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Y3 CLASP > Transition Microbiology Revision > Flashcards

Transition Microbiology Revision Flashcards

1
Q

Define virulence

A

Degree of pathogenicity

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2
Q

Name the 4 bacteria shapes

A

Coccus
Bacillus
Fusiform
Spirochaete

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3
Q

What is the structure / appearance of gram positive bacteria? What type of toxin do they produce?

A

Purple
Thick peptidoglycan layer
Produce exotoxin inside cell and export out

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4
Q

What is the structure / appearance of gram negative bacteria? What type of toxin do they produce?

A

Pink
Thin peptidoglycan layer + LPS in outer membrane
Produce endotoxin

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5
Q

What is the appearance of strep on film?

A

Purple gram positive cocci in chains

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6
Q

How are strep classified? Be specific

A

Haemolysis

Alpha partial - green - viridans, pneumoniae
Beta complete - clear - group A strep pyogenes
Gamma none - group B enterococci

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7
Q

How are staph classified? Be specific

A

Coagulate

\+ve = aureus
-ve = others e.g. epidermidis
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8
Q

What is the appearance of staph on film?

A

Purple gram positive cocci in clusters

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9
Q

What is the best antibiotic against s. aureus? What is used in allergies?

A

Fluclox

Allergy vanco

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10
Q

What is the appearance of clostridium on film?

A

Gram positive anaerobic bacilli

Produces spores

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11
Q

What is the best antibiotic against clostridium?

A

Metronidazole

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12
Q

What is the appearance of neisseria (gonococcus and meningitides) on film?

A

Gram negative aerobic diplococci

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13
Q

How are gram negative bacilli classified?

A

Lactose positive = coliform

Lactose negative = h. pylori, pseudomonas

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14
Q

What is a coliform? Include examples

A

Gram negative aerobic bacilli. Some are gut commensals e.g. e.coli, Klebsiella, proteus, enterobacter. Some are pathogens e.g. salmonella, shigella, e.coli 0157

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15
Q

What antibiotic is used against coliforms?

A

IV genta then switch to PO co-trimoxazole

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16
Q

Name the 2 strict aerobes

A

Pseudomonas, legionella

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17
Q

What antibiotic is used against strict anaerobes?

A

Metronidazole

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18
Q

Name the 4 C antibiotics? What is the risk?

A

Cephalosporins e.g. ceftriaxone
Co-amoxiclav
Ciprofloxacin
Clindamycin

C. diff

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19
Q

What are the 2 components of co-amoxiclav? What gram negative bacilli does it not protect against?

A

Amoxicillin + clavulanic acid

Pseudomonas

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20
Q

How are penicillins excreted? What is their mechanism?

A

Renal

Inhibit beta lactamase

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21
Q

Give an example of a cephalosporin. What is their mechanism?

A

Ceftriaxone

Inhibit beta lactamase

22
Q

What antibiotic is only effective against gram positives?

A

Vancomycin

23
Q

What is the mechanism of vancomycin?
What type of bacteria is it active against?
What routes is it available?

A

Inhibits peptidoglycan synthesis
Only gram positives
Only IV

24
Q 
How is gentamicin excreted?
What is it effective against?
What are the side effects?
What is used if genta is contraindicated?
When is genta contraindicated?
A 
Kidneys
Gram negative aerobes
Kidney / CNVIII damage
Aztreonam
CKD / pregnant
25
Q

Give an example of a tetracycline
What routes is it available?
How is it excreted?
When is it contraindicated?

A

Doxycycline
PO only
Liver
Pregnancy and children

26
Q

What is metronidazole active against?

A

True anaerobes and some protozoa

27
Q

Which antibiotic inhibits folic acid synthesis?

A

Trimethoprim

28
Q

Define sepsis

A

Life-threatening organ dysfunction due to dysregulated host response to infection

29
Q

What would an ABG show in sepsis? Why?

A

Metabolic acidosis

Lactic acid from hypoperfusion and anaerobic metabolism

30
Q

What effect does sepsis have on TPR, CO and the circulation volume?

A

Decreased TPR
Decreased CO
Hyperdynamic circulation

31
Q

How is sepsis diagnosed?

A

NEWS >5 + presumed infection

32
Q

qSOFA is only used as a prognostic indicator in ICU. T or F

A

True

33
Q

What is the sepsis 6? What time frame should it be done in?

A

Less than 1 hour

Oxygen
IV empirical ABx
Blood culture
Fluid 0.9% 500ml NaCL
FBC, lactate, biochemistry
Monitor UO
34
Q

How many fluid boluses should be given in sepsis? What type of fluid should never be given?

A

Till normal BP

Never 5% dextrose

35
Q

In sepsis management, if hypotension persists despite euvolaemia, what drugs (name and class) should be initiated? By what route?

A

Inotrope/ vasoconstrictor;

Noradrenaline alpha agonist
Adrenaline alpha/ beta agonist

Central venous catheter

36
Q

What is the management of mild and severe CAP? Include penicillin allergies

A

Mild
1st PO amox
2nd PO doxy

Severe
1st IV co-amox + PO doxy
2nd IV levofloxacin

37
Q

What test is done to diagnose C. diff?

A

Stool toxin test

38
Q

What is the management of severe and non-severe c. diff?

A

Non-severe PO metron

Severe PO vanco

39
Q

What is c. diff infection? Why does it recur?

A

ABx induced pseudomembranous colitis

Spores

40
Q

What is the management of peritonitis? Include penicillin allergy, what each is against and the PO switch

A

Amox - gram +ve enterococci

Genta - coliforms

Metron - anaerobes

Allergy vanco + genta + metron

PO switch to co-trimox + metron

41
Q

What criteria diagnoses endocarditis? What investigations (par blood tests) are done?

A

Duke criteria

6 cultures
Echo

42
Q

What is the commonest cause of the following endocarditis scenarios

  • Native valve acute
  • Native valve subacute
  • Intra-op
  • Prosthetic valve
  • PWID
A
  • Native valve acute S. AUREUS
  • Native valve subacute VIRIDANS / ENTEROCOCCI
  • Intra-op EPIDERMIDIS
  • Prosthetic valve EPIDERMIDIS
  • PWID S. AUREUS
43
Q

What valve is effected in PWID endocarditis?

A

Tricuspid

44
Q

What is the management of the following endocarditis scenarios?

  • Mild native valve
  • Septic native valve
  • Prosthetic valve

How long are ABx given?

A
  • Mild native valve IV amox + genta
  • Septic native valve IV fluclox
  • Prosthetic valve IV vanco + PO rifampicin + IV genta

6 weeks

45
Q

What is the management of severe and non severe HAP?

A

Non-severe PO amox + metron

Severe AGM

46
Q

What is the management of mild and severe DM foot? Include penicillin allergy

A

Mild
1st fluclox
2nd doxy

Severe
1st fluclox + metron
2nd doxy + metron

47
Q

What is the bacillus cereus buzzword? What is the management?

A

Reheated rice

no ABx

48
Q

What infection is associated with petting zoos and BBQs?

A

E coli 0157

49
Q

What is the management of E coli O157 infection? What are the complications?

A

No ABx

HUS
AKI

50
Q

“Disproportionate pain to wound”

A

Necrotizing fasciitis

51
Q

Define septic shock

A

Hypotension on vasopressor + lactate>2 despite euvolemia

52
Q

What is the likely organism and Mx of septic arthritis and osteomyelitis?

A

IV 4-6wk fluclox

Y3 CLASP (4 decks)

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