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Phase 3 > Infection 2 > Flashcards

Infection 2 Flashcards

1
Q

What is the virus that causes bronchiolitis and what is the treatment?

A

Respiratory Syncytial Virus

1st:
- nebulised saline

2nd line:
- steroids

3rd line:
- Ribavirin

Prevention:
Palivizumab

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2
Q

What infection causes herpangitis? and what is it?

A

Hand foot and mouth disease
- coxsackivirus A16

Posterior oralpharngeal vesicular rash
with ulceration and constriction

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3
Q

If there is an affected joint, within 30 days of the operation. what is option 1 for management?

A

DAIR

  • debridement
  • Antibiotics
  • Inplant Retained
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4
Q

if there is an affected joint, after 30 days of operation, what is the surgical options?

A

Option 2:

Joint removal
- must removal all cement as well in order to let it heal

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5
Q

What anti-malarial drug can cause psychosis?

A

Mefloquine

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6
Q

What is the treatment for life threatening malaria?

A

Artemisinin

Quinine

Doxycycline

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7
Q

Why does HIV have so many variable genetic codes?

A

It makes a lot of mistakes when replicating leading to mutations.

during the chronic phase may actually devleop CXC4 strain which allows it to target CD4 cell more readily

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8
Q

What are some key symptoms of <200 T cell count?

A 
Constant: 
Fatigue 
Fever 
Diarrhea
Lymphadenopathy
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9
Q

What are some AIDs defining illnesses?

A

Miliary TB
Pneumocystis Jiroveci
systemic
Candidiasis

Kaposi Tumours
CNS Lymphoma - EBV

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10
Q

What tests should be done when HIV is suspected?

A

HIV antibody test - for diagnosis

HIV PCR

CD4 count - monitoring progress

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11
Q

What is the most important risk factor in the immunocompromised patient towards developing infection?

A

Neutropenia

Neutrophils are essential for promoting the next stage of attack

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12
Q

Whats the most common pathogens in neutropenic febrile cancer patients?

A

Although the cause of the fever is rarely actually infection, a neutropenic patient must be treated as infected until proven otherwise.

common infections are:

  • coagulase neg Staph
  • Staph Aureus

E.Coli

Candida infection

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13
Q

How is Sepsis scored?

A

National Early Warning Score - NEWS

  • temperature
  • blood pressure
  • respiratory
  • oxygen stats
  • oxygen supplementation
  • AVPU - alertness, voice, pain, unresponsive

higher the score the worse.

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14
Q

If a patient is neutropenic and febrile what should the management be, including antibiotic use:

A

Patient must be assessed within 15 minutes.

Identify is patient is septic and source point of infection.
definition of shock in neutropenics is:
- Neutropenic + Fever/ hypothermia
(+/- SIRS or Septic shock)

*Sepsis 6

Antibiotics:
NEWS<5:
- Tazocin

NEWS>6
- Tazocin
+
-Gentamicin

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15
Q

How quickly must a neutropenic febrile patient be assessed?

A

within 15 minutes

Commencing Sepsis 6 within 1 hour

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16
Q

In the management of a febrile neutropenic patient, what are the alternative drug routines in empirical management, with explanations.

A

If penicillin allergic: change to vancomycin + ciprofloxacin

If evidence of skin infection add Vancomycin

If Atypical pneumonia is suspected add Clarithromycin

If ESBL present, add meropenem

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17
Q

In solid organ transplant patients - name some common infections:

A

Donor Derived infections:

  • CMV
  • HSV
  • HHV - 6 (EBV)
  • syphilis
  • TB

Infections related to surgery:

  • Staph
  • Pneumonia
  • MRSA
1-6 months post operation:
mainly opportunistic infections 
- Pneumocystis Jervico 
- toxoplasmosis 
- histoplasmosis 
- cryptococcus

> 6 months - same risk as generally immunosuppressed individuals

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18
Q

List the cycle of contagious spread and name some preventions that can be done.

A

Infectious agent

Reservoirs

  • humans
  • animals

Portal of exit

  • sneezing
  • cough
  • faeces

Means of transmission

  • direct
  • indirect (airborne)

Portal of entry

  • mouth
  • open skin
  • respiratory

Susceptible host

  • vaccines
  • isolation
  • nutrients
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19
Q

What type of diarrhea does Enterotoxigenic E.Coli (ETEC) cause?
- what is ETEC also known as?

If treatment is needed, what is given?

A

Watery loose diarrhea

  • usually within 12-72 hours
  • within the 4-14 day period

self resolves. Hydration is needed.
if treatment:
ciprofloxacin `

20
Q

In the setting of malaria, what is considered a severe infection?
what are some symptoms?
what is the treatment?

A

Parasitaemia >2%

  • severe anaemia
  • renal failure
  • cerebral involvement
  • DIC

treatment:

  • Artmenther
  • Doxycycline
  • Quinine
21
Q

What is the prevention medication for malaria?

A

Mefloquine

Doxycycline

Malarone

22
Q

What the management for enteric fever?

A

Ceftriaxone
or
Quinolones

23
Q

What the history of viral Hemorrhagic fevers?

A

Exposure >

Febrile of unknown source>

Hemorrhagic manifestations>

Septic Shock>

Death

24
Q

Name some common pathogens of biliary sepsis:

A

Gram Negatives:
E.Coli
Klebsiella
Enterobacter

Gram Positives:
Enterococci
Anaerobes - C.Diff `

25
Q

What drugs should be withheld in Necrotising fasciitis?

A

NSAIDs

26
Q

What are the types of Necrotising fasciitis?

A

Type I - poly microbial - anaerobic involved

Type II - S. pyogenes

Type III - sea water trauma

Type IV - Fungal

27
Q

How is the severity of C.Diff measured? and how does this influence treatment?

A

Severe Colitis - CT Scan

Pseudomembranous involvement/ Toxic megacolon

Fever

Rising Creatinine

If any of these are high, it will give a severity marker, meaning the most appropriate treatment would be:
Vancomycin

28
Q

List the treatment of C.Diff:

A

metronidazole/ Vancomycin

Rehydration

Stopping medication that may be participating in it

  • antibiotics
  • PPI

Barrier treatment

  • PPE
  • Isolation

Reviewing of patient

29
Q

Outline the main tests done for the core STIs:

A

Blood tests:
HIV - Antigen
Syphilis - Dark field Microscopy (from the chanre) and Antigen testing
Hep B (done for men who have sex with men)

NAAT:

  • Chlamydia
  • Gonorrhea
30
Q

What are the risks associated with HSV?

A

This DNA virus is a life long virus. It can shed even when asymptomatic. It sheds about 1 every 50 days without symptoms.

Ulceration increase risk of other STI infections

31
Q

Gonorrhea has multiple drug resistance properties, name some reasons for this:

What are some things that can be done to reduce resistance?

A

Gram negative species easily able to undergo conjugational change of plasmid - acquiring new genetic material

Inappropriately treated throughout history and especially in middle east.

  • rapid NAAT testing
  • Narrow spectrum prescribing
  • good sexual practice
  • notification to sexual partners - to avoid spread
32
Q

How long can primary syphilis take to present, and what is the organism?

A

> 90days

Treponema Pallidum

33
Q

When someone is initially treated for Treponema Pallidum, a certain reaction may occur - what is this? and what is the drug used?

A

The person may present with a fever and malasia following

34
Q

List some important history points to take from someone presenting with diarrhea:

A

Food history

Travel history

Past medical history
- specifically about the bowel

History of illness in close contacts
- contagious bug?

Occupational

C.Diff Risk factors

  • > 65years
  • Recent hospitalisation
  • Recent antibiotics
35
Q

What are the C.Diff risk factors?

A

> 65 years

recent antibiotics

Recent hospitalisation

36
Q

List the common types of gastrointestinal viruses and give a basic outline their diagnostic tests and their management:

A

Norovirus
sapovirus
**these are caliciviridae family

Rotavirus - <2 years old

  • G1-4, G9.
  • IgA antibodies - VP4,7
  • Rotarix vaccine

Adenovirus - DNA
- 40 and 41

Astrovirus - RNA

Tests:
- PCR from samples

IV fluids
Anti-spasmodics
Anti- pyrexial
Analgesia

37
Q

What are the strains of rotavirus and which is the most common?

Why do the infections become less severe with time?

A

G1-4 and G9

G1 accounts for 70% of infections

IgA production against the virus. namely the VP4 and VP7 of the virus

38
Q

Only particularly strains of adenovirus causes gastrointestinal upset - which are they?

A

40

41

39
Q

In Septic Arthritis: Outline the most common pathogens for age group:

A

Children:

  • H. Influenza
  • N. Meningitis

Young adults

  • N. gonorrhea
  • S. Aureus

Older adults:

  • S. Aureus
  • MRSA
40
Q

What family does the rhinovirus belong too? What type of virus is it? and what does it cause?

A

Picornaviridae

ssRNA

Causes common cold

41
Q

Pharyngitis is typically caused by which virus, but what other viruses may cause it?

What treatment can be given to those that are high risk?

A

Adenovirus

EBV

Monoclonal antibodies against the EBV.
- Palivizumab

42
Q

What family does Influenza virus belong to?

A

Orthomyxovirus group.

3 main strains:
A
B
C

43
Q

Outline the pathogenesis of influenza, name those most at risk, some diagnostic tests and treatment:

A

Haemagglutinin binds to sialic acid, 2-6. enters cell.
uses cellular machinery - RNA polymerase

Neuraminidase used to exit the cell - destroying it.

Sailic acid 2-6 found heavily on upper respiratory cells

those at risk:

  • > 65 years
  • pregnant women
  • <1 month year old

*Rapid Influenza Diagnostic tests - detects influenza antigens

  • Quadrivalent vaccines - children - Live
  • trivalent vaccines
  • live attenuated one
  • non live one
44
Q

What is SARS and give an example:

A

Coronavirus infection

Middle Eastern Respiratory Syndrome

45
Q

What are the tests you should order for someone with diarrhea?

A

FBC

WWC
- infection

ESR
- inflammation

Stool cultures

Faecal Leukocytes

C.Diff toxins assay A and B toxins
- if reason to suspect C. Diff

In the setting of autoimmune:
- anti body testing - Anti tTG

Colposcopy

Phase 3 (50 decks)

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