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MS3 - Microbiology > Respiratory infections > Flashcards

Respiratory infections Flashcards

1
Q

Neisseria meningitidis source?

A

Lives in the nose. normal commensals

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2
Q

what group of pathogens does Neisseria meningitidis belong to?

A

G neg diplococci.

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3
Q

Neisseria meningitidis causes what diseases?

A

Cause meningitis and septicaemia.

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4
Q

Haemophilus influenzae source

A

nose.

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5
Q

what group of pathogens does Haemophilus influenzae belong to?

A

G neg cocco-bacilli.

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6
Q

Haemophilus influenzae causes what diseases?

A

Cause otitis media (children) and pneumonia (adults).

  • Type b (“Hib”)– (capsulated) causes invasive disease in children including
    meningitis
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7
Q

Strep pneumonia source

A

nose

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8
Q

Strep pneumonia what group of pathogens does it belong to?

A

G pos (diplo)cocci.

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9
Q

strep pneumonia causes what diseases?

A
  • otitis media (children)
  • pneumonia (children and elderly adults)
  • invasive disease including meningitis.
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10
Q

Moraxella (Branhamella) catarrhalis source

A

nose.

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11
Q

what group of pathogens does Moraxella (Branhamella) catarrhalis belong to?

A

G neg diplococci (kidney bean shaped).

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12
Q

Moraxella (Branhamella) catarrhalis causes what diseases?

A
  • otitis media in children

- sinusitis + COPD in adults.

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13
Q

what type of abx is Cefotaxamine

A

3rd generation cephalosporins,

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14
Q

Cefotaxamine used for what types of bacteria?

A

Broad spectrum
I. especially good for Gram negatives (Neisseria, Haemophilus),

II. good for some Gram positives (Most Streptococci incl pneumococci, not Staph)

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15
Q

Cefotaxamine route of administration

A

IV

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16
Q

Cefotaxamine CSF penetration?

A

Good CSF penetration.

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17
Q

what type of abx is Amoxycillin

A

Broad spectrum penicillins.

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18
Q

Amoxycillin used for what types of bacteria?

A

Broad spectrum penicillins.

broad spectrum, activity against Gram negatives as well as positives.

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19
Q

route of administration of Amoxycillin

A

PO

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20
Q

Amoxycillin co-administrated with?

A

Can be given with betalactamase inhibitors (Clavulanic acid) to impede resistance: Coamoxyclav/Augmentin

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21
Q

Anthonisen criteria for abx for infective exacerbation of COPD?

A

Antibiotic therapy indicated if two of:

  • Increased breathlessness
  • Increased sputum volume
  • Increased sputum purulence
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22
Q

Likely pathogens for infective COPD?

A
  • 40% of acute exacerbations are viral!

- may have colonisation of the LRT with organisms normally found in the URT such as H. influenzae, M. cattarhalis.

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23
Q

Abx for infective COPD?

A

Give amoxicillin or a tetracycline

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24
Q

Influenza caused bronchitis treatment

A
  • Amantidine, rimantidine (interfere with virus uncoating and assembly)
  • Neuranimidase inhibitors: inhaled zanamivir + oral oseltamivir
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25
Sputum culture useful for which pathogens?
TB or Legionella only
26
Throat swab useful for which pathogens?
Influenza PCR
27
BAL
Bronchio-alveolar lavage; optimal sample but only in severe cases since invasive
28
Urine culture useful for which pathogens?
Legionella | S.pneumoniae
29
Assessing severity of CAP
CURB65
30
CURB65 components
- Confusion (AMT of 8 or less) - Urea raised >7 mmol/l - Respiratory rate > 30 / min - SBP<90 mmHg +/- DBP <60 mmHg - 65 and over
31
CURB65 interpretation in hospital
≥3 - Severe pneumonia (mortality 22%, admit to hospital) = 2 - Non-severe , (mortality 9.2%, consider admission) 0 or 1 - Non-severe (mortality 1.5%, treat at home)
32
CRB65 interpretation in community
≥ 3 Urgent Hospital admission 1 or 2 Hospital referral and assessment 0 Treat in community
33
Typical pneumonia anatomical distribution
Often lobar
34
Atypical pneumonia anatomical distribution
Often multisystem, multilobar
35
Typical pneumonia age group
older patients, less nasty pathogens
36
Atypical pneumonia age group
younger patients
37
Abx for typical pneumonia?
Amoxicillin sensitive, Sometimes macrolide sensitive
38
Abx for atypical pneumonia?
Amoxicillin resistant, Macrolide sensitive
39
Common typical pneumonia pathogens
Streptococcus pneumoniae
40
Common atypical pneumonia pathogens
Mycoplasma, Chlamydia, Coxiella, Legionella
41
Aspiration pneumonia cause
Inhalation of material (eg food); | Usually neurological problem predisposing
42
Aspiration pneumonia affects which parts of the lung
Commonly affects posterior segment of right upper lobe
43
Aspiration pneumonia complication
Can lead to abscess formation
44
Aspiration pneumonia mx
- penicillin or cephalosporin | - PLUS metronidazole
45
Nosocomial pneumonia def
hospital acquired pneumonia
46
HAP management if a patient is not already on an abx?
co-amoxiclav or cefuroxime
47
HAP management if a patient is already on an abx?
cefotaxime or ceftriaxone
48
Pathogens for infected bronchiectasis/cystic fibrosis
Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis and Pseudomonas aeruginosa
49
RFs for TB reactivation?
I. HIV II. Immunosuppressive drugs III. Age: very young; very old IV. Poor nutrition
50
Histological findings of TB?
Granulomata with central caseous necrosis
51
Mantoux test used instead of which test?
used instead of heaf test (not used anymore)
52
Mantoux test procedure
killed MTB, mash it up, inject into skin
53
Mantoux test interpretation?
-ive: no reaction in skin | +ive: after 3 days a rash in the injected area/necrosis
54
Problems with Mantoux test
false +ive if BCG vaccinated (poor specificity) | false -ive if inactive TB
55
IGRA test?
Interferon Gamma Release Assay for latent TB
56
IGRA procedure
ESAT6 and CFP10 genes added to blood and and see how much interferon gamma they produce
57
Limitation of IGRA
ESAT6 and CFP10 genes also present in non tuberculosis mycobacteria
58
IGRA advantage over mantoux?
dont show a false +ive if the person had a BCG vaccine
59
NICE guidelines for management of latent TB?
Step 1: If positive Mantoux or IGRA, then assess for active infection Step 2: if no active, but high RFs, give either: - 3 months of isoniazid and rifampicin or - or 6 months of isoniazid
60
MDR-TB
- Multidrug Resistant TB | - strains of tuberculosis that are resistant to at least the two main first-line TB drugs - isoniazid and rifampicin.
61
XDR-TB
- Extensive Drug Resistant TB is MDR-TB that is also resistant to three or more of the six classes of second-line drugs.

MS3 - Microbiology (11 decks)

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