MEDICINE > Infections > Flashcards

Infections Flashcards

(37 cards)

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1
Q

Features of underlying immunodeficiency in shingles

A

Severe disease

Prolonged duration of rash

Multiple dermatomal involvement

Recurrence

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2
Q

CNS involvement in shingles

A

Ramsay Hunt syndrome

  • due to geniculate ganglion
  • facial palsy
  • I/L loss of taste
  • buccal ulceration
  • rash in external auditory canal

Myelitis
Cranial nerve palsy
Encephalitis

Granulomatous cerebral angiitis - stroke like syndrome a/w shingles (esp in an ophthalmic distribution)

Post herpetic neuralgia

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3
Q

Post herpetic neuralgia

A

Persistent pain following healing of the rash of shingles

  • for 1-6 months or longer
  • common with advancing age

Rx :
- Aggressive analgesia

  • Amitriptyline 25-100 mg daily OR
    Gabapentin (start at 300 mg daily, increase slowly to 300 mg twice daily or more)
  • Capsaicin cream (0.075%)
  • Corticosteroids (controversial)
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4
Q

Complications of EBV infection

A

Severe pharyngeal edema

Antibiotic induced rash (80-90 % with ampicillin)

Hepatitis (80%)

Prolonged post viral fatigue (10%)

Jaundice (

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5
Q

CNS & CVS complications of EBV infection

A

CNS

  • Cranial nerve palsies
  • Polyneuritis
  • Transverse myelitis
  • Meningoencepahilitis

CVS

  • Myo & Pericarditis
  • ECG abnormalities
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6
Q

Hematological complications of EBV infection

A

Hemolytic anemia

Thrombocytopenia

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7
Q

Renal abnormalities of EBV infection

A

Abnormal urine analysis

Interstitial nephritis

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8
Q

EBV associated malignancy

A

Nasopharyngeal Ca

Burkitt’s lymphoma

Primary CNS lymphoma

Hodgkin’s disease

Duncan’s syndrome - lymphoproliferative disease in immuno compromised

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9
Q

How does vertical transmission occurs in dengue ?

A

If infection occurs within 5 weeks of delivery

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10
Q

How long does the protection of yellow virus vaccination last ?

A

Single vaccination with a live attenuated vaccine lasts for atleast 10 years

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11
Q

Bartonellosis - Name the diseases

A

Trench fever
Cat scratch disease
Bacillary angiomatosis

Bacteremia & endocarditis in the homeless

Oroya fever & verruga peruana (Carrion’s disease)

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12
Q

Brucella spp

A

B.melitensis - most severe
B.abortus
B.suis - a/w abscess formation
B.canis

G -ve
Intracellular
Survive for long periods in the RE system

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13
Q

C/F of acute brucellosis

A

High swinging temperature
Rigors
Lethargy

Headache
Joint & muscle pain
Scrotal pain

CNS - Delirium
GIT - Abdominal pain, Constipation

Signs

  • Enlarged LN
  • Splenomegaly –> hypersplenism, thrombocytopenia
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14
Q

CNS involvement in brucellosis

A

Meningitis
IC or SAH
Stroke

Cranial nerve palsies

Myelopathy
Radiculopathy

Eyes

  • Uveitis
  • Retinal thrombophlebitis
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15
Q

CVS involvement in brucellosis

A

Endocarditis

Myocarditis

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16
Q

Respiratory system involvement in brucellosis

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A

Pneumonitis or abscesses

Hilar LAP

17
Q

Bone involvement in brucellosis

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A

Spinal spondylitis or sacroiliitis
Paravertebral or psoas abscess

Suppurative arthritis
Synovitis
Bursitis
Osteomyelitis

18
Q

GIT & GU involvement in brucellosis

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A

Splenic abscess or calcification
Hepatitis

Epididymo-orchitis

19
Q

Hematological abnormality in brucellosis

20
Q

General examination finding in brucellosis

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A

Malodorous perspiration

LAP

21
Q

MC HIV related cancer

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A

HHV-8 related Kaposi’s sarcoma

22
Q

EBV related cancers occurring in HIV patients

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A

Non-Hodgkin lymphoma

Hodgkin lymphoma

23
Q

HPV related cancers occurring in HIV patients

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A

Anal Ca

Cervical Ca
Vulval Ca

Penile Ca

24
Q

CNS involvement in HIV

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A

Cognitive Impairement

ICSOLs

Meningitis

25
ICSOLs occurring in AIDS patients
Toxoplasmosis Primary CNS lymphoma Tuberculoma Cryptococcoma
26
Causes of meningitis in AIDS patients
Cryptococcal TB Pneumococcal HIV
27
Post exposure prophylaxis for AIDS
1st dose asap (preferably within 6-8 hours) NO use starting PEP after 72 hours Low risk exposure - Dual NRTIs (Tenofovir + Emtricitabine) High risk exposure - Dual NRTIs + PI or Efavirenz (NNRTI) HIV antibody testing at 6, 12, 24 weeks after exposure
28
Common causes of chronic watery diarrhoea in AIDS patients
When CD4+ T cell count
29
Opportunistic infections in AIDS reduced by Cotrimoxazole
Pneumocystis jiroveci pneumonia Isospora belli diarrhoea Cerebral toxoplasmosis Dose : 960 mg daily
30
Opportunistic infections in AIDS along with Rx
Cryptococcosis - Fluconazole 200 mg daily CMV - Valganciclovir 900 mg daily MAC - Clarithromycin 500 mg BD - Ethambutol 800 mg daily
31
MC drug rash occurring in HIV patients
Erythematous MP rash - maybe scaly MC drugs - Sulphonamides - NNRTIs Life threatening features of rashes - Blistering - TEN ( blistering >30% of surface area) - SJS (involves mucous membranes) - Systemic involvement with fever or organ dysfunction
32
Organisms causing mucormycosis
Mucoraceous moulds - Lichthemia (Absidia) - Rhizomucor spp - Mucor spp - Rhizopus spp
33
Disease patterns in mucormycosis
Rhinocerebral/Craniofacial Pulmonary Cutaneous Systemic
34
Predisposing factors for mucormycosis
Profound immunosuppression - Neutropenia - HSC transplantation Uncontrolled DM Iron chelation therapy - Desferrioxamine Severe burns
35
Rx of mucormycosis
Antifungal therapy - Amphotericin B - Posaconazole Surgical debridement Correction of predisposing factors
36
Rx of schistosomiasis
PRAZIQUANTEL - 20 mg/kg orally - twice daily for 1 day - Kills adult worms & stops egg laying - In early infection, it reverses hepatomegaly, UB wall thickening & granuloma SURGERY - for residual lesions - Eg: Ureteric strictures, small fibrotic UB, granulomatous masses in brain & spinal cord
37
C/F of shingles (herpes zoster)
Burning discomfort in the affected dermatome - Thoracic dermatomes - Ophthalmic (Vth CN) - vesicles appear on cornea --> ulceration --> blindness Discrete vesicles appear 3-4 days later (a/w brief viremia) Zoster sine herpetica - paraesthesia occurs without rash
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