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CC2 > Microbiology and Antibiotic Therapy > Flashcards

Microbiology and Antibiotic Therapy Flashcards

1
Q

What colour do acid-fast bacteria stain? Why?

A

Red due to myocolic acid in cell wall

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2
Q

What are the 3 ways to describe bacteria?

A
  1. Shape
  2. Stain
  3. Growth requirements
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3
Q

What influences how a bacteria stains on a gram stain?

A

Gram positive: violet/purple due to thick layer in peptidoglycan cell wall.
Gram negative: stain with safranin (counterstain) due to thinner peptidoglycan cell wall.

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4
Q

How can the growth requirements of bacteria be described?

A

Aerobic, anaerobic or facultative

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5
Q

What type of bacteria are S. aureus?

A

Gram positive cocci in a cluster

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6
Q

What type of bacteria are Strep. pneumoniae?

A

Gram positive cocci in chains, alpha-haemolytic

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7
Q

What type of bacteria are Str. pyrogenes (GAS)?

A

Gram positive cocci, chains, beta-haemolytic

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8
Q

What type of bacteria are C. difficile?

A

Gram positive rods

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9
Q

What type of bacteria is Treponema. pallidum?

A

Spirochaete (corkscrew) shaped and does not take up gram stain easily (atypical stain)

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10
Q

What type of bacteria is Niesseria meningitidis?

A

Gram negative diplococci

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11
Q

What type of bacteria is E. coli?

A

Gram negative bacilli

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12
Q

What type of bacteria is Haemophilus influenza?

A

Gram negative bacilli

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13
Q

What type of bacteria is Helicobacter pylori?

A

Gram negative bacilli

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14
Q

What type of bacteria is Campylobacter jejuni?

A

Gram negative bacilli

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15
Q

What type of bacteria is Neisseria gonorrheae?

A

Gram negative diplococci, intracellular

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16
Q

What type of bacteria is Mycobacterium tuberculosis?

A

Atypical gram stain, Ziehl-Neelson positive for Acid-Fast Bacillus

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17
Q

What are general systemic observations indicating infection?

A

Temperature, RR/HR sensitive, BP/shock, pain/symptoms related to body system

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18
Q

Which bloods can be done to indicate infection?

A
  • White cells; neutrophilia more likely bacterial and lymphocytosis more likely viral (NOT COVID)
  • CRP
  • Cultures, gram stain
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19
Q

Common symptoms of URTI?

A 
Tonsillitis, otitis media, laryngitis, sinusitis
Cough
Sore throat
Rhinorrhoea
Nasal congestion
Sneezing
Headache
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20
Q

Common symptoms of LRTIs?

A 
Bronchitis, pneumonia
Productive cough (usually green or yellow)
Fever
Breathlessness
Chest pain
Flu-like symptoms, i.e. muscle ache
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21
Q

What are important investigations for a respiratory tract infection?

A

Sputum culture
Blood cultures
Urinary antigens for atypical pneumonias
CXR

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22
Q

Which bacteria commonly cause CAP, HAP and infective exacerbation of COPD?

A

Most common: strep. pneumoniae, haemophilus influenza
Less common: staph. aureus
Rare: legionella, mycoplasma

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23
Q

What is 1st line antibiotic for CAP? What would you add if is caused by legionella?

A

Amoxicillin, add clarithromycin

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24
Q

Which bacteria cause HAP but not CAP?

A

Pseudomonas aeruginosa & Klebsiella pneumoniae

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25
Q

Which organism causes infective exacerbations of COPD but not HAP/CAP?

A

Moraxella catarrhalis

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26
Q

What is the difference between HAP and CAP?

A

To be considered HAP, it must be acquired at least 48 hours into admission.

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27
Q

How would you treat an infective exacerbation of COPD or bronchiectasis?

A

Doxycycline & prednisolone. May later need amoxicillin.

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28
Q

What is the treatment for pulmonary TB?

A

6 months RIPE: rifampicin, isoniazid, pyrazinamide (first 2 months only), ethambutol (first 2 months only)

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29
Q

What signs point to infective carditis?

A

IE specific: splinter haemorrhages, Osler’s nodes, Janeway lesions
Non-specific: Fever, malaise, weakness, petechiae, cardiac murmur, shortness of breath

30
Q

If you suspect cardiovascular infection, what investigations should you do?

A

Blood cultures
ECG
CXR
Definitive: ECHO

31
Q

Which bacteria cause infective endocarditis?

A

Staph. aureus
Staph. epidermidis
Viridans Streptococci

32
Q

What is first line treatment for infective endocarditis?

A

IV flucloxacillin

33
Q

How should you treat IE caused by MRSA?

A

IV Vancomycin

34
Q

What signs may indicate a GI infection?

A 
Diarrhoea (bloody)
Nausea + vomiting
Abdominal pain
Fever
Rigors
Indigestion/reflux
35
Q

Which signs may indicate peritonitis?

A

Diffuse pain and tenderness
Involuntary guarding, rigidity
Rebound tenderness

36
Q

Which investigations are important for a suspected GI infection?

A

Stool culture x3 for
MC+S
Ova, Cysts and Parasites
C-urea breath test

37
Q

Which bacteria commonly cause gastroenteritis?

A

Campylobacter jejuni
Salmonella
E.coli
Shigella

38
Q

When do you need to notify public health authorities about a case of gastroenteritis?

A

Suspected food poisoning or bloody diarrhoea

39
Q

When should you give antibiotics for gastroenteritis? Which antibiotic should you give?

A

Ciprofloxacin only if known organism and severe

40
Q

Which bacteria commonly causes peptic ulcers and reflux?

A

H. pylori

41
Q

How do you eradicate H. pylori?

A

Triple therapy: PPI, amoxicillin, metronidazole

42
Q

Which symptoms/signs indicate UTI?

A

Dysuria, change in smell, cloudy urine, suprapubic tenderness/pain

43
Q

Which symptoms/signs indicate pyelonephritis?

A

Fever, rigors, N/V, loin to groin pain, writhing in pain on bed (peritonitis)

44
Q

What investigations should you do if ?UTI/pyelonephritis?

A

Urine dip

Mid-stream urine (MSU) MC&S

45
Q

What bacteria are lower UTIs caused by?

A

E. coli

Occasionally Klebsiella

46
Q

How do you treat a lower UTI?

A

Trimethoprim and nitrofurantoin then swap if needed after MC&S comes back. Different for men, women and age.

47
Q

What skin changes indicate skin infection?

A

Hot, erythematous, painful, swollen, rapidly spreading, obvious skin wound, fever, rigors

48
Q

What investigations are important for ?skin infection?

A

Wound swab MC&S

Blood cultures

49
Q

What bacteria can cause cellulitis?

A

Staph. aureus
MRSA
Strep. pyogenes (GAS - group A streptococcal disease)

50
Q

How do you manage cellulitis?

A

Draw around infection in permanent marker to monitor.

First line = flucloxacillin -> coamoxiclav

51
Q

What are symptoms/signs of an STI?

A

Asymptomatic
Sores/lumps in genital/oral/rectal area, discharge (more, consistency, smell, colour), dysparaeunia (painful sex), dysuria, lower abdominal pain, rash, fever, testicular swelling/tenderness

52
Q

What investigations would you do for STI?

A

First-void urine (FVU) nucleic amplification test (NAAT)
Swab MC&S
Serology (HIV, hepatitis, syphilis)

53
Q

Which bacteria cause chlamydia?

A

Chlamydia trachomatis

54
Q

What are complications of chlamydia?

A

Trachoma
Neonatal conjunctivitis
Reiter’s syndrome (reactive arthritis, urethritis and conjunctivitis)

55
Q

How do you treat chlamydia?

A

Doxycycline -> erythromycin

56
Q

What bacteria causes gonorrhea?

A

Neisseria gonorrhoeae

57
Q

Complications of gonorrhea?

A

Gonococcal ophthalmia neonatorum

Septic arthritis if untreated

58
Q

How do you treat gonorrhea?

A

1st line: IM Ceftriaxone

Then ciprofloxacin if sensitivity known

59
Q

What causes Trichomoniasis?

A

Trichomoniasis vaginalis protozoan

60
Q

How do you treat Trichomoniasis?

A

Metronidazole then trinidazole

61
Q

What causes syphilis?

A

Treponema pallidum

62
Q

How does syphilis progress?

A
  1. Primary: painless chancre (genital ulcer)
  2. Secondary: diffuse rash
  3. Latent: usually asymptomatic for years
  4. Tertiary: neurosyphilis & gummas (soft, benign growths)
63
Q

How do you treat syphilis?

A

1st line: IM benzathine benzylpenicillin

2: IV benzylpenicillin

64
Q

What are the signs of sepsis?

A 
Mottled/cyanosed skin 
Increased RR
Tachycardia/hypotension 
N/V
Decreased urination 
Very high or low temperature 
Rigors
65
Q

What are signs of meningitis?

A 
Non-blanching rash 
Headache 
Neck stiffness 
Fever
Photophobia/phonophobia 
Confusion/altered consciousness
66
Q

What investigations are needed if you suspect meningitis?

A

Blood cultures

Lumbar puncture analysis

67
Q

Which bacteria commonly cause sepsis?

A 
Lots!
Staph aureus
Group A Strep 
Strep. pneumoniae 
E. coli 
Neisseria meningitidis 
Pseudomonas aeruginosa
68
Q

Which antimicrobials are used to treat sepsis?

A

1st line: IV piperacillin with tazobactam (tazocin)

  • If MRSA add vancomycin
  • Blood cultures to guide narrowing
69
Q

Which bacteria cause meningitis?

A

Neisseria meningitidis (meningococcus)
Strep. pneumoniae
Haemophilus influenzae

70
Q

Antimicrobial treatment for meningitis?

A

First line: IV Benzylpenicillin (G) URGENT

Can give IM if no venous access

CC2 (7 decks)

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