Infectious Disease Flashcards by Emily Heyting

Pseudomonas Auriginosa
Aerobe or anaerobe?
Commonly causes what infection in which patient group?

Aerobe

Pneumonia in CF patients - mucous limits O2 diffusion

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Neisseria meningitidis 
Type of bacteria?
Aerobe or anaerobe?
Who carries it where?
What does it cause and in who?

Gram positive diplococci
Aerobe
10% of adults are carriers in the nasopharynx
Causes bacterial meningitis in young adults and children

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Which organisms cause chronic infections in CF? (5)

H. Influenzae
Stash aureus 
Pseudomonas auriginosa 
atypical mycobacteria
Candida albicans

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What chronic infections can occur in uncontrolled diabetes? (4)

Malignant otitis externa
Rhinocerebral mucormycosis
UTIs - enterobacteria or pseudomonas aeriginosa
Skin and soft tissue infections - staph aureus

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What are the principals of antibiotic stewardship? (5)

Appropriate use of antimicrobials
Optimal clinical outcomes
Minimise toxicity and side effects
Reduce the cost of healthcare for infections
Limit the selection of antimicrobial resistant strains

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What organisms causes osteomyelitis

Staph aureus

In sickle cell anaemia salmonella more predominate

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Risk factors for osteomyelitis

Diabetes mellitus, sickle cell anaemia, IVDU, immunosuppression, alcohol abuse

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Investigation of osteomyelitis

MRI

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Treatment of osteomyelitis

Flucloxacillin or cindamycin if penicillin allergic

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Penicillins class
Examples x4
MOA

Penicillin, Amoxicillin, Flucloxacillin, Co-amoxiclav

Inhibit transpepsidase - beta-lactams - to prevent bacterial cell wall repairs

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what is flucloxacillin used to treat?

staphylococcal soft tissue infections

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Cephalosporins
examples x3
MOA

cefaclor, cefotaxime, aztrennam

targe beta-lactams in the cell wall by inhibiting transpeptidase

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Tetracyclines
examples x3
MOA

Tetracycline, doxycycline, oxytetracycline

prevent protein synthesis by locking tRNA to mRNA

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Aminoglycosides
examples x2
MOA
important side effects x2

Gentamicin, Neomycin
Prevent 30s ribosome subunit from translating mRNA
ototoxic, nephrotoxic

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Hepatits B
transmission
Incubation
Symptoms x6
Blood abnormality

Blood, sex, vertical transmission
6/52 to 6/12 incubation
jaundice, fatigue, abdominal discomfort, anorexia, arthralgia
AST/ALT in the 1000s

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Hepatitis B
management
outcomes

supportive

most will clear infection, 6-10% chronic infection, could result in hepatic failure or hepatocarcinoma

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Causative organisms for:

1) prosthetic valve endocarditis
2) prosthetic joint infection
3) cardiac pacing wire endocarditis

all caused by coagulase negative staphylococci

cardiac pacing wire endocarditis can also be caused by staph aureus.

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which cause of pneumonia classically causes desaturation on exercise?

Pneumocysitis jiroveci

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3 Most common organisms for bronchiectasis exacerbation

Haemophilus Influenzae
Pseudomonas Aeruginosa
Moraxella Catarrhalis

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Which organisms commonly cause endocarditis?

Staph aureus - most acute cases including prosthetic valves and IVDU related endocarditis
Strep viridans - usually sub acute IE
Group D streptococcus and Streptococcus intermedius - usually subacute

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Which organisms most commonly cause community acquired pneumonias?

Streptococcus pneumoniae
Mycoplasma pneumoniae
Haemophilus Influenzae

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What organisms most commonly cause hospital acquired pneumonias?

2 day onset - S. pneumoniae, H. influenzae and Moraxella catarrhalis
4 day onset - S. aureus or L. pneumophila

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What is the quadruple therapy for TB?

6 months - rifampicin and isoniazid

2 months - pyrazinamide and ethambutol

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What are the side effects of TB abx

all but ethambutol are hepatotoxic
rifampicin - orange secretions, rashes
ethambutol - visual disturbance/blindness
isoniazid - peripheral neuropathy (give prophylactic pyridoxine), rash, psychosis
Pyrazinamide- rash, vomiting, arthralgia

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What antibiotics for CAP?

Mild-moderate (CURB 0-1): Amoxicillin 5 days oral or doxy if allergic Moderate (CURB 2): amoxicillin and doxycycline 5 days oral Severe (CURB 3+): IV Co-amoxiclav and oral doxycycline 5 days If non anyphalactic penicillin allergy give meropenem IV with doxy oral for 5 days.

What antibiotics are used for HAP?

Mild-moderate; Co-amoxiclav oral 5 days. Doxy if allergic. Severe -IV co-amoxiclav 5 days or meropenum if non-anaphylactic allergy Ventilator associated - tazocin IV for 5 days - meropenum if on-anaphylactic allergy

Antibiotics for Chlamydia trachomatis infection

7 days PO doxycyline although if risk of gonorrhoeae infection then give IM ceftriaxone.

Antibiotics for Neisseria gonorroea

IM ceftriaxone

Treatment for bacterial vaginosis

PO metronidazole 7 days

Herpes simplex virus treatment

PO acyclovir

Treatment for genital thrush

topical clomitrazole or oral fluconazole

causative organism for gas gangrene

C. perfringens

What is erythema chronicum migrans and in what infection is it commonly seen?

bull's eye rash | Lyme disease

Bacillus cereus typical infection symptoms and cause

vomiting and diarrhoea within 6 hours of ingestion, stereotypically due to rice

E-coli gastroenteritis - typical infection symptoms and who gets it

Common amongst travellers Watery stools Abdominal cramps and nausea

features of giardiasis gastroenteritis

prolonged diarrhoea without blood

features of cholera gastroenteritis

Profuse, watery diarrhoea Severe dehydration resulting in weight loss Not common amongst travellers

Features of shigella gastroenteritis

Bloody diarrhoea | Vomiting and abdominal pain

features of staph aureus gastroenteritis

Severe vomiting | Short incubation period

features of campylobacter gastroenteritis

A flu-like prodrome is usually followed by crampy abdominal pains, fever and diarrhoea which may be bloody May mimic appendicitis Complications include Guillain-Barre syndrome

features of amoebic dysentery

Gradual onset bloody diarrhoea, abdominal pain and tenderness which may last for several weeks

Mx of first-episode genital herpes

Oral antiviral therapy is indicated for primary genital herpes infections, even if the presentation is delayed for up to 5 days

Abx of choice for meningitis

Ceftriaxone IV

Abx for UTI in pregnancy

nitrofurantoin | avoid trimethoprim!

What is the Jarisch-Herxheimer reaction?

reaction following initial treatment with benzylpenicillin for syphilis which occurs within several hours. Fever, tachycardia, and rash due to the release of bacterial endotoxin. No wheeze or hypotension.

What infections are post-splenectomy patients most at risk of?

pneumococcus, Haemophilus, meningococcus and Capnocytophaga canimorsus (from dog bites)

interpreting Hepatitis serology 1) Anti-HBs 2) AntiHBc 3) HBsAg

1) Anti-HBs - immunity to hepatitis B 2) AntiHBc - chronic infection with hepatitis B 3) HBsAg - acute infection with hepatitis B

What is Yellow Fever?

Type of viral haemorrhagic fever zoonotic infection: spread by Aedes mosquitos incubation period = 2 - 14 days

Clinical features of yellow fever?

may cause mild flu-like illness lasting less than one week sudden onset of high fever, rigors, nausea & vomiting +/- bradycardia A brief remission is followed by jaundice, haematemesis, oliguria

findings on liver biopsy in yellow fever

Councilman bodies (inclusion bodies) may be seen in the hepatocytes

Diagnosis of lyme disease

erythema migrans present - start treatment without further testing other wise enzyme-linked immunosorbent assay (ELISA) antibodies to Borrelia burgdorferi are the first-line test

Management of Lyme disease

doxyxycline first line. If pregnant use amoxicillin | in disseminated disease use ceftriaxone

What organism stains with India ink?

Cryptococcus neoformans

What causes genital warts?

human papilloma virus HPV, especially types 6 & 11

features of genital warts

small (2 - 5 mm) fleshy protuberances which are slightly pigmented may bleed or itch may be keratinised

management of genital warts

multiple, non-keratinised warts: topical podophyllum | solitary, keratinised warts: cryotherapy

mx of asymptomatic bacteriuria in pregnant women?

start abx immediately

treatment of chronic Hep C infection

currently a combination of protease inhibitors (e.g. daclatasvir + sofosbuvir or sofosbuvir + simeprevir) with or without ribavirin are used

Abx for gonorrhoea

IM ceftriaxone

Abx for extensive otitis externa

flucloxacillin

Abx for PID

doxycycline + metronidazole + ceftriaxone

When can you give post expoure prophylaxis for HIV

asap up to 72 hours

Pneumocystis jiroveci penumonia abx

co-trimoxazole- a mix of trimethoprim and sulfamethoxazole

URTI symptoms + amoxicillin → rash | what diagnosis are you suspecting?

?glandular fever

tetanus vaccination schedule

``` 2 months 3 months 4 months 3-5 years 13-18 years ```

Diagnosis and abx for legionella pneumonia

Diagnosis urinary antigen Management treat with erythromycin/clarithromycin

Causative organisms Cellulitis

Streptococcus (most common group), especailly S. pyogenes or Staphylcoccus aureus.

Abx for cellulitis

flucloxacillin | if severe co-amoxiclav

Infectious Disease Flashcards

(68 cards)