14 Infection in the immunocompromised host Flashcards Preview

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Flashcards in 14 Infection in the immunocompromised host Deck (15):
1

Explain how neutrophils may have qualitative defects.

Chemotaxis - rare, inadequate signalling/receptors/movement
Killing - CGD - no NADPH oxidase, no hydrogen peroxide. Staph aureus risk.

2

What might cause a quantitative lack of neutrophils?

Cancer rx.
Bone marrow malignancy.
Aplastic anaemia caused by drugs.

3

Which infections are neutropenic patients especially at risk of? (5).

E. coli (G-ve bacilli).
S. aureus (G+ve cocci).
Coagulase -ve staph.
Candida spp.
Aspergillus spp.

4

What is the treatment for an infection in a neutropenic patient? (2,2,1)

Aminoglycoside and an antipseudomonal penicillin.
2nd line - carbapenem, antifungals.
GCSF.

5

Which drugs may cause T cell deficiencies? (2).

Ciclosporin (transplantation).
Steroids.

6

Which bacterial, viral (3) and fungal (2) infections are T cell deficient patients most susceptible to?

Listeria monocytogenes.
Mycobacteria.
HSV, CMV, VZV.
Candida spp, ctyptococcus spp.

7

Which protozoan and parasitic infections are T cell deficient patients most at risk of? (3)

Cryptosporidium pavum (faecal-oral, symptomatic rx only).
Toxoplasma gondii (cat, or heart with bradyzoites - asymptomatic).
Strongyloides stercoralis.

8

Three causes of acquired hypogammaglobulinaemias and three commonly resulting infections.

Multiple myeloma, CLL, burns.
Usually encapsulated bacteria:
S. pneumoniae, Giardia lambia, Cryptosporidium.

9

Which infections occur with a complement deficiency? (3)

Encapsulated bacteria
S. pneumoniae - poor opsonisation.
If C5-8 Neisseria meningitides.

10

What does the spleen do? (2)

Source of complement and B cells, removes opsonised bacteria.

11

Which infections are people who take biological therapies at risk of? (4).

Tuberculosis.
Herpes zoster.
Legionella pneumophila.
Listeria monocytogenes.

12

What are the five stages of different infections that can follow organ transplantation?
Which infections occur? (1,2,2,2,2)

Initial disease: Hep B.
Surgery related: ventilator acquired pneumonia, S. aureus.
Organ: Toxoplasmosis, CMV.
Initial opportunistic: CMV, Aspergillus.
Later opportunistic: VZV, Listeria.

13

Which prophylactic antimicrobials are used in immunocompromised patients? (4).

Penicillin.
Cotrimoxazole.
Acyclovir.
Passive immunoglobulin.

14

When should Strongyloides stercoralis be suspected? (3).

Eosinophilia.
G-ve septicaemia.
Tropical/ old POW.

15

Which infections commonly occur after a splenectomy? (4).

Streptococcus penumoniae.
Haemophilis influenza type B.
N meningitides.
Malaria.

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