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1
Q

Treatment of neisseria meningitidis

A

Ceftriaxone - meningococcal sepsis

3rd generation cephalosporin
Beta lactam- penicillin V
Cell wall synthesis inhibitor

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2
Q

Neissseria meningitidis features

A

Gram negative diplococci
Causes sepsis
Virulence factor - lipopolysaccharide

Common commensal of nasalpharynx
Ask for nasopharyngeal swab

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3
Q

Ecoli conditions

A

UTI
Peritonitis
Neonatal meningitis

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4
Q

Ecoli is a commensal of the…

A

Colon

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5
Q

What gram stain is E. coli

A

Gram negative bacilli

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6
Q

How to treat e.coli

A

Trimethoprim- UTI
Inhibitor of folic acid synthesis

Cefotaxime for neonatal meningitis

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7
Q

Staphylococcus aureus gram stain

A

Gram positive coccus

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8
Q

Staphylococcus aureus conditions

A

Cellulitis
MRSA
Skin abscess

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9
Q

Staphylococcus aureus commensal of the….

A

Skin

Take nose swab

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10
Q

Staphylococcus aureus treatment

A

Flucloxacillin - cellulitis

Vancomycin- MRSA

Cell wall synthesis inhibitors

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11
Q

Staphylococcus epidermis commensal of the …

A

Skin

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12
Q

Features of staphylococcus epidermis

A

Forms biofilm
Quorum sensing
Very difficult to remove

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13
Q

Gram stain of staphylococcus epidermis

A

Gram positive cocci

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14
Q

Treatment of staphylococcus epidermis

A

Remove prosthetic device
Use silver coated central lines
Flucloxacillin - cellulitis

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15
Q

Staphylococcus epidermis condition

A

Cellulitis

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16
Q

Streptococcus pyogenes commensal of…

A

Skin

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17
Q

Features of streptococcus pyogenes

A

Group A beta haemolytic

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18
Q

Virulence factors of streptococcus pyogenes

A

Hyaluronic acid capsule - seems like self

M protein - hijacks respiratory burst mechanism of neutrophils

Streptokinase - breaks down blood clots

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19
Q

Streptococcus pyogenes causes

A

Pharyngitis

Tonsillitis

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20
Q

Streptococcus pyogenes gram stain

A

Gram positive cocci

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21
Q

Treatment of streptococcus pyogenes

A

Penicillin V

Clarythromycin - if resistant

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22
Q

Clostridium difficile commensal of the…

A

Colon

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23
Q

Clostridium difficile features and virulence factors

A

Associated with antibiotic use
Sporulating - difficult to remove

Virulence factors:

Toxin A enterotoxin causing inflammation and build of excess fluid in bowel - diarrhoea

Toxin B - cytotoxic which disrupts protein synthesis and disrupts cytoskeleton

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24
Q

Clostridium difficile gram stain

A

Gram positive bacilli

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25
Treatment of clostridium difficile
Metronidazole- mild | Vancomycin-serious
26
Strep pneumoniae features
Community acquired Viridans group of strep - alpha haemolytic Polysaccharide capsule
27
Gram stain for strep pneumoniae
Gram positive cocci
28
Treatment of strep pneumoniae
Mild: amoxicillin Penicillin Allergy: doxycycline Moderate: amoxicillin and doxycycline Severe: co-amoxiclav (IV) and doxycycline Allergy: meropenem and doxycycline
29
Viridans streptococci features
``` Oral commensal Cause: - tooth decay - bacterial endocarditis (rheumatic fever vegetative valves) Alpha haemolytic E.g streptococcus mutans Group of gram positive cocci Antibiotic prophylaxis ```
30
Heamophilus influenzae commensal
Nasopharyngeal
31
Haemophilus influenzae features
Opportunistic infection Produces Beta lactamase Associated with children and pneumonia
32
Haemophilus influenzae gram stain
Gram negative bacilli
33
Haemophilus influenzae treatment
Amoxicillin
34
Salmonella typhi causes...
Typhoid Enteric fever Travel related infection - ingestion of contaminated water
35
Treatment for salmonella typhi
Ceftriaxone | Fluoroquinolones can also be used
36
Salmonella typhi
Gram negative bacilli with flagella Low infectious dose Survives gastric acid Fimbriae Reside within macrophages
37
Legionella pneumophila causes
Legionnaire’s disease Legionellosis Acute lobar pneumonia
38
Transmission of legionella pneumophila
Air droplet
39
Gram stain of legionella pneumophila
Gram negative bacilli
40
Treatment of legionella pneumophila
Clarythromycin | or Fluoroquinolones
41
Epstein -Barr virus
DsDNA Enveloped Causes: Infects B cells T cell proliferation Splenomegaly
42
Epstein Barr virus diagnostics
PCR EBV serology FBC - elevated lymphocytes T differential - increased cd8+
43
Complications of Epstein Barr virus
``` Reed Steinberg cells - Hodgkin’s lymphoma Gastric lymphoma Burkit’s lymphoma Nasopharyngeal carcinoma Sore throat Headache ```
44
Microscopy of Epstein Barr virus
Abnormal lymphocytes
45
Treatment of Epstein Barr virus
Supportive treatment | Acyclovir
46
Varicella Zoster features
Enveloped First presents as chickenpoxs Latent in dorsal root ganglia Then presents as shingles on single dermatome Vesicular rash
47
Who gets varicella zoster
Immunocompromised | Young
48
Treatment of varicella zoster
Acyclovir | Viral replication inhibitor
49
Hepatitis B features
dsDNA Enveloped Blood borne virus 6weeks - 6months After 6months - chronic infection
50
Hepatitis B clinical presentation
``` Fatigue Loss of appetite Nausea Abdominal pain Jaundice ```
51
Investigation for Hepatitis B
Raised: ALT AST Bilirubin Hep B serology PCR - HBV DNA
52
Hepatitis B complications
Jaundice | Cirrhosis
53
Treatment of hep B
``` Supportive Life long antivirals to suppress viral replication Vaccine Self limiting disease If chronic - no cure ```
54
Hepatitis C features
Blood borne virus Associated with: IV drug users Hepatocellular carcinoma 80% chronically infected Leads to end stage liver disease - hospitalisation
55
Clinical presentation of hep C
``` Mostly asymptomatic Fatigue Anorexia Abdominal pain Nausea ```
56
Investigation for hep c
Serology - anti hep C antibody | PCR
57
Complications of hep C
Jaundice Cirrhosis Chronic inflammation and infection of hepatocytes
58
Treatment of hep C
Ribovarin and interferon (8-12wk treatment) Can get reinfected No vaccine
59
HIV features
SsRNA Enveloped Retrovirus Causes: Opportunistic conditions e.g. Oral thrush - Candida albicans Kaposis sarcoma - HHV8 Pneumocystis pneumonia - pneumocystis jirovecii Reactivation of latent infections: EBV Shingles CMV Viral load inversely proportional to cd4 count T cell count less than 100 - AIDS
60
HIV treatment
2x nucleoside inhibitors (reverse transcriptase inhibitors) AND 1 x non nucleoside reverse transcriptase inhibitor OR 1 x protease inhibitor OR 1 x integrate inhibitor
61
Adenovirus features
dsDNA Non enveloped Replicates in endothelial cells
62
Clinical presentation of adenovirus
Conjunctivitis Sore throat Fever Cough
63
Treatment of adenovirus
Supportive
64
Norovirus
Winter vomiting bug - closed environment like hospital SsRNA Non enveloped Fecal - oral route Low viral load required to cause infection
65
Investigations for norovirus
ELISA | Stool sample
66
Treatment of norovirus
Supportive: Antipyretic IV fluids
67
Plasmodium falciparum
Parasite | Female anopheles mosquito as vector
68
Effects of plasmodium falciparum
Heaptomegaly Splenomegaly Jaundice - increased bilirubin due to increased RBC destruction
69
Investigations for malaria
3 x blood film | LFTs
70
Treatment of malaria
Quinine Doxycycline G6PDH test before administering chloroquinine for p.vivax and p.ovale
71
Candida albicans features
Fungi Yeast (unicellular) Opportunist infection Commensal of vagina and mouth
72
Treatment of Candida albicans
Nystatin Clotrimazole IV fluconazole Systemic: amphotericin B
73
Aspergillous features
Fungi Acute infection of lungs Opportunistic
74
Treatment of aspergillous
Amphotericin B
75
Cellulitis causative organisms
Staph aureus | Strep pyogenes
76
Treatment of cellulitis
Flucloxacillin
77
Tonsillitis complications
``` Peritonsillar abscess Rheumatic fever Acute post strep glomerulonephritis Impetigo Erysipelas Necrotising fasciitis ```
78
Causative organisms of tonsillitis
Streptococcus pyogenes
79
Treatment of tonsillitis
Penicillin V
80
Meningococcal sepsis causative organism
Neisseria meningitidis
81
Treatment of meningococcal sepsis
Ceftriaxone 3rd generation cephalosporin Beta lactam: penicillin V
82
UTI features (Ecoli)
More common in females Dysuria Increased urination frequency
83
Ecoli UTI treatment
Trimethoprim
84
UTI (Candida) features
Itching and burning pain | White discharge
85
Treatment of Candida UTI
Topical nystatin or clotrimazole IV fluconazole if severe Systemic: amphotericin B
86
Chemotherapy causing candidiasis treatment
Amphotericin B
87
Chemotherapy causing shingles features and treatment
Caused by varicella zoster reactivation (Latent In dorsal ganglia) Acyclovir
88
Skin abscess causative organism and features
Staph aureus Can occur due to minor scratches in diabetics or immunocompromised host
89
Treatment of skin abscesses
MRSA - vancomycin | If not, flucloxacillin
90
Peritonitis causative organism features
E. coli Large bowel adenocarcinoma (perforation) Lower abdominal pain Hot and sweaty Ascites Air in abdominal cavity
91
Treatment of peritonitis
Trimethoprim
92
Pneumonia features
Consolidation in lungs | Pulmonary oedema with inflammatory cell infiltration
93
Pneumonia treatment
Mild: amoxicillin Penicillin Allergy: doxycycline Moderate: amoxicillin and doxycycline Severe: co-amoxiclav (IV) and doxycycline Allergy: meropenem and doxycycline
94
Causative organisms of pneumonia
Streptococcus pneumonia | Haemophilus influenzae
95
Profuse diarrhoea causative organism
Clostridium difficile
96
Profuse diarrhoea treatment
mild - metronidazole | Severe - vancomycin
97
Aortic stenosis/ endocarditis organisms
Viridans streptococci | commensal of mouth
98
Treatment of endocarditis
IV penicillin | Gentamicin
99
Infected prosthetic/ central line organism organisms and treatment
Staphylococcus epidermis Treat infected prosthetic Replace Flucloxacallin if in blood
100
Vomiting and diarrhoea cause identification
ELISA PCR Stool sample
101
Causes of pharyngitis
EBV Strep pyogenes Adenovirus Droplet transmission
102
cause of shingles
Varicella zoster
103
Treatment of shingles
Acyclovir
104
Cause of malaria
Plasmodium falciparum from female anopheles mosquito
105
Treatment of malaria
Quinine | Doxycycline
106
Cause of Schistosomiasis
Helminths Causes hepatomegaly and fibrosis of liver and bladder Eosinophilia Take oral corticosteroids Self limiting
107
Enteric fever
Incubation: 7 - 14days Fever Headache Abdominal discomfort Dry cough
108
Dengue
Arbovirus Aedes mosquito First infection - asymptomatic or fever Supportive treatment Reinfenction - haemorrhagic fever in children - dengue shock syndrome
109
Myiasis
Rural areas | Fly larva - bot fly
110
Ebola causative organism
Filovirus - filoviridae
111
Symptoms of Ebola
``` Severe haemorrhagic fever Vomiting Diarrhoea Headache Confusion Rash ```
112
Zika virus
Arbovirus - aedes mosquito Dengue like symptoms Congenital microcephaly Foetal loss
113
Transmission of Zika virus
Vertical transmission | Sexual transmission
114
Flu
Acute viral infection of the resp tract

Infection (10 decks)

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