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CC2 > Infection > Flashcards

Infection Flashcards

1
Q

3 mechanisms through which bacteria can cause disease

A
  1. Directly eg cell destruction
  2. Exotoxin production
  3. Activate immune system
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2
Q

Process of gram staining bacteria

A 
CIAS
Crystal violet
Iodine
Alcohol 
Safranin
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3
Q

What is gram positive bacteria

A

Bacteria that retain crystal violet stain because of thick peptidoglycan wall
PURPLE

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4
Q

What are gram negative bacteria

A

Bacteria with thin peptidoglycan cell wall so crystal violet stain washes out and counter stain with pink safranin remains

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5
Q

Name gram -ve cocci

A

Neiserria meningitidis (aer)
Neiserria gonorrhoea
Moraxella catarrhalis

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6
Q

Name gram - rods and infection

A
  1. E coli
  2. Klebsiella pneumoniae and oxytoca (UTI)
  3. Proteus murabilis
  4. Shigella
  5. H pylori
  6. Typhoid
  7. whooping
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7
Q

Name gram + cocci and infection

A
  1. Staph (coag + = aureus, coag - = epidermis) skin + st infections
  2. Strep
    pneumoniae
    beta haemolytic = nec fasc, cellulitis
    vividans = endocarditis
  3. Enterococcus
    faecalis = amox sens
    faecium = amox neg
    endocarditis + abdo infection
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8
Q

Name gram + rods

A
  1. Actinomyces = coil
  2. Bacillus cereus = rice
  3. Corynebacterium = diptheria
  4. Listeria = food, meningitis
  5. C diff
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9
Q

What does Ziehl Neelsen stain pick up

A

Acid fast bacilli ( rods that are ?mycobacteria, nocardia)

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10
Q

TB typical tx

A 
6 MONTHS RIPE
rifampicin
isoniazid
pyrazinamide
ethambutol
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11
Q

Dyes used in ZN stain

A

malachite green

or methylene blue

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12
Q

HSV appearance

A

fried egg

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13
Q

What kind of infections does HSV cause

A

HSV1 - oral

HSV2- genitals

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14
Q

HSV tx

A

Aciclovir

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15
Q

Tx of influenza

A

Tamiflu = Oseltamivir

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16
Q

What drug are anaerobes most sensitive to

A

metronidazole

aerobes
gram -ve cocci = n men
gram + rods = diptheria + listeria

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17
Q

Main mechanisms of AMR

A
  1. Enzyme production
  2. changes to antimicrobial target/pathway
  3. efflux pumps
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18
Q

3 big resistant pathogens

A

Methicillin resistant staph aureus (MRSA)

Vancomycin resistant enteroccoci (VRE)

Extended spectrum beta lactamase producing enterobacteriacae (ESBL)

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19
Q

UTI RF

A 
DM
Pregnancy
Impaired voiding
GU malformation
Prostatic hypertrophy
Renal stones
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20
Q

Organisms causing sore throat

A
  1. Viral
  2. Bacterial = group A beta haemolytic strep
    also group C/G step
  3. Bacterial = corynebacterium diptheria
  4. fusobacterium necrophorum
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21
Q

What criteria is used to see if abx should be given for sore throat

A

Centor to rule in/out group a strep

  • fever?
  • inflammation?
  • no cough or runny nose
  • present within 3 days
  • pus on tonsils
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22
Q

Management of group A strep pharyngitis

A
  1. 10 days oral penicillin V or macrolide like clarithromycin if allergy
  2. isolate if in hospital
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23
Q

What happens if you don’t treat group A strep pharyngitis

A
  1. quinsy (paratonsillar abscess)
  2. scarlet fever
  3. rheumatic fever
  4. glomerulonephritis
  5. nec fasc
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24
Q

How can diptheria manifest

A
  1. pharyngitis/tonsilitis(stuck)

2. myocarditis, neuropathy

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25
Q

Features of mono

A

Fever, tired, sore throat
lymphadenopathy
splenomegaly
rash if given amoxicillin

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26
Q

EBNA

A

+ for EBV 2 months later

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27
Q

Management of mono

A

symptomatic

avoid contact sports for 6 weeks risk of splenic rupture

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28
Q

Organisms usually causing otitis media + sinusitis

A
  1. viral
  2. strep pneumoniae (mastoiditis and meningitis risk)
  3. haemophilus influenzae
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29
Q

Symptoms of OM/sinusitis

A

Fever, pain, tenderness

- deafness, dizziness

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30
Q

Organism causing acute epiglottitis

A

Haemophilus influenzae B

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31
Q

Symptoms of acute epiglottitis

A

Distress, dysphonia, dysphagia, drooling

32
Q

Management of acute epiglottitis

A

Intubate, IV ceftriaxone

33
Q

What organism causes whooping cough

A

Bordetella Pertussis

34
Q

Course of whooping cough

A
  1. 2 weeks highly infectious, standard virus symtpoms
  2. Intense cough for 2-6 weeks
  3. Chronic cough
35
Q

Consequences of whooping cough

A

Pneumothorax
Apnoea, brain damage
failure to thrive

36
Q

Management of whooping cough

37
Q

What causes croup in kids

A

viruses eg RSV

= inflammation in U+LRT

38
Q

Clinical features of croup

A

barking cough

39
Q

Management of croup

A

oral dexamethasone, paracetamol, oxygen NO ABX

40
Q

Name two neuraminidase inhibitors

A

Oseltamivir(oral) = tamiflu

Zanamivir (inh)

41
Q

What organisms causes bronchiolitis

42
Q

What is considered as an exacerbation of COPD

A

Baseline change in 2/3 of:

  • volume of sputum
  • colour of sputum
  • breathlessness + wheeze
43
Q

Organisms causing COPD exacerbations

A
  1. Viruses (rhino, rsv, flu, adeno)
    Bacterial - strep pneumo, haemophilus, moraxella, ecoli + kleb
    Can have non infective causes
44
Q

Which abx for exacerbation of COPD

A

amoxicillin , doxycycline

45
Q

Assessing pneumonia mortality risk

A 
Confusion
Urea
Resp rate
BP 
65+
46
Q

treatment of pneumococcal pneumonia

A

benzylpenicillin

clarithromycin/levofloxacin if allergy

47
Q

What can legionella cause

A

pneumonia
colonises water systems
can cause a severe pneumonia

48
Q

How is legionella pneumophilia diagnosed

A

urine antigen

49
Q

How is legionella treated

A

Levofloxacin, macrolide

50
Q

Erythema nodosum + pneumonia in a young adult

A

Mycoplasma pneumoniae
Dx: throat swab PCR
Tx: macrolid

51
Q

Which organisms can cause an atypical presentation/ CXR of pneumonia

A
  1. Legionella
  2. Mycoplasma
  3. Chlamydophilia pneumonia
  4. Clamydophilia psitacci (bird droppings, rash, hep)
  5. Viral
52
Q

Bronchiectasis can be post infective - from what?

A

TB
Pneumonia
Pertussis (whooping)
childhood infections

53
Q

What is lemierre’s syndrome

A

Infection caused by anaerobe fusobacterium necrophorum that spreads to IJV, blood, lungs (abscess) and others

54
Q

Treatment of HAP

A

Early: co-amoxiclav
Late: piperacillin+tazobactam

55
Q

Which organisms cause aspiration pneumonia

A

Gram -ves

anaerobes

56
Q

Which fungi can cause a pneumonia

A
  1. candida
  2. aspergillus
  3. cryptococcus
  4. pneumocystis jiroveci
57
Q

For which two organisms causing RTI is urine antigen detection useful

A

Legionella

Strep pneumo

58
Q

What organism can cause myocarditis in central and south america

A

Trypanosoma cruzi causes Chagas disease
Bites near eyes and mouth
Can cause myocarditis -> heart failure
+ megaoesophagus and megacolon

59
Q

Which organism usually causes acute endocarditis

A

Staph aureus

60
Q

Which organism usually causes subacute endocarditis

A

Strep

Staph epidermidis

61
Q

Commonest organism causing infection in IVDU

A

Staph aureus

62
Q

Which organism is associated with infective endocarditis and colon cancer

A

Strep bovis

63
Q

?infective cause of throat pain what should you test for

64
Q

Which organism usually causes oesophagitis

65
Q

Tests for H pylori infection

A

Urea breath test

rapid urease test w endoscopy sample

66
Q

Complications of untreated H pylori

A

Gastric cancer

Gastric MALT lymphoma

67
Q

TX of H pylori infection (gastritis)

A

1 week triple therapy:

  1. PPI
  2. Clarithromycin
  3. Metranidazole/ Amoxicillin
68
Q

How can staph aureus cause diorrhoea

A

Contaminated food, not cooked properly so organisms produce toxins that survive on cooking

69
Q

Causes of c diff infection

A

Broad spectrum abx

PPIs

70
Q

Symptoms of c diff infection

A

FOUL smelling diarrhoea, fever, dehydration, shock

71
Q

Complications from c diff toxin production

A
  1. pseudomembranous colitis + toxic megacolon

2. bowel perforation

72
Q

Does alcohol gel kill c diff

A

no

spores that are formed resist

73
Q

Treatment of c diff

A

Mild : metronidazole
Moderate/severe = oral/rectal vancomycin
Recurrent c diff = fidoxamycin
faecal transplant

74
Q

How dose cholera cause diarrhoea

A

Pumps chloride into gut lumen -> water follows

75
Q

Bloody diarrhoea + reactive arthritis + conjunctivitis + haemolytic uraemic syndrome

CC2 (8 decks)

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