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Semester 3 - me > Infection > Flashcards

Infection Flashcards

(70 cards)

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1
Q

What does SIRS stand for?

A

Systemic Inflammatory Immune Response

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2
Q

What clinical features does SIRS consist of?

A 
You need 2 of the following:
HR >90bpm
Temp 38
WBC 12 
RR >20/min
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3
Q

Define bacteraemia

A

This is where there is bacteria in the blood but no clinical symptoms

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4
Q

Define septicaemia

A

This is where there is bacteraemia clincally

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5
Q

Define sepsis

A

This is clinical presentation + SIRS

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6
Q

Define severe sepsis

A

SIRS and organ dysfunction

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7
Q

Define septic shock

A

This is where the blood pressure does not increase despite IV fluids`

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8
Q

What investigations would you perform for sepsis?

A 
FBC
LFT
Urea and electrolytes 
Blood culture 
Blood sugar
Blood gases
CRP
Clotting factors
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9
Q

What is the sepsis 6 and when should you do it?

A

Within one hour

1) deliver high o2
2) take blood cultures
3) IV antibiotics
4) measure serum lactate
5) IV fluids
6) urine output measurement

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10
Q

What antibiotics are used for meningitis and why?

A

Ceftriaxone because it can cross the CSF

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11
Q

What are life threatening complications of sepsis?

A 
Liver failure
Irreversible hypotension
Kidney failure 
Raised intracranial pressure
Ischaemic necrosis of peripheries
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12
Q

How would you confirm the diagnosis of sepsis?

A

Blood culture
PCR
Lumbar puncture (turbidity, colour, microscopy)

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13
Q

What can sepsis lead to in terms of coagulation?

A

Cytokines promote thrombin and inhibit fibrinolysis

This can lead to necrosis, lack of perfusion, organ dysfunction and failure

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14
Q

Describe neisseria meningitidis

A 
This is a gram negative diplococcus 
More common in the winter or Africa
It's a normal oral commensal 
Antiphagocytotic capsule 
Lipopolysaccharide activates TLR4 - sepsis
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15
Q

What are the symptoms of meningitis?

A

Fever
Headaches
Stiff neck
Rash

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16
Q

Should treatment of meningitis wait conformation?

A

No!

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17
Q

How is neisseria meningitidis spread?

A

Direct aerosol

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18
Q

Describe streptococcus pneumoniae

A

Gram positive coccus
Causes pneumonia, meningitis, resp infection, endocarditis
Invades the blood
Susceptable to penicillin

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19
Q

Describe E. coli

A 
This is a normal flora in the GI tract 
Causes food poisoning/UTI
facultative 
faecal oral transmission or faecal perineal 
Gram negative bacilli
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20
Q

When is the onset of hospital infections?

A

At least 48 hours after transmission

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21
Q

What percentage of patients are hospital infections?

A

8%

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22
Q

Name some hospital acquired infections

A 
Pneumonia
GI
UTI
C diff
MRSA 
Surgical wounds 
Skin 
Bloodstream
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23
Q

Name some common hospital acquired viruses

A

Hep B
Norovirus
Influenza
Chicken pox

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24
Q

Name some common hospital acquired fungi

A

Aspergillus

Candida

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25
Name a hospital acquired parasite
Malaria
26
Who is at risk of a hospital acquired infection?
``` Extremes of age Diabetes Immunocompromised Chemotherapy Obese Malnutrition Surgery Smoker ```
27
How can you prevent hospital acquired infections?
``` Stop smoking Diet Diabetes control Iodine Handwashing Sterilisation Pressure rooms Bed layout Individual rooms Steam cleaning ```
28
How can antibiotic resistance occur?
``` Increased efflux Decreased influx Altered target Altered transcription Impermeability ```
29
Describe staph aureus
``` Commensal in URT Gram positive bacilli Facultative Spreads by air MRSA ```
30
What infections does staph aureus cause?
``` Toxic Shock Syndrome MRSA Endocarditis Impetigo Surgical wounds ```
31
What antibiotics are used to treat staph aureus?
Tetracycline, erythromycin, clindamycin
32
Describe C difficile
``` Watery, yellow, pale diarrhoea Endotoxins Spore Anaerobe Gram positive bacilli Antibiotic associated ```
33
What is diarrhoea defined as?
Over 3 loose stools per day
34
What symptoms do you get with c diff?
Abdo pain Nausea Diarrhoea
35
How do you treat c diff?
Stop antibiotics Treat with metronidazole for 10 days IV if severe
36
Describe norovirus
``` Infection common in winter D+V in hospitals Projectile Diagnose by NAAT Ward closure ```
37
What are the key aspects of a travel history?
Where, when, with who, what did you do, was it direct, where did you stay, how long for?
38
What are common diagnoses of travel infections?
``` Typhoid Dengue Malaria Yellow Fever TB ```
39
Where can you get information on outbreaks of where a patient has travelled?
NICE WHO Centre of disease control
40
What organisms cause malaria?
Plasmodium falciforum (most fatal) Plasmodium ovale Plasmodium malariae Plasmodium vivax
41
How is malaria transmitted?
Bite of anopholes mosquito
42
What symptoms are associated with malaria?
Headache, cough, malaise, fever every 3rd/4th day, arthralgia
43
What is the incubation period of malaria?
3 weeks
44
How would you investigate malaria?
``` Infectious disease physician Blood smear urea, electrolytes, fb CT Microscopy ```
45
How do you treat malaria?
Quinine for falcifarum | Primiquine for the rest
46
What is the pathway of events of malaria?
``` Gets into blood Liver Multiplies Red cells Another bite ```
47
How do you prevent malaria?
Chemoprophylaxis | Spray, nets, clothing
48
What is enteric fever?
Thyphoid and parathyphoid | Poor sanitation
49
How does enteric fever spread?
``` Faecal oral Invasion of intestine Spread to lymph Bacteraemia Multiply in peyers patches ```
50
What are the symptoms of enteric fever?
``` Headache Diarrhoea Vomitting Rosy rash on abdomen Hepatosplenomegaly Cough Bradycardia ```
51
What investigations would you do for enteric fever?
``` Anaemia Lymphopenia Culture FBC Serology ```
52
What antibiotic would you use for enteric fever?
Ceftriaxone
53
What is antigenic drift?
A minor change in the genome of a pathogen Large number of people with no immunity Epidemic results
54
What is antigenic shift?
This is when there is a major change in the genome so noone is protected and causes a pandemic
55
Describe influenza A and antigentic shift
Swine flu Spanish flu Bird flu
56
What is a virion?
Genome and capsid
57
What is the sequence of events of replication of a virus?
``` Absorption Entry Uncoating Transcription Virion synthesis Assembly Replication Release ```
58
What investigations can you use for viruses?
Antibody detection Viral Load CD4 PCR
59
Describe HIV
This is a lentivirus | RNA single stranded
60
Describe the process of infection of HIV
``` Attachment to host CD4 Reverse transcriptase Integration into host cell Reproduction of viral components Assembly of new viruses Release ```
61
What happens when host CD4 drops?
Weirder infections
62
What are the symptoms of primary HIV?
``` Fever Rash Flu like symptoms Pharyngitis Lymphadenopathy ```
63
How do you diagnose HIV?
Immunoassay PCR Viral load Antibodies and antigens
64
What investigations do you perform with HIV?
Full body Chest x ray Comorbidities
65
How can you treat HIV?
3 antivirals to suppress but no cure
66
Describe hepatitis B
This is a hepadnavirus Double stranded DNA 6 month incubation There is a vaccine
67
What would you examine for with Hep B?
``` Caput medusa White nails Clubbing Jaundice Ascites ```
68
How do you treat hep b?
monitor viral load and decide when to give antivirals
69
Describe hep c
Flavavirus IVDU main cause High risk of chronic infection There is a vaccine
70
Explain the pros/cons of drugs used with hep c
They lower cancer and cirrhosis risk | Have horrible side effects

Semester 3 - me (8 decks)

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