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Infection > Infection > Flashcards

Infection Flashcards

1
Q

What is an infection?

A

Invasion of a host tissue and multiplication of organisms

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2
Q

How broadly is disease caused by infection?

A

By microbial multiplication, toxins, host reponse

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3
Q

What is virulence?

A

Genetic, biochemical or structure features that enable an organism to produce a disease

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4
Q

What is toxic shock?

A

Fever, hypotension, multisystem organ failure, erythematous rash caused by toxins of esp staph aureus

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5
Q

What is catalase? What is coagulase? What are they used to differentiate between?

A

Catalase - enzyme that can convert H2O2 to H2O and O2 to prevent Ros damage of bacteria (virulence)

Coagulase - enzyme that can clot blood - helps prevent neutrophil phagocytosis of bacteria (virulence).

Catalase differentiates between strep and staph (positive)

Coagulase differentiates between types of staph (+ or -)

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6
Q

What is facultatively anaerobic vs obligate anaerobic?

A

Will do respiration anaerobically in the absence of O2 but in the presence of O2 will do it aerobically

Obligate anaerobes are poisoned by O2 so do respiration anaerobically only

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7
Q

What is agar?

A

General nutrients + 5% sheeps blood useful for cultivating organisms with complex nutritional needs and determining haemolytic properties of an organism

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8
Q

What is post-infection sequelae? Give an example?

A

Disease that occurs from prior infection e.g. rheumatic heart disease –> valve problems due to strep pyogenes infection

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9
Q

What is sepsis vs septic shock??

A

Life threatening organ dysfunction due to dysregulated host response to infection

Septic shock is persisting hypotension requiring treatment to maintain blood pressure despite fluid resuscitation.

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10
Q

What is bacteraemia?

A

Presence of bacteria in the blood +/- clinical symptoms

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11
Q

What is the sepsis 6 bundle?

A 
Antibiotics (IV)
Fluids
O2
Urine output measurement 
Cultures
Lactate
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12
Q

How would you determine if someone has an infection?

A

History - clinical symptoms/history of infection
Examination - physical signs
Investigations - blood tests/cultures etc

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13
Q

What is supportive care?

A

Managing the symptoms of the disease but not treating the underlying cause e.g. painkillers/fluids/O2

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14
Q

What is the human micro biome?

A

The total number and diversity of microbes living in and on the human body

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15
Q

Where are you most likely to find human flora?

A

the skin, eye, and mouth as well as the upper respiratory, gastrointestinal, and urogenital tracts.

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16
Q

Name 2 common skin flora

A

Staph epidermis - 90%

Staph aureus

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17
Q

Name 3 common skin floras of the eye

A

Staph epidermis
Strep pneumonia
Staph aureus

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18
Q

Name 2 common mouth/nose flora

A

Staph epidermis

Staph aureus

19
Q

Name a common flora of the intestine

A

Escherichia coli

20
Q

Name a common flora of the GU tracts (also skin)

A

Candida Albicans

21
Q

What are the benefits of human flora?

A

Compete with pathogens for resources so protect against disease

Some gut bacteria have antimicrobial properties

Can synthesise vit K

Can aid digestion and absorption

22
Q

What are some potentially harmful effects of normal flora/related to normal flora?

A

Depletion = allows invasion of pathogens e.g. from antibiotics allows C diff

Over growth of own flora can cause pathology - candida albicans

Can displace from normal site to distant site and cause disease e.g. S epidermis –> endocarditis

Can convert some foods (some sugars) into carcinogens in the gut

23
Q

What is the model of infection

A

Pathogen, Patient, Infection, Mechanism of infection, Pathogenesis (Innate/Acquired immunity), Management, Outcome

24
Q

What three pathogen and three patient factors determine disease progression?

A

Virulence
Inoculum size
Antimicrobial resistance

Site of infection
Comorbidites
Immune response

25
Q

What is gram staining? How does it differentiate between bacteria?

A

Dyeing a collection of cells with different colours/decolouring and the cells will either appear purple or red depending on the components of their cell wall.
Purple - gram positive due to their thick peptidoglycan layer in cell wall
Red - gram negative due to thin peptidoglycan layer in cell wall

26
Q

What is the bacterial version of a nucleus?

A

Nucleoid

27
Q

What is the difference between fimbrae and pili?

A

Fimbrae are usually shorter

28
Q

What do flagella enable?

A

Bacteria to move in a directional fashion

29
Q

What is an antigen?

A

A molecule capable of inducing an immune response on the host organism. Any substance that causes the immune system to produce antibodies against it.

30
Q

What is an antibody?

A

Immunoglobulin - large Y shaped protein produced mainly by plasma cells that is used by the immune system to neutralise pathogens such as bacteria and viruses

31
Q

What 3 things does management (of patient) include?

A

Diagnosis
Treatment
Infection prevention

32
Q

How do you recognise sepsis?

A

Use early warning score system
(basic observations e.g. HR BP resps temp)
check for red flags in these observations e.g. unresponsive, high RR low BP etc

33
Q

What do you do when you find someone has sepsis?

A 
Inform senior Dr for review
Send urgent investigations
Sepsis 6 bundle within an hour
Consider early referral to ITU
Regular monitoring and reassessment
34
Q

What urgent investigations would you do for sepsis? (8)

A 
FBC, U&E
EDTA bottle for PCR ?viral?
Blood sugar
LFTs
CRP
Coagulation studies
Blood gases (venous/arterial)
Microbiology - CSF, urine etc
35
Q

Which part of the bacteria triggers inflammation and can lead to septic shock in gram neg?

A

Endotoxin

36
Q

How do endotoxins lead to sepsis (6)?

A

1) Endotoxin binds to macrophages
2) Macrophages release cytokines (TNF-alpha & IL-1) - to stimulate inflammatory response to promote wound repair and recruit RE system
3) Cytokines released into circulation (systemic)
4) Cytokines stimulate growth factor, macrophages and platelets - goal is to contain infection
5) Cytokines lead to activation of humeral cascades and RE system = circulatory insult inc DIC and organ injury
6) Sepsis - infection not controlled

37
Q

What is the reticulo-endothelial system?

A

Mononuclear phagocytic system - monocytes and macrophages.

Mainly spleen but also in lymph nodes - part of humeral and cell mediated immunity. Important role in defence against bacteria virus fungi protozoa mycobacteria etc etc

38
Q

How do cytokines initiate the coagulation cascade and microvascular thrombus (3)?

A

They initiate production of thrombin and thus promote coagulation
Cytokines also inhibit fibrinolysis
Hence microvascular thrombosis, DIC, organ ischaemia, dysfunction and failure.

39
Q

What is the major cause of shock and multi organ failure?

A

Microvascular injury

40
Q

What are 5 life threatening complications of sepsis?

A

1) Irreversible hypotension
2) Respiratory failure
3) Acute Kidney Injury (renal failure)
4) Raised intracranial pressure
5) Ischaemic necrosis of digits, hands feet

41
Q

What would you do microscopy and culture/PCR of CSF for?

A

Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis for meningitis (maybe other things too?)

42
Q

Why would you do liver function tests in septic patient?

A

Liver has role in clearing pathogen

Liver can be damaged due to haemodynmic compromise in sepsis (organ failure)

43
Q

How does sepsis lead to hypotension?

A

Vasodilation - reduced TPR - inflammatory mediators

Reduced cardiac output

44
Q

What are spores?

A

Minute one celled reproductive units of organisms - are thermostable so need to sterilise surgical instruments for spores

Infection (14 decks)

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