Formative !!!

Question 1

Usual source of Strep viridans

Answer 1

Gastrointestinal tract

Question 1

Criteria for infective endocarditis

Answer 1

Duke criteria

Question 2

Typical organisms infective endocarditis

Answer 2

• HACEK group organisms
• Staphylococcus aureus
• Enterococcus faecalis
• Strep viridans

Question 3

Test to diagnose C. difficile infection

Answer 3

Stool toxin test

Question 4

Post-surgical sepsis + 10 (type 7) bowel motions per hour

Answer 4

C. difficile infection

Question 5

Petting zoo, bloody diarrhoea, fever

Answer 5

E. coli

Question 6

E. coli - antibiotics?

Answer 6

Avoid antibiotics

Don’t help the infection + increase risk of HUS
(they lyse bacteria leading to release of their toxin)

Question 7

E. coli gram stain

Answer 7

Gram-negative rods/bacilli

Question 8

Reheated rice causative organism

+ gram stain

Answer 8

Bacillus cereus

Gram-positive rods

Question 9

Bacillus cereus treatment

Answer 9

Supportive management only

Question 10

Antibiotic with no activity against anaerobes

Answer 10

Gentamicin

Question 11

Antibiotic gram-positives only

Answer 11

Vancomycin

Question 12

Antibiotic gram-negatives only

Answer 12

Gentamicin

Question 13

4 Cs antibiotics

Answer 13

Co-amoxiclav
Cephalosporins
Fluoroquinolones (e.g. ciprofloxacin)
Clindamycin

Question 14

Examples of fluoroquinolones

Answer 14

Ciprofloxacin
Levofloxacin
Moxifloxacin

Question 15

PWID causative organism

Answer 15

Staph aureus

Question 16

Blood cultures before/after antibiotics

Answer 16

3 sets of blood cultures over 1hr then antibiotics

(Antibiotics would skew blood culture results)

Question 17

Gram-positive (purple) clusters =

Answer 17

Staphylococcus

Question 18

Staph - best antibiotic in bloodstream infection?

Answer 18

IV flucloxacillin

Question 19

Staph - best antibiotic in bloodstream infection + penicillin allergy

Answer 19

IV vancomycin

Question 20

Staph infection - how long on antibiotics?

Answer 20

6 weeks

Question 21

Sepsis screening tools

Answer 21

SIRS, SOFA, Q-SOFA, SEWS, NEWS, NICE

Question 22

Over which time period should Sepsis 6 be delivered?

Answer 22

1 hour

Question 23

How much saline given to sepsis patients?

Answer 23

500ml bolus

Question 24

Most likely pathogens for sepsis caused by a diverticular abscess

Answer 24

Coliforms and anaerobes

Question 25

Treatment for sepsis caused by a diverticular abscess

Answer 25

Amoxicillin, gentamicin and metronidazole (all IV)

Then source control

Then switch to co-trimoxazole + metronidazole

Question 26

Sepsis caused by a diverticular abscess

What does source control refer to?

Answer 26

Surgical drainage of abscess

Question 27

Best oral antibiotic to switch to following source control in sepsis caused by a diverticular abscess?

Answer 27

Co-trimoxazole and metronidazole

Question 28

MRSA blood stream infection - treatment?

Answer 28

Intravenous vancomycin

Question 29

MSSA blood stream infection - treatment?

Answer 29

Intravenous flucloxacillin

Question 30

Treatment for ESBL (extended spectrum beta lactamase) producing coliform in blood

Answer 30

Intravenous meropenem

Question 31

Staph aureus - coagulase positive or negative ?

Answer 31

Coagulase positive

Question 32

Septic shock definition

Answer 32

Sepsis + drop in blood pressure

(leads to tissue hypoperfusion characteristic of shock)