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Clinical conditions > Infection > Flashcards

Infection Flashcards

1
Q

Neisseria Meningitidis

Mechanism of action?

A
  • Direct contact with respiratory secretions
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2
Q

Neisseria Meningitidis

Interaction with host?

A
  • Lives in the Naso/oropharynx
  • Colonises and attacks the meninges of the brain
  • Spreads to blood and causes a non-blanching rash
  • Sereve immune reaction due to endotoxins
  • Leads to septic shock, multi organ failure and death
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3
Q

Neisseria Meninigitidis

Gram Positive or Negative?

A
  • Gram Negative
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4
Q

Neisseria Meningitidis

How would you diagnose?

A
  • History
    • Sudden onset, neck pain, fever, photophobia, nausea, malaise, abdomen pain, head ache, non blanching rash
    • Several days of illness, gets worse before better due to endotoxin
  • Examination
    • Raised temperature, tachometer, tachocardia, low BP, pale and cold extremities
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5
Q

Neisseria Meningitidis

Possible sequalae?

A
  • Septic shock and death
  • Respiratory failure, kidney failure, raised ICP, coma and death
  • Hearing loss, Ischemia and necrosis
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6
Q

Neisseria Meningitidis

Treatment and Prevention?

A
  • Supportive
    • High flow O2
    • Adrenaline
    • IV
    • Measure urine output and lactate
    • Analgesia
  • Specific
    • Blood cultures and blood spectrum antibiotics
    • Ceftriaxone
  • Prevention
    • Vaccine, stay away from people with Meningitis
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7
Q

Escherichia Coli

Is it Gram Positive or Negative?

A
  • Gram Negative
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8
Q

Escherichia Coli

Interaction with host?

A
  • Colonise GI tract
  • Gastroenteritis
  • Peritonitis
  • Infectio by ingestion of contaminated food or directly from a perforated bowel
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9
Q

Escherichia Coli

How would you diagnose?

A
  • History
    • Nausea, Vomiting, Fever, Malaise, Muscle weakness, Stomach cramps, chills
    • Usually lasts a few days - resolves itself
  • Examination
    • Tender abdomen, raised temperature, BP, HR and respiratory changes
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10
Q

Escherichia Coli

Possible sequalae?

A
  • Peritonitis, Septic shock and death
  • Usually resolves
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11
Q

Escherichia Coli

Treatment and Prevention?

A
  • Supportive
    • IV, fluids and O2
  • Specific
    • Broad spectrum antibiotics
    • Source control for peritonitis
  • Prevention
    • Disinfect food prep areas
    • Do not share belonginings with others who have gastroenteritis
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12
Q

Staph Aureus

Is it Gram Positive or Negative?

A
  • Gram Positive
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13
Q

Staph Aureus

Mechanism of infection?

A
  • Invasion
  • Inhalation
  • Ingestion
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14
Q

Staph Aureus

Interaction with host?

A
  • Coagulase- converts fibrinogen to fibrin forming microclot to protect itself
  • Hyaluronidase- breaks down hyaluronidase acid in connective tissue so can break down barriers and spread
  • DNA Ribonuclease- Breaks down host DNA
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15
Q

Staph Aureus

How to diagnose?

A
  • Skin lesions
  • If leads to sepsis will have tachycardia and hypotension
  • Lasts a few days to weeks depending on severity of abscess
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16
Q

Staph Aureus

Possible Sequalae?

A
  • Chronic abscess formation
  • Scar tissue
  • Resolution
  • Sepsis
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17
Q

Staph Aureus

Treatment and Prevention?

A
  • If sepsis then septic 6
  • antibiotics
  • Drain Abscess
  • Hand washing tenchique and decontamination of cooking surfaces
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18
Q

Staph Epidermis

Is it Gram Positive or Gram Negative?

A
  • Gram Positive
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19
Q

Staph Epidermis

Mechanism of infection?

A
  • Inoculation onto prosthetic surfaces during surgery
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20
Q

Staph Epidermis

Interaction with host?

A
  • Usually part of normal flora
  • Biofilms on surgical equiptment cause local infections
  • If sheared off can cause sepsis and shock
  • Can cause rejection of prothetics
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21
Q

Staph Epidermis

How to diagnose?

A
  • History
    • Pain in the site of implant
    • unsteadiness on affected joint
    • Tenderness at the site of infection
    • Joint dysfunction until new prosthetic
  • Examination
    • malaise
    • fever
    • myalgia
    • reduced power in limbs
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22
Q

Staph Epidermis

Possible sequalae?

A
  • Septicemia
  • Septic shock
  • Death
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23
Q

Staph Epidermis

Treatment and Prevention?

A
  • Manage fever
  • physiotherapist
  • Replace prosthetic joint
  • Surgical explore and removal
  • Antibiotic
  • Silver coated IV line as has an antibacterial agent, sterile surgical environment and antibiotic prophylaxis
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24
Q

Streptoccus Pneumoniae

Mechanism of infection?

A
  • Direct contact
  • Normal flora of upper respiratory tract
  • Can colonise in lungs
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25
Q

Streptococcus Pneumoniae

Interaction with host?

A
  • Pneumonia occurs when the bacteria colonise the lungs
  • The capsule means it is not easily phagocytosed
  • Pus from dead neutrophils accumulates in the lungs
  • If left unchecked my cause bacteriaemia and meningitis
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26
Q

Streptococcus Pneumoniae

Gram positive or Gram Negative?

A
  • Gram Positive
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27
Q

Streptococcus Pneumoniae

How to diagnose?

A
  • History
    • 3 days of dyspnea and malaise, 4 or 5 days of yellow sputum
    • Lasts 3 weeks after treatment
  • Examination
    • crackles and bronchial breathing over area of lung, tachometer, tachycardia, mild hypotension, decreased O2 sats
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28
Q

Streptococcus Pneumoniae

Possible Sequlae?

A
  • Consolidation of lung tissue
  • possible caseous necrosis
  • clearance of inflammatory exudate via lymphatic
  • small chance of passage into the blood and then meningitis may result
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29
Q

Streptococcus Pneumoniae

Treatment and Prevention?

A
  • high flow of O2
  • correct fluid balance
  • salbutamol
  • broad spectrum antibiotics
  • pneumonectomy
  • Prevention- antibiotic prophylaxis
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30
Q

Streptococcus pyogenes

Gram Positive or Negative?

A
  • Gram Positive
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31
Q

Streptococcus pyogenes

Mechanism of action?

A
  • Respiratory droplets
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32
Q

Streptococcus Pyogenes

Interaction with host?

A
  • Streptokinase- dissolute clots through conversion of plasminogen to plasmin
  • Streptococcal pyrogenic exotoxins
  • M protein- inhibits complement pathway so resists phagocyotic
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33
Q

Streptococcus pyogenes

How to Diagnose?

A
  • Pharyngitis
  • Rheumatic fever
  • Impetigo
  • Cellulitis
  • Necrotising fascitis
  • Toxic shock syndrome
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34
Q

Streptococcus Pyogenes

Possible sequalae?

A
  • Scarlet fever
  • High fever
  • sepsis
  • arthritis
  • jaundice
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35
Q

Streptococcus pyogenes

Treatment and Prevention?

A
  • Penicillin and Amoxicillin
  • Avoid contact with people with infection and wash hands and surfaces
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36
Q

Clostridium Difficile

Gram Positive or Negative?

A
  • Gram Positive
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37
Q

Clostridium Difficile

Mechanism of infection?

A
  • Infection when microbiota of the gut is eliminated by antibiotics
  • The flora in gut usually fight off c diff
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38
Q

Clostridium Difficile

Interaction with host?

A
  • Exotoxin 1 causes inflammation and intracellular spaces widen due to histamine
  • Exotoxins B exits through the gaps and kills healthy cells
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39
Q

Clostridium Difficile

How to diagnose?

A
  • History
    • 2 days of severe diarrhoea, abdo discomfort, rare vomiting, previous antibiotic use
    • 7-20 days
  • Examination
    • Tender abdomen, BP low slightly and slightly tachycardia
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40
Q

Clostridium DIfficile

Possible Sequalae?

A
  • Acute renal failure
  • Cognitive impairment
  • Toxic megacolon, peritonitis and septic shock
41
Q

Clostridium Difficile

Treatment and Prevention?

A
  • IV fluid bolts and ORT
  • Faecal transplant, metronidazole, discontinue causative antibiotics
  • Isolation, respoinsible prescribing, barrier medicine e.g. throw away gloves
42
Q

Viridans Steptococci

Gram Negative or Gram Positive?

A
  • Gram Positive
43
Q

Viridans Streptococci

Mechanism of action?

A
  • Normally in oral cavity
  • Can cause tooth decay and spread to CVS
44
Q

Viridans Streptococci

Interaction with host?

A
  • Colonises tooth surface where converts sucrose into lactic acid
  • Lowers pH of tooth enamel and leaved vulnerable to break down
  • If oral mucosa is breached by low pH or abrasion then the bacteria enter the systemic circulation
  • Bacteraemia
  • Stuck on heart valves- infective endocarditis
45
Q

Viridans streptococci

How to diagnose?

A
  • History
    • poor access to dental care, fever and chills for 6 weeks, lack of energy, breathlessness, toothache, anorexia, cahexia
    • 3 week long illness while wait for surgery
  • Examination
    • poor dentition, heart murmur, tachypnea, tachycardia and hypotension, oedema
46
Q

Viridas streptococci

Possible sequalae?

A
  • Heart failure
  • Valvular dysfunction
  • Cardiogenic shock
47
Q

Viridans Streptococci

Treatment and prevention?

A
  • Measure urine output
  • O2 for tachypnea
  • Replace defective valve
  • Penicillin and gentamicin
  • Prevent with good dental hygiene
48
Q

Norovirus

Shape?

A
  • Icosahedral
  • Non enveloped
  • ssRNA
49
Q

Norovirus

How is it spread?

A
  • Fecal oral transmission
  • Contaminated food/person
50
Q

Norovirus

Interaction with host?

A
  • Multiplies within the small intestine and irritates the lining of the GI tract
51
Q

Norovirus

Symptoms?

A
  • Diarrhoea
  • Vomiting
  • 72 hours
52
Q

Norovirus

Treatment?

A
  • IV fluids to restore fluid balance
  • Wash everything
53
Q

Adenovirus

Shape?

A
  • Isohedral
  • Non-enveloped
  • dsSNA
54
Q

Adenovirus

Mechanism?

A
  • Droplet infection
  • Direct contact
  • Faecal oral transmission
55
Q

Adenovirus

Interactions?

A
  • Enters through respiratory route
  • Colonise pharynx and Upper airways to cause URTI or down to oesophagus
56
Q

Adenovirus

Symptoms?

A
  • Pharynx pain
  • Cough
  • Sinus pain
  • Temperature
  • Malaise
57
Q

Adenovirus

Examination?

A
  • Red inflamed pharynx
  • Enlarged tonsils
  • lymphadenitis
58
Q

Adenovirus

Treatment?

A
  • Mild pain relief e.g. paracetamol and increase fluid
  • Only if strain 14 would give antivirals as the strain is potentially lethal
59
Q

HIV

Shape?

A
  • Roughly circular, enveloped and ssRNA
60
Q

HIV

Mechanism of spread?

A
  • Bodily fluid so unprotected sex, needles, vertical transmission, medical procedures
61
Q

HIV

Interaction with host?

A
  • Enters the blood stream
  • Infects CD4+ T cells
  • ssRNA is converted to DNA by transverse transcriptase and inserted into genome of T cells
  • Transcribed and translated and budding of immature protein occurs
  • The exit causing lysis of T cells
  • Viral proteases cuts the protein making it on active virus
  • This then repeats
  • Become immunodeficient as T cells decline so lossof cell mediated immunity
62
Q

AIDs

What are some signs of AIDs?

A
  • Oral thrush (oppurtunistic oral candida albicans)
  • Extra pulmonary mycobacterium tuberculosis
  • Pneumonia
63
Q

HIV

Symptoms?

A
  • Flu like illness in first few weeks
    • Malaise, lethargy, fever, muscle aches with AIDs
  • Weight loss, lymph node enlargement and chronic fatigue with AIDs
64
Q

HIV

Specific treatment

A
  • Regularly check CD4+ count
  • HAART- highly active antiretroviral therapy
    • 2NTRIs
    • And 1 NNRTI or proteases inhibitor or integrase inhibitor
65
Q

Hepatitis B

Shape?

A
  • Isohedral
  • Enveloped
  • dsDNA non-sense
66
Q

Hepatitis B

Mechanism

A
  • Spread through bodily fluids
  • Can occur during unprotected sex
  • Sharing of needles
  • Vertical transmission
  • Medical procedures
67
Q

Hepatitis B

Interaction with Host?

A
  • Enters the blood stream and replicates within hepatocytes which leads to host damage by inflammation when the active immune system recognise the viral molecules
68
Q

Hepatitis B

Symptoms?

A
  • Fatigue
  • Abdominal pain
  • Anorexia
  • Nausea
  • Vomiting
  • Athralgia
  • Malaise and Myalgia
  • Heptosplenomegaly and jaundice
69
Q

Hepatitis B

Treatment?

A
  • Vaccination
  • Peginterferon-alpha-2a to stimulate immune system to destroy infection
  • Antiretroviral drugs
70
Q

Hepatitis B

How long does it usually last?

A
  • Resolved after about 6 months
71
Q

Hepatitis C

Shape?

A
  • Isohedral
  • Enveloped
  • ssRNA (Sense)
72
Q

Hepatitis C

Mechanism?

A
  • Blood to blood contact
  • Classic spread of infection is sharing of needles in IV drug users
73
Q

Hepatitis C

Interaction with host?

A
  • Travels to the liver and replicates within hepatocytes but does not usually cause symptoms
74
Q

Hepatitis C

Symptoms?

A
  • Usually asymptomatic
  • May have fatigue, nausea, anorexia, dark urine and RUQ abdominal pain
75
Q

Hepatitis C

Treatment?

A
  • Lifestyle changes
  • Pegylated interferon and ribavirin
  • 80% of patients develop chronic conditions
76
Q

Epstein Barr Virus

Other names?

A
  • Glandular fever
  • Mono
  • Herpes virus
77
Q

Epstein Barr virus

Symptoms?

A
  • Fatigue
  • Fever
  • lack of appetitie
  • rash
  • sore throat
  • swollen glands
  • weakness and sore throat
78
Q

Epstein Barr Virus

Treatment?

A
  • Rest
  • Fluids
  • Paracetamol
  • lasts 2-3 weeks
  • asoociated with cancers like hodgkins lymphoma
79
Q

Herpes Zoster

Other names?

A
  • Chicken pox and shingles
80
Q

Herpes zoster

Symptoms?

A
  • Painful skin rash with blisters
  • Fever and headache
81
Q

Herpes zoster

Treatment?

A
  • Painkillers
  • Antivirals and covering the rash
82
Q

Malaria

History?

A
  • Fever
  • chills
  • sweat
  • unwell
  • confused
  • moderate jaundice
  • bite marks
83
Q

Malaria

Examination?

A
  • High temperature, low blood pressure, tachycardia, hepatosplemomegaly , low FBC, high urea, creatinine, bilirubin, CRP, red blood cells have parasites in dot
84
Q

Malaria

Severe malaria symptoms?

A
  • tachycardia, hypotension, arrhythmias, ARDs, diarrhoea, bilirubin, acute kidney injury, confusion, fits, cerebral malaria, low wbc, throkobocytopemia, metabolic acidosis, hypoglycaemia, secondary infection
85
Q

Malaria

Vector?

A
  • Female anopheles mosquito
86
Q

Malaria

Incubation period?

A
  • Minimum 6 days
  • Maximum 1 year
87
Q

Malaria

Investigations?

A
  • Infectious disease specialist, 3 blood smears, full blood count, head CT, chest X-ray
88
Q

Malaria

Treatment and prevention?

A
  • p.falciparum- artesunate, Quinine and doxycycline, others are choloroquine and primaquine, hypnozoites are liver stages
  • assess risk, bite prevention, chemophloraxis
89
Q

Typhoid Enteric Fever

Mechanism?

A
  • Faecal-oral route
90
Q

Typhoid Enteric Fever

Incubation period?

A
  • 7-14 days
91
Q
A
92
Q

Typhoid Enteric Fever

Investigations?

A
  • Anaemia
  • Lymphnia
  • Raised LFTs
  • Culture of blood and faeces
93
Q

Typhoid Enteric Fever

Treatment and Prevention?

A
  • Ciprofloxacin now used due to resistance
  • Prevented by food and water hygiene and vaccine
94
Q

Dengue Fever

Mechanism?

A
  • Mosquito
95
Q

Dengue Fever

Incubation period?

A
  • 4-10 days after the bite
96
Q

Dengue Fever

Symptoms?

A
  • Rash
  • May be asymptomatic first time
  • Reinfection with different serotype- dengue haemorrhage gever or shock syndomre
97
Q

Dengue Fever

Investigations?

A
  • Dengue PCR and serology
98
Q

Dengue Fever

Treatment and Prevention?

A
  • Supportive treatment first time
  • Prevent by mosquito awareness

Clinical conditions (17 decks)

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