Week 6 Flashcards

Learn all CBLs

1
Q

How should bloods be taken when dealing with a patient with possible bacterial endocarditis?

A
  • 3 sets of blood cultures (with the first and last 1 hour apart)
  • taken from peripheral veins
  • 10mls of blood in each bottle
  • taken before antibiotics
  • meticulous sterile technique
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2
Q

What is the most contaminants in a blood culture?

A

Coagulase-negative staphylococci

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3
Q

When a patient has CDI what precautions are put in place?

A
  • standard infection precautions
  • isolation of the patient
  • hand hygeine with soap and water
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4
Q

What facts should you establish in a sexual history?

A
  • date of last sex
  • gender of their sexual partners
  • type of sex
  • did he/the partner use a condom
  • has he ever has a sexual health check-up
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5
Q

What tests are taken at a sexual health test?

A
  • Blood test for HIV and syphilis
  • NAAT (nucleic acid amplification test) for gonorrhoea and chlamydia (swabs taken from relevant sites)
  • Test for Hep B should be tested for in blood if MSM
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6
Q

What are the benefits of regular sexual health checks for men having sex with men?

A
  • Allows discussion of preventative measures: condom use, safe sex, HIV symptom awareness, drugs and alcohol
  • People often misjudge personal risk
  • Psychological support: recreational drug use, ‘coming out’, relationship issues. Can signpost to other services
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7
Q

What type of infection is HSV?

A

Chronic recurrent STI

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8
Q

How is gonorrheoa treated?

A

IM ceftriaxone and oral azithromycin

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9
Q

What can be done to minimise the development of drug resistant strains of gonorrhoea?

A
  • Rapid accurate diagnosis
  • Avoid blind therapy with inappropriate drugs
  • Partner notification
  • Epidemiological monitoring of resistance data
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10
Q

What advice can you give to help a man reaquiring a gonnorhoea infection?

A
  • reinforce safer sex with condom
  • not having sex with recent sexual partners until they are tested and treated
  • test of cure at 2 weeks post treatment
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11
Q

What is a rash involving the palms in sexual health patient indicative of? How long can this condition take to appear?

A

Syphilis

Primary = up to 90 days

Secondary = up to 6 months

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12
Q

A woman comes to the doctors reporting acute onset diarrheoa. What should you ask her when taking a history?

A
  1. Food history
  2. Ill contacts
  3. Travel history
  4. PMH
  5. Occupational history
  6. Risk factors for CDI (i.e >65, recent hospitalisation, recent course of antibiotics) (having 2/3 of these factors should make you consider CDI)
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13
Q

What are some non-infectious causes of diarrhoea?

A
  • IBD (UC, Crohn’s)
  • Diveticular disease
  • Chronic pancreatitis
  • HIV
  • Ischaemic bowel
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14
Q

What are the most common causes of gastroenteritis?

A
  • Campylobacter
  • Salmonella
  • E. coli 0157
  • Norovirus
  • Rotavirus’
  • Giardiasis
  • Enterohaemorrhagic E. Coli
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15
Q

Which viruses cause a vesicular rash?

A
  • HSV -1/2
  • Varicellar zoster virus (chicken pox)
  • Enteroviruses (Hand Foot and Mouth Disease)
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16
Q

What can variecella zoster virus be reactivated to? Who is at risk of this?

A
  • Reactivation to herpes zoster (shingles)

- Pregnant women, neonates, immunocompromised

17
Q

How do you diagnose a vesicular rash?

A

Chickenpox can be diagnosed clinically

HSV1/2, varicella zoster virus and enterovirus can be diagnosed in the lab using PCR on a vesicle swab

18
Q

How is varicellar zoster transmitted?

A
  1. Respiratory transmission

2. Contact with vesicle fluid

19
Q

How do we provide evidence of VZV immunity in immunocompromised individuals?

A

VZV IgG testing

20
Q

What would an immunocompromised individual with VZV be at risk of?

A
  • Bacterial infection of the skin and soft tissues
  • Disseminated varicella
  • haemorrhagic varicella
  • VZV encephalitis
  • VZV pneumonitis
21
Q

What prophylaxis can an immunocompromised individual be given for VZV?

If this prophylaxis is unsuccessful what therapy is availble?

A

VZ Immunoglobulin prepared from pooled plasma of non-UK donors (due to risk of vCJD)

Aciclovir