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End Of Year > Med Micro > Flashcards

Med Micro Flashcards

0
Q

Factors doctors should take into account when choosing antibiotics

A
  • site of infection
  • toxicity of agent
  • age of patient
  • organism commonly causing infection
  • if antibiotic is avail as an oral formulation
  • cost of agent
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1
Q

Most common cause of UTIs

A

Escherichia coli

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2
Q

Why women more likely to develop cystitis

A

Women have shorter urethral and so easier for organisms to ascend the urinary tract to the bladder

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3
Q

Pathogenesis of UTI in enlarged prostate

A
  • difficulty emptying bladder

- residual urine is good culture medium for any organisms that have ascended the urethra

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4
Q

Causes of sterile pyuria

A
  • renal TB
  • urethritis (gonococcal or chlamydial)
  • use of antibiotics prior to urine collection
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5
Q

Potential complications of a UTI

A
  • recurrent infection
  • renal damage and subsequent renal dysfunction
  • hypertension
  • renal abscess/ perinephric abscess
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6
Q

Difference between sterilization and disinfection

A
  • sterilization implies killing of all micro organisms

- disinfection is removal of most vegetative organisms except spores

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7
Q

Sterilization methods

A
  • filtration
  • heat
  • chemicals
  • irradiation
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8
Q

Method commonly used to sterilize in hospitals

A
  • autoclaving
  • cheap
  • effective
  • non-toxic
  • not suitable for heat sensitive items
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9
Q

Antibiotic to treat pneumonia

A

Should always include antibiotic with action against strep pneumoniae
- penicillin

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10
Q

Significance of finding gram positive cocci in clusters

A

Indicates staphylococcus

  • s aureus is pathogenic and would require specific antibiotic therapy
  • could be coagulase negative staph which is probably a contaminant and therefore has no significance
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11
Q

Tests to diagnose malaria

A

Blood smears

Antigen detection

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12
Q

Clinical presentation of cystitis

A
  • dysuria
  • frequency
  • urgency
  • mild lower abdo pain
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13
Q

Clinical presentation of pyelonephritis

A

All the same as cystitis and signs of systemic infection (fever)

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14
Q

Conditions predisposing to UTI

A
  • bladder tumour
  • stones
  • loss of neurological control of bladder
  • diabetes
  • catheterization
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15
Q

Transmission of TB

A

Airborne route

  • infectious particles remain airborne for hours and can circulate in air currents
  • can infect people far removed from infectious patient
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16
Q

Measures to limit TB spread in hospitals

A
  • rapid identification of TB suspects and separate waiting areas
  • adequate ventilation in waiting areas
  • isolation of patients with pulm TB in side wards
  • encourage cough etiquette
  • wearing if appropriate masks
  • masks for patients in public areas
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17
Q

Complications of malaria

A
  • cerebral malaria
  • acute tubular necrosis
  • pulmonary oedema
  • jaundice
  • GIT haemorrhage
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18
Q

How malaria is transmitted

A
  • by bite of anopheles mosquito
  • blood transfusions
  • sharing of needles
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19
Q

Measures to prevent malaria

A
  • chemoprophylaxis (mefloquine)

- prevention of bites (bed nets, insect repellant)

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20
Q

Organisms that are not gram negative that could cause UTIs in patient with I dwelling urinary catheter

A
  • coagulase negative staph

- yeasts

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21
Q

Risk factors for getting UTIs

A
  • females - short urethra
  • sexual intercourse (mech factor promoting bacteria in urethra)
  • pregnancy, large prostate, calculi (incomplete emptying, residual volume, stasis of urine)
  • neurological problems (incomplete emptying of bladder)
  • anatomical abnormalities (reflux or urine up ureters)
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22
Q

Procedure for collecting urine sample from patient with in dwelling catheter

A
  • milk catheter tube to push urine in tubing into bag
  • clamp catheter just below collection port until 5-10ml collected above clamp
  • clean the collection port with alcohol
  • aspirate urine through collection port with syringe
  • unclamp catheter
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23
Q

Primary infections caused by strep pyogenes

A
  • pharyngitis
  • impetigo
  • erysipelas
  • cellulitis
  • necrotising fasciitis
  • scarlet fever
  • puerperal sepsis/ wound sepsis
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24
Q

Things to expect on urine sample of patient with UTI

A
  • numerous white cells/ polymorphs indicating infection

- scanty/ no epithelial cells indicating a well taken sample

25
Q

Appearance of strep pyogenes

A

Gram positive cocci in chains

26
Q

Significance of epi cells in urine sample

A
  • probably come from vaginal epi

- suggest poorly taken sample

27
Q

Instructions for patients when collecting a urine sample

A
  • clean perineal area with soap and water
  • collect midstream sample
  • collect specimen into sterile container
28
Q

Methods of collecting urine from infants

A
  • urine bag specimen
  • in-out catheter
  • supra public aspirate (best quality)
29
Q

Antibiotics useful as empiric therapy in UTIs

A
  • co amoxiclav
  • ciprofloxacin
  • oral cephalosporin
30
Q

Why BCG given?

A

To reduce the risk of serious childhood TB (meningitis and miliary)
- doesn’t protect well against pulm TB

31
Q

Possible aetiologies of UTIs

A
  • ascending from urethra

- haematogenous spread to kidney

32
Q

Organisms thatcommonly cause community acquired UTIs

A
  • E. coli
  • staph saprophyticus
  • proteus spp
33
Q

Organisms that commonly cause hospital acquired UTIs

A
  • E. coli
  • p. Aeruginosa
  • klebsiella
  • yeast
  • parasites - schistosomiasis
34
Q

Empiric treatment of acute uncomplicated UTIs

A

1 dose of quinolone

35
Q

Empiric treatment of complicated lower UTIs

A 
Oral
- Co-amoxiclav
- cephalosporin
- quinolone
IV 
- gentamicin
- cephalosporin 
(5-7 days)
Lower = (10-14 days)
36
Q

Prevention of UTIs

A
  • avoid catheters
  • empty bladder regularly
  • long courses of antibiotics to prevent recurring infection in susceptible women
37
Q

4 types of plasmodium

A
  • falciparum
  • ovale
  • vivax
  • malariae
38
Q

Receptor for P falciparum

A

Universally present protein of ABO blood group

39
Q

Lysis of RBCS in malaria causes

A
  • fever
  • anaemia
  • reticulocytosis
  • increased liver enzymes
  • pigmentation
  • hypertrophy of RES
  • haemoglobinuria
40
Q

Clinical presentation of malaria infection

A
  • cold stage
  • hot stage
  • sweating stage
  • apparent recovery
41
Q

Tests for malaria

A
  • blood smears (giemsa)
  • rapid diagnostic tests
  • serology
42
Q

Chemoprophylaxis given for malaria

A
  • mefloquine
43
Q

Treatment for p falciparum

A

Coartem

44
Q

Treatment for schistosomiasis

A

Praziquantel

45
Q

Enzymes, haemolysins and toxins in strep pyogenes

A
  • streptokinase
  • DNAases
  • streptolysin O
  • erythrogenic toxin
46
Q

Suppurative complications of strep pyogenes infection

A
  • peritonsillar abscess
  • otitis media
  • sinusitis
  • arthritis
  • endocarditis
  • osteomyelitis
47
Q

Why is malaria important?

A
  • many deaths
  • affects healthy people
  • being spread by modern travel
  • often a diagnostic dilemma
  • emergence of resistant strains
  • mosquitoes are becoming resistant to insecticides
48
Q

What P falciparum looks like under microscope

A
  • commonly multiple rings in 1 red cell
  • May be marginated
  • double chromatin dot
49
Q

Antigens of enterobacteria

A

O - outer membrane
K - capsular
H - flagella

50
Q

Mechanisms of antibiotic resistance

A
  • destruction or modification of antibiotic
  • modification of target site
  • pumps and pores
51
Q

Action of B lactams

A
  • target penicillin binding proteins that are involved in wall synthesis
  • disrupt wall synthesis
52
Q

Action of B lactamase

A
  • destroy antibiotics
53
Q

Why is strep can be resistant to penicillin

A
  • alters PBP

- clavulanic acid doesn’t work because not Blactamase mediated resistance

54
Q

Class of schistosoma

A

Trematoda

55
Q

Life cycle of schistosoma

A
  • eggs
  • miracidia
  • sporocytes
  • cercaria
  • schistosomulae
  • worms
56
Q

Pathology of schistosoma

A
  • most related to host immune response to egg antigen
  • cercaria cause HS reaction in skin
  • schistosomulae cause sweating, urticaria and eiosinophilic infiltrate
57
Q

Types of schistosoma

A
  • mansoni (bowel)

- haematobium (bladder)

58
Q

Pathogenesis of s mansoni

A
  • eggs in caps of intestine
  • inflam response leads to fibrosis and thickening of intestine wall
  • some eggs reach liver (portal HT, splenomegaly)
  • some eggs reach lungs (pulm HT)
59
Q

Pathology of a haematobium

A
  • eggs in venous plexus of bladder
  • acute haemorrhagic cystitis
  • eggs calcify and fibrosis
  • obstruction of ureters
  • hydronephrosis
  • secondary infection
60
Q

Explain katayama syndrome

A
  • acute allergic response to large amounts of schistosoma egg antigen
  • onset 4-8 weeks post infection
  • fever, headache,malaise
61
Q

Classes of antibiotics

A
  • inhibitors of call wall biosynthesis
  • modifiers of cell membrane function
  • inhibitors of protein synthesis
  • inhibitors of nucleic acid biosynthesis
  • miscellaneous

End Of Year (12 decks)

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