Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Microbio > 7 clinical scenarios > Flashcards

7 clinical scenarios Flashcards

1
Q

what are the 7 clinical scenarios?

A
  1. UTI
  2. Skin and Soft Tissue Infections (SSTIs)
  3. URTI and LRTI
  4. Red eye
  5. GI
  6. Meningitis
  7. STD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are Lower tract UTI symptoms

A

frequency, urgency, dysuria (painful urination), small volumes, lower abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are Upper tract UTI symptoms

A

pyelonephritis with flank pain, high fever, sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the Empirical treatment for UTIs?

A

Co-amoxyclav (Augmentin) & cephalexin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what organisms can cause UTI in a 24 year old woman for the first time?

A

Escherichia coli
Staphylococcus Saprophyticus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

E. coli morphology and lab test results

A

Gram negative rods, facultatively anaerobic, lactose-fermenting

normal GIT commensal bacteria (spread over from anus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the treatment for E. coli in a 24 year old woman for the first time

A

cephalexin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Staphylococcus Saprophyticus morphology and lab test results

A

Gram positive cocci, facultatively anaerobic, catalase positive
Coagulase negative staphylococci (CNS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

who is more prone to get Staphylococcus Saprophyticus?

A

sexually active young women, during reproductive years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the treatment for Staphylococcus Saprophyticus in in a 24 year old woman for the first time

A

empirical treatment: cephalexin

if recurrent: co-trimoxazole

methicillin-resistant S. saprophyticus: vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what organisms can cause UTI in a male baby

A

Escherichia coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the treatment for E. coli in a male baby

A

IV Gentamicin and oral cephalexin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

complications of E. coli

A

E. coli diarrheal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what organisms can cause UTI in a male adult

A

if male adult has UTI, they are likely already immunocompromised
Hence, more susceptible to Proteus and Klebsiella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Proteus morphology and lab test results

A

Gram-negative coliforms
Non-lactose fermenting
Urease positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Klebsiella morphology and lab test results

A

Gram-negative coliforms
Lactose-fermenting
Part of normal colonic flora but cause UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the treatment for proteus or klebsiella in a male adult

A

co-trimoxazole or ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

complications of Klebsiella

A

Severe form of pneumonia with abscess formation: Freidlander’s pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what organisms can cause severe UTI or pyelonephritis

A

E. coli
Proteus
Klebsiella
Enterococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Enterococci morphology and lab test results

A

Gram-positive rod, Lancefield Group D cocci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the treatment for severe UTI or pyelonephritis

A

IV: gentamicin and co-amoxyclav

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

complications of enterococci

A

Endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what organisms can cause post treatment recurrence or hospital acquired infection with catheter

A

E. coli
Proteus
Klebsiella
Enterococci
Enterobacter
Pseudomonas aeruginosa (PAE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

PAE morphology and lab test results

A

Gram-negative rod, facultatively aerobic
Non lactose-fermenting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is the treatment for hospital acquired or catheter UTI

A

Cefepime (anti-psuedomonal) +amikacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

complications of PAE

A

Septicaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

why are males more unlikely to get UTIs than females

A

males have a longer urethra than females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

investigations for UTIs

A

Urine microscopy and culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

main organisms that cause SSTIs

A

Staphylococcus aureus (has obvious wound)
Streptococcus pyogenes (no obvious wound)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

staphylococcus aureus morphology and lab test results

A

Gram positive cocci, typically seen in clusters
Catalase & coagulation positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Streptococcus pyogenes morphology and lab test results

A

Gram positive
β-haemolytic
Catalase negative
Group A streptococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what does staphylococcus aureus cause

A

Boils, carbuncles
HAI wound (definitely caused by MRSA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what treatment for staphylococcus aureus

A

Incision and drainage of boils and carbuncles first
Cloxacillin
For penicillin allergic patients: Erythromycin
If MRSA → vancomycin

If HAI wound that is bowel associated: Vancomycin and add on Pip-tazo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

complications of staphylococcus aureus

A

Toxic shock syndrome toxin-1(TSST-1)
Endocarditis
Osteomyelitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what does Streptococcus pyogenes cause

A

leg cellulitis with no wound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

complications of streptococcus pyogenes

A

scarlet fever
acute glomerulonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what treatment for streptococcus pyogenes

A

IV benzylpenicillin (penicillin G)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what causes SSTI with water

A

S. aureus (most common)
Strep. Pyogenes (more common)
Pseudomonas aeruginosa (PAE)
Vibrio vulnificus
Aeromonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Vibrio vulnificus morphology and lab test results

A

Gram negative, curved rods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Aeromonas morphology and lab test results

A

Gram-negative, facultative anaerobic rod

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

SSTI with water treatment

A

Aggressive wound debreidement/amputation

Empirical treatment: combination of
IV ciprofloxacin: quinolones
AND
IV cloxacillin: targets mainly Streptococcus & Staphylococcus

For gram negative bacteria (Pseudomonas aeruginosa (PAE), Vibrio vulnificus, Aeromonas):
Ceftazidime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Vibrio vulnificus complications

A

oedema, erythema & life-threatening necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what organisms cause Diabetic foot ulcer

A

Mixed organisms (Gram positives plus Gram negatives infect together)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

treatment for diabetic foot ulcer

A

Debridement

IV co-amoxyclav AND Metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what organisms cause necrotising fasciitis

A

Staphylococcus aureus
Streptococcus pyogenes
Synergistic infections (complex mixture of bacteria usually including anaerobes)
Vibrio vulnificus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

how to treat necrotising fasciitis

A

Debridement +
cloxacillin +
benzylpenicillin +
clindamycin +
IVIG (IV immune globulin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what organisms cause Necrotising fasciitis with water exposure

A

Staphylococcus aureus
Streptococcus pyogenes
Vibrio vulnificus
Aeromonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what treats necrotising fasciitis with water

A

Debridement +
cefazolin +
ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what organisms cause gas gangrene

A

Clostridium perfringens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Clostridium perfringens morphology

A

Sporing gram positive rods, obligate anaerobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

how to treat gas gangrene

A

Debridement+
benzylpenicillin +
clindamycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what organism can cause a black lesion on a farm animal worker

A

Bacillus anthracis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Bacillus anthracis morphology

A

Large gram positive rods with spores & grow aerobically

54
Q

how to treat bacillus anthracis

A

Ciprofloxacin + Benzylpenicillin

55
Q

what organism can cause a red lesion with pus after an animal bite

A

Pasteurella

56
Q

pasteurella morphology and lab test results

A

Gram-negative, facultatively anaerobic bacteria
Catalase & oxidase-positive

57
Q

how to treat pasteurella

A

incision and drainage

58
Q

investigations for SSTIs

A

Sample microscopy, culture & susceptibility test

59
Q

what organisms cause acute pharyngitis

A

Viruses
Streptococcal pyogenes

60
Q

what investigations for acute pharyngitis

A

Culture test for Group A Streptococcal
Respiratory viruses: rapid antigen detection

61
Q

how to treat acute pharyngitis

A

Virus: NIL
Oral penicillin V for S. pyogenes

62
Q

what organisms cause acute epiglottitis

A

-Haemophilus influenza
-Streptococcal pneumoniae

63
Q

streptococcal pneumoniae morphology

A

Commensal throat flora: gram positive cocci, α-hemolytic,

64
Q

Haemophilus influenza morphology

A

Gram-negative rods, some capsulated

65
Q

investigations for acute epiglottitis

A

Blood culture

66
Q

how to treat acute epiglottitis

A

IV ceftriaxone

67
Q

what organisms cause community acquired typical pneumonia

A

Streptococcal pneumoniae
Haemophilus influenza
Moraxhella catarrhalis

68
Q

how to treat community acquired typical pneumonia

A

penicillin or augmentin
Levofloxacin if allergic to penicillin

69
Q

what organisms cause community acquired atypical pneumonia

A

Mycoplasma pneumoniae
Chlamydia pneumoniae
Legionella

70
Q

how to treat community acquired atypical pneumonia

A

tetracycline
For Legionella: tetracycline + macrolide (azithromycin or erythromycin)

71
Q

what virus causes community acquired pneumonia and how to treat it

A

Influenza virus
Treat with Oseltamivir (Tamiflu)

72
Q

what causes hospital acquired pneumonia

A

PAE
MRSA
Gram negatives (Buckholderia pseudomallai, Klebsellia pneumoniae)

73
Q

how to treat hospital acquired pneumonia

A

PAE: piptazo
MRSA: Vancomycin and tetracycline
Gram negatives: Gentamicin

74
Q

what organisms cause conjunctivitis

A

Adenovirus
Strep. Pneumoniae
H. influenzae

75
Q

how to treat conjunctivitis

A

Bacteria:Fluoroquinolone + Chloramphenicol + Fusidic acid

Adenovirus: NIL

76
Q

what organism causes dendritic ulcer
what organism causes local zoster

A

dendritic ulcer: herpes simplex virus 1
Local zoster: varicella zoster virus

77
Q

how to test for dendritic ulcer and local zoster

A

fluorescent stain

78
Q

how to treat dendritic ulcer and local zoster

A

Acyclovir

79
Q

what organism can cause red eye in a soft contact lens user

A

Pseudomonas aeruginosa (PAE)

80
Q

how to investigate red eye in soft contact lens user

A

Corneal scrape for microscopy, culture & susceptibility test

81
Q

how to treat red eye in soft contact lens user

A

Ciprofloxacin + gentamicin

82
Q

complication of PAE in soft contact lens user

A

Pseudomonas keratitis: small corneal ulcer -> rapidly penetrate -> perforate cornea -> blindness

83
Q

what organism can cause red eye in someone who swims with contact lenses

A

Acanthamoeba (causes occular pain)

84
Q

how to treat red eye in someone who swims with contact lenses

A

corneal graft

85
Q

what can cause Red eye with trauma

A

PAE
Bacillus cereus
Aspergillus
Candida

86
Q

what can cause red eye in neonate (day 1-3)

A

Neisseria gonorrhoeae

87
Q

Neisseria gonorrhoeae morphology

A

Gram -ve cocci, oxidase +ve, transport in charcoal medium, grow on chocolate agar

88
Q

how to investigate red eye in neonate (day 1-3)

A

Smear or culture
Urine PCR for gonorrhoeae & chlamydia

89
Q

how to treat red eye in neonate (day 1-3)

A

Ceftriaxone

90
Q

what can cause red eye in neonate (day 3-10)

A

Chlamydia trachomatis

91
Q

how to investigate red eye in neonate (day 3-10)

A

PCR for Chlamydia trachomatis

92
Q

how to treat red eye in neonate (day 3-10)

A

erythromycin

93
Q

what organisms can cause diarrhoea in children

A

rotavirus

94
Q

how to manage and prevent rotavirus infection

A

management: oral rehydration
prevention: oral live attenuated vaccines (Rotateq and Rotarix)
once infected once, lifelong immunity

95
Q

what can cause food related diarrhoea and vomiting

A

Milk: Staphylococcus aureus
Uncooked meat: Salmonella, Campylobacter
Water: Shigella
Fried rice: Bacillus cereus
Seafood: Norovirus

96
Q

how to treat food related diarrhoea and vomiting

A

Staphylococcus aureus: NIL
Salmonella: Ceftriaxone
Campylobacter: Oral rehydration therapy, erythromycin or ciprofloxacin if severe
Shigella
Bacillus cereus: ciprofloxacin or azithromycin
Norovirus: Oral rehydration therapy

97
Q

what can cause travel related diarrhoea and vomiting

A

E. coli
Two types:
Enteropathogenic (EPEC): in developing countries Enterotoxic (ETEC): toxin-producing, traveller’s diarrhoea

Vibrio cholerae

98
Q

how to treat travel related diarrhoea and vomiting

A

E. coli: Ciprofloxacin
Vibrio cholerae: Doxicycline

99
Q

what causes Bloody diarrhoea with HUS (hemolytic uremic syndrome)

A

Enterohaemorrhagic E. coli (EHEC)

100
Q

what causes sudden explosive watery diarrhoea with bulky, frothy, greasy, foul-smelling stools

A

Giardia

101
Q

how to treat giardia

A

Metranidazole

102
Q

what causes antibiotic related diarrhea

A

Clostridium difficule

103
Q

how to treat antibiotic related diarrhea

A

vancomycin

104
Q

investigations for GI organisms

A

stool culture

105
Q

what causes neonate to look blueish and lethargic + fever

A

Streptococcal agalactiae (infection from mother’s birth canal)
E. coli
Listeria monocytogenes

106
Q

how to treat neonate looking blueish and lethargic + fever

A

Ceftriaxone +
Penicillin +
Gentamycin

107
Q

what causes infant looking blueish and lethargic + fever

A

Neisseria meningitidis (is life threatening)
H. influenzae
Strep. pneumoniae

108
Q

how to treat infant looking blueish and lethargic + fever

A

ceftriaxone + vancomycin

IF confirmed Nesseria meningitidis, ceftriaxone + vancomycin + IV penicillin

109
Q

how to test for acute meningitis and what are the expected results

A

CSF culture
High CSF WBC (in 1000s), Low CSF glucose

110
Q

what causes acute meningitis in adults

A

Strep. pneumoniae
Neisseria meningitides

111
Q

how to treat acute meningitis in adults

A

ceftriaxone + vancomycin

IF confirmed Nesseria meningitidis, ceftriaxone + vancomycin + IV penicillin

112
Q

if CSF findings are CSF WBC (in 100s), Normal CSF glucose, what is causing it

A

Enterovirus

113
Q

if CSF findings are high protein, low glucose, WBC in 100s, and patient has had a headache for 5 days, what is causing it

A

M. tuberculosis

114
Q

how to treat m. tuberculosis

A

RIPE (rifampicin, isoniazid, pyrazinamide, ethambutol)

115
Q

what causes blisters on genitals

A

Herpes Simplex Virus 2(most common)
Primary syphilis (Treponema pallidum)

116
Q

how to investigate blisters on genitals

A

Swab wet blister/puncture blister to swab contents -> PCR (most sensitive)

117
Q

how to treat genital blisters

A

For HSV2: oral acyclovir
For primary syphilis: IM benzylpenicillin

118
Q

what causes Dysuria & urgency, thin discharge

A

Chlamydia trachomatis: commonest STD in SG
Mycoplasma genitalium

119
Q

how to test for chlamydia

A

Morning urine PCR

120
Q

how to treat Chlamydia trachomatis, Mycoplasma genitalium

A

Oral doxycycline + Oral azithromycin

121
Q

complications of Chlamydia trachomatis

A

conjunctivitis

122
Q

what causes Purulent urethral discharge

A

Nesseria gonorrhoea

123
Q

how to treat nesseria gonorrhea

A

Ceftriaxone AND Azithromycin

124
Q

what causes cheesy vaginal discharge + pruritus

A

Candida albicans yeast

125
Q

how to treat candida albicans yeast

A

topical clotrimazole AND Systemic amphotericin B

126
Q

what causes foul smelling vaginal discharge

A

Bacterial vaginosis

127
Q

how to treat bacterial vaginosis

A

Oral metronidazole

128
Q

what causes Copious, foamy, purulent, frothy, yellow-greenish vaginal discharge

A

Trichomonas vaginalis

129
Q

how to treat Trichomonas vaginalis

A

Oral metronidazole

130
Q

what causes genital warts

A

HPV

131
Q

how to treat genital warts

A

Topical Podophyllotoxin

Microbio (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions