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Icm > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What is a common gram positive diplococcus

A

Streptococcus pneumonia

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2
Q

Intracranial complications from pneumococal septicaemia

A 
Meningitis
Abscess
Empyema 
Infarction 
Oedema
Nerve palsy
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3
Q

What is the role of dexamethasone for in children with bacterial meningitis

A

Reduces the incidence of hearing loss and neurological sequalae
Does not reduce mortality

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4
Q

What organisms commonly cause CAP necessitating ITU admission.

A 
Strep pneumonia
Legionella pneumophila
Staphylococcus aureus 
Haemophilus influenza
Pseudomonas aeruginosa
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5
Q

What are the non respiratory complications of legionella

A 
Encephalitis
Pancreatitis
Pericarditis
Polyarthropathy 
Hyponatraemia 
Deranged lfts 
Thrombocytopenia 
Diarrhoea
Aki
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6
Q

How do antibiotics work

A

They are either bacteriostatic or bacteriocidal.

Bacteriostatic limit the bacterial growth allowing for the immune system to remove the bacteria from the body
Macrolides/ tetracyclines/ trimethoprim

Bacteriocidal cause bacterial death whilst the host cells remain Undamaged. This relies on an Intact immune system.
Penicillin/ cephalosporin/ aminoglycosides

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7
Q

Four methods that antibiotics work

A
  1. Inhibit cell wall synthesis: penicillin, cephalosporins, glycopeptides

2.inhibit dna synthesis or function:
Metronidazole, rifampicin, cipro

  1. Inhibit THF -tetrahydrofolate synthesis : co-trimoxazole
  2. Inhibit protein synthesis: tetracycline, aminoglycosides, macrolydes
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8
Q

What drugs are macrolydes

A

Erythromycin
Clari
Azith

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9
Q

What drugs are aminoglycosides

A

Gentamicin

Amikacin

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10
Q

What drugs are glycopeptides

A

Vanc

Teic

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11
Q

What drugs are cephalosporins

A

Cephalexin
Cefuroxime
Ceftriaxone

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12
Q

What drugs are penicillins

A

Fluclox
Amoxicillin
Tazocin
MeropemeM

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13
Q

What is time dependant killing

A

An antibiotics whose activity depends on the amount of time the serum concentration is above the minimum inhibitory concentration -penicillins clinda vanc

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14
Q

What is concentration dependant killing

A

Antibiotics who’s activity correlates with peak serum concentration - gent.

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15
Q

Which antibiotics are gram positive cocci

A

Coag neg :

Strepto cocci

  • b haemolytic (group a (progenies) and b (agalactia))
  • y haemolytic enterococcus
  • a haemolytic (pneumonia and viridans)

Coag pos;
Epidermidis
Aureus

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16
Q

Gram positive bacilli

A 
A actinomyces
B bacillus
C clostridia
D diphtheria 
L listeria

Stain purple

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17
Q

Gram negative cocci

A

Neisseria
Moraxella
Gonorrhoea

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18
Q

Gram negative bacilli

A

Pseudomonas
Klebsiella
Salmonella

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19
Q

Intrinsic methods of antibiotics resistance to bacteria

A

Lack of molecular transport
Membrane impermeability
Antibiotic cannot enter the cell

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20
Q

Extrinsic methods that confer antibiotic resistance to bacteria

A

Drug inactivation (beta- lactams)
Reduced permeability (carbopenems can’t penetrate psa)
Efflux of drugs (penicillins pumped out of psa)
Aletered molecular target (mrsa altered penicillin binding site)

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21
Q

How do bacteria acquire resistance

A

Sporadic mutations
Gene transfer via

  1. Transformation : free dna release from layer bacteria
  2. Transduction : bacteriophages transfer dna
  3. Conjugation: contact between 2 bacteria
  4. Transposition : transposons move between bacterial chromosomes
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22
Q

What is selective decontamination of the digestive tract

A

Administration of non absorbable oral and enteral antibiotics and short term IV antibiotics

  • tobramycin/ polymixin E/ apmhoterecin oral paste
  • add in vanc for mrsa
  • cefotaxime for 4/7

Aim to prevent and reduce colonisation
Reduce mortality and vap

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23
Q

Define nosocomial infection

A

Infection diagnosed 48-72 hours after admission

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24
Q

Crbsi causative agents

A

Coagulase negative staph
Staph aureus
Ecoli

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25
Q

Matching Michigan care bundle components for crbsi

A 
Hand Hygiene
Asepsis 
2% chlorhex/ 70% alcohol 
Avoid femoral route
Review daily + remove when not needed
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26
Q

What is a VAP

A 
Pneumonia 48-72 hours post intubation 
New or progressive Infiltrates
Signs of infection (fever / wcc)
Changes in sputum 
Culture of causative agent
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27
Q

Classification of VAP

A

Early onset - within 4 days
Pneumonia/ haemophilus/ mssa

Late onset - > 4 days
Mrsa psa esbl

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28
Q

Risk factors for VAP

A 
Burns
Lung pathology
Supine
Enteral nutrition. 
Sedation 
Smoking in
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29
Q

Diagnosis of VAp

A

Cpis score

Score of 0-2 for

temperature 
leukocytes
 PF ratio
 CXR infiltrates
Tracheal secretions
Culture growth
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30
Q

What are the severity grade of c. Diff

A 
Mild - no wcc rise
Moderate wcc <15
Severe > 15 
With aki  >50% baseline
Temp >38.5
Radiological colitis 
Life threatening- tmc or shock
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31
Q

What does rsv stand for

A

Respiratory syncytial virus

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32
Q

In a needle stick what blood need to be taken from the patient

A

HIV antibodies
Hep c antibodies
Hep b surface antigens

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33
Q

What is the cpis score

A 
Temp
Wcc
CXr
PF ratio
Tracheal secretions
Tracheal cultures
34
Q

How do you calculate the PF ratio.

A

Pao2/ fio2

35
Q

Vap prevention

A 
Head up 
Oral decontamination 
Sedation hold
Subglotic ports
Ppi
Cuff pressure
36
Q

VAP organisms

A

Strep pneumonia
H influenza
Mssa
E.coli

37
Q

Cause of tetanus

A

Gram positive

Clostridium tetani

38
Q

Pathophysiology of tetanus

A 
Toxin release into circulation 
Binds irreversibly to neuronal protein 
Travel to spine
Prevents neuro transmission at the presynaptic gaba.
Uncontrolled motor activity and spasms
39
Q

Characteristics of tetanus

A

Rigidity
Muscle spasm
Autonomic instability

40
Q

What colour are gram positives microbes and why

A

Violet/ purple

Retain stain in the thick peptoglycan wall after washing

41
Q

4 types of anti fungal

A

Azoles (keto/ flucon)

Polyenes (ampho)

Echinocandins (caspo)

Allylamines (terbinafine)

42
Q

What are the escape pathogens

A 
Enterococcus faecium
Staph aureus
Kleb
Acinetobacter
Pseudomonas 
Entrobacter
43
Q

What infections at risk of post splenectomy

A 
strep pneumonia
Haem influenza 
Neisseria meningitis 
Salmonella
Malaria
44
Q

Water bacteria associated with brain abscess

A

Scedosporium apiospermum

45
Q

Drugs used in mssa

A

Flucloxacillin
Cephalosporins
Daptomycin

46
Q

Drugs used in mrsa

A

Daptomycin
Linezolid
Vanc
Teicoplanin

47
Q

What type of bacteria is clostridium difficile

A

Gram positive spore forming

48
Q

Define leptospirosis

A

Caused by spirochete bacteria.
Characterised by an acute phase and immune phase. Common symptoms include jaundice aki and bleeding. Associated with pulmonary haemorrhage

49
Q

How to diagnose and treat leptospirosis

A

Pcr
Microscopy
Treatment with doxycycline

50
Q

Gram positive cocci

A

Strep

Staph

51
Q

Gram positive rods

A

Acinitobacter
Bacillus
Clostridia
Listeria

52
Q

Gram negative cocci

A

Neisseria

Morexella

53
Q

Gram negative Bacilli

A

E.coli

Psa

54
Q

Define bacteriostatic

A

Limit growth allowing immune system to remove the bacteria

E.g macrolides

55
Q

Define bacteriocidal

A

Cause bacterial death

E.g penicillin

56
Q

Define concentration dependant killing

A

Actively correlated to peak serum. Concentration

  • aminoglycosides
57
Q

Define time dependant killing

A

Agents that need high concentration above the mic for a period of time

  • tazocin
58
Q

Which antibiotics act on cell wall synthesis

A

Penicillin

Cephalosporins

59
Q

Which antibiotics act on DNA synthesis

A

Metronidazole

60
Q

Which antibiotics act on THF synthesis

A

Trimethoprim

61
Q

Which antibiotics work on protein synthesis

A

Gent

Linezolid

62
Q

Define HIV

A

Retrovirus that infects the CD4 cells
Transmission through sex blood and vertical
hiv 1 and 2

63
Q

HIV replication.

A

Enters the macrophage via glycoprotein
Injection of RNA
RNA transcribed and integrated into DNA of host
Viral replication

64
Q

What drug do you give as pep for hiv

A

Zidovudine

65
Q

Define malaria

A

Protozoan parasite
Spread by anopheles mosquitoes
5 types-falciparum, malariea, ovale, vivax and knowlesi

66
Q

Life cycle of malaria

A

Mosquito ingests the gametocyte
Undergoes sporogenic cycle in the mosquito to form oocysts
Injected into humans the oocysts rupture
Sporozoites release
Shizont dormant phase in the liver
Eetthrocytic phase in the blood with they mature to trophozoites

67
Q

Parasite load in malaria to be classified as severe

A

> 10%

68
Q

Treatment of malaria

A

Artusunate

69
Q

Define tuberculosis

A

Mycobacterium tuberculosis aerobic bacilli

Producing a granulomatous inflammatory disease

70
Q

Treatment of TB

A

2 RIpE

4 Ri

71
Q

Define MDr and xdr TB

A

MDr- iso or rif resistance

Xdr- also fluroquinolones

72
Q

Define HEp a

A

RNA virus

Water or fecal contact

73
Q

Define hep b

A

DNA virus
Blood/body fluids
5% chronic -> cancer

74
Q

Hep c treatment

A

Ribavirin

Peg interferon alpha

75
Q

Hep c definition

A

RNA virus
Blood borne 1:30
70% chronic

76
Q

Changes in protein, wcc, cells and glucose with bacterial meningitis

A

High protein
High cells
Low glucose
Polymorphs

77
Q

Changes in protein, wcc, cells and glucose with viral meningitis

A

Normal protein
500 cells
Lymphs
Normal glucose

78
Q

Changes in protein, wcc, cells and glucose with fungal meningitis

A

Raised protein
100-500 cells
Lymph’s
Normal glucose

79
Q

Changes in protein, wcc, cells and glucose with TB meningitis

A

High protein
Normal cells
Lymphs
Low glucose

80
Q

Incubation leptospirosis

A

5-14 days

81
Q

Causes of eosinophilia

A 
Connective tissue disorders
Helminth infections
Idiopathic 
Neoplastic- para/ NHL 
Allergic- asthma, anaphylaxis, ten/ dress
82
Q

What are the Hacek bacteria

A 
Haemophylus
Actinobacillus
Cardiobacterium
Eikenella
Kingella

Icm (16 decks)

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