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Clinical Pathology (RIP) > T2 - L3 PATHOGEN-INFECTION-ANTIBIOTIC MATCHING > Flashcards

T2 - L3 PATHOGEN-INFECTION-ANTIBIOTIC MATCHING Flashcards

1
Q

what colour do gram negative bacteria stain?

A

red/pink

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2
Q

what colour do gram positive bacteria stain?

A

blue/purple

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3
Q

why does gram positive stain blue/purple?

A

thicker peptidoglycan cell wall

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4
Q

how is gram negative bacteria morphologically different from gram positive?

A
  • two cell membranes (inner and outer).

- thinner peptidoglycan cell wall.

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5
Q

what does the neisseria spp appear like when stained?

A

gram negative diplococci - neisseria species look like this, come in pairs/look like beans.

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6
Q

what does the catalase test do?

A

It is used to differentiate those bacteria that produces an enzyme catalase, such as staphylococci, from non-catalase producing bacteria such as streptococci.

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7
Q

what bacteria is catalase positive?

A

staph aureus

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8
Q

what bacteria characteristically produces green pus?

A

step pyogenes

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9
Q

penicillins e.g. amoxicillin, attack what part of the bacterium?

A

cell wall

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10
Q

cefuroxime attacks what part of the bacterium?

A

cell wall

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11
Q

meropenem attacks what part of the bacterium?

A

cell wall

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12
Q

vancomycin attacks what part of the bacterium?

A

cell wall

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13
Q

ciprofloxacin attacks what part of the bacterium?

A

DNA replication

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14
Q

Metronidazole attacks what part of the bacterium?

A

DNA replication

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15
Q

Rifamycin/rifampicin attacks what part of the bacterium?

A

RNA synthesis

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16
Q

doxycycline attacks what part of the bacterium?

A

protein synthesis

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17
Q

erythromycin attacks what part of the bacterium?

A

protein synthesis

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18
Q

chloramphenicol attacks what part of the bacterium?

A

protein synthesis

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19
Q

gentamicin attacks what part of the bacterium?

A

protein synthesis

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20
Q

what is a bacteriostatic antibiotic?

A

limit the growth of bacteria by interfering with bacterial protein production, DNA replication or other aspects of bacterial cellular metabolism.

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21
Q

what is a bactericidal antibiotic?

A

inhibit cell wall synthesis. (KILL)

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22
Q

is penicillin bactericidal or bacteriostatic?

A

bactericidal (irreversible killing)

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23
Q

are tetracyclines bactericidal or bacteriostatic?

A

bacteriostatic (reversible stoppage)

24
Q

what is a broad spectrum antibiotic?

A

an antibiotic that acts on gram positive and gram negative bacteria

25
Q

what are the 5 mechanisms by which a bacteria can become resistant to antibiotics?

A
  1. produces enzymes
  2. alters binding site
  3. efflux pump
  4. porin loss in membrane
  5. alteration of metabolic pathway
26
Q

give an example of enzymes bacteria produce to breakdown antibiotics?

A

Staph aureus – penicillinase,

E. Coli - carbapenemase

27
Q

MRSA occurs as a result of which mechanism of resistance?

A

change of binding site

Staph aureus (MRSA)- Alteration of Penicillin binding site, flucloxacillin can’t bind and therefore fluclox resistant.

28
Q

what are beta lactam antibiotics?

A

β-lactam antibiotics (beta-lactam antibiotics) are a class of antibiotic consisting of all antibiotic agents that contain a beta-lactam ring in their molecular structures. This includes penicillin derivatives (penams), cephalosporins (cephems), monobactams, and carbapenems.

e.g. amoxicillin

29
Q

what enzyme do bacteria produce to break down beta lactam antibiotics?

A

β-lactamase

30
Q

what enzyme do bacteria produce to break down penicillin?

A

β-lactamase

31
Q

what enzyme do bacteria produce to break down amoxicillin?

A

β-lactamase

32
Q

list beta lactam antibiotics.

A

penicillins (amoxicillin, penicillin)

cephalosporin (cefuroxime)

carbapenem (meropenem)

33
Q

what part of the bacteria do beta lactam antibiotics attack?

A

cell wall

as a general rule of thumb

34
Q

what antibiotics would you give for a curb-65 score of 1?

A

low severity (CURB-65 0 or 1) pneumonia = amoxicillin

35
Q

what antibiotics would you give for a curb-65 score of 3?

A

High severity (CURB-65 >3) pneumonia = co-amoxiclav + clarithromycin.

36
Q

what symptoms is the curb score based on?

A 
Confusion
BUN>7 mmol/l
Respiratory rate >30
SBP <90mmgHg, 
DBP<60mmHg
Age >65
37
Q

why does the curb-65 trust underestimate the severity of pneumonia in young people?

A

they’re never going to present with over 3 due to their age and they might not be confused.

38
Q

what are the worst antibiotics to cause c.diff?

A

The “C” antibiotics; ciprofloxacin, cefuroxime, co-amoxiclav

etc.

39
Q

what antibiotics would you use to treat a lower urinary tract infection and how would a lower urinary tract infection present?

A

nitrofurantoin
trimethoprim
pivmecillinam

dysuria
frequency

40
Q

what antibiotics would you use to treat a upper urinary tract infection and how would a upper urinary tract infection present?

A

IV cefuroxime
IV gentamicin
PO/IV ciprofloxacin
PO/IV co-amoxiclav

fever
loin pain
tachycardia
low blood pressure

41
Q

what is co-amoxiclav and what is it used for?

A

amoxicillin + clavulanic acid

useful against beta-lactamase producers

42
Q

what is “honeymoon cystitis”?

A

cystitis caused by sexual activity - usually only ever seen in younger females.

43
Q

what most commonly causes UTIs?

A

E.coli

44
Q

what is Meningococcal septicaemia?

A

meningococcal bacteria causing an infection of the blood

45
Q

what does SIRS stand for?

A

systemic inflammatory response syndrome

2 of the following: Temp >38 Heart rate >90 Resp rate >20 WBC >12

46
Q

what is sepsis?

A

SIRS AND a suspected focus of infection.

47
Q

what is septic shock?

A

Sepsis and low blood pressure (<90/60)

48
Q

what is the treatment for sepsis?

A

BUFALO

Blood cultures
urine output 
fluids 
antibiotics 
lactate 
oxygen
49
Q

what do you give for the F in BUFALO?

A

Fluids

500ml IV saline over 15 minutes. Aim 30ml/kg in 1 hour

50
Q

how would you perform the U in BUFALO?

A

Urine

Output Catheterise to measure

51
Q

how would you perform the O in BUFALO?

A

Oxygen

15 l/min via reservoir face mask

52
Q

which antibiotic do we treat cellulitis with?

A

Flucloxacillin. (doxycyclin if there is a penicillin allergy)

53
Q

what antibiotics do you treat necrotising fasciitis with?

A

Meropenem + clindamycin

54
Q

which antibiotics are safe to use during pregnancy?

A

beta lactam antibiotics

55
Q

which antibiotics should be avoided during pregnancy?

A

Quinolones (ciprofloxacin) – damage to cartilage •

Trimethoprim – folic acid antagonist

Tetracyclins – deposits and stains bones/teeth

Clinical Pathology (RIP) (49 decks)

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