capsule infections Flashcards

1
Q

what does purpuric or petechial means

A

blood in extravascular space

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2
Q

how to treat N. meningitidis

A

ceftriaxone- cover most peniclin resistant pneumococci and most staphylococci0 not MRSA

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3
Q

would you give steroids to pt with meningococcal sepsos

A

yes for initial management of bacterial meningitis

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4
Q

causes of atypical pneumonia

A

not detectable on gram stain- chlamydia pneumophila, legionella pneumophilla, mycoplasm pneumonia

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5
Q

how to treat pneumocystis carnii pneumonia

A

2L of O2 via nasal spec, co trimoxazole, steroids

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6
Q

what things change lymphocyte count

A

chronic leukaemia inc lymphocyte count.
immunosupression, HIV infection, renal failure, all cause dec

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7
Q

headache, fever+ short Hx of behavioural changes and dec consciousness

A

viral encephalitis secondary to HSV infection

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8
Q

what would viral infection cause on LP

A

high protein, raised lymphocytes, normal glucose

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9
Q

how would you treat hepes encephalitis

A

hihg dose IV aciclovir- 10mg/kg tds IV in normal real function

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10
Q

RF for meningism

A

overcrowded places, HIv, travel to meningitis belt in sub saharan africa

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11
Q

most commonest complication of bacterial meningitis

A

sensorineural deafness

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12
Q

what is used as chemo prophylaxis and whow should be given it

A

rifampicin, flatmates and partner

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13
Q

how would you differentiate between meningitis and encephalitis

A

pt with meningitis are cognitively intact but may be lethargic or be dominated by pain of their headache.
encephalitis: have abnormal brain function-altered mental status, behavioural or personality changes

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14
Q

how to differentiate between viral and bacterial meningitis

A

CSF on LP- lymphocytes, modesly raised protein, normal glucose- viral

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15
Q

hep A Pc

A

RNA virus-icteric, ache, previous holiday
passed in faecal oral route or sexual contact

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16
Q

Hep A Ix

A

Liver function test, serum hep A IgG or IgM

17
Q

what type of ABx is ciprofloxacin

A

quinolone ABx which inhibits the metabolis of theophyline via CYP450 enzymes and enhanced effect of warfarin

18
Q

Hep C

A

RNA virus-4 genotypes, high rates in africa
spread via blood and needles
some are symptomatic with acute icteric episode
incubation period for 4-20 weeks

19
Q

phase 1 Hep C

A

A prodromal ‘flu-like illness lasting 3-10 days. Malaise, myalgia, sometimes with RUQ pain

20
Q

phase 2 Hep C

A

Icteric illness lasting 1-3 weeks generally but has been seen to persist for over 12 weeks. Jaundice, itch, anorexia, nausea. Fever is not generally seen in this phase.

21
Q

Ix for Hep C

A

HCV core Antibody- person exposed to Hep C in lifetime, positive after 3 months of infection
HCV-RNA: confirm active infection, positive after 2 weeks infection

22
Q

gram positive cocci

A

strep pyogenes, MRSA (vancomycin)

23
Q

GRAM NEGATIVE RODS

A

E.COLI, pseudomonous aeruginosa, Haemophilus influenza

24
Q

gram neg cocci

A

N. meningitidis

25
Q

PC measles

A

high fever, cough, coryza, conjuncitvitis, koplic spots on hands and soles of feet also

26
Q

how is measles spread

A

airborne, contact

27
Q

how to test for measles

A

positive IgM- acute infection. IgG- previous exposure to either natural infection or immunisation

28
Q

complications of measles

A

encephalitis, ototis media, penumonitis

29
Q

Abx for diverticulitis

A

cefuroxime, metronidazole IV

30
Q

Abx for uti

A

cirpo, gentamycin, cefotaxime
sepsis: broad spec anti-pseydomonal penicillin= piperacilin+ tazobactam or broad spec cephalosporin (eg cefotaxime or ceftazidime)

31
Q

Abx for c.diff

A

vancomycin

32
Q

Abx for dog bite

A

co-amox and tetanus booster

33
Q

treatment for MRSA

A

Vancomycin or doxycycline

34
Q

what medication should you not take with warfarin

A

flucloxacillin like many other ABc- unpredictable rise in INR

35
Q

what electrolyte imbalances can piperacillin with tazobactam lead to

A

low K+ and high Na+

36
Q

which Abx is active against pseudomonous

A

ciprofloxacin

37
Q

clarithromycin and theophyline

A

may inc plasma levels leading to possible theophyline toxicity. inc riks of convulsions when quinolones given with theophyline

38
Q

amitriptyline cool facts

A

useful for SOB in endstage COPD
has anti muscurinic properties