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Infection Flashcards

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1
Q

Neisseria Meningitidis

Mechanism of action?

A
  • Direct contact with respiratory secretions
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2
Q

Neisseria Meningitidis

Interaction with host?

A
  • Lives in the Naso/oropharynx
  • Colonises and attacks the meninges of the brain
  • Spreads to blood and causes a non-blanching rash
  • Sereve immune reaction due to endotoxins
  • Leads to septic shock, multi organ failure and death
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3
Q

Neisseria Meninigitidis

Gram Positive or Negative?

A
  • Gram Negative
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4
Q

Neisseria Meningitidis

How would you diagnose?

A
  • History
    • Sudden onset, neck pain, fever, photophobia, nausea, malaise, abdomen pain, head ache, non blanching rash
    • Several days of illness, gets worse before better due to endotoxin
  • Examination
    • Raised temperature, tachometer, tachocardia, low BP, pale and cold extremities
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5
Q

Neisseria Meningitidis

Possible sequalae?

A
  • Septic shock and death
  • Respiratory failure, kidney failure, raised ICP, coma and death
  • Hearing loss, Ischemia and necrosis
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6
Q

Neisseria Meningitidis

Treatment and Prevention?

A
  • Supportive
    • High flow O2
    • Adrenaline
    • IV
    • Measure urine output and lactate
    • Analgesia
  • Specific
    • Blood cultures and blood spectrum antibiotics
    • Ceftriaxone
  • Prevention
    • Vaccine, stay away from people with Meningitis
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7
Q

Escherichia Coli

Is it Gram Positive or Negative?

A
  • Gram Negative
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8
Q

Escherichia Coli

Interaction with host?

A
  • Colonise GI tract
  • Gastroenteritis
  • Peritonitis
  • Infectio by ingestion of contaminated food or directly from a perforated bowel
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9
Q

Escherichia Coli

How would you diagnose?

A
  • History
    • Nausea, Vomiting, Fever, Malaise, Muscle weakness, Stomach cramps, chills
    • Usually lasts a few days - resolves itself
  • Examination
    • Tender abdomen, raised temperature, BP, HR and respiratory changes
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10
Q

Escherichia Coli

Possible sequalae?

A
  • Peritonitis, Septic shock and death
  • Usually resolves
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11
Q

Escherichia Coli

Treatment and Prevention?

A
  • Supportive
    • IV, fluids and O2
  • Specific
    • Broad spectrum antibiotics
    • Source control for peritonitis
  • Prevention
    • Disinfect food prep areas
    • Do not share belonginings with others who have gastroenteritis
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12
Q

Staph Aureus

Is it Gram Positive or Negative?

A
  • Gram Positive
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13
Q

Staph Aureus

Mechanism of infection?

A
  • Invasion
  • Inhalation
  • Ingestion
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14
Q

Staph Aureus

Interaction with host?

A
  • Coagulase- converts fibrinogen to fibrin forming microclot to protect itself
  • Hyaluronidase- breaks down hyaluronidase acid in connective tissue so can break down barriers and spread
  • DNA Ribonuclease- Breaks down host DNA
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15
Q

Staph Aureus

How to diagnose?

A
  • Skin lesions
  • If leads to sepsis will have tachycardia and hypotension
  • Lasts a few days to weeks depending on severity of abscess
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16
Q

Staph Aureus

Possible Sequalae?

A
  • Chronic abscess formation
  • Scar tissue
  • Resolution
  • Sepsis
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17
Q

Staph Aureus

Treatment and Prevention?

A
  • If sepsis then septic 6
  • antibiotics
  • Drain Abscess
  • Hand washing tenchique and decontamination of cooking surfaces
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18
Q

Staph Epidermis

Is it Gram Positive or Gram Negative?

A
  • Gram Positive
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19
Q

Staph Epidermis

Mechanism of infection?

A
  • Inoculation onto prosthetic surfaces during surgery
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20
Q

Staph Epidermis

Interaction with host?

A
  • Usually part of normal flora
  • Biofilms on surgical equiptment cause local infections
  • If sheared off can cause sepsis and shock
  • Can cause rejection of prothetics
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21
Q

Staph Epidermis

How to diagnose?

A
  • History
    • Pain in the site of implant
    • unsteadiness on affected joint
    • Tenderness at the site of infection
    • Joint dysfunction until new prosthetic
  • Examination
    • malaise
    • fever
    • myalgia
    • reduced power in limbs
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22
Q

Staph Epidermis

Possible sequalae?

A
  • Septicemia
  • Septic shock
  • Death
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23
Q

Staph Epidermis

Treatment and Prevention?

A
  • Manage fever
  • physiotherapist
  • Replace prosthetic joint
  • Surgical explore and removal
  • Antibiotic
  • Silver coated IV line as has an antibacterial agent, sterile surgical environment and antibiotic prophylaxis
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24
Q

Streptoccus Pneumoniae

Mechanism of infection?

A
  • Direct contact
  • Normal flora of upper respiratory tract
  • Can colonise in lungs
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25
**_Streptococcus Pneumoniae_** Interaction with host?
* Pneumonia occurs when the bacteria colonise the lungs * The capsule means it is not easily phagocytosed * Pus from dead neutrophils accumulates in the lungs * If left unchecked my cause bacteriaemia and meningitis
26
**_Streptococcus Pneumoniae_** Gram positive or Gram Negative?
* Gram Positive
27
**_Streptococcus Pneumoniae_** How to diagnose?
* History * 3 days of dyspnea and malaise, 4 or 5 days of yellow sputum * Lasts 3 weeks after treatment * Examination * crackles and bronchial breathing over area of lung, tachometer, tachycardia, mild hypotension, decreased O2 sats
28
**_Streptococcus Pneumoniae_** Possible Sequlae?
* Consolidation of lung tissue * possible caseous necrosis * clearance of inflammatory exudate via lymphatic * small chance of passage into the blood and then meningitis may result
29
**_Streptococcus Pneumoniae_** Treatment and Prevention?
* high flow of O2 * correct fluid balance * salbutamol * broad spectrum antibiotics * pneumonectomy * Prevention- antibiotic prophylaxis
30
**_Streptococcus pyogenes_** Gram Positive or Negative?
* Gram Positive
31
**_Streptococcus pyogenes_** Mechanism of action?
* Respiratory droplets
32
**_Streptococcus Pyogenes_** Interaction with host?
* Streptokinase- dissolute clots through conversion of plasminogen to plasmin * Streptococcal pyrogenic exotoxins * M protein- inhibits complement pathway so resists phagocyotic
33
**_Streptococcus pyogenes_** How to Diagnose?
* Pharyngitis * Rheumatic fever * Impetigo * Cellulitis * Necrotising fascitis * Toxic shock syndrome
34
**_Streptococcus Pyogenes_** Possible sequalae?
* Scarlet fever * High fever * sepsis * arthritis * jaundice
35
**_Streptococcus pyogenes_** Treatment and Prevention?
* Penicillin and Amoxicillin * Avoid contact with people with infection and wash hands and surfaces
36
**_Clostridium Difficile_** Gram Positive or Negative?
* Gram Positive
37
**_Clostridium Difficile_** Mechanism of infection?
* Infection when microbiota of the gut is eliminated by antibiotics * The flora in gut usually fight off c diff
38
**_Clostridium Difficile_** Interaction with host?
* Exotoxin 1 causes inflammation and intracellular spaces widen due to histamine * Exotoxins B exits through the gaps and kills healthy cells
39
**_Clostridium Difficile_** How to diagnose?
* History * 2 days of severe diarrhoea, abdo discomfort, rare vomiting, previous antibiotic use * 7-20 days * Examination * Tender abdomen, BP low slightly and slightly tachycardia
40
**_Clostridium DIfficile_** Possible Sequalae?
* Acute renal failure * Cognitive impairment * Toxic megacolon, peritonitis and septic shock
41
**_Clostridium Difficile_** Treatment and Prevention?
* IV fluid bolts and ORT * Faecal transplant, metronidazole, discontinue causative antibiotics * Isolation, respoinsible prescribing, barrier medicine e.g. throw away gloves
42
**_Viridans Steptococci_** Gram Negative or Gram Positive?
* Gram Positive
43
**_Viridans Streptococci_** Mechanism of action?
* Normally in oral cavity * Can cause tooth decay and spread to CVS
44
**_Viridans Streptococci_** Interaction with host?
* Colonises tooth surface where converts sucrose into lactic acid * Lowers pH of tooth enamel and leaved vulnerable to break down * If oral mucosa is breached by low pH or abrasion then the bacteria enter the systemic circulation * Bacteraemia * Stuck on heart valves- infective endocarditis
45
**_Viridans streptococci_** How to diagnose?
* History * poor access to dental care, fever and chills for 6 weeks, lack of energy, breathlessness, toothache, anorexia, cahexia * 3 week long illness while wait for surgery * Examination * poor dentition, heart murmur, tachypnea, tachycardia and hypotension, oedema
46
**_Viridas streptococci_** Possible sequalae?
* Heart failure * Valvular dysfunction * Cardiogenic shock
47
**_Viridans Streptococci_** Treatment and prevention?
* Measure urine output * O2 for tachypnea * Replace defective valve * Penicillin and gentamicin * Prevent with good dental hygiene
48
**_Norovirus_** Shape?
* Icosahedral * Non enveloped * ssRNA
49
**_Norovirus_** How is it spread?
* Fecal oral transmission * Contaminated food/person
50
**_Norovirus_** Interaction with host?
* Multiplies within the small intestine and irritates the lining of the GI tract
51
**_Norovirus_** Symptoms?
* Diarrhoea * Vomiting * 72 hours
52
**_Norovirus_** Treatment?
* IV fluids to restore fluid balance * Wash everything
53
**_Adenovirus_** Shape?
* Isohedral * Non-enveloped * dsSNA
54
**_Adenovirus_** Mechanism?
* Droplet infection * Direct contact * Faecal oral transmission
55
**_Adenovirus_** Interactions?
* Enters through respiratory route * Colonise pharynx and Upper airways to cause URTI or down to oesophagus
56
**_Adenovirus_** Symptoms?
* Pharynx pain * Cough * Sinus pain * Temperature * Malaise
57
**_Adenovirus_** Examination?
* Red inflamed pharynx * Enlarged tonsils * lymphadenitis
58
**_Adenovirus_** Treatment?
* Mild pain relief e.g. paracetamol and increase fluid * Only if strain 14 would give antivirals as the strain is potentially lethal
59
**_HIV_** Shape?
* Roughly circular, enveloped and ssRNA
60
**_HIV_** Mechanism of spread?
* Bodily fluid so unprotected sex, needles, vertical transmission, medical procedures
61
**_HIV_** Interaction with host?
* Enters the blood stream * Infects CD4+ T cells * ssRNA is converted to DNA by transverse transcriptase and inserted into genome of T cells * Transcribed and translated and budding of immature protein occurs * The exit causing lysis of T cells * Viral proteases cuts the protein making it on active virus * This then repeats * Become immunodeficient as T cells decline so lossof cell mediated immunity
62
**_AIDs_** What are some signs of AIDs?
* Oral thrush (oppurtunistic oral candida albicans) * Extra pulmonary mycobacterium tuberculosis * Pneumonia
63
**_HIV_** Symptoms?
* Flu like illness in first few weeks * Malaise, lethargy, fever, muscle aches with AIDs * Weight loss, lymph node enlargement and chronic fatigue with AIDs
64
**_HIV_** Specific treatment
* Regularly check CD4+ count * HAART- highly active antiretroviral therapy * 2NTRIs * And 1 NNRTI or proteases inhibitor or integrase inhibitor
65
**_Hepatitis B_** Shape?
* Isohedral * Enveloped * dsDNA non-sense
66
**_Hepatitis B_** Mechanism
* Spread through bodily fluids * Can occur during unprotected sex * Sharing of needles * Vertical transmission * Medical procedures
67
**_Hepatitis B_** Interaction with Host?
* Enters the blood stream and replicates within hepatocytes which leads to host damage by inflammation when the active immune system recognise the viral molecules
68
**_Hepatitis B_** Symptoms?
* Fatigue * Abdominal pain * Anorexia * Nausea * Vomiting * Athralgia * Malaise and Myalgia * Heptosplenomegaly and jaundice
69
**_Hepatitis B_** Treatment?
* Vaccination * Peginterferon-alpha-2a to stimulate immune system to destroy infection * Antiretroviral drugs
70
**_Hepatitis B_** How long does it usually last?
* Resolved after about 6 months
71
**_Hepatitis C_** Shape?
* Isohedral * Enveloped * ssRNA (Sense)
72
**_Hepatitis C_** Mechanism?
* Blood to blood contact * Classic spread of infection is sharing of needles in IV drug users
73
**_Hepatitis C_** Interaction with host?
* Travels to the liver and replicates within hepatocytes but does not usually cause symptoms
74
**_Hepatitis C_** Symptoms?
* Usually asymptomatic * May have fatigue, nausea, anorexia, dark urine and RUQ abdominal pain
75
**_Hepatitis C_** Treatment?
* Lifestyle changes * Pegylated interferon and ribavirin * 80% of patients develop chronic conditions
76
**_Epstein Barr Virus_** Other names?
* Glandular fever * Mono * Herpes virus
77
**_Epstein Barr virus_** Symptoms?
* Fatigue * Fever * lack of appetitie * rash * sore throat * swollen glands * weakness and sore throat
78
**_Epstein Barr Virus_** Treatment?
* Rest * Fluids * Paracetamol * lasts 2-3 weeks * asoociated with cancers like hodgkins lymphoma
79
**_Herpes Zoster_** Other names?
* Chicken pox and shingles
80
**_Herpes zoster_** Symptoms?
* Painful skin rash with blisters * Fever and headache
81
**_Herpes zoster_** Treatment?
* Painkillers * Antivirals and covering the rash
82
**_Malaria_** History?
* Fever * chills * sweat * unwell * confused * moderate jaundice * bite marks
83
**_Malaria_** Examination?
* High temperature, low blood pressure, tachycardia, hepatosplemomegaly , low FBC, high urea, creatinine, bilirubin, CRP, red blood cells have parasites in dot
84
**_Malaria_** Severe malaria symptoms?
* tachycardia, hypotension, arrhythmias, ARDs, diarrhoea, bilirubin, acute kidney injury, confusion, fits, cerebral malaria, low wbc, throkobocytopemia, metabolic acidosis, hypoglycaemia, secondary infection
85
**_Malaria_** Vector?
* Female anopheles mosquito
86
**_Malaria_** Incubation period?
* Minimum 6 days * Maximum 1 year
87
**_Malaria_** Investigations?
* Infectious disease specialist, 3 blood smears, full blood count, head CT, chest X-ray
88
**_Malaria_** Treatment and prevention?
* p.falciparum- artesunate, Quinine and doxycycline, others are choloroquine and primaquine, hypnozoites are liver stages * assess risk, bite prevention, chemophloraxis
89
**_Typhoid Enteric Fever_** Mechanism?
* Faecal-oral route
90
**_Typhoid Enteric Fever_** Incubation period?
* 7-14 days
91
92
**_Typhoid Enteric Fever_** Investigations?
* Anaemia * Lymphnia * Raised LFTs * Culture of blood and faeces
93
**_Typhoid Enteric Fever_** Treatment and Prevention?
* Ciprofloxacin now used due to resistance * Prevented by food and water hygiene and vaccine
94
**_Dengue Fever_** Mechanism?
* Mosquito
95
**_Dengue Fever_** Incubation period?
* 4-10 days after the bite
96
**_Dengue Fever_** Symptoms?
* Rash * May be asymptomatic first time * Reinfection with different serotype- dengue haemorrhage gever or shock syndomre
97
**_Dengue Fever_** Investigations?
* Dengue PCR and serology
98
**_Dengue Fever_** Treatment and Prevention?
* Supportive treatment first time * Prevent by mosquito awareness

Clinical conditions (17 decks)

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