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
2
Q
Rusty coloured sputum with lobar consolidation on CXR
A
Streptococcus pneumoniae
3
Q
Streptococcus pneumoniae under microscope
A
Gram positive diplococcus
4
Q
Pneumonia post flu infection, cavitation on CXR
A
Staphylococcus Aureus
5
Q
Staphylcoccus aureus under miscroscope
A
Gram positive coccus in grape shaped clusters
6
Q
Smoker with history of COPD has pneumonia
A
Moraxella catarrhalis, haemophilus influenzae
7
Q
Moraxella catarrhalis under microscope
A
Gram negative diplococcus
8
Q
Haemophilus influenzae under microscope
A
Gram genative bacilli
9
Q
Elderly alcoholic pt presents with pneumonia, haemoptysis
A
Klebsiella pneumoniae
10
Q
Klebsiella pneumoniae under microscope
A
Gram negative rod
11
Q
Pt with headache, myalgia, hyponatraemia, deranged LFTs, hypophosphataemia. Just spent a week in a hotel.
A
Legionella Pneumophila (atypical penumonia)
12
Q
Legionella pneumophila under microscope
A
Gram negative rod
13
Q
University student with flu like symptoms, erythema multiforme. Cold-agluttinin positive.
A
Mycoplasma pneumoniae (atypical pneumonia)
14
Q
Mycoplasma pneumoniae under microscope
A
Obligate intracellular
15
Q
Patient with exotic parrot, pneumonia, splenomegaly
A
Chlamydia psittaci (atypical pneumonia)
16
Q
Chlamydia psittaci under microscope
A
Intracellular
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
18
Q
TB treatment
A
6 months Rifampicin
6 months Isoniazid
2 months Pyrazinamide
2 months Ethambutol
19
Q
Man has watery diarrhoea, abdo cramps, headache and fever after eating unpasteurised dairy.
A
Listeria monocytogenes
20
Q
Listeria monocytogenes under microscope
A
gram positive rod
21
Q
Man comes back from India with bloody diarrhoea and renal failure
A
escherichia coli
22
Q
escherichia coli under microscope
A
gram negative rod
23
Q
Rice water diarrhoea without inflammatory cells, after eating shellfish
A
Vibrio cholerae
24
Q
Vibrio cholerae under microscope
A
comma shaped
25
Homosexual man/ traveller with non-bloody steatorrhoea. Cysts seen in stool under microscopy
Giardia lamblia
26
Giardia lamblia under microscope
pear-shaped trophozite
27
Slow onset fever, myalgia, constipation, splenomegaly, rose spots on trunk.
salmonella typhi
28
salmonella typhi under microscope
gram negative rod
29
typhoid treatment
IV ceftriaxone, the PO azithromycin
30
pt eats chicken at bbq, has bloody, foul smelling diarrhoea. poor chap goes on to develop GBS
campylobacter jejuni
31
vomiting 4 hours after eating rehated rice
bacillus cereus
32
24 hrs of watery diarrhoea after eating reheated meat. gas gangrene if extremely unlucky
staphylcoccus aureus
33
outbreak of bloody diarrhoea amongst MSM
Shigella
34
non-bloody diarrhoea after eating chicken sashimi
salmonella enterides
35
dysentry, chornic weight loss and liver abcess. Flask shaped ulcer
entamoeba histolytica
36
chronic fever, headache and confusion. CSF is colourless, with raised protein, raised lymphocytes and low glucose.
TB meningitis
37
man who volunteers at a zoo has fever, headache, malaise and photphobia. CSF shows raised white cells, microscopic agglutination test positive
leptospira interrogans
38
20 y/o w/ photophobia, neck stiffness, headache, fever.
Neisseria meningitidis (only one with rash))
Streptococcus pneumoniae
39
neisseria meningitidis under microscope
gram negative dipplococcus
40
HIV patient with meningism. CSF examination with india ink staining shows yeast cells with surrounding halo
cyrptococcus neoformans
41
recurrent meningitis, CSF is clear with raised white cells and normal glucose
Herpes simplex virus 2
other forms of viral meningitis - enterovirus, mumps
42
hiker develops flu like symptoms, then late neuro signs, and bullseye rash (erythema chronicum migrans)
borrelia burgdorferi
43
woman bitten by bat has hypersalivation, hydrophobia. Negri bodies on histopathology
Rabies
44
chlamydia trachomatis management
doxycycline 100mg BD 7d
or
azithromycin 1g stat
45
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
treponema pallidum (syphilis)
46
syphilis treatment
IM benzathine penicillin stat
47
gonorrhoea management
ceftriaxone 250mg IM stat
48
painful genital ulcer with unilateral swollen inguinal nodes
haemophilus ducreyi
49
fishy vaginal discharge, clue cells on microscopy
bacterial vaginosis
50
donovan bodies on giemsa stain
klebsiella granulomatis
51
Abx for skin infections with s. aureus
flucloxacillin
52
Abx for pharyngitis
benzylpenicillin
53
Abx for mild community acquired pneumonia
amoxicillin
54
Abx for severe community acquired pneumonia
co-amoxiclav
55
Abx for atypical community acquired pneumonia
clarithromycin
56
Abx for hospital acquired pneumonia
co-amoxiclav + gentamycin/ tazocin
57
Abx for bacterial meningitis
ceftriaxone + amoxicllin if young/ old (listeria)
58
Abx for UTI
trimethoprim/ nitrofurantoin/ cephalexin/ co-amoxiclav
59
Abx for C. diff
metronidazole
vancomycin
60
Amoxicillin uses
mild CAP
UTI
listeria meningitis
endocarditis prophylaxis
protection vs s. pneumoniae in asplenic pts
61
Flucloxacillin uses
s. aureus
cellulitis, folliculitis, mastitis
osteomyelitis
septic arthritis
endocarditis
62
Vancomycin uses
MRSA
c. diff
63
cefotaxime uses
pyelonephritis
sepsis secondary to HAP
soft tissue infections
64
doxycycline
COPD exacerbations
STIs
Acne
65
meropenem
broad spectrum for v sick pts
beta-lactamase resistant
66
what does HHV8 cause
kaposi sarcoma
67
hep b serology in vaccinated individual
HBsAg NEGATIVE
Anti-HBc NEGATIVE
HBsAb POSITIVE
68
hep b serology in acute infection
HBsAg POSITIVE
Anti-HBc IgM POSITIVE
HBsAb NEGATIVE
69
hep b serology resolved infection
HBsAg NEGATIVE
Anti-HBc IgG POSITIVE
HBsAb POSITIVE
70
hep b serology chronic infection
HBsAg POSITIVE
Anti-HBc IgG POSITIVE
HBsAb NEGATIVE
71
hep b treatment
interferon alpha w/ nrti (zidovudine, lamivudine)
80%+ acute, rest chronic
72
hep c treatment
pegylated IFN-alpha
60-80% chronic
73
fungus that causes hypopigmentation in dark skinned people, hyperpigmentation in light skinned people. microscopy with KOH stain shows a speghetti with meatballs appearance
pityriasis vesicolor
74
IVDU patient with fever, new mumur, roth spots, osler's nodes, janeway lesions
infective endocarditis
75
infective enodcarditis management
IV Abx 6 wks
76
Infective endocarditis organisms
acute - strep pyogenes, staph aureus (IVDU), CoNS (prosthetic valves)
aubacute - staph epidermidis, strep viridans
77
aflatoxin is a risk factor for
hepatocellular carcinoma
78
HIV positive man with sob, cough. CXR shows sphericla opacity (aspergilloma)
aspergillus flavus
79
rose gardner develops nodular lesions that are initially painless, that become ulcerated
sporothrix schenckii
80
man who frequents the woods develops a warty lesion resembling a cauliflower
phialphora verrucosa
81
child develops scaly red lesions on head with loss of hair, expanding ring on scalp
tinea capitis
82
raised red rings affecting trunk, arms and legs
tinea corporis
83
man has fever, myalgia, arthralgia, tiredness and depression after eating unpasteruized cheese and spending some time at a cow petting zoo
brucellosis
84
man develops fever, dry cough and plueral effusion after spending some time clearing up faeces on a livestock farm
Q fever (coxiella burnetti)
85
woman develops nodules on elbows, knees and feet after being bitten by a fish
mycobacterium marinium
86
culture medium for TB
lowenstein-jensen medium (grows as brown, coffee coloured, breadcumb-like colonies)
87
stain for mycobacterium leprae (leprosy)
fite stain
88
positive mantoux test means...
someone has been exposed to TB
89
what diameter is considered a positive mantoux
5mm or more if HIV +
10mm or more if high risk
15mm or more in anyone
90
optochin resistant alpha haemolytic strep
strep viridans
91
optochin sensitive alpha haemolytic strep
strep pneumoniae
92
acute endocarditis most common causative organism
staph aureus
common in IV drug users
93
subacute endocarditis most common causative organism
strep viridans
94
subacute endocarditis presentation
insidious onset of fevers, night sweats, weight loss, potentially stroke/ pe
95
foscarnet use
CMV (inhibits viral DNA polymerase)
96
most common UTI cause
e coli
97
gram negative, lactose fermenting, rod implicated in UTIs in immunocompromised
enterobacter
98
patients immunocompromised or with indwelling catheter are at increased risk of UTI from this organism
klebsiella
99
second most common UTI cause in young, sexually active women
staph saphrophyticus
100
flagellated protozoan (pear shaped) parasite causing weight loss, flatulence, chronic diarrhoea and bloating
giardia lamblia
101
giardasis treatment
metronidazole
102
undulating fevers, arthralgia, myalgia, weight loss, fatigue, lymphadenopathy, sacroilitis, depression following contact with livestock
brucellosis
103
brucellosis management
doxycycline or gentamicin for 6 weeks
104
character of erythema chronicum migrans
begins as red macule/ papule
approx 1 week later - expands to target appearance with central fading
105
most common cause of septic arthritis in young, sexually active adults
neisseria gonorrhoea
106
most common cause of septic arthritis in older adults
staphylococcus aureus
107
gram negative septic arthritis management
IV cefotaxime for 4-6 weeks
108
staphylococcal septic arthritis management
IV flucloxacillin for 4-6 weeks
109
HBcAb IgM POSITIVE
HBcAb IgG POSITIVE
HBsAg POSITIVE
anti-HBs NEGATIVE
HBeAg POSITIVE
anti-HBe NEGATIVE
acute hep b infection
110
HBcAb IgM NEGATIVE
HBcAb IgG POSITIVE
HBsAg POSITIVE
anti-HBs NEGATIVE
HBeAg POSITIVE/ NEGATIVE
anti-HBe POSITIVE/ NEGATIVE
Chronic Hep B infection
111
HBcAb IgM NEGATIVE
HBcAb IgG POSITIVE
HBsAg NEGATIVE
anti-HBs POSITIVE
HBeAg NEGATIVE
anti-HBe POSITIVE/ NEGATIVE
cleared hep b
112
HBcAb IgM NEGATIVE
HBcAb IgG NEGATIVE
HBsAg NEGATIVE
anti-HBs POSITIVE
HBeAg NEGATIVE
anti-HBe NEGATIVE
vaccinated
113
c diff treatment
10-14 days oral metronidazole
second line = 10-14 days oral vancomycin
114
sudden decline in cognitive function, combined with myoclonic jerks, normal CT + dementia screen
consider sporadic creutzfeldt-jakob disease
115
CJD diagnostic test
EEG
116
why lumbar puncture in CJD
look for 14-3-3 protein
117
turbid CSF with raised neutrophils, raised protein, low glucose
bacterial meningitis
118
clear/ slightly turbid CSF, slightly raised protein, raised lymphocytes, normal glucose
viral meningitis
119
clear/ slightly turbid CSF, v high protein, raised lymphocytes, reduced glucose
TB meningitis
120
patient with chronic liver disease --> pyrexia, abdo tenderness, tachycardia, ascites, nausea
spontaneous bacterial peritonitis
121
spontaneous bacterial peritonitis organisms
e coli
gram-positive cocci
enterococci
122
spontaneous bacterial peritonitis management
cefotaxime
123
ethambutol worrying side effect
ocular toxicity
124
isoniazid side effect
peripheral neuropathy
125
falciparum malaria management
ADMIT
if uncomplicated --> oral quinine + doxycycline 5-7 days
if severe --> IV quinine, IV artesunate if v severe
126
first line abx for treatment of bacterial sore throat
phenoxymethylpenicillin
127
which herpes virus in encephalitis
HSV 1
128
athlete's foot antifungal
clotrimazole
129
athlete's foot organism
trichophyton rubrum
130
first line abx for treatment of bacterial sore throat (penicillin allergy)
clarithromycin
131
dengue vector
female aedes mosquito
132
tapeworms treatment for adults
praziquantel
133
blood test prior to starting systemic anti-fungals
LFTs
134
pregnancy UTI abx
nitrofurantoin
135
schistosomiasis is associated with which cancer
bladder
136
what does maternal parvovirus increase the risk of
hydrops fetalis
137
q fever organism
coxiella burnetii
138
abx for copd infective exacerbation
amoxicillin
139
abx for acute otitis media
amoxicillin
