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Memorising Medicine - Mnemonics > Infection & Antibiotic Prescribing > Flashcards

Infection & Antibiotic Prescribing Flashcards

1
Q

Cellulitis - common organisms and antibiotics

A

Group A streptococcus eg. S. pyogenes, Stapholococcus aureus. Less commonly - Strep pneumoniae, Haemophilus influenza, Pseudomonas auriguinosa

Flucloxicillan
Clarithromycin or Clindamycin if pen allergic.

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2
Q

Common cold

A

Rhinovirus

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3
Q

Most common cause of community acquired pneumonia

A

Streptococcus pneumoniae

Staph aureus common cause pneumonia after having had influenza

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4
Q

Most common cause bronchiectasis exacerbation

A

Haemophilus influenza
Pseudomonas auruginosa
Moraxella catarrhalis

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5
Q

Empirical treatment regimes for community acquired pneumonia

A

Low severity, CURB 0-1: amoxicillin or if pen allergic - doxycycline or clarithromycin

Moderate severity, CURB 2: amoxicillin plus clarithromycin or if pen allergic - doxycycline

Severe severity, CURB 3-5: Co-amoxiclav IV plus clarithromyci IV or Cefuroxime plus clarithromycin IV

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6
Q

Most common cause erysipelas and treatment

A

Streptococcus pyogenes (also known as beta-hemolytic group A streptococci).

Flucloxicillan or Erythromycin

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7
Q

Antibiotic contraindicated in prolonged QT

A

Erythromycin

N.b. normal corrected QT interval is less than 430 ms in males and 450 ms in females

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8
Q

Antibiotic for invasive diarrhoea (bloody and fever)

A

Ciprofloxacin

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9
Q

Abx for traveller’s diarrhoea and non-invasive diarrhoeal illnesses when treatment is necessary

A

Clarithromycin

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10
Q

Organism responsible for scabies? Treatment?

A

Mite - Sarcoptes scabiei

Delayed type IV hypersensitivity reaction –> pruritus

Treatment -
permethrin 5% is first-line
malathion 0.5% is second-line
give appropriate guidance on contact, laundry etc
pruritus persists for up to 4-6 weeks post eradication

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11
Q

Organism and treatment for pityriasis versicolor?

A

Malassezia furfur (formerly termed Pityrosporum ovale)

Topical anti-fungal or ketonazole shampoo

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12
Q

Helicobacter pylori treatment

A

Omeprazole, amoxicillin, metronidazole

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13
Q

Following a splenectomy patients are particularly at risk from what organisms?

A

Pneumococcus, Haemophilus, meningococcus and Capnocytophaga canimorsus*(from dog bites) infections

Prophylactic abx: eg penicillin often given - but doesn’t prevent Haemophilus bacause of the beta lactamases

Vaccinations: if elective, should be done 2 weeks prior to operation
Hib, meningitis A & C
annual influenza vaccination
pneumococcal vaccine every 5 years

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14
Q

Seborrhoeic dermatitis - organism and treatment

A

Chronic dermatitis thought to be caused by an inflammatory reaction related to a proliferation of a normal skin inhabitant, a fungus called Malassezia furfur (formerly known as Pityrosporum ovale).

Special shampoo for scalp (head and shoulders) and topical antifungal eg ketoconazole, sometimes topical steroid

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15
Q

Presentation and bacteria most likely responsible in meningococcal meningitis/ septacaemia

A

Petechiae/ purpura/ septicaemic rash

Meningococcus/Neisseria meningitidis

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16
Q

Cough in a child with white cell count 32 ×109/L, 90% lymphocytes.

A

Pertussis (Whooping cough)

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17
Q

Cough associated with a raised white cell count and neutrophilia

A

Pneumococcal pneumonia

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18
Q

Pseudomonas aeruginosa isolated from sputum is likely in what condition?

A

Cystic fibrosis - Staphylococcus aureus predominate but with repeated courses of antibiotic therapy subsequent infections with multiple antibiotic resistant organisms develop. These latter organisms include Pseudomonas aeruginosa, often ‘mucoid’ strains.

Adults with bronchiectasis can often have similar infections

19
Q

Benzyl penicillin - how is it administered and give examples of indications

A

Benzyl penicillin (penicillin G) is inactivated by gastric acid and so must be given parenterally (unlike penicillin V).

It is an effective treatment for Strep. infections, for example, cellulitis, and is also effective for tetanus.

20
Q

Common organisms infective endocarditis

A

Historically Streptococcus viridans was the most common cause of infective endocarditis. This is no longer the case, except in developing countries. Staphylococcus aureus is now the most common cause of infective endocarditis

21
Q

What organism commonly colonizes indwelling lines and are the most cause of endocarditis in patients following prosthetic valve surgery? How long is it before this returns to normal?

A

Coagulase-negative Staphylococci such as Staphylococcus epidermidis

Usually the result of perioperative contamination. After 2 months the spectrum of organisms which cause endocarditis return to normal (i.e. Staphylococcus aureus is the most common cause)

22
Q

Where is Streptococcus bovis commonly found and associated with?

A

Bowel - Colon cancer

23
Q

What vaccinations must be avoided in immunosupressed individuals?

A 
Live attenuated vaccines:
BCG
MMR
oral polio
yellow fever
oral typhoid
24
Q

Presentation, responsible organism and treatment of whipples disease

A

Whipple’s disease is a rare multi-system disorder caused by Tropheryma whippelii infection. It is more common in those who are HLA-B27 positive and in middle-aged men

Features
malabsorption: diarrhoea, weight loss
large-joint arthralgia
lymphadenopathy
skin: hyperpigmentation and photosensitivity
pleurisy, pericarditis
neurological symptoms (rare): ophthalmoplegia, dementia, seizures, ataxia, myoclonus

Investigation
jejunal biopsy shows deposition of macrophages containing Periodic acid-Schiff (PAS) granules

Management
guidelines vary: oral co-trimoxazole for a year is thought to have the lowest relapse rate, sometimes preceded by a course of IV penicillin

25
Q

Most common meningitis causing organism, by age?

A

0 - 3 months
Group B Streptococcus (most common cause in neonates)
E. coli
Listeria monocytogenes

3 months - 6 years
Neisseria meningitidis
Streptococcus pneumoniae
Haemophilus influenzae

6 years - 60 years
Neisseria meningitidis
Streptococcus pneumoniae

> 60 years
Streptococcus pneumoniae
Neisseria meningitidis
Listeria monocytogenes

Immunosuppressed
Listeria monocytogenes

26
Q

Osteomyelitis - most common organism and treatment?

A

Staph. aureus - except in patients with sickle-cell anaemia: Salmonella.

flucloxacillin for 6 weeks
clindamycin if penicillin-allergic

27
Q

Antibiotics known to cause cholestasis

A

Co-amoxiclav, flucloxicillin, Erythromycin

28
Q

Organism most common in dog bites? And treatment?

A

Pasteurella multocida.

Co-amoxiclav OR
if penicillin-allergic then doxycycline + metronidazole

29
Q

Most common side effect of gentamicin

A

nephrotoxicity: accumulates in renal failure, lower doses and more frequent monitoring is required

(As well as ototoxicity: irreversible, due to auditory or vestibular nerve damage)

30
Q

What is the likely diagnosis of someone who develops a maculopapular, pruritic rash following amoxicillin for a URTI?

A

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.

Features
sore throat
lymphadenopathy
pyrexia
malaise, anorexia, headache
palatal petechiae
splenomegaly - occurs in around 50% of patients and may rarely predispose to splenic rupture
hepatitis
presence of 50% lymphocytes with at least 10% atypical lymphocytes
haemolytic anaemia secondary to cold agglutins (IgM)
a maculopapular, pruritic rash develops in around 99% of patients who take ampicillin/amoxicillin whilst they have infectious mononucleosis

Diagnosis
heterophil antibody test (Monospot test) - NICE guidelines suggest FBC and Monospot in the second week of the illness to confirm a diagnosis of glandular fever.

Management is supportive and includes:
rest during the early stages, drink plenty of fluid, avoid alcohol
simple analgesia for any aches or pains
consensus guidance in the UK is to avoid playing contact sports for 8 weeks after having glandular fever to reduce the risk of splenic rupture

31
Q

Hepatitis B serology - immune due to natural infection, immune due to hep B vaccine, acutely infected and chronically infected

A

anti-HBc, antiHBs = immune due to natural infection

anti-HBs = immune due to hepB vaccine

HBsAg, anti-HBc, IGM antiHBc = Acutely infected

HBsAg, anti-HBc = chronically infected

32
Q

Accepted as the most common cause of infectious diarrhoea in children in the developed society.

A

Rotavirus

33
Q

Can follow ingestion of dust containing dried faecal material.

A

Hepatitis A

34
Q

Attaches the small intestinal border and releases exotoxin.

A

Escherichia coli

35
Q

What is the most likely causative organism of peritoneal dialysis peritonitis?

A

Fifty per cent of episodes of PD peritonitis are caused by Gram positive organisms, and the most common organism is coagulase negative staph. contamination from skin flora.

36
Q

Most common organism seen in acute exacerbations of COPD

A

Haemophilus inluenzae

37
Q

Acute cholangitis - bacterial group and treatment

A

Anaerobes so metronidazole plus broad spectrum cephalosporins, ciprofloxacin, gentamicin are appropriate.

38
Q

Hospital acquired pneumonia - common organisms

A

Bacterial: S. aureus(17.4%), Pseudomonas aeruginosa (17.4%), Klebsiella pneumoniae and Enterobacter spp. (18.1%)

Viral pneumonia: influenza and respiratory syncytial virus and, in the immunocompromised host, cytomegalovirus- cause 10-20% of infections.

39
Q

Acute otitis media - common organisms and treatment

A

Viral, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis

Supportive - analgesia and benzocaine ear drops.

Antibiotics in bilateral acute otitis media < 2 years old, severe unilateral or bilateral over 2 - Amoxicillan, Co-amoxiclav

40
Q

Otitis externa

A

Most common - Pseudomonas aeruginosa and Staphylococcus aureus. Candida albicans and Aspergillus species are the most common fungal pathogens.

Treat with ear drops containing antibiotics and corticosteroids eg Dexamethasone 0.1%, ciprofloxacin 0.3%, Hydrocortisone acetate 1%, gentamicin 0.3%

Antifungal solutions are used in the case of fungal infections eg Flumetasone pivalate 0.02%, clioquinol 1%

41
Q

Septic arthritis - common offenders and treatment

A

Staph aureus, Streptococci, Haemophilus influenzae - previously most common in children, but less now due to vaccination, Neisseria gonorrhoeae, Escherichia coli

Flucloxacillin for 4-6 weeks (longer if infection complicated); if penicillin-allergic then use clindamycin instead.

If meticillin-resistant S. aureus (MRSA) is suspected, vancomycin (teicoplanin may also be used) for 4-6 weeks (longer if infection complicated)

If gonococcal arthritis or Gram-negative infection is suspected, cefotaxime (ceftriaxone may also be used). Treat Gram-negative infections for 4-6 weeks (longer if infection complicated). Treat gonococcal infection for two weeks.

42
Q

Uncomplicated pyelonephritis -treatment

A

Oral ciprofloxacin for 7-10 days

43
Q

Uncomplicated UTI - treatment

A

Trimethoprim or nitrofurantoin 3 days

seven days for the treatment of UTIs in me

44
Q

Flare up/ infected eczema

A

14-day course of flucloxacillin

Memorising Medicine - Mnemonics (23 decks)

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