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microbiology Flashcards

1
Q

how does gentamicin work

A

bactericidal, inhibit protein synthesis acting at 30s ribosome

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2
Q

how is gentamicin given

A

IM or IV

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3
Q

what bacteria does gentamicin work against

A

S.aureus
e.coli
klebsiella
pseudomonas aeruginosa

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4
Q

indiactions gentamicin

A

sepsis
biliary tract infections
acute pyelonephritis and prostatitis
endocarditis
HAP

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5
Q

CI/cautions with gentamicin

A

excretion via kindeys - increase dosing interval in renal impairment
avoid in pregnancy and myasthenia gravis

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6
Q

how does clindamicin work

A

bacteriostatic, inhibit protein synthesis acting at 50s ribosome

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7
Q

ow is clindamicin given

A

oral, IM, IV

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8
Q

what bacteria does clindamycin work against

A

S.aureus, haemolytic strep, clostridium perfringens, bacteroides fragillis
no gram neg cover

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9
Q

inidcation clindamycin

A

alternatibe to penicillin in staph infection
peritonitis

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10
Q

SE clindamycin

A

c.diff
abdo discomfort
oesoohagitis
taste disturbance
SJS
TEN
ED

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11
Q

how does ertythromycin work

A

bacteriostatic, inhibit protein synthesis acting at 50s ribosome, doesnt cross BBB

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12
Q

adminisering erythromicin

A

oral, IV

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13
Q

what bacteria does erythromycin work against

A

S.aureus, haem strep, strep pneumoniae, legionella, mycoplasma pneumoniae, chlamydia

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14
Q

indications erythromycin

A

alternative to penicillin
campylobacter enteritis
syphilis
non gonococcal urethritis
atypical pneumonia
chronic prostatiis
group a strep
cellulitis
whooping cough
acne vulgaris
rosacea

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15
Q

cautions/CI erythromycin

A

prolong QT

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16
Q

SE erythromycin

A

QT prolongation
nausea and vom
diarrhoea
phlebitis
myasthenia like syndrome

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17
Q

how does vancomycin work

A

bactericidal

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18
Q

what bacteria does vancomycin work against

A

staph aureus,
staph epidermidis
haem strep
enterococcus
faecalis and faceium
strep pneumoniae
no gram neg cover

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19
Q

indications vancomycin

A

infections caused by sensitive oganisms - sepsis, endocarditis

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20
Q

SE vancomycin

A

nephrotoxicity
ototoxicity
neutropaenia
phlebitis
red man syndrome
SJS
TEN
ED

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21
Q

what bacteria does ceftazidime work on

A

haemophilus infuelzae
e.coli
klebsiella
pseudomonas aeruginosa
moraxella cattahalis
no grampositive

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22
Q

indications ceftazadime

A

pseudomonal infections

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23
Q

what bacteria does cefritaxone wotk on

A

staph aureus
haem strep
strep pneumoniae
neisseria meningitidis
neisseria gonorrhoea
h. influenzae
e.coli
klebsiella
moraxella cattarhalis

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24
Q

how does ciprofloxacin work

A

bactericidal, act on DNA gyrase

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25
what bacteria does ciprofloxacin work on
staph aureus h.influenzae e.coli psuedomonas aeruginosa moraexella catarrhalis mycoplasma pneumoniae chlamydia salmonella shigella camplylobacter
26
indications ciprofloxacin
atypical CAP, UTIs, GI (typhoid), osteomyelitis, septic arthritis, gonorrhoea, septicaemia
27
cautions ciprofoxacin
lower seizure threshold exacerbate myasthenia gravius can precipitate attack in G6PD deficiency tendon rupture avoid in children and pregnancy
28
SE ciprofoxacin
nausea and vom diarrhoea tendonitis photosensitivity SJS TEN
29
what bacteria does trimethoprim work against
e.coli klebsiella shigella salmonella
30
indications trimethoprim
UTI bronchitis shigellosis invasive salmonella
31
CI trimethoprim
teratogenic in 1st trimester
32
what does cefuroxime work against
staph aureus haem strep strep pneumoniae h.infuelzae e.coli klebsiella moraxella cattarhalis
33
what does cefadroxil work against
staph aureus haem strep strep pneumoniae e.coli
34
indications cefadroxil
UTIs in pregnancy otitis media sinusiits skin and soft tissue infection
35
SE cefadroxil
diarrhoea nause and vom headache SJS TEN
36
bacteria benpen works agaisnt
haem strep strep pneumoniae enterococcus faecalis listeria monocytogenes clostridium perfrigens neisseria meningitidis
37
infications benpen
throat infections otitis media endocardiits meningococcal disease pneumoniae cellulitis antrhax intrapartum GBS
38
SE benpen
hypersensitivity rash CNS toxicity interstitial nephroitis haemolytoc anaemia leucopenia thrombocytopenia diarrhoea
39
bacteria metronidazole works against
anaerobes protozoa
40
SE metronidazole
disulfiram like reaction with alcohol GI upset taste disturbance
41
cautions metronidazole
liver impairment
42
inidcations penicillin
oral infection tonsillitis otitis media erysipelas celluliits group a strep rheumatic fever pneumococcal infection
43
indications benzathine penicilloin
syphilis
44
what does piptazobactam/tazocin work against
staph aureus haem strep enterococcus faecalis strep pneumoniae clostridium perfringens bacteroides fragilis h.influenzae e.coli klebsiella psuedomonas aeruginosa moraxella cattarhalis
45
indications piptazobactam/tazocin
hospital acquired pneumonia septicaemia peritonitis complicated UTIS pseudomonal infections
46
what do carbapenems work against
staph aureus haem strep enterococcus faecalis strep pneumoniae listeria monocytogenes clostridium perfringens bacterioides fragillis neisseria meningitidis h.influenzae e.coli klebsiella pseudomonas aeruginosa moraxella cattarhalis
47
indications carbapenems
severe hospital acquired infections sepsis intra abdo infection skin and soft tissue infections complicated UTIs
48
SE carbapenems
nausea and vom diarrhoea raised LFTs headache thrombocytopenia
49
what bacteria does co-amoxiclav/augmentin work on
staph aureus haem strep enterococcus faecalis strep pneumoniae clostridium perfringens h.influenzaew e.coli moraxella cattarhalis
50
indications for co-amoxiclav
celluliits osteomyelitis septic arthritis genito-urinary infections abdo infections severe dental infection
51
SE co-amoxiclav
cholestatic jaundice SJS toxic epidermal necrolysis exfoliative dermatitis vasculitis CNS toxicity
52
what bcateria to ampicillin and amoxicillin work against
haem strep enterococcus faecalis strep pneumoniae listeria monocytogenes clostridium perfringens
53
indications ampicilin/amoxicillin
UTI otitis media sinusiits bronchitis community acquired pnuemonia
54
cautions ampicillin/amoxicillin
suspected glandular fever lymphocytic leukaemia
55
sE ampicillin/amoxicillin
nause and vom diarrhoea rash
56
what does fluclox work against
staoh aureus haem strep
57
indications fluclox
otitis externa pneumonia impetigo cellulitis osteomyelitis endocardiitis
58
gram staining
POSITIVE – PURPLE NEGATIVE - RED
59
ziehl neelsen staining
USED FOR MYCOBACTERIA THEY ARE ACID FAST – PINK/RED What does acid fast mean? THIS MEANS THAT THEY RESIST ACID DE-COLOURISATION PROCEDURES
60
catalase tests
TELLS YOU THE DIFFERENCE BETWEEN: STAPHYLOCOCCI STREPTOCOCCI/ENTEROCOCCI staphylococci use catalase to protect against hydrogen peroxide – reaction you see bubbles – catalase positive if not present there is no reaction – catalase negative
61
coagulase test
Used to differentiate between: Staphylococcus aureus Other Staphylococci COAGULASE is an enzyme that causes coagulation – fibrin to clot BACTERIA + PLASMA = CLOT - STAPH AUREUS – coagulase positive BACTERIA + PLASMA = NO CLOT – OTHER STAPH SPEICES – coagulase negative
62
oxidase test
Identifies bacteria that are oxidase positive – produce cytochrome oxidase Pseudomonas Neisseria POSITIVE TEST RESULT – BLACK/PURPLE COLOUR NEGATIVE TEST RESULT – NO COLOUR CHANGE
63
optochin test
Differentiates: Streptococcus pneumoniae – what type of cocci… Diplococci in chains From other alpha haemolytic streptococci Clear zone of lysis – strep. pneumoniae
64
blood agar
Differentiates Alpha haemolytic streptococci Beta haemolytic streptococci Alpha – green pigment Beta – clear zones of lysis Non-haemolytic – no change
65
macconkey agar
Bile salts only permit the growth of enteric bacteria Lactose fermentation causes an acidic environment – red/pink colour change with the indicator Red/pink colony – E Coli, Klebsiella Clear colony – Salmonella, Shigella, Pseudomonas
66
gram positive aerobic bacilli
cornybacterium: c.diptheria listeria: listeria monocytogenes bacilus: b. anthracis, b.cerus
67
gram positive anaerobic bacili
clostridium
68
gram positive alpha haemolytic strep
s.pneumoniae s.oralis s.sanguis
69
gram positive beta haemolutic strep
s. pyogenes (A) s. agalactiae (B)
70
gram positive non haemolytic strep
s.mutans s.milleri enterococcus faecalis (D)
71
gram positive coag negative staph
s.epidermidis s. saprophiticus
72
gram positive coag posiitve staph
s.aureus
73
gram negative bacilli aerobic lactose fermenters (macConkey pink)
e.coli K.pneumoniae
74
gram negative aerobic non lactose fermenters bacili
salmonella: s.typhi, s.paratyphi, s.enterica shigella: s.sonnei, s.dysenteriae proteus: p.mirabilis
75
gram negative cocci
n.meningitidis, n.gonorrhoea moraxella catarrhalis
76
gram negative aerobic bacili with fastidious growth requirements
parvobacteria: h.influenzae, bordatella pertussus, legionella pneumophilia, brucella, campylobacter jejuni helicobacter pylori
77
obligate intracellular bacteria
chlamydia coxiella rickettsia
78
ziehl neelson positive bacteria
mycobacteria
79
spirochaetes
treponema pallidum borrelia leptospira
80
exotoxin
secreted by bacteria (MAINLY GRAM POSITIVE) – specific actions – like paralysis with botulinum toxin
81
endotoxin
– released when bacteria is damaged, less specific action – septic shock
82
TB mx
Rifampicin - RED urine, hepatotoxicity Isoniazid – peripheral neuropathy – N for neuropathy Pyrizinamide - hepatotoxicity Ethambutol – ocular/EYE toxicity
83
UTI causes
E Coli Other causative organisms Proteus Klebsiella
84
mx UTI
First line Trimethoprim/nitrofurantoin Or amoxicillin
85
cause pyelonephritis
E Coli Other causative organism Enterococcus faecalis
86
mx pyelonephritis
Use cefuroxime or quinolone (floxacin – ciprofloxacin) Gentamicin
87
cause prostatitis
E Coli But also Proteus Mirabilis Klebsiella
88
mx prostatitis
Quinolones (ciprofloxacin)
89
cause imptigo
s.aureus
90
mx impetigo
fusidic acid
91
cause celullitis
s.aureus
92
mx cellulitis
fluclox
93
cause resp pneumonia
Strep Pneumonia Other causes H Influenzae Atypicals – Coxiella, Chlamydophilia, Mycoplasma, Leigionella
94
mx CAP
Low severity=Amoxicillin Moderate=Amoxicillin High severity=Benzylpenicillin + clarithromycin (why clarithromycin?)
95
mx HAP
Co-amoxiclav – if early onset (less than 5 days into admission) Tazoin – if late onset (more than 5 days)
96
cause osteomyelitis
S Aureus Other=Enterocbacter Streptococcus if sickle cell anaemia=Salmonella
97
mx osteomyelitis
fluclox
98
cause septic arthritis
S Aureus Other Streptococci Neisseria – in sexually active young adults
99
mx septic arthritis
fluclox
100
cause eye infections
S Aureus Other causes Streptococci Haemophilus
101
mx eye infections
Chloramphenicol
102
tx c.diff
Metronidazole – use in situations where anaerobic bacteria are suspected
103
cause meningitis
Neisseria Meningitidis Streptococcus Pneumoniae
104
mx meningitis
3 months -50 years=Cefotaxime Over 50 years=Cefotaxime and amoxicillin
105
what type of diarrhoea does cholera cause
rice water
106
Abx that work by affecting folate (nucleic acid synthesis)
Sulfonamides Trimethoprim
107
Abx that affect DNA gyrase (nucleic acid) synthesis
Quinolones
108
Abx that affect RNA polymerase synthesis (nucleic acid synthesis)
Rifampicir
109
Abx that affect cell wall synthesis
Beta lactams Vancomycin Bacitracin Cell membrane synthesis: polymyxins
110
Beta lactams
Penicillins Cephalosporins Carbapanems Monobactams
111
Abx that affect 50 s subunit (protein) synthesis
Macrolides Clindamycin Linezolid Chloramphenicol Streptogramins
112
Abx that affect 30s ribosome (protein) synthesis
Tetracycline Aminoglycosides
113
Where does first pass metabolism happen
Liver
114
Drugs that increase risk c diff
Abx: c drugs Ciprofloxacin Clindamicin Cephalosporin Co amox Carbapenems
115
Antibiotics stewardship
Start smart: only start if clinical evidence, comply with local guidelines, document clinical indication and when to rev, cultures before start Focus: after 48-72h: stop if no infection, IV to oral, narrow the spectrum, continue and document review/start date, outpatient parenteral abx if still need
116
What to write in exam if unsure which abx
Give antibiotics as per local guidelines (name of drug in brackets if know)
117
Ciprofloxacin SE
REDUCES seizures threshold Increases QT interval Predisposes to Aortic dissection C. Diff Tendo rupture
118
What to NEVER prescribe with trimethoprim
Methotrexate
119
When to avoid nitrofurantoin
If eGFR less than 45 as its really excreted so won't work
120
Abx for hospital acquired pneumonia sheffield
If well: doxcycycline Unwell: tazocin (piperacillin/tazobactam)
121
Severity markers c diff and what do if present
WCC high, AKI, abdominal pain, fever over 38.5 Call surgeons, query colitis
122
Mx c. Diff
Oral vancomycin Fidaxomicin second line (due to costs)
123
Which abx SE is red man syndrome
Vancomycin infusion
124
Red man syndrome sx
pruritus an erythematous rash that involves the face, neck, and upper torso. Less frequently, hypotension and angioedema can occur.
125
Blood Borne virus screen
HIV hep B Hep C

finals (31 decks)

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