microbiology/ID Flashcards
What is the first line abx for c.diff infection without sepsis? What is second line abx?
Oral vancomycin is the first line treatment option for C. difficile. A 10-day course is recommended. Intravenous metronidazole would be added if there was a life-threatening infection
Oral fidaxomicin is a second line therapy for C difficile infection. It may also be used for recurrent C. difficile cases.
What abx are used in pregnancy for UTI? how long?
first-line: nitrofurantoin (should be avoided in third trimester)
second-line: amoxicillin or cefalexin
Need 7 day course
What is first line abx for meningitis and what do you add in if elderly/ immunocomp?
IV cefotaxime (first line)
IV amoxicillin is reserved for scenarios where there is suspicion of Listeria monocytogenes
First line abx for non-dessimated lyme diseae and length of course? Second line? In dessimated disease?
First line treatment of non-disseminated Lyme disease is a 21 day course of oral doxycycline,
Amoxicillin is 2 nd line
Ceftriaxone is used in disseminated disease.
Treatment should be started based on clinical suspicion as serology can take 3-8 weeks to become positive.
What is the most common cause of bronchiectasis exacerbations?
Haemophilus influenzae
What are the features of discitis? What is the most common causitive agent?
back pain
fever/ gen unwell
neurological features
Most common agent is bacterial (S.aureus)
What is used as prophylaxis for contacts of patients with meningococcal meningitis?
Oral ciprofloxacin or rifampicin
How do you treat latent TB? What is it?
Latent TB - asymptomatic and non-infectious. Have a positive tuberculin skin test/ Interferon-Gamma Release Assay (IGRA) combined with a normal CXR (can have calcified ghon complex)
3 months of isoniazid (with pyridoxine) and rifampicin, or
6 months of isoniazid (with pyridoxine)
1st line vs 2nd line abx for lyme disease?
1st line - doxycycline
2nd line - amoxicillin
management of Campylobacter jejuni?
usually self-limiting
the BNF advises treatment if severe or the patient is immunocompromised eg high fever, bloody diarrhoea, >8 stools a day or sx lasted >7 days
1st line = clarithromycin
What are the most common micro organisms responsible for otitis media?
Streptococcus pneumonaie, Haemophilus influenzae and Moraxella catarrhalis
1st line abx for msra?
vancomycin
microorganism responsible for epiglottitis?
Hib - haemophilus influenza b
What is diptheria?
Diphtheria is a bacterial infection caused by Corynebacterium diphtheriae which primarily infects the throat and upper airways, leading to difficulty in breathing and swallowing. A grey coating surrounding the tonsils, fever, and cervical lymphadenopathy are classic symptoms of this disease
What is dengue fever?
viral illness
transmitted via mosquitoes
high fever, headache, pain behind the eyes, joint pain, rash, mild bleeding.
What is typhoid/ paratyphoid? (enteric fever)
caused by different strains of Salmonella. Typhoid and Paratyphoid fevers present with prolonged high-grade fever associated with relative bradycardia, malaise, headache, cough, constipation, rose spots
What is the most common causitive agent of COPD exacerbation
Haemophilus influenzae
Mycoplasma pneumonia presentation?
Stereotypical history of mycoplasma pneumonia: worsening flu-like symptoms and a dry cough. Erythema multiforme is associated
Legionella presentation?
Classic exam q - pick up on holidy via A/C
lymphopaenia
hyponatraemia
pleural effusion
What commonly causes pneumonia post influenza?
Staphylococcus aureus
Treatment can vary
What protozoan infections are associated with cat litter? Mx of this?
Toxoplasma gondii
Immunocompetent patients with toxoplasmosis don’t usually require treatment
metronidazole if immunocomp
What features would you expect from campylobacter infection? mx of this?
Campylobacter infection is the most common bacterial cause of infectious intestinal disease in the UK. Typically have prodrome and bloody diarrhoea. The incubation period for Campylobacter is 1-6 days
Associated with bbqs
Campylobacter can mimic appendicitis
clarithromycin
What GI infection causes fat malabsorption (greasy stools)?
giargia
What causes infectious mono?
AKA glandular fever is caused by EBV
Which malarial prophylaxis can cause neuropsychiatric issues?
Mefloquine
What is used as a prophylactic abx in recurrent COPDE?
azithromycin
Mx of legionella?
Macrolides such as clarithromycin are used to treat Legionella
What is the abx of choice for pregnant women if they are penicillin allergic and being treated for eg cellulitis
Erythromycin is the antibiotic of choice for cellulitis in pregnancy if the patient is penicillin allergic
CLarithromycin is CI!!!
How does leptospirosis infection present?
AKA weils disease
presents with fever, headache, chills, muscle aches and vomiting. It can also cause jaundice and AKI.
It is associated with exposure to contaminated water or soil eg sewage worker, fisherman
What is in co-trimaxazole?
Co-trimoxazole contins trimethoprim and therefore should never be prescribed with methotrexate
used for Pneumocystis jiroveci pneumonia (PCP) - which is a fungal infection
abx for shigella and salmonella?
ciprofloxacin
Which gastrointestinal infection has the shorted incubation period?
staph aureus
Characterisitics of shigella infection?
Salmonella enteritidis has an incubation period of 12 - 48 hours and is usually associated with severe vomiting and a high fever. It can cause bloody diarrhoea.
What anitbodies are found for EBV on bloods?
heterophile antibodies
What are the different SE of TB meds?
Rifampicin
potent liver enzyme inducer
hepatitis, orange secretions
flu-like symptoms
Isoniazid
peripheral neuropathy: prevent with pyridoxine (Vitamin B6)
hepatitis, agranulocytosis
liver enzyme inhibitor
Pyrazinamide
hyperuricaemia causing gout
arthralgia, myalgia
hepatitis
Ethambutol
optic neuritis: check visual acuity before and during treatment
dose needs adjusting in patients with renal impairment
Features of malaria?
hepatospleenomegaly, jaundice, fever, low platelets
What is chagos?
From the Americas from redulivid bugs
get sx 10-20 yrs later: irregular HR, HF, cardiac arrest, can’t swallow as oeseophagus enlarges, enlagred colon
What is yellow fever?
Carried by mosquito in Africa and South america
fever, muscle pain, N+V for 3 days
slow pulse with elevated temp = fagets sign
AIDs defining illnes?
Invasive cervical cancer
Kaposi sarcoma
Lymphoma: Burkitt
Mycobacterial infections eg TB
Recurrent bacterial pneumonia
HIV-associated dementia
coccidioidomycosis
Pneumocystis jirovecil pneumonia (PCP) !!!
histoplasmosis
Cerebral toxoplasmosis
Extrapulmonary cryptococcosis (especially cryptococcal meningitis)
Cryptosporidiosis
Esophageal candidiasis
Herpes simplex virus causing any of the following: ulcer for >1m, bronchitis, pneumonitis, oeseophagitis
Mycobacterium avium complex
Cytomegalovirus infection of any of the following: retina/ colon, Any other organ, excluding the liver, spleen, or lymph nodes
How does schistosomiasis present?
fever, flu sx, rash, cough, hepatosplenomegaly, in africa caused by flukes
years later can cause cystitis, blood diarrhoea, lower limb paralysis
What is onchocerciasis?
in subsaharan africa/ south america
parasite
causes blindness, skin changes, nodules, lichenification of skin
notifiable diseases?
acute encephalitis Routine
Acute infectious hepatitis (A/B/C) Urgent
Acute meningitis Urgent
Acute poliomyelitis Urgent
Anthrax Urgent
Botulism Urgent
Brucellosis Routine. Urgent if acquired in UK
Cholera Urgent
COVID-19 Routine
Diphtheria Urgent
Enteric fever (typhoid or paratyphoid fever) Urgent
Food poisoning Routine. Urgent if part of a cluster or outbreak
Haemolytic uraemic syndrome (HUS) Urgent
Infectious bloody diarrhoea Urgent
Invasive group A streptococcal disease Urgent
Legionnaires’ disease Urgent
Leprosy Routine
Malaria Routine. Urgent if acquired in UK
Measles Urgent
Meningococcal septicaemia Urgent
Mpox (previously known as monkeypox) Urgent
Mumps Routine
Plague Urgent
Rabies Urgent
Rubella Routine
Severe Acute Respiratory Syndrome (SARS) Urgent
Scarlet fever Routine
Smallpox Urgent
Tetanus Routine. Urgent if associated with injecting drug use
Tuberculosis Routine. Urgent if healthcare worker, or suspected cluster or multi-drug resistant
Typhus Routine
Viral haemorrhagic fever (VHF) Urgent
Whooping cough Urgent if diagnosed in acute phase. Routine in later diagnosis
Yellow fever
Dengue?
A mosquito-borne tropical disease that causes fever, arthralgias, and headache. Onset of symptoms occurs 2 to 10 days after infection. A hemorrhagic phase characterized by bleeding, shock, and organ dysfunction can follow the initial phase. Treatment is largely supportive.
Japanese encephalitis?
mosquito-borne viral disease endemic in Asia and the Western Pacific.
range from asymptomatic disease to acute encephalitis/ neurological features,
following a short period of non-specific febrile illness. Seizures are common, especially in children. acute psychosis and spastic or flaccid paralysis.
Lassa?
A viral hemorrhagic fever caused by Lassa virus. Most cases are mild and cause fever, malaise, and headache. Can cause pharyngitis, cough, retrosternal chest pain, and severe bleeding. Deafness is a common complication.
classical exam question features of strep pneumoniae?
rust coloured sputum
lobular pneumonia
What is tamiflu drug name?
oseltamivir
Cause of gas gangrene?
There are multiple causes of gas gangrene but often clostrida species, particularly clostridium perfringens are implicated
56 year old hill walker, rash, then bilateral wrist arthritis, other wise well ?cause
lymes disease
