Infectious Diseases: The Basics Flashcards
Outline the current BNF guidelines for antibiotic treatment of Exacerbations of chronic bronchitis
Amoxicillin or tetracycline or clarithromycin
Outline the current BNF guidelines for antibiotic treatment of Uncomplicated community-acquired pneumonia
Amoxicillin
Doxycycline or clarithromycin in penicillin allergic
add flucloxacillin if staphylococci suspected e.g. In influenza
Outline the current BNF guidelines for antibiotic treatment of Pneumonia possibly caused by atypical pathogens
Clarithromycin
Outline the current BNF guidelines for antibiotic treatment of Hospital-acquired pneumonia
Within 5 days of admission: co-amoxiclav or cefuroxime
More than 5 days after admission: piperacillin with tazobactam OR a broad-spectrum cephalosporin (e.g. ceftazidime) OR a quinolone (e.g. ciprofloxacin)
Outline the current BNF guidelines for antibiotic treatment of Lower urinary tract infection
Trimethoprim or nitrofurantoin.
Alternative: amoxicillin or cephalosporin
Outline the current BNF guidelines for antibiotic treatment of Acute pyelonephritis
Broad-spectrum cephalosporin or quinolone
Outline the current BNF guidelines for antibiotic treatment of Acute prostatitis
Quinolone or trimethoprim
Outline the current BNF guidelines for antibiotic treatment of Impetigo
Topical hydrogen peroxide
Oral flucloxacillin or erythromycin if widespread
Outline the current BNF guidelines for antibiotic treatment of Cellulitis
Flucloxacillin (clarithromycin, erythromycin or doxycycline if penicillin-allergic)
Cellulitis (near the eyes or nose)
Co-amoxiclav (clarithromycin, + metronidazole if penicillin-allergic)
Outline the current BNF guidelines for antibiotic treatment of Erysipelas
Flucloxacillin
clarithromycin, erythromycin or doxycycline if penicillin-allergic
Outline the current BNF guidelines for antibiotic treatment of Animal or human bite
Co-amoxiclav
doxycycline + metronidazole if penicillin-allergic
Outline the current BNF guidelines for antibiotic treatment of Mastitis during breast-feeding
Flucloxacillin
Outline the current BNF guidelines for antibiotic treatment of Throat infections
Phenoxymethylpenicillin
erythromycin alone if penicillin-allergic
Outline the current BNF guidelines for antibiotic treatment of Sinusitis
Phenoxymethylpenicillin
Outline the current BNF guidelines for antibiotic treatment of Otitis media
Amoxicillin (erythromycin if penicillin-allergic)
Outline the current BNF guidelines for antibiotic treatment of Otitis externa
Flucloxacillin (erythromycin if penicillin-allergic)
Outline the current BNF guidelines for antibiotic treatment of Periapical or periodontal abscess
Amoxicillin
Outline the current BNF guidelines for antibiotic treatment of Gingivitis: acute necrotising ulcerative
Metronidazole
Outline the current BNF guidelines for antibiotic treatment of Gonorrhoea
Intramuscular ceftriaxone
Outline the current BNF guidelines for antibiotic treatment of Chlamydia
Doxycycline or azithromycin
Outline the current BNF guidelines for antibiotic treatment of Pelvic inflammatory disease
Oral ofloxacin + oral metronidazole or intramuscular ceftriaxone + oral doxycycline + oral metronidazole
Outline the current BNF guidelines for antibiotic treatment of Syphilis
Benzathine benzylpenicillin or doxycycline or erythromycin
Outline the current BNF guidelines for antibiotic treatment of Bacterial vaginosis
Oral or topical metronidazole or topical clindamycin
Outline the current BNF guidelines for antibiotic treatment of Clostridium difficile
First episode: metronidazole
Second or subsequent episode of infection: vancomycin
Outline the current BNF guidelines for antibiotic treatment of Campylobacter enteritis
Clarithromycin
Outline the current BNF guidelines for antibiotic treatment of Salmonella (non-typhoid)
Ciprofloxacin
Outline the current BNF guidelines for antibiotic treatment of Shigellosis
Ciprofloxacin
What type of vaccine is BCG?
Live attenuated
What type of vaccine is influenza?
Live attenuated
What type of vaccine is MMR?
Live attenuated
What type of vaccine is oral polio?
Live attenuated
Which vaccines are inactivated preparations?
rabies
hepatitis A
influenza (intramuscular)
Which vaccines are inactivated toxins/toxoids?
tetanus
diphtheria
pertussis
What type of vaccine is pneumococcus?
subunit/conjugate
What type of vaccine is hepatitis B?
subunit/conjugate
Give examples of
Gram-positive cocci
staphylococci + streptococci (including enterococci)
Give examples of
Gram-negative cocci
Neisseria meningitidis + Neisseria gonorrhoeae, also Moraxella catarrhalis
Give examples of
Gram-positive rods (bacilli)
ABCD L Actinomyces Bacillus anthracis (anthrax) Clostridium Diphtheria: Corynebacterium diphtheriae Listeria monocytogenes
Give examples of Gram-negative rods
Escherichia coli Haemophilus influenzae Pseudomonas aeruginosa Salmonella sp. Shigella sp. Campylobacter jejuni
The pneumococcal polysaccharide vaccine is offered to all adults over the age of 65 years and those with
asplenia or splenic dysfunction chronic respiratory disease chronic heart disease chronic kidney disease (at stages 4 and 5) chronic liver disease diabetes mellitus if requiring medication immunosuppression cochlear implants patients with cerebrospinal fluid leaks
The Department of Health recommends annual influenza vaccination for people older than 65 years and those with:
chronic respiratory disease chronic heart disease chronic kidney disease (at stages3, 4 and 5) chronic liver disease chronic neurological disease diabetes mellitus immunosuppression asplenia or splenic dysfunction pregnant women
Healthcare staff/residential care homes
Identifying gram-positive bacteria - which type makes CATALASE
Staphylococci (not strep)
Identifying gram-positive bacteria - which type makes COAGULASE
Staph Aureus
Identifying gram-positive bacteria -
Describe hemolysis in streptococci
partial haemolysis (green colour on blood agar): α-haemolytic complete haemolysis (clear): β-haemolytic no haemolysis: γ-haemolytic
What is sepsis?
life-threatening organ dysfunction caused by a dysregulated host response to infection
What is septic shock?
a more severe form sepsis, technically defined as ‘in which circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone
qSOFA score criteria include?
Respiratory rate > 22/min
Altered mentation
SYSTOLIC blood pressure < 100 mm Hg
‘Sepsis Six’ includes?
- Administer oxygen: Aim to keep saturations > 94% (88-92% if at risk of CO2 retention e.g. COPD)
- Take blood cultures
- Give broad spectrum antibiotics
- Give intravenous fluid challenges: NICE recommend a bolus of 500ml crystalloid over less than 15 minutes
- Measure serum lactate
- Measure accurate hourly urine output