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4th Year Infectious Diseases > Core ID Conditions > Flashcards

Core ID Conditions Flashcards

1
Q

Strep pneumoniae is the the cause of meningitis in which age group?

A

> 21

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2
Q

Neisseria meningitidis is the the cause of meningitis in which age group?

A

10-21

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3
Q

Listeria is the the cause of meningitis in which age group?

A

(>60 years or immunocompromised or neonates (including alcohol dependency and diabetes)

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4
Q

Viral meningitis is most commonly caused by what?

A

Enterovirus

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5
Q

> 2000 white cells, glucose in the CSF being low compared to the blood & increased neutrophils indicates which type of meningitis?

A

Bacterial

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6
Q

primarily polymorphonuclear leukocytes (polymorphs) are found in what kind of meningitis?

A

Bacterial

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7
Q

Low WBC, minimally elevated protein and normal glucose would indicate which type of meningitis?

A

Aseptic (viral)

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8
Q

What antibiotic needs to be added to the standard treatment of meningitis (ceftriaxone + dexamethasone) when listeria cover is required?

A

Amoxicillin IV

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9
Q

What should replace ceftriaxone in the case of penicillin allergy when treating meningitis?

A

Chloramphemicol

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10
Q

Should you continue the dexamethasone if you discover the meningitis has a viral cause?

A

No - just give supportive treatment

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11
Q

What virus is the most common cause of encephalitis?

A

Herpes simplex

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12
Q

What is the most common causative organism in epiglottitis?

A

Haemophilus influenzae

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13
Q

What is the most common bacterial causative organism in tonsillitis & pharyngitis?

A

Group A beta haemolytic streptococci (mostly strep pyogenes)

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14
Q

What is the most common bacterial causative organism in sinusitis?

A

Pneumococcus

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15
Q

The treatment if a tonsillitis patient is scoring 0-1 on the centor criteria should be what?

A

No antibiotic

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16
Q

The treatment if a tonsillitis patient is scoring 2-3 on the centor criteria should be what?

A

Should receive an antibiotic (penicillin) if symptoms progress

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17
Q

The treatment if a tonsillitis patient is scoring 4-5 on the centor criteria should be what?

A

Treat empirically with an antibiotic

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18
Q

What number on the FeverPAIN score would make you consider immediate antibiotics for tonsillitis?

A

≥4

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19
Q

What would make you consider giving antibiotics in acute otitis media?

A
  • <2 years and bilateral
  • Bulging membrane and marked multiple
    symptoms
  • Otorrhoea
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20
Q

When cellulitis is from a dental / mandibular / sinus source what antibiotic should be used instead of flucloxacillin?

A

Co-amoxiclav

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21
Q

What are the 5 components of the centor criteria?

A

1 point for each:

  • History of fever
  • Tonsillar exudates
  • Tender anterior cervical adenopathy
  • Absence of cough

Age <15 add 1 point
Age >44 subtract 1 point

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22
Q

What are the 5 components of CURB65

A 
C = confusion
U = urea (>7 mmol/L)
R = RR (>30/min)
B = Blood pressure (Systolic <90 or diastolic <60)
65 = >65 years
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23
Q

What CURB65 score is considered mild CAP?

A

0-1

24
Q

What CURB65 score is considered moderate CAP?

A

2-3

25
Q

What CURB65 score is considered severe CAP?

A

4-5

26
Q

What is the most common cause of pneumonia?

A

Streptococcus pneumoniae - 80% of cases

27
Q

What organism commonly causes pneumonia in COPD patients?

A

Haemophilus influenzae

28
Q

What organism commonly causes pneumonia following an influenza infection?

A

Staphlococcus aureus

29
Q

What organism commonly causes pneumonia that presents with a dry cough and atypical CXR findings +/- autoimmune haemolytic anaemia and erythema multiforme?

A

Mycoplasma pneumoniae

30
Q

What organism commonly causes atypical pneumonia that often presents with hyponatraemia and lymphopenia

A

Legionella pneumophilia

31
Q

What organism commonly causes pneumonia in alcoholics that classically presents with bloody or yellow sputum

A

Klebsiella pneumoniae

32
Q

What organism typically causes pneumonia in patients with HIV

A

Pneumocystis jiroveci

33
Q

Which are the 2 most like organisms to cause mild/moderate CAP?

A

Streptococcus pneumoniae / haemophilus influenzae

34
Q

What organism is most likely to cause acute native valve endocarditis?

A

Staph aureus

35
Q

What organisms are most likely to cause subacute native valve endocarditis?

A

Viridans streptococci or enterococci

36
Q

What organisms are most likely to cause prosthetic valve or MRSA endocarditis

A

Coagulase negative staphylococci

37
Q

How many blood culture sets should be taken in chronic/subacute endocarditis?

A

3

38
Q

What are the severity markers for c.diff?

A

One or more of:

  • Temperature >38.5
  • Ileus, colonic dilatation or toxic megacolon
  • WBC >15 cells x 10 to the power of 9 /L
  • Rising serum creatinine >1.5 x baseline
  • Remaining c.diff after 2 courses of therapy
39
Q

Who needs to be contacted about suspected cases of r E coli O157?

A

Health Protection & Infection Control

40
Q

How many days does it take on average to develop HUS caused by E coli O157?

A

6-8 days

41
Q

What is the key symptom indicating HUS caused by E coli O157?

A

Bloody diarrhoea

42
Q

What will the blood cells look like on the blood film in HUS?

A

Fragmented

43
Q

When should blood and urine cultures be sent in UTI?

A

Complicated infection, or male

44
Q

Should you ever send a urine sample from a catheter?

A

Only if you consider the catheter to be the source of infection

45
Q

Why is ceftriaxone used for meningitis when pneumococci & meningococci are sensitive to penicillin?

A

Ceftriaxone is chosen because of the need for high CSF levels to be maintained & the ease of dosing (twice a day).
It also provides better cover for the rare strain that may have borderline sensitivity to penicillin

46
Q

What age does Scottish guidance recommend testing for c.diff?

A

≥3 years

47
Q

What are the major risk factors for contracting c.diff?

A
  • Current or recent (within 3 months) use of antibiotics
  • Increased age
  • PPIs
  • Prolonged hospital stay
  • Serious underlying condition
  • Surgical procedures (especially bowel procedures)
  • Immunosurpression
48
Q

Is severe c.diff always associated with diarrhoea?

A

No

49
Q

What symptoms apart from diarrhoea can be present in c.diff infection?

A
  • Abdo cramps
  • Fever
  • Frequent stool
  • Raised WBC count
  • Rarely pseudomembranous colitis, toxic megacolon and peritonitis
50
Q

What transmission based precautions should be taken for c.diff patients?

A

Standard infection control + contact precautions:

  • Hand washing with soap and water
  • Gloves and aprons
  • Patient isolated to a single room with en suite toilet
  • Treat linen as infected
  • Decontaminate room daily and clean immediate environment twice a day
51
Q

What is the definition of diarrhoea?

A

The passage of three or more loose or liquid stool per day, or more frequently than normal for the individual

52
Q

How is c.diff spread

A

Spores via the faecal oral route

53
Q

When is treatment initiated in c.diff?

A

As soon as it is suspected without waiting for lab confirmation

54
Q

When are c.diff patients considered to be clear of infection

A

When they are 48hrs symptom free

55
Q

Clearance samples are required to be sent to the lab in c.diff infection. True or false?

A

False

56
Q

What is severe sepsis?

A

Sepsis (SIRS + presumed/confirmed infection)
+
at least one acute organ dysfunction

57
Q

What is septic shock?

A

Severe sepsis with hypotension refractory to adequate volume resuscitation

4th Year Infectious Diseases (4 decks)

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