Infectious diseases

Question 1

sources of bacteraemia

Answer 1

skin - cellulitis, wound, ulcer
bone - osteomyelitis
prosthesis 
IE 
Septic arthritis
discitis 
septic emboli 
pneumonia
indwelling lines
UTI
IVDU

Question 2

what is the sepsis 6 protocol

Answer 2

O2 
fluids 
antibiotics 
cultures - blood, urine, prosthesis, wound, bone 
urine output 
lactate

Question 3

what imaging should be done for bacteraemia

Answer 3

TTE followed by TOE if abnormal

Question 4

antibiotic regimen for bacteraemia

Answer 4

2 weeks IV flucloxacillin/vancomycin

Question 5

antibiotic regimen duration for osteomyelitis

Answer 5

4 weeks

Question 6

antibiotic regimen for IE

Answer 6

4 weeks

Question 7

RF for IE

Answer 7

abnormal heart valves - calcification, prosthetic, CHD, post rheumatic fever
IVDU
indwelling lines
dental treatment

Question 8

organisms causing native valve IE

Answer 8

staph aureus
viridans strep
enterococcus
staph epi

Question 9

what is the name of the criteria used for IE

Answer 9

Dukes criteria

Question 10

work up of investigations for IE

Answer 10

blood cultures
TTE
TOE

Question 11

Gm + cocci in clusters

Answer 11

staph

Question 12

Gm + cocci in chains

Answer 12

strep

Question 13

staph epi is a skin contaminant

Answer 13

yes

but can also infect prosthetic material

Question 14

other skin contaminant

Answer 14

corynebacterium

Question 15

presenting symptoms of acute IE

Answer 15

sepsis and heart failure

Question 16

presenting features of subacute IE

Answer 16

weight loss 
night sweats 
malaise 
tiredness 
SOB

Question 17

signs of subacute IE

Answer 17

fever 
new murmur
finger clubbing 
splinter haemorrhages 
splenomegaly 
Roth spots - eyes 
Janeway lesions - hands
Oslers nodes - 'ouch' hands
microscopic haematuria

Question 18

where are IVDU more likely to get IE

Answer 18

tricuspid valve (RHS)

Question 19

colonisation

Answer 19

presence of microbe with no inflammation

Question 20

infection

Answer 20

inflammation due to microbe

Question 21

bacteraemia

Answer 21

presence of viable bacteria in the bloodstream

Question 22

sepsis

Answer 22

dysregulated host response to infection

life threatening organ dysfunction

Question 23

criteria for septic shock

Answer 23

sepsis AND
persistent hypotension
lactate >2
failure with fluid resuscitation

Question 24

pathogen

Answer 24

any bug that has the potential to cause disease

Question 25

Gm + have thick/thin peptidoglycan wall

Answer 25

thick