HD2 Revision6 Flashcards
Describe pathophysiology caused by Corynebacterium diphtheriae
- What process does the A-B subunit inhbit? [1]
- What are the pathological consequences for the heart [2] & nerves? [3]
- What structural change occurs in mouth? [1]
Diphtheria toxin: A and B subunits inhibits protein synthesis:
Heart implications:
- Myocarditis
- Heart block
Nerve implications:
- Difficulty swallowing
- Paralysis
- Diplopia
Get pseudomembrane in mouth
What are the three cocci gram +ve organsims need to know? [3]
Staphylococcus
Streptococcus
Enterococcus
What are the four bacilli gram +ve organsims need to know? [3]
Corynebacterium
Listeria
Bacillus: cereus (food pois); anthracis (anthrax)
Clostridium: tetani botulinum, difficile
Which part of the LPS membrane of bacteria is toxic? [1]
When is this released? [1]
Lipid A
Released during lysis of organsim
Meningococcal disease refers to any illness caused by bacteria called []
Pneumococcal disease is a name for any infection caused by bacteria called []
Meningococcal disease refers to any illness caused by bacteria called Neisseria meningitidis.
Pneumococcal disease is a name for any infection caused by bacteria called Streptococcus pneumoniae
Describe the pathogenesis of meningococcal disease
Which two molecules are activated by LPS that cause inflammatory cascade for meningococcal disease? [2]
IL-6
TNF-α
Name three most common causes of septicaemia and meningitis [3]
Streptococcus pneumoniae
Neisseria meningitidis
* Group B and C
* Increase in Group W since 2009
* Teenagers, university students
Haemophilus influenzae B (HiB)
Describe what would indicate on a gram stain that have a Streptococcus pneumoniae infection? [1]
Diplococci (come in pairs)
What are the three cocci gram +ve organsims need to know? [3]
Staphylococcus
Streptococcus
Enterococcus
Which of the following causes “Pneumococcus”
Staphylococcus
Streptococcus
Enterococcus
Staphylococcus
Streptococcus
Enterococcus
Explain three immune defects that could predispose an individual to an pneuomococcal infection [3]
- HIV infection
- Hypogammaglobulinaemia (low levels of IgG due to B cells not being able to mature)
- Absent / non-functional spleen
Give three reasons for an absent / non-functional spleen [3]
Congenital asplenia
Traumatic removal
Hyposplenism (eg sickle cell)
Name 4 invasive features of Streptococcus pneumoniae infection
- Meningitis
- Sepsis
- Osteomyelitis
- Septic arthritis
- Peritonitis
- Lobar pneumonia
- Empyema
Name the two most common presentations of Pneumococcal pneumonia (Streptococcus pneumoniae) [2]
- Lobar pneuomonia
- Empyema (a serious complication characterized by pus and bacteria in the pleural)
How would you manage empyema caused by pneuomococcal pneuomonia? [2]
Chest drain
Video-assisted thoracoscopic surgery (VATS)
Name two rheumatological implications of pneuomococcal pneuomonia infection
Osteomyelitis (inflammation in a bone and bone marrow, usually caused by bacterial infection)
Septic arthritis
Name the two vaccinations for Streptococcus pneumoniae [2] and how many serotypes they protect agaisnt [2]
Pneumococcal polysaccharide vaccine (PPV): Penuomax - covers 23 serotypes
Pneumococcal conjugate vaccine (PCV): Prevenar protects against 13 serotypes
Meningococcal disease describes infections caused by the bacterium []
Meningococcal disease describes infections caused by the bacterium Neisseria meningitidis
Which pathogen causes A? [1]
Corynebacterium dipetheria
Which pathogen cauese this symptom? [1]
Neisseria meningitidis - septic patient
What is the most common cause of lobal pneumonia?
Streptococcus pneumoniae
What is the most common organism responsible for infective endocarditis?
Streptococcus bovis
Staphylococcus epidermis
Staphylococcus aureus
Streptococcus viridans
What is the most common organism responsible for infective endocarditis?
Streptococcus bovis
Staphylococcus epidermis
Staphylococcus aureus
Streptococcus viridans
A 6-year-old child presents to your clinic unwell with a fever and sore throat. Upon further history taking you discover he has not had any vaccinations. On examination, there is a grey-white coloured membrane covering his tonsils.
What is the most likely diagnosis?
Diphtheria
Mumps
Rubella
Measles
Scarlet Fever
A 6-year-old child presents to your clinic unwell with a fever and sore throat. Upon further history taking you discover he has not had any vaccinations. On examination, there is a grey-white coloured membrane covering his tonsils.
What is the most likely diagnosis?
Diphtheria
Mumps
Rubella
Measles
Scarlet Fever
Which pathogen is most likely to have caused this symptom?
Diphtheria
Mumps
Rubella
Measles
Scarlet Fever
Which pathogen is most likely to have caused this symptom?
Diphtheria
Mumps
Rubella
Measles
Scarlet Fever
Which pathogen is most likely to have caused this symptom?
Diphtheria
Mumps
Rubella
Measles
Scarlet Fever
Which pathogen is most likely to have caused this symptom?
Diphtheria
Mumps
Rubella
Measles
Scarlet Fever
Which pathogens cause A & B? [2]
A: measles
B: scarlet fever
Which pathogen is most likely to have caused this symptom?
Diphtheria
Mumps
Rubella
Measles
Scarlet Fever
Which pathogen is most likely to have caused this symptom?
Diphtheria
Mumps
Rubella
Measles
Scarlet Fever - looks a little bit like sunburn
Which pathogen is most likely to have caused this symptom?
Diphtheria
Mumps
Rubella
Measles
Scarlet Fever
Which pathogen is most likely to have caused this symptom?
Diphtheria
Mumps
Rubella
Measles
Scarlet Fever Scarlet fever: white strawberry tongue (left) and red strawberry tongue (right)
Which of types of malaria can lie dormant? [2]
F. vivax, F. ovale
What type of virus is enterovirus, Hep A & rotavirus?
Enveloped RNA
Envelopoed DNA
Non-enveloped RNA
Non-enveloped DNA
What type of virus is enterovirus, Hep A & rotavirus?
Enveloped RNA
Envelopoed DNA
Non-enveloped RNA
Non-enveloped DNA
Name this symptom [1]
What causative agent is most likely to have caused this infection?
Herpetic whitlow
Caused by HSV-1 (60% of cases, HSV-2 in 40%)
Name the most likely causative agent of this symptom [1]
Epstein-Barr Virus - causing infectious mononucleosis (glandular fever)
What causative agent is most likely to have caused this? [1]
Congenital CMV infection
Which pathogen is most likely to have caused this symptom?
Diphtheria
Mumps
VZV
Measles
Scarlet Fever
Which pathogen is most likely to have caused this symptom?
Diphtheria
Mumps
VZV
Measles
Scarlet Fever
What is this infection? [1]
Name the two most likely causative agents? [1]
Impetigo
Agents: group A Streptococcus and Staphylococcus aureus.
Label the causative agents of A-C
A: VZV
B: Scarlet Fever
C: Measles
Name the most likely causative agent of this symptom [1]
Epstein-Barr Virus - causing infectious mononucleosis (glandular fever)
Which is the most severe form of malaria? [1]
Plasmodium falciparum
Explain pathophysiology of malaria life cycle
Malaria is spread by mosquitoes
Infected blood is sucked up by feeding female Anopheles mosquito.
Malaria in the blood reproduces in the gut of the mosquito producing thousands of sporozoites (malaria spores).
The mosquito bites another human or animal the sporozoites are injected by the mosquito. These sporozoites travel to the liver of the newly infected person
Sporozoites mature in the liver into merozoites which enter the blood and infect red blood cells.
merozoites reproduce over 48 hours, after which the red blood cells rupture releasing loads more merozoites into the blood and causing a haemolytic anaemia
What are severe consequences of malaria? [4]
- Haemolytic Anaemia
- Respiratory distress
- Cerebral malaria (coma, seizures)
- Hypoglycaemia
Treatment for malaria? [3]
- Artesunate.
- Combination treatment (eg Coartem: artemether-lumefantrine
- Quinine dihydrochloride
What are the important enveloped RNA viruses need to know? [10]
Measles, mumps, rubella (MMR)
RSV, influenza, parainfluenza
SARS-CoV-2
Hepatitis C
HIV
Often respiratory viruses
What are the important not-enveloped RNA viruses need to know? [3]
Rotavirus
Enteroviruses (includes polio)
Hepatitis A
All enteric viruses
What are the important enveloped DNA viruses need to know?
Herpes viruses
* Herpes simplex
* Varicella zoster
* CMV
* Epstein-Barr
* HHV 6/7/8
Hepatitis B
Poxviruses
Learn all lol
What are the non-enveloped DNA viruses need to know? [3]
Papillomavirus
Adenovirus
Parvovirus (ssDNA)
PAPs
Explain the differences in the presentations of Herpes simplex in older children and adults [3] compared to very young children [2]
Older children and adults: relatively benign
* Herpes labialis
* Herpetic whitlow
* Cold sore
Neonates: causes perncious effects via two presentations:
- Disseminated HSV
- HSV encephalitis:
Treatment of congenital CMV? [2]
How does it work agaisnt CMV [1]
How long should treatment last? [1]
IV ganciclovir
or
oral valganciclovir (pro-drug) :inhibits DNA synthesis
6 months of treatment reduces hearing loss and improves neurodevelopment
What are potential secondary bacterial infections of VZV? [1]
Name a consequence of this secondary bacterial infection [1]
Strep. infection (specifically Strep A)
Causes Necrotizing fasciitis
Name a virus that is usually asymptomatic in early life but is typically worse in 15-25 years old [1]
Epstein-Barr virus: causes infectious mononucleosis (glandular fever)
Which virus has differing chronicty depending on age at infection? [1]
Hep. B
How does Hepatitis B chronicity depend on age at infection?
Chronic HBV infection occurs in approximately 90% of newborns infected perinatally, 30% of children aged under 5 years, and <5% of immunocompetent adults.
