Infectious Disease

Question 1

Which antibiotic is associated with ‘red man syndrome’?

Answer 1

Vancomycin (glycopeptides)

Question 2

In a patient with a penicillin allergy, which other antibiotics should be used cautiously?

Answer 2

Cephalosporins and carbapenams (cross-reactivity)

Question 3

Which antibiotics are most associated with the development of pseudomembranous collitis?

Answer 3

Cephalosporins + amoxicillin

clostridium difficile GI infection

Question 4

What is the characteristic rash of amoxycillin/ampicillin?

Answer 4

Widespread erythematous maculopapular rash, often arising after 7 days of treatment and resolving within a week of ceasing treatment

Question 5

What is the empiric antibiotic therapy for an uncomplicated UTI in females?

Answer 5

Trimethoprim

Question 6

What are the most common organisms implicated in UTI?

Answer 6

K - Klebsiella pneumoniae
E - E. Coli
E - Enterococcus faecalis / Enterobacter
P - Pseudomonas aeruginosa / Proteus
S - Staph Aureus

Question 7

What is augmentin?

Answer 7

Brand name for amoxycillin with clavulonic acid

Question 8

What antibiotic is used to treat MRSA?

Answer 8

Vancomycin

Question 9

Which antibiotic is generally given for gram positive bacteria (e.g. strep pneumoniae)?

Answer 9

Amoxicillin or ampicillin

Question 10

What antibiotic is used to treat clostridium difficile infection?

Answer 10

Metronidazole

Question 11

What organisms are commonly associated with traveller’s diarrhoea and which antibiotic is given empirically?

Answer 11

E. coli + campylobacter jejuni (Asia)

Treat with norfloxacin

Question 12

What is the empiric treatment for bacterial meningitis?

Answer 12

Cephtriazone

Question 13

What are the major side effects of gentamycin?

Answer 13

Ototoxicity (reversible in 50%)

Nephrotoxicity (usually reversible)

Question 14

Which bacteria cause atypical pneumonia?

Answer 14

Mycoplasma pneumoniae
Legionella
Chlamidophila pneumoniae

Question 15

What is the empirical antibiotic therapy for treating CAP in the outpatient setting?

Answer 15

RAH: amoxicillin (typical cover) + doxycycline (atypical cover)

Question 16

What is the empirical antibiotic therapy for treating CAP in the inpatient setting?

Answer 16

RAH: amoxicillin + clavulonic acid (augmentin)

Question 17

What are the most common organisms implicated in CAP?

Answer 17

1. Strep pneumoniae
2. Haemophilus influenzae B
3. Mycoplasma pneumoniae

Question 18

What is the empirical antibiotic treatment for aspiration pneumonia?

Answer 18

Amoxicillin + clavulonic acid (Augmentin)

Question 19

Which bacteria is the most common cause of post-influenza bacteral pneumonia?

Answer 19

Staph aureus

Question 20

What is the likely cause of CAP in a patient with bronchiectasis?

Answer 20

Pseudomonas aeruginosa

Question 21

What is the likely cause of CAP on a background of alcohol abuse, diabetes and COPD?

Answer 21

Klebsiella pneumoniae

Question 22

What is the likely cause of CAP in an elderly patient with underlying respiratory disease?

Answer 22

Haemophilus influenzae B

Question 23

Which patients are at a particularly high risk of developing bacterial pneumonia caused by pseudomonas aeruginosa?

Answer 23

Patients with cystic fibrosis

Question 24

What is the empirical antibiotic therapy for the treatment of an uncomplicated UTI in a male?

Answer 24

Amoxicillin + clavulonic acid (augmentin)

Question 25

What is the most common cause of bacterial tonsillitis?

Answer 25

Group A Beta-Haemolytic Streptococcus = Streptococcus Pyogenes (penicillin)

Question 26

Which types of bacteria are most likely to induce a massive inflammatory response, leading to pus formation?

Answer 26

``` Encapsulated Bacteria (e.g. staph, strep) Capsule contains lectin which activates compliment and recruits neutrophils (content of pus) ```

Question 27

List 5 complications of Group A Streptococcal pharyngitis.

Answer 27

Non-suppurative: acute rheumatic fever, scarlet fever, toxic shock syndrome, acute glomerulonephritis, PANDAS Suppurative: peritonsillar abscess, sinusitis, otitis media, mastoiditis, meningitis, brain abscess

Question 28

List 5 complications of Group A Streptococcal pharyngitis.

Answer 28

Non-suppurative: acute rheumatic fever, scarlet fever, toxic shock syndrome, acute glomerulonephritis, PANDAS Suppurative: peritonsillar abscess, sinusitis, otitis media, mastoiditis, meningitis, brain abscess

Question 29

Which 4 drugs are first-line therapy for the treatment of confirmed mycobacterium tuberculosis infection?

Answer 29

Rifampicin Isoniazid Pyrazinamide Ethambutol (or streptomycin)

Question 30

Which investigations are useful for diagnosing acute rheumatic fever?

Answer 30

ESR, CRP Throat swab & blood culture for GABHS Anti-DNAse B and Anti-streptolysin O ECHO

Question 31

Which antibiotic is commonly used to treat streptococcal infections?

Answer 31

Penicillin

Question 32

Which antibiotic is commonly used to treat e. coli infections?

Answer 32

Gentamicin

Question 33

Which antibiotic is commonly used to treat anaerobic infections?

Answer 33

Metronidazole

Question 34

Give one example of an anaerobic bacteria.

Answer 34

Bacteroides

Question 35

Give 5 complications of shingles.

Answer 35

1. Post-herpetic neuralgia (trigeminal nerve) 2. Ramsay Hunt syndrome (facial nerve) 3. Herpes zoster ophthalmicus 4. Acute retinal necrosis 5. Bacterial skin infection

Question 36

What medication may be given to treat shingles?

Answer 36

Acyclovir

Question 37

How does neisseria meningiditis appear on microscopy and gram stain?

Answer 37

Gram negative diplococcus (pink)

Question 38

How does staph aureus appear on microscopy and gram stain?

Answer 38

Gram positive cocci in clusters (purple)

Question 39

How does strep pneumoniae appear on microscopy and gram stain?

Answer 39

Gram positive cocci (purple)

Question 40

How does haemophilus influenzae appear on microscopy and gram stain?

Answer 40

Gram negative coccobacilli (pink)

Question 41

How does e. coli appear on microscopy and gram stain?

Answer 41

Gram negative rods (pink)

Question 42

What does a positive test for HBsAg indicate?

Answer 42

Current HBV infection

Question 43

What does a positive test for HBsAb indicate?

Answer 43

Immunity to HBV (from vaccination or previous infection)

Question 44

What does a positive test for HBcAb indicate?

Answer 44

Current or recent infection (no immunity)

Question 45

What does a positive test for HBeAg indicate?

Answer 45

Chronic HBV infection