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Phase 3 > Week 7 - Clinical Microbiology and Infection 2 > Flashcards

Week 7 - Clinical Microbiology and Infection 2 Flashcards

1
Q

What are the 2 categories by which bacteria can cause illness?

A

Infection - contaminate food then grow in the gut

Intoxication - grow in food and produce toxins

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2
Q

Give examples of bacteria which cause illness by

a) infection
b) intoxication

A

a) Salmonella, Campylobcater, E.Coli

b) Bacillus cereus, S. Aureus

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3
Q

Define gastroenteritis

A

N/V, diarrhoea and abdominal discomfort

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4
Q

What barriers of GI infection are present in the mouth?

A

Lysozyme

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5
Q

What barriers of GI infection are present in the stomach?

A

Acid pH (HCl)

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6
Q

What barriers of GI infection are present in the small intestine?

A
  • Mucous
  • Bile
  • Secretory IgA
  • Lymphoid tissue (Peyer’s patches)
  • Epithelial turnover
  • Normal flora
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7
Q

What barriers of GI infection are present in the large intestine?

A
  • Epithelial turnover

- Normal flora

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8
Q

What is the difference between enrichment broth, selective and differential agar

A

Enrichment broth - has nutrients to promote differential growth of many pathogens

Selective agar - surpasses broth of normal flora but allows growth of pathogens

Differential agar - can differentiate between pathogens on the same plate (e.g. by colour)

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9
Q

What are the 2 species which are well differentiated on agar due to being non-lactose fermenters?

A

Salmonella

Shigella

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10
Q

When are antibiotics used in GI Infections?

A

If symptoms are severe or have not gone away (prolonged)

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11
Q

What are the dangers of using antibiotics for a GI infection if unnecessary?

A
  • promotes resistance
  • may prolong symptoms
  • may exacerbate symptoms
  • may actually be harmful (e.g. STEC)
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12
Q

In what ways can GI infection be controlled?

A

-Safe, clean drinking water
-Proper sewage disposal
Education in food preparation - hand hygiene/ cross contamination/ proper cooking
-Pasteurisation of milk and dairy
-Sensible food travel practises

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13
Q

Define pneumonia

A

Infection of the lower, sterile part of the respiratory tract.

Due to sterility being breached

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14
Q

What is the most common pathogen causing community acquired pneumonia?

A

Streptococcus pneumoniae

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15
Q

What are the most common typical and atypical bacteria causing pneumonia?}?

A

Typical:

  • Strep pneumoniae
  • Haemophilus influenzae
  • Moraxella catharralis

Atypical:

  • Mycoplasma pneumoniae
  • Legionella pneumoniae
  • Chlamydophila pneumoniae
  • Chlamydophila psittaci
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16
Q

What are the risk factors for developing community acquired pneumonia?

A
  • Alcohol (immune def.)
  • Smoking (destroy innate immunity in RT)
  • Influenza virus/ HIV
  • Asthma
  • Cancer
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17
Q

How does Strep pneumoniae usually present?

A
  • Abrupt Onset
  • Cough
  • Fever
  • Pleuritic chest pain
  • Consolidation in lungs (Seen on X-ray)
  • Dull to percussion
  • Course crepitations
  • Increased vocal resonance
18
Q

How is Strep pneumoniae treated?

A

Penicillin

If allergy: Macrolide (Clarithromycin) or Tetracycline (doxycycline)

19
Q

Who does Haemophilus Influenzae tend to cause pneumonia in?

A

Older people

People with underlying lung disease

20
Q

What type of Haemophilus Influenzae is vaccinated against

A

Type B (HibB)

21
Q

How does Haemophilus Influenzae cause infection?

A

It normally colonises upper RT but it travels down to cause infection

22
Q

How does Haemophilus Influenzae usually present?

A
  • Abrupt Onset
  • Cough
  • Fever
  • Pleuritic chest pain
  • Dull percussion
  • Coarse crepitations
  • Increased vocal resonance
23
Q

How is Haemophilus Influenzae treated?

A

Amoxicillin ± b-lactamase inhibitor (Co-Amoxiclav)

If allergy: Macrolide (Clarithromycin) or Tetracycline (doxycycline)

24
Q

How does Mycolplasma Pneumoniae spread?

A

Person to person

25
Q

When is Mycolplasma Pneumoniae most common?

A

Autumn/ winter

26
Q

How does Mycolplasma Pneumoniae present?

A

ATYPICAL:

  • Slightly non-specific (atypical)
  • Slight cough
  • Flu-like symptoms
  • Consolidation in lungs on examination/ X-ray
27
Q

What systemic features (outwith lungs) can Mycolplasma Pneumoniae
have?

A
  • Haemolysis (can form cold agglutinins)
  • Guillain-Barre – associated with this
  • Erythema multiforme – rash
  • Cardiac conduction problems
  • Arthritis (reactive)
28
Q

What antibiotics do not work against Mycolplasma Pneumoniae and why?

A

Beta-lactams - these work on the cell wall and Mycolplasma Pneumoniae
doesn’t have a cell wall

29
Q

What is the treatment for Mycolplasma Pneumoniae?

A

Macrolide (Clarithromycin) or Tetracycline (doxycycline) or Quinolones (Ciprofoxacin)

30
Q

How is Mycolplasma Pneumoniae tested for?

A

Nucleic acid testing - PCR from gargle/ sputum/ throat swab

31
Q

How is Legionella Pneumophila contracted?

A

Exists in ameba in water sources, which humans ingest/ inhale and it affects macrophages in the lungs

32
Q

How does Legionella Pneumophila present?

A

ATYPICAL

33
Q

How is Legionella Pneumophila tested for?

A

Testing urine for antigen

also serology and culture sometimes

34
Q

How is Legionella Pneumophila treated?

A

Not beta-lactams - they have no cell wall

Macrolide (Clarithromycin) or Tetracycline (doxycycline) or Quinolones (Ciprofoxacin)

35
Q

What defines the CURB65 score?

A 
C - confusion
U - urea >7
R - Resp rate ≥ 30
B - BP <60/90
65 - over 65 yrs old
36
Q

What defines the qSOFA score?

A

Systolic BP <100
Altered mental status
Resp rate >22 bpm

37
Q

What defines severe pneumonia?

A

CURB score of 2 or more
Multilobar consolidation OR
Hypoxia on room air

38
Q

What blood tests are done for pneumonia?

A

FBC - WBC, haemolysis
U&Es
ABGs/Oxygen sats

39
Q

What microbiology tests are done for pneumonia?

A

Blood cultures
Sputum culture
Throat swab
Urine legionella antigen

40
Q

What investigations are done for pneumonia?

A

ECG

CXR

Phase 3 (4 decks)

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