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Sepsis > Concepts in Infection > Flashcards

Concepts in Infection Flashcards

1
Q

4 bugs that don’t gram stain

A

mycobacterium tuberculosis,
chlaymdiia,
treponema pallidum (syphillis),
mycoplasma

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2
Q

Gram positive - what causes it to be purple on gram staining?

A

thick peptidoglycan layer traps it

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3
Q

Gram negative - what causes it to be pink?

A

thin peptidoglycan layer s crystal violet is easily rinsed away leaving behind red dye

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4
Q

What is on outside of gram negative organisms? What is it’s significance?

A

Outer membrane has lipopolysacchardies which are highly charged and contribute to pathogenicity of gram -ves, is an endotoxin

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5
Q

unpasteurised milk associated bugs (4)

A

brucella,
listeria,
Salmonella,
E.coli

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6
Q

Coliforms are gram -ve rods. List 5 coliforms

A 
e.coli, 
klebsiella, 
proteus, 
enterobacter, 
serrate
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7
Q

E.coli can cause what in neonates? (2)

A

HUS,

neonatal meningitis,

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8
Q

ciprofloxacin side effects (4)

A

c.difficile,
lowers seizure threshold so for people,
AA ruptures,
tendonitis

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9
Q

Antibiotics that may be active against gram negatives (6)

A 
beta lactates, 
aminoglycosides, 
macrolides, 
tetracyclines, 
chloramphenicol, 
co-trimoxazole
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10
Q

Atypical pneumonias - why are they called atypical?

A

present atypically to pneumococcus

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11
Q

Mycoplasma peaks every how many years

A

4 years

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12
Q

bronchiectasis associated with what bacterial lung infection

A

pseudomonas

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13
Q

COPD

A

morexella

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14
Q

coxiella associated with what job

A

farmers

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15
Q

psittacosis associated with what

A

parrots,

parakeets

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16
Q

mild to - moderate CAP bugs

A

pneumococcus,

haemophilus influenzae

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17
Q

what type of bug is haemophilus influenzae and what antibiotic

A

gram negative coccobacillus - amoxicillin or doxy

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18
Q

What was associated with haemophilus influenza type b

A

hearing loss,

vaccine changeds

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19
Q

List 4 atypical pneuomonias

A

mycoplasma pneumonia,
acute coxiella brunette,
chlamydophila psittaci,
legionella

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20
Q

Atypical pneumonias respond to what (4)

A

doxycycline, (but not legionella!!),
clarithromycin,
quinolone,
amoxicillin doesn’t work!!

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21
Q

First choice for legionella

A

quinolone e.g. levofloxacin

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22
Q

Legionella associated with what

A

lukewarm water,
showers,
air conditioning,
taps

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23
Q

Legionella is more common in those with what (7)

A 
smokers, 
males, 
COPD, 
immunosuppressed, 
malignancy, 
diabetes, 
dialysis
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24
Q

Gram negatives associated with sepsis (6)

A 
e.coli, 
Klebsiella, 
Enterobacter, 
Pseudomonas aeruginosa, 
Neisseria meningitidis, 
Neisseria gonorrhoea
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25
Q

Gram +ve bacilli to know (4)

A

corynebacterium (diphtheria),
clostridium,
listeria,
bacillus

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26
Q

corynebacterium disease

A

diphtheria - can cause prosthetic infection

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27
Q

clostridium diseases

A

tetanus,
colitis,
perfringens - skin/soft tissue

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28
Q

Bacillus cereus

A

gastroenteritis

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29
Q

listeria diseases

A 
gastroenteritis, 
septicaemia, 
meningitis,
 encephalitis,
 pneumonia, 
neonatal, 
endocarditis
(risks = soft cheeses, unpasteurized milk, meats)
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30
Q

IV antibiotics preferable for sepsis most of the time. When are oral antibiotics good for sepsis?

A

c.diff

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31
Q

Strep in sepsis causes

A

strep pneumonia,
strep viridians,
group A strep,
group B strep neonates

32
Q

beta haemolytic

A

clear zone - complete haemolysis

33
Q

gamma haemolytic

A

nothing - no haemolysis

34
Q

strep pyogenes haemolyiss

A

beta

35
Q

strep pneuomniae haemolysis

A

alpha

36
Q

strep viridians haemolysis

A

alpha

37
Q

strep gallolyticus infections (2)

A

endocarditis,

gi associations

38
Q

strep pneumonia treatment

A

penicillin
but if recent travel
add vancomycin!

39
Q

syphillis treatment

A

penicillin

40
Q

enterococcus

A

e. faecalis most common,

e. faecium

41
Q

enterocossu

A

UTI,

endocarditis

42
Q

enterococcus treatment

A

amoxicillin,
(amoxicillin),
vancomycin if amoxicillin resistant

43
Q

staph aureus in sepsis

A

no longer penicillin sensitive,

fluclox IV or vancomycin IV in allergy or MRSA

44
Q

staph epidermis

A

not as virulent as staph aureus, many fluclox resistant

45
Q

staph aureus causing sepsis tends to come from what two systems

A

endocarditis,

pneumonia,

46
Q

gram +ve bacilli in bloods - what risk factors should we check?

A 
intra-abdo infection, 
skin and soft tissue, 
prosthetic, 
meningitis/encephalitis/immunosuppressed, 
PWID/animal skins (anthrax)
47
Q

Which organism is not a typical organism in the major criteria for diagnosing endocarditis?

A

Escherichia species

48
Q

intra-abdo sepsis bugs (3)

A

coliforms,
enterococci,
anaerobes

49
Q

initial treatment in intra-abdo sepsis

A

IV amoxicillin+ gentamicin + metronidazole

50
Q

step down therapy after sepsis caused by intra-abdominal infection

A

oral cotrimoxazole and metronidazole

51
Q

intra abdo sepsis treatment if penicillin allergy

A

vancomycin + gentamicin + metronidazole

52
Q

cholangitis/cholecystitis common bug

A

enterococcus faecalis

53
Q

diabetic bugs acute & chronic

A

acute: staph aureus,
chronic:
staph aureus,
coliforms,
anaerobes

54
Q

cellulitis bugs

A

staph aureus,

group a strep (pyogenes)

55
Q

bacillus cereus differs in presentation to the other bacterial causes of gastroenteritis how

A

vomiting more than diarrhoea

56
Q

4cs

A

clindamycin,
co-amoxiclav,
ciprofloxacin/quinolones,
cephalosporins

57
Q

treatment for c.difficile

A

oral vancomycin ! normally doesn’t penetrate gut well so don’t do IV

58
Q

risk factors for c.diff (6)

A 
recent hospital stay, 
recent antibiotic use, 
use of pips, 
increasing age, 
recent surgery,
immunosuppression
59
Q

petting zoo (!!) & bbq (not so much), bloody diarrhoea, fever, aki - bug ?

A

E coli

60
Q

complication of giving antibiotics in e coli with AKI

A

HUS

61
Q

spirochetes (2)

A

lyme and syphilis

62
Q

campylobacter presentation

A

usually watery diarrhoea, sometimes bit bloody but bloody normally e.coli!

63
Q

C.diff what 3 tests should you think of

A

stool toxin & culture,
WCC,
creatinine

64
Q

C.diff within how many weeks of risk factors

A

within 12

65
Q

C.diff does alcohol gel do enough

A

No doesn’t kill spores

66
Q

C.diff infection control procedures

A

isolation room,
own commode,
proper hand washing

67
Q

Test for legionella

A

urinary antigen,

sputum PCR

68
Q

Test for coxiella burnetti/chlamydophilia psittaci

A

serology

69
Q

Mycoplasma test

A

PCR on viral swab

70
Q

Presentation suggestive of CAP more than Covid (4)

A

unilateral changes,
neutrophilic,
lack of lymphopenia,
productive cough

71
Q

CAP treatment and step down for strep pneumonia

A

IX vo-amoxiclav and oral doxy,

step down to oral amoxicillin

72
Q

Cellulitis

A

consider tine pedis,
fluclox if mild, doxy if allergic,
sepsis fluclox or vancomycin IV,
septic shock or NEC fluxloc + clindamycin + gentamicin if allergic just clindamycin and gentamicin

73
Q

When should you suspect HAP vs CAP?

A

If in hospital >48 hours

74
Q

Pseudomonas causes (3)

A

Pneumonia in people with bronchiectasis,
UTI,
Otitis externa

75
Q

Brucella associated with

A

Sheep, goats, cattle, unpasteurised milk

Sepsis (8 decks)

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