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Alice's finals cards > Infectious disease > Flashcards

Infectious disease Flashcards

(105 cards)

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1
Q

Which stain is used to differentiate between gram positive and gram negative bacteria? What is the result?

A

Crystal violet stain. Gram positive bacteria are stained but gram negative don’t

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2
Q

What is the name for rod shaped bacteria?

A

Bacilli

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3
Q

What is the name for circular shaped bacteria?

A

Cocci

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4
Q

What is the counterstain called which identifies gram negative bacteria? What colour does it turn?

A

safarin. Red/ pink

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5
Q

What is the difference in cell structure between gram positive and a negative bacteria?

A

Gram positive have a thick peptidoglycan cell wall

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6
Q

Name 3 gram-positive cocci?

A

Staphylococcus
Streptococcus
Enterococcus

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7
Q

What does MRSA stand for?

A

Methicillin- resistant staphylococcus aureus

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8
Q

Name 3 antibiotic treatment options for MRSA

A

Doxycyline
Clindamycin
Vancomycin

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9
Q

What are the 2 broad mechanisms of actions of antibiotics?

A

Bactericidal

Bacteriostatic

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10
Q

Which bacteria does amoxicillin cover?

A

Streptococcus, listeria and enterococcus (all gram +ve)

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11
Q

Which bacteria does co-amoxiclav cover?

A

Staphylococcus, haemophilus and e.coli

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12
Q

Which bacteria does tazocin cover?

A

Pseudomonas

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13
Q

Which bacteria does meropenem cover?

A

ESBLs (extended spectrum beta lactamases) These are bacteria which produce an enzyme which makes them resistant to beta lactamases

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14
Q

Which bacteria do teicoplanin and vancomycin cover?

A

MRSA

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15
Q

Which bacteria do clarithromycin and doxycyline cover?

A

Atypical bacteria

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16
Q

Why is oedema a feature of sepsis?

A

Massive cytokine release occurs in response to pathogen. This causes the endothelial lining of cells to be more permeable leading to fluid leakage.

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17
Q

What can oedema cause in sepsis and why?

A

tissue hypoxia because fluid leakage creates a space between vessels and tissue

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18
Q

Why does DIC occur in sepsis?

A

Coagulation system is activated leading to deposition of fibrin throughout the circulation system. This causes platelets to be used up

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19
Q

Why is blood lactate high in sepsis?

A

Hypo-perfusion of tissues causes tissues to switch to anaerobic respiration. A by-product of anaerobic respiration is lactate

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20
Q

What are the two main symptoms which measure if a patient is in septic shock?

A

Systolic blood pressure less than 90

Hyperlactaemia (>4mmol/L)

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21
Q

How is septic shock managed?

A

IV fluid boluses to improve BP and perfusion. If this doesn’t wrk then use inotropes (such as noradrenalin) to stimulate the CV system, increase BP and perfusion

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22
Q

How is severe sepsis defined?

A

When sepsis is present and results in organ dysfunction

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23
Q

What is the screening tool for sepsis used in hospitals?

A

NEWS (national early warning score)

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24
Q

What is often the first sign if sepsis?

A

Tachypnoea

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25
Investigations for sepsis?
``` FBC (asses neutrophils) U&Es for kidney function LFTs CRP Clotting (DIC) Blood cultures ABG (lactate, pH and glucose) ```
26
What is the sepsis 6?
Three tests: 1. Blood lactate 2. Blood cultures 3. Urine output Three treatments: 1. O2 (94-98% target) 2. Empirical broad spectrum antibiotics 3. IV fluids
27
What is neutropenic sepsis?
Sepsis in a patient with a low neutrophil count of less than 1x10^9/L
28
Which 2 bacteria most commonly cause chest infections?
1. Streptococcus pneumonaie (50%) | 2. Haemophilus influenzae (20%)
29
What is the most appropriate initial antibiotic in the community for a chest infection?
Amoxicillin
30
Which bacteria most commonly cause UTIs?
E.coli
31
What are the 4 main symptoms of pyelonephritis?
Fever Loin pain Haematuria Renal angle tenderness
32
What would show on a urine dipstick if someone has a UTI?
Nitrites | Leukocytes
33
What length of antibiotic treatment should women be put on for UTI?
3 days
34
What length of antibiotic treatment should women who are immunosupressed or have abnormal kidney function be put on for UTI?
5-10 days
35
What length of antibiotic treatment should men, pregnant women or people with catheter related UTIs be put on for UTI?
7 days
36
Which antibiotics are the initial choices for UTI?
Trimethoprim | Nitrafurantoin
37
Which antibiotic for UTI is avoided in the third trimester?
Nitrofurantoin, causes haemolytic anaemia in newborns
38
Which antibiotic for UTI is avoided in the first trimester?
Trimethoprim due to anti-folate effects
39
What does a gold-yellow crust indicate?
Staphylococcus aureus infection
40
What is the name of the classification used for cellulitis?
Eron classification
41
Which antibiotic is most commonly used for cellulitis?
Flucloxacillin. Very effective against staph
42
Which bacteria most commonly causes bacterial tonsillitis?
Group A strep (mainly streptococcus pyogenes)
43
Which bacteria most commonly causes otitis media, sinusitis and tonsilitis?
Streptococcus pneumoniae
44
Whats the first line antibiotic for tonisilitis?
Phenoxymethylpenicillin
45
What is the first line antibiotic for sinusitis?
Phenoxymethylpenicillin
46
What is the most common causative organism of septic arthritis?
Staphylococcus aureus
47
What is the management of septic arthritis?
Joint aspiration PRIOR to abx | Start empirical abx (often flucloxacillin plus rifampicin)
48
Who is the flu vaccine given to for free?
``` Aged 65+ Young children Pregnant women Chronic health conditions Healthcare workers ```
49
How do you diagnose the flu?
Viral nasal or throat swabs | Then PCR
50
What are the 3 most common causes of viral gastroenteritis?
Rotavirus Norovirus Adenovirus
51
What is a complication of E.coli and why does this mean that antibiotic therapy is contraindicated?
Haemolytic uraemic syndrome. the use of antibiotics increase the risk of HUS so shouldn't be used
52
What are the symptoms of e.coli gasteroenteritis?
Bloody diarrhoea, vomiting and abdo cramps
53
Whats the most common cause of travellers diarrhoea?
campylobacter jejuni
54
Which bacteria often causes gastroenteritis after the patient eats rice?
Bacillus cereus
55
What is the treatment for giardia?
Metronidazole
56
Which bacteria most commonly causes meningococcal septicaemia?
neisseria meningitidis and streptococcus pneumoniae
57
What causes the non-blanching rash in meningitis?
DIC and subcutaneous haemorrhages
58
What are the two special tests for meningeal irritation?
Kerning's test | Brudzinski's test
59
What should be given as a stat dose in a primary care setting if meningitis is suspected?
IM benzylpenecillin
60
When is a lumbar puncture contraindicated
if there is purpura
61
Which antibiotics should be used if the patient <3 months and has meningitis?
Cefotaxime and amoxicillin
62
Which antibiotics should be used if the patients is >3months and has meningitis?
Ceftriaxone
63
Which medication is given alongside abx to children with meningitis? Why?
Steriod to reduce the chance of hearing loss and neuro damage
64
What should be given as post exposure prophylaxis to meningitis contacts? Within what time frame?
People who have been in close contact 7 days prior should be given a single dose of ciprofloxacin
65
What are the features bacterial meningitis lumbar puncture?
Cloudy, high protein, low glucose, high WCC (neutrophils)
66
What are the features viral meningitis lumbar puncture?
Clear, normal protein, normal glucose, high WCC (lymphocytes)
67
Which bacteria causes TB?
Mycobacterium tuberculosis
68
Which stain should be used for mycobacterium tuberculosis? What colour does it turn them?
Zeihl-Neelsen stain. Red against a blue background
69
What does active TB mean?
There is active infection in various areas of the body
70
What does latent TB mean?
There has been active TB. Now the immune system has managed to encapsulate sites of infection and stop the progression of the disease
71
What is secondary TB?
When latent TB reactivates
72
What is miliary TB?
Severe TB
73
What is a cold abscess?
A firm and painless abscess caused by TB, usually in the neck
74
What kind of vaccine is the BCG vaccine?
Live attenuated
75
How do you test if someone has antibodies to TB?
Mantoux test
76
What are the symptoms of TB?
``` Lethargy Fever Night sweats Weight loss Erythema nodosum Lymphadenopathy ```
77
How do you investigate TB?
Check for immune response (mantoux test or interferon gamma release assay) Use Ziehl-Neelsen stain Chest X-Ray Cultures
78
What is the interferon-gamma release assay test used for?
To confirm a diagnosis of latent TB in patients who have had a positive mantoux test
79
What might primary TB show on a chest X-ray?
Consolidation Pleural effusions Hilar lymphadenopathy
80
What may reactivated TB show on a chest X-ray?
Patchy or nodular consolidation with cavitation (gas filled spaces) in the lungs
81
What may disseminated Miliary TB show on chest X-ray?
Millet seeds, uniformly distributed throught the lung fields
82
How can latent TB be managed?
Isoniazid and rifampicin for 3 months or just isoniazid for 6 months
83
How should acute TB be managed?
``` RIPE: Rifampicin for 6 months Isoniazid for 6 months Pyrazinamide for 2 months Ethambutol for 2 months ```
84
What should always be prescribed alongside isoniazid?
Pyridoxine (vitamin B6) because isoniazid can cause peripheral neuropathy
85
Where should patients with active TB be treated?
In hospital negative pressure rooms until they are established on treatment
86
What is a side effect of rifampicin?
Red/ orange discolouration of secretions.
87
What is a side effect of isoniazid?
Peripheral neuropathy. Pyridoxine should be prescribed alongside
88
What is a side effect of pyrazinamide?
Hyperuricaemia. This can result in gout
89
What is a side effect of ethambutol?
Colour blindness and reduced visual acuity
90
What kind of virus is HIV?
It is an RNA retrovirus
91
Which cells in the body does HIV attack?
CD4 T helper cells
92
Name some AIDS-defining illnesses
``` Kaposi's sarcoma PCP Cytomegalovirus infection Candidiasis (oesophageal or bronchial) Lymphomas Tuberculosis ```
93
How long can a HIV antibody test be negative for following exposure?
3 months
94
Which test for HIV can give a positive result faster than an antibody test?
p24 antigen
95
What does PCR testing for HIV RNA show?
Viral load
96
What 2 things do you monitor in HIV?
CD4 count | Viral load
97
How is HIV treated?
Antiretroviral therapy until they have a normal CD4 count and an undetectable viral load
98
Which type of vaccines should HIV patients avoid?
Live vaccines
99
What is the current post exposure prophylaxis regime for HIV?
Truvada and raltegravir for 28 days
100
How is malaria spread?
Through bites from the female anopheles mosquitoes
101
What are the symptoms of malaria?
``` Fever, sweats and rigors Malaise Myalgia Headache Vomiting ```
102
What are the signs of malaria?
Pallor due to anaemia Hepatosplenomegaly Jaundice
103
How do you diagnose malaria?
Malaria blood film
104
How do you exclude malaria?
3 malaria blood films over 3 consecutive days
105
How do you treat malaria?
If uncomplicated, oral quinine sulphate | If severe, IV artesunate

Alice's finals cards (21 decks)

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