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Finals > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

Pseudomonas Auriginosa
Aerobe or anaerobe?
Commonly causes what infection in which patient group?

A

Aerobe

Pneumonia in CF patients - mucous limits O2 diffusion

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2
Q 
Neisseria meningitidis 
Type of bacteria?
Aerobe or anaerobe?
Who carries it where?
What does it cause and in who?
A

Gram positive diplococci
Aerobe
10% of adults are carriers in the nasopharynx
Causes bacterial meningitis in young adults and children

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3
Q

Which organisms cause chronic infections in CF? (5)

A 
H. Influenzae
Stash aureus 
Pseudomonas auriginosa 
atypical mycobacteria
Candida albicans
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4
Q

What chronic infections can occur in uncontrolled diabetes? (4)

A

Malignant otitis externa
Rhinocerebral mucormycosis
UTIs - enterobacteria or pseudomonas aeriginosa
Skin and soft tissue infections - staph aureus

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5
Q

What are the principals of antibiotic stewardship? (5)

A
  1. Appropriate use of antimicrobials
  2. Optimal clinical outcomes
  3. Minimise toxicity and side effects
  4. Reduce the cost of healthcare for infections
  5. Limit the selection of antimicrobial resistant strains
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6
Q

What organisms causes osteomyelitis

A

Staph aureus

In sickle cell anaemia salmonella more predominate

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7
Q

Risk factors for osteomyelitis

A

Diabetes mellitus, sickle cell anaemia, IVDU, immunosuppression, alcohol abuse

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8
Q

Investigation of osteomyelitis

A

MRI

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9
Q

Treatment of osteomyelitis

A

Flucloxacillin or cindamycin if penicillin allergic

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10
Q

Penicillins class
Examples x4
MOA

A

Penicillin, Amoxicillin, Flucloxacillin, Co-amoxiclav

Inhibit transpepsidase - beta-lactams - to prevent bacterial cell wall repairs

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11
Q

what is flucloxacillin used to treat?

A

staphylococcal soft tissue infections

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12
Q

Cephalosporins
examples x3
MOA

A

cefaclor, cefotaxime, aztrennam

targe beta-lactams in the cell wall by inhibiting transpeptidase

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13
Q

Tetracyclines
examples x3
MOA

A

Tetracycline, doxycycline, oxytetracycline

prevent protein synthesis by locking tRNA to mRNA

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14
Q

Aminoglycosides
examples x2
MOA
important side effects x2

A

Gentamicin, Neomycin
Prevent 30s ribosome subunit from translating mRNA
ototoxic, nephrotoxic

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15
Q 
Hepatits B
transmission
Incubation
Symptoms x6
Blood abnormality
A

Blood, sex, vertical transmission
6/52 to 6/12 incubation
jaundice, fatigue, abdominal discomfort, anorexia, arthralgia
AST/ALT in the 1000s

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16
Q

Hepatitis B
management
outcomes

A

supportive

most will clear infection, 6-10% chronic infection, could result in hepatic failure or hepatocarcinoma

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17
Q

Causative organisms for:

1) prosthetic valve endocarditis
2) prosthetic joint infection
3) cardiac pacing wire endocarditis

A

all caused by coagulase negative staphylococci

cardiac pacing wire endocarditis can also be caused by staph aureus.

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18
Q

which cause of pneumonia classically causes desaturation on exercise?

A

Pneumocysitis jiroveci

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19
Q

3 Most common organisms for bronchiectasis exacerbation

A

Haemophilus Influenzae
Pseudomonas Aeruginosa
Moraxella Catarrhalis

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20
Q

Which organisms commonly cause endocarditis?

A

Staph aureus - most acute cases including prosthetic valves and IVDU related endocarditis
Strep viridans - usually sub acute IE
Group D streptococcus and Streptococcus intermedius - usually subacute

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21
Q

Which organisms most commonly cause community acquired pneumonias?

A

Streptococcus pneumoniae
Mycoplasma pneumoniae
Haemophilus Influenzae

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22
Q

What organisms most commonly cause hospital acquired pneumonias?

A

2 day onset - S. pneumoniae, H. influenzae and Moraxella catarrhalis
4 day onset - S. aureus or L. pneumophila

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23
Q

What is the quadruple therapy for TB?

A

6 months - rifampicin and isoniazid

2 months - pyrazinamide and ethambutol

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24
Q

What are the side effects of TB abx

A

all but ethambutol are hepatotoxic
rifampicin - orange secretions, rashes
ethambutol - visual disturbance/blindness
isoniazid - peripheral neuropathy (give prophylactic pyridoxine), rash, psychosis
Pyrazinamide- rash, vomiting, arthralgia

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25
Q

What antibiotics for CAP?

A

Mild-moderate (CURB 0-1): Amoxicillin 5 days oral or doxy if allergic
Moderate (CURB 2): amoxicillin and doxycycline 5 days oral
Severe (CURB 3+): IV Co-amoxiclav and oral doxycycline 5 days
If non anyphalactic penicillin allergy give meropenem IV with doxy oral for 5 days.

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26
Q

What antibiotics are used for HAP?

A

Mild-moderate; Co-amoxiclav oral 5 days. Doxy if allergic.
Severe -IV co-amoxiclav 5 days or meropenum if non-anaphylactic allergy
Ventilator associated - tazocin IV for 5 days - meropenum if on-anaphylactic allergy

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27
Q

Antibiotics for Chlamydia trachomatis infection

A

7 days PO doxycyline although if risk of gonorrhoeae infection then give IM ceftriaxone.

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28
Q

Antibiotics for Neisseria gonorroea

A

IM ceftriaxone

29
Q

Treatment for bacterial vaginosis

A

PO metronidazole 7 days

30
Q

Herpes simplex virus treatment

A

PO acyclovir

31
Q

Treatment for genital thrush

A

topical clomitrazole or oral fluconazole

32
Q

causative organism for gas gangrene

A

C. perfringens

33
Q

What is erythema chronicum migrans and in what infection is it commonly seen?

A

bull’s eye rash

Lyme disease

34
Q

Bacillus cereus typical infection symptoms and cause

A

vomiting and diarrhoea within 6 hours of ingestion, stereotypically due to rice

35
Q

E-coli gastroenteritis - typical infection symptoms and who gets it

A

Common amongst travellers
Watery stools
Abdominal cramps and nausea

36
Q

features of giardiasis gastroenteritis

A

prolonged diarrhoea without blood

37
Q

features of cholera gastroenteritis

A

Profuse, watery diarrhoea
Severe dehydration resulting in weight loss
Not common amongst travellers

38
Q

Features of shigella gastroenteritis

A

Bloody diarrhoea

Vomiting and abdominal pain

39
Q

features of staph aureus gastroenteritis

A

Severe vomiting

Short incubation period

40
Q

features of campylobacter gastroenteritis

A

A flu-like prodrome is usually followed by crampy abdominal pains, fever and diarrhoea which may be bloody
May mimic appendicitis
Complications include Guillain-Barre syndrome

41
Q

features of amoebic dysentery

A

Gradual onset bloody diarrhoea, abdominal pain and tenderness which may last for several weeks

42
Q

Mx of first-episode genital herpes

A

Oral antiviral therapy is indicated for primary genital herpes infections, even if the presentation is delayed for up to 5 days

43
Q

Abx of choice for meningitis

A

Ceftriaxone IV

44
Q

Abx for UTI in pregnancy

A

nitrofurantoin

avoid trimethoprim!

45
Q

What is the Jarisch-Herxheimer reaction?

A

reaction following initial treatment with benzylpenicillin for syphilis which occurs within several hours.
Fever, tachycardia, and rash due to the release of bacterial endotoxin.
No wheeze or hypotension.

46
Q

What infections are post-splenectomy patients most at risk of?

A

pneumococcus, Haemophilus, meningococcus and Capnocytophaga canimorsus (from dog bites)

47
Q

interpreting Hepatitis serology

1) Anti-HBs
2) AntiHBc
3) HBsAg

A

1) Anti-HBs - immunity to hepatitis B
2) AntiHBc - chronic infection with hepatitis B
3) HBsAg - acute infection with hepatitis B

48
Q

What is Yellow Fever?

A

Type of viral haemorrhagic fever
zoonotic infection: spread by Aedes mosquitos
incubation period = 2 - 14 days

49
Q

Clinical features of yellow fever?

A

may cause mild flu-like illness lasting less than one week
sudden onset of high fever, rigors, nausea & vomiting +/- bradycardia
A brief remission is followed by jaundice, haematemesis, oliguria

50
Q

findings on liver biopsy in yellow fever

A

Councilman bodies (inclusion bodies) may be seen in the hepatocytes

51
Q

Diagnosis of lyme disease

A

erythema migrans present - start treatment without further testing
other wise enzyme-linked immunosorbent assay (ELISA) antibodies to Borrelia burgdorferi are the first-line test

52
Q

Management of Lyme disease

A

doxyxycline first line. If pregnant use amoxicillin

in disseminated disease use ceftriaxone

53
Q

What organism stains with India ink?

A

Cryptococcus neoformans

54
Q

What causes genital warts?

A

human papilloma virus HPV, especially types 6 & 11

55
Q

features of genital warts

A

small (2 - 5 mm) fleshy protuberances which are slightly pigmented
may bleed or itch
may be keratinised

56
Q

management of genital warts

A

multiple, non-keratinised warts: topical podophyllum

solitary, keratinised warts: cryotherapy

57
Q

mx of asymptomatic bacteriuria in pregnant women?

A

start abx immediately

58
Q

treatment of chronic Hep C infection

A

currently a combination of protease inhibitors (e.g. daclatasvir + sofosbuvir or sofosbuvir + simeprevir) with or without ribavirin are used

59
Q

Abx for gonorrhoea

A

IM ceftriaxone

60
Q

Abx for extensive otitis externa

A

flucloxacillin

61
Q

Abx for PID

A

doxycycline + metronidazole + ceftriaxone

62
Q

When can you give post expoure prophylaxis for HIV

A

asap up to 72 hours

63
Q

Pneumocystis jiroveci penumonia abx

A

co-trimoxazole- a mix of trimethoprim and sulfamethoxazole

64
Q

URTI symptoms + amoxicillin → rash

what diagnosis are you suspecting?

A

?glandular fever

65
Q

tetanus vaccination schedule

A 
2 months
3 months
4 months
3-5 years
13-18 years
66
Q

Diagnosis and abx for legionella pneumonia

A

Diagnosis
urinary antigen

Management
treat with erythromycin/clarithromycin

67
Q

Causative organisms Cellulitis

A

Streptococcus (most common group), especailly S. pyogenes or Staphylcoccus aureus.

68
Q

Abx for cellulitis

A

flucloxacillin

if severe co-amoxiclav

Finals (34 decks)

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