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infectious diseases Flashcards

1
Q

feature gram positive bacteria

A

thick peptidoglycan cell wall

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2
Q

bacilli

A

rod

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3
Q

cocci

A

circular

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4
Q

gram positive cocci

A

staph
strep
enterococcus

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5
Q

gram positive rod

A

corneybacteria
mycobacteria
listeria
bacillus
nocardia

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6
Q

common gram negative bacteri

A

n.meningitidis
n.gonorrhoea
h.influenzae
e.coli
klebsiella
pseudomonas aeruginosa
moraxella cattarhali

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7
Q

gram positive anaerobes

A

clostridium
lactobacillus
actinonyces
propionibacterium

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8
Q

features atypical bacteria

A

cant be gram stained
often cause atypical pnuemonia

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9
Q

what is MRSA

A

staph aureus resistant to beta lactams

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10
Q

mx MRSA

A

doxycycline, clindamycin, vancomcin, teicoplanin, linezolid

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11
Q

e.g. extended spectrum beta lactamase bacterua

A

e.coli
klebsiella

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12
Q

mx extended spectrum beta lactamase bacterua

A

carbapanems (meropenem, imipenem)

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13
Q

abx that inhibit cell wall synthesis with a beta lactam ring

A

penicllin
carbapenems
cephalopsporins

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14
Q

abx that inhibit cell wall synthesis without a beta lactam ring

A

vancomycin
teicoplanin

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15
Q

abx that inhibit folic acid metabolism

A

sulfamethoxazole: blocks DHFA to THFA
trimethoprim: blocks THFA ro folic acid

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16
Q

mechanisms action abx

A

inhibit cell wall synthesis
inhibit folic acid metabolism
inhibit nucleic acid synthesis
inhibit protein synthesis

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17
Q

how does metronidazole work

A

inhibits nucleic acid synthesis in anaerobes

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18
Q

abx that inhibit protein synthesis by targeting ribosome

A

macrolides
clindamycin
tetracyclines
gent
chloramphenicol

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19
Q

penicillins

A

pen v
amoxicillin
fluclox
benpen
coamox
tazocin

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20
Q

what does pen v work against

A

beta haemolytic strep, strep pneumoniae, anaerobes

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21
Q

what does amoxicillin work against

A

beta haemolytioc strep
strep pnuemonia
enterococcus
anaerobes

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22
Q

what does fluclox work against

A

staph aureus
beta haem strep
anaerobes

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23
Q

what does benpen work against

A

beta haem strep
strep pnuemonia
enterococcus
n.meningitidis

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24
Q

what does co amox work against

A

staph aureus
beta haemolytic strep
strep pneumonia
enterococus
h.influenzae
e.coli
anaerobes

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25
Q

what does tazocin work against

A

staph aureus
beta haem strep
strep pneumonia
enterococcus
h.influenzae
e.coli
pseudomonas aueruginosa
moraxella catarrhalis
anaerobes

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26
Q

e.g. cephalosporin

A

ceftriaxone

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27
Q

what does ceftriaxone work against

A

staph aureus
beta haemolytic strep
strep pneumoniae
n.meningitidis
h.influenzae
e.coli
moraxella catarrhalis

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28
Q

e.g. carbapenems

A

meropenem

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29
Q

what does meropenem work against

A

staph aureus
beta haem strep
stre pnuemonae
enterococcus
n.meningitidis
h.influenzae
e.coli
ESBL
pseudomonas aeruginosa
moraxella catarrhalis
anaerobes

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30
Q

what does trimethoprim work against

A

e.coli

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31
Q

e.g. macrolides

A

erythromicin
clarithromycin
azithromycin

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32
Q

what does macrolides work against

A

staph aureus,
beta haem strep
strep pneumonia
atypicals

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33
Q

e.g. lincosamides

A

lindamycin

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34
Q

what does lindamycin work against

A

staph aureus
beta haem strep
strep pneumoniae
anaerobes

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35
Q

what does gentamicin work against

A

staph aureus
MRSA
e.coli
pseudomonas aeruginosa
moraxella catarrhalis

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36
Q

e.g. aminoglycoside

A

gentamicin

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37
Q

e.g. quinolones

A

ciprofloxacin
levofloxacin

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38
Q

what does ciprofoxacin work against

A

staph aureus
n.meningitidis
h.influenzae
pseudomonas aeruginosa
moraxella catarrhalis
atypicals

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39
Q

what does levofloxacin work against

A

staph aureus
n.meningitidis
h.influenzae
pseudomonas aeruginosa
moraxella catarrhalis
atypicals
strep pneumonia

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40
Q

e.g. glycopeptides

A

vanomycin
teicoplanin

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41
Q

what does vancomycin and teicoplanin work against

A

staph aureus
MRSA
beta haem strep
strep pnuemonia
enterococus

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42
Q

what does metronidazole work against

A

anaerobes

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43
Q

give e.g. tetracyclines

A

doxycycline

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44
Q

what does doxycycline work against

A

staph aureus
MRSA
strep pneumoniae
h.influenzae
moraxella catarrhalis
anaerobes
atypicals

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45
Q

what is sepsis

A

immune response to pathogens->cytokines->immune activation ->vasodilation
more permeable=oedema
activation coag syte ->thrombocytopenia and haemorrhage ->DIC
increased lactate due to anaerobic resp

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46
Q

features septic shock

A

BP<90
lactate >4

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47
Q

mx septic shock

A

fluids
inotropes (noradrenaline)

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48
Q

what is severe sepsis

A

organ dysfunction e.g. hypoxia, oliguria, AKI, thrombocytopaenia, coag, low BP high lactate

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49
Q

presentation sepsis

A

increased RR
confused
infection source
AF
temp
reduced urine output
mottled skin

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50
Q

mx sepsis

A

within 1 hr: blood lactate, blood cultures, urine output + oxygen, broad sepctrum abx, iV fluid

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51
Q

neutropenic sepsis

A

sepsis and neutrophils <1

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52
Q

when to suspect neutropenic sepsis

A

temp>38

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53
Q

mx neutropenic sepssi

A

abx e.g. tazocin

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54
Q

meds causing neutropenia

A

chemo
clozapine
hydroxychloroquine
methotrexatee
quinines
sulfasalazine
carbimazole
infliximab
rituximab

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55
Q

lowe UTI sx

A

dysuria
suprapubic pain
frequency
urgency
incontinence
confusion

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56
Q

sx pyelonephritis

A

fever
loin/back pain
N+V
redued appetite
haematuria
renal angle tenderness

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57
Q

ix UTI

A

dipstick: nitrities=bacteria, leukocytes=infection/inflammation
MSU culture

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58
Q

causes UTI

A

e.coli
klebsiella pneumoniae
enterococcus

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59
Q

mx simple UTI

A

trimethoprim or nitrofurantoin
F=3d, F abnormal anatomy=5-10d, M or catheter=7d

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60
Q

mx UTI in pregnancy

A

7d nitrofurantoin (not in 3rd T) or cefalexin

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61
Q

mx pyelonephritis

A

7-10d cefalexin, co-amox, trimethoprim, ciprofloxacin

62
Q

features cellulitis

A

warm
erythema
oedematous
bullaie

63
Q

causes cellulitis

A

staph aureus
group A strep (pyogenes)
group C strep (dysgalactiae)
MRSA

64
Q

features staph aureus cellulitis

A

gold crust

65
Q

class cellulitis

A

1=no systemic activity
2=systemic toxicity or comborbidity
3= significant systemic toxicity or comborbidity
4=sepsis

66
Q

mx cellulitis

A

admit for IV if class 3/4
abx: fluclox. 2nd line=clarithromycin or co-amox

67
Q

cause tonsilliti

A

viral
group A strep (pyogenes)

68
Q

centor criteria

A

bacterial tonsiliits:
fever>/= 38
tonsillar exudate
no cough
lymphadenopathy

69
Q

mx tonsilitis

A

centor score >/= 3 = 10d penicillin V

70
Q

features otitis media

A

bulging red tympanic membrane

71
Q

cause otitis media

A

viral
strep pyogenes
strep pneuminoae

72
Q

mx otitis media

A

3-7d without abx or amoxicillin
2nd line: clarithromycin, co-amox

73
Q

mx sinusitis

A

none
after 10d: 2w steroid nasal spray
if likely bacteria then penicillin V or clarithromycin

74
Q

commob causes intra abdo infecion

A

anaerobes: bacteroids, Clostridium
e.coli
klebsiella
enteroccocus
strep

75
Q

mx intra abdo infection

A

abx
oral if mild +/- stat gentamicin
co-amox or amox + gent + metronidazole or ciprofloxacin +metronidazole

76
Q

mx spontaneous bacterial peritonitis

A

piperacillin + tazobactam
levofloxacin + metronidazole

77
Q

septic arthritis sx

A

often knee
hot
red
reduced ROM
fever
sepsis

78
Q

cause septic arthritis

A

staph aureus
neisseria gonorrhoea

79
Q

mx septic arthritis

A

aspiraye and culture/gram staine
abx: IV fluclox and rifampicin for 3-6w

80
Q

what s influenza

81
Q

types influenza

A

A, B and x
A and B most common

82
Q

ix influenza

A

nasal/throat swab

83
Q

mx influenza

A

none
if high risk: oral oseltamivir or inhaled zanamivir within 48h

84
Q

common viral causes gastroenteritis

A

rotavirus
norovirus
adenovirus

85
Q

features e.coli gastroenteritis

A

faeces, salads, water
e.coli157: shiga toxin->bloody diarrhoea and vom

86
Q

features salmonella gastroenteritis

A

raw eggs and poultry
sx start 12h-3d after: water diarrhoea

87
Q

features campylobacter jejuni gastroenteritis

A

travellers: poultry, water, milk
after 2-5d: bloody diarrhoea, vom
give azithromycin

88
Q

features shigella gastroenteritis

A

faeces
bloody diarrhoea after 1-2d

89
Q

features bacillus cerus gastroenteritis

A

rice
vom after 5h, watery diarrhoea after 8h, resolves after 24h

90
Q

features yersina enterocolitica gastroenteritis

A

pork
after 4-7d: watery/bloody diarrhoea. lymphadenopathy
often children
can last 3w
adults=mesenteric lymphadenitis

91
Q

features staph aureus toxin gastroenteritis

A

eggs, dairy, meat
D+V within hours, resolves 1d

92
Q

features giardiasos

A

parasite
faeco-oral
chronic diarrhoea
give metronidazole

93
Q

mx gastroenteritis

A

culture stool
rehydration
avoid work for 48h after sx resolve

94
Q

complications gastroenteritis

A

lactose intolerance
IBS
reactive arthritis
GBS

95
Q

what is TB

A

acid fast bacili

96
Q

stain for acid fast bacili

A

zeihl nellson
goes red

97
Q

where can TB spread

A

extra-pulmonary: lymph nodes (cold abscess)
pleura
CNS
GI
GU
bones

98
Q

miliary TB

A

disseminated and severe

99
Q

presentation TB

A

lethargy
fever/night sweat
decreased wt
cough +/- haemoptysis
lymohadenipathy
erythema nodosum

100
Q

ix TB

A

mantoux test
interferon gamma release assay
CXR
cultures and NAAT - sputum, blood, lymoh node

101
Q

mantoux test

A

result >5mm = TB vaccination, latent or active TB

102
Q

interferon gamma release assay TB

A

confirms latent

103
Q

CXR findings TB

A

primary: patchy consolidation, pleural effusion, hilar lymohadenopathy
secondary: patchy or nodular consolidation with cavitation
miliary=millet seeds

104
Q

mx latent TB

A

isoniazid or rifampicin for 3m or isoniazid 6m

105
Q

mx active TB

A

rifampicin and isoniazid 6m
pyrazinamide and ethambutol 3m

106
Q

SE rifampicin

A

red urine and reduced effect other drugs

107
Q

SE isoniazid

A

peripheral neuropathy
need pyridoxine (vit B6) alongside

108
Q

SE pyrazinamide

A

increased uric acid

109
Q

SE ethambutol

A

colour blind
reduced visual acuity

110
Q

TB vaccination

A

BCG vaccine for those at risk

111
Q

what is HIV

A

RNA retrovirus
types 1 and 2
destroys CD4 TH cells

112
Q

HIV progression

A

flu like illness
asx
immunocompromised and AIDs

113
Q

AIDS defining illnesses

A

kaposis sarcoma
pneumocystis
jirovecci
pneumonia
CMV
candidiasis
lymphomas
TB

114
Q

testing for HIV

A

Ab
PCR p24 Ag
PCR HIV RNA

115
Q

monitoring HIV

A

CD4 count <200=AIDS
viral load

116
Q

mx HIV

A

ART e.g. HAART=protease inhibitor, integrase inhibitor, nucleoside reverse transcriptase inhibitor, non-nucleosude reverse transcriptase inhibitor, transcriptase inhibitor, entry inhibitor

prophylactic co-trimoxazole for PCP
monitor: CVD, cervical smears,
vaccines (no live): flue, pneumococcal, hep A+B, tetanus, diphtheria, polio

117
Q

HIV post exposure prophylaxis

A

start within 72h for 3w
truvada + raltegravir
HIV test after 3m

118
Q

malaria cause

A

plasmodia (protozoan parasites)
spread through bite of female anopheles mosquito

119
Q

types plasmodium in malaria

A

plasmodium falciparum = most sev
plasmodium vivax
plasmodium ovale
plasmodium malariae

120
Q

life cycle malaria

A

infected blood sucked up by anopehles ->reproduces in mosquito producing sporozites ->bites new person ->sporozites to persons liver

then either lay dormant (in P.vivax and P.ovale) or mature into merozoites->enter RBC->rupture_>haemolytic anaemia

121
Q

sx malariea

A

incubation 1-4w
fever
rigot
malaise
myalgia
headache
vom
pallor due to anaemia
hepatospenlomegaly
jaundice

122
Q

ix malaria

A

blood film on 3 consecutive days

123
Q

mx malaria

A

uncomplicated: oral riamet/malarone/quinine sulphate/doxycycline
complicated=IV artesunate, quinine dihydrochloride

124
Q

malaria prophylaxis

A

spray (DEET)
nets
malarone: progvanil, atovoquone
mefloquine
doxycycline

125
Q

falciparum complications

A

cerebral malaria
seizure
LOC
AKI
pulmonary oedema
DIC
haemolytic anaemia
multiorgan failure

126
Q

fever and been to nigeria

A

malaria
typhoid
dengue fever

127
Q

fever and been to india

A

typhoid fever
dengue fever
chikungunya

128
Q

fever and been to brazil

A

dengue fever
chinungunya
scrub typhus

129
Q

swimming in lakes i africa

A

schistosomiasis

130
Q

where is typhoid fever common

A

south asia (india, pakistan bangladesh)
southern and eastern africa

131
Q

e.g. viral haemorrhagic fever

A

lassa
ebola
marburg

132
Q

which abx to avoid in EBV and why

A

amoxicillin and ampicillin - cause widespread rash

133
Q

what to avoid after EBV infection and why

A

contact sports for 4 w - complication EBV is splenomegaly which can rupture and haemorrhage

134
Q

Mild pneumonia and mx

A

Curb 0/1
Amoxicillin PO

135
Q

Sev pneumonia and mx

A

Curb 3-5
IV co amox + PO clarithromycin

136
Q

Definition HAP

A

Been in hospital over 48h
Or been admitted in past 30d

137
Q

First line ix IE

A

3 sets blood cultures at 30 mins apart with at least 10ml blood (high vol) before abx)

138
Q

Cause IE IVDU

A

Staph aureus

139
Q

Cause IE hx prostatitis

A

Enterococcus faecalis

140
Q

Cause IE immunocompromised

141
Q

Cause IE prosthetic valve (early)

A

Staph epidermidis

142
Q

Cause IE poor oral dentition

A

Strep mutans

143
Q

Mx suspected meningitis while waiting LP

A

Assume bacterial unless confused
Ceftriaxone and dexamethasone
Add amoxicillin IV if over 60y to cover listeria

144
Q

?Meningitis and normal CSF

A

IT IS NOT MENINGITIS
stop any abx if started

145
Q

Abx if UTI/pyelonephritis and unwell

A

Iv co amox
If old = IV Piperacillin and tazobactam

146
Q

Why is nitrofurantoin not good for pyelonephritis

A

Is concentrated in the urine

147
Q

how does rifampicin effect contraception

A

reduced effectiveness COCP

148
Q

what needs prescribing with isoniazid

A

pyridoxine (vit b6) to reduce peripheral neuropathy

149
Q

which TBV tx can cause uric acid stones

A

pyrazinamide - increaes uric acid causing kidney stones and gout

150
Q

how to test for legionnaires disease

A

urine antigen testing

151
Q

mx legionnaiers pnuemoniae

A

clarithromycin

152
Q

how can legionnaires pneumoniae present

A

SIADH
hyponatraemia

finals (31 decks)

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