Infectious diseases Flashcards
What does Gram positive mean?
Thick peptidoglycan cell wall
What are the Gram positive anaerobes (CLAP)?
Clostridium
Lactobacillus
Actinomyces
Propionibacterium
What are the antibiotic treatment options for MRSA?
Doxycycline
Clindamycin
Vancomycin
Teicoplanin
Linezolid
Which antibiotics inhibit cell wall synthesis?
With a beta lactam ring:
Penicillin
Carbapenems such as meropenem
Cephalosporins
Without a beta lactam ring:
Vancomycin
Teicoplanin
Antibiotics that inhibit folic acid metabolism
Sulfamethoxazole
Trimethoprim
Co-trimoxazole (combo of the above)
How does metronidazole work?
Inhibits nucleic acid synthesis
Why does metronidazole only work in anaerobes?
It has to be reduced into its active form, which only happens in anaerobic cells
Which antibiotics inhibit protein synthesis by targeting the ribosome?
Macrolides (erythromycin, clarithromycin and azithromycin)
Clindamycin
Tetracyclines (e.g. doxycycline)
Gentamycin
Chloramphenicol
What bacteria does co-amoxiclav not cover?
Pseudomonas or atypical bacteria
Give examples of quinolone antibiotics
Ciprofloxacin and levofloxacin
What can quinolones not cover?
Anaerobes
What does metronidazole not cover?
Aerobic bacteria
What does vancomycin not cover?
Gram negatives and anaerobes
What do cephalosporins not cover
Anaerobes
What are the antibiotics in Tazocin?
Piperacillin
Tazobactam
What does Tazocin not cover?
ESBLs, atypical bacteria or MRSA
What does Meropenem not cover
Atypical bacteria or MRSA
What is first line in Spontaneous bacterial peritonitis?
Tazocin
What protozoa causes malaria?
Plasmodium
Most dangerous is plasmodium falciparum
How is malaria spread?
Bites of the female Anopheles mosquito
Why do people with malaria have high fever spikes every 48 hrs?
Merozoites in the RBCs reproduced over 48 hours - when they rupture the RBCs, it causes haemolytic anaemia
What is the incubation period for malaria?
1-4 weeks
What are the symptoms of malaria
Fever, sweats and rigors
Malaise
Myalgia
Headache
Vomiting
What are the signs of malaria
Pallor due to anaemia
Hepatosplenomegaly
Jaundice
How is malaria diagnosed?
Blood film - 3 samples are sent over 3 consecutive days
What is the management for malaria?
Uncomplicated malaria:
1. Artemether with lumefantrine (Raiment)
2. Proguanil and atovaquone (Malarone)
3. Quinine sulphate
4. Doxycycline
Complicated:
1. Artesunate
2. Quinine dihydrochloride
What are the complications of falciparum malaria?
Cerebral malaria
Seizures
Reduced consciousness
AKI
Pulmonary oedema
DIC
Severe haemolytic anaemia
Multi-organ failure and death
What are the prophylactic antimalarials?
Proguanil and atovaquone (Malarone) - daily 2 days before, during and 1 week after
Mefloquine - once weekly 2 weeks before, during and 4 weeks after (but can cause bad dreams and psychotic disorders)
Doxycycline - daily 2 days before, during and 4 weeks after (photosensitive skin)
