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Phase 2 > MICROBIOLOGY > Flashcards

MICROBIOLOGY Flashcards

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1
Q

Doxycycline mechanism and is used for..

A

Inhibits bacterial protein synthesis…. Broad gram +ve’s. Chest infections

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2
Q

Cephalosporins.. mechanism, used for, examples

A

Beta lactam - has best resistance to beta lactamases. Good bactericide. Used when want to kill bacteria quickly. Endocarditis, meningitis.
Cefotaxime

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3
Q

Macrolide.. mechanism, used for, examples..

A

Inhibits protein synthesis, used for gram positives and atypical pneumonia pathogens, clarithromycin and erythromycin

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4
Q

Metranidazole… mechanism, used for…

A

Inhibits nucelic acid synthesis, can only do this in anaerobic bacteria, eg bacteroides, C Diff (although may need something like Vancomycin for C Diff instead)

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5
Q

What antibiotic combination would you give for a pt with suspected aerobic (eg E coli) and anaerobic (eg Bacteroides) infection of peritoneum (eg from appendix rupture)

A

Beta lactam to cover aerobe - eg. penicillin (if not allergic), co-amoxiclav, cephalosporin (if concerned about resistance) + metronidazole to cover anaerobes

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6
Q

Is E coli aerobic or anerobic

A

Aerobic - t/f do not treat with metronidazole

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7
Q

Is C Diff aerobic or anerobic - how would this guide antibiotics?

A

Its anerobic so could you metronidazole. But something like IV vancomyosin could also be used.

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8
Q

Empirical antibiotics for suspected bacterial meningitis

A

Cephalosporin - cefotaxime

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9
Q

Empirical antibiotics for strep pnemoniae

A

Amoxicillin (beta lactam - gram +ve)

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10
Q

Empirical antibiotics for staph aureus (no resistant) and resistant; penicillin allergy

A

Not resistant - flucloxicillin
?Resistance - co-amoxiclav, cephalosporin
Penicillin allergy - vancomysin

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11
Q

Empirical antibiotics for cellulitis and why

A

Probably gram positive stap or strep.

  1. If no penicillin allergy - start on beta lactam. Use something that covers resistance until you know more - eg co-amoxiclav (if it is sensitive to just penicillin, can use this later). Bactericide - will kill bacteria.
    • clindomyacin (protein synthesis inhibitor) - bacteriostatic - stops bacteria from making endotoxins - so will neutralise endotoxin release from active bacteria
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12
Q

Empirical antibiotics from UTI and why

A

Gram -ve = trimethoprim, nitrofuratoin

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13
Q

Snail worm infection is called…

A

Schistosomiasis

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14
Q

Define protozoa

A

Single cell eukaryotic organism.

Have parasitic and symbiotic relationships

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15
Q

List 5 important infectious protozoa

A

Giardia - treat w/ metronidazole. No blood. Flatulence & cramping.

Cryptosporidium (water) - No blood. D&V. No cramping. fluids & antiemetic

Amoeba - amoebic dysentery (blood) and liver abscess - metronidozole.

Toxoplasmosis - would see this is immunocomp - HIV

Malaria - treat depending on resistence, quiniolones

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16
Q

What antibiotics are commonly used for parasitic infections

A

Metronidazole

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17
Q

Treatment of cryptosporidium infection

A

IV fluids & anti-emetics

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18
Q

What is the most common tropical disease in UK

What are the symptoms & signs, how would you check for it

A

Malaria
Fever, sweats, chills, diarrhoea, nausea, vomitting, headache, myaglia, fatigue
Signs: jaundice, anaemia, hepatosplenomegaly, black water fever - dark urine

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19
Q

What antibiotics cause C Diff

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A 
Antibiotics “rule of C’s”
Clindamycin
Ciprofloxacin (Quinolones)
Co-amoxiclav (Penicillins)
Cephalosporins (especially 2nd and 3rd generation)
20
Q

List some risk factors for developing C diff

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A 
Age
If patient is on PPI (can increase risk)
Long hospital stay
Immunocompromised
Nasal tube, GI surgery
21
Q

What is the treatment for C Diff

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A

Metrondazole
ORAL Vancomycin
Rifampicin/rifaximin
Stool transplant

22
Q

What is the commonest site of infection

Study These Flashcards
A

Respiratory tract

23
Q

What is the characteristic presentation of chickenpox rash

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A

Central distribution - likes warm places, so usually torso under skin, not peripheral where it is cooler
Starts as macule (not raised - could be anything at this stage) - then papule (raised) - vesicle (fluid)- pustule (pus) - enlarges - crusts over and heals

macule - papule - vesicle - pustule

24
Q

What is the infectious period of chickenpox

Study These Flashcards
A

Infectious from 2 days before rash presents till all pustules have crusted over

25
What is the most important complication of primary varicella virus (chickenpox) infection and which patient groups should you be worried about with this complication
Pneumonia Pregnant women Compromised *NB this is only a complication for those who have never been exposed as it is to do with the virus being in the respiratory tract
26
Systemic symptoms of respiratory infection are most commonly associated with which conditions
Pneumonia and Influenza A | Examples: myalgia (muscle aches), arthralgia (joint aches)
27
Sore throat and headache is associated with which respiratory pathogen
Mycoplasma pneumonia - really bad cold with sore throat, headache/ congestion - occurs in epidemics
28
If you have a patient with presentation of bacterial pharyngitis, what pathogens do you need to consider and rule out
Strep pyogenes - scarlet -> rheumatic fever Mycoplasma pneumoniae - headache/ congestion Neisseria gonorrhoea Corynebacteria Diptheria Lemierres disease - IJV
29
What are the complications of bacterial sinusitis
Brain abscess, Sinus vein thrombosis, ortibal cellulitis
30
How can you tell if sinusitis is viral or bacterial
Bacterial signs: Unilateral facial pain Pus discharge from nose (purulent discharge) >10 days of fever acute onset with complications - eg swelling and signs on vein thombosis
31
What are the phases of whooping cough - what is the pathogen
Incubation 7-10 (5-21d) Catarrhal phase 1-2 weeks; rhinorrhoea, conjunctivitis, low-grade fever and at end of phase lymphocytosis Paroxysmal phase 1-6 weeks coughing spasms ,inspiratory ‘whoop’ post-ptussive vomitting, cough>14d Convalescent phase
32
List some paraneoplastic signs on lung cancer
``` Finger clubbing Hypertrophic pulmonary osteoarthropathy Hypercalcaemia Weight loss Anorexia Peripheral neuropathy (muscle weakness of the limbs) ```
33
Describe the causes and pathology of lung cancer
``` Causes: Smoking Asbestos Radon Chromium Coal products ``` Pathology: Small cell lung cancer - neuroendocrine cells (15%) Non-small cell lung cancer (80%) -squamous cell carcinoma (squamous hyperplasia of columnar cells) (20%) -adenocarcinoma (columnar cells) (40%) -large cell - poorly differentiated -NOS - not any of the above. - cant be identified
34
Describe how lung cancer presents
``` Often asymptomatic until stage 3 or 4 - when it has metastasised Symptoms can be local: Cough Chest pain Haemoptysis Hoarse voice ``` ``` Symptoms can be from metastises: Bone pain Brain - seizures, neurological deficit Lymph - adenopathy, swelling Adrenal Liver - hepatic pain; abnominal pain ```
35
Which stages of lung cancer are resectable
Stages 1 and 2 Before it metastises Outcomes declines the more tumours and nodes there are involved, even if still only local invasion
36
Outline the survival rates (roughly) for the different stages of lung cancer
``` Survival at 5 years Stage 1: T1 - 60%; T2 - 40% Stage 2: T1, N1 - 30%; T3 - 20% Stage 3: 5-10% Stage 4: 1% ```
37
What stage does NSCLC most often present at
70% of presentations are stage 3 or 4
38
What affects chemotherapy outcomes in NSCLC
Performance status - there is approximately a 20-30% benefit in survival at one year in those with performance status 0-1 vs 3. 0-1 with chemo = 35% survival at 1 year. 3 with chemo = <5% survival. Performance status 4 + chemo = 0% survival at 1 year
39
Outline the treatment options for the different stages of NSCLC
Stages 1 & 2 = surgery & RTX. +/- chemo. | Stages 3 & 4 = palliative chemo, palliative care, chemo + RTX (palliative?)
40
What is the main difference in management / treatment options between NSCLC and SCLC
Some NSCLC will be eligible for surgery SCLC - surgery is not an option. Both have bad outcomes, but a low stage NSCLC probably has the best outcomes out of them all.
41
What investigations are required for a patient who you suspect might have lung cancer
Imaging: CXR CT PET - be aware of false positive (infection etc) and negatives - some tumours don;t show up ``` Biopsy: Bronchoscopy Bronchoscopy +/- US guided biopsy percutaneous (CT guided) needle biopsy US guided aspirate or biopsy Surgical biopsy ``` Bloods: to look for signs of metastatic spread and damage being done to any organs, or to rule out other causes - infection etc CT thorax/abdo, PET scan, CT head, medistinoscopy, pleural aspiration,
42
What should be the focus of a history for a patient that you suspect may have lung cancer
1.Social & occupational history -Do they smoke? -Where do they live - Radon exposure? -What is or was their job - asbestos, chromium exposure? Try to identify any risk factors of lung cancer. 2.Past medical history -Have they previously had cancer? -Think about breast, prostate, colorectal cancers that can metastasise to lung 3.Symptoms of metastatic spread -any recent onset bone, joint pain? -any weakness in muscles? - peripheral neuropathy? -any swelling anywhere - lymph adenopathy? -think about brain, bone, lymph, adrenal glands etc 4.Any paraneoplastic symptoms Finger clubbing Peripheral neuropathy etc 5.Performance status -Ask the patient about their daily living - what are they able to manage?
43
What would you include in a differential for lung cancer
Pneumonia Pulmonary embolism Any other lung disease that can cause a cough or chest pain GORD
44
What lung cancer has the best outcomes
Stage 1: T1 N0 M0 - 60-80% survival at 5 years
45
What serology profile would indicate that a patient does not have chronic hepatitis after an acute infection
Presence of Antibodies against Hep B surface antigen | + No detectable levels of HepB surface antigen or cor antigen
46
What serology profile would indicate that a pt who has previously had an acute hep B infection has progressed to chronic
Detectable levels of Hep B surface antigen in bloods >6 months after acute infection No antibodies against HepB surface antigen

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