Med B - Infectious disease

Question 1

what criteria is used for endocarditis?

Answer 1

modified Duke criteria

Question 2

which organisms may cause endocarditis?

Answer 2

• staph aureus
• coagulase negative staphylococci
• strep viridans
• strep bovis group
• enterococci

Question 3

how does the treatment of endocarditis differ for different groups of organisms?

Answer 3

Stretococcal endocarditis - benzylpenecillin

Staph aureus - flucloxacillin

Enterococcus - amoxicillin and gentamicin

Question 4

distinguishr community acquired vs hospital acquired pneumonia?

Answer 4

CAP

• commonly G+
• such as strep pneumoniae and haemophilus influenza

HAP

• more likely G-
• psuedomonas aureginosa
• klebsiella pneumoniae
• E.coli

Question 5

antibiotic treatments used for hospital acquired pneumoniae?

Answer 5

• extended spectrum penicillin’s such as pipercillin-tazobactam
• or third generation cephalosporins such as cefriaxone
• carbapenems - meropenem

Question 6

What are carbapenemase-producing enterobacteriaceae?

Answer 6

• gram negative
• produce a specific beta lactamase enzyme called a carbepenemase, usually carried on a transferable plasmid

Agents used for treating
CPE include tigecycline, fosfomycin and colistin

Question 7

How can antibiotic-associated diarrhoea, C. difficile colonisation and C. difficile colitis be
distinguished?

Answer 7

Glutamate dehydrogenase GDH - tests for presence of C Difficile specific antigen

Question 8

how is C-diff treated?

Answer 8

• oral vancomycin
• metronidazole
• and fidaxomicin
• given for 10-14 days

Question 9

Which vaccinations are important to consider prior to travelling to India?

Answer 9

1. Cholera
2. Hepatitis B
3. Rabies
4. Tuberculosis (BCG)
5. Japanese encephalitis

Question 10

what is the most commonly acquired species of malaria in travellers in UK?

Answer 10

• plasmodium falciparum

Question 11

important complications of malaria?

Answer 11

The most important
complications are :
1. Anaemia (due to haemolysis and hypersplenism)
2. Renal failure
3. Cerebral malaria
4. Acute Respiratory Distress Syndrome
5. Severe acidosis
6. Severe thromocytopenia, 7. coagulopathy and bleeding

Question 12

how is malaria treated?

Answer 12

acute severe malaria

–> treated with intravenous artesunate (or IV quinine if former not available)