determining the site of infection

Question 1

RUQ pain

Answer 1

• cholecystitis
• ascending cholangitis
• pyelonephritis
• ureteric colic
• hepatitis
• pneumonia

Question 2

LUQ pain

Answer 2

• gastric ulcer
• pyelonephritis
• ureteric colic
• pneumonia

Question 3

RLQ pain

Answer 3

• appendicits
• ureteric colic
• inguinal hernia
• UTI
• gynaecological
• testicular torsion
• IBD

Question 4

LLQ pain

Answer 4

• diverticulitis
• ureteric colic
• inguinal hernia
• IBD
• UTI
• gynaecological
• testicular torsion

Question 5

epigastric pain

Answer 5

• peptic ulcer disease
• cholescytitis
• pancreatitis
• myocardial infarction

Question 6

peri-umbilical pain

Answer 6

• appendicitis
• small and large bowel obstruction
• abdominal aortic aneurysm

Question 7

normal flora of mouth

Answer 7

strep viridans, neisseria species, anaerobes, candida, staphylococci

Question 8

normal flora of stomach duodenum

Answer 8

usually sterile small amount of candida and staphylococci

Question 9

PPIS

Answer 9

increase risk of infection because they alter the normal pH of the stomach

Question 10

normal flora of the jejunum

Answer 10

small amounts of coliforms and anaerobes

Question 11

normal flora of the colon

Answer 11

large amount of coliforms, anaerobes and enterococcus faecalis

Question 12

normal flora of the bile ducts

Answer 12

sterile

Question 13

what are coliforms

Answer 13

gram negative large bacilli which is aerobic (E.coli, klebsieela, proteus, enterobacter, seratia)

Question 14

sepsis caused by coliforms

Answer 14

gentamicin is the drug of choice to cover coliforms (aztreonam can be used if gentamicin is contra-indicated i.e. in severe renal failure where EGFR is less than 20), co-trimoxazole is given orally as the step down

Question 15

strict anaerobes will

Answer 15

not grow in oxygen

Question 16

what organisms are strict anaerobes

Answer 16

clostridium and bactericides

Question 17

drug of choice for covering anaerobes

Answer 17

metronidazole

Question 18

e.coli is

Answer 18

a gram negative aerobic bacilli which is lactose fermenting

Question 19

pseudomonas aerguinosa is a

Answer 19

gram negative strict aerobic bacilli which is not lactose fermenting

Question 20

drug of choice for covering enterococcus

Answer 20

amoxicillin, switch to co-trimoxazole when stepping down

Question 21

opportunistic pathogens

Answer 21

are pathogens that cause infections in vulnerable hosts

Question 22

example of an opportunistic pathogen

Answer 22

Pneumocystis jirovecci which causes pneumonia in people with HIV