Table Flashcards
Treatment of neisseria meningitidis
Ceftriaxone - meningococcal sepsis
3rd generation cephalosporin
Beta lactam- penicillin V
Cell wall synthesis inhibitor
Neissseria meningitidis features
Gram negative diplococci
Causes sepsis
Virulence factor - lipopolysaccharide
Common commensal of nasalpharynx
Ask for nasopharyngeal swab
Ecoli conditions
UTI
Peritonitis
Neonatal meningitis
Ecoli is a commensal of the…
Colon
What gram stain is E. coli
Gram negative bacilli
How to treat e.coli
Trimethoprim- UTI
Inhibitor of folic acid synthesis
Cefotaxime for neonatal meningitis
Staphylococcus aureus gram stain
Gram positive coccus
Staphylococcus aureus conditions
Cellulitis
MRSA
Skin abscess
Staphylococcus aureus commensal of the….
Skin
Take nose swab
Staphylococcus aureus treatment
Flucloxacillin - cellulitis
Vancomycin- MRSA
Cell wall synthesis inhibitors
Staphylococcus epidermis commensal of the …
Skin
Features of staphylococcus epidermis
Forms biofilm
Quorum sensing
Very difficult to remove
Gram stain of staphylococcus epidermis
Gram positive cocci
Treatment of staphylococcus epidermis
Remove prosthetic device
Use silver coated central lines
Flucloxacillin - cellulitis
Staphylococcus epidermis condition
Cellulitis
Streptococcus pyogenes commensal of…
Skin
Features of streptococcus pyogenes
Group A beta haemolytic
Virulence factors of streptococcus pyogenes
Hyaluronic acid capsule - seems like self
M protein - hijacks respiratory burst mechanism of neutrophils
Streptokinase - breaks down blood clots
Streptococcus pyogenes causes
Pharyngitis
Tonsillitis
Streptococcus pyogenes gram stain
Gram positive cocci
Treatment of streptococcus pyogenes
Penicillin V
Clarythromycin - if resistant
Clostridium difficile commensal of the…
Colon
Clostridium difficile features and virulence factors
Associated with antibiotic use
Sporulating - difficult to remove
Virulence factors:
Toxin A enterotoxin causing inflammation and build of excess fluid in bowel - diarrhoea
Toxin B - cytotoxic which disrupts protein synthesis and disrupts cytoskeleton
Clostridium difficile gram stain
Gram positive bacilli
Treatment of clostridium difficile
Metronidazole- mild
Vancomycin-serious
Strep pneumoniae features
Community acquired
Viridans group of strep - alpha haemolytic
Polysaccharide capsule
Gram stain for strep pneumoniae
Gram positive cocci
Treatment of strep pneumoniae
Mild: amoxicillin
Penicillin Allergy: doxycycline
Moderate: amoxicillin and doxycycline
Severe: co-amoxiclav (IV) and doxycycline
Allergy: meropenem and doxycycline
Viridans streptococci features
Oral commensal Cause: - tooth decay - bacterial endocarditis (rheumatic fever vegetative valves) Alpha haemolytic E.g streptococcus mutans Group of gram positive cocci Antibiotic prophylaxis
Heamophilus influenzae commensal
Nasopharyngeal
Haemophilus influenzae features
Opportunistic infection
Produces Beta lactamase
Associated with children and pneumonia
Haemophilus influenzae gram stain
Gram negative bacilli
Haemophilus influenzae treatment
Amoxicillin
Salmonella typhi causes…
Typhoid
Enteric fever
Travel related infection - ingestion of contaminated water
Treatment for salmonella typhi
Ceftriaxone
Fluoroquinolones can also be used
Salmonella typhi
Gram negative bacilli with flagella
Low infectious dose
Survives gastric acid
Fimbriae
Reside within macrophages
Legionella pneumophila causes
Legionnaire’s disease
Legionellosis
Acute lobar pneumonia
Transmission of legionella pneumophila
Air droplet
Gram stain of legionella pneumophila
Gram negative bacilli
Treatment of legionella pneumophila
Clarythromycin
or Fluoroquinolones
Epstein -Barr virus
DsDNA
Enveloped
Causes:
Infects B cells
T cell proliferation
Splenomegaly
Epstein Barr virus diagnostics
PCR
EBV serology
FBC - elevated lymphocytes
T differential - increased cd8+
Complications of Epstein Barr virus
Reed Steinberg cells - Hodgkin’s lymphoma Gastric lymphoma Burkit’s lymphoma Nasopharyngeal carcinoma Sore throat Headache
Microscopy of Epstein Barr virus
Abnormal lymphocytes
Treatment of Epstein Barr virus
Supportive treatment
Acyclovir
Varicella Zoster features
Enveloped
First presents as chickenpoxs
Latent in dorsal root ganglia
Then presents as shingles on single dermatome
Vesicular rash
Who gets varicella zoster
Immunocompromised
Young
Treatment of varicella zoster
Acyclovir
Viral replication inhibitor
Hepatitis B features
dsDNA
Enveloped
Blood borne virus
6weeks - 6months
After 6months - chronic infection
Hepatitis B clinical presentation
Fatigue Loss of appetite Nausea Abdominal pain Jaundice
Investigation for Hepatitis B
Raised:
ALT
AST
Bilirubin
Hep B serology
PCR - HBV DNA
Hepatitis B complications
Jaundice
Cirrhosis
Treatment of hep B
Supportive Life long antivirals to suppress viral replication Vaccine Self limiting disease If chronic - no cure
Hepatitis C features
Blood borne virus
Associated with:
IV drug users
Hepatocellular carcinoma
80% chronically infected
Leads to end stage liver disease - hospitalisation
Clinical presentation of hep C
Mostly asymptomatic Fatigue Anorexia Abdominal pain Nausea
Investigation for hep c
Serology - anti hep C antibody
PCR
Complications of hep C
Jaundice
Cirrhosis
Chronic inflammation and infection of hepatocytes
Treatment of hep C
Ribovarin and interferon
(8-12wk treatment)
Can get reinfected
No vaccine
HIV features
SsRNA
Enveloped
Retrovirus
Causes: Opportunistic conditions e.g.
Oral thrush - Candida albicans
Kaposis sarcoma - HHV8
Pneumocystis pneumonia - pneumocystis jirovecii
Reactivation of latent infections:
EBV
Shingles
CMV
Viral load inversely proportional to cd4 count
T cell count less than 100 - AIDS
HIV treatment
2x nucleoside inhibitors (reverse transcriptase inhibitors)
AND
1 x non nucleoside reverse transcriptase inhibitor
OR
1 x protease inhibitor
OR
1 x integrate inhibitor
Adenovirus features
dsDNA
Non enveloped
Replicates in endothelial cells
Clinical presentation of adenovirus
Conjunctivitis
Sore throat
Fever
Cough
Treatment of adenovirus
Supportive
Norovirus
Winter vomiting bug - closed environment like hospital
SsRNA
Non enveloped
Fecal - oral route
Low viral load required to cause infection
Investigations for norovirus
ELISA
Stool sample
Treatment of norovirus
Supportive:
Antipyretic
IV fluids
Plasmodium falciparum
Parasite
Female anopheles mosquito as vector
Effects of plasmodium falciparum
Heaptomegaly
Splenomegaly
Jaundice - increased bilirubin due to increased RBC destruction
Investigations for malaria
3 x blood film
LFTs
Treatment of malaria
Quinine
Doxycycline
G6PDH test before administering chloroquinine for p.vivax and p.ovale
Candida albicans features
Fungi
Yeast (unicellular)
Opportunist infection
Commensal of vagina and mouth
Treatment of Candida albicans
Nystatin
Clotrimazole
IV fluconazole
Systemic: amphotericin B
Aspergillous features
Fungi
Acute infection of lungs
Opportunistic
Treatment of aspergillous
Amphotericin B
Cellulitis causative organisms
Staph aureus
Strep pyogenes
Treatment of cellulitis
Flucloxacillin
Tonsillitis complications
Peritonsillar abscess Rheumatic fever Acute post strep glomerulonephritis Impetigo Erysipelas Necrotising fasciitis
Causative organisms of tonsillitis
Streptococcus pyogenes
Treatment of tonsillitis
Penicillin V
Meningococcal sepsis causative organism
Neisseria meningitidis
Treatment of meningococcal sepsis
Ceftriaxone
3rd generation cephalosporin
Beta lactam: penicillin V
UTI features (Ecoli)
More common in females
Dysuria
Increased urination frequency
Ecoli UTI treatment
Trimethoprim
UTI (Candida) features
Itching and burning pain
White discharge
Treatment of Candida UTI
Topical nystatin or clotrimazole
IV fluconazole if severe
Systemic: amphotericin B
Chemotherapy causing candidiasis treatment
Amphotericin B
Chemotherapy causing shingles features and treatment
Caused by varicella zoster reactivation
(Latent In dorsal ganglia)
Acyclovir
Skin abscess causative organism and features
Staph aureus
Can occur due to minor scratches in diabetics or immunocompromised host
Treatment of skin abscesses
MRSA - vancomycin
If not, flucloxacillin
Peritonitis causative organism features
E. coli
Large bowel adenocarcinoma (perforation)
Lower abdominal pain
Hot and sweaty
Ascites
Air in abdominal cavity
Treatment of peritonitis
Trimethoprim
Pneumonia features
Consolidation in lungs
Pulmonary oedema with inflammatory cell infiltration
Pneumonia treatment
Mild: amoxicillin
Penicillin Allergy: doxycycline
Moderate: amoxicillin and doxycycline
Severe: co-amoxiclav (IV) and doxycycline
Allergy: meropenem and doxycycline
Causative organisms of pneumonia
Streptococcus pneumonia
Haemophilus influenzae
Profuse diarrhoea causative organism
Clostridium difficile
Profuse diarrhoea treatment
mild - metronidazole
Severe - vancomycin
Aortic stenosis/ endocarditis organisms
Viridans streptococci
commensal of mouth
Treatment of endocarditis
IV penicillin
Gentamicin
Infected prosthetic/ central line organism organisms and treatment
Staphylococcus epidermis
Treat infected prosthetic
Replace
Flucloxacallin if in blood
Vomiting and diarrhoea cause identification
ELISA
PCR
Stool sample
Causes of pharyngitis
EBV
Strep pyogenes
Adenovirus
Droplet transmission
cause of shingles
Varicella zoster
Treatment of shingles
Acyclovir
Cause of malaria
Plasmodium falciparum from female anopheles mosquito
Treatment of malaria
Quinine
Doxycycline
Cause of Schistosomiasis
Helminths
Causes hepatomegaly and fibrosis of liver and bladder
Eosinophilia
Take oral corticosteroids
Self limiting
Enteric fever
Incubation: 7 - 14days
Fever
Headache
Abdominal discomfort
Dry cough
Dengue
Arbovirus
Aedes mosquito
First infection - asymptomatic or fever
Supportive treatment
Reinfenction - haemorrhagic fever in children
- dengue shock syndrome
Myiasis
Rural areas
Fly larva - bot fly
Ebola causative organism
Filovirus - filoviridae
Symptoms of Ebola
Severe haemorrhagic fever Vomiting Diarrhoea Headache Confusion Rash
Zika virus
Arbovirus - aedes mosquito
Dengue like symptoms
Congenital microcephaly
Foetal loss
Transmission of Zika virus
Vertical transmission
Sexual transmission
Flu
Acute viral infection of the resp tract
