Infectious Diseases: The Basics Flashcards by M Njm

Outline the current BNF guidelines for antibiotic treatment of Exacerbations of chronic bronchitis

Amoxicillin or tetracycline or clarithromycin

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Outline the current BNF guidelines for antibiotic treatment of Uncomplicated community-acquired pneumonia

Amoxicillin

Doxycycline or clarithromycin in penicillin allergic

add flucloxacillin if staphylococci suspected e.g. In influenza

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Outline the current BNF guidelines for antibiotic treatment of Pneumonia possibly caused by atypical pathogens

Clarithromycin

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Outline the current BNF guidelines for antibiotic treatment of Hospital-acquired pneumonia

Within 5 days of admission: co-amoxiclav or cefuroxime

More than 5 days after admission: piperacillin with tazobactam OR a broad-spectrum cephalosporin (e.g. ceftazidime) OR a quinolone (e.g. ciprofloxacin)

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Outline the current BNF guidelines for antibiotic treatment of Lower urinary tract infection

Trimethoprim or nitrofurantoin.

Alternative: amoxicillin or cephalosporin

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Outline the current BNF guidelines for antibiotic treatment of Acute pyelonephritis

Broad-spectrum cephalosporin or quinolone

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Outline the current BNF guidelines for antibiotic treatment of Acute prostatitis

Quinolone or trimethoprim

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Outline the current BNF guidelines for antibiotic treatment of Impetigo

Topical hydrogen peroxide

Oral flucloxacillin or erythromycin if widespread

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Outline the current BNF guidelines for antibiotic treatment of Cellulitis

Flucloxacillin (clarithromycin, erythromycin or doxycycline if penicillin-allergic)

Cellulitis (near the eyes or nose)
Co-amoxiclav (clarithromycin, + metronidazole if penicillin-allergic)

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Outline the current BNF guidelines for antibiotic treatment of Erysipelas

Flucloxacillin

clarithromycin, erythromycin or doxycycline if penicillin-allergic

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Outline the current BNF guidelines for antibiotic treatment of Animal or human bite

Co-amoxiclav

doxycycline + metronidazole if penicillin-allergic

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Outline the current BNF guidelines for antibiotic treatment of Mastitis during breast-feeding

Flucloxacillin

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Outline the current BNF guidelines for antibiotic treatment of Throat infections

Phenoxymethylpenicillin

erythromycin alone if penicillin-allergic

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Outline the current BNF guidelines for antibiotic treatment of Sinusitis

Phenoxymethylpenicillin

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Outline the current BNF guidelines for antibiotic treatment of Otitis media

Amoxicillin (erythromycin if penicillin-allergic)

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Outline the current BNF guidelines for antibiotic treatment of Otitis externa

Flucloxacillin (erythromycin if penicillin-allergic)

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Outline the current BNF guidelines for antibiotic treatment of Periapical or periodontal abscess

Amoxicillin

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Outline the current BNF guidelines for antibiotic treatment of Gingivitis: acute necrotising ulcerative

Metronidazole

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Outline the current BNF guidelines for antibiotic treatment of Gonorrhoea

Intramuscular ceftriaxone

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Outline the current BNF guidelines for antibiotic treatment of Chlamydia

Doxycycline or azithromycin

Outline the current BNF guidelines for antibiotic treatment of Pelvic inflammatory disease

Oral ofloxacin + oral metronidazole or intramuscular ceftriaxone + oral doxycycline + oral metronidazole

Outline the current BNF guidelines for antibiotic treatment of Syphilis

Benzathine benzylpenicillin or doxycycline or erythromycin

Outline the current BNF guidelines for antibiotic treatment of Bacterial vaginosis

Oral or topical metronidazole or topical clindamycin

Outline the current BNF guidelines for antibiotic treatment of Clostridium difficile

First episode: metronidazole

Second or subsequent episode of infection: vancomycin

Outline the current BNF guidelines for antibiotic treatment of Campylobacter enteritis

Clarithromycin

Outline the current BNF guidelines for antibiotic treatment of Salmonella (non-typhoid)

Ciprofloxacin

Outline the current BNF guidelines for antibiotic treatment of Shigellosis

Ciprofloxacin

What type of vaccine is BCG?

Live attenuated

What type of vaccine is influenza?

Live attenuated

What type of vaccine is MMR?

Live attenuated

What type of vaccine is oral polio?

Live attenuated

Which vaccines are inactivated preparations?

rabies hepatitis A influenza (intramuscular)

Which vaccines are inactivated toxins/toxoids?

tetanus diphtheria pertussis

What type of vaccine is pneumococcus?

subunit/conjugate

What type of vaccine is hepatitis B?

subunit/conjugate

Give examples of | Gram-positive cocci

staphylococci + streptococci (including enterococci)

Give examples of | Gram-negative cocci

Neisseria meningitidis + Neisseria gonorrhoeae, also Moraxella catarrhalis

Give examples of | Gram-positive rods (bacilli)

``` ABCD L Actinomyces Bacillus anthracis (anthrax) Clostridium Diphtheria: Corynebacterium diphtheriae Listeria monocytogenes ```

Give examples of Gram-negative rods

``` Escherichia coli Haemophilus influenzae Pseudomonas aeruginosa Salmonella sp. Shigella sp. Campylobacter jejuni ```

The pneumococcal polysaccharide vaccine is offered to all adults over the age of 65 years and those with

``` asplenia or splenic dysfunction chronic respiratory disease chronic heart disease chronic kidney disease (at stages 4 and 5) chronic liver disease diabetes mellitus if requiring medication immunosuppression cochlear implants patients with cerebrospinal fluid leaks ```

The Department of Health recommends annual influenza vaccination for people older than 65 years and those with:

``` chronic respiratory disease chronic heart disease chronic kidney disease (at stages3, 4 and 5) chronic liver disease chronic neurological disease diabetes mellitus immunosuppression asplenia or splenic dysfunction pregnant women ``` Healthcare staff/residential care homes

Identifying gram-positive bacteria - which type makes CATALASE

Staphylococci (not strep)

Identifying gram-positive bacteria - which type makes COAGULASE

Staph Aureus

Identifying gram-positive bacteria - | Describe hemolysis in streptococci

``` partial haemolysis (green colour on blood agar): α-haemolytic complete haemolysis (clear): β-haemolytic no haemolysis: γ-haemolytic ```

What is sepsis?

life-threatening organ dysfunction caused by a dysregulated host response to infection

What is septic shock?

a more severe form sepsis, technically defined as 'in which circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone

qSOFA score criteria include?

Respiratory rate > 22/min Altered mentation SYSTOLIC blood pressure < 100 mm Hg

'Sepsis Six' includes?

1. Administer oxygen: Aim to keep saturations > 94% (88-92% if at risk of CO2 retention e.g. COPD) 2. Take blood cultures 3. Give broad spectrum antibiotics 4. Give intravenous fluid challenges: NICE recommend a bolus of 500ml crystalloid over less than 15 minutes 5. Measure serum lactate 6. Measure accurate hourly urine output