Clincal Conditions Flashcards
What is the presentation of someone with Neisseria meningitidus
Fatigue, fever, headache, stiff neck, non-blanching rash
What type of swab would you do for a suspected Neisseria meningitidus
Nasopharyngeal swab
What is the gram stain for Neisseria Meningitidsu
Gram negative diplococcus
What is the treatment of Neisseria Meningitidus
Ceftriaxone
What are the most common causative organisms of meningitis in newborns, children and adults
Newborns - E. coli, Group B streptococcus
Children - Haemophilius influenzae, Group B strep, Neisseria meningitidus
Adults - Neisseria menignitidus and Strep pneumoniae
What 2 things can E. coli present as
- gastroenteritis
- UTI
How is E. coli spread?
- perforated bowel
- feacal oral
What is the gram stain for E. coli?
Gram negative bacilli
What tests would you do to identify E. coli
Nitrites, leukocyte ester as expected, dipstick test, CRP, lactate
What is the treatment for E. coli and how does this antibiotic work?
Trimethoprim - inhibits folic acid synthesis
How does Haemophilius influenzae Present
- as a URTI
- as meningitis
Where is Haemophilius influenzae found as part of the normal flora
Nasopharynx
What can staphylococcus aureus cause
- skin infections
- pneumonia
- abscess
- prosthetic infections
Where is staph aureus found as part of the normal flora
Skin and respiratory tract
What are the exotoxins for staph aureus
- superantigens
- coagulase enzymes
- hyaluronidase
- haemolysins
What is the gram stain for staphylococci
Gram positive cocci in clusters
What is the treatment for staph aureus and what do they do?
Penicillin but flucoxacillin if unsure it its strep - these are beta lactams which prevent cell wall synthesis
What microbes commonly cause prosthetic infections after surgery
Under 1 year - coagulase negative staphylococcus
Over 1 year - staph aureus or viridans streptococcus
What is used to treat MRSA
Vancomycin
How can you prevent biofilms forming on IV lines
Make silver coated IV lines
What can Staphlococcus epidermis cause?
Biofilm formations on equipment such as catheters
What are the 3 types of haemolysis for streptococci
Alpha - partially break down the RBCs
Beta - fully break down RBCs
Gamma - dont break down the RBCs
What are the 2 types of alpha streptococcus
- strep pneumoniae
- viridans streptococcus
How does strep pneumoniae interact with the host
Enters the alveoli and stimulates an immune response so the alveoli fill with an exudate/pus. It may then infect the blood and cause complications.
What is the gram stain for streptococci
Gram positive cocci in chains
What commonly causes infective endocarditis
Viridans streptococcus
What are the features of infective endocarditis
Fever, heart murmur, janeway lesions, Osler nodes
Why must you look at dental hygiene with suspected infective endocarditis
As viridans streptococcus is naturally found in the mouth so could be able to enter the blood through poor dental hygiene
What type of beta streptococci are there
Streptococcus pyogenes
What are the virulence factors of streptococcus pyogenes
- M protein
- hyaluronic acid capsule
- streptokinase
- Exotoxins which cleave IgG
What is the presentation of strep pharyngitis
Sore throat, headache, pus exudate on tonsils
How do you treat strep throat
Initially only supportive to try and develop M protein specific antibodies
What are the complications of strep throat
- peritonsillar abscess
- post streptococcal glomerulonephritis
- scarlet fever
- rheumatic fever
What skin infections can strep pyogenes cause
Impetigo, erysipelas, cellulitis, necrotising fasciitis
How does strep pyogenes cause toxic shock syndrome
It invades into the blood stream and their superantigens cause the proliferation of T cells, releasing lots of cytokines leading to organ failure and vascular collapse
What is the gram stain for c diff
Gram positive bacilli
What is the treatment for c diff
Metronidazole
Why is c diff so hard to remove
It replicates using spores which are resistant to boiling water, chemical and UV so are very hard to remove
What are the exotoxins for c diff
Exotoxins A - causing inflammation
Exotoxins B - kills healthy gut cells by preventing protein synthesis
Why is using antibiotics a risk factor for developing a c diff infection
Antibiotics deplete the normal flora meaning there is reduced competition for the c diff
Describe the formation of a biofilm
The bacteria adhere to a surface
They begin to multiple and create a slime coating
Nutrients and other bacteria can move through this slime capsule into the biofilm
What are the advantages to the bacteria of a biofilm
Prevents competition from other bacteria, prevents complement and phagocytosis and prevents antibiotics
What is a vegetation
A collection of bacteria on heart valves
Where is E. coli found as part of the normal flora
Intestines
Where is h pylori found as part of the normal flora
Stomach
What is the grain stain for h pylori
Gram negative