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Lecture week 4 > Antibiotics > Flashcards

Antibiotics Flashcards

1
Q

Colour of staining of bacteria:

  • gram positive
  • gram negative
A
  • gram positive -> purple
  • gram - negative -> pink
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2
Q

Important gram positive cocci

  • general names (x2)
  • examples (x2 each group)
A
  • Staphylococcus
  • S aureus*
  • S* epidermidis
  • Steptococcus
  • S* pyogenes
  • S* pneumoniae
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3
Q

Important gram positive rods

  • general name (1)
  • example (1)
A

Gram +ive rods

Clostridia

- C difficile

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4
Q

Important gram negative cocci

  • general names (1)
  • examples (2)
A

Gram negative cocci

  • Neisseria*
  • N meningitidis
    • N gonnorhoea*
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5
Q

Important gram negative rods

  • general names (6)
A

Gram negative rods

  • E coli
    • Proteus*
    • Klebsiella*
    • Pseudomonas*
    • Salmonella*
    • Haemophilus (e.g.H influenza B)*
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6
Q

Forms of Haemophilus (2)

example of conditions they cause

A
  • capsulated (much more pathogenic e.g. acute epiglottitis)
  • non- capsulated (colonise lungs)

*Haemophilus B capsulated -> we can vaccinate against it -> so we can prevent epiglottitis

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7
Q

Example of anaerobic bacteria (1)

Location of it

A

Anaerobic

Strep faecalis

it survives in the gut

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8
Q

What bacteria is likely to cause this (picture)?

A

Staphylococcus Aureus

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9
Q

What bacteria is likely to cause this (picture)?

A

Streptococcus Pyogenes

*bacteria arranged in chains

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10
Q

What bacteria is it caused by? (picture)

A

Neisseria meningitidis

*polymorphic nuclei of the cells

* gram-negative intracellular diplococci = Neisseria

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11
Q

What bacteria is it caused by? (picture)

*this pt has a Hospital acquired infection - pt was ventilated at ITU then went to the ward

A

Staphylococcus Aureus

Streptococcus Pneumoniae

*it’s a mix infection

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12
Q

What bacteria is it caused by? (picture)

A

E. Coli

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13
Q

What organism is likely to cause this? (picture)

A

Candida Albicans

*fungus - branches/trees - like visible on microscopy

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14
Q

‘normal’/community-acquired pneumonia

  • history/presentation
  • likely organism
A

History: productive/ green cough, fever, pleuritic chest pain; lobar consolidation

Organism: Strep pneumonia (90% pneumococcus)

* 5-10 % atypical organisms

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15
Q

Atypical pneumonia

  • features/ clinical picture
  • what does it look like on chest x ray?
  • likely organisms (4)
A

Atypical pneumonia

A. Features:

  • dry, non-productive cough
  • headache
  • myalgia
  • fever

B. CXR: lots of consolidation, sometimes on both sides, not confined to one side

C. Organisms:

  • coxiella burnetii
    • mycoplasma pneumonia*
    • chlamydia* pneumoniae
    • legionella*
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16
Q

Antibiotics for young and fit person with community-acquired pneumonia

A

Amoxicillin (penicillin) + Macrolide

*this is to cover pneumococcus and atypical organisms

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17
Q

Cigarette smoker with mucociliary function impaired and repeated chest infections

  • what organism may colonise that person and cause chest infections?
A

Organisms:

  • Haemophilus
  • Pseudomonas (if bronchiectasis and repeated chest infections)

*these are nasty infections, multi-drug resistant

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18
Q

Just look at the picture

A
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19
Q

Aspiration pneumonia

  • examples of patients at risk
  • organisms causing it
  • antibiotic used
A

Aspiration pneumonia

Patients at risk: patients who vomit and inhale -> epileptic/fitting, alcoholics, stroke

Organisms: anaerobes

Antibiotics: metronidazole

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20
Q

Patients who are at risk of pneumonia caused by TB

A
  • HIV/ immunosuppressed
  • people from Sub-Saharan Africa, South East Asia; Eastern Europe, India
21
Q

Organisms causing UTI

A

UTI

  • gram negatives
  • catheter: staphs, candida

-

22
Q

Abdominal infections (bowel)

  • what organisms cause it
A

small bowel -> sterile

large bowel -> gram negatives + anaerobes

*therefore small bowel operations are separated from large bowel (on the surgeries list - small bowel operations will be first on the list)

23
Q

Meningitis

What are likely organisms causing it (according to the group)?

A. normal/ adults

B. kids <5

C. neonates

A

Meningitis

Adults: N. meningitidis + Strep pneumoniae

Kids <5: Haemophilus

Neonates: group B Streptococcus, gram negatives, Listeria, HSV

24
Q

presentation of meningitis:

A. adults

B. neonates

A

A. Adult: photophobia, neck stiffness, headache, fever

B. Newborn: cry, fever*

*a lot of meningitis happen in neonates presenting with cry and fever (as possible meningitis)

25
Q

Just look at the picture

A
26
Q

What’s the cause of food poisoning?

Do antibiotics help?

A

Food poisoning -> ingestion of pre-formed toxin

Antibiotics would not help

*if dehydrated, may need IV drip

27
Q

What’s gastroenteritis?

  • what location is infected?
  • how does the diarrhoea look like?
  • likely organisms
  • management
A

Gastroenteritis -> ingestion of the bug -> it colonises the gut and multiplies (may or not produce toxins)

  • location: small bowel is infected
  • diarrhoea: green and watery
  • likely organisms: viral, salmonella, E coli

Management:

  • -* usually no antibiotics
  • usually self-limiting
28
Q

Colitis

  • location of infection
  • appearance of diarrhoea/ features of infection
  • likely organisms
  • management
A

Colitis

  • Location: large bowel
  • Diarrhoea: less watery/more formed (than gastroenteritis), but more sick (abdominal pain, feverr, high WBCs, fresh/red blood in the stool)
  • Organisms: Campylobacter, E coli 0157, Ameobic dysentery
  • Management: needs antibiotics
29
Q

Bacteria (2) causing skin/ soft tissue/ bone infections

A

Staphylococcus, Streptococcus

30
Q

Organisms causing endocarditis associated with:

A. native valve

B. IVDU

C. Artificial valve

A

A. native valve -> Strep viridans

B. IVDU -> Staph aureus, fungal

C. Artificial vale -> staphs (they love plastics/metals)

31
Q

What are the key questions to be asked before we prescribe antibiotics?

A
  • is there an infection
  • what’s the location
  • what’s the likely organism
  • what antibiotics are likely to be effective
  • is there likely resistance
  • will antibiotic penetrate the site of infection
  • route of administration
  • what’s the toxicity and cost
32
Q

Look at the pic

MoA and examples of:

B- lactams

Aminoglycosides

A
33
Q

Look at the pic

MoA and examples of:

  • Macrolides
  • quinolones
A
34
Q

Look at the pic

MoA of:

  • metronidazole
  • glycopeptides
  • tetracycline
A
35
Q

Flucloxacillin

- against which organism?

  • what type of spectrum is it?
A

Flucloxacillin

  • against Staphs

it is narrow spectrum

36
Q

What spectrum activity amoxicillin has?

A

Amoxicillin

  • brad spectrum (covers some gram-negative and positives)
37
Q

What’s in the Co-Amoxiclav (2 substances)

  • spectrum
  • side effect
A

Amoxicillin + clavulanic acid (Co-Amoxiclav)

clavulanic acid -> it is an inhibitor of Beta-lactamase (so bacteria cannot incorporate B-lactams into their cell wall)

S__pectrum: broad -> positives (Penicillins), anaerobes and negatives

Side effect: more of own bacteria killed -> risk of C Diff diarrhoea

38
Q

What’s the most commonly Cephalosporin used?

  • spectrum
A

Ceftriaxone -> broad spectrum

39
Q

What’s the name of antibiotic from carbapenam class that is reserved for difficult infections?

  • what’s its spectrum?
A

Imipenem

(very broad spectrum)

40
Q

Aminoglycosides

  • MoA
  • examples
  • spectrum
A

look at the picture

41
Q

Macrolides

  • MoA
  • examples
  • spectrum
A

Look at the picture

42
Q

Quinolones

  • MoA
  • example
  • spectrum
A

Look at the picture

43
Q

Tetracyclines

  • MoA (simple)
  • example
  • spectrum
A

Look at the picture

44
Q

Anti-folate

  • MoA (simple)
  • example
  • spectrum
A

Look at the pic

45
Q

Glycopeptides

  • MoA (simple)
  • example
  • spectrum
A

look at the pic

46
Q

Metronidazole

  • MoA (simple)
  • example
  • spectrum
A

look at the pic

47
Q

What questions (3) and why do we need to ask in terms of antibiotics (related to resistance)?

A
  • community-acquired or hospital-acquired? -> hospital-acquired are usually resistant
  • previous antibiotic? -> if one antibiotic does not work -> prescribe different one
  • travel history? -> e.g. penicillin-resistant pneumococcus is rare in the UK, but may be even 20% in Spain/ Southern Europe; depends on the country
48
Q

What factors (in term of the patient’s condition ) would prompt us to use IV antibiotics?

A
  • very sick patient
  • serious infection
  • the barrier to drug absorption
  • malabsorption
  • vomiting/swallowing problems
  • poor bioavailability
  • poor tissue penetration

Lecture week 4 (18 decks)

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