Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

T Year > Medical Microbiology > Flashcards

Medical Microbiology Flashcards

1
Q

CAP antibiotic treatment

A

Low severity (CURB65 0-1): doxycycline PO 200mg stat then 100mg OD (5-7 days)

Moderate severity (CURB65 2-5): benpen IV 1.2- 4 hrly + doxycycline PO 200mg STAT then 100mg OD (7-10days in total IV and PO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

COPD infective exacerbation antibiotic treatment

A

doxycycline PO 200mg STAT then 100mg OD (5-7 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Uncomplicated UTI antibiotic treatment

A

Nitrofurantoin 50mg PO 6 hourly

Males: 7 days
Females: 3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Soft tissue infection antibiotic treatment

A

Non-severe: flucloxacillin PO 500mg 6hrly (7 days)

Severe: flucloxicillin IV 2mg 6 hrly (review IV after 5-7 days depending on response)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the effect of antibiotics on the gut and skin flora

A

broad spectrum abx suppress the normal gut flora

this allowed C Diff to develop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is c diff

A

gram positive rod that produces an exotoxin which causes intestinal damage leading to PSEUDOMEMBRANOUS COLITIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the leading cause of c diff

A

second and third generation cephalosporins

ceftriaxone, cefotaxima, cefoxitin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the diagnosis of c diff?

A

stool sample detecting the toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

treatment of c diff

A

oral metronidazole for 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

meningococcal septicaemia/meningitis rash

A

petechial or purpuric rash
80-90% of patients
most commonly 4 to 18 hours after initial symptoms of illness

typically non-blanching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

sepsis six

A

give oxygen (sats >94%)
give broad spectrum antibiotics (coamoxiclav IV and amikacin IV)
give IV fluid challenge

take blood cultures
measure serum lactate
measure hourly urine output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is pyrexia of unknown origin (PUO)

A

a temperature over 38.3 for >3 weeks with no obvious source despite appropriate investigations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are possible causes of PUO?

A

infections: abscesses, empyema, RF, TV, parasites, fungi
neoplasms: lymphomas

CT disease: RA, polymyalgia rheumatica

others: drugs, PE, IBD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

examples of intermittent fevers

A 
malaria
septicaemia
UTI
PID
TB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

investigation of common STIs

A 
detailed examination of genitalia
urine dipstick and MC+S
ulcers: swab for HSV
urethral smear: gonorrhoea
urethral swab: chlamydia
blood tests: syphilis, hepatitis, HIV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

about chlamydia

A

most prevalent STI in the UK
approx 1 in 10 young women in the UK have chlamydia
incubation period 7-21 days

asymptomatic in around 70% of women dn 50% of men
women - cervicitis, dysuria
men - urethral discharge, dysuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

complications of chlamydia

A

epididymitis
PID
endometritis
infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

management of chlamydia

A

doxycycline (7d) or azithromycin (single dose)

if pregnant, azithromycin, erythromycin or amoxicillin may be used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

about gonorrhoea

A

gram negative diplococcus neisseria gonorrhoea
incubation period is 2-5d

males: urethral discharge, dysuria
females: cervicitis e.g. leading to vaginal discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

potential complications of gonorrhoea

A

urethral strictures
epididymitis
salpingitis (therefore infertility)
DIC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

management of gonorrhoea

A

cephalosporins - ceftriaxone 500mg IM as a single dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

about syphilis

A

characterised by primary, secondary and tertiary stages

primary: painless ulcer at site of sexual contact, local non-tender lymphadenopathy
secondary: (6-10w) fevers, lymphadenopathy, rash on trunk, palms and soles
tertiary: granulomatous lesions of the skin and bones, ascending aortic aneurysms, general paralysis of the insane

incubation period 9-90days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

management of syphilis

A

benzylpenicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

about herpes simplex

A

primary infection may present with a severe gingivostomatitis

cold sores

painful genial ulceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

management of herpes simplex

A

oral aciclovir

26
Q

genital warts

A

common cause of attendance at GUM clinics

HPV is the cause - type 16 and 18 predispose to cervical cancer

small fleshy protuberances which are slightly pigmented

managed with topical podophyllum or cryotherapy

27
Q

about thrush

A

candida albicans
commonest cause of discharge
vulva and vagina may be red, fissured and sore

managed with clotrimazole pessary

28
Q

bacterial vaginosis

A

causes a fishy smelling discharge
vagina is not inflamed
management: oral metronidazole for 5-7 days

70-80% initial cure rate
relapse rate of >50% within 3 months

29
Q

what is PID

A

Pelvic inflammatory disease (PID) is a term used to describe infection and inflammation of the female pelvic organs including the uterus, fallopian tubes, ovaries and the surrounding peritoneum. It is usually the result of ascending infection from the endocervix

30
Q

causative organisms of PID

A

Chlamydia trachomatis- the most common cause
Neisseria gonorrhoeae
Mycoplasma genitalium
Mycoplasma hominis

31
Q

features of PID

A 
Lower abdominal pain
Fever
Deep dyspareunia
Dysuria and menstrual irregularities may occur
Vaginal or cervical discharge
Cervical excitation
32
Q

management of PID

A

oral ofloxacin nd oral metronidazole

33
Q

complications of PID

A

infertility
chronic pelvic pain
ectopic pregnancy

34
Q

life threatening complications of malaria

A 
AKI
hypoglycaemia (esp pregnant women)
severe anaemia
DIC
septicaemia
seizures or other CNS complications
35
Q

risk factors for typhoid fever

A

overcrowded living in endemic areas e.g. india
poor sanitation/untreated water in endemic areas
poor personal hygiene in endemic areas

36
Q

symptoms of typhoid fever

A 
HIGH FEVER (sometimes stepwise fashion with 5-7d of daily increments)
dull frontal headache
abdominal pain
anorexia
apathic-lethargic state
constipation
cough
diarrhoea
malaise

rouse spots- abdomen, chest, blanching erythematous maculopapular lesions

37
Q

risk factors for UTI

A 
sexual activity
spermicide use
post menopause
positive family history
history of recurrent UTI
presence of a foreign body
38
Q

organisms in UTI

A

E coli in 70-95% of uncomplicated cases

staph aureus in 5-20% of cases

broad range of bacteria can cause complicated UTIs, and many are resistant to antimicrobial agents

39
Q

ascending pathway of UTI colonisation

A

The most common route of infection in females is via an ascending pathway. Colonisation of the vagina may occur first, then ascends into the urinary tract. Ascending UTI is amplified by factors that promote the introduction of bacteria at the urethral meatus and by iatrogenic means. Stasis of bladder urine impairs the defence against infection provided by bladder emptying.

40
Q

investigations of UTI

A

urine dipstick
urine microscopy
urine culture and sensitivity

41
Q

abacteriuric frequency or dysuria (‘urethral syndrome’)

A

Causes of truly abacteriuric dysuria include postcoital bladder trauma, vaginitis, atrophic vaginitis or urethritis in the elderly, and interstitial cystitis. In symptomatic young women with ‘sterile pyuria’, Chlamydia infection and tuberculosis must be excluded.

42
Q

what diseases does herpes simplex virus cause?

A

cold sores
painful genital ulveration
severe gingicostomatitis

43
Q

what diseases does herpes zoster (shingles) cause?

A

acute, unilateral, painful blistering rash caused by reactivation of the varicella zoster virus

44
Q

what does herpes simplex keratitis cause?

A

presents with a dendritic corneal ulcer - red and painful eye

45
Q

infectious mononucleosis

A

Infectious mononucleosis (glandular fever) is caused by EBV in 90% of cases. The classic triad is seen in around 98% of patients:
Sore throat
Lymphadenopathy (May present in the anterior and posterior triangles of neck)
Pyrexia

Other features include:
Malaise, anorexia, headache
Splenomegaly
Lymphocytosis

46
Q

meningitis signs and symptoms

A

Meningitis is inflammation of the meninges usually caused by bacterial, viral or fungal infection.

Headache 
Nausea or vomiting 
Neck stiffness 
Fever 
Photophobia 
Confusion and seizures
47
Q

diagnosis and management of meningitis

A

Diagnosis:
LP
Blood culture in patients where LP is delayed

Management
All patients should be transferred to hospital urgently
Patients in pre-hospital setting (e.g. GP) IM Benzylpenicillin
Hospital Ceftriaxone + Aciclovir

48
Q

what is encephalitis?

A

Encephalitis is defined as inflammation of the brain parenchyma associated with neurological dysfunction such as altered state of consciousness, seizures, personality changes, cranial nerve palsies and speech problems. It is the result off direct inflammation of the brain tissue, as opposed to the inflammation of the meninges, and can be the result of infectious or non-infectious causes

49
Q

signs and symptoms of encephalitis

A

Fever Seen in infectious causes
Rash E.g. Vesicular eruption in HSV, erythema nodosum in TB
Altered mental state
Focal neurological deficit E.g. aphasia, hemiparesis, ataxia

50
Q

diagnosis and treatment of meningitis

A

Diagnosis:
LP
Bloods FBC, U+E’s, LFTs, blood cultures
Imaging CXR, CT brain

Treatment depends on the underlying cause

51
Q

cerebral abscess

A

CNS abscesses may result from a number of causes including, extension of sepsis from middle ear or sinuses, trauma or surgery to the scalp, penetrating head injuries and embolic events from endocarditis.

52
Q

signs and symptoms of cerebral abscess

A

The presenting symptoms will depend upon the site of the abscess (those in critical areas e.g.motor cortex) will present earlier. Abscesses have a considerable mass effect in the brain and raised intra cranial pressure is common.

Although fever, headache and focal neurology are highly suggestive of a brain abscess the absence of one or more of these does not exclude the diagnosis, fever may be absent and even if present, is usually not the swinging pyrexia seen with abscesses at other sites

53
Q

diagnosis and management of cerebral absess

A

Diagnosis
• Assessment of the patient includes imaging with CT scanning

Management
• Treatment is usually surgical; a craniotomy is performed and the abscess cavity debrided. The abscess may reform because the head is closed following abscess drainage

54
Q

causes of meningitis

A

0-3 months
o Group B streptococcus
o E.Coli
o Listeria monocytogenes

3months – 6 years
o Neisseria meningitidis
o Streptococcus pneumoniae
o Haemophilus influenza

6 years – 60 years
o Neisseria meningitidis
o Streptococcus pneumonia

Immunosuppressed
o Listeria monoctogenes

55
Q

CSF in bacterial meningitis

A

cloudy
low glucose (<1/2 plasma)
high protein (>1g/l)
10-5000 polymorphs (white cells)

56
Q

CSF in viral meningitis

A

clear/cloudy
60-80% plasma glucose
normal/raised protein
15-1000 lymphocytes (white cells)

57
Q

CSF in TB meningitis

A

slightly cloudy, fibrin web
low glucose (<1/2 plasma)
high protein (>1g/l)
10-1000 lymphocytes (white cells)

58
Q

indications of LP

A

suspicion of meningitis
suspicion of SAH
suspicion of CNS diseases such as GBS

59
Q

complications of LP

A

coning

introduction of infection into the CSF

60
Q

contraindications of LP

A

local skin sepsis
bleeding diathesis e.g. anticoagulant therapy
signs of spinal cord compression
papilloedema or other signs of raised ICP
suspicion of intracranial or cord mass
congenital neurological lesions in lumbosacral region

61
Q

contraindications for LP in children/young people with suspected meningitis or meningococcal disease

A

• Signs suggesting raised ICP, reduced or fluctuating level of consciousness (GCS less than 9 or a drop of 3 or more)
o Relative bradycardia and hypertension
o Focal neurological signs
o Abnormal posture or posturing
o Unequal, dilated or poorly responsive pupils
o Papilloedema
• Shock
• Extensive or spreading purpura
• After convulsions until stabilised
• Coagulation abnormalities
o Coagulation results outside the normal range
o Platelet count below 100 x 109/litre
o Receiving anticoagulant therapy
• Local superficial infection at the LP site

T Year (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions