A phlebotomist gives herself a needlestick injury whilst taking blood from a patient who is known to be hepatitis B positive. The phlebotomist has just started her job and is in the process of being immunized for hepatitis B but has only had one dose to date.
What is the most appropriate action to minimize her risk of contracting hepatitis B from the needle?
Correct Answer C:
Post-exposure prophylaxis:
Hepatitis A:
Hepatitis B:
Hepatitis C:
HIV:
Varicella zoster:
Estimates of transmission risk for single needlestick injury:
What is the first line antibiotic in the treatment of Shigella dysentery?
Shigella:
Overview:
Which one of the following conditions is not associated with prior Epstein-Barr virus infection?
Correct Answer B: Adult T-cell leukaemia is associated with HTLV-1 infection.
Epstein-Barr virus: associated conditions:
Malignancies associated with EBV infection:
The non-malignant condition hairy leukoplakia is also associated with EBV infection.
*EBV is currently thought to be associated with both African and sporadic Burkitt's.
A 38-year-old homeless man is diagnosed as having pulmonary tuberculosis. It is decided that directly observed therapy should be used.
How often will he need to take anti-tuberculosis medications?
Tuberculosis: drug therapy: The standard therapy for treating active tuberculosis is:
Initial phase - first 2 months (RIPE):
Continuation phase - next 4 months:
The treatment for latent tuberculosis is isoniazid alone for 6 months.
Patients with meningeal tuberculosis are treated for a prolonged period (at least 12 months) with the addition of steroids.
Directly observed therapy with a three times a week dosing regimen may be indicated in certain groups, including:
A 44-year-old man who is known to have HIV is admitted to the Emergency Department following a seizure. He has been taking antiretroviral therapy for the past two years. A CT scan (without contrast) shows a solitary lesion in the basal ganglia.
What is the most effective method to help differentiate between lymphoma and toxoplasmosis?
Correct Answer C: Differentiating between toxoplasmosis and lymphoma is an important aspect of managing neurocomplications relating to HIV. Given the more limited availability of SPECT compared to CT many patients are treated empirically on the basis of scoring systems, for example there is a 90% likelihood of toxoplasmosis if all of the following criteria are met:
HIV: neurocomplications:
Generalized neurological disease:
Encephalitis:
Cryptococcus:
Progressive multifocal leukoencephalopathy (PML):
AIDS dementia complex:
Focal neurological lesions:
Toxoplasmosis:
Primary CNS lymphoma:
Differentiating between toxoplasmosis and lymphoma is a common clinical scenario in HIV patients. It is clearly important given the vastly different treatment strategies. The table below gives some general differences. Please see the Radiopaedia link for more details.
Tuberculosis:
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