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Y3- Transition > Microbiology > Flashcards

Microbiology Flashcards

1
Q

Partner notification ‘look back’ period for chlamydia?

A

6 months

4 weeks male urethral

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2
Q

Partner notification ‘look back’ period for gonorrhoea?

A

3 months

2 weeks male urethral

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3
Q

Partner notification ‘look back’ period for primary syphilis?

A

90 days

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4
Q

Partner notification ‘look back’ period for secondary syphilis?

A

2 years

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5
Q

Which vaccinations do MSM receive?

A

Hep A, B, HPV

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6
Q

What is PreP?

A

Pre-Exposure Prophylaxis- taken before exposure to reduce risk of infection

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7
Q

What is PEPSE?

A

Post-Exposure Prophylaxis- taken after exposure to reduce risk of infection

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8
Q

What is the PEPSE for Hep B?

A

Vaccination up to 7 days

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9
Q

What is the PEPSE for HIV?

A

3 antiretrovirals within 72 hours for 28 days

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10
Q

Risk factors for GBV?

A 
Female
Disability
Pregnancy
Addictions
HIV
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11
Q

What is sepsis?

A

life-threatening organ dysfunction caused by a dysregulated host response to infection

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12
Q

What is septic shock?

A

subset of sepsis with circulatory and cellular/metabolic dysfunction associated with a higher risk of mortality

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13
Q

Symptoms/signs of peritonitis?

A

Pain, guarding, fever, chills/rigors, N+V, constipation/diarrhoea, malaise, anorexia

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14
Q

qSOFA criteria?

A

RR >22
sBP <100mmHg
Altered GCS

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15
Q

SIRS criteria?

A 
Temp >38
HR >90
RR >20
WCC >12000mm3
\+ presumed or confirmed infectious processes
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16
Q

Supportive treatment of infection?

A 
Fluids
Analgesia
VTE prophylaxis
Oxygen
Electrolytes
Transfusion?
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17
Q

Examples of coliforms?

A

E.coli
Klebsiella sp.
Proteus sp.
Enterobacter sp.

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18
Q

Examples of aerobes?

A

Pseudomonas sp.
Staphylococci,
Streptococci
Enterococci

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19
Q

Example of anaerobe?

A

Clostridium sp.

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20
Q

Antibiotic for coliforms?

A

Gentamicin

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21
Q

Antibiotic for anaerobes?

A

Metronidazole

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22
Q

Antibiotic for enterococcus?

A

Amoxicillin

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23
Q

What is the empirical treatment of intra-abdominal infections?

A

Gentamicin + Amoxicillin + Metronidazole

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24
Q

What is regularly monitored during gentamicin therapy?

A

Renal function

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25
Q

Can abscesses be treated with antibiotics?

A

No- no blood supply and so antibiotics will not penetrate it well

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26
Q

Normal mouth flora?

A

Strep. viridans
Neisseria sp.
Anaerobes
Candida sp. (few), Staphylococci

27
Q

Normal flora of stomach + duodenum?

A

Usually sterile

28
Q

What contributes to faecal flora?

A

Coliforms
Anaerobes
Enterococcus

29
Q

SEE STIs and other GUM infections

A

In Y3- TO LEARN

30
Q

What causes aseptic meningitis?

A

Virus (e.g. enterovirus, HSV, syphilis)
Fungi
Malaria

31
Q

What is acute encephalitis?

A

Infection of brain parenchyma

32
Q

What does pyogenic meningitis produce?

A

Thick layer of suppurative exudate (pus) on meninges

33
Q

Presentation of encephalitis?

A 
Meningismus (e.g. headache, neck sitffness, photophobia)
Stupor/coma
Vomiting
Fever
Seizures
Confusion
Speech/memory problems
34
Q

Azithromycin is given as a single dose because?

A

Due to a very long half-life (5 days)

Not used anymore due to concerns about resistance

35
Q

Symptoms of sepsis?

A

Fever, vomiting, drowsy, confusion, muscle pain, pale, rash, headache, neck stiffness, photophobia, seizures

36
Q

Cause of bacterial meningitis in neonates?

A

Listeria, Group B strep, E.coli

37
Q

Cause of bacterial meningitis in children?

A

H. influenza

38
Q

Cause of bacterial meningitis in age 10-21?

A

Neisseria meningitidis (from throat)

39
Q

Cause of bacterial meningitis in >21 years?

A

Strep pneumoniae

40
Q

Cause of bacterial meningitis in >65 years?

A

Strep pneumoniae

41
Q

Can resume having sex with partner after how long (after treatment of chlamydia)?

A

No sex for 7 days (even if protected)

42
Q

Cryptococcal meningitis is found in which patients?

A

HIV (CD4 <100)

43
Q

Investigations in meningitis?

A

Blood cultures

LP- microscopy, culture, biochem, PCR

44
Q

What is listeria monocytogenes?

A

Gram +ve bacilli

Associated with soft cheese and deli food

45
Q

Treatment of listeria monocytogenes?

A

IV Ampicillin/amoxicillin

Hysteria (listeria)= don’t AMP up

46
Q

Typical CSF results for bacterial meningitis?

A

High WBC
High neutrophils
High protein
Low glucose (consumed by bacteria)

47
Q

Typical CSF results for viral meningitis?

A

High lymphocytes
Normal protein
Normal glucose

48
Q

When should a CT be performed before LP in meningitis?

A

Immunocompromised

SEIZURE

49
Q

Empirical therapy for bacterial meningitis?

A

First Dexamethasone 10mg IV
Then IV ceftriaxone 2g bd

BCD- bacterial= ceftriaxone + dexamethasome (or chloramphenicol)

50
Q

What should be added to empirical therapy if listeria is suspected (e.g. in elderly)?

A

IV amoxicillin/ampicillin

51
Q

Why give steroids in bacterial meningitis?

A

Reduce mortality

52
Q

Who should be informed about meningitis cases?

A

Public health (Health Protection team)

Within 24 hours of admission!

53
Q

What contact prophylaxis can be given in meningitis?

A

500 mg ciprofloxacin orally

54
Q

NEWS score suggestive of sepsis?

A

5 or more

+ suspicion of infection

55
Q

What kinds of pathogens can be contaminants in blood?

A

Staph epidermidis

Staph aureus

56
Q

Which antibiotic can you use as a substitute for gentamicin after the standard 3 day dose?

A

Aztreonam (also covers coliforms)

57
Q

4 Cs of antibiotics?

A

cephalosporins, clindamycin, co-amoxiclav and quinolones

58
Q

What do you substitute for ceftriaxone in treatment of bacterial meningitis if penicillin allergic?

A

Chloramphenicol

however penicillins are ALWAYS more effective than Chloramphenicol can ever be

59
Q

CSF with lymphocytes, low WBC, protein raised, no gram stain etc. could suggest?

A

Viral meningitis/encephalitis
OR
Partially treated bacterial meningitis

60
Q

Why might a bacterial meningitis be culture negative?

A

It antibiotics were given pre-LP

61
Q

Apart from infection, what else can cause SIRS score to increase?

A

Trauma, burns, pancreatitis and other insults

62
Q

4Cs to avoid and why?

A
  • Clindamycin
  • Cephalosporins
  • Co-amoxiclav
  • Ciprofloxacin

Increase C.diff infection

63
Q

Normal serum lactate levels, and why is it raised in sepsis?

A

<1.8 mmol/l

Elevated levels indicate hypoperfusion/hypoxia

Y3- Transition (9 decks)

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