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3 Infections and Clinical Practice EJR > week 2 > Flashcards

week 2 Flashcards

1
Q

what are the 3 stages according to the sepsis 3 criteria

A

simple infection
sepsis
septic shock

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2
Q

what are the criteria for sepsis

A

lactate >2
new AKI
or one or more of

altered mental state
RR≥25
HR≥130
SBP <90 OR 40% below normal
Urine output <0.5mls/kg/hr or anuric for 18 hours
ashen or mottled skin or purpuric rash
cyaniotic skin lips or tongue
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3
Q

what is the criteria for septic shock

A

persisting hypotension or >2 lactate despite 3L IV fluid

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4
Q

what is sepsis 6

A 
give oxygen
give fluids
give antibiotics
take lactate
take cultures
record urine/fluid balance
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5
Q

what antibiotic is commonly used prophylactically for chronic chest infection

A

azithryomycin

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6
Q

what is VBG useful for

A

lactate
pH
glucose
U&Es

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7
Q

co-amoxiclav can cause jaundice T or F

A

T

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8
Q

what is creatinine kinase an indicator of

A

muscle damage

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9
Q

old person with HR of 150 is until proven other wise?

A

tachy AF

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10
Q

why can BP be low in AF?

A

heart is pumping fast but inefficiently

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11
Q

how long is an acute wound classed as

A

<6 weeks

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12
Q

3 stages of wound healing

A

inflammatory phase
proliferation phase
remodelling/maturation phase

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13
Q

difference between healing by primary secondary and tertiary intention

A

primary is clean, low infection risk, minimal scar

secondary; slightly bigger scar, takes longer, partial or full thickness

tertiary; high infection risk, left open to heal before attempting to close

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14
Q

criteria for stage 1 AKI

A

creatinine >50-99% increase within 7 days

or

urine output <0.5ml/kg/hour for more than 6 hours

or creatinine rise >26 micromol within 48 hours

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15
Q

which cell does the HIV infect

A

CD4

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16
Q

3 routes of transmission for HIV

A

sexually
blood borne
vertically

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17
Q

how does HIV kill you

A

infect CD4 cells, destroying them progressively, as CD4 count goes lower, opportunistic infections and other complications arise, eventually leading to death

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18
Q

describe primary HIV infection

A

most patients go through seroconversion which manifests as flu-like symptoms - fever, malaise, anorexia, myalgia, rash, lymphadenopathy

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19
Q

what are CD4 and viral loads like during seroconversion

A

VL is high

cd4 drops

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20
Q

what happens after seroconversion

A

viral load drops
cd4 counts go back up

virus goes into dormant phase

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21
Q

what is the window period for HIV testintg

A

4-8 weeks

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22
Q

who should you offer HIV screening test

A

GUM clinic with risk factors
high-risk area GP registrations
diagnosis of HIV/AIDS associated illnesses

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23
Q

how are HIV patients monitored

A

CD4 and viral counts are checked 6 monthly to assess need for commencement of treatment

risk factors continually assessed

24
Q

what is AIDS defined as in terms of CD4 count

A

<200 x 10^6/ml

25
Q

some side effects of HAART

A

anaemia
neutropaenia
thrombocytopaenia

26
Q

4 non-infectious AIDS defining illnessess

A

kaposis’ sarcoma
lymphoma
progressive multifocal leucoencephalopathy
AIDS dementia

27
Q

what is the expected order of opportunistic infections as CD4 counts drop

TB
CMV retinitis
PCP
shingles

A

shingles
TB
PCP
CMV

28
Q

what is PCP?

A

pneumocystis jerovecii pneumonia

presents with - sob, tachypnea, dry cough, fever

29
Q

when should prophylaxis for PCP be given to HIV patients?

A

CD4 <200 OR hx of PCP infection

30
Q

what is toxoplasmosis

A

caused by protozoan toxoplasmosis gondii

infects the brain causing neurological symptoms

31
Q

symptoms of toxoplasmosis in HIV patients

A 
seizures
focal neurological deficits
hemiparesis
headache
confusion
32
Q

what is PML?

A

progressive multifocal leucoencephalopathy

progressive demyelination of white matter in brain, leads to progressive neurological and cognitive loss and death

33
Q

4 types of medicine given in HAART

A

nucleotide reverse transcriptase inhibitors (NRTI)
Non-NRTI
protease inhibitors
integrase inhibitors

34
Q

name some classes of antibiotics that target the 30s or 50s RNA subunits

A

amingoglycosides
macrolides (50s)
tetracyclines

35
Q

what is co-amoxiclav most given for?

A

RTIs

36
Q

what does clavulanic acid do

A

inhibits beta lactamase

37
Q

co-amoxiclav is given for MRSA - T or F?

A

F

38
Q

what is the 1st line antibiotic for cellulitis

A

flucloxacillin

39
Q

flucloxacillin only exists as IV preperation - T or F

A

F, oral or IV

40
Q

3rd generation cephalosporins are more potent than 1st generation ones - T or F

A

F, they have different spectrum of activity

41
Q

cefutaxime is generation of cephalosporin

A

3rd gen

42
Q

what is cef & met commonly given for

A

intra-abdominal infections

43
Q

what is cefutaxime commonly given for

A

bacterial meningitis

44
Q

what route of administration is meropenem given as

A

IV

45
Q

name 1 glycopeptide

A

vancomycin

46
Q

what is the target of glycopeptides

A

cell wall synthesis

47
Q

why are tetracyclines not given to children and pregnant women

A

it gets deposited in teeth and bone

48
Q

give 2 examples of a macrolide

A

erythromycin azithromycin clarithromycin

49
Q

in severe pneumonia, co amoxiclav and clarithromycin are given, what does clarithromycin cover?

A

atypical organisms

50
Q

ciprofloxacin, moxifloxacin are what class antibiotics?

A

quinolones

51
Q

what is ciprofloxacin especially active against?

A

gram negative intracellular infections

52
Q

which of these is an aminoglycoside - erythromycin gentamicin doxycyline?

A

gentamicin

53
Q

what 2 organs do aminoglycosides damage most?

A

ototoxicty and nephrotoxicity

54
Q

what is co-trimoxazole made up of and what is it used for commonly

A

trimethoprim and sulfamethoxazole, PCP

55
Q

what can you not take with metronidazole?

A

alcohol

56
Q

what kind of organisms does metronidazole work against

A

anaerobes and protozoans

3 Infections and Clinical Practice EJR (6 decks)

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