBV DNA

serological markers in hepatitis B of chronic infection

HBs Ag HBe Ag HBC IgG HBV DNA

serological markers in hepatitis B of resolved infection

Anti HBs Ab Anti HBc IgG Anti HBe Ab -ve HBV DNA

serological markers in hepatitis B of immunity from vaccination

anti HBs Ab

which hepatitis B serological marker is a sign of infectivity

HBe Ag

how does hepatitis D happen

co-infection (same time) or superinfection (after) with hepatitis B

which is worse with hepatitis D co infection or superinfection?

superinfection

what risk is increased in hepatitis D superinfection

liver cirrhosis, failure and HCC

there is a vaccine for hepatitis C T or F?

most hepatitis C cases resolve within a month and never appear again - T or F

False- 75% of acute cases become chronic

hepatitis C or B which is more likely to cause cirrhosis and HCC

why is hep C more likely to cause long term damage?

because it can exist for decades before becoming detectable