Other

Question 1

How do you Dx infection / organism

Answer 1

Blood culture
Urine culture
Stool culture
Sputum culture
Wound swab

Question 2

What should you put on form for micro

Answer 2

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

Question 3

How long do you treat UTI in young women

Answer 3

3 days

Question 4

How long exacerbation COPD

Answer 4

7 days

Question 5

Minor wound

Answer 5

Short

Question 6

Septic arthritis

Answer 6

Long

Question 7

What is a true penicillin allergy

Answer 7

Anaphylaxis

Urticarial or rash immediately after

Question 8

When would you give penicillin if severe infection

Answer 8

If complain of GI upset or rash >72 hours

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

Question 9

Can you have co-amoxiclav if penicillin allergic

Answer 9

No

Question 10

What is a major RF for infection

Answer 10

DM

Question 11

What is important in the history

Answer 11

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

Question 12

When do you consider sexual

Answer 12

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

Question 13

Trauma

Answer 13

Bites
Athlete foot
Itchy skin
Lymphoedema
Ulcers

Question 14

How do you investigate

Answer 14

Blood culture
Swab open wound
ASOT - strep

Question 15

What are indications for culture

Answer 15

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

Question 16

When may infection / sepsis be muted

Answer 16

DM 
Elderly
Young 
Immunocompromised 
Prosthesis - may only have pain

Question 17

What do prosthesis tend to be infected with

Answer 17

Low grade pathogen
S.epidermis
Enterococci
Yeast

Question 18

What is common in IVDA

Answer 18

Hep C
S.aureus
Group A strep

Question 19

What infections common

Answer 19

Bone
Abscess
Infected DVT / PE
Endocarditis - tricuspid

Question 20

How do you look for abscess

Answer 20

CT

Question 21

How do you treat

Answer 21

IV fluclox
Clindamycin better strep
Longer if infected clot of abscess

Question 22

How do you diagnose virus

Answer 22

Antigen detection - PCR
Serology - IgG or IgM
NAAT

Question 23

Why don’t you do culture

Answer 23

Takes too long

Needs transported in viral medium

Question 24

When do you do microscopy

Answer 24

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

Question 25

What is antigen detection

Answer 25

``` ELISA - hep B surface Rota Adenovirus HIV Syphillis ```

Question 26

What do you do for respiratory virus

Answer 26

Immunoflurosence of NPA

Question 27

What is NAAT

Answer 27

Nucleic acid amplification | PCR if virus

Question 28

What is serology

Answer 28

IgM and IgG | Ab detection

Question 29

When is it of little use

Answer 29

Immunocompromised

Question 30

Virology

Answer 30

Will only detect tests you ask for Serology Antigen detection NAAT

Question 31

What does gram stain do

Answer 31

Info about type of organism | Do on blood culture

Question 32

What can infection be mimicked by

Answer 32

Autoimmune Drugs Haem malignancy

Question 33

How does S.aureus bacteraemia present

Answer 33

``` Skin / bone / joint infection Cellutlits Joint infection Pneumonia Abscess Metastatic ```

Question 34

Metastatic presentation S.aureus

Answer 34

Vertebral OM Endocarditis Discitis

Question 35

What does S.aureus prroduce

Answer 35

Enterotoxin - gastroenteritis | TSS1

Question 36

How do you investigate

Answer 36

Blood culture | TTE for all bacteraemia

Question 37

Other investigation

Answer 37

CT / MRI if discitis Joint aspiration CXR

Question 38

Why do you repeat culture

Answer 38

Show infection under control | In case its a contaminant

Question 39

How do you Rx

Answer 39

IV fluclox

Question 40

How long for

Answer 40

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

Question 41

What causes MRSA

Answer 41

B lactase production

Question 42

How do you treat MRSA

Answer 42

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

Question 43

What. is S.epididermis

Answer 43

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

Question 44

What should you screen for in all surgical patients

Answer 44

MRSA

Question 45

How do you screen and when

Answer 45

Nasal swab + any skin lesion Elective admission Emergency admission

Question 46

When do you eradicate MRSA and how

Answer 46

If +ve Nasal mupricon Skin chlorhexidine

Question 47

What does strep. Pneumonia cause

Answer 47

Pneumonia Otitis meda Meningitis Sensitive to pen

Question 48

What does strep viridian's cause

Answer 48

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

Question 49

What does strep pyogenes cause

Answer 49

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

Question 50

What does group B strep cause

Answer 50

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

Question 51

What is non-haemolytic

Answer 51

Enterococcus GI tract UTI / intra-abdominal abscess

Question 52

How do you Rx

Answer 52

Amoxiccilin | May need vancomycin