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Infection > Y4 - Microbiology Tutorial > Flashcards

Y4 - Microbiology Tutorial Flashcards

1
Q

What is the incubation period of the influenza virus?

A

1-4 days

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2
Q

What is the transmission of influenza?

A

Droplet

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3
Q

How does droplet transmission differ from aerosol?

A

Droplet involves larger particle sizes (>5microns) Aerosol is smaller particles (can travel further as they are smaller and more infective)

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4
Q

What sorts of patients would you give antivirals to if they had flu?

A

Immunocompromised, elderly, really young, pregnant, heart/lung/other chronic disease

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5
Q

If you want to use antivirals to treat the flu, and there is high resistance to oseltamivir, what antiviral should you use?

A

Zanamivir

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6
Q

How do you treat uncomplicated flu?

A

Fluid, rest, analgesia etc.

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7
Q

What is the incubation period of norovirus?

A

72 hours

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8
Q

What is the advice you should give to a healthcare worker who has norovirus?

A

Don’t come back to work until you are >48h symptom free

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9
Q

What is the transmission of norovirus?

A

Faecal-oral, contact, droplet (swallowing droplets)

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10
Q

What is the treatment of norovirus?

A

Supportive If elderly/immunocompromised can get into kidney failure (dehydration)

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11
Q

Define incubation period

A

Period of time between contracting the pathogen and displaying overt symptoms

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12
Q

True or false: When there is an outbreak of norovirus, hand gel is sufficient to kill the bacteria

A

False Must wash hands with soap and water as norovirus is a non-enveloped virus so alcohol gel doesn’t work

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13
Q

What is the difference between gram negative and positive bacteria?

A

Structure of their cell wall: Gram positive: single thick peptidoglycan layer Gram negative: thin peptidoglycan layer & outer cell membrane with lipopolysaccharide layer

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14
Q

Describe the process of gram staining

A
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15
Q

What bacteria tend to cause eye infections?

A

Staph aureus

Nessieria gonorrhoea

Chlamydia trachomatis

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16
Q

What infections tend to cause sinusitis?

A

Strep pneumoniae

H. influenzae

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17
Q

What bacteria tend to cause URTIs?

A

Strep pyogenes

H. influenzae

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18
Q

What infections tend to cause gastritis?

A

H. pylori

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19
Q

What bacteria can cause food poisoning?

A

Campylobacter jejuni

Salmonella

Shigella

Clostridium

Staphylococcus aureus

E. coli

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20
Q

What bacteria tend to cause UTIs?

A

E. coli

Other enterococci

Staphylococcus saprophyticus

Pseudomonas aeruginosa

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21
Q

What bacteria cause STIs?

A

Chlamydia trachomatis

Neisseria gonorrhoea

Treponema pallidium

Ureplasma urealyticum

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22
Q

What bacteria commonly cause skin infections?

A

Staph aureus

Strep pyogenes

Pseudomonas aeruginosa

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23
Q

What bacteria tend to cause community acquired pneumonias?

A

Strep pneumoniae

H. influenzae

Staph aureus

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24
Q

What bacteria cause atypical pneumonia?

A

Mycoplasma pneumoniae

Chlamydia pneumoniae

Legionella pneumophila

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25
What bacteria causes TB?
Mycobacterium tuberculosis
26
What bacteria causes otitis media?
Strep pneumoniae
27
What bacteria commonly cause meningitis?
Strep pneunmoniae Neisseria meningitidis H. influenzae Strep agaetiae Listeria monocytogenes
28
What is strep pyogenes also known as?
Group A strep
29
What is the clinical signifiance of group B strep?
Importance cause of neonatal sepsis Tested for in pregnancy
30
What does group C strep tend to cause?
Skin and soft tissue infections
31
What can strep pyogenes cause?
Tonsilitis, necrotising fasciitis, scarlett fever etc.
32
Give examples of gram negative rods
Enteric bacteria: * E. coli * Salmonella * Shigella * Yersinia * Pseudomonas * Proteus * Vibrio cholerae * Klebsiella pneumoniae Other gram -ve rods: * Bodetella pertussis * H. influenzae * Campylobacter jejuni * H. pylori * Legionella pneumophilia Anaerobes: * Bacteriodes fragilies * Fusobacterium
33
What is the main thing that proteus bacteria cause?
UTIs
34
What main things does pseudomonas cause?
Chronic lung infection in those with CF Seen in a lot of ulcers too
35
Do we culture bordetella pertussis?
No takes too long Can do PCR (from throat/nasal swab) in first 2 weeks of infection After 2 weeks can do bordetella serology
36
What does bacteriodes fragilis cause? How do you treat it?
Abscesses Rx: metronidazole (used for anaerobes!)
37
What infections do fusobacterium cause?
Sore throat and tonsilitis that doesn't seem to get better. Seen more in young fit people and can cause jugular vein thrombosis
38
Give examples of gram negative cocci?
Neisseria gonorrhoea (gonoccocus) Nesseria meningitidis (meningococcus) nb these are both gram -ve intracellular diplococci
39
What are the gram positive cocci?
Staphylococci Streptococci
40
Which of the gram positive cocci are catalase positive?
Staphylococci
41
What is the apearance of staphylcocci?
Gram positive cocci in clusters
42
What bacteria are staphylococci?
Staphylococcus aureus Staph. epidermis and other CNS
43
How do you tell the difference between staph aureus and staph epidermis?
Staph aureus is coagulase positive, other staph are coagulase negative (CNS)
44
What are the streptococci?
Strep pyogenes Strep pneumoniae Viridians type strep Enterococci faecalis NB: chains of strep tend to be group A/B/C strep, diplococci of strep tend to be strep pneumoniae
45
Staph aureus/epidermis is usually significant when found in blood culture.
Staph aureus Staph epidermis usually a contaminant
46
What are the gram positive rods?
Clostridia * Anaerobes * C. perfringens * C. tetani * C. botulinum * C. difficle Bacillis cereus (aerobe) Listeria monocytogenes (facultative anaerobe)
47
What can C. perfringens cause?
Gas gangrene
48
What can listeria cause?
Meningitis in neonates, immunocompromised, pregnant
49
Where is listeria contracted from?
Usually soft cheese, pate etc.
50
What types of bacteria are not gram-stainable?
Unusual gram positives Spirochaetes
51
What are the unusual gram positives?
Mycobacteria (M. tuberculosis, M. avium) May be weakly positive/unstained on gram stain
52
What stain must you use for mycobacteria?
Ziehl-Neelsen stain | (as they are acid-fast bacilli)
53
What is the appearance of spirochaetes?
Thin spiral bacteria
54
How do you visualise spirochaetes?
Phase-contrast microscopy/silver stain
55
Give examples of spirochaetes
Treponema pallidium Borrelia burgdorferi
56
What causes lyme disease?
Borrelia burgdorferi
57
What vectors carry lyme disease?
Lxodes ricnus complex hard ticks (sheep ticks)
58
What is the classic rash associted with lyme disease?
Erythema migrans
59
What can happen if lyme disease is left untreated?
Dissemination to CNS, joints and heart
60
How do you treat suspected lyme disease?
Doxycyline 100mg BD for 3 weeks
61
What is staph aureus bacteraemia?
Cause of serious healthcare associated blood stream infection
62
What is the mortality rate associated with staph aureus bacteriaemia?
20-40%
63
True or false: Staph areus can colonise patients
TRUE Can live on people's skin and mucosa (nose) without causing infection It can cause infection if it enters the body through broken skin or medical procedure
64
What infections can staph aureus bacteraemia come from?
Wounds Cellulitis Pneumonia Joint infection Bacteraemia Endocarditis
65
Once in the bloodstream, staph aureus can release toxins - name these.
Enterotoxins, toxic shock syndrome toxin 1, epidermolytic toxins
66
What are the complications associated with staph aureus bacteraemia?
Metastatic infections, e.g. endocarditis, vertebral osteomyelitis, discitis High mortality
67
How do you prevent staph aureus bacteraemia?
Hand hygiene, aseptic technique doing invasive procedures
68
What examination findings may help point to a cause in staph aureus bacteraemia?
Murmurs, skin and bone and joint tenderness (e.g. SA/discitis), urinary catheters, prostheses (prosthetic joints/valves)
69
How do you investigate staph aureus bacteraemia?
CT/MTI (discitis), joint aspiration, TTE, CXR, repeat blood cultures
70
How do you treat staph aureus bacteraemia?
Methicillin sensitive - IV flucloxacillin 2g 4-6hrly assuming normal renal function TREAT FOR AT LEAST 14 DAYS IV (longer for deep seated infection such as endocarditis)
71
Define endocarditis
Infection of endocardial surface of the heart
72
What is the mortality associated with endocarditis?
20%
73
What valves are most commonly affected by endocarditis?
Mitral and aortic alone (left side more common due to pressure difference) IVDA more commonly get the right side of the heart and are also more likely to get lung abscess
74
What is the pathogenesis of endocarditis?
Requires simultaneous occurence of many events Altered valve surface-bacterial attachment and colonisation Platelet-fibrin deposition Bacteria adhesion-colonisation-invasion
75
What organisms can cause endocarditis?
Staph (most common) Strep Enterococci Gram -ve and fungi v. rare Culture negative causes may incl. prev course of antibiotics, Q fever (coxiella burnetti)
76
What are the clinical features of endocarditis?
Fever Heart murmur New murmur Others: chill, weakness, SoB, anorexia, weight loss, stroke Osler nodes Janeway lesions Roth spots Glomerulonephritis (haematuria) Septic emboli to brain/lungs/spleen
77
Describe janeway lesions
Non-tender, microabscesses Tend to be on palms/soles
78
Describe Roth spots
Retinal lesions surrounded by haemorrhage and usually located near the optic disc
79
Describe Osler's nodes
Non-specific, tender, immunological sign
80
What investigations should you do for endocarditis?
Hx, Ex ESR, CRP, WCC, dipstick for haematuria Blood cultures - 3 sets Serology for blood culture negative endocarditis Echo (TOE more sensitive than TTE, but use TTE first)
81
What criteria is used for assessing endocarditis?
Duke criteria Endocarditis: 2 major or 1 major and 3 minor or 5 minor
82
What are the major duke criteria?
* Positive blood cultures for IE (e.g. staph/strep/enterococci) * Evidence of endocardial involvement - +ve echo with mass on valve, new valvular regurgitation
83
What are the minor duke criteria?
* Predisposition - valve abnormality, IVDU * Fever * Vascular-arterial emboli, septic pulmonary infarct, Janeway lesions * Immunological: Osler's nodes, Roth spots * Microbiological phenomena: positive blood culture but not met major criteria * Echo findings: consistent with endo but not met major criteria
84
What is the management of endocarditis?
Antibiotics dependent on organism and sensitivity E.g. flucloxacillin 2g IV 4-6hrly for 4 weeks for flucloxacillin sensitive staph aureus native valve endocarditis For PVE due to MSSA use combination of flucloxacillin, rifampicin and gentamicin for 6 weeks
85
What are the indications for surgical management of endocarditis?
* Heart failure - refractory pulmonary oedema or cardiogenic shock esp in prosthetic heart endocarditis * Perivalvular infection with abscess * Failure of medical Rx-persistent fever and positive blood culture \>10 days after appropriate antimicrobial therapy * Septic emboli especially from AV or MV with large vegetation \>10mm

Infection (22 decks)

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