Corrections - Infectious Diseases Flashcards
What basic classification of bacteria is vancomycin generally effective against?
Gram positive bacteria
What are the 3 most common viral causes of gastroenteritis?
1) Norovirus
2) Rotavirus
3) Adenovirus
What is the basic classification of Streptococcus pyogenes?
Gram positive cocci
What are the treatment options for chronic diarrhoea caused by Giardia lamblia? (2)
Tinidazole
Metronidazole
What organism is associated with abdominal cramping and vomiting within 5 hours of ingestion of leftover food that has not been refrigerated?
What is the toxin responsible for these symptoms?
Bacillus cereus
Cereulide
Which tuberculosis treatment can cause colour blindness and reduced visual acuity?
Ethambutol
What basic classification of bacteria is metronidazole generally effective against?
Anaerobic
What does ESBL stand for when referring to bacterial infection? (1)
What have these bacteria become resistant to? (1)
Which IV antibiotics may be used to treat severe infections with this bacteria? (1)
Extended spectrum beta-lactamase bacteria
Beta lactam Abx (e.g. pencillins and cephalosporins)
Carbapenems e.g. meropenem
What is the usual first-line treatment for uncomplicated malaria?
Artemether with lumefantrine (Riamet)
What is the basic classification of Mycoplasma pneumoniae?
Atypical
What is the usual first-line antibiotic in suspected septic arthritis?
IV flucloxacillin
What is the usual first-line antibiotic for acute sinusitis when indicated?
Penicillin V (phenoxymethylpenicillin)
What is the usual treatment regime for active tuberculosis? (4)
Rifampicin for 4 months
Isoniazid for 6 months
Pyrazinamide for 2 months
Ethambutol for 2 months
What is the usual first-line choice of antibiotic for cellulitis near the eyes and nose?
Co-amoxiclav
What type of analysis on nasal swabs is performed in a virology laboratory for influenza?
PCR
Which antibiotics work by inhibiting folic acid metabolism in the bacteria? (2)
Trimethoprim
Sulfamethoxazole
Which antibiotics work by inhibiting bacterial cell wall synthesis and have a beta-lactam ring? (3)
1) Pencillins
2) Carbapenems (e.g. meropenem)
3) Cephalosporins
What bacteria would vancomycin cover that would not be covered by meropenem?
MRSA
Which tuberculosis treatment can cause hyperuricaemia (high uric acid levels), resulting in gout and kidney stones?
Pyrazinamide
What is required to exclude malaria in a patient where malaria is a possible diagnosis?
3 negative malaria blood films taken over 3 consecutive days
What is the most common bacterial cause of tonsillitis?
GAS (Strep. pyogenes)
What term is used for severe and disseminated tuberculosis infection, giving a characteristic appearance on a chest x-ray?
What appearance is seen on a chest x-ray?
Miliary TB
Millet seets uniformly distributed across the lung fields
What test is used to diagnose malaria?
Malaria blood film
What is the alternative to using antibiotics when the symptoms of acute sinusitis are not improving after 10 days?
High dose steroid nasal spray for 14 days (e.g. mometasone 200mcg twice daily)
What are the treatment options for Clostridium difficile infection? (2)
1st: Oral vancomycin
2nd: Oral fidaxomicin
3rd: Oral vancomycin + IV metronidazole
Which antiretroviral therapy (ART) medication may be given to the mother or neonate during or after birth to protect against vertical transmission of HIV, depending on individual circumstances?
Zidovudine
What classification system can be used to grade the severity of cellulitis?
Eron classification
What is the usual first-line antibiotic for suspected bacterial tonsillitis?
What duration?
Penicillin V
10 days
What animal carries and spreads malaria to humans?
Female Anopheles mosquito
What strain of Escherichia coli (E. coli) produces the Shiga toxin? (1)
What complication can this toxin cause in patients with gastroenteritis? (1)
What other cause of gastroenteritis can produce this toxin? (1)
E. coli 0157
HUS
Shigella
What basic classifications of bacteria is co-amoxiclav generally effective against? (3)
Gram positive
Gram negative
Anaerobic
What is the usual primary presenting symptom of malaria?
What characteristic pattern does this symptom follow?
Fever
Fever spikes very high every 48 hours
What complication of Clostridium difficile is characterised by inflammation in the large intestine, with yellow/white plaques on the inner surface of the bowel wall?
Pseudomembranous colitis
What is the basic classification of Clostridium?
Gram positive anaerobes
What is the basic classification of Neisseria gonorrhoea?
Gram negative
What test involves injecting tuberculin into the intradermal space on the forearm and assessing the reaction after 72 hours?
Mantoux test
What are the top differentials of a single acute hot swollen joint? (5)
1) Septic arthritis
2) Gout
3) Pseudogout
4) Reactive arthritis
5) Haemathrosis
What characteristic of the tuberculosis bacteria makes them difficult to stain? (1)
What special stain is used? (1)
What colours are seen with this stain when the tuberculosis bacteria are present? (1)
They are acid-fast (resistant to acids used in stains)
Zeihl-Neelsen stain
The bacteria are bright red against a blue background
What is the typical first-line antibiotic for treating lower urinary tract infections in pregnancy? (1)
What is the usual duration of antibiotics? (1)
Cefalexin
7 days
When would prophylactic co-trimoxazole be given to a patient with HIV? (1)
What does this protect against? (1)
CD4 count <200
PCP
What is the usual choice for post-exposure prophylaxis for those with close, prolonged contact with someone with meningococcal infection? (1)
Single dose of ciprofloxacin
What complications can occur following an episode of gastroenteritis? (5)
1) Lactose intolerance
2) IBS
3) Reactive arthritis
4) Guillain-Barre syndrome
5) HUS
What common classes of medication are associated with Clostridium difficile infection? (2)
1) Broad spectrum Abx
2) PPIs e.g. omeprazole
How do PPIs predispose to C. diff?
Elevated gastric pH (i.e. more alkaline)
What is the typical antibiotic choice for meningitis in children under 3 months? (1)
What about children over 3 months and adults? (1)
<3 months –> cefotaxime + amoxicillin
> 3 months & adults –> ceftriaxone
What cancer screening test is used more frequently in patients with HIV?
How frequently is it performed?
Cervical smears for cervical cancer
Yearly
What is another name for spinal tuberculosis?
Pott’s disease of the spine
What are the two special examination tests to identify meningeal irritation in patients with suspected meningitis?
1) Kernig’s test
2) Brudzinski’s test
What sexually transmitted organism can cause septic arthritis? (1)
What is the usual first-line antibiotic when this is suspected? (1)
Neisseria gonorrhoea
Ceftriaxone
What factors are used to diagnose septic shock? (2)
1) Low mean arterial pressure (<65 mmHg) despite fluid resuscitation
2) Raised serum lactate (>2 mmol/L)
What criteria can be used to assess the severity of organ dysfunction in patients with sepsis?
Sepsis-related organ failure assessment (SOFA) criteria
What are the most common causes of viral meningitis? (3)
HSV
VSV
Enteroviruses e.g. coxsackievirus
What is the usual first-line treatment for severe or complicated malaria? (1)
IV artesunate
What features are included in the FeverPAIN score for estimating the probability that tonsillitis is due to bacterial infection? (5)
Fever in the past 24h
Purulence (pus on tonsils)
Attended within 3 days of onset of symptoms
Inflamed tonsils (severely inflamed)
No cough or coryza
What are the key characteristics that distinguish gram-positive bacteria from gram-negative bacteria? (2)
Gram positive bacteria have a thick peptidoglycan cell wall that stains with crystal violet stain.
What is the usual first-line antibiotic for suspected bacterial otitis media?
Amoxicillin
Which two blood tests are monitored to assess the response to treatment for HIV?
1) CD4 count
2) Viral load
