Investigation of infections in general practice Flashcards
What test is done for possible urinary infection in clinic?
Dipstix
What is a sign of urinary infection?
Cloudy urine - means white blood cells present
What do vaginal swabs test for?
Thrush
Bacterial vaginosis
Chlamydia
Gonorrhoea
What test is used for streptococcus?
Throats swabs
What test is used for persistent conjunctivitis in babies?
Eye swabs
What test is used for mouth thrush?
Mouth swab
What is needed to test for fungal nail infections?
Nail clippings
What do you test for in people with gastritis symptoms?
Helicobacter pylori
What does overuse of antibiotics cause?
Encourages growth of harmful superbugs
What bugs cause chest infections?
Strep pneumoniae
Haemophilus
Mycoplasma pneumoniae
How can you tell if a patient is ill?
Temperature - high
Pulse rate - high
Respiratory rate - high
Capillary refill time > 2sec
What antibiotics are recommended for community acquired pneumonia?
Streps - amoxicillin
General - doxycycline
What influences prescription of antibiotics of community acquired pneumonia?
Diabetes
Frailty
HIV
Immunosuppression
When would you consider sending a patient for a chest xray?
Wheezing
Coughing up blood (check for lung cancer if they are a smoker)
What are impetigo and cellulitis?
Impetigo = little pustules on the skin
Cellulitis = common in elderly, red and swollen areas of skin
What causes impetigo?
Staphylococcus or Streptococcus
What causes cellulitis?
Streptococcus
What antibiotics are used for impetigo and cellulitis?
Staphylococcus = flucloxicillin
Streptococcus = penicillin V or amoxicillin
How is impetigo spread?
Close contact to infected children or by using towels, wash cloths etc.
What is conjunctivitis?
Sticky eyes
Common in babies
Viral or occasionally strep or staph
What is used to treat conjunctivitis?
Chloramphenicol
What happens if the conjunctivitis is severe 24-48hrs post delivery?
May be chlamydia caught during delivery
Do a swab
Describe UTIs
Very common in women
Often associated with sexual intercourse
What are symptoms of UTIs?
Burning on passing urine
Urine looks cloudy due to pus cells
What do dipstix test check for?
Leucocyte esterase
Protein
Blood
Nitrites Also glucose if they are diabetic
What is the most common bug for UTI?
E coli
What are symptoms of chlamydia?
Usually asymptomatic
Symptoms include dysuria, pain in testicles (men), vaginal discharge, spotting or pelvic pain (women)
What can chlamydia lead to?
Pelvic inflammatory disease
Infertility
Ectopic pregnancy
What should be done for vaginal discharge?
Take swabs for candida/thrush and bacterial vaginosis, chlamydia and gonorrhoea
What treatment is given for candida and BV?
Usually oral
Topical treatment for thrush during pregnancy because fluconazole is teratogenic (causes developmental malformations)
What causes diarrhoea?
Often food poisoning eg. campylobacter
Can be viral and resolve within 5 days
Describe tonsilitis/sore throat
Mostly viral
Can sometimes get scarlet fever with tonsilitis, strawberry tongue and rash
What should be tested for if antibiotics are not being given in tonsilitis?
Throat swab for beta haemolytic streptococcus
What antibiotic can be used to treat tonsilitis?
Penicillin
What are shingles?
Painful rash on one side
Known as Herpes zoster virus
What can shingles lead to?
Post herpetic neuralgia, especially in old people and those who are immunosuppressed
What causes fungal infections eg. athletes foot?
Fungi like warm, wet places
In the case of athletes foot, maybe not changing socks, sweaty shoes/socks
What should be done to treat athlete’s foot?
Keep clean and dry and open to air, e.g wear flip flops
Topical treatment first line = clotrimazole or miconazole cream
If not responsive then consider oral treatment eg. fluconazole
What are likely causes of skin infections?
Staph or strep
What are possible treatments for skin infections?
Flucloxacillin
Clarithromycin if allergic to penicillin
Topical fucidic acid if mild
What are likely causes of conjunctivitis?
Staph or strep
What are possible treatments for conjunctivitis?
Chloramphenicol eye drops
What are likely causes of ear, nose and throat (ENT) infections?
Strep or haemophilus influenzae
What are possible treatments for ENT infections?
Amoxicillin or clarithromycin
What are likely causes of lung infections?
Strep pneumoniae, mycoplasma
What are possible treatments for lung infections?
Doxycycline
What are likely causes of UTIs?
E.coli if straight forward
Otherwise proteus, pseudomonas etc. depends on sensitivities
What are possible treatments of UTIs?
Nitrofurantoin
