Micro Flashcards
Virus that resides in pharynx and GIT
Polio Virus 1:100 encephalitis, 1:1000 destruction of motor neurons
Neutralizing antibodies are formed against this
gp120. Think GP (as being neutral)
Non-neutralizing antibodies are formed against this.
Answer – p24!!!Think HIV Test
Conformational change of HIV
gp41 can only penatrate the cells where there was conformational change of CD4+
enzyme that copies with errors
reverse transcriptase
The natural chemokine able to inhibit HIV fusion to CD4 cells
MIP-1 alpha
Syphilis Mx
Benzyl penicillin
Gonorrhoea Mx
cephalosporins: Ceftraixone or Cefexime
Trichomonas Mx
Metronidazole
Painless indurated ulcer, grown on dark brown medium, spiral shaped organism found.
Treponema Palladium
Condylomata Acumina strains
6 and 11 are causative
Lady with discharge, no other symptoms, and causative infection found on wet slide microscopy.
Trichomonas
. Guy with urethral discharge. Partner has itchy vaginaand THIN white discharge. >5 Polymorphs on microscopy
Gonorrhea
Gonorrhoea Mx
ceftriaxone 500 mg IM + azithromycin 1 g oral as a single dose. The azithromycin is thought to act synergistically with ceftriaxone and is also useful for eradicating any co-existent Chlamydia infections. This combination can be used in pregnant women as well
Molluscum contagiosum. What is the causative organism?
Pox Virus
Haemorrhagic cystitis post-transplant:
BK virus
Post-transplant lymphoproliferative disease:
EBV
Nigeria, rats, haemorrhagic, arenaviridae
Lassa fever
Arbovirus, America, mosquitoes, polio-like
West Nile
Smoking, COPD, gram negative coccobacilli
H.influenza
CAP: moderate to severe
clari + one of co-amoxiclav or cefuroxime
CAP atypical
Atypical - macrolide or tetracycline
Man goes to wedding in Devon, comes back with pneumonia + confusion (hyponatraemia)
Legionella
Transplant patient on immunosuppressives (post-transplkant) has pneumonia - halo sign (multiple) on Xray or cavitatiting lesion
Aspergillums
cold autoimmune haemolytic anaemia (cold agglutinin test!!!!!)
Mycoplasma pneumoniae
Abdo pain and fever + CONSTIPATION but no diarrhoea
Sallmonella
Sallmonella Mx
Ceftriaxone or ciprofloxacin
Food poisoning +/- bloody diarrhoea, affects distal colon
Shigella
the commonest cause of bloody diarrhoea, headache, abdominal pain, drinking unpasteurized milk associated severe cramps per umbilical abdominal pain and fever; drinking unpasteurised milk (hedache_fever +bloody + foul smelling diarrhoea)
campylobacter
Giardia
ELIZA
○ Peyer’s patches, gram negative non lactose fermenter, necrotising granulomas
○ Complications: Reactive arthritis, erythema nodosum, enterocolitis
● Gram negative, coccobacilli
● Typically produces a protracted terminal ileitis that may mimic Crohns disease
Yeresnia
A 26 year old presents with abdominal pain, watery diarrohoea, three days after eating undercooked meat
Cryptospioris
Cryptospioris diagnosis
Diagnosis stool: modified Ziehl-Neelsen stain stool ova and parasites: positive
Listeria diagnostic test
stool culture: rarely positive, blood and CSF culture: positive
Pseudomonas ABx
Ceftazidime
(below the diaphragm) - Gram negatives
Ciprofloxacin
MRSA, 3rd episode of
Vancomycin + taicoplanin,
meningitis prophylaxis in contacts:
oral ciprofloxacin
Patient on ITU develops sepsis – gram (+) cocci in chains MacConkey plate Enterococcus gram (+) cocci in chains aesculin positive (Vancomycin/Teicoplanin Resistant?)
Linezolid
super resistant, grow on McKoney agar plate.
Enteroccus – gram (+) cocci –
Strep sore throat treatment in kid
Phenoxymethylpenicillin
Broad spec, no pseudomonal activity usually given with a beta lactamase inhibitor
Augmentin=Co-amoxiclav
A glycopeptide used to treat MRSA C diff or not tolerating/responding to metronidazole
Vancomycin + teicoplanin
A DNA synthesis inhibitor used to treat Pseudomonas infections but bad against anaerobes
Gentamycin
HAP Within 5 days of admission:
co-amoxiclav or cefuroxime
Hospital-acquired pneumonia more than 5 days
piperacillin with tazobactam
OR a broad-spectrum cephalosporin (e.g. ceftazidime)
OR a quinolone (e.g. ciprofloxacin)
Abx of the Macrolide/lincosamide/streptogrammin group used to treat some atypical pneumonias
clarithomycin
Burn victims gramm (-) green pigment oxidase positive:
Pseudomonas
Trauma, open wound, gas gangrene
Clostridium perfringens
Mum with skin infection, son has sore throat
Strep pyogenes
Child with red rash oedematous, first on face and crosses nasal bridge and spreads quickly
erysipelas
34 year old farmer cuts his leg whilst working. 3 days later he presents to A&E with a grossly oedematous leg that is discoloured with multiple necrotic bullae:
necrotising facilities, streptococus pyogenes
Fever + contact with cattle
brucella abortus
shell-fish, contaminated water, incubation 2-6 weeks, IgM and high ALT
Hep A
mostly caused by Leishmania donovani, occurs in the Mediterranean, Asia, South America, Africa, fever, sweats, rigors, massive splenomegaly. Hepatomegaly, poor appetite*, weight loss, grey skin - ‘kala-azar’ means black sicknes
Visceral leishmaniasis (kala-azar):
A 27 year old male recently returned from visiting India complains of lethargy and fatigue. On examination his sclera are visibly jaundiced
Plasmodium falciparum
10) A 27 year old male recently returned from visiting India complains of malaise and arthralgia. On examination he is febrile at 38. - if contact with cattle
Dengue fever or Brucelliosis (gram negative rod)
fever, headache, malaise. rose spots
Typhoid
Typhoid investigation
Culture from blood
prurituic purpuric swimmers rash
Schistomiasis
Tinea capitis (ring-worm of the scalp)
Microsporum canis
Pulmonary infection, immunocompromised, found in soil assoc/ with bat or bird droppings
Histoplasmosis
○ Opportunistic, really bad, rapidly spreads, brain, lungs, black discharge from nose
○ Needs amphotericin B (cryptococcal meningitis
Mucur Inducus
● Child, gram negative cocci
Men
gram (+) cocci in chains
Gr B Streptococcus
Gram positive bacillus
Listeria
Gram-negative, coccobacilly
Haemophilus influenza:
Can transmit via placenta especially in late pregnancy
syphillis
Haemorrhagic cystitis in children , virus
adenovirus
● Protozoan infection which can be passed on to baby to the unborn child including microcephaly, hydrocephalus, cerebral calcification and choroidoretinitis.
toxoplasmic
french people, elevated liver enzymes,
toxoplasma
CSF may reveal a pleocytosis, with ‘tumbling motility’ on wet mounts, unpasteurised milk, pregnant and HIV
(gram +) rod
Listeria
Disease that requires rapid vaccination at birth/immunoglobulins if mother is highly infectious.
Hep B
Disease that require C-section if mother has an outbreak at 34wks or later due to risk of transmission vaginally
HSV:
Disease which if transmitted to baby: they can initially be symptomless but then come down with problems - long term sequelae
Beta herpes virus = CMV
Skin lesions, lymphadenopathy, failure to thrive -
syphillis
2nd most common in young women UTI
Staph saprophyticus
Associated with renal calculus
Proteus
UTI in cather men
e.coli
associated with anatomical abnormalities of the urinary track
Klebsiella
Woman with UTI - Culture grows gram positive cocci in clusters
Staphylococcus saprophyticus
Rat bite with lymphadenopathy (could also be streptobacillus moniliformis)
Spirillum minus
Hyatid disease - ecinococcus granulosus
Cysts in brain and liver, sheep related, rugby player bursts cyst -L> anaphylaxis type reaction
refers to a type of cerebral oedema in which the blood brain barrier (BBB) is disrupted (cf. cytotoxic cerebral oedema, where BBB is intact). It is an extracellular oedema which mainly affects the white matter via leakage of fluid from capillaries.
Vasogenic cerebral oedema
It is most frequently seen around brain tumours (both primary and secondary) and cerebral abscesses, although some vasogenic oedema may be seen around maturing cerebral contusion and cerebral haemorrhage.
Hepato-renal faulure, phtofobia,microagglutination test
Leptospiriosis
donvovanosis
klebsiella granulomatis
should be used in caution in patients with megaloblastic anemia
trimetophrim
binds to 30s ribosomal subunit, COPD exacerbation
doxycycline
acts on 50s subunit, side effect is aplstic anemia
chloroamphenicol
effective reverse transctiptase both for Hep B and HUV
lamivudine
inhibition of reverse transcription enzyme
efavfarinez
inhibits viral assembly
ritonavir -protease inhibitor
hypopigemntation of the skin pityriasis versicolor
malasessia furfur
type I hypersensitivity leading to bronchospasm and oesinophilia
aspergiliosis
fungus of the scalp in children
tinea capitis
tinea corporis affecting trunk arms and legs
raised red rings
contact with animals (farm) plus athralygia (back pain) plus muscle pain
brucelliosis
hedache + fever + mylagia, rash theat spreads from teh LIMBS TO THE TRUNK
ricketssia or rocky moutain spotted fever
cat scratch disease
bartonella
crusted lesion at site of bite
may be underlying ulcer, sandfly
Cutaneous leishmaniasis
caused by Leishmania braziliensis
skin lesions may spread to involve mucosae of nose, pharynx etc, sandfly, ulcer does not heal
Mucocutaneous leishmaniasis
fever, sweats, rigors
massive splenomegaly. hepatomegaly
poor appetite*, weight loss
grey skin - ‘kala-azar’ means black sickness
visceral leishmaniasis
the most common cause of artheritis in young adult is
gonnorhoea nor staph aureus!!!!!! Remember broad spectrum antibiotic !!!!!
associated with colonic malignacy
s.bovis
actually colonises the cathethers
Klebsiella (gram - rod)
UTI in immunocompromised
Entrtoccocous
nausea, vomitting, constipation, abdo pain and then diarroohoea
Salmonella enteritidies not salmonella typhi!!!!
flask shaped ulucer - silver flask
amoeba!!!
Salmonella Typhi
ABCCDE athralagia bradycardia cough constipation diarrhoea erthmatues rose spots
the name of the rash in rheumatic fever
erythema marginatum
Met is used for
GET you difficult bugs!
Giardiasis Entomeba Trichomonas C difficile
glycopeptide antibiotic, inhibits cell wall synthesis, active against gram (+) not gram negatives
vancomycin Remember it as a van with big RED CROSS
side efefct of vancomycin
Driver in Van being very angry,brght red face - red man syndrome
Sudden decline in cognitive function at 65 , rapid dementia followed up by the jerking movements
sporoadic CJD
demented LAMB: dementia, akinetic mutism, myoclonus, cortical blindness,
electrogradiogram
Tonilar biopsy is needed for
variant CJD
young onset of the condition dem
Psychiatry symptoms first with young age of onset.
development of portal hypertension in patient with chronic liver disease
spontaneuos bacterial peritonitis
chagas dizease
kissing bug, tryptosonama cruzi , tse-tse
Progressive multifocal leukoencephalopathy:
JC virus
Smoking, gram negative coccus
M catarrhalis
Pt from south america with weight loss, haemoptysis and weight loss, upper lobe pneumonia
aspergilliosis
IVDU patient with Ground glass on xray
Pneumocystis jiroveci pneumonia
Typically accompanied by fever and vomiting for the first 2 days. The diarrhoea may last up to a week
rotavirus
○ consumption of shellfish, prepared foods, salads, sandwiches, fruit
○ symptoms: nausea, abdominal cramps, followed by diarrhoea and vomiting;
Norovirus
○ MSSA
○ Gram positive + penicillin allergy
Erythromycin
flask shaped cysts in liver
Entomeba
A 27 year old male recently returned from visiting India complains of malaise and arthralgia. On examination he is febrile at 38.6.
Dengue fever or Brucelliosis
Disease that causes Hydrops fetalis if caught in first 20wks:
Parvovirus B19
A 34-year-old female at 24 weeks gestation complains of reduced foetal movements. An ultrasound scan reveals that the foetus is hydropic. Her 4-year-old child recently had a febrile illness and an associated erythematous rash on the face with circumoral pallor. What is the most likely infectious agent?
Chicken pox
Disease which if transmitted to baby: they can initially be symptomless but then come down with problems - long term sequelae.
beta herpes virus=CMV
gram (+) cocci in clusers in cathers
staphyloccous saphroticus