Year 5 passmed Flashcards by HARRY RICHARDSON

abx of choice to treat mycoplasma

doxy or azithromycin

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side effects of doxycycline

photosensitivity
discoluration of thyroid gland
fontanelle bulging in infants
tooth discoluration
GI discomfort

dont give them in pregnancy

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What is the most appropriate test to check for latent tuberculosis?

A TB skin test (“Mantoux”) can show if you have latent TB infection.

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exmape of a non-lactose fermenting, oxidase-positive, gram-negative bacilli

pseudomonas aeruginosa

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oxidase negative bacteria common

Oxidase (-) Burkholderia spp.
E. coli.
Proteus spp. Salmonella spp. Shigella spp.

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oxidase positive bacteria

Oxidase (+) P. aeruginosa. Aeromonas spp.

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hepatomegaly causes

infections: Hep A, B or C , cytomegalovrius and mononucleosis

Alcohol

autoimmune - sarcoidosis and SLE

Genetic - hemochromatosis, wilsons disease, alpha 1 anti-typrsin

cogestive heart failure and thrombosis

neopalstic; leuakemia, lymphoma , HPC

sicle cell anaemai

pregnancy

amyloidosis

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generalised liver disease sx

abdominal pain
bruising
fatigeu
itching
jaundice
muscle aches
nausea
poor appetite
swelling

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splenomegaly causes

malaria
hodgkins
leukaemia
HF
cirrrhosis
tumours
viral bacterial and parastie
SLE and RA
mononcuelosis
suphylis

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headache, myalgia, fever and a cough. On auscultation her chest is clear but she has a temperature of 38.6ºC - these are all typical flu sx what causes the flu

influenza

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cause of the common cold

rhinovirus

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what genital ulcers are painful and whats more common than the other

painful: herpes much more common than chancroid

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what genital ulcers are painless and whats more common

painless: syphilis more common than lymphogranuloma venereum

behecets also cause ulcers - do not know if painful or not

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chancroid caused by

Chancroid is a tropical disease caused by Haemophilus ducreyi. It causes painful genital ulcers associated with unilateral, painful inguinal lymph node enlargement. The ulcers typically have a sharply defined, ragged, undermined border.

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lymes disease abx tx

doxycycline
amox if preg

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management of pt with bacterial meningitis (4)

IV access to get bloods and cuture
IV abx - cefotaxime if 3m-50 and over 50 cefotaxime and amox
Iv dexamethaone - particularly if pneumococcal - improve outcomes by reducing neurological sx
CT scan

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when getting an LP what are you looking and testing for

glucose, protein, microscopy and culture
lactate
meningococcal and pneumococcal PCR
enteroviral, herpes simplex and varicella-zoster PCR
consider investigations for TB meningitis

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what do you give to contacts of meningitis if close contact witin 7 days

oral ciprofloxacin or rifampicin

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if you have chronic hepatitis what vaaccine should you be offered

one-off pneumoccoal vaccine

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choice of abx in cellultiis in preg

erythromcyin - if not preg clairthomycin

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most common cause of viral meningitis

Coxsackievirus or other enteroviruses

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characterised by a prodrome, abdominal pain and bloody diarrhoea what infection for gi infection

campylobacter

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bacterial vag tx
can in preg and breastfeed

Metronidazole 400mg bd for 5 days

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Patient has had a full course of tetanus vaccines, with the last dose < 10 years ago do you need any tetanus tx

no vaccine nor tetanus immunoglobulin is required, regardless of the wound severity

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Patient has had a full course of tetanus vaccines, with the last dose > 10 years ago do you need vaccine

yes but depends if tetanus prone wound- puncture , foregin body burn , bite : reinforcing dose of vaccine high-risk wounds- heavy contamination (e.g. compound fractures, delayed surgical intervention, significant degree of devitalised tissue): reinforcing dose of vaccine + tetanus immunoglobulin

pneumonia pathogen in alcoholics

klebsiella

worsening cellulitis with worsening pain in keeping with physical features what you thinking and who should you refer to

nec fasc and surgeons

Chest X-ray shows a partially-filled cavity with a crescent of air post TB

aspergilloma

what is metronidazoles affect on warfarin

Metronidazole increases the anticoagulant effect of warfarin increasing INR as delayed antucoagualtn effect

most likely pathogen associated with gangrene

Clostridium perfringens is the most likely pathogen to be associated with gangrene.

cavitating lesion causing pneumonia what pathogen

staph aureus

Fever, abdominal pain, constipation, 'rose' spots

typhoid - salmonella typhi

oral herpes what cause

HSV-1 is more commonly associated with oral herpes

despite taking penicillin abx - Which organism is he particularly susceptible to, despite taking prophylactic antibiotics?

h.influenzae

if HIV is dx when should antiviral therapy be started

Antiretroviral therapy should generally be started as soon as HIV is diagnosed Prescribe two nucleoside reverse transcriptase inhibitors (NRTI) and a protease inhibitor (PI)

one solitary gential keratinised wart - how do you treat

solitary, keratinised warts: cryotherapy

if you have multiple non- keratinised warts how do you treat

multiple, non-keratinised warts: topical podophyllum

what is lemierre syndrome

Lemierre's syndrome presents with thrombophlebitis of the internal jugular vein following an anaerobic oropharngeal infection.

if abx treatment is needed for a campylobacter infection what should you give

Campylobacter infection is often self-limiting but if severe then treatment with clarithromycin may be indicated

The BNF recommends treating invasive diarrhoea (causing bloody diarrhoea and fever) with

ciprofloxacin Most viral or bacterial gastroenteritis do not require treatment. The BNF recommends antibiotics for bacterial gastroenteritis in severe infections or in immunocompromised patients. Clarithromycin is used for traveller's diarrhoea and non-invasive diarrhoeal illnesses when treatment is necessary.

Erratic blood glucose control, bloating and vomiting think

gastroparesis

kocher criteria for septic arthritis

Fever: A temperature of 101.3°F (38.5°C) or higher Erythrocyte sedimentation rate (ESR): An ESR of more than 40 millimeters per hour (mm/hour) White blood cell (WBC) count: A WBC count of more than 12,000 cells/mm3 Inability to bear weight: The patient is unable to put weight on the affected si modified adds on crp will also have restricted movement needing synvoial fluid sampling, joint imgiign and blood cultures

difference between bacterial and viral csf

bacterial low glucose and high protein vial high glucose and normal protein fungal low glcuose and high protein

cardiac tamponade follows what

truma, MI, TB or inf , lupus, cancer , CKD, surgery

risk factors for GI bleed

NSAID, anticagoaulans, SSRI alcohol and smoke colitis or ulcers surger cancer RF , liver dissease vomit radiation tx can increase risk of peptic ulcers

how does constrictive pericarditis lead to heart failure

pericardium thickens and stiffens making it difficult for the heart to expand. This prevents the heart chambers from filling with enough blood, which can to lead to heart failure sx such as swelling peipherally taifgue and SOB

Gonorrhoea 1st and 2nd line

Im ceft then oral cefixime 400mg (single dose) + oral azithromycin 2g (single dose)

extnsive OE

Flucloxacillin

pelvic inflammatory disease tx 3 drugs

Doxycycline + metronidazole + ceftriaxone

A test of cure MSU should be sent in pregnant women treated for a UTI what is it post abx

Midstream urine microscopy and culture

meningitis over 50 what tx

IV cefotaxime and amoxicillin

Genital wart treatment if solitary or multiple

multiple, non-keratinised warts: topical podophyllum solitary, keratinised warts: cryotherapy

chlam in preg what to treat

azithromycin

HIV what vaccines are contraindicated live vaccines

Yellow fever Oral polio Intranasal influenza Varicella Measles, mumps and rubella (MMR) TB BCG

Campylobacter infection is often self-limiting but if severe then treatment with

clarithromycin

For a patient undergoing an elective splenectomy, when is the optimal time to give the pneumococcal vaccine?

two weeks before surgery

when do you treat toxoplasmosis

only if immunosuppressed pts

Which of the following combinations of vaccinations are routinely offered to pregnant women in the UK?

Influenza and pertussis

ALL tb pt what else should be offered

HIV test

in sarcoid why do you need CXR

a mass of granulation tissue, typically produced in response to infection, inflammation, or the presence of a foreign substance. non casating ( tissue turning into soft cheese like substance) granulomas

Raised ALP in the presence of normal LFT's should raise suspicion

malignancy

Heparin can cause hyperkalaemia

true

Year 5 passmed Flashcards

(62 cards)