CP3-7, 9 & 10 pathogen-infection-antibiotic matching

Question 1

What test can be used to differentiate staphylococcus from streptococcus bacteria?

Answer 1

Catalase test

Question 2

What are the four mechanisms of drug resistance?

Answer 2

1) drug inactivation or modification
2) alteration of target or binding site
3) alteration of metabolic pathway
4) reduced drug accumulation

Question 3

What are two common bacterias that cause drug resistance by drug inactivation or modification? Which enzyme does this?

Answer 3

Staph aureus = penicillinase
E. Coli = carbapenemase

Question 4

What common bacteria causes drug resistance by alteration of target or binding site? What protein is targeted?

Answer 4

Staph aureus = alters Pencicillinbinding protein

Question 5

What bacteria can cause drug resistance by alteration of metabolic pathway? How?

Answer 5

Sulfa resistant bacteria by using pre-formed folic acid

Question 6

What drug group is affected by reduced drug accumulation drug resistance? Where does it accumulate?

Answer 6

Quinolones - accumulates at the efflux pumps

Question 7

What is co-amoxiclav a combination of?

Answer 7

Amoxicillin and clavulanic acid

Question 8

What bacterial product causes amoxicillin to be degraded?

Answer 8

Beta lactamase

Question 9

How does clavulanic acid reduce amoxicillin resistance?

Answer 9

By inhibiting beta lactamase preventing amoxicillin degradation.

Question 10

What is tazocin a combination of?

Answer 10

Piperacillin and tazobactam

Question 11

What bacteria is co-amoxiclav useful against?

Answer 11

Beta lactamase producing bacteria

Question 12

What infections is amoxicillin used to treat?

Answer 12

ENT, respiratory and urinary infections

Question 13

What antibiotics do beta lactams affect?

Answer 13

Penicillins
Cephalosporins
Carbapenems

Question 14

What initial broad spectrum treatment is started for high risk pneumonia infection?

Answer 14

IV Co-amoxiclav and oral clarithromycin

Question 15

What treatment is started for high risk pneumonia in patients with a penicillin allergy?

Answer 15

Levofloxacin orally

Question 16

What treatment is started for medium risk pneumonia?

Answer 16

Amoxicillin and clarithromycin both orally

Question 17

What treatment is started for medium risk pneumonia in patients with a penicillin allergy?

Answer 17

Doxycycline or levofloxacin PO

Question 18

What is the initial broad spectrum treatment started for low risk pneumonia?

Answer 18

Amoxicillin orally

Question 19

What treatment is given for low risk pneumonia in patients with a penicillin allergy?

Answer 19

Doxycycline or clarithromycin orally.

Question 20

What is the most common bacteria causing pneumonia?

Answer 20

Streptococcus pneumoniae

Question 21

What broad spectrum antibiotic is used to treat strep pneumonia?

Answer 21

Penicillin

Question 22

What bacterial infection can present with abdo pain and green, watery diarrhoea?

Answer 22

C. Difficile

Question 23

What is used to treat c. Difficile infection?

Answer 23

Oral vancomycin

Question 24

What is a negative consequence of taking broad spectrum antibiotics?

Answer 24

Destroys gut bacteria allowing some to overgrown

Question 25

What is caused by toxin release of C. Difficile?

Answer 25

Colitis

Question 26

What are common antibiotics that can lead to c.difficile infection?

Answer 26

Ciprofloxacin Cefuroxime Co-amoxiclav

Question 27

What are the symptoms of an upper UTI?

Answer 27

Lower UTI symptoms like dysuria and frequency of urination. Fever Shivers and chills Nausea and vomiting Confusion Agitation and restlessness Pain in sides and/or back

Question 28

What are the symptoms of a lower UTI?

Answer 28

Increased frequency and urgency of urination Dysuria Lower abdominal pain Feeling as if bladder doesn’t empty fully Cloudy, smelly urine +/- haematuria

Question 29

What is the most common bacterial cause of UTIs?

Answer 29

E. Coli

Question 30

What are common bacterial causes of UTIs (other than E. coli)?

Answer 30

Other gut bacteria e.g. proteus and klebsiella species Staphylococcus saprophyticus

Question 31

What is the main cause of meningitis in children and young adults?

Answer 31

Neisseria meningitides

Question 32

What is the main cause of meningitis in elderly patients?

Answer 32

Streptococcus pneumoniae

Question 33

What is the initial broad spectrum treatment of meningitis?

Answer 33

IV ceftriaxone

Question 34

When does meningitis become meningococcal septicaemia?

Answer 34

Meningitis is infection in CNS only whereas meningococcal septicaemia is when the blood stream is infected.

Question 35

What is sepsis?

Answer 35

Life threatening organ dysfunction caused by a dysregulated host response to infection leading to injury of the body’s own tissues and organs

Question 36

What SOFA score shows organ dysfunction?

Answer 36

2 or more

Question 37

What mneumonic represent how to treat sepsis?

Answer 37

BUFALO

Question 38

What does the mneumonic BUFALO stand for?

Answer 38

Blood cultures (2 sets) Urine output (catheterise to measure) Fluids (500ml IV saline over 15 mins) Appropriate antibiotics Lactate (check via arterial blood gas) Oxygen (15l/min via reservoir face mask)

Question 39

What bacteria causes cellulitis?

Answer 39

Gram positive cocci like staph aureus and strep pyogenes

Question 40

What antibiotic is used to treat cellulitis caused by gram positive cocci?

Answer 40

Flucloxacillin

Question 41

What is necrotising fasciitis?

Answer 41

A severe skin and soft tissue infection caused by a polymicrobial mix.

Question 42

What bacteria is usually involve in necrotising fasciitis?

Answer 42

Streptococcus pyogenes

Question 43

How is necrotising fasciitis treated?

Answer 43

Debridement of damaged and surrounding tissues Meropenem and clindamycin

Question 44

What are the most common bacteria which cause infective endocarditis?

Answer 44

Staph aureus Streptococci

Question 45

What is the treatment for infective endocarditis?

Answer 45

Around 6 weeks of IV antibiotics (antibiotic is dependent on the bacteria)

Question 46

What antibiotics are well tolerated and safe in pregnancy?

Answer 46

Beta lactams I.e. the penicillins and cephalosporins

Question 47

What antibiotics should be avoided in pregnancy and why?

Answer 47

Quinolones (e.g. ciprofloxacin) - damage cartilage Trimethoprim - folic acid antagonist Tetracyclins - deposits and stains bones and teeth

Question 48

What are common antibiotic combinations used as broad spectrum antibiotics?

Answer 48

Amoxicillin-clavulanic acid Piperacillin-tazobactam Meropenem/ertapenem Cefuroxime and metronidazole Teicoplanin1, Ciprofloxacin and metronidazole Amoxicillin, Ciprofloxacin and metronidazole Amoxicillin, gentamicin and metronidazole

Question 49

What antibiotics are commonly used for gram positive bacteria?

Answer 49

teicoplanin Vancomycin Flucloxacillin Linezolid Macrolides e.g. clarithromycin Penicillin/amoxicillin (mainly for streptococcus)

Question 50

What are antibiotics are commonly used for gram negative bacteria?

Answer 50

Aztreonam (a monobactam) Ciprofloxacin (a fluoroquinolone) Gentamicin (an aminoglycoside)

Question 51

What antibiotics are commonly used to treat E. coli cystitis?

Answer 51

Nitrofurantoin Trimethoprim (a sulfonamide) Fosfomycin Pivmecillinam (a penicillin) Cephalexin (a cephalosporin)