Micro

Question 1

What is the difference between cell walls in gram positive and negative bacteria?

Answer 1

Gram positive has a thick cell wall, gram negative is thin with additional plasma membrane

Question 2

How are staphlococcus arranged?

Answer 2

Clusters

Question 3

What are the 4 gram positive rods?

Answer 3

Non-spore Carynebacterium, Listeria

Spore CLOSTRIDIUM, Bacillus

Question 4

What enzyme are all staphylococcus positive for?

Answer 4

Catalase

Question 5

What bacteria does not have a cell wall?

Answer 5

Mycoplasma

Question 6

Why is staph aureus more virulent than staph epidermidis or saprophyticus?

Answer 6

Coagulase positive

Question 7

What shape are neisseria?

Answer 7

Diplococci (gram negative)

Question 8

How are streptococci categorised?

Answer 8

Haemolytic: alpha = partial (viridans, pneumonia), beta = complete, non

Question 9

What are the four Cs of C Diff

Answer 9

Ciprofloxacin
Co-amoxiclav
Clindamycin
Cephalosporin

Question 10

When would ABx be considered in sinusitis and which one?

Answer 10

• Toothache

- Temperature above 38

Question 11

What is the first line treatment of community acquired pneumonia?

Answer 11

Co-amoxiclav and clarithromycin

Question 12

What investigations are carried out for the diagnosis of infective endocarditis?

Answer 12

3 blood cultures separated over 24 hours

Duke’s criteria

Question 13

What do coag -ve staph secrete?

Answer 13

Exopolysaccharides

Question 14

How is infective endocarditis treated?

Answer 14

Native - vancomycin, cipro, rif

Prosthetic - vanco, gento, rif

Question 15

What suggests a surgical site is infected?

Answer 15

Erythema, wound break down, pus, tender, fever

Question 16

How would cellulitis be managed:

a) MSSA
b) Strep pyogenes
c) MRSA

Answer 16

a) IV fluclox with 48 hour oral switch (clarithromycin if pencillin allergic)
b) Strep pyogenes: BenPen 48 hour oral switch to amoxicillin (vanco - clarithro if allergic)
c) iv vancomycin/clarithromycin/linezoid (oral switch to clarithromycin)

Question 17

How would septic arthritis be managed?

Answer 17

IV flucloxacillin or vancomycin

Question 18

What ABx prevent cell wall synthesis?

Answer 18

Penicillin, carbapenem, cephalosporin.

Glycopeptides: vancomycin

Question 19

What ABx treats Gram positive only?

Answer 19

Vancomycin

Question 20

What ABx target protein synthesis?

Answer 20

Macrolides: erythromycin, clarithromycin
Tetracyclines
Aminoglycosides: gentamicin

Question 21

What ABx target DNA synthesis?

Answer 21

Metronidazole

Quinolones

Question 22

What immune reaction occurs if a rash appears following penicillin intake?

Answer 22

IgG

Question 23

When should trimethoprim be avoided?

Answer 23

First trimester of pregnancy

Question 24

When should nitrafurantoin be avoided?

Answer 24

Term of pregnancy - haemolytic anaemia risk

Question 25

What rare complications can occur with long term nitrafurantoin?

Answer 25

Pulmonary fibrosis
Hepatic impairment
Peripheral neuropathy

Question 26

Which ABx may cause Red Man’s Syndrome?

Answer 26

Vancomycin

Question 27

Which ABx can cause discolouration of tooth enamel and binds teeth and bones?

Answer 27

Tetracycline

Question 28

Why should quinolones be avoided in children?

Answer 28

Growing - increased risk of ruptured tendons

Question 29

What should tetracyclines be taken two hours apart from?

Answer 29

Calcium
Iron
Antacids

Question 30

What ABx are P450 inhibitors?

Answer 30

Metronidazole

Erythro/clarithromycin

Question 31

What drugs can prolong QT?

Answer 31

Macrolides (eryth/clarith)
Quinolones 
Amiodarone 
Anti-psychotics
Quinine 
SSRIs

Question 32

What ABx can cause ototoxicity?

Answer 32

Gentamicin and vancomycin (esp in combo with loop diuretic)

High dose macrolides

Question 33

What ABx must not be combined with alcohol?

Answer 33

Metronidazole: inhibits acetaldehyde dehydrogenase

Question 34

What is an example of a quinolone?

Answer 34

Ciprofloxacin

Question 35

What side effects can occur with prolonged use of metronidazole?

Answer 35

• optic/peripheral neuropathy

- Seizures & encephalopathy