Infectious disease Flashcards
What are some key interventions to manage antimicrobial resistance (AMR) as outlined in the provided guidance?
Key interventions to manage antimicrobial resistance (AMR) include political commitment to prioritise AMR, monitoring antimicrobial use and resistance, developing new drugs and diagnostics, promoting infection prevention and control measures, and educating healthcare professionals and the public on appropriate antimicrobial use.
What is the significance of antimicrobial stewardship (AMS) in addressing antimicrobial resistance (AMR)?
Antimicrobial stewardship (AMS) plays a crucial role in addressing antimicrobial resistance (AMR) by promoting judicious use of antimicrobials to preserve their effectiveness for future generations. It involves organisational or healthcare system-wide approaches to monitor and improve antimicrobial prescribing practices, thereby mitigating the accelerated development of AMR.
What guidance is provided for healthcare organisations regarding antimicrobial stewardship (AMS) programmes?
- Establish a team of experts.
- Create guidelines for prescribing.
- Train staff on proper antimicrobial use.
- Monitor antimicrobial use and resistance.
- Use electronic tools for prescribing.
- Collaborate with community partners.
- involve patients in education.
- Continuously evaluate and adjust strategies.
What are common clinical presentations of viral infections?
Fever, cough, sore throat, runny nose, body aches, fatigue, rash (e.g., measles, chickenpox).
What symptoms are typical of bacterial infections in healthcare settings?
Fever, localized pain/swelling, redness, warmth, tenderness, chills, rigors, malaise, altered mental status (e.g., pneumonia, UTI, skin infections).
What clinical signs suggest fungal infections in immunocompromised individuals?
Fever, cough, dyspnea, chest pain (pulmonary involvement), skin rash, itching, lesions, weight loss, fatigue (varies with type and organs involved).
What symptoms may indicate parasitic infections in travellers to endemic regions?
Fever, fatigue, diarrhea, abdominal pain, nausea, weight loss, malaise, “rice water” stools (cholera), perianal itching (pinworms).
When is a patient infectious with meningitis?
The patient is initially infectious through the droplet route until he has had 24 hours of appropriate antimicrobial therapy.
What public health actions should you take as a doctor with a patient diagnosed with acute meningitis?
- Ensure the patient is being managed in a side-room with droplet precautions
- Inform the hospital infection control team
- Inform the local health protection consultant by phone even if out of hours
What are some risk factors for meningitis?
- University student (overcrowded places)
- Travel to the meningitis belt in Sub-Saharan Africa
- HIV
- Complement component deficiency
- Functional or anatomical asplenia
What two things must you do before a lumbar puncture?
- Plasma glucose should be taken to allow comparison to CSF glucose
- FBC and clotting should be done to check that it is safe to do a lumbar puncture
What are the complications of meningitis?
- Cerebral oedema
- Cerebral venous sinus thrombosis
- Long term brain damage
- Hearing loss is the most commonly encountered problem. (sensorineural deafness)
With meningitis, how do you know who to give chemoprophylaxis to?
‘Kissing contacts’
Those that spend several hours a day with the patient.
Chemoprophylaxis is provided to close contacts that have a high risk of exposure to the infectious droplets.
What drug is used in chemoprophylaxis in meningitis?
Rifampicin
A commonly used alternative is Ciprofloxacin although off license.
What two tests do you do before you start someone on medication for tuberculosis
Liver function tests
Visual acuity testing
How do you diagnose infective endocarditis?
Duke criteria
Major diagnostic criteria include more than one positive blood culture (typical organism in 2 separate cultures or presistently positive blood cultures), or positive echocardiogram findings of vegetation, abscess or abscess prosthetic valve.
Minor criteria include:
predisposition (cardiac lesion, IV drug use);
fever over 38 °C;
vascular signs, e.g. mycotic emboli, Janeway lesions (painless palmar/plantar macules);
immunological signs e.g. Oslers nodes (painful swelling fingers/toes), positive RhF, glomerulonephritis
microbiological evidence not fitting major criteria.
Diagnosis is made on 2 major, 1 major/3minor or >5 minor criteria.
Would focal lesions on the spleen and positive rheumatoid factor be diagnostic for infective endocarditis?
Yes
What may be picked up on serology when investigating infective endocarditis?
Serology may be needed for some atypical organisms e.g. Coxiella burnetti (Q fever), Bartonella and Brucella.
What is the suggested antibiotic therapy for a native valve infective endocarditis?
Amoxicillin
What are examples of TNF-a inhibitors?
- Etanercept
- Infliximab
- ## Adalinumab
What set of investigations are important to do before you start on medication for Tuberculosis?
- FBC
- Vision testing
- Urea and electrolytes
- LFTs
What would toxoplasmosis infection show on CT head?
- Ring enhancing lesions
Treat with
sulfadiazine and pyrimethamine.
