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Finals > Infectious diseases > Flashcards

Infectious diseases Flashcards

1
Q

Which groups of antibiotics can have cross reactivity in those with penicillin allergies?

A

Cephalosporins - cephalexin, ceftriaxone
Carbapenems - meropenem

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2
Q

What kind of bacteria is metronidazole good at treating?

A

Anaerobes

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3
Q

Name some macrolide antibiotics

A

Erythromycin, clarithromycin

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4
Q

Name some tetracycline antibiotics

A

Doxycyline, lymecyclline

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5
Q

Give an example of a quinolone antibiotics and what are its common side effects?

A

Ciprofloxacin

Tendon rupture, lowers seizures threshold, prolonged QTc

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6
Q

Why is nitrofurantoin only used to treat lower UTIs?

A

Gets excreted and concentrated in the urine/bladder, once concentrated it can kill the bacteria but low levels in blood

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7
Q

What antibiotic is commonly used to treat MRSA?

A

Tecioplanin or vancomycin

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8
Q

What antibiotic is commonly used to treat ESBL?

A

Meropenem

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9
Q

What is the definition of sepsis?

A

When body launches a large immune system response to an infection causing systemic inflammation and organ dysfunction

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10
Q

What NEWS2 score should trigger a sepsis review?

A

> 5 or clinical concern

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11
Q

What is the sepsis 6?

A

3 out: lactate, blood cultures, urine output

3 in: oxygen to maintain sats, empirical borad spectrum antibiotics, IV fluids

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12
Q

What volume of IV fluids should be given to someone with suspected sepsis?

A

If lactate >2 or BP <90 give 500ml in less than 15 mins

If lactate <2 consider IV fluids

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13
Q

When should you be concerned about neutropenic sepsis?

A

Someone with a neutrophil count below 1

Presenting with temperature above 38 is neutropenic sepsis until proven otherwise even in the absence of any other symptoms

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14
Q

What is the management of neutropenic sepsis?

A

Broad spectrum antibiotics such as Tazocin

Emergency admission to hospital

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15
Q

What kind of bacteria is c.diff?

A

Gram positive rod - anaerobe

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16
Q

Which antibiotics can cause c.diff infection?

A

Clindamycin, ciprofloxacin, cephalosporins, carbapenems

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17
Q

What is the presentation of c.diff infection?

A

Diarrhoea, nausea, abdo pain

If severe can lead to colitis, dehydration and systemic symptoms

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18
Q

How is c.diff diagnosed?

A

Stool sample

Initially tested for c.diff antigen, if that is positive test for toxins which gives definitive diagnosis

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19
Q

What is the management of c.diff?

A

1st line = oral vancomycin
2nd line = oral fidaxomicin

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20
Q

What are the complications of c.diff infection?

A

Pesudomembranous colitis, toxic megacolon, bowel perforation, sepsis

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21
Q

How is HIV transmitted?

A

Unprotected sex, vertical transmission, bodily fluids

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22
Q

How does Kaposi’s sarcoma present?

A

Raised purple lesions on skin

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23
Q

What are the features of PCP infection and how is it treated?

A

Most common opportunisitic infection in HIV

Shortness of breath, dry cough, fever

CXR: bilateral interstitial pulmonary infiltrates

Mangement = co-trimoxazole

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24
Q

What is the most common infective cause of diarrhoea in HIV patients?

A

Cryptosprodium

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25
Q

A patient with HIV and oesophagitis is likely to have what..?

A

Oesophageal candidiasis

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26
Q

What symptoms are associated with seroconversion (initial infection) with HIV?

A

Sore throat, lymphadenopathy, malaise, myalgia, diarrhoea, rash, mouth ulcers

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27
Q

What is the most common opportunistic neuro infection in those with HIV?

A

Cerebral toxoplasmosis
Imaging will show brain lesions with ring enhancement

28
Q

At what CD4 count are patients susceptible to opportunistic infections?

A

<200

29
Q

When should ART be commenced in someone with HIV?

A

As soon as diagnosis occurs

Usually two NRTIs plus third agent (can get combined in one tablet)

30
Q

What is the aim of ART treatment?

A

Normal CD4 count and undetectable viral load

31
Q

Can you breastfeed if you have HIV?

A

The safest option is to avoid breastfeeding as it can be transmitted even if viral load is low

32
Q

How can HIV transmission be prevented during birth?

A

if viral load over 50 pre-labour c-section is recommended

If viral load >1000 or unknown IV zidovudine is given as infusion during labour

Prophylaxis can also be given to the baby depending on mothers viral load

33
Q

When can post-exposure prophylaxis be used and how long is it taken for?

A

Must be commenced within 72 hours of exposure

ART therapy is given for 28 days

34
Q

What is the most severe and dangerous type of malaria?

A

Plasmodium falciparum

35
Q

What is the presentation of malaria?

A

Incubation period 1-4 weeks
Fever +/- rigors, fatigue, myalgia, headache, nausea, pallor, hepatosplenomegaly, jaundice

36
Q

How is malaria diagnosed?

A

Malaria blood film - thick and thin

3 negative samples over 3 consecutive days are required to exclude malaria

37
Q

How is malaria treated?

A

Artemether with lumefantrine if uncomplicated

Artesunate if severe or falciparum malaria

38
Q

How can malaria be prevented?

A

Spray, nets, antimalarial medication e.g. doxycyline, proguanil with atovaquone (malarone)

39
Q

What are the risk factors for infective endocarditis?

A

IVDU, structural heart pathology, CKD, immunocompromised, previous history of infective endocarditis

40
Q

What are the common causes of infective endocarditis?

A

Most common = staph aureus

Strep viridans (common after dental work)

41
Q

What is the presentation of infective endocarditis?

A

New or changing heart murmur, fever, fatigue, splinter haemorrhages, Janeway lesions, Osler’s nodes, Roth spots, finger clubbing

42
Q

What investigations are done in infective endocarditis?

A

3 blood culture samples are recommended (taken at least 6 hours apart)

Transoesophageal echo

43
Q

What criteria is used to diagnose infective endocarditis?

A

Duke criteria

Two major or one major + 3 minor or five minor

44
Q

What is the management of infective endocarditis?

A

Liaise with micro/ID
IV broad spectrum antibiotics (amoxicillin and optional gentamicin)

45
Q

What is the presentation of cellulitis?

A

Erythema, warm, tense, thickened, oedematous, bullae, can be systemically unwell

46
Q

What is the management of cellulitis?

A

If severe admission for IV antibiotics is required

1st line = flucloxacillin (if penicillin allergy clarithromycin)

47
Q

What are the causes of bacterial meningitis?

A

Neisseria meningitidis, strep pneumoniae, haemophilus influenzae, group B strep (neonates), listeria (neonates)

48
Q

What is Kernig’s test?

A

Lying patient on back, flex one hip and knee to 90 degrees then straighten the knee - will produce pain or resistance to movement in meningitis

49
Q

What is Brudzinki’s test?

A

Lying patient flat and gently lifting their head and neck off the bed flexing their chin to chest, causes patient to flex their hips and knees

50
Q

What is the CSF analysis of a patient with bacterial meningitis?

A

Cloudy, high protein, low glucose, high neutrophils

51
Q

What is the CSF analysis of a patient with viral meningitis?

A

Clear, normal protein, normal glucose, high lymphocytes

52
Q

When should you CT before an LP in suspected meningitis?

A

Focal neurological signs, papilloedema or other signs of raised ICP, continuous seizures, GCS <12

53
Q

When should you not perform an LP in suspected meningitits?

A

Any neuroimaging findings, continuous seizures, rapidly declining GCS, sepsis or rapidly evolving rash, cardiac or respiratory compromise

54
Q

What is the emergency treatment given in the community for suspected meningitis?

A

IM benzylpenicillin (as long as it does not delay transfer)

55
Q

What is the management of meningitis?

A

Cefotaxime (+ amoxicillin if under 3 months or over 50 to cover listeria)

+ dexamethasone to reduce frequency and severity of hearing loss

56
Q

What is given as prophylaxis for close contacts of those with meningitis?

A

Single dose ciprofloxacin (if close prolonged contact within 7 days of onset of illness)

Alternative is rifampicin

57
Q

What is encephalitis?

A

Meningitis + confusion

58
Q

What are the symptoms of Giardia and how does someone catch it?

A

Non bloody diarrhoea, abdo cramping/bloating

Associated with swimming in rivers/lakes in India

59
Q

Who is likely to get cryptosporidiosis and what are the symptoms?

A

Immunocompromised and HIV patients

Water diarrhoea, cramps and fever

60
Q

What are the symptoms of campylobacter and who is likely to get it?

A

Flu like illness as prodrome before bloody diarrhoea, vomiting, abdo pain

Most common cause of infective diarrhoea in UK

61
Q

What are the symptoms of entamoeba histolytica, where is it endemic and what is the treatment?

A

Profuse bloody diarrhoea

Endemic in South America - incubation period is long so can present months later

Metronidazole

62
Q

What are the symptoms of yellow fever and where is it found?

A

Mild flu like illness –> period of remission –> jaundice, haematemesis, oliguria

Found in Africa and rural areas of South America

63
Q

What are the symptoms of typhoid?

A

Systemic upset, abdominal pain, constipation, high fever, bradycardia

Present within 21 days of return from travel - endemic in India

64
Q

Which valve is most commonly affected in infective endocarditis?

A

Mitral valve (but tricuspid is most commonly affected in IVDU)

65
Q

What is the most common pathogen that causes leg cellulitis?

A

Strep (group B)

66
Q

If a patient is presenting with recurrent thrush what do you need to test for?

A

Diabetes

67
Q

What is the most common cause of traveller’s diarrhoea?

A

E.coli

Finals (21 decks)

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