Infections

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What are the clinical signs of infection? (14)
Changes in BP, HR, RR, Chest X ray. Confusion in elderly, Drowsiness, irritability and poor apetit in children. Dec renal function. Fever, aches and pains. Pus, swelling and redness.
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What are the biochemical signs of infection? (5)
Increase in: WBC, Neutrophils, CRP, ESR and altered platelets.
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What are the symptoms of infection? (1)
Often infection specific; regional pain, rash etc.
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What patient factors must be considered when selecting an antibiotic? (12)
Allergies. Renal and Hepatic Impairment. Route available. Disease severity. Age. Preg & BFeed. C/I and interactions. Weight. Dosing.
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When should ABx be given via IV? (5)
NBM. Absorption issues. No oral alternative. Infection in poorly penetrable sites, Seriously ill or shock
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What are the benefits of limiting IV Abx? (6)
Reduced morbidity. Comfort and Convenience. Reduced Errors. Reduced Cost. Reduced nursing time. Earlier patient discharge.
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What are the parameters to confirm and IV to Oral switch? (7)
Temp above 37.5 for >24hours. Clinical imp: dec WBC, CRP, ESR. No abs issues. High tissue conc. not needed. Oral form available.
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Outline antibiotic stewardship.
Write out and check against flow chart.
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What are the signs and symptoms of CAP? (11)
Signs: Fever, Tachypnoea, Tachycardia, Abnormal chest signs. Hypotension. Confusion. Symp: Cough, Sputum, Chest Pain, Haemotypsis, Dyspnoea.
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What are the investigations for CAP? (10)
X-ray, O2 Sats, FBC, U's and E's, LFTs, CRP, Blood cultures, Sputum Culture, Legionella Antigen Test, Viral Serology.
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What is CURB-65? (5)
Confusion, Urea >7mmol/L, Respiratory Rate >30/min, Low BP, Over 65
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Stages of CAP?
Comm 0 no admin, 1-2 maybe refer, 3 hospitalise. Hosp 0-1 home treatment, 2 short stay, 3 High risk consider ITU
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Other infection risk factors of CAP? (4)
Co-existing disease, O2 Sats
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Organisms responsible for CAP?
Strep Pneumonia. Mycoplasma Pneumonia. Haemphilis influenza. Chlamydia Penumonia. Moraxella Catarhalis. Legionella. Staph Aureus. Coxiella Burnetti
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How to treat low severity CAP?
Amoxicillin 500mg TDS for 7 days ( 14-21 if Staph) Alt: Doxycycline or Clarithromycin
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How to treat moderate CAP?
Amoxicillin + Clarithromycin or Doxycycline alone. 7 day duration (14-21 if staph)
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How to treat severe CAP?
Benzylpenicillin + Clarithromycin or Benzylpenicillin + Doxycycline. 7-10 duration (14-21 and add vancomycin if staph)
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What if co-morbidies, gram -ve or living in a nursing home?
Co-amoxiclav and Clarithromycin. Cefuroxiome and clarithromycin
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What is HAP?
Respiratory infection developing 48 hours after admission to hospital.
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Organisms responsible for HAP?
Klebisella Pneumonia. Proteus Spp. Enterobacter. Acientobacter. Psudemonas Argineusoa. SA, SP, fungi.
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Who is at risk of HAP? (1)
Pts who have had recent antibiotics or ventilation.
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In which patients are UTI's complicated? (5)
Male pts, Abnormal renal tract, impaired renal function, impaired host defences, virulent organisms.
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Signs and symptoms of a lower UTI? (6)
Frequency, Dysuria, Urgency, Haematuria, Suprabupic pain, smelly urine, confusion
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Signs and symptoms of a high UTI? (5)
Fever. Rigors. Loin pain. Tenderness and Vomiting
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Investigations of UTIs? (5)
MSU (microscope, diptest, culture) FBC, U's and E's, CRP's. Poss blood cultures
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Most common cause of UTI? (1)
E.coli
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How to treat uncomplicated lower UTI? (4)
Trimethoprim = 200mg BD, Nitrofurantoin = 50mg QDS, Co-amoxiclav 375-625 TDS, Cefalxein 250-500 QDS Uncom = 3 days Comp = 5-7 days
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What is cellulitis? (1)
An acute spreading infection of skin with visually distinct borders
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Risk factors of Cellulitis (8)
Weak immune system, IVDU, Lymphodema, Ulcer, Venous insufficiency, Obese, previous episodes of cellulitis, Poorly controlled diabetes.
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Signs and symptoms of cellulitis? (8)
Red, painful, hot, swollen, tender skin, blisters N&V, Chills
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Investigations for cellulitis? (6)
FBC, U's and E's, CRP, swabs, temp, blood cultures.
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How to treat cellulitis? (4)
Oral: Amoxicillin 500mg TDS and Flucloxacillin 500mg QDS. IV: Benzylpenicillin 1.2g e46h. Penicillin allergic Clindamycin 450mg QDS
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How to treat C.Diff? (2)
Non-Sev: Metronidazole 400mg TDS 10-14 days Sev: Vancomycin 125mg QDS 10 -14 days
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Other cards in this set

Card 2

Front

What are the biochemical signs of infection? (5)

Back

Increase in: WBC, Neutrophils, CRP, ESR and altered platelets.

Card 3

Front

What are the symptoms of infection? (1)

Back

Preview of the front of card 3

Card 4

Front

What patient factors must be considered when selecting an antibiotic? (12)

Back

Preview of the front of card 4

Card 5

Front

When should ABx be given via IV? (5)

Back

Preview of the front of card 5
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