Clinical Microbiology Flashcards
give me some facts about M.tuberculosis
weakly gram positive
Gene X-pert can identify TB directly from samples
what part of the TB infection does isoniazid target
actively growing organisms
what part of the TB infection does pyrazinamide target
semi-dormant organisms inhibited by an acid environment
what part of the TB infection does Rifampicin target
semi-dormant organisms with spurts of active metabolism
symptoms of TB
cough
sputum
haemoptysis
fever
weight loss
night sweats
what is the test for latent TB
Mantoux
and interferon gamma release assays such as t-spot-TB and quantiferon
what is the treatment for active TB
adverse reaction rifampicin
adverse reaction to isoniazid
liver injury DILE
ethanbutol adverse reaction
toxic optic neuropathy
pyrazinamide adverse reaction
liver injury and raised lactate
drugs used in drug resistant TB
BDQ
Delamanid
pretomanid
what questions do you need to ask in relation to travel history
where did they go
how long were they there
did they take any anti-malarials
why is there often an incubation period in malaria
this is due to the fact that sporozoites enter the liver and become schizonts that are stored in the liver until they are released into the circulation
what do thick blood films in malaria test for
these provide a diagnosis of malaria
what do thin blood films in malaria test for
this confirms what type of malaria a patient is experiencing
What are the other tests used in the diagnosis of malaria
antigen testing
PCR
what are the two types of malaria
non falciparum malaria and falciparum malaria
What is the management of non-falciparum malaria
oral chloroquine (this treats the blood stages of the disease)
Artemether containing therapies
Oral primaquine (this treats the hypnozoites which aids in preventing reoccurrence)
REMEMEBER that viva and vale are the ones that have the ability to cause relapse due to hypnozoites
what are some features of severe falciparum malaria
these often reflect the sludge up of the microcirculation
- impaired consciousness and seizures
- renal impairment
- acidosis
- hypoglycaemia
- pulmonary oedema or ARDS
- shock
- spontaneous bleeding
how do we manage uncomplicated falciparum malaria
how do we manage severe falciparum malaria
what is the prognosis of malaria
early treatment and diagnosis
the cause of any deaths related to malaria are usually due to:
- lack of antimalarial prophylaxis
- late diagnosis
- even cerebral malaria has a mortality of 15-20%
what are the two bacteria associated with enteric fever
S.typhi and S.paratyphi
how is enteric fever transmitted
- human to human
- contained food/water
humans are the only reservoir
ONLY NEEDS 1000 TO CAUSE DISEASE
what is the pathogenesis of enteric fever
the organisms are ingested from the contaminated water, the organism then moves through the peyers patches in the small bowel to then infect the reticuloendothelial system and this then effects the liver and blood products
what are the clinical features of enteric fever
fever
myalgia
headache
cough
abdo pain
constipation
diarrhoea
how do you diagnose enteric fever
travel history
blood cultures
stool samples
serology
what is the treatment for enteric fever
dengue fever
caused by day biting and an incubation time of 5-14 days
what are the clinical features of dengue fever
headache
fever
retro-orbital pain
Myalggia
rash
what are the clinical features of dengue fever
headache
fever
retro-orbital pain
Myalggia
rash
what lab tests indicate gengue fever
leucopenia
thrombocytopenia
transaminitis
liver inflammation
what defines haemorrhagic fever
increased vascular permeability
thrombocytopenia
fever
bleeding
What marker is raised in inflammatory bowel disease
faecal calprotectin
