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IMS > Infection > Flashcards

Infection Flashcards

1
Q

Define reservoir

A

This is where the germ lives and grows (on/in a person, equipment, environment, food and water)

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2
Q

What is a parasite?

A

A parasite is an organism that has a relationship with the host in which the parasite benefits and the host is harmed

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3
Q

What is a communicable disease?

A

Diseases that can be passed between person, environment and animal

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4
Q

What is a susceptible person?

A

Someone who is at risk of illness

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5
Q

What is an endogenous infection?

A

An infection that comes from ourselves

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6
Q

What is exogenous infection?

A

Infection from other people, animals or the environment

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7
Q

What is the most common cause of endogenous infection?

A

When bacteria from your normal flora get into the wrong place

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8
Q

What is an example of an endogenous infection?

A

Cystitis
Infection if the lower urinary tract
Most commonly from bacteria from the gut

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9
Q

What are the ways endogenous infections are caused?

A

Migration
Perforation
Blood

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10
Q

What are the ways exogenous infections are caused?

A

Contact
Injuries
Airborne
Oral
Blood borne
Sex
Mother to baby

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11
Q

Where do healthcare associated infections often come from?

A

Surgical sites
Mucosal surfaces
Ventilators
Catheters
Implant associated surgery

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12
Q

What are healthcare associated infections?

A

Infections that occur while receiving healthcare, developed in a hospital that first appear 48 hours or more after hospital admission or within 30 days after having received healthcare

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13
Q

What makes a pathogen able to cause infection? (Pathogen factors)

A

Infectious dose
Virulence factors & toxins
Resistance to antimicrobials

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14
Q

What barriers do we have to infection?

A

Skin & mucous membranes
Stomach acid
Native bacteria
Immune system
Behaviour

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15
Q

What behaviour and social history is relevant to infection?

A

Occupation
Travel
Recreation
Sex
Drugs
Contacts

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16
Q

What 5 things are important to ask about when you take history?

A

Non-specific symptoms
Specific symptoms
PMH
DH
Lifestyle

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17
Q

What 3 types of white blood cells are tested for in a white blood cell count and why might they be elevated (provide examples)?

A
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18
Q

What are the 4 basic tests?

A

FBC
LFT
C-reactive protein (marker of inflammation)
U&E (kidney function)

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19
Q

Ideally should samples be taken before or after antibiotic treatment starts?

A

Before

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20
Q

What do we have to inform the lab of when we send them samples?

A

Background clinical information
If important samples are on the way

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21
Q

What tests do microbiologists do with the samples you send?

A

PCR
Antibiotic sensitivity testing
Culture
Antibody detection
Microscopy
Antigen detection

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22
Q

What different types of microscopy staining can we do?

A

Gram stain (bacteria)
Calcofluor (fungi)

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23
Q

What are the 2 types of antibiotic sensitivity testing?

A

Disc sensitivities testing
MIC (minimum inhibitory concentration testing)

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24
Q

How do we detect organisms that we can’t grow in the lab?

A

Identify part of the organism (proteins/DNA)
Identify the bodies immune response to the infection (antibodies)

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25
Q

What are some infections do we use PCR to identify their DNA/RNA?

A

Meningitis
HIV
Hepatitis B and C
Respiratory viruses

26
Q

Describe the features of the antibody testing IgM and IgG

A

IgM
-initial antibody response
-appears within a week
IgG
-later antibody response
-appears 10-14 days
-FINISH THIS

27
Q

Why is tuberculosis different from other bacteria in terms of cell wall?

A

TB has a waxy cell wall so needs a different kind of stain
Normal bacteria are gram positive or gram negative due to cell wall composition (peptidoglycan)

28
Q

What staining methods can be used for tuberculosis?

A

Zeihl Neelsen stain
Auramine stain

29
Q

Why is tuberculosis different from other bacteria?

A

Insert table

30
Q

Describe how we grow a culture of TB?

A

Done on a special solid medium and a liquid medium
Needs culturing for up to 6-8 weeks as bacilli are slow growing

31
Q

What do we ideally want an antimicrobial to do?

A

Selective toxicity
Bacteriocidal rather than bacteriostatic
No resistance
Good pharmacokinetics
No side effects
Not inactivated by enzymes secreted by microbes or by the host

32
Q

What are the problems with antimicrobials?

A

Variable spectrum of activity
Some cannot be given orally
Many cause side effects
Bacterial resistance

33
Q

What are the 8 goals of the antimicrobials stewardship programs?

A

Insert picture

34
Q

How can we reduce environmental pathogens?

A

General
-clean drinking water
-improving sanitation
-hygienic food preparation
In hospital
-cleaning wards, rooms and equipment
-filtered air in operating theatres
-using sterile instruments

35
Q

What are the classes of organisms that can cause infection?

In size order

A

Helminths
Insects
Protozoa
Fungi
Bacteria
Viruses
Prions

36
Q

What are some non human sources of exogenous infection?

A

Influenza (from pigs/birds)
Dengue (mosquito)
Rat bite fever

37
Q

What is the source of the following exogenous infections?
Clostridium tetani
Cholera
Schistosomiasis

A

Soil and water

38
Q

Which of the following is a specific symptom when taking a patients history?

A

Fever
Pneumonia
Loss of appetite
Aching muscles

39
Q

What extras other than symptoms are important when taking a patients history?

A

Do they have any existing conditions that make people more susceptible to infection?
Do they have any lifestyle activities that bring people in to contact with infection?

40
Q

What is a lumbar puncture?

A

Examination of cerebrospinal fluid for signs of meningitis

41
Q

What microscopy stains can you use for bacteria and fungi?

A

Bacteria - gram stain
Fungi - calcofluor

42
Q

What are the two types of antibiotic sensitivity testing?

A

Disc sensitivity testing
MIC (minimum inhibitory concentration) testing

43
Q

How do we detect organisms that we can’t grow in the lab?

A

Identify part of the organism (proteins or DNA/RNA)
Identify the body’s immune response to the infection (IgG/IgM)

44
Q

What are two examples of antigen testing?

A

Urine test (for pneumonia)
SARS COV-2 antigen detection

45
Q

At what point do you test for which class of antibody after an immune response?

A

IgM
- initial antibody response
- appears within a week
IgG
- Later antibody response
- Appears 10-14 days
- Persistes throughout life

46
Q

Why is tuberculosis different from other bacteria?

A

Normal bacteria is gram positive or negative due to peptidoglycan cell wall
Tuberculosis has a waxy cell wall made from mycolic acid so needs a different stain

47
Q

What are the staining methods for tuberculosis?

A

Zeihl Neelsen stain
Auramine stain

48
Q

What kind of culture is tuberculosis grown in?

A

A special solid and liquid medium
Needs culturing for up to 6-8 weeks as bacilli are slow growing
Often Löwenstein-Jensen medium used

49
Q

How is tuberculosis tested for using a skin test?

A

Skin test
- a small amount of TB protein is put under the top layer of skin
- if exposed the skin reacts to the antigens by developing a firm red bump

50
Q

What are the two types of blood test for tuberculosis?

A

Quantiferon - ELISA based interferon gamma release assay
T-SPOT - T cell bases assay

51
Q

What are the two groups of ways we can treat infection called?

A

Supportive therapy
Specific therapy

52
Q

What are two ways of supportive therapy?

A

Symptomatic - e.g. paracetamol for fever
Dehydration/ low blood pressure IV fluids

53
Q

What are two ways of specific therapy?

A

Antimicrobials
Antibiotics

54
Q

What do we ideally want an antimicrobial to do?

A
  • Selective toxicity (kills microbe but not host)
  • Bacteriocidal (kills organism not just inhibit growth)
  • No resistance
  • Good pharmacokinetics (not give multiple doses)
  • No side effects
  • Not inactivated by enzymes
55
Q

Penicillin and mupirocin are both antibiotics - where do they come from?

A

Penicillin is derived from a mould
Mupirocin is produced by a fluorescent bacteria

56
Q

What is the problem with antimicrobials?

A
  • variable spectrum of activity
  • some cannot be given orally
  • many cause side effects
  • bacterial resistance
57
Q

What are the 8 goals of the antimicrobial stewardship program?

A

INSERT PIC

58
Q

In general how can we reduce environmental pathogens?

A

Clean drinking water
Improving sanitation
Hygienic food preparation

59
Q

In hospitals how can we reduce environmental pathogens?

A

Cleaning wards, rooms and equipment
Filtered air in operating theatres
Using sterile instruments when operation/taking blood/etc.

60
Q

What are some prophylactic treatments to protect the potential host?

A
  • antimalarials
  • antibiotics given to very immunosuppressed patients

IMS (10 decks)

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