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Year 3 Medicine Block > INFECTIOUS DISEASE: Lung and heart infections > Flashcards

INFECTIOUS DISEASE: Lung and heart infections Flashcards

1
Q
A
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2
Q

Name atypical bacteria that cause atypical pneumonia

A

Legions of Psittaci MCQs
Legionella pneumophila
Chlamydia psittacosis
Mycoplasma pneumoniae
Chlamydophila pneumoniae
Q fever - coxiella burneti

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3
Q

Common bacteria that cause chest infections/pneumonia ( spell them too!)

A

Streptococcus pneumoniae
Haemophilus influenzae

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4
Q

Less common/opportunistic bacteria that cause chest infections/pneumonia and when?

A
  • Moraxella catarrhalis- in immunocompromised patients and those with chronic pulmonary disease
  • Pseudomonas aeruginosa- patients with CF or bronchiectasis
  • Staphylococcus aureus- In patients with CF
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5
Q

Chest infection presentation?

A

Cough
Sputum production
Fever
Lethargy
Crackles on the chest

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6
Q

Common bacteria that cause chest infections ( spell them too!)

A

Streptococcus pneumoniae
Haemophilus influenzae

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7
Q

Antibiotic for chest infection in community?

A

Amoxicillin or erythromycin or doxycycline

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8
Q

Exam patient with Chlamydophila pneumoniae?

A

School aged child with mild- moderate chronic pneumoniae and wheeze

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9
Q

Q fever exam patient?

A

Farmer with flu like symptoms
Q-fever linked to animal exposure and their bodily fluids

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10
Q

Chlamydia psittaci exam pt?

A

Parrot owner- contracted from infected birds

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11
Q

Presentation of infective endocarditis?

A

Main symptom and sign = fever and murmer (aortic valve regurgitation)

Symptoms: Headache, myalgia, weight loss, abdominal pain, night sweats, pleuritic chest pain, cough

Signs: Janeway lesions, osler nodes, non-blanching petechiae. murmer.

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12
Q

Investigations for suspected infective endocarditis?

A

ECG

FBC, U+Es, LFTs, CRP

3 blood culture samples (from different sites) - check have not missed infection

1st line imaging = transthoracic echo

Most sensitve imaging modality = transoesophageal echo

CXR

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13
Q

RF for infective endocarditis?

A

Valvular damage

  • prosthetic valve
  • age related valvular damage
  • previous rheumatic heart disease

IV drug use

Male

Age 60 +

Poor dentition

Previous endocarditis

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14
Q

Initial management of endocarditis (called Blind therapy)?

A

Benzylpenicillin and gentamicin

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15
Q

Management of native valve (i.e. not prosthetic valve) infective endocarditis caused by Staphylococcus aureus?

A
  • Flucloxacillin 4 weeks
  • Penicillin allergy = Vancomycin + rifampicin 4 weeks
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16
Q

Management of prosthetic valve infective endocarditis caused by Staphylococcus aureus?

A

Flucloxacillin + gentamicin + rifampicin for 4-6 weeks

17
Q

Management of infective endocarditis caused by Steptococci sp?

A

Benzylpenicillin 4-6 weeks

18
Q

Complications of infective endocarditis?

A

Heart failure - from acute valvular insufficiency

Stroke, haemorrhages

Renal failure

Osteomyelitis

Septic arthritis

19
Q

Common valve affected in IV drug users with infective endocarditis?

A

Tricuspid valve on R side of the heart

20
Q

Entry mechanism of Strep viridans causing infective endocarditis?

A

Poor dental hygiene

21
Q

Entry mechanism for Staph epidermidis which causes infective endocarditis?

A

Indwelling devices - cannulas.

22
Q

Major clinical criteria of Modified Dukes criteria for infective endocarditis?

A
  1. Blood culture positive
  2. Echo positive or PET CT +ve or CardioCT +ve
23
Q

Minor clinical criteria of Modified Dukes criteria for infective endocarditis?

A
  1. Predisposition present - IVDU, Heart condition
  2. Fever of 38C<
  3. Vascular phenomena present - arterial emboli, infarcts, conjunctival haemorrages
  4. Immunological phenomena present - glomerulonephritis, osler nodes, Rheumatoid factor
  5. Serology evidence of infective endocarditis
24
Q

How is definitive infective endocarditis calculated using Dukes Modified criteria?

A

pathological criteria positive, or
2 major criteria, or
1 major and 3 minor criteria, or
5 minor criteria

25
Q

Xray features of Mycoplasma pneumoniae?

A

Bilateral consolidation

26
Q

CXR findings for pneumonia ?

A

Consolidation

27
Q

Investigations for pneumonia and corresponding findings ?

A

CXR - consolidation

FBC - neutrophillia I.e. high WCC

U+Es - dehydration - urea in CURB6

CRP - raised as response to infection

ABG - indicated if O2 sats are low

Sputum culture - find sensitivity for abx

28
Q

Classic organism causing pneumonia in alcoholics?

A

Klebsiella pneumoniae

Year 3 Medicine Block (56 decks)

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