My Infectious Diseases

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Author:
Mike2556
ID:
127034
Filename:
My Infectious Diseases
Updated:
2012-01-10 18:14:35
Tags:
STIs virology bacteriology parasitology
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STIs, virology, bacteriology, parasitology
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  1. What is the causative organism of bacterial meningitis? What are its complications?
    • Neisseria meningitidis (meningococcus)
    • Meningococcal septicaemia and septic shock
  2. Macrolides
    - Spectrum
    - Mechanism of action
    - Examples
    • Gram +ves except MRSA. Campylobacter (erythro), CAP (claryth)
    • Bind to 50S
    • Erythromycin, clarythromycin
  3. What hypersensitivity reactions are most common when taking antibiotics?
    • Type 1: Immediate allergic reaction
    • Type 2: Delayed type hypersensitivity
    • Most 'allergic reactions' are actually side effects
  4. Rifampicin
    - Spectrum
    - Mechanism of action
    • Staph infection in joints, TB, legionella
    • Lipophilic action. Inhibits transcriptive enzymes
  5. What bacterium is the cause of most URTIs?
    Streptococcus pharyngitis
  6. What are some of the clinical features of meningitis in a child?
    • Decreased GCS
    • Purpuric rash
    • Photophobia
    • Irritability
    • Seizures
    • Neck stiffness
  7. What is the goal of antibiotics stewardship?
    • Ensure cost-effectiveness
    • Improve patient outcome
    • Preventing bacterial resistance
  8. What bacteria are commonly responsible for UTIs?
    Gram negative, e.g. E.coli, strep, pseudomonas
  9. How and what does aciclovir work against?
    • Inhibits nucleic acid synthesis
    • Used in HSV and genital herpes
  10. Aminoglycosides
    - Spectrum
    - Mechanism of action
    - Examples
    • Gram negatives, including pseudomonas. No GI absorption or abscess entry. Treat g-ve sepsis
    • Inhibit protein synthesis by binding to 30S
    • Gentamicin
  11. Glycopeptides
    - Spectrum
    - Mechanism of action
    - Examples
    • Narrow; only works on gram +ve, including MRSA
    • Inhibits peptidoglycan (cell wall) synthesis
    • Vancomycin, teicoplanin
  12. Define an 'outbreak'
    An epidemiological term, used to describe an occurence of disease greater than would otherwise be expected
  13. List some infections that are capabe of bypassing the defences in foetal growth
    • Varicella zosters
    • Rubella
    • Measles
    • CMB
    • HIB
  14. What are the essentials to be considered when prescribing antibiotics?
    • Appropriate spectrum
    • Appropriate route of administration
    • Appropriate duration
    • Appropriate prescription time
  15. What are ESBLs?
    • Extended spectrum beta-lactamases
    • Gram negatives use ESBLs to hydrolyse cephalosporins
  16. Wbat drugs are commonly associated with C diff colitis?
    • Cephalosporins
    • Clindamycin
    • Co-amoxiclav
    • Ciprofloxacin (quinolones)
  17. How and what does oseltamivir work against?
    • Blocks viral release from cell
    • Used in type A and B influenza
  18. Define fitness cost
    The amount an organism's efficiency is reduced in order to become resistant
  19. What factors can be used to classify antibiotics?
    • Selectiveness: What pathway (e.g. demethylase inhibitor)
    • Spectrum: Narrow or broad
    • Cidality: Bacteriostatic/cidal
  20. Beta lactams
    - Spectrum
    - Mechanism of action
    - Examples
    • MSSA, strep, anaerobes
    • Inhibit cell wall synthesis
    • Cephalosporins, carbapenems
  21. Give a nmemonic for remembering the gram classifaction of some bacteria
    • Positive: Cess (clostridium, enterococcus, staph, strep)
    • Negative: P-HEN (pseudomonas, haemophilus, e.coli, neisseria)
  22. Give 4 common reasons why antibiotics may be misused
    • In diagnostic uncertainty; non-infectious pyrexia
    • Poor documentation/ward transfer
    • Excessive duration
    • Inappropriate route, dose or timing
  23. What methods of environmental control can be used in healthcare to reduce infection?
    • Hand hygeine
    • Isolation
    • Personal protective equipment
    • Cleaning
  24. Lincosamides
    - Spectrum
    - Mechanism of action
    - Examples
    • Toxin organisms, e.g. S. pyogenes, s.aureus, MSSA and some MRSA
    • Bind to 50S
    • Clindamycin
  25. How and what does ganciclovir work against?
    • Inhibits nucleic acid synthesis
    • Similar to aciclovir, except more effective and with more side effects
  26. Tetracyclines
    - Spectrum
    - Mechanism of action
    - Examples
    • Streps and staphs, some g-ve. CAP, SSTI
    • Bind to 30S
    • Tetracycline, doxycycline
  27. What are the main mechanisms of antibiotic resistance?
    • Alters the antibiotics target molecule (H/N in flu)
    • Alters antibiotic intake
    • Inactivates the antibiotics (beta lactamase)
    • Develops a new metabolic pathway
  28. Quinolones
    - Spectrum
    - Mechanism of action
    - Examples
    • Broad spectrum bactericidal
    • MSSA, /step, /pseudomonas. Gonorrhea, UTIs, pneumonia if penicillin allergic
    • Inhibit DNA uncoiling = no transcription/duplication
    • Ciprofloxacin
  29. What are the basic stages of outbreak control in a national sense?
    • Confirm
    • Collect
    • Collate
    • Communicate
    • Control
  30. What important factors in history should be in a differential of a fevered traveller?
    • Any pre-morbid state before travel?
    • Any pre-travel vaccines or prophylaxis?
    • Which country and where in it?
    • How long were they there?
    • How did they travel?
    • What did they do (includes STIs)
  31. What is the most likely diagnosis of a fevered traveller?
    An immune reaction to malaria
  32. How is dengue fever spread?
    Where is it endemic?
    • Aves and anopheles mosquito, biting during the day
    • Caribbean, pakistani and indian cities
  33. What is the causative organism of typhoid fever?
    How does it commonly present?
    • Salmonella typhi
    • Non-specifically; constipation, low HR, rose spots and liver/spleen enlargement
  34. How is typhoid treated?
    Quinolones, cephalosporins and azithromycin
  35. What are the blood film findings of P. Falciforum?
    • Several merozoites found in each RBC
    • NO enlargement of infected RBCs
  36. Patient presents with localised dermatitis after travel
    Schistosomiasis (swimmer's itch)
  37. Outline the life cycle of gardiasis
    • Received faecal-orally in cyst
    • In small intestine, cysts release trophozoites
    • Trophozoites asexually multiply, attach to mucosa
    • Migrate to large intestine and re-encyst.
    • Excreted
  38. Patient presents with abdominal cramps, watery diarrhoea, vomiting and fever
    • Gardiasis
    • Possible food poisoning
  39. Classify the cause of gonorrhea
    What are the disease's complications?
    How is it treated?
    • Neisseria gonorrhoeaea; gram negative diplococci
    • Causes PID, epididymitis and sterility
    • Ceftriaxone the only effective treatment due to high resistance
  40. Classify the cause of chlamydia
    What are its clinical features?
    How is it treated?
    • Chlamydia trachomatis; gram negative coccobacilli
    • Purulent discharge, cervical inflammation and post-coital bleeding, if not asymptomatic
    • Azithromycin
  41. Classify the cause of syphilis
    How is it treated?
    • Treponema pallidum; spirochaetes
    • Penicillin usually, but many antibiotics effective
  42. What is NG-Mast?
    • A type of PCR used to examine DNA and record sequences
    • Used to track gonorrhea mutations in communities
  43. What is candida?
    What are its consequences in the immunodeficient?
    How is it treated?
    • A fungus, normally found in respiratory, GU and GI tract
    • Can disseminate; endocarditis, nephritis, splenomegaly
    • Fluconazole, or amphotericin if neutropenic
  44. What is aspergillus?
    Who does it commonly affect?
    How is it treated?
    • A very common mould, usually breathed from cough
    • Patients with steroids
    • Neutrophil reconstitution
  45. What are the clinical features of herpes simplex?
    How is it detected in histology?
    • Painful, protracted oral lesions. Mucositis. Oesophagitis
    • Multinucleated giant cells
  46. What diseases are caused by varicella zoster?
    How is it treated?
    • Chickenpox: Diffuse, itchy blistering
    • Shingles: Adult chickenpox
    • Cortical infarcts: multifocal vasculitis

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