5. Infections (2) Flashcards

1
Q

What is amoebiasis?

A
Amoebic dysentry.
Infection by Entamoeba histolytica. 
Mainly found in tropical areas.
Painful stomach cramps
Bloody diarrhoea/ mucus containing diarrhoea
Vomiting 
High temperature
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Treatment of amoebiasis (amoebic dysentry)

A
Usually self resolves in 3-7 days.
Oral rehydration + paracetamol
Avoid loperamide
Stay home 48h after diarrhoea resolves
If severe, may give metronidazole or tinidazole or meparcine hydrochloride (antiprotozoal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which antibiotics are more likely to be associated with adverse reactions related to the selection of resistant organisms? (e.g. fungal infections/ antibioric associated oclitis)

A

Broad spectrum antibacterials e.g. cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Example of a class of broad spectrum antibiotics

A

Cephalosporins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Notifiable diseases

A
Anthrax
Botulism
Brucellosis
Cholera
Diarrhoea (infectious/ bloody)
Diptheria
Encephalitis, acute
Food poisoning
Haemolytic uraemic syndrome
Haemorrhagic fever (viral)
Legionnaires' disease
Leprosy
Malaria
Measles
Meningitis
Meningococal septicaemia
Mumps
Paratyphoid fever
Plague
Poliomyelitis, acute
Rabies
Rubella
SARS
Scarler fever
Smallpox
Streptococcal disease 
Tetanus
Tuberculosis
Typhoid fever
Typhus
Whooping cough
Yellow fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment of patients identified as being at high risk of severe illness of death due to suspected sepsis

A

Broad spectrum antibacterial at maximum recommended dose within 1 hour
If source identified treat in line with local guidelines
Assess need for IV fluids, inotropes, vasopressors and oxygen assed
Consider lactate, SBP, risk of death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment of patients with suspected sepsis who are not immediately deemed to be at high risk of severe illness/ eath

A

Re-assess regularly for need for empirical treatment

Take into consideration all risk factors including lactate concentration and evidence of AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is sepsis?

A

Sepsis is a syndrome defined as life-threatening organ dysfunction due to a dysregulated host response to infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is rheumatic fever?

A

A very rare complication that can develop after bacterial throat infection. Causes painful joints+ heart problems. If you have had it once it makes it more likely that it could come back.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Prevention of recurrence of rheumatic fever

A

Phenoxymethylpenicillin or sulfadiazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is meningococcal meningitis?

A

Inflammation of the membranes (meninges) around the brain or spinal cord caused by Neisseria meningitidis bacteria.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Prevention of recurrence of meningococcal meningitis

A

Ciprofloxacin or rifampicin or unlicensed im ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is haemophilus influenzae type B (Hib)?

A

A bacterial infection that can cause meningitis, sepsis, pneumonia, pericarditis, epiglottitis, septic arthritis, cellulitis, osteomyeleitis
Even with treatment, 1 in every 20 children with Hib meningitis will die

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Prevention of secondary cases of Hib

A

Rifampicin or unlicensed im/ iv ceftriaxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is diptheria?

A

Highly contagious bacterial infection that can affect the nose and throat and sometimes the skin.
Usually causes a thick grey-white coating at the back of the the throat, swollen glands in the neck, difficulty breathing and swallowing. Can also cause pus filled blisters on legs, feet and hands, large ulcers surrounded by red, sore looking skin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is pertussis?

A

Bacterial infection of the lungs and breathing tubes. Coughing bouts that last for a few minutes and are worse at night.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Prevention of secondary cases of diptheria

A

Erythromycin or another macrolide e.g. azithromycin/ clarithromyxcin

18
Q

Prophylaxis of pertussis

A

Clarithromycin (or azithromycin/ erythromycin)
Within 3 weeks of onset of cough in the index case give antibacterial prophylaxis to all close contacts if criteria for prophylaxis met.

19
Q

What are pneumococcal infections?

A

Caused by the bacterium Streptococcus pneumoniae and can lead to pneumonia, septicaemia and meningitis.

20
Q

Prophylaxis of pneumococcal infections in asplenia or sickle cell

A

Phenoxymethylepnicillin

If penicillin allergic, erythromycin

21
Q

What is sickle cell?

A

Inherited health condition: produce unusually shaped red blood cells that can cause problems because they do not live as long as usual RBCs and can block vessels

22
Q

What is asplenia?

A

Splenectomy. Other organs, such as the liver can take over many of the spleen’s functions. But there is still a small risk that a serious infection may develop quickly. Always stay up to date with vaccinations. Take abx for rest of life. Beware of animal and tick bites. Carry medical ID. Travel advice.

23
Q

What is tuberculosis?

A

Infection caused by Mycobacterium tuberculosis complex bacterium. May be active/ latent disease. Symptoms of active disease: weight loss, fever, night sweats, anorexia, may have cough, breathlessness, haemoptysis. Check for risk factors e.g. being born in high prevlance areas.

24
Q

Animal and human bites, antibactieral prophylais

A

Co-amoxiclav
or doxycycline+metronidazole if pen allergic
Clean wound thoroughly
Give human tetanus immunoglobulin
Consider rabies prophylaxis if in endemic country
If wound <72h
Give for up to 5 days

25
Q

What is septicaemia?

A

An infection caused by a large amounts of bacteria entering the bloodstream. May be community acquired, hospital acquired, related to a vascular catheter or meningococcal.

26
Q

Treatment for hospital acquired and community acquired septicaemia

A

A broad spectrum antipseudomonal beta lactam antibacterial e.g. tazoicn, ceftazidime

27
Q

What is endocarditis?

A

A rare bacterial infection of the inner lining of the endocardium (inner lining of the heart - pericardium = outer layer).

28
Q

What is bacterial meningitis?

A

Bacterial infection of the protective membranes that surround the brain and spinal cord. Can cause septicaemia.
Symptoms: rash that does not fade when glass is rolled over it, stiff neck, dislike of bright lights, n+v

29
Q

Treatment of meningitis

A

Benzylpenicillin (meningococci - the rash)
Cefotaxime
Ceftriaxone
Amoxicillin if caused by listeria

30
Q

What is a diabetic foot infection?

A
Any type of skin, soft tissue or bone infection below the ankle in patients with diabetes. Defined by the presence of at least 2 of:
local swelling or induration
erythema
local tenderness or pain
local warmth
purulent discharge
NICE have a guidance on classification
31
Q

Define induration

A

Deep thickening of the skin

32
Q

Define erythema

A

Redness of skin/ mucous membranes

33
Q

Treatment of diabetic foot infection

A

Mild - fluclox

Moderate/ severe -fluclox + maybe iv gent

34
Q

What is otitis externa?

A

Inflammation of the external ear canal. Either acute (<3 weeks) or chronic (>3 months).
Can be triggered by a bacterial infection caused by P.aeruginosa or Staph aureus.

35
Q

Treatment of otitis externa

A

Consider systemic antibacterial if spreading cellulitis or patient systemically unwell
Fluclox, clarithro if pen allergic
Cipro if pseudomonas suspected

36
Q

What is otitis externa?

A

Inflammation in the mddle ear, associated with an effusion (fluid) and accompanied by an ear infection
Commonly seen in children
Generally caused by viruses or bacteria, both often coexist

37
Q

Effusion

A

Fluid in the ear

38
Q

Viruses that cause otitis media

A

RSV

Rhinovirus

39
Q

Bacteria that cause otitis media

A

Haemophilus influenzae
Streptococcus pneumoniae
Streptococcus pyogenes
Moraxella catarrhalis

40
Q

Treatment of otitis media

A

Offer abx t children who are very unwell or at hihg risk
Amoxicillin first line
Pen allergy clarithromycin/ erythromycin first line (erythro preferred in pregnancY)c