clinical infections Flashcards
what are the symptoms of a systemic infection, (mention older population and children)?
increased: temperature heart rate CRP (C reactive protein) ESR (erythrocyte sedimentation rate) white cell count
low blood pressure
children: drowsiness, irritability, loss of appetite, increased/decreased temperature
elderly: confusion
what are the symptoms of local infection?
pus
rash
increased sputum production (mucous)
pain when urinating
what are CRP and ESR an indication of?
inflammation
what is the first line of treatment when the type of bacteria is not known? what does it involve?
empirical antimicrobial treatment
it involves having an “educated guess” on the site of infection. based on this a broad spectrum antibiotic is used to treat the possible pathogens that can affect that location; while taking into account any resistance patterns
which bacteria are the most common culprits behind skin infections? (2)
gram-positive Staphylococcus Aureus and Streptococcus pyogenes
- what is impetigo?
- symptoms
- how does it spread?
- what is the usual treatment?
- superficial skin infection
- sores, blisters, crusting
- spread by direct contact
- topical antibiotic (fusidic acid or mupirocin if MRSA), extensive disease treated with oral antibiotics
- what is cellulitis?
- symptoms
- treatment
-infection of the dermis or subcutaneous fat
-heat, rash, induration, tenderness
-penicillin antibiotic, if allergic use clarithromycin.
if gram negative the use broad spectrum antibacterial
what does co-amoxiclav contain?
amoxicillin
potassium clavulanate, a beta lactam inhibitor (slows down break down of beta lactam antibiotics in resistant bacteria)
which infections affect the upper respiratory tract (5) and the lower respiratory tract(4)?
upper: common cold, influenza, sinusitis, pharyngitis, otitis media
lower: bronchitis, pneumonia, tuberculosis, exacerbation COPD
- what is acute otitis media?
- treatment
-infection of the middle ear
-usually resolves alone, antibiotics not needed.
antibiotics beneficial for some sub-groups, for example in children: under 2 with bilateral infection, discharge, systemically unwell, recurrent infection
usually amoxicillin or clarithromycin
- what is sinusitis?
- symptoms
- treatment
- infection of the sinus
- nasal discharge, congestion, headache, earache, facial pain, fever, toothache
- self-limiting
- what is acute bronchitis
- symptoms
- treatment
- inflammation of bronchi
- irritating cough with or without sputum, with discomfort behind sternum, tightness of chest, wheezing, shortness of breath, fever
- self-limiting, may be treated with amoxicillin or tetracycline
- what is pneumonia
- location, consequences
- types and difference
- infection of the functional tissue of the lung
- alveoli, causes problems with gas exchange, thus possibly life threatening
- community acquired and hospital acquired, hospital acquired pneumonia is caused by atypical pathogens
-explain severity assessment in primary care and hospital setting (CURB65 score)
- primary care: higher score indicates higher mortality rate and therefore need for referral to secondary care. total of 4 scores: confusion, raised respiratory rate, low blood pressure, age 65 or more
- secondary care: higher score indicates higher mortality rate. total of 5 scores: confusion, raised blood urea nitrogen, low blood pressure, raised respiratory rate, age 65 or more. (same as in primary care with added urea nitrogen levels)
what is the general management in community
- assess for severity and referral/hospital admission
- review after 2 days if needed
- drink fluids
- stop smoking
- simple analgesia, NICE says start antibiotics ASAP?
- pulse
what are the factors generally investigated in hospital? (pneumonia)
-why are LFTs carried out?
- oxygen saturation
- chest radiography
- U and E, CRP, FBC, LFTs (pneumonia 4th most common infection in patients with cirrhosis)
-general management of pneumonia in hospital
- oxygen therapy
- fluid levels-fluid iv
- prophylaxis for thromboembolism (pneumonia is a risk factor)
-what factors should be monitored (secondary care pneumonia)
- oxygen saturation
- temperature
- respiratory rate
- pulse
- blood pressure
- mental status
-management community acquired pneumonia
- start antibiotics as soon as possible after diagnosis
- antibiotic choice depends on severity
- start on oral if possible, if starting from iv review after 48 hours and consider switching to oral
- reassess if there is no/slow improvement
management hospital acquired pneumonia
- start on empirical antibiotic treatment asap after diagnosis
- choice of antibiotic dependant on severity
- once microbial test available review choice of antibiotic, change antibiotic if appropriate (e.g. use narrower-spectrum antibiotic)
- reassess if symptom don’t improve
- what is influenza
- types
- symptoms
- treatment
- prevention
- viral infection affecting upper respiratory tract
- A, B, C
- headache, fever, cough
- symptomatic treatment (antipiracy=lowers fever), other treatment is used during pandemics
- vaccination
measles
-symptoms
-viral infection, cold-like illness, white spots in buccal mucosa followed by rash
which diseases are caused by herpes viruses?
- herpes
- varicella/chickenpox
- shingles
- which type of herpes simplex virus causes labial herpes and genital herpes
- treatment
- HSV-1 causes lip herpes, while HSV-2 causes genital herpes
- topical, oral, iv antivirals depending on symptoms
