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CLASP Sepsis > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What type of bacteria is gentamicin covering in AGM

A

gram negatives

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2
Q

What type of bacteria is metronidazole covering in AGM

A

anaerobes

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3
Q

What type of bacteria is amoxicillin covering in AGM

A

gram positives

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4
Q

Name 3 gram positive cocci in chains

A

Strep pneumonia, pyogenes and viridans

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5
Q

What broad branch of antibiotic can treat strep infections

A

Penicillins

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6
Q

Which organisms exhibit alpha haemolysis

A

strep pneumoniae and viridans

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7
Q

Which organisms exhibit beta haemolysis

A

Group A strep

Strep pyogenes

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8
Q

What does the DUKE criteria score for

A

infective endocarditis severity

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9
Q

Which organisms are typical in diagnosis of endocarditis

A

Staph aureus
Enterococcus
Strep viridans
HACEK species

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10
Q

Which organisms exhibit gamma haemolysis

A

enterococcus

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11
Q

What are the 4 C antibiotics

A

Clindamycin, cephalosporin, co-amoxiclav, ciprofloxacin (represents all quinolone - oxacin)

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12
Q

What is the consequence of giving antibiotics to someone with an E.coli infection

A

Haemolytic-uraemic syndrome

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13
Q

List the main gram positive cocci

A

Staph - aureus, epidermidis
Strep
Enterococci - faecalis, faecium and VRE

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14
Q

List the main gram positive bacilli

A

Listeria
C.diff
Clostridium perfringens
Diptheriods

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15
Q

Where is clostridium perfringens found

A

wound infections

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16
Q

Which antibiotics are included in the B lactam class

A 
Penicillin 
Flucloxacillin 
Amoxicillin 
Cephalosporins 
Piperacillin/tazobactam 
Carbapenems
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17
Q

Oral penicillin is not as well absorbed as oral amoxicillin - true or false

A

True

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18
Q

What is the only sepsis case where oral antibiotics are given

A

C. diff - vancomycin cannot pass through the gut wall from the blood

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19
Q

Are penicillin’s only taken once per day

A

NO - multiple doses

Need to keep level above the mean inhibitory concentration

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20
Q

Which parts of the body is it difficult to get antibiotics into

A

Anywhere with tight junctions

CNS, eyes, prostate

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21
Q

Which diseases can strep pneumoniae cause

A

otitis
pneumonia
meningitis

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22
Q

Pneumococcal vaccine protects us from which pathogen

A

Strep pneumoniae

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23
Q

Which antibiotic would you use to treat enterococcus infection

A

Amoxicillin

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24
Q

Where are enterococci found

A

GI tract

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25
What diseases can enterococci cuase
UTI, endocarditis , bacteraemia, peritonitis
26
How do you test for antibiotic sensitivity/resistance using plates
Place antibiotic discs on agar and then try grow the bacteria If the antibiotics work there will be a large cleared area around disc If bugs get close to disc, they aren’t working well Or put strips with different conc of drugs
27
What is the mean inhibitory concentring
concentration of drug required for kill of 99.9% of organisms during 18 to 24 hours
28
Which staph strain is coagulase positive
staph aureus
29
What antibiotic is used to treat staph aureus infection
Flucloxacillin | Vancomycin if allergic or MRSA
30
Where are staph aureus and staph epi found
on the skin
31
Which type of bacteria have a thinner cell wall
gram negative
32
What is aztreonam and what is it used for
A monobactam | used in place of gentamicin if patient has kidney problems
33
Which host factors can affect lng infection
``` Being hospitalised for >48hr Ventilation Time of year Immunosuppression Chronic lung diseases Travel ```
34
Why must you ask about travel to England
more resistant gram negatives found there
35
Which drug is used to treat haemophilus influenza infection
Amoxicillin
36
Describe the appearance of h. influenza
Gram negative coccobacillus
37
Which organism cause atypical pneumonia
Mycoplasma pneumoniae Coxiella burnetii Chlamydophila psittaci Legionella
38
Which antibiotics are used to treat atypical pneumonias
Most resposnd to doxycycline Clarithromycin also works Quinolones used for legionella
39
What organism grows on chocolate agar
Haemophilus influenza
40
List important causes of gram negative sepsis
E.coli Klebsiella Pseudomonas Neisseria meningitides
41
What are coliforms
E. coli and similar organisms | Gram negative rods
42
What is clavulanate
other component of co-amoxiclav | inhibit beta lactamase – allow the penicillin's to work
43
What are the immune defences of the skin
Keratinocytes secrete antimicrobial peptides (defensins) Sebaceous glands secrete microbe-inhibiting substances Antigen-presenting cells in skin
44
What are the immune defences of the mucosa of the respiratory, Gi and GU tracts
Antimicrobial substances e.g. lysozyme Secretory immunoglobulin A (IgA) Gastric acid
45
What skin conditions can increase susceptibility to infection
``` Eczema Psoriasis Tinea pedis Ulcers or pressure sores All impair the physical barrier ```
46
What lung conditions can increase susceptibility to infection
Cystic fibrosis Bronchiectasis COPD Poor mucous clearance Poor swallow - aspiration risk
47
What GI conditions can increase susceptibility to infection
Mucositis secondary to chemotherapy Inflammatory bowel disease Bowel cancer
48
What GU conditions can increase susceptibility to infection
Impaired bladder emptying - e.g. due to spinal cord injury | Catherisation
49
What organisms are phagocytes mainly responsible for dealing with
Bacteria and fungi
50
Deficiency or impaired function of phagocytes is seen in which conditions
``` Haematological malignancy (esp acute leukaemia, myelodysplasia) Cytotoxic chemotherapy ```
51
Deficiency of T lymphocytes is seen in which conditions
HIV - CD4+ Lymphoma Primary immunodeficiency syndromes
52
Which immunoglobulin is produced first
IgM | weaker affinity
53
Deficiency or impaired function of B cells are seen in which conditions
Myeloma Primary immunodeficiency syndromes Immunosuppressant use - rituximab
54
What is the result of HIV infection
It infects the CD4 lymphocytes and causes progressive decline in number and therefore immunodeficiency
55
What infections does HIV make you more susceptible to
Invasive pneumococcal disease CD4<350 - TB, candidiasis CD4<200 - pneumocystis jirovecii CD4<100 - Cryptococcus and CMV
56
What is hyposplenism and what can cause it
decreased spleen function | cause: splenectomy, sickle cell, cirrhosis, coeliac
57
hyposplenism puts you at risk of infection from which organisms
Strep pneumoniae H. influenza Neisseria meningitidis
58
How does old age affect your immunity
Less able to distinguish self from non-self Phagocytes work slower T cells respond Less antibody is produced and its less effective Less compliment produced
59
What are the effects of immunocompromise
Often have different symptoms More likely to have an atypical infection Lower threshold for treatment
60
What infections can steroids increase your susceptibility for
Wide range | Especially fungal ones such as candida or aspergillus
61
What infections can anti-TNFa drugs increase your susceptibility for
Strong association with TB | Fungal infections - particularly aspergillus
62
Which groups are offered extra vaccines
``` pregnant women chronic diseases - lung, heart, kidney immunocompromised diabetics elderly hyposplenism children ```
63
Which antibiotic makes you photosensitive
Doxycycline | Need to warn patients about this
64
What are some of the major side effects of quinolones
``` Lower seizure threshold Tendonitis C.diff infection Psychological problems Aneurysm rupture ```
65
Which antibiotic is not absorbed well systemically when given by mouth
Vancomycin
66
Do you need a positive sputum culture to diagnose CAP
NO
67
Quinolones have poor oral bioavailability - true or false
False | Have very good availability
68
Aztreonam is only available as IV - true or false
True
69
List 3 AIDS defining conditions
Recurrent pneumonia, oropharyngeal candida and salmonella bacteraemia
70
In which group should tetracyclines be avoided
Under 12's
71
Does MSSA need repeated blood cultures
Yes after 2/3 days

CLASP Sepsis (4 decks)

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