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2nd Year Medicine > CLASP > Flashcards

CLASP Flashcards

1
Q

Holiday heart syndrome?

A

SVT with spontaneous resolution (caused by binge-drinking)

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2
Q

Tx methanol poisoning?

A

Ethanol/dialysis

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3
Q

Antabuse?

A

Inhibits aldehyde dehydrogenase making drinking unpleasant (rehab)

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4
Q

Why does heart beat faster when intoxicated?

A

Alcohol is negative inotrope (faster HR to maintain CO)

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5
Q

Veisalgia cephalgia?

A

Headache :)

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6
Q

Septic shock?

A

Septic shock = sepsis + BOTH of the following:

  • Persistent hypotension (requiring vasopressors to maintain MAP greater than 65)
  • Lactate greater or equal to 2
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7
Q

qSOFA criteria?

A 
RR > 22
aBP <100
altered GCS
* 0 = <1% mortality
* 1 = 2-3%
* >2 = >10%
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8
Q

when should you think sepsis?

A

NEWS score >5 + evidence of infection

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9
Q

SEPSIS 6?

A

BUFALO

  • Blood cultures
  • Urine output
  • Fluids IV - crystalloid, 250-500 mls over 15 mins, aim for 30ml/kg over first 3 hours
  • Antibiotics IV
  • Lactate - high lactate is sign of hypoperfusion + high mortality if >4
  • Oxygen - 94-98%
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10
Q

What if no response to fluids?

A

if no response refer to HDU for CVC and vasopressors (noradrenaline)

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11
Q

how to tell if septic patient is deteriorating?

A
  • New confusion
  • High RR
  • Low BP
  • Low BM
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12
Q

Gram positive organisms?

A

Cocci

  • staphylococci (aureus + epidermidis)
  • streptococci
  • enterococci (E. faecalis)

Bacilli

  • listeria
  • clostridia (c.diff)
  • corynebacterium (diptheroids)
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13
Q

B lactams? (6)

A
  • penicillin
  • flucloxacillin
  • amoxicillin
  • cephalosporins
  • piperacillin/tazobactam
  • carbepenems
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14
Q

features of streptococci? (2)

A
  • facultative anerobes

* catalase positive

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15
Q

Classification of strep via agar?

A

B haemolytic
Alpha haemolytic - green
Gamma haemolytic

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16
Q

Classification of strep via antigens?

A

Lancefield group

  • GAS
  • Group B
  • Group C
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17
Q

Types of streptococci? (5)

A
  • strep pyogenes - GAS (pharyngitis, skin)
  • strep agalactaiae - group B (pregnancy and neonates)
  • streptococcus pneumoniae
  • viridans streptococcal group (own group)
  • streptococcus gallollyticus - typical endocarditis pathogen
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18
Q

Tx enterococcus faecium?

A

resistant to penicillin, fluclox, cephalosporin, aminoglycosides

19
Q

gram positive?

gram negative?

A 
\+ = purple
- = pink
20
Q

streptococcus pneumoniae causes? (3)

A
  • otitis
  • pneumonia
  • meningitis
21
Q

tx streptococcus pneumoniae?

A

If not penicillin resistant, penicillin

bind to penicillin binding proteins needed to synthesise peptidoglycan

22
Q

E. faecialis found?

Ax?

A

Gastrointestinal tract

  • UTI
  • endocarditis
  • bacteraemia
23
Q

Tx E. faecalis?

A

Amoxicillin IV

* step down to oral amox or co-trimoxazole

24
Q

What is used to treat enterococcus (E. faecialis etc) if amoxicillin resistant?

A

Vancomycin

25
Q

Tx VRE (vancomycin resistant enterococcus)? (4)

A
  • linezolid
  • daptomycin
  • tigecycline
  • quinupristine/dalfopristin
26
Q

what is mean inhibitory concentration (MIC)?

A

concentration of drug required to kill 99.9% of organisms in first 24 hrs

27
Q

Tx staphylococcus aureus? (2)

A

Flucloxacillin IV in sepsis

* vancomycin IV in allergy or MRSA

28
Q

Tx coagulae negative staph (i.e. not staph aureus)?

E.g?

A

many are flucloxacillin resistant
* oral doxycycline, cotrimoxazole, clindamycin

e.g. staph epidermidis

29
Q

pharmacokinetics?

Pharmacodynamics?

A 
pharmacokinetics = how body processes drug
Pharmacodynamics = relationship between infection outcome and drug outcome
30
Q

gram negative cell envelope?

A

contains additional outer membrane composed of phospholipids and lipopolysaccharides

31
Q

Pathogenesis of gram-negative bacteria?

A

stems from lipopolysaccharide (LPS)

32
Q

antibiotics active against gram negatives?

A
  • B-lactams!
  • aminoglycosides!
  • macrolides
  • tetracyclines
  • chloramphenicol
  • co-trimoxazole!
  • polymixins!
33
Q

Haemophillus influenzae?

Growth?

A

gram-negative coccobacillus

* chocolate agar media

34
Q

Tx haemophillus influenzae?

A
  • Amoxicillin

* Doxycycline

35
Q

Atypical pneumonia?

A

Not strep pneumonia

* mycoplasma pneumoniae, coxiella burnetti, chlamydophila psittaci, legionella pneumophila

36
Q

Tx for atypical pneumonia? (3)

A
  • doxycycline - not legionella
  • clarithromycin
  • quinolones (levofloxacin) - legionella
37
Q

Ax legionella?

Risk factors? (8)

A
  • showers
  • air conditioning
  • taps

Risk factors

  • smokers
  • males
  • COPD
  • immunosuppressed
  • malignancy
  • diabetes
  • dialysis
  • hot tubs
38
Q

pathogenesis legionella?

A

invades and grows within alveolar macrophages

39
Q

which serogroup of legionella causes most disease?

A

Serogroup 1

40
Q

Coliforms?

Examples?

A

gram negative rods

* E.coli and similar organisms e.g. klebsiella, proteus, enterobacter, serratia

41
Q

Agar for coliorms + E.coli?

A

Macconkey agar = turns pink

42
Q

Extended spectrum B lactamases (ESBLs)?

A

reistant to penicillins, cephalosporins, and aztreonam

43
Q

Tx ESBLs? (3)

A
  • clavulanate
  • sulbactam
  • tazobactam

2nd Year Medicine (24 decks)

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