formative Flashcards
new prosthetic mitral valve, gram positive chains with alpha haemolysis - most likely organism?
streptococcus viridans
infective endocaditis
scoring for infective endocarditis
Duke criteria
source of strep viridans
GI tract
typical organisms that cause infective endocarditis
staph aureus
enterococcus faecalis
viridans strep
HACEK group organisms
2 separate positive blood cultures in the absence of alternative source
investigations for infective endocarditis
blood cultures required before antibiotics
3 sets of blood cultures spread over 1 hr then start antibiotics
what does enterococcus faecalis look like on gram stain?
clusters of bright pink
(gram positive)
72y/o, 2wk post total hip replacement, on PPI, co-amoxiclav prophylaxis for their surgery. hypotensive, fast pulse, confused, SKI
most likely pathogen? best test to diagnose?
clostridium difficile
ix = stool toxin test
increased risk of C.diff
antibiotics within preceding 3 months
PPIs
prolong hospitalisation
immunosuppression
*obesity does not increase risk
2 day after visiting a petting zoo followed by a BBQ, fever + bloody diarrhoea
most likely pathogen? investigation?
Ecoli
- gram neg rod/bacillus
stool cultures
complication of E.coli and how can it be avoided?
haemolytics uraemic syndrome
AVOID antibiotics
disproportionate pain in skin wound? Mx?
necrotising fasciitis
Mx = urgent surgical debridement
Abx with anti-toxin effect = linezolid, clindamycin
vancomycin active against gram neg or pos?
gram pos ONLY
is gentamicin active against anaerobes?
NO, active against gram neg organisms ONLY
4C antibiotics
clindamycin
ciprofloxacin/levofloxacin ->quinolones
cephalosporins - ceftriaxone
coamoxiclav
drugs safe + not safe in penicillin allergy?
safe = azetronam
NOT
- piperacillin tazobactam
- ceftriaxone
- co-amoxiclav
- cefuroxime
