Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Dylan's flashcards > micro > Flashcards

micro Flashcards

1
Q

hiv drug in pregnancy

A

Zidovudine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

fungal antigens and which fungus ?

A

beta-d-glucan= candida

galactomannan= aspergillus

glucuronoxylomannan= cryptococcus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

which abx for lyme disease and which organim?

A

spirochaete = Borrelia burgdorferi

abx = doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

depending on CURB 65 what abx regimen ??

A

0-1 (mild) Amoxicillin PO 5d 2nd line or if pen allergic-macrolide PO Outpatient treatment

2 (mod) Amoxicillin PO + Clarithromycin PO Consider admission

3-5 (severe) Co-amoxiclav IV + Clarithromycin IV Admit +/- consider ITU

remember this is for community acquired pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Treatment of Hospital-Acquired Pneumonia:

A
  • 1st line: ciprofloxacin + vancomycin
  • If severe: tazocin + vancomycin
  • Aspiration pneumonia: tazocin + metronidazole
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how to calc curb 65 score ?

A

Calculate CURB-65: 1 point for confusion, urea >7, RR >30, BP <90/60, ≥65yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

hostology for TB

A

· Classic histology finding: caseating granulomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ix for TB different types what xo you find

A

o CXR: upper lobe cavitation, hilar lymphadenopathy, patchy consolidation

o Sputum samples x3
 Microscopy on Ziehl-Neelson stain; culture on Lowenstein-Jensen medium for 6wks → acid fast bacilli seen. Gold standard for diagnosis

 Bronchoalveolar lavage if unable to produce sputum
 Auramine stain can be used to screen for TB however is not diagnostic

o Tuberculin skin tests (Mantoux/Heaf): Positive result seen in active and latent infection AND previous BCG vaccination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

o Hospital-acquired Common pathogens =

A

Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA) and other nonpseudomonal Gram-negative bacteria are the most common causes.

Enterobacteriaceae (most common) such as the gram negs mentioned above: e coli, kelbsiela

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

community acquired pneumoina most commong bugs

A

Strep pneumoniae (most common), Haemophilus, Mycoplasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

pneumonia

Rusty-coloured sputum. Lobar on CXR

caused by what and give microscpe

A

strep pnuemoniae

+ve diplococci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

pnuemonia

Assoc. w/ smoking, COPD. Most common cause of bronchopneumonia

caused by what and give microscope

A

Haemophlius influenza

-ve cocco-bacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pneumonia

Assoc. w/ recent viral infection (post-influenza) ± cavitation on CXR

caused by what and give ,microscope

A

staph aureus

+ve cocci clusters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

pneumonia

Alcoholics, DM, elderly. Upper lobe cavitating lesion

A

Klebsiella

-ve rod (enterobacteriae)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

pneumonia + Travel with stay in hotel, air conditioning, hepatitis, hyponatraemia

how do you diagnose ?

A

legionella pnuemophilia

daignosed with urinary antigen test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

pneumonia –> Outbreaks in young people at school or university, dry cough, arthralgia

what is it ? how to diagnose ? how to treat?

A

Mycoplasma pneumoniae

cold agglutinin test / AIHA, erythema multiforme.

Treated best with tetracycline or macrolide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

pneumonia seen Seen in people who keep birds

A

Chlamydia psittaci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

resp infection with people who have HIV + how to treat and what do you see on xray ?

A

o Pneumocystis jiroveci (PCP). Desaturation upon walking around room, bat’s wing appearance on CXR, treat with co-trimoxazole
o TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

resp infection for someone with splenectomy

A

encapsulated organisms = H. influenzae, S. pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

patients with neutropenia get this resp infection

A

o Aspergillus. Interstitial CXR changes. Halo sign on CT scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Risk factors for infective endocarditis

A
  • Abnormal valves: prosthetic valve, rheumatic heart disease, congenital heart disease
  • Bacteraemia: long-term lines (e.g. dialysis), IVDU, poor dentition / dental abscess
  • Immunosuppression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

most common pathogens in infective endocarditis

A
  • Acute (high-virulence bacteria): Strep pyogenes (Group A Strep), Staph aureus (most common in IVDU), CoNS (most common in prosthetic valve)
  • Subacute (low-virulence bacteria): Staph epidermidis, Strep viridans, HACEK
    o HACEK organisms are uncommon causes and do not grow on culture → consider if high suspicion but culture -ve
     Haemophilus, Aggregatibacter, Cardiobacterium, Eikenella, Kingella
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

ix for infective endocarditiis

A

Investigations:
* Blood cultures - >3x from different sites, ideally before starting Abx
* Echo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

signs and sx of infective endocarditis

A
  • Fever (most common symptom, often presents as PUO)
  • Non-specific Sx: anorexia, weight loss, malaise, fatigue, night sweats, SOB, clubbing
  • New heart murmur, often changes day to day, usually regurgitant
  • In subacute:
    o Embolic phenomena: Janeway lesions, splinter haemorrhages, splenomegaly, septic abscesses in lungs/brain/spleen/kidney, microemboli
    o Immune phenomena: Roth spots, Osler’s nodes, haematuria (due to glomerulonephritis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what criteria for infective endocarditis

A

modified dukes criteria

Clinical criteria: (BE TIMER)

Infective endocarditis = 2 major, OR 1 major + 3 minor, OR 5 minor criteria

Major
- Blood cultures positive (>2x >12hrs apart typical organisms consistent with IE)
- Endocardial involvement evidence i.e. new murmur, vegetation on echo

Minor
- Temp > 38 (fever)
- Immune phenomena (see above)
- Microbiological evidence not meeting major criteria
- Embolic phenomena (see above)
- Risk factors

o Embolic phenomena: Janeway lesions, splinter haemorrhages, splenomegaly, septic abscesses in lungs/brain/spleen/kidney, microemboli
o Immune phenomena: Roth spots, Osler’s nodes, haematuria (due to glomerulonephritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

tx for infective endocarditids

A
  • IV Abx for 4-6wks (use local guidelines)
    o Start empirically after cultures taken, then change according to sensitivities
    o Acute: flucloxacillin
    o Subacute: benzylpenicillin + gentamicin
    o Prosthetic valve: vancomycin + gentamicin + rifampicin (6w)
  • Surgical debridement for some patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

3 types of diarhhoea and causative organisms and explain each type

A
  1. · Secretory diarrhoea
    o Toxin production → Cl- secreted into lumen → loss of water and electrolytes → D+V → Watery diarrhoea, no fever
    o Cholera, ETEC, EPEC, viruses
  2. Inflammatory diarrhoea
    o Inflammation and bacteraemia → Bloody diarrhoea (dysentery), fever
    o CHESS: Campylobacter jejuni, EHEC, Entamoeba, non-typhoidal Salmonella, Shigella
  3. Enteric fever
    o Unwell with fever, fewer GI symptoms
    o Typhoidal salmonella, Yersinia, Brucella
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

if nitrite negative on urine dip what does this mean for pathogenic origin of uti ?

A
  • Staphylococcus saprophyticus: common in young females. Note: E coli still most common among young women but if in question nitrites are negative, S. saprophyticus more likely
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what do ou expect to see on urine dip for people with UTI ?

A

· Urine dip: +ve nitrites and leukocytes
o Nitrites are quite specific for UTI – if nitrites -ve, unlikely to be UTI
o Leukocytes are not specific (also seen in STI, bladder cancer, renal stones, catheters, TB)
o Note: do NOT use urine dipsticks in people with catheters or aged over 65 over as non-pathological bacteriuria common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

if squamous epithelial cells present on urine mc&s what does it mean ?

A

contaminatoin

alsom if its says mixed growth as well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

surgical site infection

most common organism and managemetn

A

S. aureus (MRSA + MSSA), E. coli, Pseudomonas

Abx: fluclox for Staph

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

osteomyletiis

most common organiusm and management

A

stpah aureus

IV Abx –> flucloxacillin (clindamycin if penicillin allergic), with consideration of the addition of fusidic acid or rifampicin for the first two weeks
If meticillin-resistant staphylococcus aureus (MRSA) is suspected, vancomycin or teicoplanin is recommended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

septic arthritis

most common organism and managemtn

A

S. aureus (most common), Strep, E. coli, N. gonorrhoea if young

IV Abx- cephalosporin or flucloxacillin
Drain joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

ix for septic arthritis

A

Joint aspirate – MC&S. Synovial count >50,000 cells/mm³
Blood culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Prosthetic joint infection

most common organism and management >?

A

Cogulase negative staph (most common), S. aureus, E. coli

IV Abx
Remove prosthesis and revise replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

most common cause viral meningtisi

A

Viral: Enterovirus (coxsackie, echovirus)- most common cause of all meningitis, mumps, HSV2m

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

most common cause of all meningitis ?

A

Enterovirus (coxsackie, echovirus)- most common cause of all meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

most common cause of bacterila meningitis

A

N. menigitidis, S pneumoniae, H. influenzae. M. Tuberculosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

pathogens for meningitis in neonates

A

Group B Strep, Listeria monocytogenes, E. coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

pathogens for meningntis in yougn people

A

N. menigitidis, S. pneumoniae, H. Influenzae

41
Q

pathogens for meninigtis in elderly

A

Group B Strep, Listeria monocytogenes

42
Q

fungal meningits caus e?

A

Cryptococcus neoformans

43
Q

how to manage meningitis (don’t forget the special add ons)

A

Management: Resuscitate! IV ceftriaxone and corticosteroids (unless meningococcal)

  • Add ampicillin to cover Listeria if neonate or elderly
  • If consciousness affected, consider IV acyclovir to cover encephalitis

avoid dexamethasone in septic shock, meningococcal septicaemia, or if immunocompromised, or in meningitis following surgery’

44
Q

encephalitis

features, causes (+most common), ix, mx

A

Symptoms: confusion, fluctuating consciousness, focal neurology, seizures

Causes:
· Viral: HSV 2 (most common cause), Enteroviruses, Western Nile Virus
· Bacterial: Listeria
· Amoebic: Naegleria Fowleri, found in warm freshwater and thermal pools
· Parasitic: Toxoplasmosis Gondii
· Note: Encephalitis can also be autoimmune

Investigations: 1st line CT, lumbar puncture to identify causes if no ICP, MRI is gold standard

Management: 1st line- IV acyclovir

45
Q

which STI’s give discharge ?

A

Gonorrhoea
Chlamydia
Trichomonas
Candida
Bacterial Vaginosis

46
Q
A
47
Q

which STI’s give rashes, lumps/ growths

A

Genital warts - HPV
Molluscum contagiosum
Scabies
Pubic lice

48
Q

features, diagnosis and tx for gonorrhea

A

men = mucopurulent discharge
women = mucopurlent cervitis

Diagnosis: urethral/rectal smears – producing a culture from these is Gold Standard.

Treatment: Ceftriaxone IM – 250mg single dose

49
Q

features , daignosis and tx for chlamydia

A

features –> often asymptomatic

Diagnosis: NAAT (nucleic acid amplification tests) from genital swabs

Treatment: azithromycin 1g stat, or doxycycline 100mg BD for 7 days

50
Q

pathogen for syphhilis

A

Treponema pallidum – Obligate gram-negative spirochaete.`

51
Q

syphilis tx

A

Treatment: Single dose IM Benzathine Penicillin (Doxycycline if allergic)

52
Q

strawberry cervix

what pathogen and how to treat

A

Trichomoniasis vaginalis

· Men: usually asymptomatic, sometimes urethritis
· Females: discharge, strawberry cervix

Diagnosis: wet prep microscopy, (flagellated organisms seen), PCR

Rx: metronidazole

· Associated with increased risk of HIV infection (due to mucosal damage)

53
Q

clue cells

A

bacterial vaginosis

54
Q

discharge + odour from vagina - what is it?

A

·Abnormal vaginal flora, polymicrobial, ↓lactobacilli.
· Discharge, odour
· Sexually associated, not transmitted. Associated with hygiene practices (soaps)

·Diagnosis: microscopy of gram stain, raised pH, whiff test, clue cells which appear as stippled epithelial cells

Rx: lifestyle - just use water for washing (no soaps). Metronidazole PO/topical

55
Q

candidiasis

what pathogen
features in men and women
give management

A

·Usually Candida albicans, yeast
· Thick white discharge (“cottage cheese”), itching, soreness, redness
· Vulvovaginitis in women, balanitis in men
· Not sexually transmitted; can be part of normal flora

· Associated with immunodeficiency (incl. pregnancy, DM), hygiene practices (soaps)

· Rx: Oral fluconazole or topical clotrimazole

56
Q

Skin infection

which common organism therefore whihc abx?

A

S. aureus

Flucloxacillin (unless allergy)

57
Q

pharingitis

which common organism therefore which abx?

A

β-haemolytic Streptococcus

Phenoxymethylpenicillin

58
Q

community acquired pneumonia

mild and severe

A

Mild
Amoxicillin (or doxycycline)

Severe
Co-amoxiclav + clarithromycin

59
Q

Sepsis

whcih abx

A

Severe
Tazocin / ceftriaxone, metronidazole ± Gent

Neutropenic
Tazocin + gentamicin

60
Q

Colitis

which common organissm and which abx

A

Clostridium difficile Oral vancomycin

61
Q

Natural reservoir of Influenza A is …`

A

ducks

62
Q

2 methods viruses change

A

Antigenic Drift = Accumulation of point mutations (Due to error prone RNA polymerases) changes the nature of the antigen over time (drift).

Antigenic Shift = Recombination of genomic segments of two co-infecting flu strains -> leads to rapid potentially whole antigenic change for a viral strain (shift).

63
Q

which antiviral for herpes simplex virus

A

aciclovir or valaciclovir

64
Q

which antiviral for varicella zoster virus ?

A

aciclovir

65
Q

Human Cytomegalovirus (HCMV) which antiviral

A

1st line Ganciclovir (IV)/ valganciclovir
2nd line Foscarnet (IV)
3rd line Cidofovir

66
Q

Epstein-Barr virus (EBV) which aniviral

A

trick question

largely supportive

67
Q

what does EBV cause ?

A

Glandular fever

· Triad of fever, pharyngitis, posterior cervical lymphadenopathy
· maculopapular rash
· fatigue

Note: Predisposes to Burkitt’s lymphoma

In immunocompromised:
Post-transplant lymphoproliferative disease (Predisposes to lymphoma. Treatment – reduce immunosuppression + give Rituximab (anti-CD20 monoclonal Ab))

Diagnosis- monospot for heterophile antibodies (Note also positive in CMV). Most sensitive and specific are EBV-specific antibodies

68
Q

antiviral for inlfuenza virus

A

oseltamivir

69
Q

Hep A

features, transmission route, diagnosis, management

A

· Acute hepatitis – fever, abdo pain, jaundice, malaise
· Faeco-oral transmission, recent travel to endemic nation

Diagnosis: Acute - Anti-HAV IgM

Largely supportive care

70
Q

gold standard diagnosis for active infection of Hep B?

A

Hepatitis B surface antigen (HBsAg)

71
Q

what defines chronic HBV infection in terms of serology?

A

HBsAg > 6 months

72
Q

HBV transmission

A

bolidy fluids, MSM , IVDU, tattoo,

73
Q

how does HCV manifest? and give how its diagnosed

A

· Mainly chronic disease (50% progress to chronicity)
· Severity mainly determined by genotype of virus
· Mainly blood product spread- transfusions, sharing needles
· Progresses to cirrhosis, liver failure and hepatocellular carcinoma

Diagnosis: Anti-HCV antibodies become active >4wks after infection. If suspect acute infection measure HCV RNA

74
Q

oultine Hep D virus

A

Can only contract 2 ways:
· Co-infection simultaneously with Hep B
· Superinfection (on top of chronic) Hep B (more severe – often leads to cirrhosis within 2-3yrs)
Transmission: Sexual, parental, perinatal (only possible in combination with HBV)

75
Q

outline Hep E virus

A

· Acute hepatitis, can only be chronic in immunosuppressed
· Faeco-oral transmission, most common in South and East Asia

· Main thing to know for exams is that if contracted in pregnancy, the disease can be very severe, often lethal

· Rare complications: CNS disease – Bell’s palsy, Guillain Barre, other neuropathy

Diagnosis: HEV IgM and IgG. Immunosuppressed HEV RNA

76
Q

features of rubella virus

A

German measles
· Maculopapular rash which starts on face and spreads rapidly to body
· Lymphadenopathy
· Fever
· Lesions on soft palate (Forchheimer sign)

77
Q

features of Human parvovirus B19

A

In children - slapped cheek/fifth disease/erythema infectiosum
· Bright red rash on cheeks
· Arthralgia
· Fever and malaise
In adults- flu-like illness
Diagnosis- serology for IgM for current infection

78
Q

features of measles and name of virus ?

A

morbillivirus

Measles
· Fever, malaise
· Cough, coryzal symptoms, conjunctivitis
· Koplik’s spots (buccal mucosa)
· Maculopapular rash which starts behind ears and spreads to body over a few days
Diagnosis- clinical diagnosis but can use nasopharyngeal swab for PCR

79
Q

features of mumps

A

· parotid swelling- painful and tender
· malaise
· fever

80
Q

complications with mumps

A

· Epididymo-orchitis (can lead to infertility)
· Pancreatitis
· Meningitis

81
Q

serology of carrier in HBV

A

this means they have chronic infection, they may be asymptoamtic

HBsAg positive
anti-HBsAg negative

IgM anti-HBc negative
anti - HBc antigen positive

they have surface antigen in their blood and they havent made antibodies to surface antigen yet but they have made antibodies to the core antigen ]

82
Q

List the 5 main congenital infections and the memory aid to remember them

A

TORCH

Toxoplasmosis
Other (HIV , HBV)
Rubella
CMV
HSV

83
Q

how does congenital toxoplasmosis present ? and how to manage ?

A

· Symptoms: Chorioretinitis, hepatosplenomegaly, jaundice, cerebral calcifications, microcephaly
· Can be asymptomatic at birth then present later with low IQ and deafness
· Mother often asymptomatic

· Management: pyrimethamine and sulfadiazine

84
Q

how does congenital HIV present ?

A

· HIV- Asymptomatic until immunosuppression develops

85
Q

how does congenital HBV present ?

A

Asymptomatic until later life when develops jaundice, abdo pain, dark urine and pale stool

86
Q

how does congenital syphalis present ?

A

persistent rhinitis, hepatosplenomegaly, jaundice, maculopapular rash progressing to desquamation and crusting, Hutchinson teeth

87
Q

common fetal defects with congenital rubella

A

PDA and catarcts

88
Q

how does congenital HSV present ?

A

· Foetal infection from ascending genital maternal infection, greatest risk in 3rd trimester where offer c-section if within 6 weeks of birth
· 3 types of presentation
o Skin, eye, mouth disease- keratoconjunctivitis, vesicular rash on face
o CNS involvement- seizures, lethargy, irritable
o Disseminated- septic presentation often involving liver and lungs
· Treat with aciclovir

89
Q

define pyrexia of unknown origin

A

> 38.3⁰C fever on several occasions persisting >3/52 without diagnosis despite >1/52 of intensive Ix.

90
Q

which organisms for typhoid ? and how do you manage ?

A

· Salmonella typhi and paratyphi (anaerobic gram -ve bacilli)

· Management: IV ceftriaxone then PO azithromycin

91
Q

how does typhoid present ?

A

· Causes enteric fever by infecting Peyers patches in intestines
o 5S’s: rose Spots, hepatosplenomegaly, solid stools, sphygmothermic dissociation (low HR + fever aka Faget’s sign)

92
Q

dengue virus?

A

flavavirus

93
Q

symptoms of dengue ?

A

· Symptoms: myalgia, fever, rash, retro-orbital headache. Reasonably mild + self-limiting
· If re-infected with a different serotype…
o Dengue haemorrhagic fever / dengue shock syndrome
o Can be associated with non-blanching rash
o Rare in travellers (as uncommon to be re-infected)
o Supportive management

94
Q

most common subtype of malaria pathogen ?

A

Plasmodium falciparum: most common

95
Q

tx for malaria ?

A

IV artesunate

96
Q

erythema chronicum migrans

A

bulls eye rasj h - you get this in lyme disease

97
Q

Yeasts Vs Moulds:

A

dimorphism – yeast during infection, mould in nature.

98
Q

what causes ringworm?

A

Tricophyton rubrum

99
Q

what causes atheletes foot?

A

Tricophyton rubrum

Dylan's flashcards (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions