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Finals > Micro n Infection > Flashcards

Micro n Infection Flashcards

1
Q

Gram +ve cocci?

A

Staphylococcus
Streptococcus
Enterococcus

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2
Q

Gram +ve aerobes

A

‘Aerobic Rods and Corney Mike’s List of Basic Nokias’
- Aerobic rods
- Corneybacteria ‘corney’
- Mycobacteria ‘mike’
- Listeria ‘list of’
- Bacillus ‘basic’
- Nocardia ‘nokia’s’

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3
Q

Gram +ve anaerobes?

A

“Rods anaerobic CLAP”
Clostridium
Lactobacillus
Actinomyces
Propionibacterium

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4
Q

Common gram -ve

A

Neisseria meningitis
Neisseria gonorrhoea
Haemophilia influenza
E. coli
Klebsiella
Pseudomonas aeruginosa
Moraxella catarrhalis

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5
Q

Atypical (non culturable) organisms

A

Chlamoydophila pneumonia
Chlamydia psittaci
Coxiella burnetti
Legionella pneumophilia
Mycoplasma pneumonia

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6
Q

What is MRSA

A

Methicillin resistant staph aureus

Resistant to beta lactam abx

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7
Q

Treatment options for MRSA

A

Doxycycline
Clindamycin
Vancomycin
Teicoplanin
Linezolid

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8
Q

Most common cause of bacterial chest infection

A

Strep pneumoniae (gram +ve cocci)

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9
Q

2nd most common cause of bacterial chest infection

A

Haemophilus influenzae (gram -ve)

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10
Q

What 1st line abx covers strep?

A

Amoxicillin

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11
Q

What 1st line abx covers staph?

A

Co-amoxiclav

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12
Q

What 1st line abx covers ecoli

A

Co amoxiclav

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13
Q

What abx covers haemophilus

A

Co amoxiclav

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14
Q

What abx covers pseudomonas

A

Tazocin

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15
Q

What is ESBL and what treats is

A

Extended spectrum beta lactamase bacteria

Meropenam abx

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16
Q

What abx covers MRSA?

A

Teicoplanin

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17
Q

What’s usually used to cover atypical infections?

A

Clarithromycin or doxycycline

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18
Q

What bacteria does amoxicillin usually cover?

A

Streptococcus

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19
Q

What bacteria does co amoxiclav cover?

A

Staphylococcus
Haemophilus
E. coli

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20
Q

What bacteria does tazocin cover?

A

Pseudomonas

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21
Q

What is meropenam used to treat?

A

ESBL- Extended spectrum beta lactamase bacteria, usually ecoli or klebsiela
Often UTIs

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22
Q

What is Teicoplanin used to cover?

A

MRSA

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23
Q

MOA: Abx that inhibit protein synthesis in bacteria?

A

Act on bacterial ribosome

Doxycycline (tetracycline)
Erythromycin
Chloramphenicol
Clindamycin
Gentamicin
Amikacin

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24
Q

MOA: abx that inhibits cell wall synthesis

A

Abx WITH Beta lactam ring
- penicillin
- carbapenams
- cephalosporins

Abx WITHOUT beta lactam ring
- vancomycin
- teicoplanin

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25
Q

Moa of
Penicillins
Vancomycin
Teicoplanin
Gentamicin
Doxycyline
Clindamycin

A

Penicillins (has beta lactam ring)
- inhibits cell wall synthesis
Vancomycin and teicoplanin(hasn’t got beta lactam ring) - but still inhibits cell wall synthesis
Gentamicin, doxy and Clindamycin- inhibit protein synthesis in ribosome

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26
Q

5 antibiotics that inhibit cell wall synthesis?

A

Penicillin
Carbapenams
Cephalosporins
Vancomycin
Teicoplanin

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27
Q

Examples of penicillins?

A

Penicillin
Amoxicillin
Co-amoxiclav
Flucloxacillin
Phenoxymethylpenicillin

Often used for skin, chest and UTIs

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28
Q

Examples of cephlosporins?
What are they commonly used for?

A

Cefalexin

Wide range, good for severe e.g. sepsis and meningococcal septicaemia

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29
Q

Macrolide antibiotics e.gs? And use

A

Azithromycin
Erythromycin
Clarithromycin

Lung infections. Good in penicillin allergy

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30
Q

What abx usually used for UTIs?

A

Nitrofurantoin
Trimethoprim

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31
Q

Stain for ?TB

A

Zeihl Neelson stain
+ve =red
-ve stays blue

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32
Q

TB antibiotics

A

RIPE
Rifampicin -6m
Isoniazid- 6m
Pyrazinamide- 2m
Ethambutol- 2m

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33
Q

What is pyridoxine? Why is it given to people with TB?

A

Vitamin B6

Given to prevent peripheral neuropathy, which can be a side effect of isoniazid

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34
Q

Potential side affects of TB medications?

A

Rifamipicin “red and orange pissin”
Red/orange secretions, hepatitis, flu like sx

Isoniazid “I’m so numb azid”
Peripheral neuropathy, hepatitis, agranulocytosis

Pyrazinamide
Hyperuricaemia —>gout, hepatitis

Ethambutol “eye-thambutamol”
Optic neuritis, check vision before and during

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35
Q

Side effects of rifampicin?

A

Rifamipicin “red and orange pissin”

Red/orange secretions, hepatitis, flu like sx

36
Q

Side effects of isoniazid

A

Isoniazid “I’m so numb azid”
Peripheral neuropathy, hepatitis, agranulocytosis

37
Q

Side effects with Pyrazinamide?

A

Pyrazinamide
Hyperuricaemia —>gout, hepatitis

38
Q

Side effects of ethambutol?

A

Ethambutol “eye-thambutamol”
Optic neuritis, check vision before and during

39
Q

Which antibiotics inhibit cell wall synthesis but don’t have a beta lactam ring?

A

Vancomycin
Teicoplanin

40
Q

Which antibiotics inhibit cell wall synthesis and have a beta lactam ring?

A

Penicillins
Carbapenams
Cephalosporins

41
Q

2 most common causes of bacterial chest infections?

A

Streptococcus pneumoniae (AKA pneumococcus)- 50%
Haemophilus influenzae- 20%

42
Q

Chest infection organisms seen in patients with a low CD4 count?

A

Maroxella catarrhalis
Pneumocystis jiroveci- a yeast like fungus

43
Q

1st line abx for pneumonia in community?

A

Amoxicillin
Could also use doxycycline or clarithromycin

44
Q

Most common bacteria seen in septic arthritis?

A

Staph. aureus- most common
Group A strep
Neisseria gonorrhoea- more common in sexually active
Haemophilus influenza
E.coli

45
Q

Treatment if septic arthritis suspected?

A

Aspirate joint before abx
Empirical IV abx for 4-6weeks
Flucloxacillin
If pen allergic, clindamycin

46
Q

Abx that inhibit folic acid mechanism

A

Sulfamethoxazole
Trimethoprim
These combined- septrin (cotrimoxazole

47
Q

Most common cause of meningococcal septicaemia in children?

A

Neisseria meningitidis- a gram negative meningococcus

48
Q

Suspected meningitis is community. Stiff neck, headache, photophobia, fever, altered conciousness, non-blanching rash. What to do?

A

Urgent transfer to hospital
IM benzylpenicillin
<1yr 300mg
1-9yr 600mg
>10+yr 1200mg

49
Q

Meningitis in hospital management?

A

Lumbar puncture
<3m - cefotaxime + amoxicillin (to cover listeria from mother)
> 3m - ceftriaxone
+/- Vancomycin

50
Q

Lumbar punctures. What you see in bacterial, viral and TB?

A

Bacterial- low glucose, high protein, cloudy, high opening pressure, high neutrophils
Viral- normal glucose, mildly raised protein, clear, normal opening pressure, high lymphocytes
TB- same as bacterial but high lymphocytes. low glucose, high protein, cloudy, high opening pressure, high lymphocytes

51
Q

Treatment for malaria falciparum?

A

Admit as can deteriorate
IV artesunate- most effective but unlicensed
IV quinine dihydrochloride
Doxycycline

52
Q

Side effect of doxycycline

A

Sensitivity to light- can burn easily

53
Q

What antimalarial can cause bad dreams and even psychotic disorders?

A

Mefloquine

54
Q

Diagnosis of neutropenic sepsis?

A

Neutrophils <1
Temp >38. Or meeting other sepsis criteria

55
Q

Treatment of neutropenic sepsis?

A

IV tazocin- broad spec abx
*after taking blood cultures. Don’t delay

56
Q

Most common bacterial cause of toncillitis?
And abx treatment?

A

Group A strep
Pen V- phenoxymethylpenicillin

57
Q

Most common cause of otitis media?

A

Strep pneumonia

58
Q

Most common cause of rhinosinusitis?

A

Strep. pneumoniae

59
Q

4 most common causes of bacterial toncillitis?

A

Group A strep- phenoxymethypenicillin tx
Strep. pneumoniae
Haemophilus influenzae
Morazella catarrhalis
Staph aureus

60
Q

Most common cause of UTI?
Plus some others

A

E.coli

Klebisiella
Pseudomonas auruginosa
Staph saphrophyticus
Enterococcus
Candida albicans- fungal

61
Q

1st line UTI abx? and other options?

A

Trimethoprim
Nitrofurantoin
Pivmecillinam

62
Q

1st line abx for pyelonephritis?

A

7-10 days abx
Cefalexin
If cultures results available:
Co-amoxiclav, trimethoprim, ciprofloxacin (can damage tendons and lower seizure threshhold)

63
Q

What are some side effects with ciprofloxacin that you need to keep in mind when prescribing??

A

Can damage tendons
Can lower seizure threshold

64
Q

What investigation do you do for ?malaria in a returning traveler?

A

Three blood films over three days. Needed due to 48hour life cycle of malaria parasite
Send EDTA (FBC bottle) with marked ‘for malaria film’

65
Q

Most common causes of cellulitis?

A

Staph aureus
Group A or C strep
Other: MRSA

66
Q

1st line abx in cellulitis? And alternatives?

A

Flucloxacillin

Clarithromycin
Pen V- phenoxymethylpenicillin- if group A strep considered most likely
Clindalycin

67
Q

Man comes back from holiday with feeling rubbish with cough, diarhoea and a temperature. What’s the most likely causative organism?

A

Legionella pneumophilia

68
Q

99yo lady with dry cough, muscle aches, feeling rubbish and temp 38.4. Covid test negative and suspect influenza. They’re a bit vulnerable being the fine age of 99 so want to treat. What do you give?

A

Oseltamivir (Tamiflu)
Must be given within 48 hours.
75mg tablet twice daily for 5 days

69
Q

Name 3 macrolides?

A

Erythromycin
Clarithromycin
Azithromycin

70
Q

Key adverse effects and interactions of macrolides?

A

Prolongation of QT

Interactions
- statins- should be stopped when taking macrolides
- warfarin
- amiodarone

71
Q

Treatment for severe c.difficile infection?

A

Oral vancomycin- better bioavailability in gut
IV metronidazole

C.diff is a gram +ve rod, it’s toxin can cause psuedomembranous colitis
Most commonly caused by cephlopsporin broad spectrum abx

72
Q

How is C.diff diagnosed?

A

C.difficile toxin in stool

73
Q

First episode, non life threatening c diff tx?

A

1st line- oral vancomycin 10 days
2nd line- oral fidaxomicin
3rd line- oral vancomycin +/- IV metronidazole

74
Q

Treatment for chronic bronchitis exacerbation?

A

Amoxicillin OR tetracycline OR clarithromycin

75
Q

Treatment for community acquired pneumonia?

A

Amoxicillin
If penicillin allergic: doxy or clarithromycin

Add flucloxacillin if staphylococci suspected e.g. in influenza

76
Q

Treatment for pneumonia with cause suspected to be aytypical?

A

Clarithromycin

77
Q

Treatment for hospital acquired pneumonia?

A

Within 5 days of admission- co-amoxiclav or cefurotaxime

> 5days- piperacillin c tazobactam
OR
Broad spectrum cephalosporin (e.g. ceftazidime)
OR
Quinolone e.g. ciprofloxacin

78
Q

Lower UTI treatment?

A

Trimethoprim
Nitrofurantoin

Or can use amoxicillin or cephalosporin

79
Q

Treatment for acute pyelonephritis?

A

Broad spectrum cephalosporin e.g.
ceftriaxone
OR quinolone e.g. ciprofloxacin

80
Q

Acute prostatitis treatment?

A

Quinolone OR trimethoprim

81
Q

Beta lactam abx groups?

A

Penicillins
Cephalosporins
Carbapenams

All pretty broad spectrum

82
Q

What abx can reduce seizure threshold in epileptic patients?

A

Ciprofloxacin

83
Q

Which abx as an absolute contraindication with methotrexate?

A

Trimethoprim

Co-tramoxisole (contains trimethoprim so shouldn’t be used either, sometimes used for HAP or PCP- an immunocompromised chest infection)

84
Q

Treatment for chronic bronchitis exacerbation?

A

Amoxicillin OR Tetracycline OR
Clarithromycin

85
Q

Treatment for community acquired pneumonia?

A

Amoxicillin
If penicillin allergic: doxy or clarithromycin

Add flucloxacillin if staph ylococci suspected e.g. in influenza

86
Q

Treatment for pneumonia with cause suspected to be aytypical?

A

Clarithromycin

87
Q

Treatment for hospital acquired pneumonia?

A

Within 5 days of admission- co-amoxiclav or cefurotaxime

> 5days- piperacillin c tazobactam
OR
Broad spectrum cephalosporin (e.g. ceftazidime)
OR
Quinolone e.g. ciprofloxacin

Finals (13 decks)

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