Core ID Conditions Flashcards by Clare Matheson

Strep pneumoniae is the the cause of meningitis in which age group?

> 21

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Neisseria meningitidis is the the cause of meningitis in which age group?

10-21

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Listeria is the the cause of meningitis in which age group?

(>60 years or immunocompromised or neonates (including alcohol dependency and diabetes)

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Viral meningitis is most commonly caused by what?

Enterovirus

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> 2000 white cells, glucose in the CSF being low compared to the blood & increased neutrophils indicates which type of meningitis?

Bacterial

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primarily polymorphonuclear leukocytes (polymorphs) are found in what kind of meningitis?

Bacterial

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Low WBC, minimally elevated protein and normal glucose would indicate which type of meningitis?

Aseptic (viral)

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What antibiotic needs to be added to the standard treatment of meningitis (ceftriaxone + dexamethasone) when listeria cover is required?

Amoxicillin IV

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What should replace ceftriaxone in the case of penicillin allergy when treating meningitis?

Chloramphemicol

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Should you continue the dexamethasone if you discover the meningitis has a viral cause?

No - just give supportive treatment

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What virus is the most common cause of encephalitis?

Herpes simplex

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What is the most common causative organism in epiglottitis?

Haemophilus influenzae

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What is the most common bacterial causative organism in tonsillitis & pharyngitis?

Group A beta haemolytic streptococci (mostly strep pyogenes)

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What is the most common bacterial causative organism in sinusitis?

Pneumococcus

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The treatment if a tonsillitis patient is scoring 0-1 on the centor criteria should be what?

No antibiotic

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The treatment if a tonsillitis patient is scoring 2-3 on the centor criteria should be what?

Should receive an antibiotic (penicillin) if symptoms progress

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The treatment if a tonsillitis patient is scoring 4-5 on the centor criteria should be what?

Treat empirically with an antibiotic

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What number on the FeverPAIN score would make you consider immediate antibiotics for tonsillitis?

≥4

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What would make you consider giving antibiotics in acute otitis media?

<2 years and bilateral
Bulging membrane and marked multiple
symptoms
Otorrhoea

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When cellulitis is from a dental / mandibular / sinus source what antibiotic should be used instead of flucloxacillin?

Co-amoxiclav

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What are the 5 components of the centor criteria?

1 point for each:

History of fever
Tonsillar exudates
Tender anterior cervical adenopathy
Absence of cough

Age <15 add 1 point
Age >44 subtract 1 point

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What are the 5 components of CURB65

C = confusion
U = urea (>7 mmol/L)
R = RR (>30/min)
B = Blood pressure (Systolic <90 or diastolic <60)
65 = >65 years

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What CURB65 score is considered mild CAP?

Study These Flashcards

0-1

What CURB65 score is considered moderate CAP?

Study These Flashcards

2-3

What CURB65 score is considered severe CAP?

4-5

What is the most common cause of pneumonia?

Streptococcus pneumoniae - 80% of cases

What organism commonly causes pneumonia in COPD patients?

Haemophilus influenzae

What organism commonly causes pneumonia following an influenza infection?

Staphlococcus aureus

What organism commonly causes pneumonia that presents with a dry cough and atypical CXR findings +/- autoimmune haemolytic anaemia and erythema multiforme?

Mycoplasma pneumoniae

What organism commonly causes atypical pneumonia that often presents with hyponatraemia and lymphopenia

Legionella pneumophilia

What organism commonly causes pneumonia in alcoholics that classically presents with bloody or yellow sputum

Klebsiella pneumoniae

What organism typically causes pneumonia in patients with HIV

Pneumocystis jiroveci

Which are the 2 most like organisms to cause mild/moderate CAP?

Streptococcus pneumoniae / haemophilus influenzae

What organism is most likely to cause acute native valve endocarditis?

Staph aureus

What organisms are most likely to cause subacute native valve endocarditis?

Viridans streptococci or enterococci

What organisms are most likely to cause prosthetic valve or MRSA endocarditis

Coagulase negative staphylococci

How many blood culture sets should be taken in chronic/subacute endocarditis?

What are the severity markers for c.diff?

One or more of: - Temperature >38.5 - Ileus, colonic dilatation or toxic megacolon - WBC >15 cells x 10 to the power of 9 /L - Rising serum creatinine >1.5 x baseline - Remaining c.diff after 2 courses of therapy

Who needs to be contacted about suspected cases of r E coli O157?

Health Protection & Infection Control

How many days does it take on average to develop HUS caused by E coli O157?

6-8 days

What is the key symptom indicating HUS caused by E coli O157?

Bloody diarrhoea

What will the blood cells look like on the blood film in HUS?

Fragmented

When should blood and urine cultures be sent in UTI?

Complicated infection, or male

Should you ever send a urine sample from a catheter?

Only if you consider the catheter to be the source of infection

Why is ceftriaxone used for meningitis when pneumococci & meningococci are sensitive to penicillin?

Ceftriaxone is chosen because of the need for high CSF levels to be maintained & the ease of dosing (twice a day). It also provides better cover for the rare strain that may have borderline sensitivity to penicillin

What age does Scottish guidance recommend testing for c.diff?

≥3 years

What are the major risk factors for contracting c.diff?

- Current or recent (within 3 months) use of antibiotics - Increased age - PPIs - Prolonged hospital stay - Serious underlying condition - Surgical procedures (especially bowel procedures) - Immunosurpression

Is severe c.diff always associated with diarrhoea?

What symptoms apart from diarrhoea can be present in c.diff infection?

- Abdo cramps - Fever - Frequent stool - Raised WBC count - Rarely pseudomembranous colitis, toxic megacolon and peritonitis

What transmission based precautions should be taken for c.diff patients?

Standard infection control + contact precautions: - Hand washing with soap and water - Gloves and aprons - Patient isolated to a single room with en suite toilet - Treat linen as infected - Decontaminate room daily and clean immediate environment twice a day

What is the definition of diarrhoea?

The passage of three or more loose or liquid stool per day, or more frequently than normal for the individual

How is c.diff spread

Spores via the faecal oral route

When is treatment initiated in c.diff?

As soon as it is suspected without waiting for lab confirmation

When are c.diff patients considered to be clear of infection

When they are 48hrs symptom free

Clearance samples are required to be sent to the lab in c.diff infection. True or false?

False

What is severe sepsis?

Sepsis (SIRS + presumed/confirmed infection) + at least one acute organ dysfunction

What is septic shock?

Severe sepsis with hypotension refractory to adequate volume resuscitation

Core ID Conditions Flashcards

(57 cards)