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RACP Paeds Written Exam > Bacterial Infections & Antibiotics > Flashcards

Bacterial Infections & Antibiotics Flashcards

(59 cards)

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1
Q

Toxin mediated diseases?

A

Toxic shock syndrome
Kawasaki Disease
Eczema exac/psoriasis

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2
Q

Pathogenesis of super antigens causing disease?

A

MHC II binds with T cell resulting in polyclonal activation (contrast to regular antigens presenting to a specific T cell receptor)
Therefore super antigen is not MHC restricted resulting in overwhelming cytokine release

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3
Q

Eagle effect and abs to use to avoid this?

A

When bacteria in stationary phase of replication penicillin is less effective
Clindamycin used instead

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4
Q

Criteria for staph TSS and management?

A 
Fever >38.9C
Hypotension <90sys
Rash - diffuse, macular erythematous
Desquamation of palms/soles 1-2/52 later
Multisystem involvement - GI, muscular, mucus membranes, kidney, liver, ham or CNS
---> treat with fluclox and clindamycin
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5
Q

Criteria for strep TSS and RFs?

A

GAS found in normally sterile site (blood, urine)
Hypotension
Kidney, coagulopathy, liver, ARDS, soft tissue necrosis

RFs - trauma, NSAIDs, surgery, viral infection, post-partum

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6
Q

Gram positive cocci, coagulase positive?

A

Staph aureus

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7
Q

Gram positive cocci, coagulase negative?

A

Staph epi, Staph hemolyticus

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8
Q

RF for coat neg staph?

A

Indwelling lines/implants

CONS forms a biofilm, enhances adhesion and resist phagocytosis

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9
Q

Treatment for CONS?

A

Vancomycin - most are resistant to fluclox

& remove devices

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10
Q

MecA positive organism?

A

MRSA

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11
Q 
Superantigen or not:
Staph food poisoning?
Staph scarlet fever?
Staph scalded skin?
TSS?
A

Food poisoning - toxin but not super antigen
Scarlet fever - toxin but not super antigen
Scalded skin - toxin but not super antigen
TSS - super antigen

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12
Q

Gram pos cocci, catalase negative?

A

Streptococci

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13
Q

Group A strep?

A

Strep pyogenes

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14
Q

Group B strep?

A

Strep agalactiae

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15
Q

Group C/D strep?

A

Beta haemolytic strep

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16
Q

Group D strep?

A

Enterococcus

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17
Q

Group E&F strep?

A

Alpha haemolytic (pneumoniae/viridians)

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18
Q

Group A Strep acute infections?

A 
Strep throat
Skin infections inc erysipelas
Nec fasc
Scarlet fever
TSS
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19
Q

GAS immune mediated illnesses?

A

Rheumatic fever
Post-strep GN
Post-strep arthritis
PANDAS

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20
Q

Transmission rate of GBS?

A

50%
Invasion rate 1-2%
10-30% of women GBS +

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21
Q

Abx in labour reduces neonatal sepsis?

A

Reduced EOS by 65%

NO CHANGE in LOS

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22
Q

RFs for GBS in labour?

A 
Prev infant w EOS GBS
GBS bacteria
SPTL <37/40
ROM >18hrs
Intrapartum fever >38C
  • if any present treat with abx
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23
Q

What else to look for in strep intermedium bacteraemia?

A

Abscesses

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24
Q

RF for enterococcus infection?

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A

Damaged mucosa, impaired immune response

25
Gram positive bacteria, lancet shaped diplococcus.
Strep pneumoniae
26
Risk groups for strep pneumoniae infection?
Sickle cell Asplenia Acute nephrotic syndrome Deficiency in humeral immunity - polysaccharide capsule prevents phagoytosis
27
Conjugate vs polysaccharide vaccine pneumococcal vaccine?
Conjugate - T cell immunity, reduces nasopharyngeal carriage (routine on imms schedule) Polysaccharide - limited response in children <2 and immune compromised (additional for high risk)
28
Gram positive rods?
Bacillus cereus - gastro Clostridium difficile, tetani, and botulinum Listeria
29
Toxin associated with clostridium ?
Tatanospasmin | ---> prevents release of glycine and GABA which blocks normal inhibition of antagonistic muscles causing contractions
30
Management of tetanus?
Tetanus IVIG and tetanus vaccine Immunoglobulin neutralises toxin - needs to be given early Exposure to toxin does not infer immunity - vaccination!
31
RFs for C Diff?
Abx - cephalosporins, Olinda and fluoroquinolone Healthcare setting PPIs Chemotherapy
32
Gram pos bacilli?
Corynebacterium diptheria
33
Only gram pos bacteria to have an endotoxin?
Listeria
34
Mortality rate of listeria in utero?
50% in prev infants 30% EOS 15% LOS
35
Gram negative cocco bacillus?
Haemophilus Influenza B
36
% of HiB producing beta-lactamase?
1/3 | Resistant to amp/amoxy so treat with augmentin
37
Gram neg diplococcus?
Moraxella catarrhalis
38
Treatment moraxella?
Augmentin
39
Gram neg pleomorphic bacillus?
Bordetella pertussis
40
Gram negative diplococcus?
Neisseria meningidites
41
Peaks of neisseria disease?
Bimodal -> <2 and teenagers
42
RFs for neisseria meningitis?
``` Complement deficiency Eculizumab treatment Asplenia HIV HSCT ```
43
Seizures/focal neurology more common with meningitis from which organisms?
HiB and Strep meningitis
44
Gram negative rods?
Non-typhoid salmonella | Campylobacter
45
Associations salmonella w underlying illness
Reactive arthritis (HLA B27) OM (sickle cell) Multi-organ failure (HIV) Toxic megacolon (IBD)
46
Mx non-typhoid salmonella?
Not recommended for uncomplicated salmonella - suppresses normal flora Neonates <3mths If febrile or toxic, bacteraemic or with vascular grafts or haemoglobinopathies Immunocompromised
47
Dysentery with HUS/SIADH?
Shigella | Shiga toxin mediated
48
RFs for cholera?
Blood group O Decreased gastric motility Malnutrition Immunocompromise
49
Painless profuse diarrhoea with metabolic acidosis, hypokalaemia and hypoglycaemia. Stool shows chloride ++ bt no leukocytes
Cholera
50
Gastro with blood 2-4 days after onset. Lasts 1-2 weeks. Pathogen?
Campylobacter
51
Complications of campylobacter?
Reactive arthritis Erythema nodosum IBS GBS
52
Enterocolitis/mesenteric adenitis in child with thalassemia?
Yersinia
53
Complications of Yersinia?
Assoc w KD - superantigen | Eryhtema nodosum, arthritis, uveitis
54
Gram neg bacilli?
E Coli
55
Gram neg aerobe?
Pseudamonas Klebsiella Bartonella
56
Ectheyma gangrenous?
Pseudamonas
57
Lymphadenitis with red papules at site of scratch. Rarely may have hepatomegaly, conjunctivitis. Pathogen?
Bartonella
58
OM/SA in child with minimal inflammation marker rise, no improvement on fluclox?
Kingella
59
Traveller from NT in wet season, presents with skin lesion and pulmonary infection?
Meliodosis | Pseudomallei

RACP Paeds Written Exam (15 decks)

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