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2 CLASP > Sepsis, Tests and Pneumonia > Flashcards

Sepsis, Tests and Pneumonia Flashcards

1
Q

what group of organisms that cause endocarditis are particularly difficult to grow in the lab?

A

HACEK group organisms

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2
Q

usual source of strep viridans pathogen?

A

GI tract (mouth)

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3
Q

which organism is not typically a cause of endocarditis: Staphylococcus aureus Enterococcus faecalis Viridans group streptococci Escherichia species HACEK group organisms

A

escherichia species

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4
Q

2 diseases caused by spiral bacteria?

A

syphilis lyme disease

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5
Q

coliforms are also known as?

A

gram -ves

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6
Q

antibiotic cover for coliforms?

A

gentamicin

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7
Q

antibiotic cover for anaerobes?

A

metronidazole

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8
Q

antibiotic cover for haemophilus influenzae?

A

amoxicillin

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9
Q

antiobiotic cover for enterococci?

A

amoxicillin

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10
Q

gram +ve antibiotic cover?

A

vancomycin

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11
Q

what antibiotic should you be very wary of prescribing for sepsis?

A

ciprofloxacin (quinolones)

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12
Q

when are cephalosporins mainly prescribed?

A

meningitis but rarely

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13
Q

when does sepsis become septic shock?

A

resuscitation attempts have been made and still not responding

need at least 1 acutely dysfunctional organ

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14
Q

“the presence of a microbe in the human body without an inflammatory response” describes what?

A

colonisation

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15
Q

bacteraemia always signifies infection: T or F?

A

F, can have bacteraemia without infection

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16
Q

define sepsis

A

the dysregulated host response to infection

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17
Q

define septic shock

A

subset of sepsis with circulatory/cellular/metabolic dysfunction associated with a higher risk of mortality

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18
Q

pathophysiology of sepsis?

A
  1. infection
  2. bacteria from infection enters bloodstream
  3. blood vessels become leaky
  4. decreased perfusion and ventilation to organs so they become dysfunctional
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19
Q

name the 4 SIRS criteria

A

RR >20

HR >90

Tem p >38 or <36

WCC >12000 or <4000mm3

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20
Q

if a patient scores highly on all criteria eg SIRS/qSOFA/NEWS do they have sepsis?

A

only if they have an infection as well

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21
Q

name sepsis 6 and show how to remember them

A

BUFALO

Blood cultures (+ other cultures eg urine/swabs)

Urine output

Fluids

Antibiotics IV

Lactate (+ FBC and biochem)

Oxygen (target >94%)

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22
Q

what sepsis criteria is mainly used now?

A

NEWS >5

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23
Q

name the components of qSOFA

A

RR >22

sBP <100mmHg

Altered GCS (<14)

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24
Q

what is qSOFA a measure of?

A

mortality in 28 days

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25
Q

how many SIRS criteria do you need to have to have sepsis?

A

2 SIRS + signs of infection

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26
Q

how can strep viridans cause infective endocarditis?

A

lives in mouth

travels in blood if dental surgery

sticks to heart valve

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27
Q

what kind ofendocarditis will strep viridans cause?

A

native valve

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28
Q

what do phagnocytes act against?

A

bacteria

fungi

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29
Q

what do t cells act against?

A

viruses

fungi

protozoa

30
Q

what do antibodies act against?

A

bacteria

viruses

31
Q

what do eosinophils act against?

A

fungi

protozoa

worms

32
Q

name the only bug that complement will act against

A

bacteria

33
Q

what 2 cell types are responsible for acting against worms

A

eosinophils

mast cells

34
Q

T cells do not work against bacteria: T or F

A

T

35
Q

a coagulase negative staph is likely to be what?

A

staph epi

36
Q

why do gram positive organisms stain purple?

A

the peptidoglycan layer traps crystal violet dye

37
Q

what organism is typically pathogenic in alcoholics?

A

strep pneumoniae

38
Q

what organism is known to be a strict aerobe

A

pseudomonas

39
Q

what can gram negative bacilli be divided into

A

lactose positive or negative aka easy and difficult organisms

40
Q

most common subtype of haemophilusi influenzae?

A

B

41
Q

name the different microbiological cultures that can be done

A

blood

stool

urine

tissue

wound

42
Q

microscopy can be done for what kind of samples?

A

stool

urine

CSF

sputum

43
Q

all abscesses cannot be treated by antibiotics T or F

A

F. small abscesses can

44
Q

normal flora of the mouth?

A

strep viridans

neiserria

anaerobes

staphylococci

45
Q

name a sterile area of the gut

A

stomach

bile duct

46
Q

where are anaerobic organisms most likely to be in the GI tract?

A

lower down eg in bowel

47
Q
A
48
Q

name the flora of the colon

A

coliforms

anaerobes

enterococcus faecalis

49
Q

describe the structure and gram stain of coliforms

A

gram negative bacilli

50
Q

drug of choice for coliforms?

A

gentamicin

51
Q

what should be given if a patient is contraindicated for 1st line Tx for coliforms?

A

give aztreonam

52
Q

oral switch antibiotic for coliform sepsis?

A

co-trimoxazole

53
Q

antibiotic for oral switch in an anaerobe sepsis?

A

metronidazole still

54
Q

antibiotic of choice for enterococci and why

A

amoxicillin as it is active against gram positive organisms

55
Q

what antibiotic should be given if there is a contraindication for the 1st line antibiotic for enterococcal sepsis

A

co-trimozazole

56
Q

what CURB65 score indicates severe CAP

A

3-5

57
Q

outline CURB65

A

new Confusion

Urea >7

RR >30

sBP <90

65+ years old

58
Q

should you do blood cultures in pneumonia?

A

only if it’s really severe

59
Q

what bacteria would indicate a contaminated blood culture and why?

A

staph epi

corynebacteria

bacillus species

all skin commensals

60
Q

problem with a sputum culture?

A

can contain commensal mouth bacteria

61
Q

how to tell if the right middle lobe is affected by a pneumonia on CXR?

A

if there is a whiteout next to the heart on the RHS

62
Q

what bacteria is likely to cause a classic pneumonia presentation?

A

strep pneumoniae

63
Q

what does haem flu grow on?

A

chocolate agar

64
Q

antibiotic for haem flu

A

amoxicillin

doxy if pen allergic

65
Q

what antibiotic is good for atypical pneumonias?

A

doxycycline

clarithromycin

66
Q

complication of Q fever?

A

culture negative endocarditis

67
Q

how to confirm an atypical pneumonia?

A

serology

virus detection

68
Q

what type of pneumonia should prompt you to do a urine antigen test and why?

A

legionella as urine legionella antigen is prevalent

69
Q

what serogroup of legionella causes the most disease?

A

1

70
Q

as a rule of thumb, when should you send a urine culture?

A

if a complicated infection is suspected

71
Q
A

2 CLASP (9 decks)

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