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Yr3 Revision > Infections > Flashcards

Infections Flashcards

1
Q

How do we score sepsis risk?

A

SOFA

qSOFA – 2+ of hypotension, tachypnoea and Alt Mental Status

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2
Q

What is the sepsis 6?

A

Give - Abx, Fluid challenge & O2

Take - Serum lactate, blood culture & UO monitoring

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3
Q

What tests can be done for sepsis? (other than the sepsis 6)

A 
FBC - infection
U&E + C -- Renal failure
CRP
ABG -- Acidosis
LFTs -- Liver damage
Coag Screen & D-dimer -- DIC
Glc -- Hyperglycaemia
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4
Q

What are the characteristics of SIRS?

A

High or low temp
Tachycardia
Tachypnoea or low PaCO2
Leukocytosis/Leukopenia

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5
Q

How do you detect parasites in gastroenteritis & treat them?

A

Stool microscopy
Duodenal Biopsy

Treat with Metronidazole

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6
Q

What form’s of gastroenteritis can cause HUS or seizures?

A

Salmonella can cause both

Enterohaemorhagic E.Coli often causes HUS –> renal failure & Anaemia

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7
Q

What causes traveller’s diarrhoea?

A

Enterotoxigenic E.coli
Shigella
Campylobacter

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8
Q

What viruses cause gastroenteritis and how do you detect them?

A

Rotavirus
Noravirus

Serum PCR or Stool Antigen tests

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9
Q

What causes food poisoning?

A 
Staph Aureus Toxin
Bacillus Cereus (Reheated rice)
Clostridium Perfringens (Undercooked meat)
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10
Q

What’s in Oral Rehydration Salts?

A

Glc
Amino acids
NaCl

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11
Q

How would you check for Infective endocarditis in a patient with PUO?

A

Look for a new murmur

If found do a TOE

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12
Q

How o you test for TB?

A

Mantoux test
Sputum sample for ZN stain & culture
Bone marrow biopsy

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13
Q

What do you do if you have a pyrexia of unknown origin and can’t find the cause?

A

Therapeutic Trial:

1) Anti-TB medication, response within 2 wks
2) Steroids, dramatic response within 48hrs

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14
Q

Pyrexia of Unknown Origin along with haematuria, what do you do?

A
  • Renal US for cancer

- Renal biopsy & Auto-Abs for Polyarteritis

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15
Q

What type of HIV causes the epidemic?

A

Type 1 HIV Group M

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16
Q

What cells does HIV target?

A

CD4+ cells e.g. macrophages, Th cells, monocytes, brian & skin

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17
Q

What are the drugs involved in cART for HIV?

A
  • Nucleoside Transcriptase Inhibitors
  • Non-nucleoside Transcriptase Inhibitors
  • Integrase Inhibitors
  • Protease Inhibitors

cART is 3 drugs from atleast 2 classes in 1 pill

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18
Q

What does an acute HIV infection look like?

A

Mostly asymptomatic
Some get seroconversion illness:
- Looks like glandular fever
- But EBV -ve

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19
Q

What conditions suggest an HIV test?

A
  • Thrush
  • Unexplained wt loss or lymphadenopathy
  • Guillain Barre
  • Dementia
  • Aspergillosis
  • Anal or lung cancer
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20
Q

What conditions define AIDS?

A
  • PML
  • Kaposi’s Sarcoma
  • Cervical Cancer
  • CMV retinitis
  • Pneumocytis Pneumonia
  • TB
  • NHL
  • Cryptococcal Meningitis
  • Cryptosporidiosis
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21
Q

How do you test for HIV?

A

Serum/Salivary ELISA for Abs & antigens

Babies need Viral Genome Detection (as they have the mum’s antibodies regardless of inf)

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22
Q

What are the common HAIs and how do you get them?

A

C.diff & Salmonella by Faecal-oral transmission
Staph Aureus by Direct transmission
TB & Neisseria Meningitidis by Droplet transmission
Group A strep & Viruses by penetrating injury

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23
Q

What methods do you have for sterilization?

A
  • Gas (Ethylene Dioxide)
  • Autoclave
  • Hot Air Oven
  • Ionising Radiation
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24
Q

How might C.Diff present?

A
  • Pyrexia
  • Diarrhoea
  • Characteristic Smell
  • Abdo Pain
  • Leukocytosis
  • pseudomembranous colitis
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25
Q

What causes Rabies and how does it present?

A

Lyssavirus

Non-specific symptoms, mania, hydrophobia, increased saliva/tears & decreased ability to swallow

They die of resp failure

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26
Q

How do you test for an treat Rabies?

A

PCR

PEP (Human Rabies Immunoglobulin & rabies vaccine)

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27
Q

How does Lyme’s disease present

A

Early - Erythema Migrans

Late:

  • Acrodermatitis Chronica Atrophicans
  • Neuroborrelliosis
  • Arthritis
  • Lymphocytoma
  • Perimyocarditis or heart block
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28
Q

How do we detect and treat lyme’s disease?

A

ELISA serology & immunoblot test

Oral Doxycycline

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29
Q

What causes Leptospirosis?

A

L. Icterohaemorrhagica (rats)
L. Hardjo (cattle)

Mostly got through contaminated water

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30
Q

How does leptospirosis present?

A

Flu like illness

Can develop Weil’s Disease:

  • AKI
  • Jaundice
  • Bleeding
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31
Q

How do you detect and treat leptospirosis?

A

ELISA Serology
PCR
Culture

Doxycycline
IV penicillin if severe
Dialysis if AKI
Mechanical Ventilation if needed

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32
Q

Where do you get brucellosis?

A

Cattle & Dairy

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33
Q

How does brucellosis present and how do we treat it?

A

Non-specific symptoms incl drenching sweats & a high undulant, resistant fever

Can develop joint pain

Arthritis, endocarditis & Epididymo-orchitis

Doxycycline for 2-3months + 1wk of rifampicin or gentamicin
CNS manifestations? –> Add Co-trimoxazole

34
Q

what are the symptoms of influenza?

A

Abrupt high fever >3days + 2 of:

  • Sorethroat or rhianorrhoea- Myalgia
  • Cough
  • Malaise
  • Headache
35
Q

Complications of influenza?

A

Acute Bronchitis
secondary bacterial pneumonia

Also Guillain Barre, Myocarditis, Viral pneumonia & exacerbating underlying illness

36
Q

When would you treat Influenza and why?

A

If complicated or very sick give:

Neuraminidase inhibitors i.e. Oral Oseltamavir or Inhaled Zanamivir

37
Q

How is flu transmitted?

A

Droplet
Direct
Indirect on surfaces
Birds

38
Q

What are the surface antigen of influenza virus

A

N - Neuraminidase - allows virus to break out of host cell

H - Haemaglutinin - enters host cells

39
Q

How does the influenza virus change?

A

Antigenic drift - Small molecular changes year on year

Antigenic Shift - Sudden combining of 2 strains –> epidemics

40
Q

How do we test for influenza?

A
  • Viral swab for PCR & Molecular detection
  • CXR (rule out pneumonia)
  • Blood culture (for other infections)- Pulse oximetry & resp rate for monitoring
  • U&Es, FBC & CRP
41
Q

What are the major types of Aspergillus infection?

A
  • Acute Invasive Aspergillosis
  • Allergic Bronchopulmonary Aspergillosis
  • Chronic Pulmonary Aspergillosis
  • Pulmonary Aspergilloma
  • Influenza Ass Aspergillosis
42
Q

How do we test for aspergillosis?

A

CT chest, PCR & bronchoalveolar lavage if a neutropenic patient

Otherwise if you suspect it you can do Sputum culture and aspergillus specific IgE/G

43
Q

How do you treat aspergillosis

A

Voriconazole

Isavuconazole

44
Q

How do we test for and treat candida?

A

Blood culture & PCR

Echinocandin & fluconazole

45
Q

How does cryptococcus present?

A

LRT infection with constitutional symptoms

Moves to brain causing headache, confusion, AMS, visual problems & Coma

Typically HIV associated

46
Q

How do you test for and treat Cryptococcus?

A

Blood Culture & Antigen testing
LP for culture, antigen testing & india ink

Amphotericin B & flucytosine (induction) & Fluconazole (maintenance)

47
Q

How do you treat Malaria?

A

Falciparum –> Riamet (Artemether & Lumafantrine)
Complicated –> IV artesunate

Non-falciparum –> Chloroquine
Vivax or Ovale –> Add Primaquine

48
Q

Complications of Malaria?

A 
Algrid Malaria
Anamia
Jaundice
Blackwater Fever
Pulm Oedema
Cerrbal Malaria
DIC
Hypoglycaemic
Acidosis
49
Q

How do you test for malaria and its complications?

A

Rapid Antigen Test
Thick & Thin blood films
QBC

FBC, U&Es + creatinine, LFTs & urinalysis
ABG & Lactace (for acidosis)
Glc (Hypoglycaemia)
Clotting screen
Blood culture (concominant sepsis)
50
Q

How do we treat hair infections and what causes them?

A

Topical Abx
Oral Abx
Surgery

Staph Aureus and sometimes Strep Pyogenes

51
Q

What toxins cause Toxic Shock Syndrome & SSSS?

A 
TSS = TSST1
SSSS = Toxin A or B

Both from Staph Aureus

52
Q

What causes Necrotizing Fasciitis and what are the risk factors?

A

Type 1 - Mixed inf – Staph, Strep, Clostridium, enterococci & Gram -ve bacilli
Type 2 - Strep Pyogenes

IVDA
DM
PVD
Surgery
Trauma
53
Q

How does Necrotizing Fasciitis present and how do we treat it?

A

Rapid swelling, redness, pain & decreased sensation
Haemorrhagic bullae, necrosis & Crepitus
Systemic Sx e.g. fever malaise etc

Supportive
Surgery
Broad Spec Abx (Clindamycin, Gentamicin & Flucloxacillin)

54
Q

How do you treat TSS?

A

GEt a blood culture & isolate the toxin

Remove the causative agent (e.g. tampon)
Fluids
Inotropes
Abx
\+/- IV immunoglobulins
55
Q

What causes pyomyositis, how does it present and what are the risk factors?

A

Staph Aureus

Fever, Muscle pain & Woody stiffness

Immunocompromise (by any means) & Rheumatological disease are RFs

56
Q

How do you test for and treat pyomyositis?

A

Blood culture
CT or MRI to isolate muscle loss & abscess

IV Abx & Drainage of abscess

57
Q

What are the risk factors for surgical site infections and what causes them?

A

.DM Smoking Obese Malnutrtion Steroids

Staph Aureus
Pseudomonas
E Coli

58
Q

What causes IV catheter infections and what’s the big risk should someone get one?

A

Staph Aureus

Endocarditis, so do an echo

59
Q

What causes Infectious Tenosynovitis and how would it present?

A

.Staph Aureus –> Strep –> Mycobacterium or fungi if chronic

Semiflexed fingers
Swollen finger
Tender tendon
Pain on extension

60
Q

What are the risk factors for septic bursitis, how do you test for and treat it?

A 
IVDA
Immunocompromise
DM
Renal Disease
Rheamtic disease
Alcoholism
61
Q

How does typhoid present?

A

Early you get a high fever, malaise, neutrophilia, bradycardia, headache, constipation & cough

Wk2 develops into peaked fever, rose spots, diarrhoea, abdo pain, tachycardia & neutropenia

Late presentations include intestinal bleeds, perforations, peritonitis & metastatic inf

62
Q

What causes typhoid, how do you test for it and how do you treat it?

A

Salmonella Typhi

Blood, marrow, urine & stool cultures
FBC & LFTs

Supportive care
Oral Azithromycin or IV Ceftriaxone if severe

63
Q

How is typhoid transmitted?

A

Faecal oral route

64
Q

How is dengue fever transmitted?

A

Aedes Aegyptii Mosquitos

65
Q

How does dengue fever present?

A

Abrupt fever & Maculopapular Rash

+/- headache, arthralgia, myalgia, petichiae & purpura

66
Q

How do you diagnose and treat Dengue fever?

A

PCR & Serology

Clinical diagnose can be made with:

  • +ve tourniquet test
  • Leukopenia
  • thrombocytopenia
  • Elevated Transaminases

Treat with supportive fluids, FFP & Platelets

Prevent with Dengvaxia Vaccine

67
Q

What spreads Schistosomiasis?

A

Fresh water (snails) spread Schistosoma Haematobium (Africa) and Japonicum (japan)

68
Q

How does Schistosomiasis present

A

Early - Swimer’s itch

Wks – Katayama Syndrome (Fever, urticaria, lymphadenpathy, diarrhoea, abdo pain, cough & hepatosplenomegaly)

1-2months – Cystitis causing haematuria or dysentery +/- portal hypertension

69
Q

How do you test for and treat Schistosomiasis?

A

Stool & Urine Microscopy for Ova
Rectal Biopsy
Antibody Tests

Praziquantel +/- prednisalone if severe

70
Q

what cause typhus & how does it present?

A

Rickettsia Conorii or Africae
Spread by ticks

Abrupt fever, headache, confusion, jaundice & rash (+/- bleeds/thrombosis)

71
Q

How do we test for and treat typhus?

A

Serology & PCR (can also do FBC, LFT CRP & U&Es)

Tetracycline

72
Q

What are the viral hemorrhagic fevers and how do they present?

A

Ebola & Lassa Fever

Abrupt High fever, myalgia & conjunctivitis plus other non-specific signs e.g. headache, prostration, pleuritic pain and malaise

73
Q

How would you manage viral haemorrhagic fevers?

A

High security inf unit and supportive therapy

74
Q

What spread Zika virus?

A

Aedes Mosquitos
Sex
Transfusion

75
Q

How would you tell fungal vs bacterial vs viral meningitis?

A

Fungal pretty much only comes along with HIV

Bacterial vs viral on LP:

  • Bacterial = High protein / Low Glucose / High pressure / Neutrophilia
  • Viral = Low protein / Normal glucose / Normal Pressure / Lymphocytosis
76
Q

What cause fungal meningitis?

A

Cryptococccus

77
Q

What causes bacterial meningitis?

A

Neonates - E coli or

Kids - Haemophilus Influenzae

Adults - Strep Pneumoniae or N Meningitidis

78
Q

How do you treat bacterial meningitis?

A

Neonates (Ecoli or ) & kids (H Influenzae) – Cefotaxime

Adults (Strep Pneumoniae or N Meningitidis) – Ceftriaxone

79
Q

What viruses cause Meningitis?

A

HSV

Enteroviruses (Coxsackie, Echovirus etc)

80
Q

How do you treat viral meningitis?

A

Aciclovir

Yr3 Revision (9 decks)

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