Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Medicine > Infectious disease > Flashcards

Infectious disease Flashcards

1
Q

What is sepsis

A

Body launches a large immune response

Get systemic inflammation that affects the functioning of organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is septic shock

A

When arterial BP drops enough to cause organ hypo-perfusion (systolic BP < 90 despite fluids)

Get buildup of lactate (organs undergoing anaerobic respiration)

Treatment: aggressive IV fluid regime, refer to HDU/ITU (for inotropes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is severe sepsis

A

Sepsis with organ dysfunction

Hypoxia, oliguria, AKI, thrombocytopenia, coagulation dysfunction, hypotension, hyperlactaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the risk factors for sepsis

A

Extremes of age

Chronic conditions

Immunosuppression

Recent surgery or trauma

Pregnancy or peripartum

Indwelling medical device

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How might sepsis present

A

High NEWS

Signs of potential source (cellulitis, wound discharge, cough…)

Non-blanching rash

Reduced urine output

Mottled skin

Cyanosis

Arrhythmia

Tachycardia often first sign

Elderly often confused and drowsy

Immunosuppressed patients may have normal obs despite being very unwell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What investigations are needed for sepsis

A

FBC, U&Es LFTs, CRP, clotting

Blood cultures

ABG

Urine dip

CXR

Lumbar puncture (if suspect meningitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Go through sepsis 6

A

Give oxygen

Give broad spectrum antibiotics

Give IV fluids

Take lactate

Take blood cultures

Take urine output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do chest infections typically present

A

Cough

Sputum production

Shortness of breath

Fever

Lethargy

Crackles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the most common causative organisms for chest infections

A

Streptococcus pneumoniae

Haemophilus influenzae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which organisms cause chest infections in cystic fibrosis

A

Pseudomonas aeruginosa

Staphylococcus aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the causative organisms for atypical pneumonia

A

Legionella pneumophila

Chlamydia psittaci

Mycoplasma pneumoniae

Chlamydophila pneumoniae

Q fever (coxiella burnetii)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the antibiotic choices for chest infections

A

Community: amoxicillin

Alternatives: erythromycin, clarithromycin, doxycycline

Atypical bacteria: clarithromycin, levofloxacin, doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How might lower UTIs present

A

Dysuria

Suprapubic pain/discomfort

Frequency

Urgency

Incontinence

Confusion (in old/frail)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How might pyelonephritis present

A

Fever

Loin, suprapubic, and back pain

Feeling generally unwell

Vomiting

Loss of appetite

Haematuria

Renal angle tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What would be the abnormalities on urine dipsticks in UTIs

A

Nitrites (gram negative break down nitrates to nitrites)

Leukocytes (rise in infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the causative organisms of UTIs

A

E coli

Klebsiella pneumoniae

Enterococcus

Pseudomonas aeruginosa

Staphylococcus saprophyticus

Candida albicans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What duration of antibiotics need to be used in UTIs

A

3 days: simple UTIs in women

5-10 days: immunosuppressed, anatomical abnormality, impaired kidney function

7 days: men, pregnant women, catheter-relates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the antibiotic choices in UTIs

A

Community: trimethoprim, nitrofurantoin

Alternatives: amoxicillin, cephalexin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How are UTIs managed in pregnancy

A

7 days: nitrofurantoin (first line, but avoid in 3rd trimester), amoxicillin, cefalexin

Higher risk of: pyelonephritis, premature rupture of membranes, preterm labour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the NICE guidelines for managing UTI pyelonephritis

A

In community, 7-10 days of: cefalexin, co-amoxiclav, trimethoprim, ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How might skin/soft tissue infections present

A

Erythema

Hot

Tense

Thickened

Oedema

Bullae

Golden-yellow crust (staph aureus infection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the causes of skin/soft tissue infections

A

Staph aureus

Group A strep (mostly strep pyogenes)

Group C strep (mostly strep dysgalactiae)

MRSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the Eron classification

A

NICE assessment of severity of cellulitis

Class 1: no systemic toxicity or comorbidity

Class 2: systemic toxicity or comorbidity

Class 3: significant systemic toxicity or comorbidity

Class 4: sepsis, or life-threatening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When should skin/soft tissue infections be admitted

A

All class 3 or 4 infections (need IV antibiotics)

Consider for: frail, very young, immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the antibiotics used for skin or soft tissue infections
Flucloxacillin (first line, IV or oral) Clarithromycin Clindamycin Co-amoxiclav
26
What are the common causative organisms of intra-abdominal infections
E coli Klebsiella Enterococcus Streptococcus
27
What is septic arthritis
Infection within a joint An emergency (mortality of 10%) Important complication of joint replacement
28
How might septic arthritis present
Single joint affected Rapid onset Hot, red, swollen, painful Stiff, reduced range of motion Systemic symptoms (fever, lethargy, sepsis)
29
Which bacteria commonly cause septic arthritis
Staphylococcus aureus Neisseria gonorrhoea Streptococcus pyogenes Haemophilus influenzae E coli
30
What are the differentials for septic arthritis
Gout Pseudogout Reactive arthritis Haemarthritis
31
What is the management for septic arthritis
Low threshold for suspicion (until ruled out by joint fluid examination) Follow local hot joint policy Empirical IV antibiotics: until sensitivity testing comes back 3 - 6 weeks of antibiotics
32
Who is offered the influenza vaccine
> 65s Young children Pregnant women Chronic conditions Healthcare workers Carers
33
How might influenza present
Fever Coryzal symptoms Lethargy and fatigue Anorexia Muscle and joint aches Headache Dry cough Sore throat
34
How is influenza diagnosed
Nasal/throat swab
35
What is the management for influenza
Only for those at risk of complications: oral oseltamivir (5 days), inhaled zanamivir (5 days) Need to start within 48 hours of symptoms Can give post-exposure prophylaxis to high risk patients (10 days of antivirals)
36
What are the complications of influenza
Otitis media Sinusitis Bronchitis Viral pneumonia Secondary bacterial pneumonia Worsening of chronic conditions Febrile convulsions Encephalitis
37
What are the viral causes of gastroenteritis
Rotavirus Norovirus Adenovirus
38
What are the bacterial causes of gastroenteritis
E coli (0157 produces shiga toxin, get haemolytic uraemic syndrome, bloody diarrhoea, avoid antibiotics (higher risk of HUS)) Campylobacter jejuni (travellers' diarrhoea, can treat with azithromycin or ciprofloxacin) Shigella (bloody diarrhoea, can get haemolytic uraemic syndrome, can treat with azithromycin or ciprofloxacin) Salmonella (raw eggs/poultry, watery diarrhoea) Bacillus cereus (rice, cramps, vomiting, diarrhoea, self resolves in 24 hrs) Yersinia enterocolitica (from pork) Staph aureus (eggs, dairy, meat) Giardia (from animals, chronic diarrhoea, treat with metronidazole)
39
What is the management for gastroenteritis
Good hygiene Immediately isolate patient Microscopy, culture and sensitivity of faeces Do a fluid challenge Rehydration solution Stay off work/school for 48 hrs after resolution) Do not give antidiarrhoeals or antiemetics
40
What are some post-gastroenteritis complications
Lactose intolerance IBS Reactive arthritis Guillain-Barre syndrome
41
What are the common causative organisms of bacterial meningitis
Neisseria meningitidis Streptococcus pneumoniae Group B strep
42
What is meningococcal septicaemia
When meningococcal bacteria infect the bloodstream Causes a non-blanching rash Can cause: DIC, subcut haemorrhage
43
How might bacterial meningitis present in adults
Fever Neck stiffness Vomiting Headache Photophobia Altered consciousness Seizures
44
How might bacterial meningitis present in neonates and babies
Non-specific signs and symptoms Hypotonia Poor feeding Lethargy Hypothermia Bulging fontanelles
45
What are the NICE guidelines for lumbar puncture in neonates and babies
Under 1 month with a fever 1 - 3 months with fever and generally unwell Under 1 with unexplained fever and features of serious illness
46
What are the special tests for bacterial meningitis
Kernig's sign Brudzinshi's sign
47
What is the management for bacterial meningitis
Community: children need stat IM/IV benzylpenicillin before transfer to hospital Hospital: blood cultures, lumbar puncture, send blood tests for meningococcal PCR, low threshold for treating Antibiotics, steroids (reduce neurological damage) Notifiable disease
48
What is the post exposure prophylaxis for bacterial meningitis
Single dose of antibiotics Close prolonged contact with someone 7 days prior to onset of illness
49
What are the causes of viral meningitis
Herpes simplex Enterovirus Varicella zoster
50
What is the management for viral meningitis
Send CSF for viral PCR testing Usually only supportive treatment needed May need antivirals
51
What are the complications of meningitis
Hearing loss Seizures and epilepsy Cognitive impairment Memory loss Focal neurological deficits
52
What is the disease course of TB
Droplet inhalation spread Granulomas containing bacteria from around the body Active TB: active infection in various parts of the body Latent TB: immune system encapsulates sites of infection, stop disease progression, becomes secondary TB when reactivates If immune system unable to control disease: disseminated TB Severe disease: miliary TB
53
How might TB present
Chronic, gradually worsening symptoms Lethargy Fever Night sweats Weight loss Cough Haemoptysis Lymphadenopathy Erythema nodosum Spinal pain (Pott's disease of the spine)
54
What are the risk factors for TB
Known contact with active TB Immigrants from high TB areas Close contact with countries with high TB rates Immunosuppression Homeless Drug use Alcoholics
55
Who is the BCG vaccine offered to for TB
Neonates from UK areas with high TB Neonates with relatives from high TB countries Neonates with family history of TB Unvaccinated children and adults with close TB contacts Unvaccinated children and young adults recently arrived from high TB country Healthcare workers
56
What are the investigations for TB
Ziehl-Neelsen staining Mantoux test: shows previous immune response, get a 'bleb' under skin, test for active disease if have positive result Interferon-Gamma release assay (IGRA): mix blood sample with TB antigen, used to diagnose latent TB CXR Cultures Nucleic acid amplification test
57
What would be seen on CXR in TB
Primary TB: patchy consolidation, pleural effusion, hilary lymphadenopathy Reactive TB: patchy or nodular consolidation with cavitation, usually in upper zones Disseminated miliary TB: 'millet seeds' uniformly throughout lung fields
58
What is the management for latent TB
No treatment in healthy people If at risk of reactivation: isoniazid and rifampicin for 3 months, or rifampicin for 6 months
59
What is the management for acute TB
RIPE Rifampicin for 6 months (causes red urine/tears and hepatotoxicity) Isoniazid for 6 months (causes peripheral neuropathy and hepatotoxicity) Pyrazinamide for 2 months (causes gout and hepatotoxicity) Ethambutol for 2 months (causes colour blindness and reduced visual acuity)
60
Which cells does HIV destroy
CD4+ T helper cells
61
How is HIV transmitted
Unprotected anal, vaginal or oral sex Vertical transmission Open wound exposure to infected blood or bodily fluids
62
What is AIDS-defining illness
Due to end-stage HIV infection CD4 count drops so low that get opportunistic infections and malignancies
63
How can HIV be tested for
Antibody blood test (P24 antigen) Patients can self-sample (get online kit, post sample) PCR for HIV RNA (can get a viral load)
64
What monitoring is needed for HIV
Viral load CD count: low count = higher risk of opportunistic infection, 500 - 1200 = normal, < 200 = end stage HIV/AIDS
65
What treatment is needed for HIV
Give antiretroviral therapy (ART) irrespective of viral load Aim: get CD4 normal CD4 count and undetectable viral load HAART medications Prophylactic co-trimoxazole Closely monitor for cardiovascular disease Yearly smear tests Avoid live vaccines
66
What are the medications in HAART management of HIV
Protease inhibitors Integrase inhibitors Nucleoside reverse transcriptase inhibitors Non-nucleoside reverse transcriptase inhibitors Early inhibitors
67
How might malaria present
Incubation of 1-4 weeks Fever, night sweats, rigors Malaise Myalgia Headache Vomiting Pallor (due to haemolytic anaemia) Hepatosplenomegaly Jaundice (due to rupturing RBCs)
68
How is malaria diagnosed
Malaria blood film (3 samples sent over 3 consecutive days, 48 hour cycle of malaria being released into bloodstream) Often see deranged bloods (anaemia, thrombocytopenia, leukopenia, abnormal LFTs)
69
How is malaria managed
Falciparum malaria: admit to treat (deteriorate very quickly) Oral options for uncomplicated malaria: riamet, malarone, quinine sulphae, doxycycline IV options for severe disease: artesunate, quinine dihydrochloride
70
What are the complications of falciparum malaria
Cerebral malaria Seizures Reduced consciousness AKI Pulmonary oedema DIC Severe haemolytic anaemia Multiorgan failure Death
71
What are some antimalarials that may be used for prophylaxis
Malarone Mefloquine Doxycycline
72
What are some common infection presentations after travel
Fever GI symptoms Jaundice Reticuloendothelial changes Respiratory symptoms Rash
73
What are some common causes of fever in a returned traveller
Malaria Dengue fever Typhoid fever
74
Which travel infections occur at 0 - 10 days
Dengue Rickettsia Viral GI
75
Which travel infections occur at 10 - 21 days
Malaria Typhoid Primary TB
76
Which travel infections occur at > 21 days
Malaria Chronic bacterial infections TB Parasitic infections
77
Where is typhoid fever common
Asia South America
78
How might typhoid fever present
Fever Anorexia Malaise Vague abdominal discomfort Altered bowel habits Dry cough Pulse-temperature dissociation Hepatosplenomegaly Rose-spots on skin
79
What investigations are needed for typhoid fever
FBC (leucopenia, lymphopena) CRP (raised) Isolate organism from cultures
80
What is the management for typhoid fever
Antibiotics
81
What is the definition of pyrexia of unknown origin
Temperature > 38 on multiple occasions Illness for > 3 weeks No diagnosis despite > 1 week of inpatient investigations
82
What are the common causes of pyrexia of unknown origin
Infective (TB, abscess, infective endocarditis, brucellosis) Autoimmune/connective tissue (adult onset Still's disease, temporal arteritis, Wegner's granulomatosis) Neoplasia (leukaemia, lymphoma, renal cell carcinoma) Other (drugs, VTE, hyperthyroidism, adrenal insufficiency)
83
Who should be screened for basic STIs
All known to have an STI All requesting a test All known to be at high risk

Medicine (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions