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Infectious Diseases Flashcards

1
Q

What broad groups of organisms are gram +ve cocci?

A

Staphylococcus

Streptococcus

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2
Q

What organisms are gram -ve cocci?

A

Neisseria Gonorrhoea
Neisseria Meningitidis
Moraxella

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3
Q

What organisms are gram +ve bacilli?

A 
Actinomyces
Bacillus antracis
Clostridium
Diptheria
Listeria 
(ABCDL)
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4
Q

What organisms are gram -ve bacilli?

A

Basically everything including E.Coli, Klebsiella, Salmonella, Proteus, Salmonella, Shigella, Psedomonas

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5
Q

What staphylococcus is coagulase positive?

A

Staph Aureus

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6
Q

What staphylococcus is coagulase negative?

A

Staph epidermidis

Staph saprophyticus

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7
Q

What is alpha-haemolytic strep?

A

Causes a partial haemolysis on blood agar

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8
Q

What is beta-haemolytic strep?

A

Causes a complete haemolysis on blood agar

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9
Q

What are examples of alpha-haemolytic strep?

A 
Strep pneumonia (Pneumococcus)
Strep viridans
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10
Q

What organism is a Group A beta-haemolytic strep?

A

Strep pyogenes

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11
Q

What organism is a Group B beta-haemolytic strep?

A

Strep agalactiae

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12
Q

What organism is Group D beta-haemolytic strep?

A

Enterococcus (faecalis, faecium)

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13
Q

How do penicillin’s work?

A

Bacteriocidal - prevent cell wall synthesis

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14
Q

What are some side effects of penicillins?

A

Hypersensitivity and allergy

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15
Q

How do cephalosporins work?

A

Bacteriocidal - prevent cell wall synthesis

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16
Q

What are some examples of cephalosporins?

A

Cefotaxime, ceftriaxone, cephalexin

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17
Q

How do monobactams work?

A

Bacteriocidal - prevent cell wall synthesis

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18
Q

What is an example of a monobactam?

A

Aztreonam

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19
Q

What cover does Aztreonam give?

A

Gram -ve cover, an alternate to Gentamicin

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20
Q

How do carbapenams work?

A

Bacteriocidal - prevent cell wall synthesis

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21
Q

What is an example of a carbapenam?

A

Menopenam

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22
Q

What is Menopenam commonly used for?

A

Multi-drug resistant infections e.g. ESBL

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23
Q

How do glycopeptides work?

A

Bacteriocidal - prevent cell wall synthesis

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24
Q

What is an example of a glycopeptide?

A

Vancomycin

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25
Q

How is vancomycin administered and why?

A

Usually IV as poor oral absorption

Given orally in C.Diff in order to act locally

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26
Q

Are glycopeptides beta-lactams?

A

No

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27
Q

How do macrolides work?

A

Bacteriostatic - inhibit protein synthesis

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28
Q

What are examples of macrolides?

A

Clarithromycin, erythromycin, azithromycin etc

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29
Q

How are macrolides excreted?

A

Via the gut

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30
Q

How do aminoglycosides work?

A

Bacteriocidal - inhibit protein synthesis

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31
Q

What is an example of an aminoglycoside?

A

Gentamicin

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32
Q

What cover does gentamicin give?

A

Gram negative

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33
Q

How is gentamicin excreted?

A

Renally

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34
Q

What are side effects of gentamicin?

A

Nephrotoxic, Ototoxic

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35
Q

How do tetracyclines work?

A

Bacteriostatic - inhibit protein synthesis

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36
Q

What are examples of tetracyclines?

A

Doxycycline, lymecycline, oxytetracycline

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37
Q

What cover do tetracyclines give?

A

Gram positive cover

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38
Q

How are tetracyclines excreted?

A

Via the gut

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39
Q

What are side effects of tetracyclines?

A

Photosensitivity, yellow staining of teeth

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40
Q

How does metronidazole work?

A

Bacteriocidal - inhibits DNA synthesis

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41
Q

What does metronidazole cover?

42
Q

What are some side effects of metronidazole?

A

Polyneuropathy, metallic taste, reacts badly with alcohol

43
Q

How do sulphonamides and trimethoprim work?

A

Bacteriocidal - inhibit DNA synthesis by inhibiting folic acid synthesis

44
Q

How do quionolones work?

A

Bacteriocidal - inhibit DNA synthesis by inhibiting replication

45
Q

What are some examples of quinolones?

A

Ciprofloxacin, ofloxacin

46
Q

What do quinolones cover?

A

Broad spectrum but mainly gram negative cover

47
Q

What is the major risk of using quinolones?

48
Q

What are the common causative organisms of UTI?

A

Coliforms (E.Coli, Klebsiella, Enterobacter)
Proteus
Enterococcus faecalis or faecium (commensals)
Staphylococcus saprophyticus

49
Q

What is the definition of a complicated UTI?

A

UTI complicated by systemic symptoms or any urinary structural abnormality

50
Q

What is bacteriuria?

A

Bacteria in the urine - may not be infection

51
Q

What type of urine sample should be taken?

52
Q

What will infection show on urine dipstick?

A

Raised leucocytes and raised nitrites

53
Q

Should UTI culture show pure or mixed growth?

A

Pure growth - mixed is not significant

54
Q

When should people with asymptomatic bacteruria be treated?

A

Only if pregnant - as may progress to pyelonephritis and can cause IUGR

55
Q

How is uncomplicated female UTI treated?

A

Nitrofurantoin 50g QDS or trimethoprim 200g BD (3 days)

56
Q

How is uncatheterised male UTI treated?

A

Send for culture - nitrofurantoin 50g QDS or trimethoprim 200g BD (7 days)

57
Q

How is a complicated UTI treated in the community?

A

Co-trimoxazole or co-amoxiclav (7 days)

58
Q

How is a complicated UTI treated in the hospital?

A

IV amoxicillin and gentamicin

Step down to oral co-trimoxazole

59
Q

What antibiotics should be used for UTI in the first and second trimester of pregnancy?

A

Nitrofurantoin 50mg QDS (7 days)

60
Q

What antibiotics should be used for UTI in the third trimester of pregnancy?

A

Trimethoprim 200mg BD (7 days)

61
Q

What organisms commonly cause cellulitis?

A

Group A Beta-Haemolytic Strep (Strep Pyogenes)

Staph Aureus

62
Q

What antibiotic is used to treat cellulitis?

A

Flucloxacilin 1g QDS

63
Q

If a patient has recurrent boils or abscesses, what should you consider swabbing for?

A

Panton-Valentine Leucocidin

64
Q

What is Panton-Valentine Leucocidin and what is it produced by?

A

Toxin produced by certain types of staph aureus

65
Q

What is bacteraemia?

A

The presence of bacteria in the blood

66
Q

What is osteomyelitis?

A

Inflammation of bone and medullary cavity

67
Q

What are the likely causative organisms of osteomyelitis?

A

Staph Aureus
Staph epidermidis
Streptococcus
Aerobic gram -ve organisms

68
Q

How is osteomyelitis treated?

A

IV flucloxacillin 2g TDS

69
Q

What are the likely causative organisms of septic arthritis?

A

Staph aureus
Streptococcus
Neisseria Gonorrohoea (in sexually active)

70
Q

What is the likely causative organism of septic arthritis in prosthetic joints?

A

Coagulase -ve staph (e.g. staph epidermidis)

71
Q

How is septic arthritis treated?

A

IV flucloxacillin 2g TDS

72
Q

What are the common causes of meningitis in neonates?

A

Listeria
Group B Beta Haemolytic Strep
E. Coli

73
Q

What is the commonest cause of bacterial meningitis in children?

A

Haemophilus Influenza (less now with vaccine)

74
Q

What is the commonest cause of bacterial meningitis in 10-21 year olds?

A

Neisseria Meningitidis

75
Q

What are the common causes of bacterial meningitis in >21s?

A

Strep Pneumoniae, Neisseria Meningitidis

76
Q

What are the common causes of bacterial meningitis in over 65s?

A

Strep Pneumonia, Listeria

77
Q

How is bacterial meningitis treated?

A

Ceftriaxone IV 2g BD + Dexamethasone IV 10mg QDS

78
Q

Patient gets an itchy erythematous rash following vancomycin administration

A

Red man syndrome

79
Q

What are ESBLs?

A

Extended spectrum beta lactamases - resistant to all penicillins

80
Q

How are ESBLs treated?

A

Temocillin or meropenem

81
Q

What are risk factors for C.diff infection?

A

Antibiotics - clindamycin, cephaloscoprins, ciprofloxacin
PPI use
Increased age
Bowel surgery

82
Q

What are features of C diff infection?

A

Diarrhoea, abdominal pain, raised white cell count

83
Q

How is non severe C. Diff treated first line?

A

Oral metronidazole (10 days)

84
Q

How is severe C. Diff treated?

A

Oral vancomycin (10 days)

85
Q

How is C. Diff investigated?

A

Stool for toxin

86
Q

How is E.Coli 0157 diagnosed?

A

Stool culture

87
Q

How is influenza diagnosed?

A

Throat swab for PCR

88
Q

What is the first line treatment for MRSA?

A

IV Vancomycin

89
Q

What is the most effective way of preventing the spread of MRSA?

A

Hand washing

90
Q

How should patients with norovirus be managed in the hospital setting to prevent spread?

A

Isolation and/or cohort nursing and closure of the ward

91
Q

How is TB investigated?

A

Sputum sample or if non productive bronchoalveolar lavage

92
Q

What is the investigation of choice for endocarditis?

A

Trans-oesophageal echocardiogram

93
Q

What is the SIRS criteria?

A 
2 from:
Temperature >38 or <36
Pulse >90
RR >20
WCC >12 or <4
94
Q

What is sepsis defined as?

A

Clinical suspicion of infection + SIRS criteria

95
Q

What is severe sepsis?

A

Sepsis + organ dysfunction

96
Q

What is septic shock?

A

Sepsis + refractory hypotension

97
Q

‘Fever on alternating days’

98
Q

What is the common cause of a post influenza pneumonia?

A

Staph aureus

99
Q

How is mycoplasma pneumoniae diagnosed?

100
Q

What is the commonest infection of central line infections?

A

Staph epidermidis

Finals Revision (22 decks)

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