A 31-year-old man from Russia who is known to be HIV positive presents with purple plaques on his skin.
Which of the following viruses is thought to be the cause of Kaposi's sarcoma?
Correct Answer C: Kaposi's sarcoma - caused by HHV-8 (human herpes virus 8).
HIV: Kaposi's sarcoma:
Kaposi's sarcoma:
Which one of the following is least associated with rabies?
Correct Answer B: Opisthotonus is associated more with tetanus. It describes a state of a hyperextension and spasticity in which a patient's neck and spinal column enter into an arching position. It is an extrapyramidal effect and is caused by spasm of the axial muscles.
Rabies:
Features:
There is now considered to be 'no risk' of developing rabies following an animal bite in the UK and the majority of developed countries. Following an animal bite in at risk countries:
A 22-year-old woman presents with lethargy, pyrexia and headaches. She is a student and returned from a holiday in Ibiza ten days ago. These symptoms have been present for the past six days and she is wondering whether she may need an antibiotic. She also has a history of menorrhagia and is concerned that she may be anaemic. Clinical examination reveals a temperature of 37.9ºC and marked cervical lymphadenopathy. You order a full blood count which is reported as follows:
What is the most likely diagnosis?
Correct Answer C: Atypical lymphocytes - ?glandular fever.
Infectious mononucleosis: Infectious mononucleosis (glandular fever) is caused by the Epstein-Barr virus (also known as human herpesvirus 4, HHV-4). It is most common in adolescents and young adults.
Management is supportive and includes:
A 45-year-old man presents with pain and swelling of his left big toe. He has recently started treatment for active tuberculosis.
Which one of the following medications is likely to be responsible?
Correct Answer E: There are case reports of ethambutol-induced gout but it is not listed as a side-effect in the BNF.
Tuberculosis: drug side-effects:
Common side effects:
Rifampicin:
Isoniazid:
Pyrazinamide:
Ethambutol:
A 34-year-old female presents with fever and lower abdominal pain. Over the past five days she has noticed deep dyspareunia and some post-coital bleeding. Her last period began 10 days ago. She is diffusely tender in the suprapubic area and vaginal examination reveals cervical excitation. Endocervical swabs are taken. A diagnosis of pelvic inflammatory disease is suspected.
What is the most appropriate management?
Correct Answer E: Consensus guidelines recommend treatment once a diagnosis of pelvic inflammatory disease is suspected, rather than waiting for the results of swabs.
Pelvic inflammatory disease: Pelvic inflammatory disease (PID) is a term used to describe infection and inflammation of the female pelvic organs including the uterus, fallopian tubes, ovaries and the surrounding peritoneum. It is usually the result of ascending infection from the endocervix.
Causative organisms:
Investigation:
Management:
Complications:
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