Infections and antibiotics

Question 1

What is the most common bacterial cause of tonsilitis?

Answer 1

group A beta-haemolytic strep (strep pyogenes)

Question 2

What is the bacteria associated with rheumatic fever?

Answer 2

group A beta haemolytic strep - usually strep. pyogenes from tonsilitis

Question 3

What are the most common bacteria associated with infective endocarditis?

Answer 3

strep viridans
staph aureus
staph epidermidis

Question 4

What causes croup?

Answer 4

parainfluenza virus type 1 or 3

Question 5

what causes acute epiglottitis ?

Answer 5

human influenza type B

Question 6

What causes bronchiolitis?

Answer 6

respiratory syncytial virus

Question 7

what bacterial most commonly causes otitis media?

Answer 7

strep pneumonia
HiB
moraxella cararrhalis

Question 8

what type of pneumonia is associated with having erythema multforme and eythema nodosum

Answer 8

mycoplasma pneumoniae

Question 9

What antibiotic is used for bacterial tonsilitis?

Answer 9

Pen V
Clarithromycin/ erythromycin in penicillin allergic

Question 10

What bacteria cause UTIS?

Answer 10

KEEPS
Klebsiella pneumoniae
Enterococci
E.coli
Proteus mirabillis
Staphylococcus aureus

Question 11

what antibiotic is used to treat UTIs in adults

Answer 11

3 days trimethoprim or nitrofuratoin in women
men/complicated= 7 days

Question 12

How are upper UTIs treated in children?

Answer 12

either IV or oral cephalosporin or co-amoxiclav

Question 13

How are UTIs treated in pregnant women?

Answer 13

if early in pregnancy can give 7 days nitrofuratoin

If later can give 7 days cefalexin or amoxicillin

Question 14

what bacteria causes syphilis?

Answer 14

treponema pallidum

Question 15

how is syphilis treated?

Answer 15

IM benzathin penicillin
(alternative = doxycyline)

Question 16

what test can be done for syphilis?

Answer 16

direct tests with swabs- dark field microscopy or PCR

serological tests: treponemal tests (TP-EIA or TPHA) or non-treponemal tests (RPR or VRDL)

Question 17

what bacteria most commonly cause otitis externa?

Answer 17

pseudomonas aeruginosa and staph aureus

Question 18

How is otitis externa treated?

Answer 18

mild- acetic acid 2%

Moderate- topical antibiotic and steroid
- neomycin (dexamethasone and acetic acid)
- neomycin and betamethasone
- gentamycin and hydrocortisone)

severe- oral antibiotics (flucloxacillin)

Question 19

What might be used to administer antibiotics if very severe otitis externa

Answer 19

an ear wick (pope wick)

Question 20

What needs to be checked before giving antibiotics for otitis externa

Answer 20

need to exclude perforated tympanic membrane- gentamycin and neomycin are ototoxic so can cause hearing loss if crossing the tympanic membrane

Question 21

What bacteria most commonly causes mastitis?

Answer 21

staph. aureus

Question 22

how is mastitis treated?

Answer 22

flucloxacillin 10-14 days

Question 23

What bacteria causes lymes disease?

Answer 23

Borrelia burgdorferi

Question 24

What antibiotics are given for lymes disease?

Answer 24

doxycyline if early disease
ceftriaxone if disseminated disease

Question 25

How is lymes disease diagnosed?

Answer 25

ELISA test (not needed if eryhtema migrans is present) - if negative repeat in 4-6 weeks - if still negative = immunoblot test

Question 26

What antiviral might be considered in those at high risk with influenza

Answer 26

oral oseltamivir or inhaled zanamivir

Question 27

How is gonorrhoea treated?

Answer 27

IM 1g ceftriaxone

Question 28

how is gonorrhoea treated in needle phobic?

Answer 28

400mg oral cefixime and 2g oral azithromycin

Question 29

How is gonorrohoea diagnosed?

Answer 29

NAAT

Question 30

HOw is chlamydia treated?

Answer 30

doxycycline 7 days

Question 31

how is chlamydia treated in pregnant women?

Answer 31

azithromycin

Question 32

What bacteria cause bacterial vaginosis?

Answer 32

gardnerella vaginalis prevotella species bacteriodes species peptostreptococcus species

Question 33

pathophysiology of how bacterial vaginosis occurs

Answer 33

bacteria such as gardnerella cause and overgrowth and replace normal vaginal bacteria- this leads to rise in pH

Question 34

How is bacterial vaginosis treated for?

Answer 34

microscopy- shows clue cells

Question 35

how is bacterial vaginosis treated?

Answer 35

oral metronidazole 400mg for 5-7 days single dose 2g metronidazole (not if pregnant) intravaginal metronidazole gel for 5 days

Question 36

What criteria is used for bacterial vaginosis ?

Answer 36

amsel criteria

Question 37

what makes up the amsel criteria?

Answer 37

vaginal pH > 4.5 typical discharge- thin, white, homogenous positive whiff-amine test clue cells on microscopy

Question 38

what bacterial causes scarlet fever?

Answer 38

Group A beta haemolytic strep (strep. pyogenes)

Question 39

How is scarlet fever treated?

Answer 39

oral pen V for 10 days (azithromycin if allergic)

Question 40

complications of scarlet fever

Answer 40

otitis media peritonsillar abscess acute rheumatic fever acute post strep glomerulonephritis pneumonia, meningitis

Question 41

How does scarlet fever present?

Answer 41

Sore throat, fever, headache pinpoint sandpaper like rash strawberry tongue cervical lymphadenopathy circumoral palor

Question 42

when can children with scarlet fever return to school?

Answer 42

24 hours after commensing antibiotics

Question 43

What bacteria causes whooping cough?

Answer 43

bordatella pertussis

Question 44

what antibiotic is used to treat whooping cough

Answer 44

azithromycin or erythromycin

Question 45

what causes slapped cheek syndrome?

Answer 45

parvovirus B19

Question 46

What causes staphyloccocal scalded skin?

Answer 46

staph aureus which produced epidermolytic toxins

Question 47

how is staphyococcal scalded skin treated ?

Answer 47

IV flucloxacillin analgesia hydration hospital admission

Question 48

what are some complications of mealses

Answer 48

otitis media pneumonia encephalitis subacute sclerosis panencephalitis

Question 49

what causes toxic shock syndrome?

Answer 49

toxin secreting staph aureus or group A streptococcal

Question 50

what is the diagnostic criteria of toxic shock syndrome?

Answer 50

temperature >38.9 hypotension (systolic BP <90) diffuse erythematous rash involvement of 3 or more organ systems (GI, mucous membranes, renal failure, CNS, thrombocytopenia)

Question 51

Pathophysiology of toxic shock syndrome

Answer 51

severe systemic reaction to staphylococcal exotoxins- in particular TSST-1 superantigen toxin

Question 52

How is impetigo treated?

Answer 52

if limited disease- topical 1% hydrogen peroxide or topical fusidic acid if severe- flucloxacillin

Question 53

When can children with impetigo return to school?

Answer 53

when all lesions are dry and crusted, or over 48 hours after starting antibiotics