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CC2 > Microbiology and Antibiotic Therapy > Flashcards

Microbiology and Antibiotic Therapy Flashcards

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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
Which organism causes infective exacerbations of COPD but not HAP/CAP?
Moraxella catarrhalis
26
What is the difference between HAP and CAP?
To be considered HAP, it must be acquired at least 48 hours into admission.
27
How would you treat an infective exacerbation of COPD or bronchiectasis?
Doxycycline & prednisolone. May later need amoxicillin.
28
What is the treatment for pulmonary TB?
6 months RIPE: rifampicin, isoniazid, pyrazinamide (first 2 months only), ethambutol (first 2 months only)
29
What signs point to infective carditis?
IE specific: splinter haemorrhages, Osler's nodes, Janeway lesions Non-specific: Fever, malaise, weakness, petechiae, cardiac murmur, shortness of breath
30
If you suspect cardiovascular infection, what investigations should you do?
Blood cultures ECG CXR Definitive: ECHO
31
Which bacteria cause infective endocarditis?
Staph. aureus Staph. epidermidis Viridans Streptococci
32
What is first line treatment for infective endocarditis?
IV flucloxacillin
33
How should you treat IE caused by MRSA?
IV Vancomycin
34
What signs may indicate a GI infection?
``` Diarrhoea (bloody) Nausea + vomiting Abdominal pain Fever Rigors Indigestion/reflux ```
35
Which signs may indicate peritonitis?
Diffuse pain and tenderness Involuntary guarding, rigidity Rebound tenderness
36
Which investigations are important for a suspected GI infection?
Stool culture x3 for MC+S Ova, Cysts and Parasites C-urea breath test
37
Which bacteria commonly cause gastroenteritis?
Campylobacter jejuni Salmonella E.coli Shigella
38
When do you need to notify public health authorities about a case of gastroenteritis?
Suspected food poisoning or bloody diarrhoea
39
When should you give antibiotics for gastroenteritis? Which antibiotic should you give?
Ciprofloxacin only if known organism and severe
40
Which bacteria commonly causes peptic ulcers and reflux?
H. pylori
41
How do you eradicate H. pylori?
Triple therapy: PPI, amoxicillin, metronidazole
42
Which symptoms/signs indicate UTI?
Dysuria, change in smell, cloudy urine, suprapubic tenderness/pain
43
Which symptoms/signs indicate pyelonephritis?
Fever, rigors, N/V, loin to groin pain, writhing in pain on bed (peritonitis)
44
What investigations should you do if ?UTI/pyelonephritis?
Urine dip | Mid-stream urine (MSU) MC&S
45
What bacteria are lower UTIs caused by?
E. coli | Occasionally Klebsiella
46
How do you treat a lower UTI?
Trimethoprim and nitrofurantoin then swap if needed after MC&S comes back. Different for men, women and age.
47
What skin changes indicate skin infection?
Hot, erythematous, painful, swollen, rapidly spreading, obvious skin wound, fever, rigors
48
What investigations are important for ?skin infection?
Wound swab MC&S | Blood cultures
49
What bacteria can cause cellulitis?
Staph. aureus MRSA Strep. pyogenes (GAS - group A streptococcal disease)
50
How do you manage cellulitis?
Draw around infection in permanent marker to monitor. | First line = flucloxacillin -> coamoxiclav
51
What are symptoms/signs of an STI?
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
What investigations would you do for STI?
First-void urine (FVU) nucleic amplification test (NAAT) Swab MC&S Serology (HIV, hepatitis, syphilis)
53
Which bacteria cause chlamydia?
Chlamydia trachomatis
54
What are complications of chlamydia?
Trachoma Neonatal conjunctivitis Reiter’s syndrome (reactive arthritis, urethritis and conjunctivitis)
55
How do you treat chlamydia?
Doxycycline -> erythromycin
56
What bacteria causes gonorrhea?
Neisseria gonorrhoeae
57
Complications of gonorrhea?
Gonococcal ophthalmia neonatorum | Septic arthritis if untreated
58
How do you treat gonorrhea?
1st line: IM Ceftriaxone | Then ciprofloxacin if sensitivity known
59
What causes Trichomoniasis?
Trichomoniasis vaginalis protozoan
60
How do you treat Trichomoniasis?
Metronidazole then trinidazole
61
What causes syphilis?
Treponema pallidum
62
How does syphilis progress?
1. Primary: painless chancre (genital ulcer) 2. Secondary: diffuse rash 3. Latent: usually asymptomatic for years 4. Tertiary: neurosyphilis & gummas (soft, benign growths)
63
How do you treat syphilis?
1st line: IM benzathine benzylpenicillin | 2: IV benzylpenicillin
64
What are the signs of sepsis?
``` Mottled/cyanosed skin Increased RR Tachycardia/hypotension N/V Decreased urination Very high or low temperature Rigors ```
65
What are signs of meningitis?
``` Non-blanching rash Headache Neck stiffness Fever Photophobia/phonophobia Confusion/altered consciousness ```
66
What investigations are needed if you suspect meningitis?
Blood cultures | Lumbar puncture analysis
67
Which bacteria commonly cause sepsis?
``` Lots! Staph aureus Group A Strep Strep. pneumoniae E. coli Neisseria meningitidis Pseudomonas aeruginosa ```
68
Which antimicrobials are used to treat sepsis?
1st line: IV piperacillin with tazobactam (tazocin) - If MRSA add vancomycin - Blood cultures to guide narrowing
69
Which bacteria cause meningitis?
Neisseria meningitidis (meningococcus) Strep. pneumoniae Haemophilus influenzae
70
Antimicrobial treatment for meningitis?
First line: IV Benzylpenicillin (G) URGENT | Can give IM if no venous access

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