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Path (hopefully more condensed) > Micro > Flashcards

Micro Flashcards

1
Q

HIV positive pt with dry cough and sob. Gomori’s methanamine silver stain shows flying saucer shaped cysts on microscopy. CXR shows diffuse bilateral pulmonary infiltrates

A

Pneumocystis jirovecii

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2
Q

Rusty coloured sputum with lobar consolidation on CXR

A

Streptococcus pneumoniae

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3
Q

Streptococcus pneumoniae under microscope

A

Gram positive diplococcus

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4
Q

Pneumonia post flu infection, cavitation on CXR

A

Staphylococcus Aureus

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5
Q

Staphylcoccus aureus under miscroscope

A

Gram positive coccus in grape shaped clusters

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6
Q

Smoker with history of COPD has pneumonia

A

Moraxella catarrhalis, haemophilus influenzae

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7
Q

Moraxella catarrhalis under microscope

A

Gram negative diplococcus

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8
Q

Haemophilus influenzae under microscope

A

Gram genative bacilli

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9
Q

Elderly alcoholic pt presents with pneumonia, haemoptysis

A

Klebsiella pneumoniae

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10
Q

Klebsiella pneumoniae under microscope

A

Gram negative rod

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11
Q

Pt with headache, myalgia, hyponatraemia, deranged LFTs, hypophosphataemia. Just spent a week in a hotel.

A

Legionella Pneumophila (atypical penumonia)

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12
Q

Legionella pneumophila under microscope

A

Gram negative rod

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13
Q

University student with flu like symptoms, erythema multiforme. Cold-agluttinin positive.

A

Mycoplasma pneumoniae (atypical pneumonia)

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14
Q

Mycoplasma pneumoniae under microscope

A

Obligate intracellular

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15
Q

Patient with exotic parrot, pneumonia, splenomegaly

A

Chlamydia psittaci (atypical pneumonia)

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16
Q

Chlamydia psittaci under microscope

A

Intracellular

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17
Q

Pt w/ fever, haemoptysis, weight loss, night sweats. CXR shows bihilar lymphadenopathy, upper lobe cavitation. Ziehl-Neelson stain reveals acid fast bacilli. Cultured on Lowenstein-Jensen medium over 6 weeks.

A

Mycobacterium tuberculosis

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18
Q

TB treatment

A

6 months Rifampicin

6 months Isoniazid

2 months Pyrazinamide

2 months Ethambutol

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19
Q

Man has watery diarrhoea, abdo cramps, headache and fever after eating unpasteurised dairy.

A

Listeria monocytogenes

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20
Q

Listeria monocytogenes under microscope

A

gram positive rod

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21
Q

Man comes back from India with bloody diarrhoea and renal failure

A

escherichia coli

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22
Q

escherichia coli under microscope

A

gram negative rod

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23
Q

Rice water diarrhoea without inflammatory cells, after eating shellfish

A

Vibrio cholerae

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24
Q

Vibrio cholerae under microscope

A

comma shaped

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25
Q

Homosexual man/ traveller with non-bloody steatorrhoea. Cysts seen in stool under microscopy

A

Giardia lamblia

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26
Q

Giardia lamblia under microscope

A

pear-shaped trophozite

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27
Q

Slow onset fever, myalgia, constipation, splenomegaly, rose spots on trunk.

A

salmonella typhi

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28
Q

salmonella typhi under microscope

A

gram negative rod

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29
Q

typhoid treatment

A

IV ceftriaxone, the PO azithromycin

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30
Q

pt eats chicken at bbq, has bloody, foul smelling diarrhoea. poor chap goes on to develop GBS

A

campylobacter jejuni

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31
Q

vomiting 4 hours after eating rehated rice

A

bacillus cereus

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32
Q

24 hrs of watery diarrhoea after eating reheated meat. gas gangrene if extremely unlucky

A

staphylcoccus aureus

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33
Q

outbreak of bloody diarrhoea amongst MSM

A

Shigella

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34
Q

non-bloody diarrhoea after eating chicken sashimi

A

salmonella enterides

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35
Q

dysentry, chornic weight loss and liver abcess. Flask shaped ulcer

A

entamoeba histolytica

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36
Q

chronic fever, headache and confusion. CSF is colourless, with raised protein, raised lymphocytes and low glucose.

A

TB meningitis

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37
Q

man who volunteers at a zoo has fever, headache, malaise and photphobia. CSF shows raised white cells, microscopic agglutination test positive

A

leptospira interrogans

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38
Q

20 y/o w/ photophobia, neck stiffness, headache, fever.

A

Neisseria meningitidis (only one with rash))

Streptococcus pneumoniae

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39
Q

neisseria meningitidis under microscope

A

gram negative dipplococcus

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40
Q

HIV patient with meningism. CSF examination with india ink staining shows yeast cells with surrounding halo

A

cyrptococcus neoformans

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41
Q

recurrent meningitis, CSF is clear with raised white cells and normal glucose

A

Herpes simplex virus 2

other forms of viral meningitis - enterovirus, mumps

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42
Q

hiker develops flu like symptoms, then late neuro signs, and bullseye rash (erythema chronicum migrans)

A

borrelia burgdorferi

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43
Q

woman bitten by bat has hypersalivation, hydrophobia. Negri bodies on histopathology

A

Rabies

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44
Q

chlamydia trachomatis management

A

doxycycline 100mg BD 7d

or

azithromycin 1g stat

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45
Q

widespread rash with lymphadenopathy. pt had a painless genital ulcer that appeared 1 month after unprotected sex with stranger, but resolved a few weeks later without treatment

A

treponema pallidum (syphilis)

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46
Q

syphilis treatment

A

IM benzathine penicillin stat

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47
Q

gonorrhoea management

A

ceftriaxone 250mg IM stat

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48
Q

painful genital ulcer with unilateral swollen inguinal nodes

A

haemophilus ducreyi

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49
Q

fishy vaginal discharge, clue cells on microscopy

A

bacterial vaginosis

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50
Q

donovan bodies on giemsa stain

A

klebsiella granulomatis

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51
Q

Abx for skin infections with s. aureus

A

flucloxacillin

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52
Q

Abx for pharyngitis

A

benzylpenicillin

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53
Q

Abx for mild community acquired pneumonia

A

amoxicillin

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54
Q

Abx for severe community acquired pneumonia

A

co-amoxiclav

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55
Q

Abx for atypical community acquired pneumonia

A

clarithromycin

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56
Q

Abx for hospital acquired pneumonia

A

co-amoxiclav + gentamycin/ tazocin

57
Q

Abx for bacterial meningitis

A

ceftriaxone + amoxicllin if young/ old (listeria)

58
Q

Abx for UTI

A

trimethoprim/ nitrofurantoin/ cephalexin/ co-amoxiclav

59
Q

Abx for C. diff

A

metronidazole

vancomycin

60
Q

Amoxicillin uses

A

mild CAP

UTI

listeria meningitis

endocarditis prophylaxis

protection vs s. pneumoniae in asplenic pts

61
Q

Flucloxacillin uses

A

s. aureus

cellulitis, folliculitis, mastitis

osteomyelitis

septic arthritis

endocarditis

62
Q

Vancomycin uses

A

MRSA

c. diff

63
Q

cefotaxime uses

A

pyelonephritis

sepsis secondary to HAP

soft tissue infections

64
Q

doxycycline

A

COPD exacerbations

STIs

Acne

65
Q

meropenem

A

broad spectrum for v sick pts

beta-lactamase resistant

66
Q

what does HHV8 cause

A

kaposi sarcoma

67
Q

hep b serology in vaccinated individual

A

HBsAg NEGATIVE

Anti-HBc NEGATIVE

HBsAb POSITIVE

68
Q

hep b serology in acute infection

A

HBsAg POSITIVE

Anti-HBc IgM POSITIVE

HBsAb NEGATIVE

69
Q

hep b serology resolved infection

A

HBsAg NEGATIVE

Anti-HBc IgG POSITIVE

HBsAb POSITIVE

70
Q

hep b serology chronic infection

A

HBsAg POSITIVE

Anti-HBc IgG POSITIVE

HBsAb NEGATIVE

71
Q

hep b treatment

A

interferon alpha w/ nrti (zidovudine, lamivudine)

80%+ acute, rest chronic

72
Q

hep c treatment

A

pegylated IFN-alpha

60-80% chronic

73
Q

fungus that causes hypopigmentation in dark skinned people, hyperpigmentation in light skinned people. microscopy with KOH stain shows a speghetti with meatballs appearance

A

pityriasis vesicolor

74
Q

IVDU patient with fever, new mumur, roth spots, osler’s nodes, janeway lesions

A

infective endocarditis

75
Q

infective enodcarditis management

A

IV Abx 6 wks

76
Q

Infective endocarditis organisms

A

acute - strep pyogenes, staph aureus (IVDU), CoNS (prosthetic valves)
aubacute - staph epidermidis, strep viridans

77
Q

aflatoxin is a risk factor for

A

hepatocellular carcinoma

78
Q

HIV positive man with sob, cough. CXR shows sphericla opacity (aspergilloma)

A

aspergillus flavus

79
Q

rose gardner develops nodular lesions that are initially painless, that become ulcerated

A

sporothrix schenckii

80
Q

man who frequents the woods develops a warty lesion resembling a cauliflower

A

phialphora verrucosa

81
Q

child develops scaly red lesions on head with loss of hair, expanding ring on scalp

A

tinea capitis

82
Q

raised red rings affecting trunk, arms and legs

A

tinea corporis

83
Q

man has fever, myalgia, arthralgia, tiredness and depression after eating unpasteruized cheese and spending some time at a cow petting zoo

A

brucellosis

84
Q

man develops fever, dry cough and plueral effusion after spending some time clearing up faeces on a livestock farm

A

Q fever (coxiella burnetti)

85
Q

woman develops nodules on elbows, knees and feet after being bitten by a fish

A

mycobacterium marinium

86
Q

culture medium for TB

A

lowenstein-jensen medium (grows as brown, coffee coloured, breadcumb-like colonies)

87
Q

stain for mycobacterium leprae (leprosy)

A

fite stain

88
Q

positive mantoux test means…

A

someone has been exposed to TB

89
Q

what diameter is considered a positive mantoux

A

5mm or more if HIV +

10mm or more if high risk

15mm or more in anyone

90
Q

optochin resistant alpha haemolytic strep

A

strep viridans

91
Q

optochin sensitive alpha haemolytic strep

A

strep pneumoniae

92
Q

acute endocarditis most common causative organism

A

staph aureus

common in IV drug users

93
Q

subacute endocarditis most common causative organism

A

strep viridans

94
Q

subacute endocarditis presentation

A

insidious onset of fevers, night sweats, weight loss, potentially stroke/ pe

95
Q

foscarnet use

A

CMV (inhibits viral DNA polymerase)

96
Q

most common UTI cause

A

e coli

97
Q

gram negative, lactose fermenting, rod implicated in UTIs in immunocompromised

A

enterobacter

98
Q

patients immunocompromised or with indwelling catheter are at increased risk of UTI from this organism

A

klebsiella

99
Q

second most common UTI cause in young, sexually active women

A

staph saphrophyticus

100
Q

flagellated protozoan (pear shaped) parasite causing weight loss, flatulence, chronic diarrhoea and bloating

A

giardia lamblia

101
Q

giardasis treatment

A

metronidazole

102
Q

undulating fevers, arthralgia, myalgia, weight loss, fatigue, lymphadenopathy, sacroilitis, depression following contact with livestock

A

brucellosis

103
Q

brucellosis management

A

doxycycline or gentamicin for 6 weeks

104
Q

character of erythema chronicum migrans

A

begins as red macule/ papule

approx 1 week later - expands to target appearance with central fading

105
Q

most common cause of septic arthritis in young, sexually active adults

A

neisseria gonorrhoea

106
Q

most common cause of septic arthritis in older adults

A

staphylococcus aureus

107
Q

gram negative septic arthritis management

A

IV cefotaxime for 4-6 weeks

108
Q

staphylococcal septic arthritis management

A

IV flucloxacillin for 4-6 weeks

109
Q

HBcAb IgM POSITIVE

HBcAb IgG POSITIVE

HBsAg POSITIVE

anti-HBs NEGATIVE

HBeAg POSITIVE

anti-HBe NEGATIVE

A

acute hep b infection

110
Q

HBcAb IgM NEGATIVE

HBcAb IgG POSITIVE

HBsAg POSITIVE

anti-HBs NEGATIVE

HBeAg POSITIVE/ NEGATIVE

anti-HBe POSITIVE/ NEGATIVE

A

Chronic Hep B infection

111
Q

HBcAb IgM NEGATIVE

HBcAb IgG POSITIVE

HBsAg NEGATIVE

anti-HBs POSITIVE

HBeAg NEGATIVE

anti-HBe POSITIVE/ NEGATIVE

A

cleared hep b

112
Q

HBcAb IgM NEGATIVE

HBcAb IgG NEGATIVE

HBsAg NEGATIVE

anti-HBs POSITIVE

HBeAg NEGATIVE

anti-HBe NEGATIVE

A

vaccinated

113
Q

c diff treatment

A

10-14 days oral metronidazole

second line = 10-14 days oral vancomycin

114
Q

sudden decline in cognitive function, combined with myoclonic jerks, normal CT + dementia screen

A

consider sporadic creutzfeldt-jakob disease

115
Q

CJD diagnostic test

A

EEG

116
Q

why lumbar puncture in CJD

A

look for 14-3-3 protein

117
Q

turbid CSF with raised neutrophils, raised protein, low glucose

A

bacterial meningitis

118
Q

clear/ slightly turbid CSF, slightly raised protein, raised lymphocytes, normal glucose

A

viral meningitis

119
Q

clear/ slightly turbid CSF, v high protein, raised lymphocytes, reduced glucose

A

TB meningitis

120
Q

patient with chronic liver disease –> pyrexia, abdo tenderness, tachycardia, ascites, nausea

A

spontaneous bacterial peritonitis

121
Q

spontaneous bacterial peritonitis organisms

A

e coli

gram-positive cocci

enterococci

122
Q

spontaneous bacterial peritonitis management

A

cefotaxime

123
Q

ethambutol worrying side effect

A

ocular toxicity

124
Q

isoniazid side effect

A

peripheral neuropathy

125
Q

falciparum malaria management

A

ADMIT

if uncomplicated –> oral quinine + doxycycline 5-7 days

if severe –> IV quinine, IV artesunate if v severe

126
Q

first line abx for treatment of bacterial sore throat

A

phenoxymethylpenicillin

127
Q

which herpes virus in encephalitis

A

HSV 1

128
Q

athlete’s foot antifungal

A

clotrimazole

129
Q

athlete’s foot organism

A

trichophyton rubrum

130
Q

first line abx for treatment of bacterial sore throat (penicillin allergy)

A

clarithromycin

131
Q

dengue vector

A

female aedes mosquito

132
Q

tapeworms treatment for adults

A

praziquantel

133
Q

blood test prior to starting systemic anti-fungals

A

LFTs

134
Q

pregnancy UTI abx

A

nitrofurantoin

135
Q

schistosomiasis is associated with which cancer

A

bladder

136
Q

what does maternal parvovirus increase the risk of

A

hydrops fetalis

137
Q

q fever organism

A

coxiella burnetii

138
Q

abx for copd infective exacerbation

A

amoxicillin

139
Q

abx for acute otitis media

A

amoxicillin

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