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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
Q

What diseases can enterococci cuase

A

UTI, endocarditis , bacteraemia, peritonitis

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26
Q

How do you test for antibiotic sensitivity/resistance using plates

A

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

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27
Q

What is the mean inhibitory concentring

A

concentration of drug required for kill of 99.9% of organisms during
18 to 24 hours

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28
Q

Which staph strain is coagulase positive

A

staph aureus

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29
Q

What antibiotic is used to treat staph aureus infection

A

Flucloxacillin

Vancomycin if allergic or MRSA

30
Q

Where are staph aureus and staph epi found

A

on the skin

31
Q

Which type of bacteria have a thinner cell wall

A

gram negative

32
Q

What is aztreonam and what is it used for

A

A monobactam

used in place of gentamicin if patient has kidney problems

33
Q

Which host factors can affect lng infection

A 
Being hospitalised for >48hr
Ventilation 
Time of year 
Immunosuppression 
Chronic lung diseases 
Travel
34
Q

Why must you ask about travel to England

A

more resistant gram negatives found there

35
Q

Which drug is used to treat haemophilus influenza infection

A

Amoxicillin

36
Q

Describe the appearance of h. influenza

A

Gram negative coccobacillus

37
Q

Which organism cause atypical pneumonia

A

Mycoplasma pneumoniae
Coxiella burnetii
Chlamydophila psittaci Legionella

38
Q

Which antibiotics are used to treat atypical pneumonias

A

Most resposnd to doxycycline
Clarithromycin also works
Quinolones used for legionella

39
Q

What organism grows on chocolate agar

A

Haemophilus influenza

40
Q

List important causes of gram negative sepsis

A

E.coli
Klebsiella
Pseudomonas
Neisseria meningitides

41
Q

What are coliforms

A

E. coli and similar organisms

Gram negative rods

42
Q

What is clavulanate

A

other component of co-amoxiclav

inhibit beta lactamase – allow the penicillin’s to work

43
Q

What are the immune defences of the skin

A

Keratinocytes secrete antimicrobial peptides (defensins)
Sebaceous glands secrete microbe-inhibiting substances
Antigen-presenting cells in skin

44
Q

What are the immune defences of the mucosa of the respiratory, Gi and GU tracts

A

Antimicrobial substances e.g. lysozyme
Secretory immunoglobulin A (IgA)
Gastric acid

45
Q

What skin conditions can increase susceptibility to infection

A 
Eczema
Psoriasis 
Tinea pedis 
Ulcers or pressure sores 
All impair the physical barrier
46
Q

What lung conditions can increase susceptibility to infection

A

Cystic fibrosis Bronchiectasis
COPD
Poor mucous clearance
Poor swallow - aspiration risk

47
Q

What GI conditions can increase susceptibility to infection

A

Mucositis secondary to chemotherapy
Inflammatory bowel disease
Bowel cancer

48
Q

What GU conditions can increase susceptibility to infection

A

Impaired bladder emptying - e.g. due to spinal cord injury

Catherisation

49
Q

What organisms are phagocytes mainly responsible for dealing with

A

Bacteria and fungi

50
Q

Deficiency or impaired function of phagocytes is seen in which conditions

A 
Haematological malignancy (esp acute leukaemia, myelodysplasia)
Cytotoxic chemotherapy
51
Q

Deficiency of T lymphocytes is seen in which conditions

A

HIV - CD4+
Lymphoma
Primary immunodeficiency syndromes

52
Q

Which immunoglobulin is produced first

A

IgM

weaker affinity

53
Q

Deficiency or impaired function of B cells are seen in which conditions

A

Myeloma
Primary immunodeficiency syndromes
Immunosuppressant use - rituximab

54
Q

What is the result of HIV infection

A

It infects the CD4 lymphocytes and causes progressive decline in number and therefore immunodeficiency

55
Q

What infections does HIV make you more susceptible to

A

Invasive pneumococcal disease
CD4<350 - TB, candidiasis
CD4<200 - pneumocystis jirovecii
CD4<100 - Cryptococcus and CMV

56
Q

What is hyposplenism and what can cause it

A

decreased spleen function

cause: splenectomy, sickle cell, cirrhosis, coeliac

57
Q

hyposplenism puts you at risk of infection from which organisms

A

Strep pneumoniae
H. influenza
Neisseria meningitidis

58
Q

How does old age affect your immunity

A

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
Q

What are the effects of immunocompromise

A

Often have different symptoms
More likely to have an atypical infection
Lower threshold for treatment

60
Q

What infections can steroids increase your susceptibility for

A

Wide range

Especially fungal ones such as candida or aspergillus

61
Q

What infections can anti-TNFa drugs increase your susceptibility for

A

Strong association with TB

Fungal infections - particularly aspergillus

62
Q

Which groups are offered extra vaccines

A 
pregnant women 
chronic diseases - lung, heart, kidney 
immunocompromised 
diabetics 
elderly 
hyposplenism 
children
63
Q

Which antibiotic makes you photosensitive

A

Doxycycline

Need to warn patients about this

64
Q

What are some of the major side effects of quinolones

A 
Lower seizure threshold 
Tendonitis 
C.diff infection 
Psychological problems 
Aneurysm rupture
65
Q

Which antibiotic is not absorbed well systemically when given by mouth

A

Vancomycin

66
Q

Do you need a positive sputum culture to diagnose CAP

A

NO

67
Q

Quinolones have poor oral bioavailability - true or false

A

False

Have very good availability

68
Q

Aztreonam is only available as IV - true or false

A

True

69
Q

List 3 AIDS defining conditions

A

Recurrent pneumonia, oropharyngeal candida and salmonella bacteraemia

70
Q

In which group should tetracyclines be avoided

A

Under 12’s

71
Q

Does MSSA need repeated blood cultures

A

Yes after 2/3 days

CLASP Sepsis (4 decks)

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