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Description
Flashcards by Andrew Street, updated more than 1 year ago
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Created by Andrew Street
over 8 years ago
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| Question | Answer |
| 1484 List acute consequences of infxn. | Cytokine effects (fever, malaise, anorexia, catabolic state, inc white cells & platelets, acute phase response) / Circulatory failure / DIC / Organ damage and failure from shock (eg renal failure), direct invasion (eg pneumonia producing resp failure), or by multiple mechanisms (eg adult resp distress synd). MAAG p85. |
| 1484 List chronic consequences of infxn. | Muscle wasting & weight loss / Anaemia of chronic DS / Permanent organ destruction (eg liver cirrhosis from chronic hepatits) / Post infective phenomena (eg lactose intolerance after GI infxn). MAAG p85. |
| 1484 List AI phenomena of infxn. | Generalised synd's (eg post streptococcal phenomena such as rheumatic fever) / System specific (eg Guillain-Barre synd post viral infxn or cerebellar synd's post chickenpox, haemolytic anaemia post Mycoplasma infxn) / Rheumatological (eg arthritis post gut infxn or UTI) / Dermatological (eg scarlet fever rash post streptococcal infxn). MAAG p85. |
| 1485 List factors predisposing to infxn (hint - split into 3 sections). | 1) Exposure: travel Hx, occupation, animal exposure, sexual activity, household contacts, living environment, ingestion of food & water, trauma, medical contact or receipt of BD or tissue. 2) Microorganism factors: infecting dose, virulence, duration of exposure, ability to evade the immune system. 3) Host factors: age, nutrition, immune status, genetic makeup. MAAG p84. |
| 1486 Define PUO. | A temperature > 38.3 C for > 3/52 with no obvious source despite appropriate investigation. OHOCM p386. |
| 1486 List common causes of PUO. | Infxn's / Neoplasms / Connective tissue DS / Others (eg drugs, PE, stroke, Crohn's, ulcerative colitis, sarcoid). OHOCM p386. |
| 1487 What DS is this rash typically associated with and describe the rash. | Meningitis. Petechial rash which is non-blanching. OHOCM p832. |
| 1488 List 1st line Ix for a febrile pt. | Ix for a PUO: FBC / CRP / ESR / U & E's / Liver biochem / BD cultures - repeat / Urine MC & S / CXR / Sputum MC & S, & acid-fast bacilli / Stools for ova, cysts, parasites & culture & sensitivity / Store serum for future Ix / Take swabs from wounds for culture / Screen for AI rheumatic disorders / Relevent Ix pertaining to travel (eg thick & thin BD films for malaria). KACCICM p2. |
| 1489 Explain the EWS system and its relavence to infxn. | EWS covers: 1) Resp rate 2) O2 sats 3) Temp 4) Systolic BP 5) Pulse 6) LOC. See https://www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news |
| 1490 Discuss how sepsis can lead to multi-organ failure. | Septic shock = severe sepsis with hypotension which persists despite adequate fluid resuscitation. This occurs due to endotoxin release from pathogens or a cytokine mediated immune response leading to +++ vasodilation & +++ vascular permeability. This can lead to hypo-perfusion of organs and loss of function. MAAG p350. |
| 1491 Describe the immediate Mx of the septic pt. | O2 / BD cultures & other antimicrobial sampling / Broad spectrum ABx post sampling / IV fluid resuscitation / Measure lactate (indicates severity) / Localise site of infxn (eg CXR, CT abdo, check IV lines) / Abscesses should be Dx using imaging and drained / Haemodynamic support / Renal support for acute failure / BD product support for anaemia, thrombocytopenia, coagulopathy. MAAG p351. |
| 1495 List causes of PUO: bacterial, viral, fungal, protozoal, neoplastic, connective tissue DS, granulomatous DS, others. | Bacterial: abscess, subacute bacterial endocarditis, TB, brucellosis, typhoid, leptospirosis, Q fever, cat scratch DS. Viral: influenza, glandular fever, HIV, CMV. Fungal: candidiasis, aspergillosis, Pneumocystis jirovecii (causes pneumonia in HIV). Protozoal: malaria, amoebiasis, toxoplasmosis. Neoplastic: hypernephroma, lymphoma, hepatoma, acute leukemia. Connective tissue DS: rheumatoid arthritis, polyarteritis nodosa and other vasculitis, temporal arteritis. Granulomatous DS: Crohn's DS, sarcoidosis. Others: MI, post-immunisation, drug induced, PE, familial Mediterranean fever, factitious. DDx p395. |
| 1496 For a pt with a PUO list useful initial screening Ix's. | FBC / LFT's / CRP / ESR / BD cultures / Urine dip / CXR. MAAG p86. |
| 1497 List common opportunistic infxn's seen in HIV. | Pneumonia (often caused by Pneumocystis carinii (jirovecii)) / CMV (occurs late stage - main problem caused is progressive retinitis but also causes gut, NS, and lung infxn's) / Toxoplasmosis (most commonly causes encephalitis in late stage) / Kaposi's sarcoma (caused by herpes virus 8) / N0n-Hodgkins lymphoma (10% in late stage) / Cryptococcal DS (yeast like fungus causing pulmonary DS, meningitis, cryptocaemia) / TB / Candida infxn's (esp oesophageal). MAAG p354 & OHOCM p410. |
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