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2 CLASP > Sepsis, Tests and Pneumonia > Flashcards

Sepsis, Tests and Pneumonia Flashcards

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1
Q

what group of organisms that cause endocarditis are particularly difficult to grow in the lab?

A

HACEK group organisms

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2
Q

usual source of strep viridans pathogen?

A

GI tract (mouth)

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3
Q

which organism is not typically a cause of endocarditis: Staphylococcus aureus Enterococcus faecalis Viridans group streptococci Escherichia species HACEK group organisms

A

escherichia species

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4
Q

2 diseases caused by spiral bacteria?

A

syphilis lyme disease

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5
Q

coliforms are also known as?

A

gram -ves

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6
Q

antibiotic cover for coliforms?

A

gentamicin

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7
Q

antibiotic cover for anaerobes?

A

metronidazole

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8
Q

antibiotic cover for haemophilus influenzae?

A

amoxicillin

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9
Q

antiobiotic cover for enterococci?

A

amoxicillin

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10
Q

gram +ve antibiotic cover?

A

vancomycin

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11
Q

what antibiotic should you be very wary of prescribing for sepsis?

A

ciprofloxacin (quinolones)

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12
Q

when are cephalosporins mainly prescribed?

A

meningitis but rarely

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13
Q

when does sepsis become septic shock?

A

resuscitation attempts have been made and still not responding

need at least 1 acutely dysfunctional organ

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14
Q

“the presence of a microbe in the human body without an inflammatory response” describes what?

A

colonisation

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15
Q

bacteraemia always signifies infection: T or F?

A

F, can have bacteraemia without infection

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16
Q

define sepsis

A

the dysregulated host response to infection

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17
Q

define septic shock

A

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

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18
Q

pathophysiology of sepsis?

A
  1. infection
  2. bacteria from infection enters bloodstream
  3. blood vessels become leaky
  4. decreased perfusion and ventilation to organs so they become dysfunctional
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19
Q

name the 4 SIRS criteria

A

RR >20

HR >90

Tem p >38 or <36

WCC >12000 or <4000mm3

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20
Q

if a patient scores highly on all criteria eg SIRS/qSOFA/NEWS do they have sepsis?

A

only if they have an infection as well

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21
Q

name sepsis 6 and show how to remember them

A

BUFALO

Blood cultures (+ other cultures eg urine/swabs)

Urine output

Fluids

Antibiotics IV

Lactate (+ FBC and biochem)

Oxygen (target >94%)

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22
Q

what sepsis criteria is mainly used now?

A

NEWS >5

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23
Q

name the components of qSOFA

A

RR >22

sBP <100mmHg

Altered GCS (<14)

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24
Q

what is qSOFA a measure of?

A

mortality in 28 days

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25
how many SIRS criteria do you need to have to have sepsis?
2 SIRS + signs of infection
26
how can strep viridans cause infective endocarditis?
lives in mouth travels in blood if dental surgery sticks to heart valve
27
what kind ofendocarditis will strep viridans cause?
native valve
28
what do phagnocytes act against?
bacteria fungi
29
what do t cells act against?
viruses fungi protozoa
30
what do antibodies act against?
bacteria viruses
31
what do eosinophils act against?
fungi protozoa worms
32
name the only bug that complement will act against
bacteria
33
what 2 cell types are responsible for acting against worms
eosinophils mast cells
34
T cells do not work against bacteria: T or F
T
35
a coagulase negative staph is likely to be what?
staph epi
36
why do gram positive organisms stain purple?
the peptidoglycan layer traps crystal violet dye
37
what organism is typically pathogenic in alcoholics?
strep pneumoniae
38
what organism is known to be a strict aerobe
pseudomonas
39
what can gram negative bacilli be divided into
lactose positive or negative aka easy and difficult organisms
40
most common subtype of haemophilusi influenzae?
B
41
name the different microbiological cultures that can be done
blood stool urine tissue wound
42
microscopy can be done for what kind of samples?
stool urine CSF sputum
43
all abscesses cannot be treated by antibiotics T or F
F. small abscesses can
44
normal flora of the mouth?
strep viridans neiserria anaerobes staphylococci
45
name a sterile area of the gut
stomach bile duct
46
where are anaerobic organisms most likely to be in the GI tract?
lower down eg in bowel
47
48
name the flora of the colon
coliforms anaerobes enterococcus faecalis
49
describe the structure and gram stain of coliforms
gram negative bacilli
50
drug of choice for coliforms?
gentamicin
51
what should be given if a patient is contraindicated for 1st line Tx for coliforms?
give aztreonam
52
oral switch antibiotic for coliform sepsis?
co-trimoxazole
53
antibiotic for oral switch in an anaerobe sepsis?
metronidazole still
54
antibiotic of choice for enterococci and why
amoxicillin as it is active against gram positive organisms
55
what antibiotic should be given if there is a contraindication for the 1st line antibiotic for enterococcal sepsis
co-trimozazole
56
what CURB65 score indicates severe CAP
3-5
57
outline CURB65
new Confusion Urea \>7 RR \>30 sBP \<90 65+ years old
58
should you do blood cultures in pneumonia?
only if it's really severe
59
what bacteria would indicate a contaminated blood culture and why?
staph epi corynebacteria bacillus species all skin commensals
60
problem with a sputum culture?
can contain commensal mouth bacteria
61
how to tell if the right middle lobe is affected by a pneumonia on CXR?
if there is a whiteout next to the heart on the RHS
62
what bacteria is likely to cause a classic pneumonia presentation?
strep pneumoniae
63
what does haem flu grow on?
chocolate agar
64
antibiotic for haem flu
amoxicillin doxy if pen allergic
65
what antibiotic is good for atypical pneumonias?
doxycycline clarithromycin
66
complication of Q fever?
culture negative endocarditis
67
how to confirm an atypical pneumonia?
serology virus detection
68
what type of pneumonia should prompt you to do a urine antigen test and why?
legionella as urine legionella antigen is prevalent
69
what serogroup of legionella causes the most disease?
1
70
as a rule of thumb, when should you send a urine culture?
if a complicated infection is suspected
71

2 CLASP (9 decks)

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