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Formative Flashcards

1
Q

What is the most likely cause of an outbreak of nausea and vomiting on a cruise ship?

  1. adenovirus
  2. enteroviruses
  3. Epstein Barr virus
  4. norovirus
  5. rotavirus
A
  1. Norovirus
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2
Q

What is the commonest cause of travellers diarrhoea?

  1. campylobacter
  2. cryptosporidium
  3. E coli O157
  4. enterotoxigenic E coli
  5. giardia
A
  1. enterotoxigenic E. coli
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3
Q

Which of the following is not diagnosed by culture?

  1. campylobacter jejuni
  2. clostridium difficile
  3. E. coli O157
  4. Salmonella enterica
  5. vibrio cholerae
A
  1. clostridium difficile
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4
Q

A 22 year old man presents to A&E with a rash on his hand which extends in patches over his chest, abdomen and legs, and developed over 6 hours. He is hypotensive (80/50) and pyrexial (39.1)

What should your immediate actions be?

  1. call for senior help
  2. give fast IV fluids
  3. IV high dose cephalosporin
  4. blood cultures
  5. all of the above
A
  1. all of the above
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5
Q

What should the family of the man presenting with the rash be given?

  1. amoxicillin or chloramphenicol
  2. rifampicin or ciprofloxacin
  3. chloramphenicol or cefalexin
  4. cefalexin or trimethoprim
  5. none of the above
A
  1. rifampicin or ciprofloxacin
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6
Q

4 days later, the man who presented with the rash becomes hypotensive and is noted to have a low sodium and high potassium, the most likely reason is;

  1. too little saline in the IV fluid regime
  2. syndrome of inappropriate ADH secretion
  3. adrenal insufficiency
  4. renal failure
  5. antibiotic-associated diarrhoea
A
  1. adrenal insufficiency
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7
Q

In meningococcal meningitis, what would you expect to find in the CSF?

  1. high protein, high glucose, gram positive bacilli
  2. low protein, high glucose, gram positive cocci
  3. high protein, low glucose, gram negative cocci
A
  1. high protein, low glucose, gram negative cocci
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8
Q

What component of neisseria meningitidus causes septic shock?

  1. capsule
  2. fimbriae
  3. lipo-polysaccharide
  4. peptidoglycan
  5. superantigens
A
  1. lipo-polysaccharide
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9
Q 
A 30 year old IV drug user is admitted with jaundice. His lab results are;
HBsAg negative
HB core antibody negative
HB surface antibody positive
Hepatitis A IgM antibody positive
Hepatitis C antibody positive
  1. He has acute hepatitis A infection
  2. He has acute hepatitis B infection
A
  1. He has acute hepatitis A infection
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10
Q 
A 30 year old IV drug user is admitted with jaundice. His lab results are;
HBsAg negative
HB core antibody negative
HB surface antibody positive
Hepatitis A IgM antibody positive
Hepatitis C antibody positive
  1. He has previously had hepatitis B infection
  2. He has previously been immunised against hepatitis B
A
  1. He has previously been immunised against hepatitis B
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11
Q

For which of the following infections is there no vaccine?

  1. Hepatitis A
  2. malaria
  3. polio
  4. typhoid
  5. yellow fever
A
  1. malaria
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12
Q

Which of the following is true of active immunisation?

  1. always contains live organism
  2. contains immunoglobulin
  3. gives immediate protection against infection
  4. stimulates the host immune response
A
  1. stimulates the host immune response
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13
Q

A 38-year-old man presents with a 3 week history of difficulty swallowing and on examination appears to have oral thrush, what its he most likely causative organism?

  1. Epstein-Barr virus
  2. Human immunodeficiency virus
  3. Herpes zoster virus
  4. Candida albicans
  5. group A strep
A
  1. candida albicans
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14
Q

The patient with oral thrush and difficulty swallowing is found to be HIV positive. The candida is treated with fluconazole. His further treatment should be;

  1. Immunise with BCG as he is at great risk of developing TB
  2. Commence at least 3 antiretrovirals
  3. Wait until he has an AIDS defining illness and then commence antiretrovirals
  4. Immunotherapy with an HIV vaccine
A
  1. Commence at least 3 antiretrovirals
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15
Q

You are taking blood from an acutely ill HIV positive patient in the Infection unit at midnight and you accidentally stab yourself with the needle, what do you do first?

  1. Phone the on-call occupational health doctor
  2. call the registrar
  3. wash the wound and encourage bleeding
A
  1. wash the wound and encourage bleeding
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16
Q

What virus carries the highest risk of blood-borne transmission?

  1. HIV
  2. Hepatitis C
  3. Hepatitis B
A
  1. Hepatitis B risk is highest
17
Q

You have isolated E. coli from two sets of blood cultures taken on a jaundiced patient who was admitted in septic shock. Which of the following is the likely source?

  1. biliary sepsis
  2. gastroenteritis
  3. infective endocarditis
  4. osteomyelitis
  5. pneumonia
A
  1. biliary sepsis
18
Q

What is the commonest cause of infective diarrhoea in the UK?

  1. salmonella
  2. E. coli O157
  3. campylobacter
  4. entamoeba histolytica
A
  1. campylobacter
19
Q 
27 year old female presents with a 6 week history of dry cough, weight loss and fevers, 3 months after returning from working in a Bolivian orphanage. 
The most likely diagnosis 
1. miliary TB 
2. HIV 
3. mycoplasma pneumonia 
4. pneumococcal pneumonia 
5. pulmonary tuberculosis
A
  1. pulmonary TB
20
Q

What rapid test would help confirm the diagnosis of pulmonary TB?

  1. gram stain
  2. india ink
  3. overnight culture
  4. ZN stain
21
Q

The patient with pulmonary TB should be initially treated with;

  1. Rifampicin
  2. isoniazid
  3. pyrazinamide
  4. ethambutol
  5. all of the above
A
  1. all of the above
22
Q

How do you make an initial diagnosis of Legionnaire’s disease?

  1. blood culture
  2. serology
  3. sputum culture
  4. urinary antigen
A
  1. urinary antigen
23
Q

A 28-year-old oil worker returns from a month working offshore in Nigeria. He is febrile, vomiting and unwell. The most important investigation is;

  1. CXR
  2. blood cultures
  3. urgent stool microscopy and culture for typhoid
  4. malaria film and antigen test
  5. urgent HIV test
A
  1. malaria film and antigen test
24
Q

The offshore worker is confirmed to have malaria. He should be treated with;

  1. artemether/lumefantrine
  2. IV quinine/artesunate
  3. IV ciprofloxacin
  4. oral quinine unless parasitaemia increases
  5. chloroquine IV or orally if tolerated
A
  1. IV quinine/artesunate
25
Q

Cellulitis would most commonly be treated with;

  1. benzylpenicillin and gentamicin
  2. ciprofloxacin and rifampicin
  3. flucloxacillin
  4. metronidazole
  5. tazocin and gentamicin
A
  1. flucloxacillin
26
Q

What is the most common cause of UTI?

  1. erythrovirus
  2. Neisseria meningitidis
  3. viridans streptococcus
  4. hepatitis C virus
  5. Pseudomonas auruginosa
  6. Mycoplasma pneumoniae
  7. Staphylococcus aureus
  8. Escherichia coli
  9. Epstein Barr virus
27
Q

What is the most common cause of glandular fever?

  1. erythrovirus
  2. Neisseria meningitidis
  3. viridans streptococcus
  4. hepatitis C virus
  5. Pseudomonas auruginosa
  6. Mycoplasma pneumoniae
  7. Staphylococcus aureus
  8. Escherichia coli
  9. Epstein Barr virus
28
Q

What is the most common cause of wound infection?

  1. erythrovirus
  2. Neisseria meningitidis
  3. viridans streptococcus
  4. hepatitis C virus
  5. Pseudomonas auruginosa
  6. Mycoplasma pneumoniae
  7. Staphylococcus aureus
  8. Escherichia coli
  9. Epstein Barr virus
A
  1. staph aureus
29
Q

What antibiotic would be the best choice for treatment of bacterial endocarditis caused by MRSA?

  1. rifampicin
  2. tetracycline
  3. flucloxacillin
  4. benzylpenicillin
  5. clarithromycin
  6. gentamicin
  7. nitrofurantoiin
  8. vancomycin
  9. isoniazid
A
  1. vancomycin
30
Q

What antibiotic would be used orally to treat C. diff infection?

  1. rifampicin
  2. tetracycline
  3. flucloxacillin
  4. benzylpenicillin
  5. clarithromycin
  6. gentamicin
  7. nitrofurantoiin
  8. vancomycin
  9. isoniazid
A
  1. vancomycin
31
Q

What antibiotic would be the best choice for treatment of gram negative sepsis in a patient with septic shock?

  1. rifampicin
  2. tetracycline
  3. flucloxacillin
  4. benzylpenicillin
  5. clarithromycin
  6. gentamicin
  7. nitrofurantoiin
  8. vancomycin
  9. isoniazid
A
  1. gentamicin

Infection (14 decks)

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