Sepsis

Question 1

What is sepsis?

Answer 1

Life threatening organ dysfunction caused by dysregulated host response to infection

Question 2

What are the elements of the qSOFA score?

Answer 2

RR > 22
Altered cognition
Systolic BP < 100

Question 3

What is the most common candida species?

Answer 3

Candida albicans

Question 4

What is the mechanism of action of triazoles (fluconazole etc)?

Answer 4

Inhibition of C-14alpha demethylase required for ergosterol synthesis

Question 5

What is the mechanism of action of polyenes (amphotericin)?

Answer 5

Binds to sterols in cell membrane to increase membrane permeability and lead to pore formation

Question 6

What is the mechanism of action of echinocandins (capsofungin)?

Answer 6

Inhibits synthesis of beta-1,3-D-glucan to inhibit cell wall synthesis

Question 7

Which candida can’t be treated with echinocandins?

Answer 7

c. parapsilosis

Question 8

Which candida can’t be treated with fluconazole?

Answer 8

c. glabrata

Question 9

Which antifungal is first line therapy for candida glabrata?

Answer 9

Caspofungin

Question 10

Which antifungal is first line therapy for candidaemia in non neutropaenic patients?

Answer 10

Fluconazole

Question 11

What is the benefit of liposomal amphotericin B vs conventional amphotericin B?

Answer 11

Less nephrotoxicity and infusion reaction, better CSF penetration

Question 12

What is the dosing of caspofungin?

Answer 12

75mg IV loading dose followed by 50mg daily

Question 13

What is the main issue with caspofungin?

Answer 13

Drug interactions

Question 14

Which antifungal is first line therapy for candidaemia in neutropaenia/unstable patients?

Answer 14

Caspofungin

Question 15

Which gene gives MRSA?

Answer 15

Mec A

Question 16

What is the mechanism of resistance of MRSA?

Answer 16

Makes a penicillin binding protein with poor affinity for the beta lactam antibiotics