Sepsis CLASP week

Question 1

What gram positive organisms do not take up the gram stain and look pink/red?

Answer 1

Neisseria gonorrhoeae

Question 2

What is the cell wall of gram positive organisms made of?

Answer 2

peptidoglycan layer and plasma membrane

Question 3

What organism is present when the catalase is positive or negative?

Answer 3

+ve = staphylococcus
-ve = streptococcus, enterococcus

Question 4

How is staphylococcus differentiated with coagulase?

Answer 4

+ve = s. aureus
-ve = s. epidermis

Question 5

How is streptococcus differentiated with haemolysis?

Answer 5

alpha (partial) = s. virdians, s. pneumoniae
beta (complete) = group a strep, s. pyogenes

Question 6

What drug is usually given for s. aureus sepsis?

Answer 6

IV fluclox.
IV vancomycin if allergic / MRSA sepsis

Question 7

What are staph negative bugs resistant to?

Answer 7

Flucloxacillin

Question 8

Where does streptococci not cause problems and why?

Answer 8

In the GI tract because it is a commensal bacteria.

Question 9

What organism is indicated in gamma haemolysis?

Answer 9

enterococci

Question 10

What bacteria is most likely to cause endocarditis and what scoring system is used?

Answer 10

S. viridans - Duke’s criteria

Question 11

What illnesses does strep. pneumonia cause?

Answer 11

Otitis, meningitis, pneumonia

Question 12

Where does enterococcus cause problems?

Answer 12

In the intestines

Question 13

What is the drug of choice for enterococcus?

Answer 13

amoxicillin - vancomycin if allergic

Question 14

What are the 4 categories for gram positive bacilli?

Answer 14

~ clostridium
~ corynebacterium
~ bacillus
~ listeria

Question 15

What are some serious gram negative bacteria which cause sepsis?

Answer 15

1. E. Coli
2. Pseudomonas aeruginosa
3. Neisseria meningitidis
4. N. gonorrhoeae

Question 16

What is unique about gram negative bacteria?

Answer 16

~ the outer membrane of the cell wall contains endotoxin
~ the periplasmic space which is the b-lactamase location

Question 17

What bacteria causes neonatal meningitis?

Answer 17

E. coli

Question 18

What needs to be monitored daily on gentamicin (only given IV)?

Answer 18

Renal function

Question 19

What antibiotic is used for MRSA?

Answer 19

vancomycin

Question 20

Why is C. diff hard to treat?

Answer 20

Spore formation which makes them resistant.

Question 21

What are specific SE of penicillins?

Answer 21

hypersensitivity / skin reactions

Question 22

Which antibiotics cause c. diff?

Answer 22

co-amoxiclav, cephalosporin, clindamycin, ciprofloxacin

Question 23

What are SE of macrolides (e.g. erythromycin, clarithromycin, azithromycin)?

Answer 23

GI disturbance, hepatitis, QT interval?

Question 24

What are SE of aminoglycosides (e.g. gentamicin)?

Answer 24

nephrotoxicity, ototoxicity

Question 25

What is a SE of chloramphenicol?

Answer 25

aplastic anaemia

Question 26

What are SE of tetracyclines (e.g. doxycycline)?

Answer 26

hepatotoxicity, staining teeth, photosensitivity, dysphagia

Question 27

What is a SE of nitrofurantoin?

Answer 27

peripheral neuropathy, pulmonary fibrosis, teratogenic in the third trimester

Question 28

How do antibiotics affect the pill?

Answer 28

GI upset - reduces absorption of pill

Question 29

What drugs have sick day rules?

Answer 29

ACEI/ARB, diuretics, metformin, NSAIDs