I.D. Flashcards

1
Q

28 year old woman is admitted via the Accident & Emergency department.
She had not gone to work due to feeling flu-like that morning.

Her boyfriend has brought her in to Accident & Emergency as she has become drowsy and has developed a rash.

She is febrile, hypotensive and confused with marked neck stiffness and purpuric rash

  • diagnosis and bug?
A

meningitis

n. meningitis

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2
Q

72 year old, usually fit and well woman has been sent to the medical admissions unit with fever, headache and neck pain.

On admission she is unwell with fever, tachycardia, neck stiffness and confusion (MSQ 6/10).

LP = white blood cells 1000/mm3 (all neutrophils), red blood cells 3/mm3, and Gram positive cocci are seen

  • bug?
A

Strep. Pneumonia

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3
Q

Ix for C. Diff

A

Stool toxin

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4
Q

Ix for E. Coli

A

Stool Culture

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5
Q

Ix for influenzae

A

Throat swab for viral PCR

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6
Q

Tayside empirical therapy for intra-abdominal sepsis

A

IV Amox + Met + Gent

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7
Q

Tayside empirical therapy for intra-abdominal sepsis - step down therapy

A

PO Co-Trimoxazole and Metronidazole

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8
Q

Tx for Pyelonephritis

A

IV Amox and Gent

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9
Q

Tx for Pyelonephritis - if pen allergic

A

IV Co-Trimoxazole and Gent

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10
Q

Tx for severe CAP

A

Co-Amox and Clarithromycin

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11
Q

cellulitis tx

A

flucloxacillin

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12
Q

cellulitis tx - if pen allergic

A

IV Vancomycin

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13
Q

c.diff tx - non-severe

A

PO Metronidazole

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14
Q

c.diff tx - severe

A

PO Vancomycin

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15
Q

A 26 year old woman presented with dysuria but no frequency. She was prescribed co-amoxiclav but has returned after three days saying her symptoms are no better and she now has vaginal discharge

  • why has treatment failed?
A

The patients symptoms are probably caused by a fungal infection

i.e. thrush

vaginal discharge is not a symptom of UTI

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16
Q

An 86 year old resident of a nursing home has become more confused. A week ago the nurses noticed that her urine was smelly and a urine culture grew Escherichia coli sensitive to Trimethoprim. Her temperature was 37oC, pulse 76bpm, respiratory rate 18 per minute, BP 130/80 mmHg. She has no other symptoms. She was treated with Trimethoprim but after 5 days of treatment her confusion has not improved.

  • why has treatmetn failed?
A

The patients symptoms are probably not caused by infection

bacteria in catheter bag not causing symptoms

17
Q

preventative action required if MRSA found?

A

hand hygiene

18
Q

preventative action required if Norovirus found?

A

isolation of the patients and/or cohort nursing, ward closure

19
Q

preventative action for THR elective operation?

A

antibiotic prophylaxis

20
Q

1st line treatment for MRSA

A

IV Vancomycin

21
Q

1st line treatment for MSSA

A

Flucloxacillin

22
Q

68 year old woman is admitted with sepsis secondary to E.coli urinary tract infection. She has no allergies and has been compliant with her treatment. She has been treated with Trimethoprim by her GP but has not responded.

  • reason for treatment failure
A

Extrinsic resistance

23
Q

A patient is admitted with a non-severe community acquired pneumonia. You treat with Amoxicillin. Serology confirms Mycoplasma pneumoniae and the patient is not improving.

  • reason for treatment failure
A

Intrinsic resistance

Mycoplasma pneumoniae is one of the organisms that cause the atypical pneumonias

24
Q

An 80 year old man required a central venous catheter following admission for a myocardial infarction and shock. Four days later his temperature is documented as 37.8oC and all other signs are normal. His WCC is 6.7 x 103 A blood culture taken through the central line reveals a growth Gram positive cocci in one bottle after 72 hours of incubation. Peripheral blood cultures taken at the same time are sterile.

  • definition?
A

bacteraemia

25
Q

A 91 year old woman with a long standing urinary catheter is admitted with smelly urine, mild confusion and fatigue. Her She has no other signs or symptoms. WCC is normal. Her catheter urine culture, taken by the residential home, has grown E.coli.

  • definition
A

colonisation

26
Q

Ix for TB if no productive cough

A

Bronchoscopy with lavage

27
Q

A 38 year old labourer present to the gastroenterology clinic with 3 months of weight loss, recurrent oral thrush and fatigue. His full blood count reveals lymphopenia

  • likely diagnosis
A

HIV

28
Q

An intravenous drug user has been an inpatient on the liver unit for investigation and management of his chronic liver disease. A phlebotomist is carrying out a venesection and sustains a significant needle stick injury. The phlebotomist has previously been adequately vaccinated against blood borne virus infections. What infection is most likely to be acquired from exposure to this patient? .

A

Hep C