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ID Flashcards

1
Q

gram positive anaerobes

A

CLAP

clostridium
lactobacillus
actinomyces
propionibacterium

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2
Q

MRSA is trested with

A

doxycycline
clindamycin
vancomycin
teicoplanin
linezolid

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3
Q

what are ESBL

A

extended spectrum beta lactamase bacteria- they have become resistant to beta lactams

usually e coli or klebsiella

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4
Q

difference between gram pos and neg

A

pos= have a peptidoglycan cell wall

neg= no cell wall

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5
Q

gram positive rods

A

corny mikes list of basic cars

cornybacteria
mycobacteria
listeria
bacillus
nocardia

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6
Q

general escalation of hospital abx

A

amoxicillin- covers strep, listeria and enterococcus
co amoxiclav- covers staph, haem and e coli
piptaz- covers pseudomonas
meropenem- covers ESBLs
teicoplanin/vanc- covers MRSA
clarith/doxy- covers atypicals

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7
Q

what is septic shock

A

when blood pressure remains low despite fluid resus

this causes hypoperfusion and anaerobic respiration so lactate rises

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8
Q

how is septic shock diagnosed

A

low MAP despite fluid resus
raised lactate

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9
Q

NEWS2 components

A

blood pressure
heart rate
temp
o2 sats
resp rate
consciousness level

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10
Q

pyelonephritis triad

A

fever
loin pain
nausea/vomitting

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11
Q

urine dip UTI results

A

nirates or leukocytes plus RBC= likely UTI

only leukocytes= send to lab

only nitrates= treat as UTI

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12
Q

what type of bacteria is e coli

A

gram negative anaerobic rod

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13
Q

avoid nitrofurantoin in

A

patients with an eGFR <45
pregnant women near term

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14
Q

abx for pyelonephritis in community

A

cefalexin 7-10 days

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15
Q

what does use of nitrofurantoin in the 3rd trimester cause

A

neonatal haemolysis

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16
Q

what dopes use of trimethoprim in the 1st trimester cause

A

NTDs

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17
Q

in cellulitis what indicates a staph aureus infection

A

a golden yellow crust

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18
Q

common bacteria associated with cellulitis

A

staph aureus
group A strep
group C strep

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19
Q

abx for cellulitis near eyes or nose

A

co amoxiclav

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20
Q

bacterial tonsillitis common bacteria

A

group A strep (strep pyogenes)

if not then usually strep pnuemoniae

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21
Q

what centor score warrants use of abx

A

3 or more

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22
Q

centor score components

A

fever over 38 degrees
tender cervical lymphadenopathy
tonsillar exudates
absence of cough

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23
Q

first line abx tonsillitis

A

penicillin V for 10 days
clarithromycin if allergic to penicillin

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24
Q

complications of tonsillitis

A

quinsy
otitis media
scarlet fever
rheumatic fever
post strep glomerulonephritis

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25
Q

otitis media abx

A

amoxicillin 5-7 days 1st line
clarithromycin if allergic
erythromycin if pregnant and allergic

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26
Q

sinusitis mx

A

10 days conservative mx
high dose steroid nasal spray 14 days
back up abx if not improving

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27
Q

chronic sinusitis mx

A

saline nasal irrigation
steroid nasal spray

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28
Q

septic arthritis most common organism

A

staph aureus
nisseria gonorrhoea if young

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29
Q

pseudogout crystals are made of

A

calcium pyrophosphate

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30
Q

septic arthritis abx

A

empirical IV abx for 4-6 weeks

fluclox usually 1st line

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31
Q

what type of virus is influenza

A

RNA

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32
Q

medications for flu

A

olsetamivir
zanamivir

33
Q

what medication increases risk of HUS

A

antibiotics- avoid use if e coli gastroenteritis is suspected

34
Q

gastroentertitis stay off work/school rules

A

till 48 hrs after sx resolve

35
Q

abx that cause c diff

A

clindamycin
cipro
cephalosporins
carbapenams

36
Q

c diff recurrence rate

A

high

37
Q

complications of c diff

A

toxic megacolon
pseudomembranous colitis
bowel perforation
sepsis

38
Q

what type of bacteria is nisseria meningitis

A

gram negative diplococcus

39
Q

most common cause of viral meningitis

A

enterovirus

40
Q

how to test for kernigs sign

A

flex the hip and knee to 90 degrees
while keeping the hip flexed straighten the knee
pain or resistance to movement indicates meningitis

41
Q

how to test for brudzinskis sign

A

lift head and neck off bed when patient is lying flat

involuntary flexion of hip and knees is positive

42
Q

CSF protein in bacterial meningitis

A

high

43
Q

CSF protein in viral meningitis

A

slightly raised or normal

44
Q

high neutrophils in CSF indicates

A

bacterial cause

45
Q

high lymphocytes in CSF indicates

A

viral cause

46
Q

benzylpenicillin dosing in meningitis

A

under 1 yr- 300mg
1-9yrs- 600mg
over 10yrs- 1200mg

47
Q

what test should be done if meningococcus is suspected in meningitis

A

meningococal PCR

48
Q

what tests can be done when examining a patient with suspected meningitis

A

brudzinski
kernigs

49
Q

meningitis abx

A

under 3 months- cefotaxime plus amoxicillin

over 3 months- ceftriaxone

50
Q

what can reduce neurological complications and hearing loss in meningitis

A

steroids

51
Q

post exposure prophylaxis for meningitis contacts

A

single dose cipro

52
Q

complications of meningitis

A

hearing loss
seizures/epilpesy
cognitive impairment
focal neurological deficit eg limb weakness/spasticity

53
Q

TB stain and result

A

zeihl neelsen
turns bright red on a blue background

54
Q

are people with latent tuberculosis infectious

A

no

55
Q

what is potts disease

A

spinal tuberculosis

56
Q

tests for immune response to TB

A

mantoux test
IGRA (interferon gamma release assay)

57
Q

mantoux test method and result

A

tuberculin is injected
after 72hrs the induration is measured
>5mm= positive

58
Q

IGRA method and result

A

pt blood is mixed with TB antigens
release of interferon gamma is positive- leukocytes that have been sensitised will release it

59
Q

miliary TB on CXR

A

millet seed appearance- small nodules disseminated through the lung field

60
Q

latent TB mx

A

isoniazid 6 months
rifampicin and isoniazid for 3 months

61
Q

what should be prescribed with isoniazid

A

pyroxidine/vitamin b6
this reduces peripheral neuropathy

62
Q

what ventilation is used in rooms where patients are isolated with infectious disease that are aiborne

A

negative pressure

63
Q

what enzyme does rifampicin affect and how

A

induces cytochrome p450

this enzyme metabolises medications like COCP so these become less effective

64
Q

pyrazinamide side effects

A

gout
kidney stones

65
Q

what cells does HIV destroy

A

CD4 T helper cells

66
Q

AIDS defining illnesses

A

kaposi sarcoma
PCP
cytomegalovirus
candidiasis
lymphoma
TB

67
Q

HIV blood test consent rules

A

in emergency departments there is assumed consent unless patients choose to opt out

68
Q

lab test for HIV tests for

A

HIV antibodies
p24 antigen

69
Q

lab test for HIV has a reliable result after how many days

A

45

70
Q

what CD4 count in HIV is high risk

A

<200 cells/mm3

71
Q

what is given to high risk HIV pts

A

prophylactic co trimox for PCP

72
Q

cervical smear frequency in HIV pts

A

yearly

73
Q

delivery plan for HIV pts

A

viral load <50= normal vaginal possible

viral load >400= c section recommended

50-400= consider c section

IV zidovudine during labour and delivery and to babies

74
Q

PEP drugs and duration

A

truvada and raltegravir for 28 days

75
Q

PrEP drugs

A

truvada

76
Q

most common malaria type

A

plasmodium falciparum

77
Q

most severe malaria type

A

plasmodium falciparum

78
Q

what is tertian fever

A

fever every 48 hrs

associated w p vivax and o ovale

79
Q
A

Zero to finals (11 decks)

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