capsule infections Flashcards
what does purpuric or petechial means
blood in extravascular space
how to treat N. meningitidis
ceftriaxone- cover most peniclin resistant pneumococci and most staphylococci0 not MRSA
would you give steroids to pt with meningococcal sepsos
yes for initial management of bacterial meningitis
causes of atypical pneumonia
not detectable on gram stain- chlamydia pneumophila, legionella pneumophilla, mycoplasm pneumonia
how to treat pneumocystis carnii pneumonia
2L of O2 via nasal spec, co trimoxazole, steroids
what things change lymphocyte count
chronic leukaemia inc lymphocyte count.
immunosupression, HIV infection, renal failure, all cause dec
headache, fever+ short Hx of behavioural changes and dec consciousness
viral encephalitis secondary to HSV infection
what would viral infection cause on LP
high protein, raised lymphocytes, normal glucose
how would you treat hepes encephalitis
hihg dose IV aciclovir- 10mg/kg tds IV in normal real function
RF for meningism
overcrowded places, HIv, travel to meningitis belt in sub saharan africa
most commonest complication of bacterial meningitis
sensorineural deafness
what is used as chemo prophylaxis and whow should be given it
rifampicin, flatmates and partner
how would you differentiate between meningitis and encephalitis
pt with meningitis are cognitively intact but may be lethargic or be dominated by pain of their headache.
encephalitis: have abnormal brain function-altered mental status, behavioural or personality changes
how to differentiate between viral and bacterial meningitis
CSF on LP- lymphocytes, modesly raised protein, normal glucose- viral
hep A Pc
RNA virus-icteric, ache, previous holiday
passed in faecal oral route or sexual contact
Hep A Ix
Liver function test, serum hep A IgG or IgM
what type of ABx is ciprofloxacin
quinolone ABx which inhibits the metabolis of theophyline via CYP450 enzymes and enhanced effect of warfarin
Hep C
RNA virus-4 genotypes, high rates in africa
spread via blood and needles
some are symptomatic with acute icteric episode
incubation period for 4-20 weeks
phase 1 Hep C
A prodromal ‘flu-like illness lasting 3-10 days. Malaise, myalgia, sometimes with RUQ pain
phase 2 Hep C
Icteric illness lasting 1-3 weeks generally but has been seen to persist for over 12 weeks. Jaundice, itch, anorexia, nausea. Fever is not generally seen in this phase.
Ix for Hep C
HCV core Antibody- person exposed to Hep C in lifetime, positive after 3 months of infection
HCV-RNA: confirm active infection, positive after 2 weeks infection
gram positive cocci
strep pyogenes, MRSA (vancomycin)
GRAM NEGATIVE RODS
E.COLI, pseudomonous aeruginosa, Haemophilus influenza
gram neg cocci
N. meningitidis
PC measles
high fever, cough, coryza, conjuncitvitis, koplic spots on hands and soles of feet also
how is measles spread
airborne, contact
how to test for measles
positive IgM- acute infection. IgG- previous exposure to either natural infection or immunisation
complications of measles
encephalitis, ototis media, penumonitis
Abx for diverticulitis
cefuroxime, metronidazole IV
Abx for uti
cirpo, gentamycin, cefotaxime
sepsis: broad spec anti-pseydomonal penicillin= piperacilin+ tazobactam or broad spec cephalosporin (eg cefotaxime or ceftazidime)
Abx for c.diff
vancomycin
Abx for dog bite
co-amox and tetanus booster
treatment for MRSA
Vancomycin or doxycycline
what medication should you not take with warfarin
flucloxacillin like many other ABc- unpredictable rise in INR
what electrolyte imbalances can piperacillin with tazobactam lead to
low K+ and high Na+
which Abx is active against pseudomonous
ciprofloxacin
clarithromycin and theophyline
may inc plasma levels leading to possible theophyline toxicity. inc riks of convulsions when quinolones given with theophyline
amitriptyline cool facts
useful for SOB in endstage COPD
has anti muscurinic properties
