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Infection > Other > Flashcards

Other Flashcards

1
Q

How do you Dx infection / organism

A 
Blood culture
Urine culture
Stool culture
Sputum culture
Wound swab
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2
Q

What should you put on form for micro

A 
Duration of Sx
Clinical info 
Allergies
Other drugs 
Pregnant or breast
Renal function 
Previous Ax tried
What test you want
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3
Q

How long do you treat UTI in young women

A

3 days

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4
Q

How long exacerbation COPD

A

7 days

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5
Q

Minor wound

A

Short

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6
Q

Septic arthritis

A

Long

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7
Q

What is a true penicillin allergy

A

Anaphylaxis

Urticarial or rash immediately after

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8
Q

When would you give penicillin if severe infection

A

If complain of GI upset or rash >72 hours

B-lactam >vancomycin if don’t have true allergy

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9
Q

Can you have co-amoxiclav if penicillin allergic

A

No

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10
Q

What is a major RF for infection

A

DM

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11
Q

What is important in the history

A 
Travel
Sexual 
Food
Contact up to 2 weeks
Antibiotics
Trauma
Occupation
Animal / pet history
Immunosuppression - DM / HIV / drugs / steroid 
IVDA
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12
Q

When do you consider sexual

A

New UTI
HIV seroconversion
Septic arthritis - gonorrhoea
Reiter’s - chlamydia

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13
Q

Trauma

A 
Bites
Athlete foot
Itchy skin
Lymphoedema
Ulcers
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14
Q

How do you investigate

A

Blood culture
Swab open wound
ASOT - strep

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15
Q

What are indications for culture

A 
High or low temp
Tachycardia
Raised WCC
Tachypnoea
Altered mental state
Hyperglycaemia but no DM 
Evidence of infection
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16
Q

When may infection / sepsis be muted

A 
DM 
Elderly
Young 
Immunocompromised 
Prosthesis - may only have pain
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17
Q

What do prosthesis tend to be infected with

A

Low grade pathogen
S.epidermis
Enterococci
Yeast

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18
Q

What is common in IVDA

A

Hep C
S.aureus
Group A strep

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19
Q

What infections common

A

Bone
Abscess
Infected DVT / PE
Endocarditis - tricuspid

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20
Q

How do you look for abscess

A

CT

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21
Q

How do you treat

A

IV fluclox
Clindamycin better strep
Longer if infected clot of abscess

22
Q

How do you diagnose virus

A

Antigen detection - PCR
Serology - IgG or IgM
NAAT

23
Q

Why don’t you do culture

A

Takes too long

Needs transported in viral medium

24
Q

When do you do microscopy

A

Film - malaria
Faeces - ova / cysts / parasites
Gram and ZN stain - bacteria/ TB
Rare for virus

25
Q

What is antigen detection

A 
ELISA - hep B surface
Rota
Adenovirus
HIV
Syphillis
26
Q

What do you do for respiratory virus

A

Immunoflurosence of NPA

27
Q

What is NAAT

A

Nucleic acid amplification

PCR if virus

28
Q

What is serology

A

IgM and IgG

Ab detection

29
Q

When is it of little use

A

Immunocompromised

30
Q

Virology

A

Will only detect tests you ask for
Serology
Antigen detection
NAAT

31
Q

What does gram stain do

A

Info about type of organism

Do on blood culture

32
Q

What can infection be mimicked by

A

Autoimmune
Drugs
Haem malignancy

33
Q

How does S.aureus bacteraemia present

A 
Skin / bone / joint infection 
Cellutlits
Joint infection 
Pneumonia
Abscess 
Metastatic
34
Q

Metastatic presentation S.aureus

A

Vertebral OM
Endocarditis
Discitis

35
Q

What does S.aureus prroduce

A

Enterotoxin - gastroenteritis

TSS1

36
Q

How do you investigate

A

Blood culture

TTE for all bacteraemia

37
Q

Other investigation

A

CT / MRI if discitis
Joint aspiration
CXR

38
Q

Why do you repeat culture

A

Show infection under control

In case its a contaminant

39
Q

How do you Rx

A

IV fluclox

40
Q

How long for

A

Minimal 14 dyas
Longer if deep seated
DO NOT discharge on OPAT

41
Q

What causes MRSA

A

B lactase production

42
Q

How do you treat MRSA

A

Vancomycin but resistance arising, doxycycline or clindamycin
Teicoplanin
Linezolid = 2nd line

43
Q

What. is S.epididermis

A

Skin commensal
Common contaminant of blood culture
Low pathogeneicty but if foreign body e.g. central line or IE can have high
Difficult to Rx with Ax

44
Q

What should you screen for in all surgical patients

A

MRSA

45
Q

How do you screen and when

A

Nasal swab + any skin lesion
Elective admission
Emergency admission

46
Q

When do you eradicate MRSA and how

A

If +ve
Nasal mupricon
Skin chlorhexidine

47
Q

What does strep. Pneumonia cause

A

Pneumonia
Otitis meda
Meningitis
Sensitive to pen

48
Q

What does strep viridian’s cause

A

IE
Normal flora of oral / throat
If isolate from culture - think endocaridits

49
Q

What does strep pyogenes cause

A 
Throat / tonsilltiis / pharyngitis
Cellulitis/ necrotising fasciitis 
Rheumatic fever
Post strep GN
Scarlet fever
Sensitive to benzypen
50
Q

What does group B strep cause

A

Neonatal sepsis / meningitis
Common commensal of female genital tract
Ax if high risk in pregnancy

51
Q

What is non-haemolytic

A

Enterococcus
GI tract
UTI / intra-abdominal abscess

52
Q

How do you Rx

A

Amoxiccilin

May need vancomycin

Infection (14 decks)

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