T2 - L3 PATHOGEN-INFECTION-ANTIBIOTIC MATCHING

Question 1

what colour do gram negative bacteria stain?

Answer 1

red/pink

Question 2

what colour do gram positive bacteria stain?

Answer 2

blue/purple

Question 3

why does gram positive stain blue/purple?

Answer 3

thicker peptidoglycan cell wall

Question 4

how is gram negative bacteria morphologically different from gram positive?

Answer 4

• two cell membranes (inner and outer).

- thinner peptidoglycan cell wall.

Question 5

what does the neisseria spp appear like when stained?

Answer 5

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

Question 6

what does the catalase test do?

Answer 6

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

Question 7

what bacteria is catalase positive?

Answer 7

staph aureus

Question 8

what bacteria characteristically produces green pus?

Answer 8

step pyogenes

Question 9

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

Answer 9

cell wall

Question 10

cefuroxime attacks what part of the bacterium?

Answer 10

cell wall

Question 11

meropenem attacks what part of the bacterium?

Answer 11

cell wall

Question 12

vancomycin attacks what part of the bacterium?

Answer 12

cell wall

Question 13

ciprofloxacin attacks what part of the bacterium?

Answer 13

DNA replication

Question 14

Metronidazole attacks what part of the bacterium?

Answer 14

DNA replication

Question 15

Rifamycin/rifampicin attacks what part of the bacterium?

Answer 15

RNA synthesis

Question 16

doxycycline attacks what part of the bacterium?

Answer 16

protein synthesis

Question 17

erythromycin attacks what part of the bacterium?

Answer 17

protein synthesis

Question 18

chloramphenicol attacks what part of the bacterium?

Answer 18

protein synthesis

Question 19

gentamicin attacks what part of the bacterium?

Answer 19

protein synthesis

Question 20

what is a bacteriostatic antibiotic?

Answer 20

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

Question 21

what is a bactericidal antibiotic?

Answer 21

inhibit cell wall synthesis. (KILL)

Question 22

is penicillin bactericidal or bacteriostatic?

Answer 22

bactericidal (irreversible killing)

Question 23

are tetracyclines bactericidal or bacteriostatic?

Answer 23

bacteriostatic (reversible stoppage)

Question 24

what is a broad spectrum antibiotic?

Answer 24

an antibiotic that acts on gram positive and gram negative bacteria

Question 25

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

Answer 25

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

Question 26

give an example of enzymes bacteria produce to breakdown antibiotics?

Answer 26

Staph aureus – penicillinase,  E. Coli - carbapenemase

Question 27

MRSA occurs as a result of which mechanism of resistance?

Answer 27

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

Question 28

what are beta lactam antibiotics?

Answer 28

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

Question 29

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

Answer 29

β-lactamase

Question 30

what enzyme do bacteria produce to break down penicillin?

Answer 30

β-lactamase

Question 31

what enzyme do bacteria produce to break down amoxicillin?

Answer 31

β-lactamase

Question 32

list beta lactam antibiotics.

Answer 32

penicillins (amoxicillin, penicillin) cephalosporin (cefuroxime) carbapenem (meropenem)

Question 33

what part of the bacteria do beta lactam antibiotics attack?

Answer 33

cell wall | as a general rule of thumb

Question 34

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

Answer 34

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

Question 35

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

Answer 35

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

Question 36

what symptoms is the curb score based on?

Answer 36

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

Question 37

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

Answer 37

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

Question 38

what are the worst antibiotics to cause c.diff?

Answer 38

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

Question 39

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

Answer 39

nitrofurantoin trimethoprim pivmecillinam dysuria frequency

Question 40

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

Answer 40

IV cefuroxime IV gentamicin PO/IV ciprofloxacin PO/IV co-amoxiclav fever loin pain tachycardia low blood pressure

Question 41

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

Answer 41

amoxicillin + clavulanic acid useful against beta-lactamase producers

Question 42

what is "honeymoon cystitis"?

Answer 42

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

Question 43

what most commonly causes UTIs?

Answer 43

E.coli

Question 44

what is Meningococcal septicaemia?

Answer 44

meningococcal bacteria causing an infection of the blood

Question 45

what does SIRS stand for?

Answer 45

systemic inflammatory response syndrome 2 of the following:  Temp >38  Heart rate >90  Resp rate >20  WBC >12

Question 46

what is sepsis?

Answer 46

SIRS    AND     a suspected focus of infection.

Question 47

what is septic shock?

Answer 47

Sepsis and low blood pressure (<90/60)

Question 48

what is the treatment for sepsis?

Answer 48

BUFALO ``` Blood cultures urine output fluids antibiotics lactate oxygen ```

Question 49

what do you give for the F in BUFALO?

Answer 49

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

Question 50

how would you perform the U in BUFALO?

Answer 50

Urine Output Catheterise to measure

Question 51

how would you perform the O in BUFALO?

Answer 51

Oxygen 15 l/min via reservoir face mask

Question 52

which antibiotic do we treat cellulitis with?

Answer 52

Flucloxacillin. (doxycyclin if there is a penicillin allergy)

Question 53

what antibiotics do you treat necrotising fasciitis with?

Answer 53

Meropenem + clindamycin

Question 54

which antibiotics are safe to use during pregnancy?

Answer 54

beta lactam antibiotics

Question 55

which antibiotics should be avoided during pregnancy?

Answer 55

Quinolones (ciprofloxacin) – damage to cartilage • Trimethoprim – folic acid antagonist Tetracyclins – deposits and stains bones/teeth