common infections and sepsis

Question 1

symptoms of pneumonia or LRTI

Answer 1

fever, sweating, chills
cough, often severe, phlegm
shortness of breath
difficulty breathing

Question 2

symptoms of intrabdominal infections/peritonitis (10)

Answer 2

abdominal pain
bloating
fever
nausea/vomiting
loss of appetite
diarrhoea
low urine output
thirst
inability to pass stool or gas
fatigue

Question 3

viral hepatitis

Answer 3

inflammation and damage to liver
can be virus, bacteria (Leptospira spp.) and other microorganisms

Question 4

congenital infections

Answer 4

intrauterine infection may result in death of fetus or congenital malformations
after primary infection during pregnancy, microorganisms enter blood, establish infection in foetus and invades foetus

Question 5

CNS infections

Answer 5

usually blood-borne or infectious agents invading via peripheral nerves
brain and spinal cord protected by enclosure in skull and vertebrae

Question 6

symptoms of meningitis (5)

Answer 6

fever
irritability
neck stiffness
photophobia
often a haemorrhagic skin rash with petechiae

Question 7

investigations of meningitis

Answer 7

preliminary microscopy results with WCC and gram staining for bacteria available within hour of CSF sample in lab

CSF/Serum ratio useful as bacteria break down glucose so low CSF sugar compared with serum indicates bacterial infection

Question 8

tetanus

Answer 8

Cl. tetani toxin is carried to CNA in peripheral nerve axons
spore enters wound, and necrotic tissue or presence of foreign body allows anaerobic growth of bacteria where tetanospasmin is produced

Question 9

3 predictors of sepsis

Answer 9

low systolic blood pressure <100mmhg
increased respiratory rate >22 b/m
altered mental state

any 2 in presence of life-threatening infection are sufficient to diagnose

Question 10

risk groups for sepsis (5)

Answer 10

under 1 and over 75
impaired immune systems
have had surgery or an invasive procedure in past 6 weeks
breach of skin integrity
indwelling lines or catheters

Question 11

desired antimicrobial properties of new antimicrobial agents

Answer 11

selectivity for microbial rather than mammalian targets
cidal activity
slow emergence of resistance
narrow spectrum of activity

Question 12

desired pharmacological activities of new antimicrobial agents

Answer 12

non toxic to host
long plasma half life
good tissue distribution including CSF
low plasma-protein binding
oral and parental dosing forms
no interference with other drugs

Question 13

5 main signs of inflammation

Answer 13

pain
redness
swelling
heat
loss of function

Question 14

10 viruses that cause a saw throat and their symtpoms

Answer 14

1. rhinoviruses and coronaviruses - mild symptoms in common cold
2. adenoviruses (types 3, 4, 7, 14, 21) - pharyngoconjuctival fever
3. parainfluenza viruses - more severe than common cold
4. influenza viruses, CMV, EBV - symptoms not always present
5. Coxsackie A and other enteroviruses - small vesicles (herpangina)
6. EBV - occurs in 70%-90% of glandular fever patients
7. herpes simplex virus type 1 - can be severe with palatal vesicles or ulcers

Question 15

5 bacteria that cause saw throat and their symptoms

Answer 15

1. streptococcus pyogenes - causes 10-20% cases of acute pharyngitis; sudden onset; mostly in 5-10 yo children
2. neisseria gonorrhoeae - often asymptomatic; usually via orogenital contact
   3.corynebacterium diphtheriae - pharyngitis often mild but toxic illness can be severe
3. haemophilus influenzae - epiglottitis
4. borrelia vincentii plus fusiform bacilli - vincents angina commonest in adolscents and adults

Question 16

what are some complications of throat infections

Answer 16

quinsy
scarlet fever
rarely; rheumatic fever, rheumatic heart disease, glomerulonephritis

Question 17

explain acute otitis media

Answer 17

acute signs of illness or signs of symptoms of middle ear infection
moderate to severe bulging of tympanic membrane
new onset of otorrhea
bacterial pathogens; S. pneumoniae, H, influenzae, and Moraxella catarrhalis

Question 18

what are the symptoms of pneumonia

Answer 18

productive cough
fever
SoB
difficulty breathing
nausea and vomiting
tachycardia
chest pain

Question 19

what is the Curb 65 score

Answer 19

used for assessing the severity of pneumonia
score out of 5; confusion, urea>7mmol/rL, RR>30, SBP<90mm Hg or DBP<60mm Hg, age>65

0-1 low risk home treatment
2 admission as close outpatient management
3-5 admission manage as severe

Question 20

what is bronchitis

Answer 20

infection of main airways
more common in teens and adults

Question 21

what is bronchiolitis

Answer 21

infection of smaller airways
more common in<2s

Question 22

how should an MSU sample be taken

Answer 22

into sterile wide mouthed container after careful cleansing of labia or glans with soap (not antiseptic) and water
allow first part of urine stream to be voided as this helps to wash out contaminants in the lower urethra

Question 23

when is a bacteriuria considered significant

Answer 23

when a properly collected MSU specimen is shown to contain over 105 organisms/mL

infected urine usually contains a single predominant bacterial species

contaminated urine usually has <104 organisms/mL and often contains more than one bacterial species

Question 24

what is the most commonly diagnosed bacterial cause of hospital acquired infectious diarrhoea and worldwide

Answer 24

clostridium difficile

noroviruses - nearly 20% of all diarrhoea episodes

Question 25

symptoms of intrabdominal infections/peritonitis

Answer 25

abdominal pain
bloating or a feeling of fullness (distention) in your abdomen
fever
nausea and vomiting
loss of appetite
diarrhoea
low urine output
thirst
inability to pass stool or gas
fatigue

Question 26

what is viral hepatitis

Answer 26

an alphabetical litany of viruses that directly target the liver

Question 27

what can happen to a foetus when the mother gets a congenital infection

Answer 27

intrauterine - death of fetus or congenital malformations

in the case of relatively non cytopathic virus, or when it is partially controlled by maternla IgG response the foetus surivves

Question 28

how is the CNS protected from infection

Answer 28

enclosure in rigid containers (skull and vertebral column)

Question 29

describe the onset of meningitis

Answer 29

incubation period of 1-3 days
sudden onset pf sore throat, headache, drowsiness
signs of meningitis are fever, irritability, neck stiffness, and photophobia
often a haemorrhagic skin rash with petechiae

Question 30

how can CSF/serum show bacterial infection

Answer 30

bacteria breakdown glucose so a low CSF sigar compared with serum glucose indicates a bacterial infection in the CSF