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Path Past Papers > Micro > Flashcards

Micro Flashcards

1
Q

Returned from holiday with fever, headache and confused

A

Legionella

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2
Q

Hypernatraemic, diarrhoea, abdo pain, just stayed in hotel

A

Legionella

with Hepatitis

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3
Q

Legionella Ix and Mx

A

Urine or serum Ag detection

Macrolides e.g. azithromycin

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4
Q

50yo, LLL pneumonia, haemoptysis, cavitation, gram -ve coccobacilli

A

H. influenzae

Associated with smoking/COPD

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5
Q

Which respiratory infection is more common in

  1. Diabetics
  2. Post influenza
A
  1. S. aureus

2. S. aureus

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6
Q

Silver stain, boat shaped organism, eosinophils in alveoli, dry cough

A

Pneumocystis jirovecii pneumonia

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7
Q

Man goes to wedding in devon, comes back with pneumonia and confusion. What’s the organism?

A

Legionella (hyponatraemia –> confusion)

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8
Q

Transplant patient develops pneumonia, halo sign on Xray/CT

A

Aspergillosis

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9
Q

Complement deficiency, septicaemia, rash and arthritis after unprotected sex

A

Disseminated gonorrheoa

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10
Q

Wet slide microscopy

A

Trichomonas Vaginalis

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11
Q

Gram +ve coccus, Coag neg

A

S. epidermis

S. aureus is coag positive

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12
Q

Gram neg rod
Lactose fermenting

Name 2

A

E coli

Klebsiella

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13
Q

UTI ass with renal calculus

A

Proteus

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14
Q

Excess ammonia –> what type of renal stones?

A

Phosphate stones

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15
Q

Rotavirus vs norovirus

  • Age group
  • Length of presentation
  • Classical symptoms
A

Rota:

  • young children or old adults
  • lasts for 1 week
  • D&V and dehydration

Noro:

  • Adults and children
  • Similar presentation but for 2-3 days
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16
Q

Diarrhoea after BBQ

  1. Potential organisms
  2. Ix
A
  1. Salmonella/shigella

2. Stool culture

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17
Q

MSM is abroad hiking, severe flatulence, foul smelling stool, steatorrhoea, cysts, pear shaped trophozoite

A

Giardia

Do stool microscopy and immunoassay to diagnose

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18
Q

Post surgery boil on legs, not responding to fluclox etc. What pathogen & treatment?

A

MRSA –> vancomycin/teicoplanin

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19
Q

MSSA with penicillin allergy

A

Macrolide e.g. erythromycin OR 3rd gen cephalosporin (but DO NOT use a ceph during acute penicillin reaction i.e. rash still present)

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20
Q

Psuedomonas Abx

A

Tazocin

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21
Q

Good for pseudomonas bad for anaerobes

A

Ciprofloxacin

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22
Q

Macrolide antibiotic for atypical pneumonias

A

Azithromycin

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23
Q

Jaundice, seizures, intracranial calcification in neonate, what antenatal infection?

A

Toxoplasmosis

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24
Q

STI can cross placenta 3rd trimester

A

Syphilis

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25
Q

If mother is highly infectious it requires rapid vaccination and immunoglobulins at birth

A

Hep B

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26
Q

Haemorrhagic cystitis in kids

A

Adenovirus

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27
Q

PTLD virus

A

EBV

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28
Q

PML virus

A

JC virus

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29
Q

Molluscum contagiosum virus

A

Pox virus

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30
Q

Patient has a skin infection and his son also has a sore throat

A

Strep pyogenes

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31
Q

Child has red oedematous rash on face then nasal bridge then spread

A

Erysipelas (?) - strep pyogenes

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32
Q

Painless ulcer on finger after trip to Afghanistan

  1. Condition
  2. Bugs
  3. Vector
A
  1. Cutaneous Leishmania
  2. L.major, L.tropica
  3. Sandfly
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33
Q

Diarrhoea, sweating, tenesmus, RUQ abscess, flask shaped ulcer on microscopy

A

Entamoeba Histolytica

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34
Q

Comma shaped, oxidase positive, bloody smelly diarrhoea

A

Campylobacter

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35
Q

Abdo pain, fever, no diarrhoea, constipation, rose spots, gram negative

A

Salmonella

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36
Q

Sandflies

A

Leishmaniasis

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37
Q

Fever, headache, shakes, confusion, just been to Tanzania

A

Malaria (falciparum)

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38
Q

Treponome specific Ab test (type of microscopy)

A

Dark-field / dark-ground

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39
Q

Antiviral for severe RS bronchiolitis

A

Ribavirin

Rsv, Ribavirin

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40
Q

Flu antiviral

A

Oseltamavir

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41
Q

Can enterovirus cause damage antenatally?

A

Yes - associated with intrauterine foetal death

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42
Q

Vector for Trypsanoma Brucei Rhodensiense

A

Tsetse fly

Causes African Trypsanomiasis

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43
Q

Man eats chicken and gets foul smelling bloody diarrhoea with abdo cramps

A

Campylobacter jejuni

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44
Q

Most common UTI organism in pregnant women

A

E coli

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45
Q

Urease-producing organism ass. with renal stones

A

Proteus

proteuS Stones

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46
Q

Catheter associated UTIs

A

S. epidermis

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47
Q

26 year old cuts leg shaving, 2 days later she presents with a well demarcated area of induration and erythema surrounding the wound - organism?

A

S. aureus

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48
Q

34 year old farmer/gardener cuts his leg whilst working, 3 days later presents to A&E with grossly oedematous leg that is discoloured with multiple necrotic bullae - organism?

A

Clostridium perfringens

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49
Q

6 year old girl presents with a well demarcated erythematous rash of her face in the nasolabial distribution - organism?

A

Strep pyogenes –> Erisypelas

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50
Q

Cysts on microscopy (lung infection)

A

PCP

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51
Q

Legionella diagnostic test

A

Urine Antigen Test

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52
Q

Listeria microscopy

A

V/L shaped, tumbling motility

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53
Q

Bloody travellers diarrhoea, anaemia and low platelets

A

HUS

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54
Q

Which GI infections have superantigens?

A

S. aureus
B. cereus
C. diff
C. perfringens

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55
Q

CSF: high protein, normal glucose, lymphocytes

A

Viral meningitis e.g. HSV

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56
Q

CSF: high protein, low glucose, lymphocytes

A

TB

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57
Q

CSF: high protein, low glucose, neutrophils

A

Bacterial

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58
Q

Chancroid

A 
Haemophilus ducreyi (on choc agar)
Painful ulcer, unilateral LNpathy
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59
Q

Mild CAP treatmetn

A

Amoxicillin

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60
Q

Severe CAP treatmetn

A

Co-amoxiclav and clarithromycin

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61
Q

Staph aureus resistant to ß-lactamase & treatment

A

MRSA (Methicillin-resistant Staph aureus)

Vancomycin/Teicoplanin

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62
Q

adynophagia meaning

A

painful swallowing

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63
Q

EBV on blood film and special test

A

Atypical lymphocytes

Positive monospot test

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64
Q

Oseltamavir target

A

NA on influenza

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65
Q

Hep B treatment

A

IFNa

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66
Q

Acyclovir (MoA and use)

A

Guanosine

HSV, VZV, EBV

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67
Q

Light and dark spots on body

Spag with meatballs on microscopy

A

Pitoriasis versicolour

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68
Q

Zoonoses from animals and dairy

A

Brucellosis

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69
Q

Ticks and macpap rash

A

Rickettsia

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70
Q

Rocky Mt Spotted fever

A

Rickettsia

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71
Q

Negribodies

A

Rabies

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72
Q

Lowen Jensen Culture

A

TB –> Brown granular

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73
Q

Pneumonia in alcoholics (+ list two more features)

A

Klebsiella pneumponiae

Cavitation + haemoptysis (red currant jelly haemoptysis)

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74
Q

GI infection which attaches to bowel but does not invade –> malnutrition, bloating, weight loss

A

Giardia lambia

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75
Q

Crusty ulcer and LNpathy after walking on the beach

A

Leishmania (cutaneous)
Leishmania major/tropica
Sandflies are vector

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76
Q

Kala azar

A

Visceral leishmania (fever and splenomegaly)

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77
Q

Presentation like cutaneous leishmania but with mouth ulcers too (later)

  1. Name
  2. Pathogen
A

Muco-cutaneous Leishmania

L. braziliensis

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78
Q

Leishmanias are what type of organism

A

Protozoa

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79
Q

Visceral Leishmania pathogens

A

donovania, chagasi and infantum

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80
Q

Septic arthritis pathogen

A

Gon > chlam

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81
Q

sCJD vs vCJD

A

Sporadic Creutzfeldt–Jakob disease

  • 14-3-3 in CSF
  • Neuro mainly

Variant Creutzfeldt–Jakob disease

  • tonsillar biopsy
  • psych before neuro
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82
Q

HBeAg

A

High Infectivity

83
Q

HBsAg

A

acute or chronic

84
Q

Anti-HBc (HBcAb) IgM

A

Acutely infected

85
Q

HBcAb IgG

What if HBsAg also +ve?

A

Previous infection, now immune

HBsAg +ve: Chronic infection

86
Q

HBsAb (anti-HBs)

A

Recovered from natural infection

If all others negative = vaccinated

87
Q

Vancomycin side effect

A

Red man syndrome (and only has gram +ve cover and MRSA)

Consider when treating C diff

88
Q

C. diff protocol

A

Metronidazole 10-14 days (two trials before moving onto vancomycin 10-14d)

89
Q

P. falciparum on blood film

A

Maurer’s cleft (membrane-limited vacuoles or sack-like structures in the cytosol of the erythrocyte)

90
Q

Treatment for listeria meningitis

A

Amoxicillin + gentamycin

Ampicillin + gentamycin

91
Q 
Meningitis
•	Escherichia coli
•	HSV
•	Listeria monocytogenes
•	Neisseria meningitidis
•	Streptococcus pneumoniae

A. A girl has been noted by her parents to be acting strange lately. A Lumbar puncture is performed and the CSF shows high lymphocytes and a raised protein, but normal glucose, what organism is the cause?
B. An 18 year old student is found to have Gram negative diplococcus causing meningitis
C. A man is found to have a Gram positive diplococcus causing meningitis
D. Gram negative rod causing sepsis in a neonate
E. Gram positive rod causing meningitis in a 72 year-old

A 
A. HSV
B. Neisseria meningitidis
C. Streptococcus pneumoniae
D. Escherichia coli
E. Listeria monocytogenes
92
Q

HIV RNA forms HIV, via which error prone enzyme?

a. RNA polymerase
b. DNA polymerase
c. RNA transcriptase
d. Reverse transcriptase

A

d. Reverse transcriptase

93
Q

Which vector transmits Trypanosoma brucei rhodesiense?

a. Anopheles mosquitoes
b. Sandfly
c. Tsetse Fly
d. Aedes

A

c. Tsetse Fly

a. Anopheles mosquitoes – Causes Malaria. Females carry the disease.
b. Sandfly – Causes Leishmaniasis (also known as Kala Azar)
d. Aedes – Causes Aedes aegypti (Yellow Fever)(Pyramids are in Egypt and pyramids are yellow)

94
Q

What does the number of True positives divided by the total number who have the disease describe?

a. Positive predictive value
b. Negative predictive value
c. Sensitivity
d. Specificity
e. Z score

A

c. Sensitivity

95
Q

Which of these does not lead to/cause Chronic Hepatitis?

a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D
e. Hepatitis E

A

a. Hepatitis A

96
Q
  1. Which of these can cause peri/neonatal illness without causing damage to the foetus if the mother is infected antenatal?
    a. Cytomegalovirus (CMV)
    b. Herpes Simplex Virus (HSV)
    c. Enterovirus
    d. Varicella Zoster Virus (VZV)
    e. Rubella
A

c. Enterovirus

97
Q
  1. Which of these is the most likely causative organism of a hospital acquired pneumonia?

a. Haemophilus influenza
b. Steptococcus pneumonia
c. Staphylococcus aureus
d. Microplasma meunomia
e. Pseudomonas aregenosa
f. Aspergillus

A

c. Staphylococcus aureus (Commonly MRSA)

Steptococcus pneumonia - Most common community acquired pneumonia

98
Q

Which/What is the most common cause of jaundice/fever in a returning traveller with a fever?

a. Malaria
b. Hepatitis
c. HIV seroconversion
d. Typhoid
e. Dengue

A

a. Malaria

99
Q

Name an infectious gram +ve and -ve microorganism which is a common cause of meningitis in 3 months or older?

A 
\+ve = Streptococcus pneumoniae
-ve = Neisseria Meningitis
100
Q

What drug is used to treat severe falciparum malaria?

A

Artesunate (and you only use quinine to treat severe malaria infections if artesunate isn’t available)

101
Q

What zoonotic disease does the Ixodes Tick cause?

A

Lyme disease

102
Q 
Antivirals treatment
•	Aciclovir
•	Ganciclovir
•	Oseltamivir
•	Ribavirin
  • CMV retinitis
  • HSV meningitis
  • VZV
  • Child with RSV
  • Asthmatic with flu
A
  • Ganciclovir
  • Aciclovir
  • Aciclovir
  • Ribavirin
  • Oseltamivir
103
Q

Cat scratch disease full name (genus and species) of bacteria

A

Bartonella henselae

104
Q

Stain used for acid-fast bacilli

A

Ziehl-Neelsen stain (Mycobacterium tuberculosis)

105
Q

Name 1 of 3 characteristics of influenza A that could cause a pandemic

A
  • Novel antigenicity
  • Efficient replication in human airway
  • Efficiency viral transmission between people
106
Q

Alcoholic man is on ceftriaxone for meningitis, what organism is he at risk of which this does not cover for?

A

Listeria monocytogenes

107
Q

What virus increases risk of nasopharyngeal cancer?

A

EBV

108
Q

What additional virus apart from HIV and HBV are screened for in platelet donations to pregnant women?

A

Cytomegalovirus

109
Q

Has contact with someone with TB, what is the risk of getting active TB?

A

10%

110
Q

A 20 y/o woman presents w 2 days of dysuria, increased urinary frequency, and suprapubic pain. Rank the organisms by likelihood of being causative:

a. Proteus mirabilis
b. Acinetobacter baumanii
c. Candida albicans
d. Escherichia coli
e. Staphylococcus saprophyticus

A

d. Escherichia coli
e. Staphylococcus saprophyticus
c. Candida albicans
a. Proteus mirabilis
b. Acinetobacter baumanii

111
Q

A neonate develops meningitis at 36 hours old. Rank the organisms by likelihood of being causative:

a. Escherichia coli
b. Group B Strep
c. Cryptococcus neoformans
d. Pseudomonas aeruginosa
e. Listeria monocytogenes

A

b. Group B Strep
a. Escherichia coli
e. Listeria monocytogenes
c. Cryptococcus neoformans
d. Pseudomonas aeruginosa

112
Q

Most common cause of constrictive pericarditis in developing world?

A

Tuberculosis

113
Q

Which organism causes pneumonia with ‘red currant jelly sputum’ in alcoholics and diabetics?

A

Klebsiella pneumoniae

114
Q

What is the most common cause of myocarditis?

A

Viral infection

115
Q

What is the most common cause of portal vein thrombosis?

A

Cirrhosis

116
Q

What is the most common primary breast cancer?

A

Invasive ductal carcinoma

117
Q

Which underlying pathology is commonly associated with nephrotic syndrome in adults?

A

Membranous glomerulonephritis or Focal segmental glomerulosclerosis

118
Q

What is the most common primary tumour of the heart?

A

Myxoma

119
Q

Raised anti-mitochondrial antibodies is associated with which liver disease?

A

Primary biliary cirrhosis

120
Q

What is the equivalent of a dysgerminoma in a testis?

A

Seminoma

121
Q

Intestinal metaplasia in Barrett’s oesophagus is most commonly due to the presence of which cell?

A

Simple columnar epithelial cells

122
Q

What type of emphysema is associated with smoking and chronic bronchitis?

A

Centrilobular

123
Q

Which vascular tumour is associated with HHV8?

A

Kaposi’s sarcoma

124
Q

Which virus causes encephalitis that particularly affects the temporal lobes?

A

Herpes Simplex virus

125
Q

29 y/o man returns from charity work in Yemen with profuse watery diarrhoea that “looks like water after you cook rice in it”. What is the causative organism?

A

Vibrio cholerae

126
Q

43 y/o receiving chemotherapy for leukaemia has ongoing fever and raised inflammatory markers after broad spectrum antibiotic therapy with Meropenem and Amikacin. CT chest shows nodules with surrounding hypoattenuation (halo signs). What is the most likely causative organism?

A

Aspergillus fumigatus

127
Q

18 y/o man with 1 day history of headache, neck stiffness, and photophobia, but no confusion or other signs of encephalitis. HSV1 detected in CSF PCR. What antiviral treatment would you recommend?

A

Aciclovir

128
Q

A 4 y/o presents to A&E with bloody diarrhoea and haemolytic-uraemic syndrome after visiting a petting farm. What is the likely causative organism?

A

Escherichia coli (specifically the 0157:H7 serotype)

129
Q

What property of the MMR vaccine makes it unsuitable for pregnant women?

A

It is a live vaccine

130
Q

42 y/o man returns from India with high fever and abdo pain but no diarrhoea. Blood cultures grow Gram negative bacilli and Malaria rapid test is negative. What is the most appropriate initial antibiotic therapy?

A

Ceftriaxone

131
Q

Which virus can cause hydrops fetalis if it infects a pregnant woman in the first 20 weeks?

A

Parvovirus B19

132
Q

Which Herpes virus causes post-transplant lymphoproliferative disorder?

A

Epstein-Barr virus (HHV4)

133
Q

27 y/o poorly controlled HIV patient presents with meningism (headache, stiff neck, photophobia) and CSF has yeasts in it. What is the likely causative organism?

A

Cryptococcus neoformans

134
Q

37 y/o woman with hot swollen, painful left knee has Gram positive cocci in clusters on joint aspirate. NKDA and MRSA screen is negative: which narrow spectrum antibiotic is most appropriate here?

A

Flucloxacillin

135
Q

73 y/o woman with headache, confusion, photophobia, and fever. Gram positive rods are found in her CSF, what is the likely causative organism?

A

Listeria monocytogenes

136
Q

This vaccine-preventable disease presents with headache, fever, and parotid swelling. Can cause epididymo-orchitis in adults and sometimes even meningitis. What is the causative organism?

A

Mumps orthorubulavirus

137
Q

Name an antibiotic class with concentration-dependent killing and prolonged persistent effects where the goal is to maximise the concentration above the Minimum Inhibitory Concentration (Peak>MIC)

A

Aminoglycosides
Fluoroquinolones
Ketolides

138
Q

78 y/o woman has loose green mucoid stool after a week of I.V. Ceftriaxone. What is the causative organism?

A

Clostridium difficile

139
Q

64 y/o man with poorly controlled T2DM develops periorbital oedema, headache, sinus pain, purulent nasal discharge, and orbital cellulitis. The symptoms started yesterday and he is taken to theatre as an emergency. What anti-fungal should be started immediately?

A

Amphotericin B

140
Q

Which virus is associated with nasopharyngeal carcinoma?

a. Epstein-Barr virus
b. Hepatitis B virus
c. Hepatitis C virus
d. HHV8
e. HPV16

A

a. Epstein-Barr virus

141
Q

What is the most common type of skin cancer?

a. Basal cell carcinoma
b. Keratoacanthoma
c. Melanoma
d. Metastatic cancer
e. Squamous cell carcinoma

A

a. Basal cell carcinoma

142
Q

What is the inheritance pattern of hereditary haemochromatosis?

a. Autosomal dominant
b. Autosomal recessive
c. Polygenic
d. X-linked dominant
e. X-linked recessive

A

b. Autosomal recessive

143
Q

An extradural/ epidural haemorrhage is caused by damage to which blood vessel?

a. Berry aneurysm
b. Bridging veins
c. Internal carotid
d. Middle cerebral artery
e. Middle meningeal artery

A

e. Middle meningeal artery

144
Q

Which type of necrosis is associated with a myocardial infarction?

a. Abscess formation
b. Caseous necrosis
c. Coagulative necrosis
d. Fat necrosis
e. Liquefactive necrosis

A

c. Coagulative necrosis

145
Q

What is the most common glial cell of the CNS?

a. Astrocytes
b. Endothelial cells
c. Ependymal cells
d. Microglia
e. Oligodendrocytes

A

a. Astrocytes

146
Q

What is the most common cause of pancreatitis in adults? (not specified whether acute or chronic)

a. Alcohol
b. Autoimmune
c. Cystic fibrosis
d. Drugs
e. Gallstones

A

e. Gallstones (acute)

a. Alcohol (chronic)

147
Q

What is the most common cause of mitral valve stenosis?

a. Congenital
b. Infective endocarditis
c. Pulmonary hypertension
d. Rheumatic heart disease
e. Systemic lupus

A

d. Rheumatic heart disease

148
Q

What is the most common type of ovarian tumour?

a. Brenner tumour
b. Mucinous cystadenocarcinoma
c. Mucinous cystadenoma
d. Serous cystadenoma
e. Serous mucinous cystadenocarcinoma

A

d. Serous cystadenoma

149
Q

What is the mechanism behind pulmonary oedema due to liver disease?

a. Decreased osmotic pressure
b. Direct injury to the alveolar wall
c. Increased hydrostatic pressure
d. Indirect injury to the alveolar wall
e. Lymphatic obstruction

A

a. Decreased osmotic pressure

150
Q

Which of the following occurs near the surface of the brain and is frequently asymptomatic?

a. Glioblastoma multiforme
b. Haemangioma
c. Meningioma
d. Oligodendroglioma
e. Schwannoma

A

c. Meningioma

151
Q

What is the most common cause of acute respiratory distress syndrome?

a. Aspiration
b. Drug reaction
c. Pancreatitis
d. Sepsis
e. Trauma

A

d. Sepsis

152
Q

Which valve is classically involved in infectious endocarditis in I.V. drug users?

a. Aortic
b. Mitral
c. Prosthetic
d. Pulmonary
e. Tricuspid

A

e. Tricuspid

153
Q

Which of the following is a characteristic of hypercalcaemia?

a. Diarrhoea
b. Easy bruising
c. Hypotension
d. Polyuria and polydipsia
e. Tetany

A

d. Polyuria and polydipsia

154
Q 
25 y/o man brought to A&E with abdominal pain followed by collapse. His blood pressure shows he is in shock and his blood gas results are:
Na+ 120 (low)
K+ 6.2 (high)
HCO3 10.1 (low)
Urea 9.4 (high)
Creatinine 146 (high)
Glucose 2.5 (low)
pH 7.2 (low)
pCO2 3.0 (low)
What is the most likely cause of the abnormal potassium?
a.	Renal loss of sodium
b.	Vomiting
c.	Renal failure
d.	Perforated appendix
e.	Dehydration
A

a. Renal loss of sodium

155
Q

Which of the following tests is useful in diagnosing invasive Candida albicans infection?

a. Beta-D-Glucan
b. Galactomannan
c. RPR
d. TPPA
e. Widal test

A

a. Beta-D-Glucan

156
Q

A 22 y/o man is a close household contact of someone diagnosed with TB. What is his lifetime risk of developing the disease?

a. 0.1%
b. 1%
c. 10%
d. 50%
e. 90%

A

c. 10%

157
Q

Which of the following is the most appropriate antibiotic for Legionella pnemophilia pneumonia?

a. Amoxicillin
b. Azithromycin
c. Ceftriaxone
d. Co-trimoxazole
e. Meropenem

A

b. Azithromycin

158
Q

Which virus is associated with severe hepatic disease and potentially death if it infects a pregnant patient?

a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Hepatitis D
e. Hepatitis E

A

e. Hepatitis E

159
Q

What is the most common form of prion disease?

a. Fatal familial insomnia
b. Iatrogenic Creutzfeldt-Jakob disease
c. Kuru
d. Sporadic Creutzfeldt-Jakob disease
e. Variant Creutzfeldt-Jakob disease

A

d. Sporadic Creutzfeldt-Jakob disease

160
Q

Streptobacillus moniliformis causes which infection?

a. Bacillary angiomatosis
b. Lyme disease
c. Q fever
d. Rat bite fever
e. Syphilis

A

d. Rat bite fever

161
Q

A 45 y/o woman with malaria has a GCS of 11, temp 39.1, HR 108, BP 90/60. Her parasitaemia is 10%, what is the most appropriate anti-malarial therapy?

a. Intravenous Artesunate
b. Intravenous Quinine
c. Oral artemether and proguanil
d. Oral atorvaquone and proguanil
e. Oral mefloquine

A

a. Intravenous Artesunate

162
Q

Which of the following drugs is used to treat Hepatitis B?

a. Aciclovir
b. Oseltamivir
c. Ribavirin
d. Tenofovir
e. Zanamivir

A

d. Tenofovir

163
Q

Infants under 1 year of age shouldn’t be fed honey because of the risk of infection with which organism?

a. Campylobacter jejuni
b. Clostridium botulinum
c. Escherichia coli 0157
d. Salmonella typhi
e. Vibrio cholerae

A

b. Clostridium botulinum

164
Q 
Pneumonia
•	Aspergillus fumigatus
•	Klebsiella pneumoniae
•	Legionella pneumophilia
•	Pneumocystis jirovecii
•	Streptococcus pneumoniae

A. HIV patient who desaturates on exercise
B. Girl receiving chemotherapy for leukaemia with ‘Halo’ sign on CXR
C. Lower lobe pneumonia in a 22 year-old who is coughing up rusty coloured sputum
D. Upper lobe cavitation on CXR in an alcoholic
E. Smoker back from holiday in Spain, also hyponatraemic and confused

A 
A. Pneumocystis jirovecii
B. Aspergillus fumigatus
C. Streptococcus pneumoniae
D. Klebsiella pneumoniae
E. Legionella pneumophilia
165
Q 
Fungi
•	Coccioides
•	Cryptococcus neoformans
•	Malassezia furfur
•	Rhizopus species
•	Trichophytum rubrum

A. HIV patient with CD4+ count of 150 with meningitis
B. Water polo player with itchy scaly rash on lateral toe which then moved along lateral side of foot
C. Pityriasis versicolor
D. Lady came back from visiting her sister in Arizona with systemic symptoms, fever etc.
E. Man in his 60s with poorly controlled diabetes presents with rapidly progressing periorbital swelling, sinus pain and confusion

A 
A. Cryptococcus neoformans
B. Trichophytum rubrum
C. Malassezia furfur
D. Coccioides
E. Rhizopus species
166
Q 
Traveller's infections
•	Entamoeba histolytica
•	Leishmaniasis
•	Malaria
•	Salmonella typhi
•	Treponema pallidum

A. A soldier returning from Afghanistan has a small ulcer on right ring finger that won’t heal and keeps getting bigger
B. Snail trail oral ulcer in a homosexual man
C. A South American man presents to a doctor in the UK with fever and bloody diarrhoea, and investigations detect a cyst in the right lobe of the liver
D. A Nigerian man presenting with fever and chills, has just returned from Nigeria, did not take prophylaxis, and was bitten a lot
E. A woman returning from travel in Asia presents with abdo pain, headache, and constipation. A Gram- rod is later cultured from her blood

A 
A. Leishmaniasis
B. Treponema pallidum
C. Entamoeba histolytica
D. Malaria
E. Salmonella typhi
167
Q 
Maternal viral infections
•	CMV
•	HSV
•	Parvovirus
•	Rubella
•	Varicella-Zoster

A. Virus that may cause Hydrops fetalis if caught in first 20wks of pregnancy
B. Immunoglobulin may be given to the mother if she is exposed to this virus in pregnancy to prevent infection
C. Virus that require C-section if mother has an outbreak at 34wks or later due to risk of transmission vaginally
D. Virus that can cause baby to have cataracts, sensorineural deafness, hepatomegaly and thrombocytopenia
E. Virus which if transmitted to baby: they can initially be symptomless but then come down with long term sequelae

A 
A. Parvovirus
B. Varicella-Zoster
C. HSV
D. Rubella
E. CMV
168
Q 
GI infections
•	Bacillus cereus
•	Campylobacter jejuni
•	Clostridium difficile
•	Entero-toxigenic Escherichia coli
•	Norovirus

A. The most common cause of traveller’s diarrhoea
B. A man develops foul-smelling diarrhoea and cramping pain 5 days after eating chicken at a barbeque
C. A woman develops vomiting a few hours after eating a Chinese meal with lots of rice
D. Women has had some surgery which required antibiotics, and now has profuse watery diarrhoea
E. A ward sister gets diarrhoea, and patients on the ward have been ill recently with similar symptoms

A 
A. Entero-toxigenic Escherichia coli
B. Campylobacter jejuni
C. Bacillus cereus
D. Clostridium difficile
E. Norovirus
169
Q 
Antibiotics
•	Amoxicillin
•	Benzylpenicillin
•	Flucloxacillin
•	Trimethoprim
•	Vancomycin

A. Included in meningitis treatment to cover Listeria monocytogenes
B. Antibiotic for Group A Strep pharyngitis
C. Young women with cystitis and fully sensitive E-Coli
D. Which antibiotic would you use for cellulitis with MRSA
E. Which antibiotic would you use to treat someone who has cellulitis with a Methicillin SENSITIVE strain of Staphylococcus aureus

A 
A. Amoxicillin
B. Benzylpenicillin
C. Trimethoprim
D. Vancomycin
E. Flucloxacillin
170
Q 
Antibiotics
•	Amoxicillin
•	Ceftazidime
•	Ciprofloxacin
•	Clarithromycin
•	Vancomycin

A. Beta lactam with anti-pseudomonal activity
B. Broad spec, no pseudomonal activity usually given with a beta lactamase inhibitor
C. A glycopeptide used to treat MRSA
D. A DNA synthesis inhibitor used to treat Pseudomonal infections but poor against anaerobes
E. Abx of the Macrolide/lincosamide/streptogrammin group used to treat some atypical pneumonias

A 
A. Ceftazidime
B. Amoxicillin
C. Vancomycin
D. Ciprofloxacin
E. Clarithromycin
171
Q 
STIs
•	Chlamydia trachomatis
•	HPV
•	Neisseria gonorrhoea
•	Treponema pallidum
•	Trichomonas vaginalis

A. Painless indurated ulcer, grown on dark brown medium, spiral shaped organism found
B. Teenager with genital warts
C. Lady with discharge, no other symptoms, and causative infection found on wet slide microscopy
D. Lady with PID and positive urinary NAAT test
E. Man with discharge - Gram negative diplococci found

A 
A. Treponema pallidum
B. HPV
C. Trichomonas vaginalis
D. Chlamydia trachomatis
E. Neisseria gonorrhoea
172
Q 
Misc. infections
•	Group B Streptococcus
•	Staphylococcus aureus
•	Staphylococcus saprophyticus
•	Streptococcus pneumoniae

A. Woman with UTI - culture grows Gram positive cocci in clusters
B. 49 Year old with no medical problems has septic arthritis
C. 19 year old rugby player with boils, members of his team have similar boils, as do members of his family
D. Neonate has meningitis, Gram positive organism in chains
E. 50 year old male smoker has meningitis with Gram positive diplococci

A 
A. Staphylococcus saprophyticus
B. Staphylococcus aureus
C. Staphylococcus aureus
D. Group B Streptococcus
E. Streptococcus pneumoniae
173
Q 
Vaccine-preventable diseases
•	Diphtheria
•	Measles
•	Mumps
•	Polio
•	Tetanus

A. Virus that resides in pharynx and GIT - 1:100 encephalitis, 1:1000 destruction of motor neurons
B. Develops a grey film over the back of the throat
C. Causes lumps on parotid and neck
D. Maculopapular rash moves from face that can cause encephalitis and pneumonitis
E. Lockjaw

A 
A. Polio
B. Diphtheria
C. Mumps
D. Measles
E. Tetanus
174
Q

Receptor/cytokine mutation that could be protective in HIV?

A

CCR5/Mip-1a/b

175
Q

What is the definition of herd immunity threshold?

A

The proportion of immune healthy people needed within a population to stop a pathogen’s spread: 1- (1/R0)%

176
Q

Returning traveller with fever and constipation (salmonella typhi) - what abx do you give if she hasn’t been started on them already?

A

Ceftriaxone

177
Q

Septic arthritis in a 56yo man - likely organism?

A

Staphylococcus aureus

178
Q

What does it mean if urine MC&S sample has epithelial cells and mixed bacterial growth?

A

It is a poor sample and has not properly been taken mid-stream

179
Q

What is the most common cause of traveller’s diarrhoea?

A

Enterotoxigenic Escherichia coli

180
Q

Which bacterial species causes scarlet fever?

A

Streptococcus pyogenes

181
Q

What is the most common cause of viral meningitis?

A

Non-polio enteroviruses (Echoviruses & Coxsackie viruses)

182
Q

What is the most likely cause of early-onset sepsis in a neonate?

A

Group B Streptococcus

183
Q

HIV +ve patient with v low CD4 + purple lesions seen on trunk. What virus causes this cancer?

A

HHV8

184
Q

What is the treatment for MRSA?

A

Vancomycin

185
Q

What does John Cunningham (JC) virus cause?

A

Progressive multifocal leukoencophalopathy

186
Q

Diffuse white plaques that can be easily brushed away are seen on an OGD, what is the diagnosis?

A

Oesophageal candidiasis

187
Q

Painless penile ulcer which healed in few weeks, followed by fine snail track oral ulcer - organism?

A

Treponema pallidum

188
Q

What is the treatment for pseudomembranous colitis?

A

Metronidazole or Vancomycin depending on severity (if in doubt say Vancomycin)

189
Q

Via which route does Hep A spread?

A

Faeco-oral

190
Q

Which would be the most useful test in confirming acute EBV infection 2 weeks after possible exposure in an immunocompetent patient?

A

IgM

191
Q

Name a complication of infection of a pregnant woman with Parvovirus B19

A

Hydrops foetalis

192
Q

How do you initially treat Malaria falciparum; 38.9 fever, hypotension, 4% parasitaemia?

A

I.V. Artesunate or I.V. Quinine if Artesunate not available

193
Q

Young gentleman brough to A&E by friends due to confusion. CSF is clear, raised lymphocytes, high protein, normal glucose. Causative organism?

A

HSV

194
Q

Neonate (2 day old) has meningitis and blood cultures isolate gram negative rods, what is the organism?

A

Escherichia coli

195
Q

Gram +ve cocci UTI in a young woman?

A

Staphylococcus saprophyticus

196
Q

Which vaccine-preventable organism causes cough, lymph node enlargement and has a potential to occlude the airway?

A

Corynebacterium diphtheriae

197
Q

What cell type is raised in the blood in schistosomiasis?

A

Eosinophils

198
Q

Boy visits grandparents in Wiltshire, comes back with 5 days of diarrhoea, no vomiting, and unexplained bruises all over body, which organism has most likely triggered this?

A

Escherichia coli 0157:H7

199
Q 
Natural antibodies against what can confer protective immunity against HIV?
A. HIV – GAG
B. HIV – gp120 
C. CXCR4 
D. Protease
E. Reverse transcriptase
A

B. HIV – gp120

200
Q 
Which of the following is the most common cause of cellulitis?
A. S. epidermidis
B. S. saprophyticus
C. S. pyogenes
D. S. agalactiae
E. E. coli
A

C. S. pyogenes

201
Q 
A Girl develops a throat infection. She is given amoxicillin, and a rash develops. It is later found out that she has infectious mononucleosis, and her symptoms persist. What is the most likely cause of the rash?
A. Drug reaction
B. Penicillin allergy
C. Mastocytosis
D. Erythema nodosum
E. Pyoderma gangrenosum
A

A. Drug reaction

202
Q 
A 69 year old man presents with a red, hot swollen knee. He has type 2 diabetes mellitus and osteoarthritis but it is a native joint. In this case of septic arthritis, rank the causative organisms below in order of likelihood, with (1) being the most likely and (5) being the least likely.
A. Staphylococcus epidermidis
B. Staphylococcus aureus
C. Brucella melitensis
D. Escherichia coli
E. Streptococcus pyogenes
A 
B. Staphylococcus aureus
E. Streptococcus pyogenes
D. Escherichia coli
A. Staphylococcus epidermidis
C. Brucella melitensis
203
Q 
A 23 year old man presents with cellulitis having cut himself while skateboarding. A wound swab has grown Streptococcus pyogenes (Group A Streptococcus). List the following antimicrobials which can beused for treatment in order of spectrum of activity with being the narrowest spectrum and 5 being the broadest spectrum agent.
Ceftriaxone
Meropenem
Piperacillin/tazobactam
Benzylpenicillin
Amoxicillin
A 
Benzylpenicillin
Ceftriaxone
Amoxicillin
Piperacillin/tazobactam
Meropenem

Path Past Papers (38 decks)

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