Radom finish Flashcards
Describe measles appearence
Measles is a paramyxovirus. Koplik spots are small bright red spots with a white centre on the buccal mucosa that precede the measles rash by 1-2 days and are pathognomonic for measles. Measles present initially with cough, coryza and conjunctivitis (three 3s) then the Koplik spots. Eventually a maculopapular rash develops, beginning at the head/neck and spreading downwards.
Describe drug exanthem
Generalised itch rash, confluenct, macular/papular rash (morbilliform),
Cell meediated immune reaction
Rash after abx a few days after (type 4)
More severe reaction if they take drug again
Tinea paedis causative organism
genus Trichophyton
Comps of acne rosacea
blepharitis, keratitis, conjunctivitis
Rhinophyma
AChilles tendon rupture RFs
Quinolone use e.g. cipro
Hypercholesterolaemia (tendonn xanthoma)
Achilles tendon test
Simmon’s test
DM stages and signs on fundoscopy
Background
Microaneurysms (small red dots)
Blot/flame haemorrhages
Hard exudate (forced out of microaneuysms), vision effected if on macula
Pre proliferative
Also with cotton wool spots (soft exudate)
Venous loops
Proliferative
New vessels - more likely to leak and bleed
Pre-retinal/ vitreous haemorrhage - inside eye (everything hazy)
Pre-rentinal fibrosis
Tractional retinal detachment
Hypertensive retinopathy stages
Caused by vasoconstriction, arteriosclerosis and increased vascular permeability (grades)
1- To torture someoen you - tortuosity of retinal arterioles/ narrowing (EARLY)
2- Nip em (AV nipping) - Focal constriction, exxagerated arterial light reflex
3- Flame em -Flame shaped haemorrhages, exudates (cotton wool spots
4- Pap em - papilledema/ neuroretinal edema
Infeciton model
Pathogen
Patient MoI
Infection
Management Outcome
Infection patient factor
Person Age Gender Co morbid Physiological state Social factors Time Calendar time Relative time Place/ environment Current Recent e.g. travel/ hospital
Mechanism of infection for pressure sores
Contiguous
Give e.g.s gram pos cocci
Staph aurea Softissue and skin Cellulitis Prosthesis Joint and hip Forms biofilm 4-6week of IV abx Fluclox Staph coag neg e.g. Epidermidis Often contaminants - not as important Can be bone and joint infections Streptocci Pneumoniae CAP Meningitis A haemolytic e.g. Strep pneumoniae and strep viridans in mouth B haemolytic e.g. Strep pyogenies (group A strep) Bacterial throat infection Immunological sequelate Heart valve Nephritis Toxic shock syndrome Generally penicillin (flucloxacillin)
gram pos bacilli
C Diff Spore forming C profringes Gas gangrene Bacillus anthrosis Anthrax Skin lesion - necrostic Haemorragic pulmonary disease Bio terrorist From animals? Lactobacillus Commensals Bacillus sareus?? Rice Corynebacterium Metronidazole - anaerobic
Gram neg bacilli
E coli Klebsiella spp Salmonella spp Legionella spp Proteus spp Enterobacterioracae^ Billiary UTI Peritonitis Liver abccess H pylori Psudomonas Different abx H influenzae Colloniseresp tract post infection e,g. CF Hot tub skin infection Clavuronic acid - inhibits lactamase In co-amoxiclav Also gentimicin (no gram pos action at all)
Gram neg cocci
N meningitis
N gonnarhea
Ceftrixane
What are ESBL
xtened spectrum beta-lactamase - Meropenem,
E coli, Klebsiella
Prinicples of antimicrobial stewardship
Permission for certain abx
• Appropriate use of antibiotics
• Minimise toxicity and adverse outcomes
• Optimal clinical outcomes
• Reduce the costs of health care for infections
• Limit the selection for antimicrobial resistant strains
Hospital guidelines
Define sepsis
life-threatening organ dysfunction caused by a dysregulated host response to infection
Define septic shock
a subset of sepsis with profound circulatory, cellular and metabolic abnormalities, associated with greater risk of mortality than sepsis alone
Indications whether an infection is bacterial or viral
Neutophils - bacterial
Lymphocytes - viral
CRP >150 tends to be bacterial
Abx for infectioned diabetic foot ulcer
Tazocin and carbapenem
Abx atypical pneumonia
Doxy/fluroquinolone
E.g. of quinolone
Cipro
Treatment of gonorrhea
IM/IV cefrixaone
