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3 - Infection > Clinical > Flashcards

Clinical Flashcards

1
Q

Diarrhoea definition

A

SUBJECTIVE

increased fluidity and frequency of stools

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2
Q

Gastro-enteritis clinical definition

A

OBJECTIVE

3 or more loose stools / day
Accompanying features

(a clinical diagnosis)

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3
Q

Dysentery definition

A

Large bowel inflammation

Bloody stools

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4
Q

Outbreak! definition

A

2 or more cases of an infection linked in time and place

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5
Q

The chain of infection

A 
Infectious agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host
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6
Q

Droplet + Airborne (aerosol) transmission based precautions (TBPs)

A 
Gloves
Apron
Mask
Eye protection
Hand hygiene
Keep door closed
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7
Q

Contact transmission based precautions (TBPs)

A 
Contact
Gloves
Apron
Hand hygiene 
Keep door closed
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8
Q

difference between droplet and aerosol

A

DROPLET:
>5micrometres
spread about 1m
drop to ground

AEROSOL:
<5micrometres
much wider spread
remain suspended in the air

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9
Q

Cleaning, disinfection and sterilisation

definitions

A

CLEANING:
= physical removal of organic material and decrease in microbial load (essential prior to disinfection/sterilisation

DISINFECTION
= large reduction in microbe numbers (spores mat remain)

STERILISATION
= removal/destruction of ALL microbes and spores

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10
Q

Methods of disinfection

A

Heat (pasteurisation, boiling)

Chemical

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11
Q

Methods of sterilisation

A

Steam under pressure (autoclave)

Hot air oven
Gas (ethylene dioxide)
Ionising radiation

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12
Q

Zoonoses definition

A

Infections that pass from living animals to humans

That do NOT depend on the human host for part of their lifecycle

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13
Q

Human infections that can be transmitted to animal are called

A

Anthroponoses

e.g influenza - birds/pigs
strep throat (dogs)
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14
Q

Production of recombinant vaccines (e.g. for Hep B)

a type of subunit vaccine

A

The DNA segment coding for HBsAg is removed, purified and mixed with plasmids
–>
This is inserted into yeasts and fermented
–>
HBsAg produced

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15
Q

The “6 in 1” vaccine

A 
Purified Bordetella pertussis (aP)
Inactivated polio virus (IPV)
Purified component of Haemophilus influenzae b (Hib)
Purified tetanus toxoid (T)
Hepatitis B rDNA (HBV)
Purified diphtheria toxoid (D)
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16
Q

The BCG vaccine protects against…

A

TB

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17
Q

The BCG vaccine is given in the UK to…

A

Some infants

  • areas with annual incidence of TB >40/100,000
  • parents/ grandparents born in a country with annual incidence > 40/100,000

Children at high risk (screened at school for risk-factors)
New immigrants from high prevalence countries
Contacts (<35yrs) of TB patients
Healthcare workers

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18
Q

Indications for the influenza vaccine

A 
65 years (Nursing home residents)
Healthcare workers
Immunodeficiency/immunosuppression
     - Asplenia/ hyposplenism
     -  DM
     - pregnancy
Chronic liver, renal, cardiac or lung disease
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19
Q

The hepatitis B vaccine is given to…

A 
All new-borns from 2018 (6-in-1)
Children at high risk of exposure
Healthcare workers
PWID
MSM
Prisoners
Chronic liver/ kidney disease
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20
Q

Varicella-zoster vaccine is given to…

A

Immunosuppression
Children in contact with those at risk of severe vzv
Healthcare workers (if sero-neg and in contact with cases)

21
Q

The VZV vaccine

type + regime

A

Live attenuated virus

2 doses, 4-8 weeks apart

22
Q

Herpes-zoster (shingles) vaccine

name, type + indication

A

Zostavax
A live attenuated virus
Given to all elderly patients (70-80 years) - boosts existing immunity

23
Q

Human normal immunoglobulin

uses

A

[Contains antibodies against hepatitis A, rubella and measles]

Used in immunoglobulin deficiencies
Used in the treatment of some autoimmune disorders (e.g. myasthenia gravis)

24
Q

Disease specific (post-exposure) immunoglobulins exist for…

A 
Hepatitis B Ig
Rabies Ig
Varicella zoster (chickenpox) Ig
Tetanus anti-toxin Ig
Diphtheria anti-toxin Ig
Botulinum anti-toxin Ig
25
Q

Sources of information on changing international travel health advice

A

British national formulary (BNF)

Immunization against infectious diseases (green book)

26
Q

Common immunisations for travellers

A 
Tetanus
Polio
Typhoid
Hepatitis A
Yellow fever
Cholera

RARER (for special circumstances): meningococcus ACWY, rabies, diphtheria, Japanese B encephalitis, Tick borne encephalitis

27
Q

Natural passive immunity is acquired…

A

maternally

28
Q

Natural active immunity is acquired…

A

post infection

29
Q

Artificial passive immunity is acquired…

A

Through immunoglobulins

30
Q

Artificial active immunity is acquired…

A

Through immunisations

31
Q

Vaccinations given at 2 months

A

6-in-1
Pneumococcal conjugate
Men B
Rotavirus

32
Q

Vaccinations given at 3 months

A

6-in-1

Rotavirus

33
Q

Vaccinations given at 4 months

A

6-in-1
Pneumococcal conjugate
Men B

34
Q

Vaccinations given at 1 year

A 
Haemophilus influenzae B (Hib)
Men C
Men B
Pneumococcal conjugate
MMR
35
Q

Vaccinations given at 2 - 8 years

A

Influenza nasal

36
Q

Vaccinations given at 3-5 years

A

4-in-1 booster (DTaP/IPV)

MMR

37
Q

HPV vaccine is given to…

A

Girls

12 - 13 years

38
Q

Vaccinations given at 14 years

A

3-in-1 booster (dT/IPV)

Men AWCY

39
Q

Steps to be taken after percutaneous exposure to blood/body fluids (needlestick injury)…

A
  1. Encourage bleeding
  2. Wash injury with warm water + soap
  3. Cover with a waterproof plaster
  4. Report immediately to supervisor
  5. Approach the source and request testing for blood-borne viruses
  6. The victim’s immunisation history should be assessed as active or active/passive immunisation may be appropriate
  7. offer the victim testing for blood-borne viruses after 3 + 6 months
40
Q

Investigations to be carried out in a traveller returning from abroad with fever

A 
o	FBC
o	Malaria films
o	LFTs
o	Stool microscopy and culture
o	Urine analysis and culture
o	Blood cultures
o	CXR
o	+ any other specific tests if indicated
41
Q

Antifungal agents to treat invasive fungal infections that works by ergosterol (maintains cell membrane) lysis

treats cryptococcal meningitis…

A

Amphotericin B formulations (IV)

(broad spectrum against most fungal pathogens)

42
Q

Antifungal agents to treat invasive fungal infections that inhibit ergosterol (maintain cell membrane) syntesis

treat cryptococcal meningitis, invasive candidiasis…

A

Azoles (IV/Oral)

  • fluconazole
  • voriconazole
  • isavuconazole …etc
43
Q

Antifungal agents to treat invasive fungal infections that inhibit glucan synthesis

treats invasive candidiasis…

A

Echinocandins (IV)

44
Q

Antifungal agent to treat invasive fungal infections that inhibit fungal DNA synthesis

treat cryptococcal meningitis…

A

Flucytosine

45
Q

Diagnosis of wound infections

A

culture of pus/ infected tissues

aim for deeper structures

46
Q

Risks of transmission (following significant percutaneous exposure to a positive source) if no preventative action taken

for Hep B, Hep C + HIV

A

Hepatitis B – 30%
Hepatitis C – 3%
HIV – 0.3%

47
Q

Post-exposure prophylaxis for HIV

A

Combination anti-retroviral therapy (CART)

Ideally started within 1 hour of exposure (still worthwhile up to 72 hours post exposure)

48
Q

Post-exposure prophylaxis for Hep B/C

A

Hep B

  • active recombinant vaccination or…
  • passive hep B immunoglobulin vaccination

Hep C
- no PEP available

3 - Infection (2 decks)

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