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Alice's finals cards > Infectious disease > Flashcards

Infectious disease Flashcards

1
Q

Which stain is used to differentiate between gram positive and gram negative bacteria? What is the result?

A

Crystal violet stain. Gram positive bacteria are stained but gram negative don’t

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2
Q

What is the name for rod shaped bacteria?

A

Bacilli

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3
Q

What is the name for circular shaped bacteria?

A

Cocci

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4
Q

What is the counterstain called which identifies gram negative bacteria? What colour does it turn?

A

safarin. Red/ pink

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5
Q

What is the difference in cell structure between gram positive and a negative bacteria?

A

Gram positive have a thick peptidoglycan cell wall

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6
Q

Name 3 gram-positive cocci?

A

Staphylococcus
Streptococcus
Enterococcus

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7
Q

What does MRSA stand for?

A

Methicillin- resistant staphylococcus aureus

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8
Q

Name 3 antibiotic treatment options for MRSA

A

Doxycyline
Clindamycin
Vancomycin

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9
Q

What are the 2 broad mechanisms of actions of antibiotics?

A

Bactericidal
Bacteriostatic

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10
Q

Which bacteria does amoxicillin cover?

A

Streptococcus, listeria and enterococcus (all gram +ve)

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11
Q

Which bacteria does co-amoxiclav cover?

A

Staphylococcus, haemophilus and e.coli

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12
Q

Which bacteria does tazocin cover?

A

Pseudomonas

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13
Q

Which bacteria does meropenem cover?

A

ESBLs (extended spectrum beta lactamases) These are bacteria which produce an enzyme which makes them resistant to beta lactamases

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14
Q

Which bacteria do teicoplanin and vancomycin cover?

A

MRSA

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15
Q

Which bacteria do clarithromycin and doxycyline cover?

A

Atypical bacteria

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16
Q

Why is oedema a feature of sepsis?

A

Massive cytokine release occurs in response to pathogen. This causes the endothelial lining of cells to be more permeable leading to fluid leakage.

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17
Q

What can oedema cause in sepsis and why?

A

tissue hypoxia because fluid leakage creates a space between vessels and tissue

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18
Q

Why does DIC occur in sepsis?

A

Coagulation system is activated leading to deposition of fibrin throughout the circulation system. This causes platelets to be used up

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19
Q

Why is blood lactate high in sepsis?

A

Hypo-perfusion of tissues causes tissues to switch to anaerobic respiration. A by-product of anaerobic respiration is lactate

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20
Q

What are the two main symptoms which measure if a patient is in septic shock?

A

Systolic blood pressure less than 90
Hyperlactaemia (>4mmol/L)

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21
Q

How is septic shock managed?

A

IV fluid boluses to improve BP and perfusion. If this doesn’t wrk then use inotropes (such as noradrenalin) to stimulate the CV system, increase BP and perfusion

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22
Q

How is severe sepsis defined?

A

When sepsis is present and results in organ dysfunction

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23
Q

What is the screening tool for sepsis used in hospitals?

A

NEWS (national early warning score)

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24
Q

What is often the first sign if sepsis?

A

Tachypnoea

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25
Q

Investigations for sepsis?

A

FBC (asses neutrophils)
U&Es for kidney function
LFTs
CRP
Clotting (DIC)
Blood cultures
ABG (lactate, pH and glucose)

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26
Q

What is the sepsis 6?

A

Three tests:
1. Blood lactate
2. Blood cultures
3. Urine output

Three treatments:
1. O2 (94-98% target)
2. Empirical broad spectrum antibiotics
3. IV fluids

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27
Q

What is neutropenic sepsis?

A

Sepsis in a patient with a low neutrophil count of less than 1x10^9/L

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28
Q

Which 2 bacteria most commonly cause chest infections?

A
  1. Streptococcus pneumonaie (50%)
  2. Haemophilus influenzae (20%)
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29
Q

What is the most appropriate initial antibiotic in the community for a chest infection?

A

Amoxicillin

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30
Q

Which bacteria most commonly cause UTIs?

A

E.coli

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31
Q

What are the 4 main symptoms of pyelonephritis?

A

Fever
Loin pain
Haematuria
Renal angle tenderness

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32
Q

What would show on a urine dipstick if someone has a UTI?

A

Nitrites
Leukocytes

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33
Q

What length of antibiotic treatment should women be put on for UTI?

A

3 days

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34
Q

What length of antibiotic treatment should women who are immunosupressed or have abnormal kidney function be put on for UTI?

A

5-10 days

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35
Q

What length of antibiotic treatment should men, pregnant women or people with catheter related UTIs be put on for UTI?

A

7 days

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36
Q

Which antibiotics are the initial choices for UTI?

A

Trimethoprim
Nitrafurantoin

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37
Q

Which antibiotic for UTI is avoided in the third trimester and why?

A

Nitrofurantoin, causes haemolytic anaemia in newborns

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38
Q

Which antibiotic for UTI is avoided in the first trimester and why?

A

Trimethoprim due to anti-folate effects

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39
Q

What does a gold-yellow crust indicate?

A

Staphylococcus aureus infection

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40
Q

What is the name of the classification used for cellulitis?

A

Eron classification

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41
Q

Which antibiotic is most commonly used for cellulitis?

A

Flucloxacillin. Very effective against staph

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42
Q

Which bacteria most commonly causes bacterial tonsillitis?

A

Group A strep (mainly streptococcus pyogenes)

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43
Q

Which bacteria most commonly causes otitis media, sinusitis and tonsilitis?

A

Streptococcus pneumoniae

44
Q

Whats the first line antibiotic for tonisilitis?

A

Phenoxymethylpenicillin

45
Q

What is the first line antibiotic for sinusitis?

A

Phenoxymethylpenicillin

46
Q

What is the most common causative organism of septic arthritis?

A

Staphylococcus aureus

47
Q

What is the management of septic arthritis?

A

Joint aspiration PRIOR to abx
Start empirical abx (often flucloxacillin plus rifampicin)

48
Q

Who is the flu vaccine given to for free?

A

Aged 65+
Young children
Pregnant women
Chronic health conditions
Healthcare workers

49
Q

How do you diagnose the flu?

A

Viral nasal or throat swabs
Then PCR

50
Q

What are the 3 most common causes of viral gastroenteritis?

A

Rotavirus
Norovirus
Adenovirus

51
Q

What is a complication of E.coli and why does this mean that antibiotic therapy is contraindicated?

A

Haemolytic uraemic syndrome. the use of antibiotics increase the risk of HUS so shouldn’t be used

52
Q

What are the symptoms of e.coli gasteroenteritis?

A

Bloody diarrhoea, vomiting and abdo cramps

53
Q

Whats the most common cause of travellers diarrhoea?

A

campylobacter jejuni

54
Q

Which bacteria often causes gastroenteritis after the patient eats rice?

A

Bacillus cereus

55
Q

What is the treatment for giardia?

A

Metronidazole

56
Q

Which 2 bacteria most commonly causes meningococcal septicaemia?

A

neisseria meningitidis and streptococcus pneumoniae

57
Q

What causes the non-blanching rash in meningitis?

A

DIC and subcutaneous haemorrhages

58
Q

What are the two special tests for meningeal irritation?

A

Kerning’s test
Brudzinski’s test

59
Q

What should be given as a stat dose in a primary care setting if meningitis is suspected?

A

IM benzylpenecillin

60
Q

When is a lumbar puncture contraindicated

A

if there is purpura - contraindicated in menegincoccal septicaemia

61
Q

Which antibiotics should be used if the patient <3 months and has meningitis?

A

Cefotaxime and amoxicillin

62
Q

Which antibiotics should be used if the patients is >3months and has meningitis?

A

Ceftriaxone

63
Q

Which medication is given alongside abx to children with meningitis? Why?

A

Steriod to reduce the chance of hearing loss and neuro damage

64
Q

What should be given as post exposure prophylaxis to meningitis contacts? Within what time frame?

A

People who have been in close contact 7 days prior should be given a single dose of ciprofloxacin

65
Q

What are the features bacterial meningitis lumbar puncture?

A

Cloudy, high protein, low glucose, high WCC (neutrophils)

66
Q

What are the features viral meningitis lumbar puncture?

A

Clear, normal protein, normal glucose, high WCC (lymphocytes)

67
Q

Which bacteria causes TB?

A

Mycobacterium tuberculosis

68
Q

Which stain should be used for mycobacterium tuberculosis? What colour does it turn them?

A

Zeihl-Neelsen stain. Red against a blue background

69
Q

What does active TB mean?

A

There is active infection in various areas of the body

70
Q

What does latent TB mean?

A

There has been active TB. Now the immune system has managed to encapsulate sites of infection and stop the progression of the disease

71
Q

What is secondary TB?

A

When latent TB reactivates

72
Q

What is miliary TB?

A

Severe TB

73
Q

What is a cold abscess?

A

A firm and painless abscess caused by TB, usually in the neck

74
Q

What kind of vaccine is the BCG vaccine?

A

Live attenuated

75
Q

How do you test if someone has antibodies to TB?

A

Mantoux test

76
Q

What are the symptoms of TB?

A

Lethargy
Fever
Night sweats
Weight loss
Erythema nodosum
Lymphadenopathy

77
Q

How do you investigate TB?

A

Check for immune response (mantoux test or interferon gamma release assay)
Use Ziehl-Neelsen stain
Chest X-Ray
Sputum culture - high diagnostic

78
Q

What is the interferon-gamma release assay test used for?

A

To confirm a diagnosis of latent TB in patients who have had a positive mantoux test

79
Q

What might primary TB show on a chest X-ray?

A

Consolidation
Pleural effusions
Hilar lymphadenopathy

80
Q

What may reactivated TB show on a chest X-ray?

A

Patchy or nodular consolidation with cavitation (gas filled spaces) in the lungs

81
Q

What may disseminated Miliary TB show on chest X-ray?

A

Millet seeds, uniformly distributed throught the lung fields

82
Q

How can latent TB be managed?

A

Isoniazid and rifampicin for 3 months or just isoniazid for 6 months

83
Q

How should acute TB be managed?

A

RIPE:
Rifampicin for 6 months
Isoniazid for 6 months
Pyrazinamide for 2 months
Ethambutol for 2 months

84
Q

What should always be prescribed alongside isoniazid?

A

Pyridoxine (vitamin B6) because isoniazid can cause peripheral neuropathy

85
Q

Where should patients with active TB be treated?

A

In hospital negative pressure rooms until they are established on treatment

86
Q

What is a side effect of rifampicin?

A

Red/ orange discolouration of secretions.

87
Q

What is a side effect of isoniazid?

A

Peripheral neuropathy. Pyridoxine should be prescribed alongside

88
Q

What is a side effect of pyrazinamide?

A

Hyperuricaemia. This can result in gout

89
Q

What is a side effect of ethambutol?

A

Colour blindness and reduced visual acuity

90
Q

What kind of virus is HIV?

A

It is an RNA retrovirus

91
Q

Which cells in the body does HIV attack?

A

CD4 T helper cells

92
Q

Name some AIDS-defining illnesses

A

Kaposi’s sarcoma
PCP
Cytomegalovirus infection
Candidiasis (oesophageal or bronchial)
Lymphomas
Tuberculosis

93
Q

How long can a HIV antibody test be negative for following exposure?

A

3 months

94
Q

Which test for HIV can give a positive result faster than an antibody test?

A

p24 antigen

95
Q

What does PCR testing for HIV RNA show?

A

Viral load

96
Q

What 2 things do you monitor in HIV?

A

CD4 count
Viral load

97
Q

How is HIV treated?

A

Antiretroviral therapy until they have a normal CD4 count and an undetectable viral load

98
Q

Which type of vaccines should HIV patients avoid?

A

Live vaccines

99
Q

What is the current post exposure prophylaxis regime for HIV?

A

a combination of oral antiretrovirals (e.g. Tenofovir, emtricitabine, lopinavir and ritonavir) as soon as possible (i.e. Within 1-2 hours, but may be started up to 72 hours following exposure) for 4 weeks

100
Q

How is malaria spread?

A

Through bites from the female anopheles mosquitoes

101
Q

What are the symptoms of malaria?

A

Fever, sweats and rigors
Malaise
Myalgia
Headache
Vomiting

102
Q

What are the signs of malaria?

A

Pallor due to anaemia
Hepatosplenomegaly
Jaundice

103
Q

How do you diagnose malaria?

A

Malaria blood film

104
Q

How do you exclude malaria?

A

3 malaria blood films over 3 consecutive days

105
Q

How do you treat malaria?

A

If uncomplicated, oral quinine sulphate
If severe, IV artesunate

Alice's finals cards (23 decks)

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