Infectious diseases

Question 1

What does Gram positive mean?

Answer 1

Thick peptidoglycan cell wall

Question 2

What are the Gram positive anaerobes (CLAP)?

Answer 2

Clostridium
Lactobacillus
Actinomyces
Propionibacterium

Question 3

What are the antibiotic treatment options for MRSA?

Answer 3

Doxycycline
Clindamycin
Vancomycin
Teicoplanin
Linezolid

Question 4

Which antibiotics inhibit cell wall synthesis?

Answer 4

With a beta lactam ring:
Penicillin
Carbapenems such as meropenem
Cephalosporins
Without a beta lactam ring:
Vancomycin
Teicoplanin

Question 5

Antibiotics that inhibit folic acid metabolism

Answer 5

Sulfamethoxazole
Trimethoprim
Co-trimoxazole (combo of the above)

Question 6

How does metronidazole work?

Answer 6

Inhibits nucleic acid synthesis

Question 7

Why does metronidazole only work in anaerobes?

Answer 7

It has to be reduced into its active form, which only happens in anaerobic cells

Question 8

Which antibiotics inhibit protein synthesis by targeting the ribosome?

Answer 8

Macrolides (erythromycin, clarithromycin and azithromycin)
Clindamycin
Tetracyclines (e.g. doxycycline)
Gentamycin
Chloramphenicol

Question 9

What bacteria does co-amoxiclav not cover?

Answer 9

Pseudomonas or atypical bacteria

Question 10

Give examples of quinolone antibiotics

Answer 10

Ciprofloxacin and levofloxacin

Question 11

What can quinolones not cover?

Answer 11

Anaerobes

Question 12

What does metronidazole not cover?

Answer 12

Aerobic bacteria

Question 13

What does vancomycin not cover?

Answer 13

Gram negatives and anaerobes

Question 14

What do cephalosporins not cover

Answer 14

Anaerobes

Question 15

What are the antibiotics in Tazocin?

Answer 15

Piperacillin
Tazobactam

Question 16

What does Tazocin not cover?

Answer 16

ESBLs, atypical bacteria or MRSA

Question 17

What does Meropenem not cover

Answer 17

Atypical bacteria or MRSA

Question 18

What is first line in Spontaneous bacterial peritonitis?

Answer 18

Tazocin

Question 19

What protozoa causes malaria?

Answer 19

Plasmodium
Most dangerous is plasmodium falciparum

Question 20

How is malaria spread?

Answer 20

Bites of the female Anopheles mosquito

Question 21

Why do people with malaria have high fever spikes every 48 hrs?

Answer 21

Merozoites in the RBCs reproduced over 48 hours - when they rupture the RBCs, it causes haemolytic anaemia

Question 22

What is the incubation period for malaria?

Answer 22

1-4 weeks

Question 23

What are the symptoms of malaria

Answer 23

Fever, sweats and rigors
Malaise
Myalgia
Headache
Vomiting

Question 24

What are the signs of malaria

Answer 24

Pallor due to anaemia
Hepatosplenomegaly
Jaundice

Question 25

How is malaria diagnosed?

Answer 25

Blood film - 3 samples are sent over 3 consecutive days

Question 26

What is the management for malaria?

Answer 26

Uncomplicated malaria:
1. Artemether with lumefantrine (Raiment)
2. Proguanil and atovaquone (Malarone)
3. Quinine sulphate
4. Doxycycline
Complicated:
1. Artesunate
2. Quinine dihydrochloride

Question 27

What are the complications of falciparum malaria?

Answer 27

Cerebral malaria
Seizures
Reduced consciousness
AKI
Pulmonary oedema
DIC
Severe haemolytic anaemia
Multi-organ failure and death

Question 28

What are the prophylactic antimalarials?

Answer 28

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)