• Personal information

          

    Prof. of Hepatology & Gastroenterology, Cairo University.

    Consultant of Hepatology,Gastroenterology and Endoscopy

    Management Positions: •

    Chief of Hepatology unit El Manial University Hospital (1994-1998).

    • Chief of Gastroentero ICU in Cairo university hospital (1997-2000)

    • President of the board of AlfaScope GI Specialized center (2004-2014).

    • Head of Endoscopy Unit in Cairo University Hospitals (2005-2010).       

     

     .Read more

     

    استاذ الكبد و الجهاز الهضمى بكلية الطب جامعة القاهرة

    استشارى الكبد و الجهاز الهضمى و المناظير

    دكتوراه امراض الكبد و الجهاز الهضمى من كلية الطب جامعة القاهرة

    الرئيس السابق لقسم الامراض الباطنية بكلية الطب جامعة ٦ اكتوبر

    الرئيس السابق لوحدة مناظير الجهاز الهضمى و مركز الكبد و الرعاية المركزة بقصر العينى

     

    إقرأ المزيد

     

About Me

Saturday, Oct 21st

Last update10:09:06 AM

        

Infections

Infections

  • PDF

 

Infections

 

Enumerate:

1. Complications of typhoid fever.

2. Complication of brucellosis.

3. Causes of meningitis.

4. Complications of meningitis.

5. Four side effects of metronidazole.

6. Four side effects of ciprofloxacin.

 

Give a short account on:

1. Clinical picture, investigations, complications & treatment of typhoid fever.

2. Etiology, pathogenesis, diagnosis & treatment of enterica.

3. Clinical features & investigations & treatment of brucellosis.

4. Clinical features, investigations & treatment of meningococcal meningitis.

5. Treatment of cerebrospinal meningitis.

6. Fever of unknown origin.

7. Clinical features, investigations & treatment of malaria.

8. Prophylaxis for malaria.

9. Give an account on 2 only of anti-malarial drugs.

10. Treatment of amoebiasis.

11. Treatment of Giardia.

12. Treatment of Ascaris.

13. Treatment of Ankylostoma anemia.

14. Treatment of Oxyuris.

15. Treatment of Schistosomiasis.

16. Treatment of intestinal schistosomiasis.

17. Treatment of cholera.

18. Treatment of cerebral malaria.

19. Etiology, pathogenesis, diagnosis, complications & treatment of cholera.

20. Clinical picture & complications of Ascariasis.

21. Enumerate 3 serous membranes that may be affected by tuberculosis. Describe the clinical picture and diagnosis of the disease in one of these sites.

22. DD and management of fever with convulsions.

23. Clinical picture, investigations & treatment of infectious mononucleosis.

24. Etiology, clinical picture & treatment of botulism.
Case 1:

A 10 year-old boy presented with jaundice and dark urine. He gave a history of  fever, anorexia & nausea for the previous 5 days.

 

1. What is the most likely diagnosis?

2. What are the investigations you need to confirm your diagnosis?

3. What is the most probable causative agent?

4. What is the investigation you do to confirm that?

 

The investigations for HAV, HEV, HBV and HCV were negative.

 

5. What were these investigations?

 

The patient did not improve, so he went to another doctor. When this doctor examined the patient, he detected congestion of the throat, palpable cervical & axillary lymph nodes and moderate degree of hepato-splenomegaly.

 

6. What would be the most probable diagnosis?

7. What are the investigations to confirm this diagnosis?

8. What type of anaemia may occur in this patient?

9. If the patient was found to have petechiae, what would be the explanation?

10. The causative agent in this case may be responsible for other medical disorders, what are these disorders?

 

Case 2:

An 18 year-old female visited her physician because of three weeks of malaise, fever and sore throat.

 

1. Enumerate causes of sore throat.

 

Physical examination showed: pharyngeal injection, enlarged tonsils with patchy white exudate, enlarged cervical, axillary and inguinal lymph nodes and minimal splenomegaly.

 

2. Enumerate causes of generalized lymphadenopathy.

3. Enumerate causes of white exudate over the tonsils.

 

CBC showed: hemoglobin 10 gm, platelets 380,000, white blood count 8,500 with 35% neutrophils, 1% eosinophils and 64% lymphocytes, of which 36% were atypical. Total serum bilirubin was 1.9 mg/dl.

4. What is the most likely diagnosis?

5. How would you prove your diagnosis?

6. Comment on the lymphocytic count in this patient.

7. Is there neutropenia in this CBC?

8. What type of anaemia is here? What is its cause? How to prove that?

9. Is there jaundice in this patient?

10. What type of serum bilirubin is elevated here?   

11. What are the complications that can occur in this patient?

12. What is the prognosis of this patient?

 

Case 3:

A 25 year old peasant living in Kafr El Shiekh, came to the hospital complaining of continuous fever of one month duration. Examination revealed  hepato-splenomegaly and a temperature of 38 C. Blood culture was positive. The patient was given Chloramphenicol 750 mg/6hours for 10 days.

 

1. What is the most probable diagnosis?

 

The patient recovered, but few days after stopping the drug fever recurred. Blood culture was positive and there were S.mansoni ova in the stool.

 

2. Why the fever recurred?

3. How to manage the patient at this step?

 

The patient was given Chloramphenicol 1000 mg/6 hours for 20 days. The temperature returned to normal after 4 days. The patient got sore throat and fever during the 15th day of treatment.

 

4. What is the investigation you would ask for? Why?

5. How would you manage the patient? What is the prognosis?

 

Case 4:

A 7 year old boy was admitted to the hospital because of high fever, intense headaches, photophobia, profuse perspiration and general malaise, of three days duration. He was noted to have neck stiffness.

 

1. What is the most probable diagnosis?

2. What are the clinical tests to be done?

3. What are the investigations to be done?

 

A spinal tap revealed turbid CSF under increased pressure, with marked reduction of the sugar and elevation of the protein.

 

4. Enumerate the possible organisms that can be found in this CSF.

5. Describe the CSF picture in cases caused by other organisms.

 

One day later the patient developed a haemorrhagic rash and severe diarrhoea and vomiting, followed in few hours by marked hypotension.

 

6. What is the most probable cause for this new event?

7. How to prove your diagnosis?

8. How to treat this new development?

9. What is the causative organism in this case?

10. How to protect contacts from getting infected?

 

Case 5:

A 35 year old female living in Cairo, went to the doctor complaining of attacks of fever, sweating, shivering and headache of one month duration. Examination revealed a palpable spleen. The temperature was 37.2 at the time of examination (8 pm). The patient denied recent travel abroad. CBC was found to be normal. Blood film was done, which diagnosed the condition.

 

1. What is the most probable diagnosis?

2. What is the causative organism in this condition?

 

The patient was prescribed a drug to be taken for 3 days. The fever subsided, but 10 days later the attacks of fever recurred again.

 

3. What was the prescribed drug and what is its dose?

4. Why the attacks of fever recurred?

5. How to manage the patient at this step?

 

Case 6:

A 15 year old male complaining of continuous fever and severe headache for six days, was seen in the out patients clinic. His temperature was 39 C, his pulse was 100/m and a spleen was palpable. There was no neck rigidity, throat congestion, palpable lymph nodes, or rash. Cardiac and chest examination revealed no abnormalities. The patient denied any urinary manifestations, disturbed bowel habits, bleeding tendency or recent history of travel abroad.

 

1. Comment on the pulse.

2. If you are allowed to ask only for 2 investigations, what would they be?

3. Enumerate causes of fever with splenomegaly.

4. Put 2 most probable possibilities for diagnosis of the case.

 

The investigations revealed that:

- TLC: 3,500 with 40% neutrophils and 60% lymphocytes.

- Widal test:

Anti O typhi: 1/20.

Anti H typhi: 1/20.

Anti H para typhi A: 1/160.

Anti H para typhi B: 1/40

- Malta test: negative.

- Urine: normal.

- Blood film for malaria: negative.

- Monospot test: negative.

 

5. Comment on the results of each investigation.

6. What would be your next step?

 

The patient was given Chloramphenicol 250 mg/6 hours for 5 days. The temperature returned normal in the fourth day of treatment, but fever recurred again three days after stopping treatment.

 

7. Comment on these developments.

8. What is the therapeutic spectrum of Chloramphenicol?

9. What are the adverse effects of Chloramphenicol?

 

The patient went to a consultant who asked for a blood culture. The culture was positive and the doctor prescribed Ciprofloxacin 500 mg/12 hours for 10 days.

The temperature returned normal and did not rise after stopping treatment.

 

10. Was this a proper time to ask for a blood culture?

11. What is the diagnosis of the case?

12. What are the possible complications of this disease?

 

Infections

 

نهتم برأيك

هل استفدت من الموقع?



Results

تابعنا

Add this

AddThis Social Bookmark Button

كيف تصل الينا

  • عنوان: 98 شارع التحرير , ميدان الدقي, القاهرة , مصر
     
  • هاتف: (+202) 376 1111 8

حقوق الملكية

 المعلومات الواردة في مختلف صفحات موقع د.سامح لبيب على الإنترنت هي معلومات صادرة عنه لأغراض تعليمية-خدميه. وتلك المعلومات محمية بموجب قوانين  حماية المصنفات الأدبية والفنية واتفاقيات دولية أخرى وبمقتضى القوانين الوطنية الخاصة بحقوق التأليف والحقوق المرتبطة بها. ويجوز استعراض أجزاء من المعلومات الواردة في الموقع أو نسخها أو ترجمتها لأغراض البحث أو لإجراء دراسة شخصية ولكن ليس لبيعها أو استخدامها لأغراض تجارية.

©  د.سامح لبيب ـ2012-2107

You are here: Revision Infections

Website Designed and Developed by Amgad