Lecture 13 Infection

Question 1

What immune cells associated bacterial and fungal infections

Answer 1

Neutrophils

Question 2

What immune cells are associated with fungal infections

Answer 2

Monocytes

Question 3

What immune cells are associated with parasite infections

Answer 3

Eosinophils

Question 4

T lymphocytes are associated with what type of infections

Answer 4

Fungal
Viral
PJP

Question 5

B lymphocytes are associated with what type of infection

Answer 5

Bacterial

Question 6

What antibiotics is used to reduce risk of sepsis in haematological malignancies

Answer 6

Ciprofloxacin

Question 7

What anti-fungal is used to reduce risk of sepsis in haematological malignancies

Answer 7

Fluconazole

Itraconazole

Question 8

What anti-viral is used to reduce risk of sepsis in haematological malignancies

Answer 8

Aciclovir

Question 9

What other supportive measures are used to reduce risk of sepsis in haematological malignancies

Answer 9

Growth factors
Stem cell rescue
Laminar flow rooms
Vaccination
Ig replacement IV

Question 10

Depletion of what immune cell is caused by hairy cell leukaemia and chemotherapy

Answer 10

Monocytes

Question 11

What gram positive bacteria cause febrile neutropenia

Answer 11

Staphylococci: MSSA, MRSA, coagulase negative

Streptococci viridans

Question 12

What gram negative bacteria cause febrile neutropenia

Answer 12

E. coli
Klebsiella
Pseudomonas aeruginosa

Question 13

What is the clinical presentation of neutropenic sepsis

Answer 13

Fever with no localising signs
Rigos
Chest infection
Cellulitis
UTI
Septic shock

Question 14

What is the first line of action to treat sepsis

Answer 14

Sepsis 6:

1. Give O2 to keep sats above 94%
2. Take blood cultures
3. Give appropriate IV antibiotics within 1 hour
4. Measure serum lactate
5. IV fluid resuscitation
6. Measure urine output

Question 15

Why is serum lactate measured in sepsis

Answer 15

Due to endogenous epinephrine stimulating beta-2 receptors which up-regulates glycolysis

Question 16

What investigations should be carried if neutropenic sepsis is suspected

Answer 16

Blood cultures
CXR
Swab of infection site
FBC, renal and liver function, coagulation screen

Question 17

What type of IV antibiotic should firstly be administered

Answer 17

Broad spectrum

Gentamicin and Tazocin

Question 18

If a gram positive organism is identified as the cause of neutropenic sepsis what should be added to the broad spectrum antibiotics

Answer 18

Vancomycin or Teicoplanin

Question 19

What is the common cause of fungal infections in immunocompromised patients

Answer 19

Candida species (Aspergillus)