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Finals > Infectious disease > Flashcards

Infectious disease Flashcards

1
Q

What colour do Gram negative bacteria stain?

A

Pink

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2
Q

What colour do Gram negative bacteria stain?

A

Purple

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3
Q

List some gram positive cocci

A

Staphylococcus
Streptococcus
Enterococcus

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4
Q

List some gram positive bacilli

A 
Corneybacterium 
Mycobacterium 
Listeria
Bacillus
Nocardia
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5
Q

List some gram positive anaerobes

A

Clostridium
Lactobacillus
Actinomycyes
Propionibacterium

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6
Q

List some gram negative bacteria

A 
Neisseria meningitis 
Neisseria gonorrhoea 
Haemophilus influenza 
E.col
Klebsiella 
Pseudomonas aeruginosa
Moraxella catarrhalis
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7
Q

What is the difference between gram positive and gram negative bacteria?

A

Gram positive - have thick peptidoglycan cell walls whereas gram negative do not

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8
Q

What are atypical bacteria?

A

Bacteria which cant be cultured in the normal way or gram stained - most often implicated in pneumonia

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9
Q

List some atypical bacteria

A 
Legionella pneumophila 
Chlamydia psittaci
Mycoplasma pneumoniae
Chlamydophila pneumoniae 
Q fever
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10
Q

What is MRSA

A

Methicillin resistant staphylococcus aureus
Resistant to beta lactam antibiotics
Problem in healthcare settings
Patients are swabbed before surgery/treatment in groin and nose
Eradication by chlorhexidine body was and antibacterial nasal cream
Doxycyline, clindamycin, vancomycin, teicoplanin, linezolid

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11
Q

What are extended spectrum beta lactamase bacteria (ESBLs)

A

Produce beta lactamase enzymes that destroy the beta lactam ring on the antibiotics - resistant to broad spectrum antibiotics
E.coli or Klebisella - cause UTI or pneumonia
Sensitive to carbopenams (meropenam or imipenem)

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12
Q

List the antibiotics which inhibit the cell wall synthesis

A

Antibiotics with a beta-lactam ring

  • Penicillin
  • Carbopenam such as meropenam
  • Cephalosporins

Antibiotics without a beta lactam ring

  • Vancomycin
  • Teicoplanin
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13
Q

List the antibiotics which inhibit folic acid metabolism

A

Sulfamethoxazole
Trimethoprim
Co-trimoxaole - combination of sulfamethoxole and trimethoprim

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14
Q

Which bacteria does metronidazole work in?

A

Anaerobic cells - partially reduced metronidazole inhibits nucleic acid synthesis and only reduced in anaerobic cells

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15
Q

List the antibiotics which inhibit protein synthesis by targeting the ribosome

A 
Macrolides - erythromycin, clarithromycin, azithromycin 
Clindamycin
Tetracyclines - doxycycline 
Gentamicin 
Chloramaphenicol
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16
Q

Which antibiotics will a proportion of penicillin allergic patients also cross react to?

A

Cephalosporin and carbopenams

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17
Q

What scoring system is used to pick up sepsis

A

NEWS

  • HR
  • BP
  • O2 sats
  • RR
  • Conscious level
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18
Q

What signs on examination may indicate sepsis

A 
Tachypneoa (often first sign) 
New onset AF 
Signs of potential sources - cellulitis, wound, cough or dysuria
Non blanching rash - meningococcal septicaemia 
Mottled skin
Reduced urine output 
Cyanosis
Elderly - confused or off legs
Neutropenic may have normal obs
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19
Q

List some investigations for sepsis

A 
FBC - WCC, neutrophils and platelets
U&Es - AKI
LFT - source and liver failuree
CRP 
Clotting - DIC 
Blood culture
LP - meningitis and encephalitis 
Urine dipstick and culture
CXR
CT scan abdomen if abscess
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20
Q

Describe the sepsis 6

A

Take

  • blood cultures
  • urine output
  • Blood lactate

Give

  • O2 (94-98% or 88-92% in COPD)
  • Empirical broad spectrum antibiotics until culture results
  • IV fluids
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21
Q

What causes neutropenia

A 
Chemotherapy
Clozapine
Hydroxychloraquine
Sulfasalazine
Carbimaxole#
Methotrexate
Quinine
Infliximab
Rituximab
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22
Q

What is neutropenic sepsis

A

Sepsis and neutrophils <1

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23
Q

How do you treat neutropenic sepsis?

A

Piperacillin with tazobactam (tazocin)

Other aspects are the same for sepsis

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24
Q

How long do you have to treat sepsis?

A

golden hour

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25
Q

Describe the pathophysiology of sepsis

A

Pathogens recognised by immune cells. Cytokines (IL and TNF) produced. Vasodilation and fluid leaking into extracellular space, reduction in intracellular volume. Oedema reduces oxygen delivery to tissue.
Activation of the coagulation system reduces perfusion - thrombocytopenia, haemorrhage and DIC
Blood lactate rises due to hypoperfusion of tissues - anaerobic respiration

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26
Q

Define septic shock

A

Arterial blood pressure and result in organ hypoperfusion
Rise in blood lactate - anaerobic respiration
SBP <90
Hyperlactaemia >4
Treat with aggressive IV fluids and inotropes (noradrenalin) if not responding to fluids

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27
Q

List some signs of severe sepsis

A 
Hypoxia
Oliguria
AKI
Thrombocytopenia
Coagulation dysfunction
Hypotension
Hyperlactaemia
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28
Q

List some risk factors for sepsis

A 
Very young or old
Chronic conditions - COPD and DM 
Chemotherapy, immunosuppressants
Surgery 
Recent trauma or burns
Pregnancy or post partum 
Indwelling medical devices
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29
Q

Who does Pseudomonas aeruginosa present in?

A

Cystic fibrosis and bronchiectasis

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30
Q

What do cystic fibrosis patients take to prevent Staphylococcus pneumonia

A

Flucloxacillin

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31
Q

Which antibiotics can be used to treat atypical pneumonias

A

Macrolides - clarithromycin
Quinolones - levofloxacin
Tetracylines - doxycycline

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32
Q

Give some symptoms of lower urinary tract infection

A 
Dysuria - pain, stingin, burning when passing urine 
Suprapubic pain or discomfort 
Frequency 
Urgency 
Incontinence #
Confusion - elderly
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33
Q

Give some sympotm sof pylenephritis

A 
Fever
Loin, suprapubic or back pain - bilateral or unilateral 
Looking and feeling generally unwell 
Vomiting 
Loss of appetite
Haematuria
Renal angle tenderness
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34
Q

What are nitrites a sign of in urine

A

Gram negative bacteria break down nitrates to nitrites

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35
Q

What type of sample is sent to lab to test the sensitivities of UTI

A

Midstream urine

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36
Q

Describe E.coli

A

Gram negative anaerobic bacilli

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37
Q

List some other bacteria which can be present in urine

A 
Klebsiella pneumoniae 
Enterococcus
Pseudomonas aerginosa
Staphylococcus saprophyticus
Candida albicans (fungal)
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38
Q

How long should you give antibiotics for in UTIs

A

3 days in simple LUTI in women
5-10 days in immuncompromised, abnormal anatomy or impaired kidney function women
7 days in men, pregnant women and catheter related UTI

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39
Q

What is the complication of UTI in pregnant

A

Increased risk of pyelonephritis, premature rupture of membranes and pre-term labour

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40
Q

Which antibiotics are avoided in pregnancy

A

Trimethoprim - avoid in 1st trimester due to anti folate effect
Nitrofuratoin - avoid in 3rd trimester - haemolytic anaemia in newborn

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41
Q

Describe the management of pyelonephritis

A

Refer to hospital if signs of sepsis

7-10 days of cefalexin, co-amoxiclav, trimethroprim or ciprofloxacin depending on local sensitivity

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42
Q

Describe the presentation of cellulitis

A 
Erythema 
Warm or hot to touch 
Tense
Thickened
Oedematous
Bullae (fluid flilled blisters) 
Golden yellow crust - impetigo - staph aureus infection
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43
Q

List the causes of cellulitis

A

Staphyloccous aureus
Group A streptococcus - strep pyogenes
Group C strep - strep dysgalactiae
MRSA

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44
Q

Describe the Eron classification

A

1) no systemic toxicity or comorbidity
2) systemic toxicity or comorbidity
3) significant toxicity or significant comorbidity
4) sepsis or life threatening

Admit patients if class 3 or 4 or old, very young or immunocompromised - IV Abx

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45
Q

How is cellulitis treated?

A

Flucloxacillin - gram positive cocci - PO/IV
Clarithromycin
Clindamycin
Co-amoxiclav

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46
Q

Which organism commonly causes bacterial tonsillitis

A

Group A streptococcus - Streptococcus pyogenes

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47
Q

WHich organism commonly causes otitis media and sinusisits and tonisitis not caused by GAS

A

Streptococcus pneumoniae
Haemophilus influenza
Moraxella catarrhalis
Staphylococcus aureus

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48
Q

Describe the Centor criteria

A

Fever >38
Tonsillar exudates
Abscence of cough
Tender anterior cervical lymph nodes

The more points, the greater likelihood of bacteria so give Abx if score >3

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49
Q

Which antibiotic is given to treat bacterial tonsillitis

A

Penicillin V for 10 days

Co-amoxiclav
Clarithromycin
Doxycyline

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50
Q

What is otitis media

A

Infection in middle ear
Bulging red tympanic membrane, may have pus if perforated
Resolves 3-5 days without antibiotics but give antibiotic if systemically unwell

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51
Q

What antibiotic should be given for otitis media

A

Amoxicillin (clarithromycin/erythromycin in allergy)

Co-amoxiclav 2nd line

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52
Q

Describe sinusitis and its treatment

A

2-3 weeks and resolves without management

<10 days - self care
2 weeks of high dose steroid nasal spray
Bacterial cause - consider delayed or immediate prescription of penicillin V for 5 day course (clarithromycin/erythromycin (pregnancy), doxycycline if allergy) or co-amoxiclav if not responding.

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53
Q

Which antibiotics can cause C.difficile infection?

A

Cephalosporin

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54
Q

What is spontaneous bacterial peritonitis and how is it treated?

A

Piperacillin/tazobactam - 1st line
Cephalosporin - cefotaxime
Levofloxacin plus metronidazole - in penicillin allergy

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55
Q

Which antibiotic is bactericidal to gram negative bacteria and so often given as a STAT dose in severe intra-abdominal infection

A

Gentamicin

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56
Q

How does septic arthritis present

A

Single joint - most often knee
Hot, red, swollen and painful joint
Stiffness and reduced range of motion
Systemic symptoms - fever, lethargy and sepsis

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57
Q

What increases the risk of septic arthritis

A

Joint replacement - particularly revision

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58
Q

List the bacteria causing septic arthritis

A

Staphylococcus aureus

Neisseria gonorrhoea (gonococcus - gram negative gonoccus) in sexually active individuals - gonoococcal septic arthritis is different to reactive arthritis

Group A streptococcus - streptococcus pyogenes

Haemophilus influenza

E.coli

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59
Q

What are the differentials of a acutely hot and swollen joint?

A

Gout
Pseudogout
Reactive arthtitis
Haemoarthosis

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60
Q

Describe the management of septic arthritis

A

Aspirate the joint - gram staining, crystal microscopy, culture and antibiotic sensitivities

Empirical IV antibiotics given until sensitives known - continue for 3-6 weeks - Flucloxacillin plus rifampicin is often 1st line, vancomycin plus rifampicin for penicillin allergy, MRSA or prosthetic joint, clindamycin is an alternative

61
Q

What type of virus is influenza

A

RNA virus

62
Q

What is H1N1 influenza

A

Swine flu

63
Q

What is H5N1 influenza

A

Avian flu

64
Q

Who is eligible for free flu jab?

A 
>65 yo 
Young children
Pregnant women
Chronic health conditions - asthma, COPD, HF, DM
Healthcare workers and carers
65
Q

Which drugs can be given to people at risk of complications who develop influenza

A

Oral oseltamivir (tamiflu) 75mg BD for 5 days or
Inhaled zanamivir 10mg BD for 5 days
Start treatment <48hrs of symptoms
Post exposure prophylaxis to high risk groups <48hrs of exposure - half the treatment dose for double the treatment time (10 days)

66
Q

List the viruses which can cause viral gastroenteritis

A

Rotavirus
Norovirus
Adenovirus

67
Q

Which bacteria can cause gastroenteritis

A

E.coli - shiga toxin E.coli 0157. Haemolytic uraemic syndrome due to shiga toxin which destroys blood cells. Antibiotics can increase risk of HUS

Campylobacter jejuni - travellers diarrhoea, most common worldwide, curved bacteria, gram negative spiral shaped bacteria, raw poultry, untreated water and unpasterised milk. 2-5 day incubation. 3-6 day symptom resolution. Antibiotics - azithromycin and ciprofloxacin

Shigella - produces shiga toxin and cause HUS. Symptoms for 1 week and resolve without treatment. Can be treasted with antibiotics in severe cases - azithromycin and ciprofloxacin

Salmonella - raw egg/poultry, incubation period 12hrs-3 days. Symptoms resolve within 1 week. Watery diarrhoea and mucus or blood, abdo pain and vomiting. Antibiotics only in severe cases and guided by stool culture

Bacillus cereus - gram positive rod spread by inadequately cooked food. Cerelide toxin causing vomiting within 5hrs, watery diarrhoea >8hrs, symptoms resolve within 24hrs. IVDU endocarditis also.

Yersinia enterocolitica - gram negative bacillus, raw pork can cause infection, young children, watery/bloody diarrhoea, lymphadenopathy, fever, abdo cramps. 4-7days incubation and long symptoms >3 weeks. Right sided abdo pain and fever in adults. Antibiotics dependent on stool culture

68
Q

Give an example of a parasite which causes gastroenteritis

A

Giardia lamblia - small intestine of mammals - release cysts in the stools of infected mammals which are transmitted by faecal-oral route. Chronic diarrhoea, diagnosis by stool microscopy. Treat with metronidazole

69
Q

How is gastroenteritis prevented

A

Isolation

Barrier nursing

70
Q

How is gastroenteritis managed

A

Stool culture
Assess for dehydration - fluid challenge
Rehydration solution - dioralyte
Slowly introduce light diet once oral intake tolerated
Stay off work or school for 48hrs after symptoms stop
Anti-diarrhoeal and anti-emetics avoided
Antibiotics only after stool culture and if risk of complications

71
Q

List some post-gastroenteritis complications

A

Lactose intolerance
IBS
Reactive arthritis
Guillian Barre syndrome

72
Q

Describe Neisseria meningitidis (meningococcus)

A

Gram negative diplococcus

73
Q

What is the significance of a non-blanching rash in meningitis

A

Meningococcal septicaemia
Bacteria in the blood
DIC

74
Q

Describe meningitis

A

Bacteria in meninges (layer round brain and spinal cord)

75
Q

What are the common causes of bacterial meningitis

A 
Neisseria meningitidis (meningococcus) 
Streptococcus pneumoniae (pneumococcus) 
Neonates - group B streptococcus - contracted in birth from vagina
76
Q

Describe the presentation of meningitis

A 
Headache#
Fever
Neck stiffness
Vomiting
Photophobia 
Altered consciousness 
Seizures

Neonates and babies - hypotonia, poor feeding, hypothermia, poor feeding, bulging anterior fontanelle - LP for <1month with fever, <3 months if fever and unwell

77
Q

Describe the presentation of meningococcal septicaemia

A

Non-blanching rash

78
Q

What special tests can be done to test for meningitis

A

Kernigs test - lie patient on back, flex one hip and knee to 90 degrees then slowly straighten knee whilst keeping hip flexed at 90 degrees - slight stretch in meninges and produces spinal pain or resistance

Brudzinskis test - lying the patient flat on their back and gently using your hands to lift their head and neck off the bed and flex their chin to their chest - positive test is when this causes the patient to involuntarily flex their knees and hips

79
Q

How is meningitis managed?

A

Primary care - IM/IV benzylpenicillin prior to hospital transfer

SEcondary care - LP to identify the bacteria for CSF, blood test for meningococcal PCR, cefotaxime plus amoxicillin if <3months and ceftriaxone if >3months

Vancomycin added if penicillin resistance - recent travel or prolonged antibiotic exposure

Steroids used to reduce frequency and severity of hearing loss and neurological damage - dexamethasone 4 times a day for 4 days

Notifiable disease

80
Q

Describe post exposure prophylaxis in meningitis

A

Risk is highest for people who had close prolonged contact within 7 days prior to illness

Guided by public health - single dose ciprofloxacin orally within 24hrs of inital diagnosis

81
Q

Which viruses can cause viral meningitis

A

Herpes simplex virus (HSV)
Enterovirus
Varicella zoster virus

82
Q

How is viral meningitis managed

A

Viral PCR testing

Aciclovir and supportive care

83
Q

Describe lumbar puncture

A

Inserting a needle in lower back (L3-L4 intervertebral space to avoid spinal cord )

Bacterial culutre, viral PCR, protein and glucose. Sample of blood glucose sent at the same time.

84
Q

Describe bacteria in the CSF

A 
Cloudy appearance
Low glucose
High protein 
High neutrophils 
Bacteria
85
Q

Describe viruses in the CSF

A 
Clear fluid
Mildly raised or normal protein 
Normal glucose
High lymphocytes
Negative for bacterial culture
86
Q

List the complications of meningitis

A

Hearing loss
Seizures and epilepsy
Cognitive impairment and learning disability and memory loss
Focal neurological problems

87
Q

Describe the bacterium which causes TB

A

Mycobacterium tuberculosis
Rod shaped bacteria
Resistant to acids used in staining procedure - Acid fastness - waxy coating

88
Q

How is mycobacterium tuberculosis diagnosed

A

Zeihl-Neelsen stain - red against blue background

89
Q

Who is TB more common in

A 
Close contacts of TB 
Asia 
HIV 
Homeless
IVDU
Alcoholics 
Immunocompromised 
Recent travel to prevalent areas
90
Q

What are multi drug reistant TB

A

Resistant to more than 1 drug

91
Q

Why are Tb hard to culture and treat

A

Slow growing

High oxygen demand

92
Q

How is Tb spread

A

Droplet infection
Then spread through lymphatics and blood
Granulomas form in the body

93
Q

What is active TB

A

Active infection

94
Q

What is latent TB

A

Immune system encapsulates the TB

95
Q

What is secondary TB

A

When the latent TB reacticates

96
Q

What is miliary TB

A

Disseminated severe disease

97
Q

Where is TB found in body

A 
LUngs 
Lymph node - cold abscess (firm painless abscess caused by TB in neck) 
Pleura
CNS
Pericardium
GI system 
GU system 
Bones and joints
Cutaneous - skin
98
Q

Describe the BCG vaccine

A

Intradermal injection of live attenuated TB

Protection against severe and complicated TB but less effective at preventing pulmonary TB

99
Q

Who is the BCG vaccine given to

A

Only those with negative mantoux test

High risk of contact with TB - people in high TB prevalence areas, family history of TB, healthcare workers

100
Q

Describe the presentation of TB

A 
Lethargy
Fever or night sweats
Weight loss
Cough with or without haemoptysis 
Lymphadenopathy
Erythema nodosum 
Spinal pain in spinal TB - Potts disease
101
Q

How is TB diagnosed

A

Ziehl Neelsen stain

Mantoux test ( previous immune response to TB suggesting vaccination, latent or active TB, inject tuberculin into intradermal space on forearm which creates a bleb under the skin, an induration of 5mm or more 72hrs later is positive) and Interferon gamma release assay (sample of blood mixed with TB antigens, WCC will be sensitised and release Interferon gamma if already had contact - positive)

CXR and cultures (3 sputum cultures/ bronchoscopy with lavage, mycobacterium blood cultures, lymph node aspiration and biopsy)

Nuclear acid amplicfication test - DNA of TB sputum or lymph node

102
Q

What are the chest Xray signs of primary TB

A

Patchy consolidation, pleural effusions and hilar lymphadenopathy

103
Q

What are the CXR signs of latent TB

A

Patchy or nodular consolidation with cavitation (gas filled spaces in lungs) typically upper zone

104
Q

What are the CXR signs of miliary TB

A

Millet seeds uniformly distributed throughout the lung fields

105
Q

Describe the management of latent TB

A

Isoniazid and rifampicin for 3 months

Isoniazid for 6 months

106
Q

Describe the management of active TB

A 
RIPE
Rifampicin for 6 months 
Isoniazid for 6 months
Pyrazinamide for 2 months 
Ethambutol for 2 months
107
Q

What side effect does isoniazid cause

A

Peripheral neuropathy

108
Q

Which drug do you give alongside isoniazid to prevent peripheral neuropathy

A

Pyridoxine (vitamin B6)

Im so numbazid

109
Q

What are the side effects of rifampicin

A

Red/orange discolouration of urine and tears - red and orange pissin
Potent inducer of the cyctochrome P450 - reduces effects of drugs metabolised by this system

110
Q

What are the side effects of Ethambutol

A

Colour blindness and visual acuity

Hepatotoxicity

111
Q

What are the side effects of pyazinamide

A

Hyperuricaemia - gout

Hepatotoxity

112
Q

What type of virus is HIV

A

RNA retrovirus

113
Q

Which cells does HIV affect

A

CD4 T helper cells

114
Q

Describe the seroconversion of HIV

A

Flu like illness a few weeks after infection

115
Q

How is HIV spread

A

Unprotected sexual activity
Vertical transmission at any stage of pregnancy and breast feeding
Needles
Blood splashed in eye

116
Q

List some AIDs defining illnesses

A 
Kaposis sarcoma
Pneumocystis jirovecii pneumonia 
CMV infection
Candidiasis - oesophageal and bronchial 
Lymphoma 
TB
117
Q

How long does it take for HIV to be detected on antibody tests

A

3 months

118
Q

Describe the investigations for HIV

A

Antibody blood test
P24 antigen - earlier diagnosis
PCR testing for the HIV RNA levels test directly for the quantity of the HIV virus in the blood and gives a viral load

CD4 count monitoring - <200 - end stage
Viral load - number of HIV RNA per ml of blood

119
Q

Define undetectable for HIV

A

Viral load <50-100 copies per ml

120
Q

How is HIV treated

A 
Antiviral therapy medications 
2 NRTIs (nuceloside reverse transcriptase inhibitors) - tenofovir and emtricitabine plus a third agent (protease inhibitors, integrase inhibitors, non-nucleoside reverse transcriptase inhibitors, entry inhibitors)

Prophylatic septrin (co-trimoxazole) for PCP

Statins as HIV increases CVD

Yearly cervical smears - HPV and cervical cancer

Vaccinations - but avoid live vaccines

121
Q

What treatment should babies be given following birth from HIV mother

A

4 weeks ART to reduce risk of vertical transmission

122
Q

Describe post exposure prophylaxis

A

Used after exposure to HIV and reduce risk of transmission

Must be started within 72hrs

ART - truvada (emtriciabine and tenofovir) and raltegravir -

HIV test minimum 3 months after and abstain from unprotected sex for 3 months

123
Q

What causes malaria

A

Plasmodium family of protozoan (single celled organism) parasites

Plasmodium falciparum - female anopheles mosquitor

124
Q

Describe the life cycle of malaria

A

Spread by female anopheles mosquitoes

Infected blood reproduces in the gut of mosquito producing thousandds of sporozoites

Sporozorites injected into human blood which travel to liver of person and lie dormant as hypnozites for severeal years in P vivax and P ovale. Mature into merozoites which enter blood and infect RBC which mature for 48hrs which then rupturee and cause haemolytic anaemia and release of lots more merozoites

Fever spikes every 48hrs

125
Q

List the four types of malaria

A

Plasmodium falciparum - most common and severe
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae

126
Q

Describe the presentation of malaria

A 
1-4 week incubation 
Travelled to high prevalence area 
Fever, sweats and rigors, malaise, myalgia, headache and vomiting 
Pallor- anaemia
Hepatosplenomegaly
Jaundice - haemolysis
127
Q

How is malaria diagnosed

A

Malaria blood film - sent in an EDTA bottle (red top used for FBC)
Parasites
3 samples sent over 3 consequtive days to exclude malaria due to 48hr cycle of malaria being release into blood

128
Q

Describe the management of malaria

A

Artemether with lumefantrine (riamet)
Proguanil and atovaquone (malarone)
Quinine sulphate
Doxycycline

Artesunate - IV
Quinine dihydrochloride - IV

129
Q

List the complications of falciparum

A 
Cerebral malaria
Seizures
GCS reduction
AKI
Pulmonary oedema
DIC
Haemolytic anaemia 
Multi-organ failure and death
130
Q

Describe malaria prophylaxisis

A

Antimalarial medications
- proguanil and atovaquone (malarone) - taken daily 2 days before and 1 week after being in endemic area, expensive, best side effect profile
- Mefloquine
Taken once weekly 2 weeks before, during and 4 weeks after being in endemic area - dreams and psychotic disorders
- Doxycyline - diarrhorea and candidal and sun sentiviities
Mosquito spray
Mosquito nets and barriers

131
Q

List some antibiotics which cover anaerobes

A

Doxycycline
Metronidazole
Piptaz
Co-amoxiclav

132
Q

What is amoxicillin and doxycyline used to treat

A

CAP

133
Q

What is ceftriaxone used to treat

A

Bacterial meningitis

Skin/soft tissue infection in penicillin allergic

134
Q

What is co-amoxiclav used to treat

A

Pyelonephritis and gut stuff

135
Q

What is piperacillin/tazobactam and gentamicin used to treat

A

Neutropenic sepsis

136
Q

What are vancomycin, gentamicin and metronidazole used to treat

A

Sepsis and in severe penicillin allergic cases

137
Q

List some reasons to avoid broad spectrum Ab

A

Risk of C.difficile

Risk of resistant organism

138
Q

List some reasons not to use narrow spectrum Ab

A

Patient too sick

Risk of the bacteria not being targeted

139
Q

What specific bacteria do pip/taz and gent cover

A

Pseudomonas

140
Q

What is the most common complication of C.diff despite best medical management

A

Relapse - 1/3

Restart treatment early

141
Q

What is ascending lymphangitis

A

Tracking up the lymphatic system - ascending up the lymph

142
Q

What non-pharmacological interventions can be useful in cellulitis

A

Mark the area and elevate the leg

143
Q

What would be the antibiotic choice for someone with cellulitis and penicillin allergy

A

Teicoplanin

144
Q

List some features of necrotising fascitis

A

Pain out of proportion

Rapidly spreading

145
Q

What is the commonest cause of viral meningitis in the UK

A

Enterovirus

146
Q

What is the commonest bacteria causing meningitis in a patient >60

A

S.pneumoniae

147
Q

Describe mumps

A 
Long incubation perior 16-18days
Aseptic meningitis in up to 15 % 
Most common symptom is parotitis 
Epididymo-orchitis in 25% 
Sensorineural deafness also well recognised Highly infectious - respiratory droplets and direct contact
148
Q

List the 4 Cs of measles

A

Cough
Conjunctivitis
Coryza
Koplik spots

Finals (18 decks)

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