Key Clinical Conditions Flashcards
Pneumonia: Common causative agent Presentation Signs and symptoms Risk factors Treatment
Virus:
Bacteria: rhinovirus, coronavirus, influenza virus
community - strep. Pneumoniae, H.influenzae, klebsiella pneumoniae
Hospital - e.coli, staph. aureus
(Some fungi and parasites)
(Also some drugs and autoimmune diseases)
Inflammatory condition of the lung, primarily affecting alveoli
Present with cough, chest pain, fever, difficulty breathing
Risk factors: smoking, immunodeficiency, alcoholism, COPD, asthma, CKD, liver disease, age
If bacterial: treat with antibiotic (community - amoxicillin, hospital - IV co-amoxiclav)
Vaccination for bacterial and viral
Meningitis: Common causative agent Presentation Signs and symptoms Treatment
Viral:
Bacterial: ebterovirus, herpes simplex, varcicella zoster, mumps, HIV
Babies - group B streptococci
Older children - neisseria meningitidis (memingococcus), haemophilius influenzae type B, strep pneumoniae (NHS)
Adults: neisseria meningitidis (meningococcus), strep pneumoniae
Other micro-organisms
Certain drugs
Acute inflammation of meninges
Present with headache, neck stiffness, fever, confusion, altered consciousness, vomiting photophobia, non-blanching rash (if bacterial)
Treatment:
Bacterial: empirical antibiotics (cephalosporin e.g. Ceftriaxone) before lumbar puncture and CSF resukts
Septicaemia (sepsis): Common causative agent Presentation / SIRS Signs and symptoms Treatment / Sepsis 6
Most commonly infection in lungs, abdomen, urinary tract
Bacterial: Staphylococci, strep pyogenes, e.coli, pseudomonas aeruginosa, klebsiella
Viral:
Fungal: candida
Systemic inflammatory response syndrome:
Temp >38 90, RR >20, WBC 12x10(9)
Whole body inflammatory response to infection
Present with fever, tachycardia, tachypnoea, confusion, symptoms specific to infection
Treatment - sepsis 6:
Antibiotics, blood culture, serum lactate & Hb, urine output monitoring, high flow oxygen, IV fluids (within first hour)
Antibiotics broad spectrum (2 beta lactams)
Diarrhoea:
Common causative agent
Presentation
Treatment
Most commonly from gastroenteritis:
Viral (most common): norovirus, rotavirus
Bacterial (more common in travellers): e.coli, salmonella, shigella, campylobacter
Parasite e.b. Giardia
Chronic e.g. In UC and crohn’s
> 3 loose / liquid bowel movements each day
Mostly treated supportively (replacing fluids / salts)
Endocarditis: Common causative agent Presentation Signs and symptoms Risk factors Treatment
Infective: e.g. Damaged heart valves in rheumatic fever allows vegetation to form - commonly staph aureua, streptococci viridans, coagulase -ve staphylococci
Non-infective: hypercoagulable state e.g. Bacterial sepsis allows vegitation to grow
Present with: fever, janeway lesions, oslers nods, murmur, splinter haemorrhages, anaemia, emboli
Inflammation of endocardium, usually involving heart valves
Lesions (vegetations - mass of platelets, fibrin, microorganisms, inflammatory cells) grow
Risk factors: prosthetic valves, poor dental hygiene, recent dental work
Treat with IV antibiotics (vancomycin, ceftriaxone) if bacterial
Malaria:
Common causative agent
Presentation/ symptoms
Treatment
Blood bourne infection: plasmodium protozoa carried by mosquito (female anopheles)
Present with fever, fatigue, vomiting, headache
Treat with artemisinin-combinatin therapy (uncomplicated / not pregnant)
Prevention: barriers, melfoquine (larium), doxycycline, atovaquone/proguanil (malarone)
Chicken pox: Common causative agent Presentation Signs and symptoms Risk factors Treatment
Varicella zoster virus (airbourne disease)
Present with skin rash (small itchy blisters that scab), fever, tiredness
Risk foetal damage in pregnancy
Virus remains dormant in dorsal root ganglion and can re-activate later as shingles (herpes zoster) e.g. If become immunocompromised
Mainly treat symptoms (adults: treat with acyclovir in 24/48hrs)
Prevented with varicella vaccine
URTI
Usually:
group A strep bacteria
Rhinovirus
Acute infection of upper resp tract (e.g. Rninitis, sinusitis, pharyngitis, laryngitis)
Viral: supportive treatment
Bacterial: antibiotics in high risk groups e.g. COPD
UTI
Mainly e.coli
Also viruses, fungi
Acute cystitis: simple affecting lower tract (painful/frequent urination), pylonephritos affecting upper tract (add fever and flank pain)
Diagnosed clinically or if complicated with urinalysis (nitrites, WBCs (leukocytes)), microscopy (haematuria, WBCs, bacteria)
Risk factors: increased sexual activity/new partner, women, catheter
Treatment:
Uncomplicated - trimethoprim or nitrofurantoin 5-7days
Complicated/pylonephritis - trimethoprim 14days or ciprofloxacin, ceftriaxone 7 days
Flu: Common causative agent Presentation Signs and symptoms Risk factors Treatment
Influenza virus (usually A)
Present with high fever, runny nose, sore throat, musc pains, headache, coughing, tired
Risk factors: immunocompromised, elderly
Prevent with good hygiene techniques, seasonal flu vaccine
Supportive treatment
Antivirals
Cellulitis: Common causative agent Presentation Signs and symptoms Risk factors Treatment
Bacterial infection: most commonly staphylococcus aureus
Affects dermis and subcutaneous fat e.g. Following break of skin
Signs and symptoms:
Area of redness increasing in size over a couple of days
Swelling, pain
If lymphatics involved: fever, tiredness
Risk factors: overweight, elderly
Treat with amoxicillin (or erythromycin if penicillin allergic)
