CC2 > Infection > Flashcards

Infection Flashcards

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1
Q

3 mechanisms through which bacteria can cause disease

A
  1. Directly eg cell destruction
  2. Exotoxin production
  3. Activate immune system
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2
Q

Process of gram staining bacteria

A 
CIAS
Crystal violet
Iodine
Alcohol 
Safranin
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3
Q

What is gram positive bacteria

A

Bacteria that retain crystal violet stain because of thick peptidoglycan wall
PURPLE

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4
Q

What are gram negative bacteria

A

Bacteria with thin peptidoglycan cell wall so crystal violet stain washes out and counter stain with pink safranin remains

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5
Q

Name gram -ve cocci

A

Neiserria meningitidis (aer)
Neiserria gonorrhoea
Moraxella catarrhalis

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6
Q

Name gram - rods and infection

A
  1. E coli
  2. Klebsiella pneumoniae and oxytoca (UTI)
  3. Proteus murabilis
  4. Shigella
  5. H pylori
  6. Typhoid
  7. whooping
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7
Q

Name gram + cocci and infection

A
  1. Staph (coag + = aureus, coag - = epidermis) skin + st infections
  2. Strep
    pneumoniae
    beta haemolytic = nec fasc, cellulitis
    vividans = endocarditis
  3. Enterococcus
    faecalis = amox sens
    faecium = amox neg
    endocarditis + abdo infection
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8
Q

Name gram + rods

A
  1. Actinomyces = coil
  2. Bacillus cereus = rice
  3. Corynebacterium = diptheria
  4. Listeria = food, meningitis
  5. C diff
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9
Q

What does Ziehl Neelsen stain pick up

A

Acid fast bacilli ( rods that are ?mycobacteria, nocardia)

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10
Q

TB typical tx

A 
6 MONTHS RIPE
rifampicin
isoniazid
pyrazinamide
ethambutol
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11
Q

Dyes used in ZN stain

A

malachite green

or methylene blue

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12
Q

HSV appearance

A

fried egg

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13
Q

What kind of infections does HSV cause

A

HSV1 - oral

HSV2- genitals

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14
Q

HSV tx

A

Aciclovir

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15
Q

Tx of influenza

A

Tamiflu = Oseltamivir

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16
Q

What drug are anaerobes most sensitive to

A

metronidazole

aerobes
gram -ve cocci = n men
gram + rods = diptheria + listeria

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17
Q

Main mechanisms of AMR

A
  1. Enzyme production
  2. changes to antimicrobial target/pathway
  3. efflux pumps
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18
Q

3 big resistant pathogens

A

Methicillin resistant staph aureus (MRSA)

Vancomycin resistant enteroccoci (VRE)

Extended spectrum beta lactamase producing enterobacteriacae (ESBL)

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19
Q

UTI RF

A 
DM
Pregnancy
Impaired voiding
GU malformation
Prostatic hypertrophy
Renal stones
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20
Q

Organisms causing sore throat

A
  1. Viral
  2. Bacterial = group A beta haemolytic strep
    also group C/G step
  3. Bacterial = corynebacterium diptheria
  4. fusobacterium necrophorum
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21
Q

What criteria is used to see if abx should be given for sore throat

A

Centor to rule in/out group a strep

  • fever?
  • inflammation?
  • no cough or runny nose
  • present within 3 days
  • pus on tonsils
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22
Q

Management of group A strep pharyngitis

A
  1. 10 days oral penicillin V or macrolide like clarithromycin if allergy
  2. isolate if in hospital
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23
Q

What happens if you don’t treat group A strep pharyngitis

A
  1. quinsy (paratonsillar abscess)
  2. scarlet fever
  3. rheumatic fever
  4. glomerulonephritis
  5. nec fasc
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24
Q

How can diptheria manifest

A
  1. pharyngitis/tonsilitis(stuck)

2. myocarditis, neuropathy

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25
Features of mono
Fever, tired, sore throat lymphadenopathy splenomegaly rash if given amoxicillin
26
EBNA
+ for EBV 2 months later
27
Management of mono
symptomatic | avoid contact sports for 6 weeks risk of splenic rupture
28
Organisms usually causing otitis media + sinusitis
1. viral 2. strep pneumoniae (mastoiditis and meningitis risk) 3. haemophilus influenzae
29
Symptoms of OM/sinusitis
Fever, pain, tenderness | - deafness, dizziness
30
Organism causing acute epiglottitis
Haemophilus influenzae B
31
Symptoms of acute epiglottitis
Distress, dysphonia, dysphagia, drooling
32
Management of acute epiglottitis
Intubate, IV ceftriaxone
33
What organism causes whooping cough
Bordetella Pertussis
34
Course of whooping cough
1. 2 weeks highly infectious, standard virus symtpoms 2. Intense cough for 2-6 weeks 3. Chronic cough
35
Consequences of whooping cough
Pneumothorax Apnoea, brain damage failure to thrive
36
Management of whooping cough
macrolide
37
What causes croup in kids
viruses eg RSV | = inflammation in U+LRT
38
Clinical features of croup
barking cough
39
Management of croup
oral dexamethasone, paracetamol, oxygen NO ABX
40
Name two neuraminidase inhibitors
Oseltamivir(oral) = tamiflu | Zanamivir (inh)
41
What organisms causes bronchiolitis
RSV
42
What is considered as an exacerbation of COPD
Baseline change in 2/3 of: - volume of sputum - colour of sputum - breathlessness + wheeze
43
Organisms causing COPD exacerbations
1. Viruses (rhino, rsv, flu, adeno) Bacterial - strep pneumo, haemophilus, moraxella, ecoli + kleb Can have non infective causes
44
Which abx for exacerbation of COPD
amoxicillin , doxycycline
45
Assessing pneumonia mortality risk
``` Confusion Urea Resp rate BP 65+ ```
46
treatment of pneumococcal pneumonia
benzylpenicillin | clarithromycin/levofloxacin if allergy
47
What can legionella cause
pneumonia colonises water systems can cause a severe pneumonia
48
How is legionella pneumophilia diagnosed
urine antigen
49
How is legionella treated
Levofloxacin, macrolide
50
Erythema nodosum + pneumonia in a young adult
Mycoplasma pneumoniae Dx: throat swab PCR Tx: macrolid
51
Which organisms can cause an atypical presentation/ CXR of pneumonia
1. Legionella 2. Mycoplasma 3. Chlamydophilia pneumonia 4. Clamydophilia psitacci (bird droppings, rash, hep) 5. Viral
52
Bronchiectasis can be post infective - from what?
TB Pneumonia Pertussis (whooping) childhood infections
53
What is lemierre's syndrome
Infection caused by anaerobe fusobacterium necrophorum that spreads to IJV, blood, lungs (abscess) and others
54
Treatment of HAP
Early: co-amoxiclav Late: piperacillin+tazobactam
55
Which organisms cause aspiration pneumonia
Gram -ves | anaerobes
56
Which fungi can cause a pneumonia
1. candida 2. aspergillus 3. cryptococcus 4. pneumocystis jiroveci
57
For which two organisms causing RTI is urine antigen detection useful
Legionella | Strep pneumo
58
What organism can cause myocarditis in central and south america
Trypanosoma cruzi causes Chagas disease Bites near eyes and mouth Can cause myocarditis -> heart failure + megaoesophagus and megacolon
59
Which organism usually causes acute endocarditis
Staph aureus
60
Which organism usually causes subacute endocarditis
Strep | Staph epidermidis
61
Commonest organism causing infection in IVDU
Staph aureus
62
Which organism is associated with infective endocarditis and colon cancer
Strep bovis
63
?infective cause of throat pain what should you test for
HIV
64
Which organism usually causes oesophagitis
CMV
65
Tests for H pylori infection
Urea breath test | rapid urease test w endoscopy sample
66
Complications of untreated H pylori
Gastric cancer | Gastric MALT lymphoma
67
TX of H pylori infection (gastritis)
1 week triple therapy: 1. PPI 2. Clarithromycin 3. Metranidazole/ Amoxicillin
68
How can staph aureus cause diorrhoea
Contaminated food, not cooked properly so organisms produce toxins that survive on cooking
69
Causes of c diff infection
Broad spectrum abx | PPIs
70
Symptoms of c diff infection
FOUL smelling diarrhoea, fever, dehydration, shock
71
Complications from c diff toxin production
1. pseudomembranous colitis + toxic megacolon | 2. bowel perforation
72
Does alcohol gel kill c diff
no | spores that are formed resist
73
Treatment of c diff
Mild : metronidazole Moderate/severe = oral/rectal vancomycin Recurrent c diff = fidoxamycin faecal transplant
74
How dose cholera cause diarrhoea
Pumps chloride into gut lumen -> water follows
75
Bloody diarrhoea + reactive arthritis + conjunctivitis + haemolytic uraemic syndrome
Shigella
CC2
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