Spirochetes

Question 1

Main clinical features of leptospirosis

Answer 1

Jaundice
Pulmonary
ARF
Haemorrhage
(myalgia, shin rash,CV, ocular, aseptic meningitis)

Question 2

Rx severe / mild-mod

Answer 2

Severe - CTX / pen 7/7 (doxy, STM)

Mild-mod - azithro, amox

Question 3

TB manifestations with HIV inf’n

Answer 3

CD4>300	CD4<200
PPD	          +ve 	-ve                     
LAD	     Unusual	common
Pulm	            UL	LL/ML
Cavitation	Common	Rare
Extra pulm	10-15%	50%+

Question 4

When to start ARVs in TB/HIV coinfection

Answer 4

CD4 50 - within 2 months

Question 5

RFs for MDR TB

Answer 5

smear / culture +ve during DOTS (>3/12)
contact with known MDR
contact with pt who died receiving DOTS
AIDS
DM
HCWs

Question 6

Definition of XDR-TB

Answer 6

INH + RIF
	\+
Any quinolone
	\+
One injectible 2nd line drug 
(STM, kanamacin/amikacin, capreomycin)

Question 7

Lepto diagnostic triad

Answer 7

Hx water/animal contact +
conjunct suffusion +
severe myalgia

Question 8

Vector of Lyme disease

Answer 8

Ixodes tick