INFECTIONS

Question 1

How would you pick up LVH? Is the heart dilated?

Answer 1

ECG - tall R waves and deep s waves
Chest x -ray - heart is NOT dilated
commonest cuase: hypertension

Question 2

Is the heart displaced in dilated heart?

Answer 2

Dilated heart - due to heart failure, thin wall

so the apex is displaced

Question 3

Gram negative intracellular dipplococci in a cell aspirate in a young person

Answer 3

Neisseria gonohorrea

Question 4

Gram negative intracellular dipplococci in an LP

Answer 4

Neisseria meningitidis

Question 5

LP Gram negative rods/bacillus in a six year old

Answer 5

Haemophilus influenza

Question 6

LP gram negative rod in a neonate

Answer 6

Ecoli - in premature neonates

Question 7

Gram positive cocci - most common

Answer 7

Strep pneumoniae

Question 8

Blood cultures gram positive diplococci

Answer 8

Strep pneumoniae

Question 9

Cold agglutinins positive but no culture grown

Answer 9

Mycoplasma

Question 10

Boil on leg - gram positive cocci clusters

Answer 10

Staph aureus

Question 11

2 months of fever, blood cultures positive for gram positive blood cocci

Answer 11

Strep viridans

Question 12

What can strep viridans cause?

Answer 12

Endocarditis and PUO

Question 13

Strep pyogenes normally colonizes where?

Answer 13

The throat, invades lots of different tissues and causes sepsis

Question 14

Subacute endocarditis clinically signs and how long it goes on for

Answer 14

Slightly damaged valves due to strep viridans from dental surgery; goes on for months

Abdo - splenomegaly due to immune complexes against the
microscopic haematuria
Hands - clubbing eventually
Chest - murmur

Question 15

Acute endocarditis - clinical signs, bacterial cause and time frame

Answer 15

Staph aureus endocarditis - patients die very quickly, sepsis

Acute - within 2 weeks

Answer 16

Lobar pneumonia - full of pus
Immune system -

Question 17

Bronchopneumonia common organism

Answer 17

Haemophilus

Legionella - rare, lobar
Mycoplasma - lobar

Question 18

CSF lymphocytes present and NO neutrophils

Answer 18

Coxsackievirus B - or viral/

Haemophilus influenzae - kids not vaccinated
Listeria monocytogenes - unpasturised cheese eating + PREGNANT WOMEN in young people
Older people - pneumococcus

Question 19

Another name for viral meningitis

Answer 19

Asceptic meningitis

Question 20

What does purulent mean?

Answer 20

Bacterial - hundreds of neutrophils

Question 21

SAH on CSF

Answer 21

Yellow with lots of RBC

Question 22

Gram negative intracellular diplocci - pink stuff inside cells

Answer 22

Neisseria meningitidis