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3 Infections and Clinical Practice EJR > week 3 > Flashcards

week 3 Flashcards

1
Q

what is the difference between primary and secondary immunodeficiencies

A

primary ones are genetically inherited

secondary immunodeficiencies are acquired later in life

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2
Q

when are most primary immunodeficiencies diagnosed

A

in early childhood

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3
Q

what is the definition of neutropenia

A

neutrophils < 0.5 x 10^9/L

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4
Q

what is the diagnostic critera for neutropenic sepsis

A

patient with neutropenia

fever of >38C

or other signs of sepsis

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5
Q

who are at high risk of neutropenic sepsis

A

cancer patients receiving chemotherapy

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6
Q

what is the general guidance for antimicrobial agent in neutropenic sepsis

A

IV broad spectrum

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7
Q

give an example of a recommended antimicrobial agent for use in treating neutropenic sepsis

A

tazocin

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8
Q

other than antibiotics, what are measures should be taken in someone with neutropenic sepsis

A

barrier nursing
IV fluids
avoid regular paracetamol

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9
Q

why is regular paracetamol avoided in neutropenic sepsis?

A

can mask fever

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10
Q

what are transplant patients at risk of infections

A

immunosuppresive drugs

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11
Q

what bacteria are common in transplant patient infections

A

ps aeruginosa

staph epidermis

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12
Q

what viruses and fungi are common in transplant patient infections

A

aspergilosis, cryptococcus, candida

hsv, cmv, vzv, ebv

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13
Q

what kind of infections are asplenic patients more susceptible to

A

bacterial infections with encapsulated bacteria

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14
Q

why is the common pattern of infection in asplenic patients

A

short prodrome with sudden deterioration (DIC, septic shock, seizures, coma)

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15
Q

common bacterial causes of meningitis

A 
Neiserria meningitis
strep pneumonia
staph aureus
GBS
listeria monocytogenes
e coli
mycobacterium TB
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16
Q

common viral causes of meningitis

A

enteroviruses
HSV 1 and 2
varicella zoster virus
EBV

17
Q

most common bacterial cause of meningitis in newborns

A

GBS

18
Q

what is the triad of features found in bacterial meningitis

A

headache
neckstiffness
photophobia

19
Q

what are the clinical features of bacterial meningitis

A 
fever
headache
neckstiffness
photophobia
altered mental state
seizure
\+ve kernigs and brudzinskis
vomiting
20
Q

what clinical feature can also be found in viral meningism, but not in bacterial

A

coryzal prodrome

21
Q

what are signs of meningococcal septicaemia

A

non-blanching purpuric rash

sepsis

22
Q

investigations for meningitis

A 
blood cultures
LP
blood glucose
bloods
head imaging
coagulation
ABG
23
Q

why is blood glucose important to do at the same time as an LP

A

to compare CSF glucose with blood

24
Q

CSF picture in bacterial meningitis

appearance
lymphocytes
polymorphs
protein
glucose
A 
cloudy
low lymphocytes
high polymorphs
high protein
low glucose
25
Q

CSF picture in viral meningitis

appearance
lymphocytes
polymorphs
protein
glucose
A 
clear
high lymphocytes
low polymorphs
mildly raise protein
normal glucose
26
Q

CSF picture in TB meningitis

appearance
lymphocytes
polymorphs
protein
glucose
A 
cloudy
delayed increase in lymphocytes
high polymorphs
high protein
low glucose
27
Q

in suspected meningitis, fastest way to check for raised ICP?

A

fundoscopy - papiloedema

28
Q

3 possible sequelae of meningitis

A

deafness
neurological defects
amputation

29
Q

treatment for meningitis

A

3rd gen cephalosporin
dexamethosone
treat sepsis

30
Q

common viral causes of encephalitis

A

HSV 1 and 2
VZV
coxsackie virus

31
Q

difference between bacterial meningitis and viral encephalitis in clinical features

A

viral encephalitis often have neurological defects and decreased consciousness

32
Q

investigations done in encephalitis

A

LP - PCR for viral dna
brain imaging
EEG
blood serology

33
Q

treatment for HSV encephalitis

A

IV aciclovir for 2-3 weeks

34
Q

what bacteria species are asplenics particularly susceptible to

A

encapsulated e.g.

strep pneumoniae
HiB
N. Menigitides
E. Coli

salmonella
Klebsiella
strep Group b

35
Q

why are splenic patients more susceptible to encapsulated bacteria?

A

because encapsulated bacteria cannot be phagocytosed and require opsonisation and cell-mediated antibody production. without a spleen, patients cannot respond appropriately to such bacteria

3 Infections and Clinical Practice EJR (6 decks)

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