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Flashcards in Infection (new facts) Deck (66):
1

Gram + alpha haemolytic strep colonising URT?

Strep pneumoniae

2

Gram + beta haemolytic strep colonising URT?

Strep pyogenes

3

What is a non-strep gram + bacteria which also colonises the URT?

Staph aureus

4

What are gram - organisms which colonise the URT?

Haemophilius influenzae, Moraxella catarrhalis

5

What are complications of the common cold?

Acute sinusitis or bronchitis

6

What are organisms causing the common cold?

Adenovirus, rhinovirus, RSV

7

What URTI shows a pseudo-membrane?

Diphtheria

8

What causes epiglottitis and what kind of organism is this?

Haemophilius influenzae type B- gram + cocco bacillus

9

How do you test for epiglottitis?

Blood culture

10

What is the treatment for epiglottitis?

Intubation and ceftriaxone

11

What is a generally big risk factor for most LRTIs?

Intubation

12

What will acute bronchitis show on chest exam and CXR?

Normal

13

As well as cold like symptoms and coughing, what is another common symptom of whooping cough?

Vomiting

14

What causes whooping cough and what type of organism is this?

Bortedella pertussis- gram - coccobacillus

15

When should you give antibiotics for whooping cough?

Cough < 21 days

16

What antibiotics can be given for whooping cough and under what conditions?

< 1 month- clarithromycin
> 1 month- clarithromycin or azithromycin
Pregnancy- erythromycin

17

How is a diagnosis of bronchiolitis made?

PCR

18

How is bronchiolitis treated?

Supportive

19

What does chlamydophila pneumoniae cause?

Mostly mild respiratory tract infections

20

Primary influenza pneumonia after flu is most common in who?

During pandemics- young adults

21

Secondary bacterial pneumonia after flu is most common in who?

Infants, elderly, pre-existing disease or pregnancy

22

What is Influenza A 5HN1?

Highly pathogenic avian flu

23

Who are the only people to receive a live attenuated flu vaccine?

Children

24

What further antibiotic cover does hospital acquired require?

Gram -

25

What further antibiotic cover does aspiration require?

Anaerobic

26

What is the treatment for mild-moderate CAP (0-2 CURB65)?

amoxicillin 1g tds IV/PO (doxycycline if penicillin allergic)

27

What is the treatment for severe CAP (3-5 CURB65)?

co-amoxiclav 1.2g tds IV + clarithromycin 500mg bd IV (levofloxacin if penicillin allergic)

28

What are organisms which can cause lobar pneumonia?

Strep pneumonia, Klebsiella or Legionella

29

Who normally gets lobar pneumonia?

CAP- previously healthy young adults

30

Where does broncho pneumonia start and spread to?

Starts in airways and spreads to adjacent alveolar lung

31

Who is broncho-pneumonia more common in?

Those with a pre-existing disease or aspiration

32

What antibiotic treatment does mycoplasma, coxiella burnetti and chlamydia psittaci respond to?

Tetracycline and macrolides e.g. clarithromycin

33

Apart from pneumonia, what else can coxiella burnetti cause?

Q fever

34

Where does coxiella burnetti come from?

Sheep and goats

35

What is a complication of coxiella burnetti?

Culture negative endocarditis

36

What does chlamydia thrachomatis cause?

Infantile pneumonia

37

Is legionella gram - or +?

-

38

Where does legionella invade?

Alveolar macrophages and then replicates

39

How is legionella diagnosed mainly?

Urinary antigen

40

How do you treat legionella?

Clarithromycin, erythromycin or quinolones e.g. levofloxacin

41

How do you treat PCP?

Co-trimoxazole and maybe prophylaxis

42

how do you diagnose aspergillus or PCP?

Bronchioalveolar lavage

43

What type of organism is mycobacterium TB?

Acid alcohol fast bacilli

44

What can latent TB cause?

Immune alterations or reactivation later on

45

Where is the pathogen taken in primary TB?

To hilar lymph nodes

46

Where is secondary TB found?

Usually localised to the upper zones but may spread via bloodstream or airways

47

What type of TB will show a Ghon Focus in the midzone and enlarged pulmonary hilar lymph nodes?

Primary

48

What will secondary TB show on CXR?

Fibrosing and cavitating apical lesion

49

What type of TB is a miliary disease?

Secondary

50

What test uses the carbol-fuschin dye and what colour does this stain?

Zeihl-Neelson, stains mycobacteria red

51

What should you always check for in patients with chronic pulmonary infection?

Underlying immunodeficiency

52

What is usually the cause of a lung abscess?

Aspiration

53

What organisms can cause an abscess?

Bacteria or fungi

54

What can cause a right sided endocarditis from a DVT?

Septic emboli

55

Who are septic emboli common in?

IV drug users

56

What shows an uncomplicated effusion?

Clear fluid, ph > 7.2, LDH < 1000, glucose > 2.2

57

What type of organisms mainly cause empyema?

aerobes

58

When do anaerobic organisms cause empyema?

After severe pneumonia or if there is poor dental hygiene

59

What would give clinical suspicion of empyema?

Slow to resolve pneumonia

60

What will show a D sign on CXR?

Empyema

61

What is the preferred test for empyema?

US

62

What initial broad spectrum antibiotics are used for empyema?

Amoxicillin and metronidazole

63

What is used to diagnose bronchiectasis?

HRCT

64

What shows hallmarks of bronchiectasis but there is no evidence of this on CXR?

Chronic bronchial sepsis

65

Who are the two groups of people most likely to get chronic bronchial sepsis?

Young women involved in healthcare
Older people with COPD

66

What have been shown to reduce exacerbations of chronic bronchial sepsis?

Low dose macrolides