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RACP Paeds Written Exam > Bacterial Infections & Antibiotics > Flashcards

Bacterial Infections & Antibiotics Flashcards

1
Q

Toxin mediated diseases?

A

Toxic shock syndrome
Kawasaki Disease
Eczema exac/psoriasis

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2
Q

Pathogenesis of super antigens causing disease?

A

MHC II binds with T cell resulting in polyclonal activation (contrast to regular antigens presenting to a specific T cell receptor)
Therefore super antigen is not MHC restricted resulting in overwhelming cytokine release

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3
Q

Eagle effect and abs to use to avoid this?

A

When bacteria in stationary phase of replication penicillin is less effective
Clindamycin used instead

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4
Q

Criteria for staph TSS and management?

A 
Fever >38.9C
Hypotension <90sys
Rash - diffuse, macular erythematous
Desquamation of palms/soles 1-2/52 later
Multisystem involvement - GI, muscular, mucus membranes, kidney, liver, ham or CNS
---> treat with fluclox and clindamycin
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5
Q

Criteria for strep TSS and RFs?

A

GAS found in normally sterile site (blood, urine)
Hypotension
Kidney, coagulopathy, liver, ARDS, soft tissue necrosis

RFs - trauma, NSAIDs, surgery, viral infection, post-partum

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6
Q

Gram positive cocci, coagulase positive?

A

Staph aureus

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7
Q

Gram positive cocci, coagulase negative?

A

Staph epi, Staph hemolyticus

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8
Q

RF for coat neg staph?

A

Indwelling lines/implants

CONS forms a biofilm, enhances adhesion and resist phagocytosis

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9
Q

Treatment for CONS?

A

Vancomycin - most are resistant to fluclox

& remove devices

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10
Q

MecA positive organism?

A

MRSA

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11
Q 
Superantigen or not:
Staph food poisoning?
Staph scarlet fever?
Staph scalded skin?
TSS?
A

Food poisoning - toxin but not super antigen
Scarlet fever - toxin but not super antigen
Scalded skin - toxin but not super antigen
TSS - super antigen

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12
Q

Gram pos cocci, catalase negative?

A

Streptococci

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13
Q

Group A strep?

A

Strep pyogenes

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14
Q

Group B strep?

A

Strep agalactiae

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15
Q

Group C/D strep?

A

Beta haemolytic strep

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16
Q

Group D strep?

A

Enterococcus

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17
Q

Group E&F strep?

A

Alpha haemolytic (pneumoniae/viridians)

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18
Q

Group A Strep acute infections?

A 
Strep throat
Skin infections inc erysipelas
Nec fasc
Scarlet fever
TSS
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19
Q

GAS immune mediated illnesses?

A

Rheumatic fever
Post-strep GN
Post-strep arthritis
PANDAS

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20
Q

Transmission rate of GBS?

A

50%
Invasion rate 1-2%
10-30% of women GBS +

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21
Q

Abx in labour reduces neonatal sepsis?

A

Reduced EOS by 65%

NO CHANGE in LOS

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22
Q

RFs for GBS in labour?

A 
Prev infant w EOS GBS
GBS bacteria
SPTL <37/40
ROM >18hrs
Intrapartum fever >38C
  • if any present treat with abx
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23
Q

What else to look for in strep intermedium bacteraemia?

A

Abscesses

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24
Q

RF for enterococcus infection?

A

Damaged mucosa, impaired immune response

25
Q

Gram positive bacteria, lancet shaped diplococcus.

A

Strep pneumoniae

26
Q

Risk groups for strep pneumoniae infection?

A

Sickle cell
Asplenia
Acute nephrotic syndrome
Deficiency in humeral immunity

  • polysaccharide capsule prevents phagoytosis
27
Q

Conjugate vs polysaccharide vaccine pneumococcal vaccine?

A

Conjugate - T cell immunity, reduces nasopharyngeal carriage (routine on imms schedule)
Polysaccharide - limited response in children <2 and immune compromised (additional for high risk)

28
Q

Gram positive rods?

A

Bacillus cereus - gastro
Clostridium difficile, tetani, and botulinum
Listeria

29
Q

Toxin associated with clostridium ?

A

Tatanospasmin

—> prevents release of glycine and GABA which blocks normal inhibition of antagonistic muscles causing contractions

30
Q

Management of tetanus?

A

Tetanus IVIG and tetanus vaccine
Immunoglobulin neutralises toxin - needs to be given early
Exposure to toxin does not infer immunity - vaccination!

31
Q

RFs for C Diff?

A

Abx - cephalosporins, Olinda and fluoroquinolone
Healthcare setting
PPIs
Chemotherapy

32
Q

Gram pos bacilli?

A

Corynebacterium diptheria

33
Q

Only gram pos bacteria to have an endotoxin?

A

Listeria

34
Q

Mortality rate of listeria in utero?

A

50% in prev infants
30% EOS
15% LOS

35
Q

Gram negative cocco bacillus?

A

Haemophilus Influenza B

36
Q

% of HiB producing beta-lactamase?

A

1/3

Resistant to amp/amoxy so treat with augmentin

37
Q

Gram neg diplococcus?

A

Moraxella catarrhalis

38
Q

Treatment moraxella?

A

Augmentin

39
Q

Gram neg pleomorphic bacillus?

A

Bordetella pertussis

40
Q

Gram negative diplococcus?

A

Neisseria meningidites

41
Q

Peaks of neisseria disease?

A

Bimodal -> <2 and teenagers

42
Q

RFs for neisseria meningitis?

A 
Complement deficiency
Eculizumab treatment
Asplenia
HIV
HSCT
43
Q

Seizures/focal neurology more common with meningitis from which organisms?

A

HiB and Strep meningitis

44
Q

Gram negative rods?

A

Non-typhoid salmonella

Campylobacter

45
Q

Associations salmonella w underlying illness

A

Reactive arthritis (HLA B27)
OM (sickle cell)
Multi-organ failure (HIV)
Toxic megacolon (IBD)

46
Q

Mx non-typhoid salmonella?

A

Not recommended for uncomplicated salmonella - suppresses normal flora
Neonates <3mths
If febrile or toxic, bacteraemic or with vascular grafts or haemoglobinopathies
Immunocompromised

47
Q

Dysentery with HUS/SIADH?

A

Shigella

Shiga toxin mediated

48
Q

RFs for cholera?

A

Blood group O
Decreased gastric motility
Malnutrition
Immunocompromise

49
Q

Painless profuse diarrhoea with metabolic acidosis, hypokalaemia and hypoglycaemia. Stool shows chloride ++ bt no leukocytes

A

Cholera

50
Q

Gastro with blood 2-4 days after onset. Lasts 1-2 weeks. Pathogen?

A

Campylobacter

51
Q

Complications of campylobacter?

A

Reactive arthritis
Erythema nodosum
IBS
GBS

52
Q

Enterocolitis/mesenteric adenitis in child with thalassemia?

A

Yersinia

53
Q

Complications of Yersinia?

A

Assoc w KD - superantigen

Eryhtema nodosum, arthritis, uveitis

54
Q

Gram neg bacilli?

A

E Coli

55
Q

Gram neg aerobe?

A

Pseudamonas
Klebsiella
Bartonella

56
Q

Ectheyma gangrenous?

A

Pseudamonas

57
Q

Lymphadenitis with red papules at site of scratch. Rarely may have hepatomegaly, conjunctivitis. Pathogen?

A

Bartonella

58
Q

OM/SA in child with minimal inflammation marker rise, no improvement on fluclox?

A

Kingella

59
Q

Traveller from NT in wet season, presents with skin lesion and pulmonary infection?

A

Meliodosis

Pseudomallei

RACP Paeds Written Exam (15 decks)

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