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CLASP - Year 3 > Sepsis Week > Flashcards

Sepsis Week Flashcards

1
Q

types of bacteria

A

gm +ve
gm -ve
anaerobes
atypical

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2
Q

difference between gram -ve and +ve staining and why

A

gram +ve = purple as thick wall so retains stain

gram -ve = piNk as thin wall

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3
Q

where are anaerobes found

A

[dirty places as don’t breathe air]

mouth, teeth, throat, sinuses and lower bowel

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4
Q

types of infection which may have aneorobes

A

abscesses, dental infections, peritonitis, appendicitis

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5
Q

where are atypical bacteria found

A

chest (resp) and genito-urinary tract

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6
Q

commoon atypical bacterial infections

A

pneumonia, urethritis, PID

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7
Q

gm +ve bacteria found whree

A

skin and mucous membranes

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8
Q

in which infections is gm +ve common

A

pneumonia, sinuitis, cellulitis, osteomyelitis, wound infection, line infecition

[found skin and mucous membranes]

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9
Q

gram negatives are usually found where

A

GIT

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10
Q

gram negatives are usually involved inwhich common infections

A

UTI, peritioinitis, biliary infection, pancreatitis, PID

[as found in GIT]

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11
Q

general adverse effects of antibiotics

A

nausea, vomiting, diarrhoea, rashses, candida infections

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12
Q

penicillin specific adverse effects [not allery]

A

hypersensitivity/skin reactions

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13
Q

fluxlocacillin and co-amoxiclav specific adverse effects [not allergy]

A

cholestatic jaundice

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14
Q

clindamycin, cephalosporins and quinolones specific adverse effects [not allergy]

A

c dif colitis

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15
Q

macrolides specific adverse effects [not allery]

A

GI distrubance, hepatitis, QT interval prolongation

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16
Q

quinolones specific adverse effects [not allery]

A

QT interval, convulsions, tendonitis

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17
Q

aminoglycosides/glycopeptides specific adverse effects [not allery]

A

nephroxociity/ototoxicity

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18
Q

vancomycin specific adverse effects [not allery]

A

red man syndrome (turn red - slow infusion)

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19
Q

tetracyclines specific adverse effects [not allery]

A

hepatotoxicity, staining teeth (avoid in children), photosensitivity (MUST wear suncream), dysphagia

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20
Q

nitrofurantoin specific adverse effects [not allery]

A

peripheral neuropathy, pulmonary fibrosis

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21
Q

sulphonamides (co-trimoxazole) specific adverse effects [not allery]

A

stevens johnson syndrome, blood dyscrasia

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22
Q

trimethoprim specific adverse effects [not allery]

A

blood dyscrasias

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23
Q

chloramphenicol specific adverse effects [not allery]

A

aplastic anaemia, grey baby

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24
Q

linezolid specific adverse effects [not allery]

A

blood dyscrasias, MAOI, optic neuropathy

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25
Q

sodium fusidate specific adverse effects [not allery]

A

hepatotoxicity

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26
Q

absorption of tetracyclines and quinolones is reduced by what

A

antacids/calcium

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27
Q

broad spc antimicrobials effect on warfarin

A

increase INR

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28
Q

coagulase positive gram positive bacteria

A

staph aureus

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29
Q

how to categorise streptococcus types

A

haemolysis

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30
Q

haemolysis results for strep

A 
alpha = partial (greenish)
beta = complete
gamma = non-haemolytic
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31
Q

coagulase test is used to differentiate which type of bacteria

A

staphylococci (gram psotive cocci)

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32
Q

staph aureus is what

A

gram +ve, catalase and coagulase positive pathogen

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33
Q

types of infection caused by staph aureus

A

skin infections

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34
Q

mx of staph aureus

A

flucloxacillin

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35
Q

ALL beta-haemolytic strep (EG: GAS) are sensitive to what

A

penicillin and flucloxacillin

36
Q

for pneumococci and menignococci what antibiotics is preferred

A

amoxicillin as better absorption orally than penicillin

37
Q

most haemophilus influenzae is sensitve to what

A

amoxicillin and doxycycline

38
Q

what do you give for acute epiglottis and why

A

ceftriaxone (due to haem influenzae but some resistant to amoxicillin so give this as cannot risk iit not working as this is a life threatening condition)

39
Q

most pneumococci are sensitive to what

A

doxycycline

40
Q

pneumococci are what

A

infections caused by streptococcus pneumoniae (Eg: ottitis media, pneumonia, bacteraemia, meningitis, sinusitis)

41
Q

if haemophilus influenzae causing severe lung infection which antibiotic covers for this

A

co-amoxiclav

42
Q

atypical antibiotic cover

A

doxycycline and clarithromysin (not for legionella)

43
Q

levofloxacin is what

A

restritcted but good cover of MRSA, haem influ, pneumococci, coliforms and legionella

44
Q

what needs high dose IV antibiotcs to prevent bacteraemia and vegitations

A

endocarditis and septic arthritis

45
Q

only time don’t give IV antibiotics in sepsis

A

c-diff infection as needs to be oral to be topical

46
Q

staph aureus antibiotics

A

flucloxacillin

47
Q

coagulase negative staph in ednocarditis mx (eg staph epi)

A

vancomycin + gent + rifampicin (as unpredictable sensitivity to fluxclos)

48
Q

most enterococci sensitive to

A

amoxicillin

49
Q

anaerobes sensitive to

A

metronidazole

50
Q

coliforms sensitive to

A

gentamicicn and most to aztreonam

51
Q

why can only use nitrofurantoin for uncomplicated lower UTIs

A

lacks kidney pentration and is NOT excreted in urine in renal impairment

52
Q

severe systemic infection of unkown cause mx

A

amoxicillin + gent + metronidazole (condiser fluclox/vanc if staph susepcted)

if pen al vanc instead

53
Q

bugs likely for meningitis

A

pneumococcus (strep pneumo)
meningococcus
and if >60 then listeria

54
Q

meningitis listeria suspected cause

A

amoxicillin (as resistant to cephalosporins)

55
Q

meningitis empirical therapy

A

ceftriaxone and dexamethasone

56
Q

encephalitis bugs

A

herpes simplex

57
Q

mx of encephalitis empirical

A

acyclovir

58
Q

epiglottitis likely bugs

A

haemophilus influenzae or streptococci

59
Q

mx of epiglotitis

A

ceftriaxone - as life threatening so give greater cover to cover resistant strains

60
Q

tonsilitis likely bug

A

GAS (s pyogenes)

61
Q

sinusitis likely bug

A

pneumococcus

62
Q

acute otitis media likely bugs

A

pneumococcus, haemophilus influenzae

63
Q

test if suspect legionella

A

urinary antigen test

64
Q

mild/mod CAP mx

A

amoxicillin or doxy if allergy

65
Q

severe CAP mx

A

co-amoxiclav + doxy (levofluoxacin monotherapy if allergy)

ICU - co-amoxiclav + clarithromycin (same alt if pen al)

66
Q

acute exacerbation of COPD mx

A
  • antibiotics if increased sputum purulence if not then NO antibiotics unless consolidation on CXR or signs of pneumonia
  • 1st line = amoxicillin, 2nd line = doxycycline
67
Q

HAP non-severe vs severe mx

A

non-severe = amoxicillin (doxy if al)

severe = IV amoxicillin + gent (co-trimoxazole if al)

68
Q

aspiration pneumo non-severe vs severe

A

non-severe = amoxicillin + metronidazole (doxy if pen al)

severe = amoxicillin + metronidazole + gentamicin)

69
Q

endocarditis likely bug:
native valve acute
native valve subacute
prosthetic valve

A

native acute = stpah aureus
native subacute = strep viridans or enterococci
pprosthetic = MRSA, coagulase neg staph (eg: stap epi)

70
Q

native valve subacute (viridans or enterococci) blood cultures

A

3 sets 6hrs apart if stable

71
Q

native valve acute samples

A

2 blood cultures and start antibiotics empriical in the hour

72
Q

native valve subacute (viridans or enterococci) mx

A

amoxicillin + gentamicin

73
Q

prosthetic valve mx

A

vancomycin + gentamicin and rifampicin

74
Q

risk factors for c diff

A

antibiotic use, prolonged hospital stay, PPI/H2 antagonist use, increased age, surgical procedure, immunosuppression

75
Q

precautions with c diff

A

isolate in single room - must use soap as spores so hand gel doesn’t work

76
Q

first line for c diff

A

ORAL vancomycin (only time give oral antibiotics in sepsis as needs to be topical)

77
Q

acute gastroenteritis antibiotics

A

NONE - risks HUS

78
Q

peritonitis/biliary tract sepsis bugs

A

polymicrobial coliforms (e coli), anaerobes and enterococci (gm +ve e faecalis etc)

79
Q

mx for Peritonitis/biliary tract sepsis/intra-abdominal

A

IV amoxicillin + metronidazole + gentamicin (replace amox with vanc if pen al)

80
Q

Spontaneous bacterial peritonitis mx

A

co-trimoxazole if mild

piperacillin or tazobactam if severe

81
Q

what to do if e coli 0157

A
  • notifiable disease
  • risk of HUS
  • do NOT give antibiotics
  • px: bloody diarrhoea
  • dx:
    • faeces for culture
    • haematology: FBC, film to look for fragmented blood cells (schistocytes) if suspect HUS or confirmed 0157
    • biochemistry: U+E, LDH, CRP
82
Q

female uncoplicated lower UTI and male no catheter

A

nitrofurantoin or trimetehoprim for 3 days in F, 7 days in M

83
Q

complicated UTI (pylonephritis etc)

A

IV amoxicillin + gentamicin - replace with trimoxazole if pen allergy

84
Q

likely bugs in cellulitis

A

staph aureus, GAS or other beta haemolytic strep

85
Q

bug for septic arthritis

A

staph aureus - so flucloxacillin

CLASP - Year 3 (3 decks)

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