Pharmacology and microbiology Flashcards
Pathogen - bronchiolitis
Respirtaory synctal virus (RSV)
Pathogen - UTI in children
E. coli (responsible for around 80% of cases)
Proteus
Pseudomonas
Antibiotic UTI children > 3 months?
Trimethoprim
Nitrofurantoin
Cefalexin
Amoxicillin
Management bacterial tonsilitis
- Oral phenoxymethylpenicillin (penicillin V?) for 5 or 10 days
- Clarithomycin or erythromycin(if penicillin allergic)5 days
Pathogen bacterial tonsilitis
GABS Group A Beta-haemolytic streptococcus
S.pyogenes
Pathogen epiglottitis
Haemophilus influenzae type B
Management of epiglottitis
Endotracheal intubation (ENT, anaesthesia)
IV antibiotics (e.g. ceftriaxone)
Steroids (i.e. dexamethasone)
Management of generalised tonic-clonic seizures?
- Sodium valproate
- Lamotrigine or carbamazepine
Management focal seizures?
- Carbamazepine or lamotrigine
- Sodium valproate or levetiracetam
Management of absence seizures?
- Sodium valproate or ethosuximide
Management atonic seizures?
- Sodium valproate
- Lamotrigine
What epilepsy syndrome benefits from ketogenic diet?
Lennox-Gastaut syndrome
Management juvenile myoclonic epilepsy
- Sodium valproate
- Lamotrigine, levetiracetam or topiramate
Management infantile spasms (west syndrome)
- Prednisolone or Vigabatrin
Pathogen most likely child or adult with pneumonia
Strep pneumoniae
treat with amoxicillin
macrolide if pen alllergic
Pathogen most likely child with moderate chronic pneumonia
Chlamydophila pneumoniae
treat with macrolides eg erythromycin
Pathogen most likely pneumonia - cheap hotel holiday and hyponatraemia
Legionella pneumophila.
hyponatraemia caused by SIADH
treat with macrolides eg erythromycin
Pathogen most likely pneumonia - parrot owner
Chlamydia pisttaci
treat with macrolides eg erythromycin
Pathogen most likely pneumonia with target lesion rash and nuerological symptoms
mycoplasma pneumoniae
treat with macrolides eg erythromycin
Pathogen most likely pneumonia farmer with flu like illness
Coxella burnetti
treat with macrolides eg erythromycin
Pathogen most likely pneumonia in alcohol dependence
Klebsiella pneumoniae
Bacterial meningitis 0-3 months
- Group B Streptococcus (most common cause in neonates)
- E. coli
- Listeria monocytogenes
Bacterial meningitis 3 months-6 years
- Neisseria meningitidis
- Streptococcus pneumoniae
- Haemophilus influenzae
Bacterial meningitis 6-60 years
- Neisseria meningitidis
- Streptococcus pneumoniae
Bacterial meningitis >60 years
- Streptococcus pneumoniae
- Neisseria meningitidis
- Listeria monocytogenes
Meningitis in immunocompromised
listeria monocytogenes
Children in community meningitis initial management
Benzylpenicillin IM or IV
< 1 year – 300mg
1-9 years – 600mg
> 10 years and adults – 1200mg
Meningitis initial empirical therapy < 3 months
IV cefotaxime + amoxicillin (or ampicillin)
Meningitis initial empirical therapy 3 months-50 years
IV cefotaxime
Meningitis initial empirical therapy > 50 years
IV cefotaxime + amoxicillin (or ampicillin)
Meningitis management - listeria
IV amoxicillin (or ampicillin)
+ gentamicin
When should dexamethasone be given for meningitis
Give if lumbar puncture reveals:
- frankly purulent CSF
-CSF white blood cell count greater than 1000/microlitre
- raised CSF white blood cell count with protein concentration greater than 1 g/litre
- bacteria on Gram stain
Withhold if:
- septic shock
- meningococcal
- septicaemia
immunocompromised
Management meningococcal meningitis
IV benzylpenicillin or cefotaxime
Post exposure prophylaxis bacterial meningitis
Ciprofloxacin single dose
This risk is highest for people that have had close prolonged contact within the 7 days prior to the onset of the illness
Most common pathogen encephalitis in children and adults
herpes simplex HSV-1 from cold sores
Most common pathogen encephalitis in neonates
herpes simplex type 2 (HSV-2) from genital herpes, contracted during birth.
think “been passed on 2”
Management ?encephalitis
aciclovir (covers HSV and varicella zoster)
Management CMV encephalitis
Ganciclovir
Two most common bacterial causes of otitis externa?
- pseudomonas aerginosa
- staphlococcus aureus
management of otitis externa
mild
1. acetic acid drops 2%
moderate:
1. Topical abtibiotic and steroid eg:
Otomize spray (Neomycin, dexamethasone and acetic acid)
Fungal:
1. Clotrimazole ear drops
Most common pathogen and others : otitis media
Streptococcus pneumoniae
Other common causes include:
Haemophilus influenzae
Moraxella catarrhalis
Staphylococcus aureus