Infectious Diseases Flashcards
(100 cards)
1
Q
What broad groups of organisms are gram +ve cocci?
A
Staphylococcus
Streptococcus
2
Q
What organisms are gram -ve cocci?
A
Neisseria Gonorrhoea
Neisseria Meningitidis
Moraxella
3
Q
What organisms are gram +ve bacilli?
A
Actinomyces Bacillus antracis Clostridium Diptheria Listeria (ABCDL)
4
Q
What organisms are gram -ve bacilli?
A
Basically everything including E.Coli, Klebsiella, Salmonella, Proteus, Salmonella, Shigella, Psedomonas
5
Q
What staphylococcus is coagulase positive?
A
Staph Aureus
6
Q
What staphylococcus is coagulase negative?
A
Staph epidermidis
Staph saprophyticus
7
Q
What is alpha-haemolytic strep?
A
Causes a partial haemolysis on blood agar
8
Q
What is beta-haemolytic strep?
A
Causes a complete haemolysis on blood agar
9
Q
What are examples of alpha-haemolytic strep?
A
Strep pneumonia (Pneumococcus) Strep viridans
10
Q
What organism is a Group A beta-haemolytic strep?
A
Strep pyogenes
11
Q
What organism is a Group B beta-haemolytic strep?
A
Strep agalactiae
12
Q
What organism is Group D beta-haemolytic strep?
A
Enterococcus (faecalis, faecium)
13
Q
How do penicillin’s work?
A
Bacteriocidal - prevent cell wall synthesis
14
Q
What are some side effects of penicillins?
A
Hypersensitivity and allergy
15
Q
How do cephalosporins work?
A
Bacteriocidal - prevent cell wall synthesis
16
Q
What are some examples of cephalosporins?
A
Cefotaxime, ceftriaxone, cephalexin
17
Q
How do monobactams work?
A
Bacteriocidal - prevent cell wall synthesis
18
Q
What is an example of a monobactam?
A
Aztreonam
19
Q
What cover does Aztreonam give?
A
Gram -ve cover, an alternate to Gentamicin
20
Q
How do carbapenams work?
A
Bacteriocidal - prevent cell wall synthesis
21
Q
What is an example of a carbapenam?
A
Menopenam
22
Q
What is Menopenam commonly used for?
A
Multi-drug resistant infections e.g. ESBL
23
Q
How do glycopeptides work?
A
Bacteriocidal - prevent cell wall synthesis
24
Q
What is an example of a glycopeptide?
A
Vancomycin
25
How is vancomycin administered and why?
Usually IV as poor oral absorption
| Given orally in C.Diff in order to act locally
26
Are glycopeptides beta-lactams?
No
27
How do macrolides work?
Bacteriostatic - inhibit protein synthesis
28
What are examples of macrolides?
Clarithromycin, erythromycin, azithromycin etc
29
How are macrolides excreted?
Via the gut
30
How do aminoglycosides work?
Bacteriocidal - inhibit protein synthesis
31
What is an example of an aminoglycoside?
Gentamicin
32
What cover does gentamicin give?
Gram negative
33
How is gentamicin excreted?
Renally
34
What are side effects of gentamicin?
Nephrotoxic, Ototoxic
35
How do tetracyclines work?
Bacteriostatic - inhibit protein synthesis
36
What are examples of tetracyclines?
Doxycycline, lymecycline, oxytetracycline
37
What cover do tetracyclines give?
Gram positive cover
38
How are tetracyclines excreted?
Via the gut
39
What are side effects of tetracyclines?
Photosensitivity, yellow staining of teeth
40
How does metronidazole work?
Bacteriocidal - inhibits DNA synthesis
41
What does metronidazole cover?
Anaerobes
42
What are some side effects of metronidazole?
Polyneuropathy, metallic taste, reacts badly with alcohol
43
How do sulphonamides and trimethoprim work?
Bacteriocidal - inhibit DNA synthesis by inhibiting folic acid synthesis
44
How do quionolones work?
Bacteriocidal - inhibit DNA synthesis by inhibiting replication
45
What are some examples of quinolones?
Ciprofloxacin, ofloxacin
46
What do quinolones cover?
Broad spectrum but mainly gram negative cover
47
What is the major risk of using quinolones?
C. Diff
48
What are the common causative organisms of UTI?
Coliforms (E.Coli, Klebsiella, Enterobacter)
Proteus
Enterococcus faecalis or faecium (commensals)
Staphylococcus saprophyticus
49
What is the definition of a complicated UTI?
UTI complicated by systemic symptoms or any urinary structural abnormality
50
What is bacteriuria?
Bacteria in the urine - may not be infection
51
What type of urine sample should be taken?
MSSU
52
What will infection show on urine dipstick?
Raised leucocytes and raised nitrites
53
Should UTI culture show pure or mixed growth?
Pure growth - mixed is not significant
54
When should people with asymptomatic bacteruria be treated?
Only if pregnant - as may progress to pyelonephritis and can cause IUGR
55
How is uncomplicated female UTI treated?
Nitrofurantoin 50g QDS or trimethoprim 200g BD (3 days)
56
How is uncatheterised male UTI treated?
Send for culture - nitrofurantoin 50g QDS or trimethoprim 200g BD (7 days)
57
How is a complicated UTI treated in the community?
Co-trimoxazole or co-amoxiclav (7 days)
58
How is a complicated UTI treated in the hospital?
IV amoxicillin and gentamicin
| Step down to oral co-trimoxazole
59
What antibiotics should be used for UTI in the first and second trimester of pregnancy?
Nitrofurantoin 50mg QDS (7 days)
60
What antibiotics should be used for UTI in the third trimester of pregnancy?
Trimethoprim 200mg BD (7 days)
61
What organisms commonly cause cellulitis?
Group A Beta-Haemolytic Strep (Strep Pyogenes)
| Staph Aureus
62
What antibiotic is used to treat cellulitis?
Flucloxacilin 1g QDS
63
If a patient has recurrent boils or abscesses, what should you consider swabbing for?
Panton-Valentine Leucocidin
64
What is Panton-Valentine Leucocidin and what is it produced by?
Toxin produced by certain types of staph aureus
65
What is bacteraemia?
The presence of bacteria in the blood
66
What is osteomyelitis?
Inflammation of bone and medullary cavity
67
What are the likely causative organisms of osteomyelitis?
Staph Aureus
Staph epidermidis
Streptococcus
Aerobic gram -ve organisms
68
How is osteomyelitis treated?
IV flucloxacillin 2g TDS
69
What are the likely causative organisms of septic arthritis?
Staph aureus
Streptococcus
Neisseria Gonorrohoea (in sexually active)
70
What is the likely causative organism of septic arthritis in prosthetic joints?
Coagulase -ve staph (e.g. staph epidermidis)
71
How is septic arthritis treated?
IV flucloxacillin 2g TDS
72
What are the common causes of meningitis in neonates?
Listeria
Group B Beta Haemolytic Strep
E. Coli
73
What is the commonest cause of bacterial meningitis in children?
Haemophilus Influenza (less now with vaccine)
74
What is the commonest cause of bacterial meningitis in 10-21 year olds?
Neisseria Meningitidis
75
What are the common causes of bacterial meningitis in >21s?
Strep Pneumoniae, Neisseria Meningitidis
76
What are the common causes of bacterial meningitis in over 65s?
Strep Pneumonia, Listeria
77
How is bacterial meningitis treated?
Ceftriaxone IV 2g BD + Dexamethasone IV 10mg QDS
78
Patient gets an itchy erythematous rash following vancomycin administration
Red man syndrome
79
What are ESBLs?
Extended spectrum beta lactamases - resistant to all penicillins
80
How are ESBLs treated?
Temocillin or meropenem
81
What are risk factors for C.diff infection?
Antibiotics - clindamycin, cephaloscoprins, ciprofloxacin
PPI use
Increased age
Bowel surgery
82
What are features of C diff infection?
Diarrhoea, abdominal pain, raised white cell count
83
How is non severe C. Diff treated first line?
Oral metronidazole (10 days)
84
How is severe C. Diff treated?
Oral vancomycin (10 days)
85
How is C. Diff investigated?
Stool for toxin
86
How is E.Coli 0157 diagnosed?
Stool culture
87
How is influenza diagnosed?
Throat swab for PCR
88
What is the first line treatment for MRSA?
IV Vancomycin
89
What is the most effective way of preventing the spread of MRSA?
Hand washing
90
How should patients with norovirus be managed in the hospital setting to prevent spread?
Isolation and/or cohort nursing and closure of the ward
91
How is TB investigated?
Sputum sample or if non productive bronchoalveolar lavage
92
What is the investigation of choice for endocarditis?
Trans-oesophageal echocardiogram
93
What is the SIRS criteria?
```
2 from:
Temperature >38 or <36
Pulse >90
RR >20
WCC >12 or <4
```
94
What is sepsis defined as?
Clinical suspicion of infection + SIRS criteria
95
What is severe sepsis?
Sepsis + organ dysfunction
96
What is septic shock?
Sepsis + refractory hypotension
97
'Fever on alternating days'
Malaria
98
What is the common cause of a post influenza pneumonia?
Staph aureus
99
How is mycoplasma pneumoniae diagnosed?
Serology
100
What is the commonest infection of central line infections?
Staph epidermidis
