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FCRAP > Infectious diseases > Flashcards

Infectious diseases Flashcards

1
Q

MRSA - gene causing resistance?

A

MecA gene

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2
Q

VRE - gene causing resistance

A

Van - multiple genes

VanB more common

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3
Q

ESBL - how is resistance transmitted

A

Plasmid mediated - multiple genes
Resistance to Pen and 3rd gen ceps,
Sensitive to 2nd gen/Carbapenems/beta lactamase inhibitors (tend to use carbapenems as other drugs not good in vivo activity)

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4
Q

ESCAPPM - how is resistance transmitted

A

Chromosomal mediated, inducible
AmpC gene leading to beta lactamase production
Rx Carbapenems

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5
Q

What genes confer resistance to carbapenems

A

Multiple genes found in enterobacteriaceae
KPC (Klebsiella Pneumonia Carbapenemase)
NDM (New Delhi Metallo beta lactamse 1) found in E.coli (and others). Rx Tigecycline, Colistin

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6
Q

Meningitis

A

ceftriaxone, aciclovir, pred

add ampicillin if immunosuppressed to cover listeria

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7
Q

IE

A

genta + benpen + fluclox

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8
Q

toxoplasma

A

HIV CD4+ < 100
multiple ring enhancing lesions
DDx: primary CNS lymphoma (single or multiple), PML (enhancing areas, CMV (non specific imaging), HIVE (diffuse change)

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9
Q

cellulitis

A

strep pyogenes, staph aureus
flucloxacillin
clindamycin if pen allergy / no response

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10
Q

COPD exacerbation

A

haemophilius influenzae
strep pneumoniae
moraxhella catarrhalis

if pneumonia - strep pneumo

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11
Q

meningitis

A

ceftriaxone - meningococcal cover
benzylpenicillin - listeria cover
vanc if hospital / surgery etc - MRSA cover

pen allergy: vanc + cipro / maxi
prophylaxis: ceftriaxone / cipro

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12
Q

pneumonia in etOH excess

A

klebsiella

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13
Q

colistin

A

GN cover only

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14
Q

malaria

A 
artemether /lumefantrine - non severe
artesunate - severe falciparum
quinine - if pregnant
mefloquine (larium) psych SEs
atovaquone /proguanil (malarone)
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15
Q

cefepime

A

no useful activity against MRSA

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16
Q

MERS

A

middle eastern respiratory syndrome
9-12 day incubation
50% mortality
diagnosis from LRT PCR

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17
Q

PCP

A

Bactrim
2nd line: clindamycin + primaquine
add steroids if PaO2 < 70mmHg

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18
Q

Staph Aureus methicillin resistance

A

via production of penicillin binding protein PBP 2A

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19
Q

nitrofurantoin

A

SEs fever + hepatitis (self limiting)

GN UTI

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20
Q

DNA gyrase mutation

A

fluoroquinolone resistance

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21
Q

GN resistance

A

efflux pumps, porins

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22
Q

penicillin resistant staph aureus

A

penicillinase production

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23
Q

live vaccines

A

MMR, oral polio, varicella, yellow fever, BCG, japanese encephalitis, rotavirus, oral typhoid, smallpox

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24
Q

HIV + TB together

A

start HAART 8/52 post TB therapy if possible

25
Q

culture negative meningitis

A

NSAIDs, cryptococcus, TB, sarcoid, behcets, malignancy

26
Q

gentamicin

A

GN sepsis incl pseudomonas

27
Q

beta lactams

A

bactericidal activity directed at cell wall

carbapenems, cephalosporins, penicillins

28
Q

carbapenems

A

GN, pseudomonas, GP
inactive against: e faecium, MRSA, pseudomonas
inactivated by metallobeta lactamases

29
Q

cephalexin, cephazolin

A

strep, staph, E coli, klebsiella

inactive: enterococci, listeria, pseudomonas

30
Q

ceftriaxone

A

GN rods, staph; meningitis
inactive: enterococci, MRSA
resistance develops: serrate, citrobacter, enterobacter; ESBL - e coli, klebsiella, enterobacter

31
Q

ceftazidime

A

enteric GN rods incl pseudomonas

inactive: ESBL enzymes

32
Q

daptomycin

A

GPs only
not for lungs
AEs: myopathy

33
Q

aztreonam

A

aerobic GNs incl haemophilus, pseudomonas

OK in penicillin allergy

34
Q

bi/flucloxacillin

A

GPs incl staph with beta lactamase

cholestatic jaundice up to 6/52 post Rx

35
Q

amoxy/ampicillin

A

drug of choice for enterococcus

36
Q

beta lactamase

A

produced by staph, bactericides fragilis, h. influenza, e. coli, klebsiella
use augment / tazocin

37
Q

tazocin / timentin

A

only penicillins for pseudomonas cover

some enterococci, klebsiella cover

38
Q

fusidic acid

A

staph

never use alone (rapid resistance)

39
Q

teicoplanin / vancomycin

A

GPs only
MRSA, MRSE
severe infx if penicillin allergy
vanc for metro resistant c diff

40
Q

clinda / lincomycin

A

GPs

41
Q

linezolid

A 
GPs
incl MRSA, coag neg staph, VRE, pen resistant strep pneumo
only use in multi drug resistant infxs
BM suppression; peripheral neuropathy
serotonin syndrome
42
Q

macrolides

A

azithro, clarithro, erythro, roxithro
GPs, legionella, corynebacteria, GN cocci, mycoplasma, chlamydia, anaerobes
erythro, clarithro - QT prolongation, inhibit 3A4
clarithro + colchicine = fatal BM toxicity

43
Q

metronidazole

A

anaerobes

44
Q

colistin

A

resistant GNs - pseudomonas

renal, neruotox

45
Q

quinolones

A

cipro, moxi, norflox, oflox

46
Q

rifampicin

A

MAC, TB, MRSA

AEs: thrombocytopaenia, AKI, flu like, orange body fluids

47
Q

pristinamycin

A

GP, neisseria, mycoplasma, ureaplasma, chlamydia, haemophilus

48
Q

Bactrim

A

PCP, MRSA, listeria, nocardia

49
Q

tetracyclines

A

GP, GN

50
Q

brain abscess

A

benpen + metro + cef

51
Q

prostatitis

A

amoxy + gent

52
Q

necrotising fasciitis

A

pen + gent + metro

53
Q

CCR5

A

early coreceptor for HIV (macrophages)

delta32 mutation predicts indolent disease and relative resistance to infection

54
Q

CXCR4

A

later coreceptor for HIV (T cell)

55
Q

HLA B57 HIV

A

allergic to abacavir

better prognosis HIV

56
Q

HIV + HCV

A

HAART first; HCV therapy once CD4 > 100

57
Q

Causes of bloody diarrhoea

A

shigella, salmonella, campylobacter, E histolytica

58
Q

varicella in pregnancy

A

infectious: 48 hours pre rash to vesicle crusting
incubation: 10-21 days
fatal threat: < 20/40; within 5/7 of delivery
VZIg within 72/24 of contact to lessen maternal illness
VZIg to baby if born within 5/7 of maternal infx or exposed in 1st week of life

59
Q

HLA associations

A 
HLA-A3 haemochromatosis
HLA-B5 Behcet's disease
HLA-B27 ankylosing spondylitis
Reiter's syndrome
acute anterior uveitis
HLA-DQ2/DQ8 coeliac disease
HLA-DR2 narcolepsy; Goodpasture's
HLA-DR3 dermatitis herpetiformis
Sjogren's syndrome, PBC
HLA-DR4 type 1 diabetes mellitus* rheumatoid arthritis

FCRAP (19 decks)

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