Antimicrobials

Question 1

What does the M in MINDME stand for?

Answer 1

Microbiology - refers to the fact that you should do a culture to determine which organism is present

Question 2

Apart from pre-surgery, give 2 examples of acceptable prophylactic use of antibiotics

Answer 2

• recurrent UTIs
• needle stick injuries involving HIV pts
• contacts of TB, meningitis
• immunocompromised patients

Question 3

Which non-penicillin class is most likely to have cross-reactivity in a patient with a penicillin allergy? Give an example

Answer 3

Class = cephalosporins 
Example = cefalexin

Question 4

Define an opportunistic pathogen

Answer 4

A pathogen that wouldn’t normally cause disease, but will do so in an immunocompromised patient

Question 5

Name 2 ways that the body’s normal flora can contribute to infection

Answer 5

• overgrowth (e.g. thrush)

- translocation (e.g. UTI)

Question 6

Raised neutrophils indicates which type of infection?

Answer 6

Bacterial

Question 7

Raised lymphocytes indicates which type of infection?

Answer 7

Viral

Question 8

Signs of chronic infection?

Answer 8

Weight loss, anaemia, decreased growth, malnutrition

Question 9

Symptoms of sepsis / septic shock?

Answer 9

Fast resp rate, hypotension, tachycardia, rash, confusion, no urine produced

Question 10

Sx that might indicate meningitis?

Answer 10

Stiff neck, non-blanching rash, photophobia (discomfort in light), bulging head in infants

Question 11

Normal temperature range when taken orally?

Answer 11

36-38 (should be 37)

Question 12

Why might older patients not have a raised temperature with infection?

Answer 12

They might have a temperature higher than their regular temp - indicating fever and infection - but it is harder to detect because the older the colder

Question 13

High fever vs mild?

Answer 13

Mild = below 39 
High = above 39

Question 14

One reason to NOT treat fever?

Answer 14

• it is a useful way to monitor progression of the infection
• raised body temperature can inhibit microbe growth

Question 15

Reasons to treat fever?

Answer 15

Symptom relief, reduce dehydration

Question 16

Is a fever with no other symptoms concerning?

Answer 16

Yes. This is a referral point

Question 17

Name 2 groups of B-lactams

Answer 17

Penicillins and cephalosporins

Question 18

Why is cefalexin’s cross-reactivity with penicillins worse than the others in its class?

Answer 18

Because not only do they share the B lactam ring, but also have a similar side chain

Question 19

Define MIC

Answer 19

The minimum inhibitory concentration - lowest concentration at which the drug will inhibit visible growth after overnight incubation

Question 20

Define VRE

Answer 20

Vancomycin resistant enterococcus

Question 21

Define MRSA

Answer 21

Methicillin resistant staphylococcus aureus

Question 22

Name 2 techniques used to reduce AB resistance

Answer 22

• reduce AB usage
• promote research and development for new drugs
• increase hospital hygiene and infection control
• raise awareness and promote appropriate AB use in community

Question 23

Which is the worse penicillin allergy - IgE mediated or IgE independent?

Answer 23

IgE mediated. This is a true allergic reaction rather than hypersensitivity