Y3 Lecture week IV > Antibiotics > Flashcards

Antibiotics Flashcards

(48 cards)

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1
Q

Colour of staining of bacteria:

  • gram positive
  • gram negative
A
  • gram positive -> purple
  • gram - negative -> pink
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2
Q

Important gram positive cocci

  • general names (x2)
  • examples (x2 each group)
A
  • Staphylococcus
  • S aureus*
  • S* epidermidis
  • Steptococcus
  • S* pyogenes
  • S* pneumoniae
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3
Q

Important gram positive rods

  • general name (1)
  • example (1)
A

Gram +ive rods

Clostridia

- C difficile

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4
Q

Important gram negative cocci

  • general names (1)
  • examples (2)
A

Gram negative cocci

  • Neisseria*
  • N meningitidis
    • N gonnorhoea*
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5
Q

Important gram negative rods

  • general names (6)
A

Gram negative rods

  • E coli
    • Proteus*
    • Klebsiella*
    • Pseudomonas*
    • Salmonella*
    • Haemophilus (e.g.H influenza B)*
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6
Q

Forms of Haemophilus (2)

example of conditions they cause

A
  • capsulated (much more pathogenic e.g. acute epiglottitis)
  • non- capsulated (colonise lungs)

*Haemophilus B capsulated -> we can vaccinate against it -> so we can prevent epiglottitis

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7
Q

Example of anaerobic bacteria (1)

Location of it

A

Anaerobic

Strep faecalis

it survives in the gut

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8
Q

What bacteria is likely to cause this (picture)?

A

Staphylococcus Aureus

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9
Q

What bacteria is likely to cause this (picture)?

A

Streptococcus Pyogenes

*bacteria arranged in chains

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10
Q

What bacteria is it caused by? (picture)

A

Neisseria meningitidis

*polymorphic nuclei of the cells

* gram-negative intracellular diplococci = Neisseria

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11
Q

What bacteria is it caused by? (picture)

*this pt has a Hospital acquired infection - pt was ventilated at ITU then went to the ward

A

Staphylococcus Aureus

Streptococcus Pneumoniae

*it’s a mix infection

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12
Q

What bacteria is it caused by? (picture)

A

E. Coli

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13
Q

What organism is likely to cause this? (picture)

A

Candida Albicans

*fungus - branches/trees - like visible on microscopy

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14
Q

‘normal’/community-acquired pneumonia

  • history/presentation
  • likely organism
A

History: productive/ green cough, fever, pleuritic chest pain; lobar consolidation

Organism: Strep pneumonia (90% pneumococcus)

* 5-10 % atypical organisms

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15
Q

Atypical pneumonia

  • features/ clinical picture
  • what does it look like on chest x ray?
  • likely organisms (4)
A

Atypical pneumonia

A. Features:

  • dry, non-productive cough
  • headache
  • myalgia
  • fever

B. CXR: lots of consolidation, sometimes on both sides, not confined to one side

C. Organisms:

  • coxiella burnetii
    • mycoplasma pneumonia*
    • chlamydia* pneumoniae
    • legionella*

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16
Q

Antibiotics for young and fit person with community-acquired pneumonia

A

Amoxicillin (penicillin) + Macrolide

*this is to cover pneumococcus and atypical organisms

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17
Q

Cigarette smoker with mucociliary function impaired and repeated chest infections

  • what organism may colonise that person and cause chest infections?
A

Organisms:

  • Haemophilus
  • Pseudomonas (if bronchiectasis and repeated chest infections)

*these are nasty infections, multi-drug resistant

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18
Q

Just look at the picture

A
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19
Q

Aspiration pneumonia

  • examples of patients at risk
  • organisms causing it
  • antibiotic used
A

Aspiration pneumonia

Patients at risk: patients who vomit and inhale -> epileptic/fitting, alcoholics, stroke

Organisms: anaerobes

Antibiotics: metronidazole

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20
Q

Patients who are at risk of pneumonia caused by TB

Study These Flashcards
A
  • HIV/ immunosuppressed
  • people from Sub-Saharan Africa, South East Asia; Eastern Europe, India
21
Q

Organisms causing UTI

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A

UTI

  • gram negatives
  • catheter: staphs, candida

-

22
Q

Abdominal infections (bowel)

  • what organisms cause it
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A

small bowel -> sterile

large bowel -> gram negatives + anaerobes

*therefore small bowel operations are separated from large bowel (on the surgeries list - small bowel operations will be first on the list)

23
Q

Meningitis

What are likely organisms causing it (according to the group)?

A. normal/ adults

B. kids <5

C. neonates

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A

Meningitis

Adults: N. meningitidis + Strep pneumoniae

Kids <5: Haemophilus

Neonates: group B Streptococcus, gram negatives, Listeria, HSV

24
Q

presentation of meningitis:

A. adults

B. neonates

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A

A. Adult: photophobia, neck stiffness, headache, fever

B. Newborn: cry, fever*

*a lot of meningitis happen in neonates presenting with cry and fever (as possible meningitis)

25
Just look at the picture
26
What's the cause of food poisoning? Do antibiotics help?
**Food poisoning** -\> ingestion of pre-formed toxin Antibiotics would not help \*if dehydrated, may need IV drip
27
What's ***gastroenteritis***? - what location is infected? - how does the diarrhoea look like? - likely organisms - management
Gastroenteritis -\> ingestion of the bug -\> it colonises the gut and multiplies (may or not produce toxins) * location: small bowel is infected * diarrhoea: green and watery * likely organisms: viral, *salmonella, E* *coli* Management: * -* usually no antibiotics - usually self-limiting
28
***Colitis*** - location of infection - appearance of diarrhoea/ features of infection - likely organisms - management
***Colitis*** * Location: large bowel * Diarrhoea: less watery/more formed (than gastroenteritis), but more sick (abdominal pain, feverr, high WBCs, fresh/red blood in the stool) * Organisms: *Campylobacter, E* *coli* *0157,* *Ameobic* *dysentery* * Management: needs antibiotics
29
Bacteria (2) causing skin/ soft tissue/ bone infections
Staphylococcus, Streptococcus
30
Organisms causing ***endocarditis*** associated with: ## Footnote A. native valve B. IVDU C. Artificial valve
A. native valve -\> Strep viridans B. IVDU -\> Staph aureus, fungal C. Artificial vale -\> staphs (they love plastics/metals)
31
What are the key questions to be asked before we prescribe antibiotics?
* is there an infection * what's the location * what's the likely organism * what antibiotics are likely to be effective * is there likely resistance * will antibiotic penetrate the site of infection * route of administration * what's the toxicity and cost
32
Look at the pic _MoA and examples of:_ B- lactams Aminoglycosides
33
Look at the pic _MoA and examples of:_ * Macrolides * quinolones
34
Look at the pic _MoA of:_ - metronidazole - glycopeptides - tetracycline
35
***Flucloxacillin*** ***-*** against which organism? - what type of spectrum is it?
Flucloxacillin - against ***Staphs*** it is narrow spectrum
36
What spectrum activity amoxicillin has?
***Amoxicillin*** - brad spectrum (covers some gram-negative and positives)
37
What's in the ***Co-Amoxiclav*** (2 substances) - spectrum - side effect
Amoxicillin + clavulanic acid (Co-Amoxiclav) clavulanic acid -\> it is an inhibitor of Beta-lactamase (so bacteria cannot incorporate B-lactams into their cell wall) _S__pectrum_: broad -\> positives (Penicillins), anaerobes and negatives _Side effect:_ more of own bacteria killed -\> risk of C Diff diarrhoea
38
What's the most commonly ***Cephalosporin*** used? - spectrum
Ceftriaxone -\> broad spectrum
39
What's the name of antibiotic from ***carbapenam*** class that is reserved for difficult infections? - what's its spectrum?
***Imipenem*** | (very broad spectrum)
40
***Aminoglycosides*** - MoA - examples - spectrum
look at the picture
41
***Macrolides*** - MoA - examples - spectrum
Look at the picture
42
***Quinolones*** - MoA - example - spectrum
Look at the picture
43
***Tetracyclines*** - MoA (simple) - example - spectrum
Look at the picture
44
***Anti-folate*** - MoA (simple) - example - spectrum
Look at the pic
45
***Glycopeptides*** - MoA (simple) - example - spectrum
look at the pic
46
***Metronidazole*** - MoA (simple) - example - spectrum
look at the pic
47
What questions (3) and why do we need to ask in terms of antibiotics (related to resistance)?
* **community-acquired or hospital-acquired**? -\> hospital-acquired are usually resistant * **previous antibiotic**? -\> if one antibiotic does not work -\> prescribe different one * **travel** **history**? -\> e.g. penicillin-resistant pneumococcus is rare in the UK, but may be even 20% in Spain/ Southern Europe; depends on the country
48
What factors (in term of the patient's condition ) would prompt us to use IV antibiotics?
* very sick patient * serious infection * the barrier to drug absorption * malabsorption * vomiting/swallowing problems * poor bioavailability * poor tissue penetration
Y3 Lecture week IV
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