Clinical skills - Infection & Immunity Flashcards

1
Q

Are urine dipsticks necessary to diagnose UTI’s in women

A

No

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2
Q

Key urinary symptoms

A

Dysuria
Nocturia
Cloudy urine

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3
Q

If a woman has 2 key urinary symptoms

A

Urine culture –> start abx

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4
Q

If a woman has 1 key urinary symptoms

A

Urinalysis

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5
Q

When are urine dipsticks unreliable

A

In men
Those over 65
Those w/ a catheter - colonised bacteria

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6
Q

Causes of red urine

A

Haematuria
Rifampicin
Food e.g. beetroot

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7
Q

Causes of brown urine

A

Jaundice
Rhabdomyolysis
Drugs e.g levodopa

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8
Q

Causes of green urine

A

Pseudomonas UTI

Drugs e.g amitriptyline, indomethacin

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9
Q

Causes of frothy urine

A

Proteinuria

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10
Q

Most prominent protein in blood plasma

A

Albumin (58%)

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11
Q

Buffy coat

A

Made up of leucocytes - mainly neutrophils

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12
Q

Production of CRP

A

IL -1, IL-6 and TNF-alpha stimulate hepatocytes to produce CRP

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13
Q

As the production of acute phase proteins increases ..

A

Albumin levels reduce

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14
Q

Three main complement pathways

A

Lectin pathway
Classical pathway
Alternative pathway

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15
Q

What is C3 activated by

A

Classic and Alternative pathways

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16
Q

What does C3 activate

A

Membrane Attack Complex: C5b, C6, C7, C8, C9

17
Q

How does C3 directly act in the process of infl

A

Dilating arterioles
Stimulating mast cells to release histamine
Cause chemotaxis of phagocytes
Opsoninisation

18
Q

Opsonination

A

Acting as a marker to attract macrophages

19
Q

Sepsis 6

A

Take 3: bloods, measure urine output, check serial lactates (venous lactate)
Give 3: IV fluids, abx, oxygen

20
Q

Presentation of scarlet fever

A

High fever (38 degrees)
White coated tongue that peels –> red and swollen
Red rash on chest and back which branches w/ gentle pressure

21
Q

Examples of notifiable diseases

A
Scarlet fever 
Malaria 
Measles 
Meningitis 
Leprosy
22
Q

Epstein-Barr virus

A

One of 8 diff types of human herpes viruses - causes glandular fever (infectious mononucleosis)

23
Q

Diseases caused by EBV

A
Infectious mononucleosis 
Burkitt lymphoma 
Nasopharyngeal carcinoma 
CNS lymphoma 
Lymoproliferative disease
24
Q

Using vision in general observation

A
Position 
Shape/ size 
Colour 
Texture 
Comparison between L and R
25
Q

Using Hearing in general observation

A

Voice, speech

Stethoscope - things that move e.g blood (heart, vessels), air (lungs), gut contents (bowel sounds)

26
Q

Using Touch in general observation

A

Temp
Texture
Pain
Attachment

27
Q

Using smell in general observation

A
Smoke 
Alcohol 
Stale sweat or urine 
Infections (e.g gangrene)
Ketosis 
Diarrhoea die to blood (melaena) or infection
28
Q

Colours of blood

A

Fresh, oxygenated is bright red
Increased blood in vessels (injected/ vascular) or diffusely (erythema)
Decreased blood = pallor/ anaemia
Breakdown products (bruise) –> purple –> green –> yellow (jaundice)
Deoxygenated blood is a deep red purple (cyanosis)

29
Q

Abdominal distension

A

6 F’s

Flatus (air)
Faeces 
Foetus 
Fat 
Fluid 
Fatal (tumours)
30
Q

Ascites

A

Build up of fluid

31
Q

Test for oedema

A

Gradually increasing pressure over a bony site - cold for at least 15 secs
Shiny, stretched, blistered, weeping or ulcerated skin

32
Q

Presentation of septic arthritis

A
Unable to weight bear 
Unable to flex joint 
Swelling is in soft tissue, extra-articular 
Joint is red, swollen and warm 
Pain on all active and passive movements
33
Q

Risk factors for developing septic arthritis

A
Age >80yrs
Any pre-existing joint disease (e.g. rheumatoid arthritis)
Diabetes mellitus or immunosuppression
Chronic renal failure
Hip or knee joint prosthesis
Intravenous drug use
34
Q

Complications of IVDU

A
Spinal epidural abscess 
False aneurysm 
DVT 
Infective endocarditis 
Hepatic cirrhosis