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Y3- Transition > Microbiology > Flashcards

Microbiology Flashcards

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1
Q

Partner notification ‘look back’ period for chlamydia?

A

6 months

4 weeks male urethral

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2
Q

Partner notification ‘look back’ period for gonorrhoea?

A

3 months

2 weeks male urethral

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3
Q

Partner notification ‘look back’ period for primary syphilis?

A

90 days

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4
Q

Partner notification ‘look back’ period for secondary syphilis?

A

2 years

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5
Q

Which vaccinations do MSM receive?

A

Hep A, B, HPV

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6
Q

What is PreP?

A

Pre-Exposure Prophylaxis- taken before exposure to reduce risk of infection

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7
Q

What is PEPSE?

A

Post-Exposure Prophylaxis- taken after exposure to reduce risk of infection

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8
Q

What is the PEPSE for Hep B?

A

Vaccination up to 7 days

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9
Q

What is the PEPSE for HIV?

A

3 antiretrovirals within 72 hours for 28 days

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10
Q

Risk factors for GBV?

A 
Female
Disability
Pregnancy
Addictions
HIV
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11
Q

What is sepsis?

A

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

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12
Q

What is septic shock?

A

subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality

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13
Q

Symptoms/signs of peritonitis?

A

Pain, guarding, fever, chills/rigors, N+V, constipation/diarrhoea, malaise, anorexia

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14
Q

qSOFA criteria?

A

RR >22
sBP <100mmHg
Altered GCS

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15
Q

SIRS criteria?

A 
Temp >38
HR >90
RR >20
WCC >12000mm3
\+ presumed or confirmed infectious processes
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16
Q

Supportive treatment of infection?

A 
Fluids
Analgesia
VTE prophylaxis
Oxygen
Electrolytes
Transfusion?
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17
Q

Examples of coliforms?

A

E.coli
Klebsiella sp.
Proteus sp.
Enterobacter sp.

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18
Q

Examples of aerobes?

A

Pseudomonas sp.
Staphylococci,
Streptococci
Enterococci

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19
Q

Example of anaerobe?

A

Clostridium sp.

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20
Q

Antibiotic for coliforms?

A

Gentamicin

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21
Q

Antibiotic for anaerobes?

A

Metronidazole

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22
Q

Antibiotic for enterococcus?

A

Amoxicillin

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23
Q

What is the empirical treatment of intra-abdominal infections?

A

Gentamicin + Amoxicillin + Metronidazole

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24
Q

What is regularly monitored during gentamicin therapy?

A

Renal function

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25
Can abscesses be treated with antibiotics?
No- no blood supply and so antibiotics will not penetrate it well
26
Normal mouth flora?
Strep. viridans Neisseria sp. Anaerobes Candida sp. (few), Staphylococci
27
Normal flora of stomach + duodenum?
Usually sterile
28
What contributes to faecal flora?
Coliforms Anaerobes Enterococcus
29
SEE STIs and other GUM infections
In Y3- TO LEARN
30
What causes aseptic meningitis?
Virus (e.g. enterovirus, HSV, syphilis) Fungi Malaria
31
What is acute encephalitis?
Infection of brain parenchyma
32
What does pyogenic meningitis produce?
Thick layer of suppurative exudate (pus) on meninges
33
Presentation of encephalitis?
``` Meningismus (e.g. headache, neck sitffness, photophobia) Stupor/coma Vomiting Fever Seizures Confusion Speech/memory problems ```
34
Azithromycin is given as a single dose because?
Due to a very long half-life (5 days) Not used anymore due to concerns about resistance
35
Symptoms of sepsis?
Fever, vomiting, drowsy, confusion, muscle pain, pale, rash, headache, neck stiffness, photophobia, seizures
36
Cause of bacterial meningitis in neonates?
Listeria, Group B strep, E.coli
37
Cause of bacterial meningitis in children?
H. influenza
38
Cause of bacterial meningitis in age 10-21?
Neisseria meningitidis (from throat)
39
Cause of bacterial meningitis in >21 years?
Strep pneumoniae
40
Cause of bacterial meningitis in >65 years?
Strep pneumoniae
41
Can resume having sex with partner after how long (after treatment of chlamydia)?
No sex for 7 days (even if protected)
42
Cryptococcal meningitis is found in which patients?
HIV (CD4 <100)
43
Investigations in meningitis?
Blood cultures | LP- microscopy, culture, biochem, PCR
44
What is listeria monocytogenes?
Gram +ve bacilli Associated with soft cheese and deli food
45
Treatment of listeria monocytogenes?
IV Ampicillin/amoxicillin | Hysteria (listeria)= don't AMP up
46
Typical CSF results for bacterial meningitis?
High WBC High neutrophils High protein Low glucose (consumed by bacteria)
47
Typical CSF results for viral meningitis?
High lymphocytes Normal protein Normal glucose
48
When should a CT be performed before LP in meningitis?
Immunocompromised | SEIZURE
49
Empirical therapy for bacterial meningitis?
First Dexamethasone 10mg IV Then IV ceftriaxone 2g bd BCD- bacterial= ceftriaxone + dexamethasome (or chloramphenicol)
50
What should be added to empirical therapy if listeria is suspected (e.g. in elderly)?
IV amoxicillin/ampicillin
51
Why give steroids in bacterial meningitis?
Reduce mortality
52
Who should be informed about meningitis cases?
Public health (Health Protection team) Within 24 hours of admission!
53
What contact prophylaxis can be given in meningitis?
500 mg ciprofloxacin orally
54
NEWS score suggestive of sepsis?
5 or more | + suspicion of infection
55
What kinds of pathogens can be contaminants in blood?
Staph epidermidis | Staph aureus
56
Which antibiotic can you use as a substitute for gentamicin after the standard 3 day dose?
Aztreonam (also covers coliforms)
57
4 Cs of antibiotics?
cephalosporins, clindamycin, co-amoxiclav and quinolones
58
What do you substitute for ceftriaxone in treatment of bacterial meningitis if penicillin allergic?
Chloramphenicol | however penicillins are ALWAYS more effective than Chloramphenicol can ever be
59
CSF with lymphocytes, low WBC, protein raised, no gram stain etc. could suggest?
Viral meningitis/encephalitis OR Partially treated bacterial meningitis
60
Why might a bacterial meningitis be culture negative?
It antibiotics were given pre-LP
61
Apart from infection, what else can cause SIRS score to increase?
Trauma, burns, pancreatitis and other insults
62
4Cs to avoid and why?
* Clindamycin * Cephalosporins * Co-amoxiclav * Ciprofloxacin Increase C.diff infection
63
Normal serum lactate levels, and why is it raised in sepsis?
<1.8 mmol/l Elevated levels indicate hypoperfusion/hypoxia

Y3- Transition (9 decks)

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