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Micro n Infection Flashcards

1
Q

Gram +ve cocci?

A

Staphylococcus
Streptococcus
Enterococcus

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2
Q

Gram +ve aerobes

A

‘Aerobic Rods and Corney Mike’s List of Basic Nokias’
- Aerobic rods
- Corneybacteria ‘corney’
- Mycobacteria ‘mike’
- Listeria ‘list of’
- Bacillus ‘basic’
- Nocardia ‘nokia’s’

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3
Q

Gram +ve anaerobes?

A

“Rods anaerobic CLAP”
Clostridium
Lactobacillus
Actinomyces
Propionibacterium

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4
Q

Common gram -ve

A

Neisseria meningitis
Neisseria gonorrhoea
Haemophilia influenza
E. coli
Klebsiella
Pseudomonas aeruginosa
Moraxella catarrhalis

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5
Q

Atypical (non culturable) organisms

A

Chlamoydophila pneumonia
Chlamydia psittaci
Coxiella burnetti
Legionella pneumophilia
Mycoplasma pneumonia

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6
Q

What is MRSA

A

Methicillin resistant staph aureus

Resistant to beta lactam abx

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7
Q

Treatment options for MRSA

A

Doxycycline
Clindamycin
Vancomycin
Teicoplanin
Linezolid

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8
Q

Most common cause of bacterial chest infection

A

Strep pneumoniae (gram +ve cocci)

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9
Q

2nd most common cause of bacterial chest infection

A

Haemophilus influenzae (gram -ve)

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10
Q

What 1st line abx covers strep?

A

Amoxicillin

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11
Q

What 1st line abx covers staph?

A

Co-amoxiclav

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12
Q

What 1st line abx covers ecoli

A

Co amoxiclav

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13
Q

What abx covers haemophilus

A

Co amoxiclav

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14
Q

What abx covers pseudomonas

A

Tazocin

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15
Q

What is ESBL and what treats is

A

Extended spectrum beta lactamase bacteria

Meropenam abx

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16
Q

What abx covers MRSA?

A

Teicoplanin

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17
Q

What’s usually used to cover atypical infections?

A

Clarithromycin or doxycycline

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18
Q

What bacteria does amoxicillin usually cover?

A

Streptococcus

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19
Q

What bacteria does co amoxiclav cover?

A

Staphylococcus
Haemophilus
E. coli

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20
Q

What bacteria does tazocin cover?

A

Pseudomonas

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21
Q

What is meropenam used to treat?

A

ESBL- Extended spectrum beta lactamase bacteria, usually ecoli or klebsiela
Often UTIs

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22
Q

What is Teicoplanin used to cover?

A

MRSA

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23
Q

MOA: Abx that inhibit protein synthesis in bacteria?

A

Act on bacterial ribosome

Doxycycline (tetracycline)
Erythromycin
Chloramphenicol
Clindamycin
Gentamicin
Amikacin

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24
Q

MOA: abx that inhibits cell wall synthesis

A

Abx WITH Beta lactam ring
- penicillin
- carbapenams
- cephalosporins

Abx WITHOUT beta lactam ring
- vancomycin
- teicoplanin

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25
Moa of Penicillins Vancomycin Teicoplanin Gentamicin Doxycyline Clindamycin
Penicillins (has beta lactam ring) - inhibits cell wall synthesis Vancomycin and teicoplanin(hasn’t got beta lactam ring) - but still inhibits cell wall synthesis Gentamicin, doxy and Clindamycin- inhibit protein synthesis in ribosome
26
5 antibiotics that inhibit cell wall synthesis?
Penicillin Carbapenams Cephalosporins Vancomycin Teicoplanin
27
Examples of penicillins?
Penicillin Amoxicillin Co-amoxiclav Flucloxacillin Phenoxymethylpenicillin Often used for skin, chest and UTIs
28
Examples of cephlosporins? What are they commonly used for?
Cefalexin Wide range, good for severe e.g. sepsis and meningococcal septicaemia
29
Macrolide antibiotics e.gs? And use
Azithromycin Erythromycin Clarithromycin Lung infections. Good in penicillin allergy
30
What abx usually used for UTIs?
Nitrofurantoin Trimethoprim
31
Stain for ?TB
Zeihl Neelson stain +ve =red -ve stays blue
32
TB antibiotics
RIPE Rifampicin -6m Isoniazid- 6m Pyrazinamide- 2m Ethambutol- 2m
33
What is pyridoxine? Why is it given to people with TB?
Vitamin B6 Given to prevent peripheral neuropathy, which can be a side effect of isoniazid
34
Potential side affects of TB medications?
Rifamipicin “red and orange pissin” Red/orange secretions, hepatitis, flu like sx Isoniazid “I’m so numb azid” Peripheral neuropathy, hepatitis, agranulocytosis Pyrazinamide Hyperuricaemia —>gout, hepatitis Ethambutol “eye-thambutamol” Optic neuritis, check vision before and during
35
Side effects of rifampicin?
Rifamipicin “red and orange pissin” Red/orange secretions, hepatitis, flu like sx
36
Side effects of isoniazid
Isoniazid “I’m so numb azid” Peripheral neuropathy, hepatitis, agranulocytosis
37
Side effects with Pyrazinamide?
Pyrazinamide Hyperuricaemia —>gout, hepatitis
38
Side effects of ethambutol?
Ethambutol “eye-thambutamol” Optic neuritis, check vision before and during
39
Which antibiotics inhibit cell wall synthesis but don’t have a beta lactam ring?
Vancomycin Teicoplanin
40
Which antibiotics inhibit cell wall synthesis and have a beta lactam ring?
Penicillins Carbapenams Cephalosporins
41
2 most common causes of bacterial chest infections?
Streptococcus pneumoniae (AKA pneumococcus)- 50% Haemophilus influenzae- 20%
42
Chest infection organisms seen in patients with a low CD4 count?
Maroxella catarrhalis Pneumocystis jiroveci- a yeast like fungus
43
1st line abx for pneumonia in community?
Amoxicillin Could also use doxycycline or clarithromycin
44
Most common bacteria seen in septic arthritis?
Staph. aureus- most common Group A strep Neisseria gonorrhoea- more common in sexually active Haemophilus influenza E.coli
45
Treatment if septic arthritis suspected?
Aspirate joint before abx Empirical IV abx for 4-6weeks Flucloxacillin If pen allergic, clindamycin
46
Abx that inhibit folic acid mechanism
Sulfamethoxazole Trimethoprim These combined- septrin (cotrimoxazole
47
Most common cause of meningococcal septicaemia in children?
Neisseria meningitidis- a gram negative meningococcus
48
Suspected meningitis is community. Stiff neck, headache, photophobia, fever, altered conciousness, non-blanching rash. What to do?
Urgent transfer to hospital IM benzylpenicillin <1yr 300mg 1-9yr 600mg >10+yr 1200mg
49
Meningitis in hospital management?
Lumbar puncture <3m - cefotaxime + amoxicillin (to cover listeria from mother) > 3m - ceftriaxone +/- Vancomycin
50
Lumbar punctures. What you see in bacterial, viral and TB?
Bacterial- low glucose, high protein, cloudy, high opening pressure, high neutrophils Viral- normal glucose, mildly raised protein, clear, normal opening pressure, high lymphocytes TB- same as bacterial but high lymphocytes. low glucose, high protein, cloudy, high opening pressure, high lymphocytes
51
Treatment for malaria falciparum?
Admit as can deteriorate IV artesunate- most effective but unlicensed IV quinine dihydrochloride Doxycycline
52
Side effect of doxycycline
Sensitivity to light- can burn easily
53
What antimalarial can cause bad dreams and even psychotic disorders?
Mefloquine
54
Diagnosis of neutropenic sepsis?
Neutrophils <1 Temp >38. Or meeting other sepsis criteria
55
Treatment of neutropenic sepsis?
IV tazocin- broad spec abx *after taking blood cultures. Don't delay
56
Most common bacterial cause of toncillitis? And abx treatment?
Group A strep Pen V- phenoxymethylpenicillin
57
Most common cause of otitis media?
Strep pneumonia
58
Most common cause of rhinosinusitis?
Strep. pneumoniae
59
4 most common causes of bacterial toncillitis?
Group A strep- phenoxymethypenicillin tx Strep. pneumoniae Haemophilus influenzae Morazella catarrhalis Staph aureus
60
Most common cause of UTI? Plus some others
E.coli Klebisiella Pseudomonas auruginosa Staph saphrophyticus Enterococcus Candida albicans- fungal
61
1st line UTI abx? and other options?
Trimethoprim Nitrofurantoin Pivmecillinam
62
1st line abx for pyelonephritis?
7-10 days abx Cefalexin If cultures results available: Co-amoxiclav, trimethoprim, ciprofloxacin (can damage tendons and lower seizure threshhold)
63
What are some side effects with ciprofloxacin that you need to keep in mind when prescribing??
Can damage tendons Can lower seizure threshold
64
What investigation do you do for ?malaria in a returning traveler?
Three blood films over three days. Needed due to 48hour life cycle of malaria parasite Send EDTA (FBC bottle) with marked 'for malaria film'
65
Most common causes of cellulitis?
Staph aureus Group A or C strep Other: MRSA
66
1st line abx in cellulitis? And alternatives?
Flucloxacillin Clarithromycin Pen V- phenoxymethylpenicillin- if group A strep considered most likely Clindalycin
67
Man comes back from holiday with feeling rubbish with cough, diarhoea and a temperature. What's the most likely causative organism?
Legionella pneumophilia
68
99yo lady with dry cough, muscle aches, feeling rubbish and temp 38.4. Covid test negative and suspect influenza. They're a bit vulnerable being the fine age of 99 so want to treat. What do you give?
Oseltamivir (Tamiflu) Must be given within 48 hours. 75mg tablet twice daily for 5 days
69
Name 3 macrolides?
Erythromycin Clarithromycin Azithromycin
70
Key adverse effects and interactions of macrolides?
Prolongation of QT Interactions - statins- should be stopped when taking macrolides - warfarin - amiodarone
71
Treatment for severe c.difficile infection?
Oral vancomycin- better bioavailability in gut IV metronidazole C.diff is a gram +ve rod, it’s toxin can cause psuedomembranous colitis Most commonly caused by cephlopsporin broad spectrum abx
72
How is C.diff diagnosed?
C.difficile toxin in stool
73
First episode, non life threatening c diff tx?
1st line- oral vancomycin 10 days 2nd line- oral fidaxomicin 3rd line- oral vancomycin +/- IV metronidazole
74
Treatment for chronic bronchitis exacerbation?
Amoxicillin OR tetracycline OR clarithromycin
75
Treatment for community acquired pneumonia?
Amoxicillin If penicillin allergic: doxy or clarithromycin Add flucloxacillin if staphylococci suspected e.g. in influenza
76
Treatment for pneumonia with cause suspected to be aytypical?
Clarithromycin
77
Treatment for hospital acquired pneumonia?
Within 5 days of admission- co-amoxiclav or cefurotaxime >5days- piperacillin c tazobactam OR Broad spectrum cephalosporin (e.g. ceftazidime) OR Quinolone e.g. ciprofloxacin
78
Lower UTI treatment?
Trimethoprim Nitrofurantoin Or can use amoxicillin or cephalosporin
79
Treatment for acute pyelonephritis?
Broad spectrum cephalosporin e.g. ceftriaxone OR quinolone e.g. ciprofloxacin
80
Acute prostatitis treatment?
Quinolone OR trimethoprim
81
Beta lactam abx groups?
Penicillins Cephalosporins Carbapenams All pretty broad spectrum
82
What abx can reduce seizure threshold in epileptic patients?
Ciprofloxacin
83
Which abx as an absolute contraindication with methotrexate?
Trimethoprim Co-tramoxisole (contains trimethoprim so shouldn’t be used either, sometimes used for HAP or PCP- an immunocompromised chest infection)
84
Treatment for chronic bronchitis exacerbation?
Amoxicillin OR Tetracycline OR Clarithromycin
85
Treatment for community acquired pneumonia?
Amoxicillin If penicillin allergic: doxy or clarithromycin Add flucloxacillin if staph ylococci suspected e.g. in influenza
86
Treatment for pneumonia with cause suspected to be aytypical?
Clarithromycin
87
Treatment for hospital acquired pneumonia?
Within 5 days of admission- co-amoxiclav or cefurotaxime >5days- piperacillin c tazobactam OR Broad spectrum cephalosporin (e.g. ceftazidime) OR Quinolone e.g. ciprofloxacin

Finals (13 decks)

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