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Yr 3 - Elderly Medicine > Microbiology > Flashcards

Microbiology Flashcards

1
Q

If a biliary infection is suspected, what is the 1ary imaging technique?

A

Abdominal US

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2
Q

Define acute bacterial gastroenteritis

A

An illness of <14 days duration characterised by the presence of diarrhoea (3 or more loose stools per day or bloody stools). It is typically self-limiting.

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3
Q

What is the cause of acute bacterial gastroenteritis?

A

Ingestion of food or water contaminated by GI flora

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4
Q

Give some common pathogens causing bacterial gastroenteritis

A
  • Campylobacter
  • Salmonella
  • Shigella
  • E. coli
  • Clostridium perfringens
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5
Q

Symptoms of bacterial gastroenteritis?

A
  • Diarrhoea
  • Abdominal pain/cramps
  • N&V
  • Fever
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6
Q

Eating what is a big risk factor for bacterial gastroenteritis?

A

Raw or undercooked foods

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7
Q

Which occupation is a risk factor for bacterial gastroenteritis?

A

Farmers or workers in the meat industry

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8
Q

Which ages are a risk factor for bacterial gastroenteritis?

A

<5 y/o

>60 y/o

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9
Q

Is antibiotic therapy recommended in acute bacterial gastroenteritis?

A

No - most patients with acute gastroenteritis have no adverse complications from acute gastroenteritis and derive no benefit from antibiotic therapy

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10
Q

What management is suggested for bacterial gastroenteritis?

A

Rehydration

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11
Q

Which 3 groups of patients do require antibiotics for bacterial gastroenteritis?

A
  1. Pregnant women
  2. Immunosuppressed
  3. Symptoms lasting >7 days
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12
Q

Who should cases of infective gastroenteritis be reported to?

A

PHE (particularly those involving food handlers)

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13
Q

What is C. difficile infection?

A

Infection of the large bowel by C. difficile

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14
Q

What is C. difficile infection?

A

Infection of the large bowel by C. difficile

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15
Q

Symptoms of C. difficile infection?

A
  • Fever
  • Abdominal pain
  • Loose stools
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16
Q

Describe stool appearance in C. difficile infection

A

Green

Slimy

Maloderous

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17
Q

One major risk factor for C. difficile infection is previous antimicrobial therapy. Which antibiotics are the biggest risk factors?

A

The ‘C’ drugs: ciprafloxacin, cephalosporins, co-amoxiclav, clindamycin (and quinolones)

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18
Q

Give other risk factors for C. difficile infection

A
  • Old age (>65 y/o)
  • Hospitalised patients
  • Previous antimicrobial therapy
  • Long duration of antibiotic use (>7 days)
  • Multiple antibiotic courses
  • Severe underlying disease
  • Presence of nasogastric tube
  • Non-surgical GI procedures
  • PPIs
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19
Q

What are the 2 diagnostic criteria for C. difficile infection?

A
  1. Presence of loose stools (type 5-7)
  2. Positive C. diff test (or clinical suspicion while awaiting results)
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20
Q

What is the 1ary test for C. difficile infection?

A

Stool sample

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21
Q

What is the non antimicrobial treatment for C. diff infection?

A

Fluid resuscitation and electrolyte replacement as appropriate

22
Q

Which policies need to be instigated in a C. diff infection?

A

Immediate instigation of isolation policy and Clostridium Difficile Infection Control Policy.

23
Q

Is antibiotic therapy used to treat symptomatic C. diff infection?

A

Yes most often

24
Q

What are the 2 most commonly used antibiotics in treating C. diff infection?

A

Oral vancomycin

Oral fidaxomicin

25
Q

Why are oral antibiotics, not IV, used to treat C. diff infection?

A

When given orally they only work in the intestines and NOT absorbed (this is where the infection is)

26
Q

Which antibiotic is most effective in life threatening C. diff infection?

A

Oral vancomycin

27
Q

Do serum levels of oral vancomycin need to be monitored? Why?

A

No - serum levels do not need to be monitored when given orally as it is NOT absorbed

28
Q

What bacteria is resistant to vancomycin?

A

VRE (vancomycin resistant enterococci).

29
Q

What is the mechanism of action of fidaxomicin?

A

Inhibits bacterial RNA polymerase

30
Q

Does Fidaxomicin or Vancomycin cause less disruption to the normal gut flora?

A

Fidaxomicin (therefore less capacity for C. Difficile spores to germinate)

31
Q

What is the function of the gut microbiome?

A

Aid digestion, regulate the immune system and protect against infection

32
Q

How does the gut microbiome protect against infection?

A

Is composed of around 39 trillion bacteria which provide a physical barrier to more harmful bacteria, and compete for space and nutrients which limit the potential for pathogenic bacteria to multiply.

33
Q

How does antibiotic use lead to C. diff infection?

A

Antibiotic use causes disruption of the gut microbiome and therefore results in a disbalance of bacteria population → which creates an ecological niche for C. difficile spores to germinate.

34
Q

What is colonisation resistance?

A

Intestinal microbiota protects itself against incursion by new and often harmful microorganisms.

35
Q

Which class of antibiotics lead to the most frequent allergic reactions?

A

Beta-lactams

36
Q

What information is important to get from a patient history regarding antibiotic allergies?

A
  • What antibiotics has the patient reacted to in the past?
  • When did the reaction take place?
  • How long after administration?
  • What is the nature of the reaction? → rash vs anaphylaxis (if rash, then describe: maculo-popular, pustular, urticarial etc.)
  • Did the reaction resolve on cessation of the antibiotics?
37
Q

What type of allergic reaction is typically mediated by penicillin specific IgE?

A

Type 1 (<1 hour)

38
Q

What is cholecystitis?

A

Inflammation of the gallbladder

39
Q

What is cholecystitis?

A

Inflammation of the gallbladder

40
Q

What is the most common cause of cholecystitis?

A

Cystic duct obstruction from cholelithiasis (calculous cholecystitis) i.e. gallstones

41
Q

What is acalculous cholecystitis?

A

An inflammatory disease of the gallbladder without evidence of gallstones or cystic duct obstruction.

42
Q

Who is acalculous cholecystitis seen primarily in?

A

Critically ill patients

43
Q

What clinical signs might be found in cholecystitis?

A
  • Positive Murphy’s sign
  • RUQ guarding/pain
  • Jaundice
  • Fever
44
Q

Which LFTs may be elevated in cholecystitis?

A

ALT & AST

45
Q

What imaging cause be used to demonstrate bile duct dilatation and/or stones in cholecystitis?

A

Ultrasound

46
Q

What is complicated acute diverticulitis?

A

Acute diverticulitis accompanied by abscess, fistula, bowel obstruction or perforation

47
Q

Treatment of complicated acute diverticulitis?

A

Broad spectrum antibiotics (until blood cultures come back)

Potential drainage of abscess

48
Q

What are MDR organisms?

A

Multidrug-Resistant Organisms

49
Q

Give some examples of MDR organisms

A

ESBL

VRE

MRSA

50
Q

How should the patient be kept if MDR organisms are identified?

A

In source isolation (ESBL and VRE and tramissible)

Yr 3 - Elderly Medicine (3 decks)

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