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MS3 - Microbiology > Immune suppression infections > Flashcards

Immune suppression infections Flashcards

1
Q

Hospital acquired infection def?

A

Infections that are neither present nor incubating when a patient enters hospital, but develop during hospital admission or are incubating when a patient leaves hospital

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2
Q

Transmission of hospital acquired infection?

A

I. Hands and contaminated equipment

II. Faecal/oral spread

III. Airborne/Droplet

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3
Q

Hospital acquired hands and contaminated equipment pathogens ?

A

MRSA

Group A Streptococcus (GAS)

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4
Q

Hospital acquired Faecal/oral spread and contaminated environment

A 
Viral Gastroenteritis (VG) 
C. difficile
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5
Q

Hospital acquired Airborne/Droplet pathogens?

A

Viral gastroenteritis
Varicella zoster and
GAS

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6
Q

Most common sites for Hospital acquired infections?

A

Urinary tract 23% (catheters)
Lower respiratory 23 (ventilators, post op NG feeding)
Blood stream 5%

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7
Q

Trachoma pathogen?

A

Chlamydia serovars A-C

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8
Q

Trachoma complication?

A

preventable blindness

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9
Q

Trachoma transmission

A

hand to eye

flies

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10
Q

Trachoma mx?

A
  • Systemic Erythromycin or Doxycycline
  • Trials of Azithromycin
  • Eyelid surgery
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11
Q

Timing for post HIV exposure prophylaxis?

A

ASAP after exposure, preferably within 24 hours, but can be considered up to 72 hours

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12
Q

Prophylaxis of HIV meds?

A

28 days Truvada and raltegravir

Hep B vaccine if clinically indicated

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13
Q

Ix for post exposure to HIV?

A

STI testing, repeat at 2 weeks

HIV testing at 8-12 weeks

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14
Q

Hep B prophylaxis post exposure?

A

I. Vaccine

II. HBIG (hep B immunoglobulin) if high risk or vaccine non-responder

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15
Q

Timing of Hep B prophylaxis

A

48 hours – up to 1 week

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16
Q

Hep C prophylaxis?

A

No effective post exposure prophylaxis

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17
Q

Polysaccharide vaccine made off?

A

are made of extracted and purified forms of the bacterial outer polysaccharide coat.

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18
Q

Polysaccharide vaccine limitations?

A
  • They do not stimulate the immune system as broadly

- Protection is not long-lasting and response in infants and young children is poor.

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19
Q

Conjugate vaccine made off?

A

Attachment of a carrier protein to a polysaccharide antigen

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20
Q

Advantage of conjugate vaccine?

A

Conjugate vaccines generate a better immune response and are effective even in young children.

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21
Q

Pneumococcal conjugate vaccine (PCV) vaccination program?

A
  • children <2 yo

- 13 capsular types of pneumococcal bacteria.

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22
Q

Pneumococcal polysaccharide (PPV) vaccination program?

A
  • All adults who are over 65 years of age.

- protection against 23 types of pneumococcal bacteria

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23
Q

HIV transmission

A

sexual contact, needlestick

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24
Q

biggest reduction in risk of transmission

A

Biggest reduction due to circumsision (if sex not safe)

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25
Clinical stages of HIV
Stage I: Acute seroconversion Stage II: Asymptomatic and PGL (progressive glandular lymphadenopathy) Stage III: Symptomatic infection (ARC although should be Stage IVC2) Stage IV: AIDS
26
Monitoring for HIV
T cells: - >500 normal - 200 to 500 asymptomatic HIV, but may start highly active retroviral therapy - <200 AIDS - <50 High risk of death in next 12 months
27
Which T cells does HIV affect?
CD4
28
Complications of HIV
opportunistic infection
29
Innate immunity
NO MEMORY - mucosal barriers - bone marrow derived phagocytes - alternative complement pathway - acute phase response - cytokines / chemokines - interferons
30
Adaptive immunity
SPECIFICITY + MEMORY - Lymphocyte mediated - T + B cell - Specific receptors for Ag - Delay in primary response - Memory gives more effective subsequent response
31
Th1 cells products?
- produce IFNγ, IL-2, IL-12
32
Th1 cells role
- Involved in cell mediated immunity | - macrophage activation
33
Th2 cells products
- produce IL-4, IL-13
34
Th2 cells role
- Involved in humoral immunity (Ab production)
35
AIDS criteria
The infections that occur with any T Cell deficiency
36
Fungal infection within AIDS criteria?
Oesophageal candidiasis
37
Protozoal infection within AIDS
Toxoplasmosis Cryptosporidiosis, chronic Pneumocystis cariini pneumonia
38
Bacterial infection within AIDS criteria?
Mycobacterium tuberculosis, any site Atypical mycobacteria Salmonella Recurrent bacterial pneumonia
39
Viral infection within AIDS criteria?
CMV retinitis | Other site CMV disease
40
Malignancy within AIDS criteria
Kaposi’s sarcoma | Lymphoma’s (NHL)
41
Overview of AIDS criteria?
Infection Malignancy Other sx
42
Other sx of AIDS?
HIV dementia | HIV wasting syndrome
43
HIV wasting syndrome
- 10% WT LOSS | - and has at least 30 days of either diarrhea or weakness and fever
44
Hairy leukoplakia
White plaques on lateral aspect of tongue EBV driven AIDS defining disease
45
Antiviral therapies
1. Antiviral Nucleosides - Act as competitive inhibitors and DNA chain terminators 2. inhibition of viral DNA polymerase - eg Aciclovir: 3. Neuraminidase Inhibitors
46
How is Aciclovir selective
activated only by the virus
47
Mech of action of Aciclovir
Competitive inhibitor of viral DNA polymerase, | Leading to viral DNA chain termination
48
Aciclovir used against
Effective against HSV types 1 & 2, and VZV infections
49
Dose and duration of Aciclovir
requires to be given 5x daily for 5-7 days. | Treatment needs to start within 24-72 hours
50
Neuraminidase inhibitors examples
- eg Oseltamivir (Tamiflu) and Zanamivir (Relenza)
51
Relenza (Zanamivir) use
- Treatment and prevention of influenza A (inc avian) and B
52
Relenza (Zanamivir) delivery
Delivery as an aerosol of powder from blister pack inhaled
53
Tamiflu (Oseltamivir) method of delivery
Oral formulation
54
Tamiflu (Oseltamivir) used for
for the treatment of influenza A and B (and prevention- o.d. regimen)
55
Tamiflu (Oseltamivir) dose and duration
(75 mg capsule) b.d for 5 days and oral suspension
56
Neuraminidase inhibitors mech of action
- Removes sialic acid from cell surface and new viruses, preventing virus slip through mucous reaching the respiratory cell epithelium
57
Neuraminidase inhibitors when to be taken
- Needs to be taken within 48 hours of first symptoms for maximum benefit but should be given later if severely unwell/ high risk group
58
Neutropenic sepsis ix?
- neutrophil count ≤0.5 ×109/l plus - either temperature >38°C - or other signs/symptoms consistent with sepsis
59
Intravascular catheter pathogens?
- mostly skin organisms | e. g. coagulase-negative staphylococci
60
Prevention of neutropenic sepsis?
1. Prophylactic abx - ciprofloxacin for duration of neutropenia 2. Granulocyte colony stimulating factor (G-CSF)
61
Prevention Of Infection In Humoral Immune Deficiency
I. Active immunisation II. Prophylactic antibiotics - penicillin or macrolide III. Immunoglobulin replacement
62
Common Fungal Infections in immune deficient patient
Candida spp. | Dermatophytes
63
Candidiasis in immune deficient common pathogens?
C. albicans and C. glabrata
64
Candidiasis in immune deficient sx
- thrush - commonly female genital tract or mucosa bloodstream infections
65
Candidiasis mx?
- depends on disease | - systemic agents include fluconazole, amphotericin B, and the echinocandins
66
Dermatophyte Infection in immune deficient: which body part infected?
Infections of skin, hair or nails
67
Dermatophyte Infection in immune deficient: which pathogen?
species belonging to the fungal genera - Trichophyton, - Microsporum and - Epidermophyton

MS3 - Microbiology (11 decks)

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