Infectious Diseases Flashcards

1
Q

Which antibiotic groups work by Time above the MIC?

A

Beta lactams
Note: why beta lactams are giving at frequent dosing as opposed to higher doses

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2
Q

Which antibiotic group works as a concentration dependent killer (peak concentration)?

A

Aminoglycosides

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3
Q

Which antibiotic group works by AUC/MIC?

A

Vancomycin
Azithromycin

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4
Q

What is the mechanism of action of aminoglycosides?

A

Binds the 30s subunit

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5
Q

What is the mechanism of action of beta lactams?

A

Bind to penicillin binding
proteins (PBPs)
* Inhibit completion of
synthesis of peptidoglycans
* Leads to bacterial cell wall
lysis in dividing cells

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6
Q

What is the mechanism of action of augmentin?

A

Bind to the beta-lactamase enzyme of bacteria to inhibit it allowing Beta-lactam antibiotic to damage bacteria
– Improves activity vs.
* Gram negative bacilli (E.coli, K. pneumoniae etc..)
* Staphylococcus aureus
* Beta-lactam producing anaerobes
* No antipseudomonal coverage

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7
Q

In a child with meningitis what level must the MIC be in order to use penicillin alone?

A

MIC <0.06

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8
Q

What is the mechanism for resistance in MRSA?

A

Altered penicillin binding sites

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9
Q

What is the drug of choice for ESBL?

A

Carbapenams +/- aminoglycosides

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10
Q

In a newborn with congenital CMV when would you treat?

A

<28 days old + moderate symptoms
Oral valganciclovir for 6 months

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11
Q

What are the clinical features of congenital rubella infection?

A
  • SNHL (58% of patients)
  • Eyes ‐ cataracts, retinopathy, micropthalmia (43% of patients)
  • Cardiac – PA stenosis and PDA
    + neurodevelopmental disability
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12
Q

When do neonates receive varicella immunoglobulin?

A
  • Neonatal exposure following maternal varicella
  • > 7days before delivery – no treatment
  • <7 before – 2(Aus) or 7 (NZ) days after delivery – VZIG
  • All <28 weeks gestation – VZIG
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13
Q

What medication can be given to mothers positive for toxoplasmosis with unaffected foetus?

A

Spiramycin - doesn’t cross the placenta

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14
Q

Treatment for congenital toxoplasmosis??

A

Pyrimethamine
Sulfadiazine
Folinic acids

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15
Q

What is the treatment of neonatal syphilis?

A

IV Benzylpenicillin for 10 days

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16
Q

When could you get a false positive HIV test result?

A

Patient who has previous had CART therapy

17
Q

How would you test for HIV in a child <18months old?

A

Viral PCR
Can’t do antibody testing as could be transferred maternal antibodies

18
Q

What is the first line therapy for HIV?

A

2 NRTIs + third drug (NNRTI, INSTI or PI)

19
Q

Which class of HIV treatment is a CYP3A4 inhibitor?

A

Protease inhibitors

20
Q

When is window treatment given for TB?

A

Child <5 years old who has been exposed to a confirmed case of TB less than 10 weeks prior whilst awaiting TST/IGRA testing.

21
Q

What is the main side effect of ethambutol that is monitored for?

A

Optic neuritis and red/green colour blindness

22
Q

What antibiotic is used to treat stenotrophomonas maltophilia?

A

IV Co-trimoxazole (also used in PJP)

23
Q

What are the features of Aspergillus on high resolution CT scan?

A

Halo sign
Air crescent sign

24
Q

What is first line treatment for invasive Aspergillus?

A

Voriconazole

25
Q

What treatment would you start in an immunosuppressed patient who you suspect has a fungal infection?

A

Liposomal Amphotericin (toxic to the kidneys)

26
Q

What is first line treatment for candidaemia or invasive candidiasis?

A

Caspofungin (doesn’t have urine or CSF penetration)

27
Q

What anti fungal is used for neonates?

A

Conventional amphotericin

28
Q

Which one of the following confers the greatest risk for the development of fungal infection in a patient undergoing chemotherapy?

A

Prolonged severe neutropenia

29
Q

Where is invasive Aspergillus mainly found?

A

Brain, chest, sinuses

30
Q

What is used to treat haemorrhagic cystitis in BK infection?

A

Cidofovir

31
Q

What are you at risk of if you are taking infliximab?

A

Reactivation of latent TB
Should have interferon gamma assay and CXR prior to commencing as it is an anti-TNF monoclonal antibody

32
Q

Which vaccines should be avoided in babies within the first 12 months whose mothers have been on biological agents such as infliximab?

A

Live attenuated vaccines such as BCG

33
Q

What are the high risk HPV serotypes?

A

HPV 16 and 18 (Cervical cancer)
Low risk 6 and 11 (cause of non-malignant genital warts and recurrent respiratory papillomatosis)

34
Q

Which bacteria are catalase negative?

A

Streptococcus
Enterococcus