400. Infection- General Flashcards
What bacteria are we particularly worried about in splenic rupture?
Bacteria with a thick outer capsule e.g.
Heamophillus influenzae
Neisseria meningitidis
Streptococcus pneumoniae
What are some good general rules to remember when prescribing antibiotics?
Need clinical evidence Take samples before prescribing Consider benefit and harm Clarify allergies Prescribe shortest effective course, review after 48 hours
What is the name of the bacteria that causes UTI’s and struvate stones
Proteus mirabillis
What are the two types of TB?
Active TB- Inadequte containment by the immune system
Latent- Persistent immune containment e.g. granuloma formation
Discuss the different regions of the body where TB can infect?
Pulmonary
Lymphs- usually subclavicular
Gastro TB- bowel thickens
Spinal
Miliary- dissemination in the blood
CNS TB- may lead to rupture and menigitis
Genitourinary TB- may lead to fibrosis
Skin- red/brown apple jelly nodules
What tests are available for TB?
Tuberculin skin test- >5mm and risk factors, >15mm no risk factors
Interferon gamma release assays- more specific, high false positives
What tests can be done to investigate active TB?
CXR
Sputum Smear
Sputum Culture
Nucleic acid amplification test (NAAT)
What are the side effects of rifampicin
Enzyme inducer
Altered liver function
What are the side effects of isoniazid
Peripheral neuropathy
Hepatitis
What are the side effects of pyrazinamide
Hepatotoxicity
What are the side effects of ethambutol
Colour blindness
Optic neuritis
Before treating Tb what tests should you offer?
HIV
Hep B
Hep C
Typical treatment for TB is 4 for 2 and 2 for 4 more. When is this not the case?
Active CNS disease- 2 for 4 more becomes 2 for 10 more
CNS and pericardial disease- adjunctive high dose steroids
Drug resistant TB
What puts you at higher risk of a having a complicated flu infection?
Chronic disease (lung, heart, kidney, liver, CNS, DM)
Immunosuppresion
Pregnancy, >65,BMI>40, <6 months
How is a complicated flu treated?
Oseltamivir
Zanamivir
