Micro hard to recall Flashcards
Which antivirals are given to untreated pregnant women with HIV to prevent vertical transmission of the virus during childbirth?
Zidovudine and lamovudine
What is an immunomodulatory therapy used in the treatment of hepatitis B?
What is used in hep C?
hep b: Interferon-α (alpha)
hep c: pegylated-IFNa
Which antiviral can be used in aerosol form to prevent respiratory syncytial virus in children with heart and lung disease?
Ribavirin
What is the MOA of aciclovir?
inhibits the action of viral DNA polymerase
Directly on viral thymidine kinase
What is used to treat CMV?
Ganciclovir
What is valaciclovir used to treat?
VZV
What is used for the treatment of severe, resistant herpes infections?
Foscarnet
Name a drug that is effective against influenza A but not influenza B
Amantadine
MOA of zidovudine?
A nucleoside analogue which inhibits reverse transcriptase
MOA of indinavir?
stopping post-translational cleaving of polyproteins by inhibiting proteases
What drug can be delivered by inhalation to treat both influenza A and B?
Zanamivir
What pneumonia are patients with CF susceptible to?
Burkholderia cepacia
What virus causes Neonatal Infection associated with vaginal delivery?
Herpes Simplex Type 2
What virus is associated with Exanthem Subitum?
Human Herpes virus 6
What virus is associated with Roseola infantum?
Human herpes virus 6 (beta)
What virus is associated with Acute necrotising encephalitis?
Herpes simplex virus type 1 (alpha)
Name a naturally occurring cytokine that is able to inhibit HIV fusion to CD4+ T-lymphocytes?
MIP-1alpha
Which viral protein is responsible for the binding or fusion of HIV to human CD4+ T-lymphocytes?
gp120
Vaccine given at 12 – 18 months to prevent otitis media, parotitis, and cataracts in patients?
MMR
Tx for 56 year old male with endocarditis caused by VRE.?
Linezolid
Tx for C.difficile colitis where metronidazole has failed?
vancomycin
Tx for Atypical pneumonia caused by Legionella in individuals with penicillin allergy?
Erythromycin
What abx is given for Long-term prophylactic treatment for post-splenectomy patients?
Penicillin V
Tx for a A 6 month old child whose father has just been diagnosed with tuberculosis.?
isoniazid
Gram-negative curved rod, whose toxin affects adenyl cyclase. Its major cause of death is shock, metabolic acidosis and renal failure
Vibrio cholera
Spread by faeco oral and occurs in epidemics. Spread by shellfish
Hep A
Affects mainly the distal colon, producing acute mucosal inflammation and erosion. It is spread by person-to-person contact, and its clinical features include fever, pain, diarrhoea and dysentery
Shigella
This microbe affects the ileum, appendix and colon. Its peyer patch invasion leads to mesenteric lymph node enlargement with necrotising granulomas. Complication can include peritonitis, pharyngitis and pericarditis.
Yersinia
Following a trip to Brazil, a patient develops bloody diarrhoea, with a high fever, sweating and on examination the patient is found to have RUQ pain.
Entamoeba Histolytica
A 40 year old homosexual man develops severe flatulence, accompanied by bloating and explosive diarrhoea
Giardia Lamblia
Mrs A became ill at about midnight after eating chicken wings for lunch at a summer BBQ. Mrs A complained of nausea, vomiting and non-bloody diarrhoea. Her symptoms resolved 3 days later.
Salmonella
Mr S became ill with nausea, vomiting and watery diarrhoea about 4 hours after eating some ham at a conference buffet lunch. Mr B’s illness was attributed to a heat stable, preformed toxin in the ham. His symptoms resolved within 24hours.
Staphylococcus
Mr C complained of fever and severe (>10 bowel movements/day) diarrhoea after looking after his neighbours dogs for a few days. Laboratory analysis of Mr C’s stools found the causative organism to be a S-shaped microaerophillic bacteria.
Campylobacter
Different geographical populations of this organism often give rise to traveller’s diarrhoea
E. coli
A 2 year old boy living in the slums who has a one day history of profuse watery diarrhoea, fever and abdominal cramps. His family’s main source of water is the river near their squatters. Organism?
Cryptosporidium parvum
A man was bitten by a rat in Asia. Ten days later he complains of fever, malaise, headache and myalgia.Organism?
Spirillum minus
A 22 year old student, who returned from a holiday in the Mediterranean 3 weeks ago, presents with an undulant fever, malaise, weakness and generalized bone pain. Upon examination lymphadenopathy and hepatosplenomegaly are also noted. Organism?
Brucellosis
A 25 year old Maltese man presented to his GP with lethargy for a month and headaches and fever. On examination, he had a temperature of 39°C and one fingerbreadth splenomegaly. Small Gram-negative coccobacilli were seen on culture in Casteneda’s medium. Organism?
Brucella melitensis
A tanner on holiday from India presented to hospital with an ulcerating papule on his hand. On inspection of the ulcer, the centre was black and necrotic. Gram-positive rods grew on blood agar culture and responded to treatment with large doses of penicillin. organism?
Bacillus anthracis
A 17 year old Nigerian girl presents at her GP with patches of hypopigmentation on her trunk. After an initial trial of steroid cream, the girl returns complaining that the rash is spreading. Woods lamp examination of the rash produces a yellow fluorescence. What is the causative fungus?
Pityrosporum orbiculare
A 19 year-old student presents to her GP with a macular rash and suboccipital lymphadenopathy. She also complains of pain on moving her hands and wrists. Dx?
rubella
What are Clutton’s joints?
arthritic manifestations of congenital syphilis at the time of puberty
Name a cause of osteomyelitis in sickle cell disease?
Salmonella
A 30 year old builder develops abdominal pain and diarrhoea 48 hours after having Texa Fried Chicken. Faecal culture shows motile, oxidase-positive colonies and gram stain shows gram-negative rods. Organism?
Campylobacter jejuni
A 45 year old female presents with fever. O/E she is pyrexial, has hepatosplenomegaly, lymphadenopathy and a severely swollen eyelid. She returned from Guatemala 2 days ago.
Chagas Disease
A 35 year old male complains of a persistent ulcer in the mucosa of the mouth. When questioned further admits to remembering a small ulcer on his upper arm which healed without treatment when holidaying in Brazil one year ago.
Mucocutaneous Leishmaniasis
A 45 year-old Egyptian male complains of haematuria. On further investigation, cystoscopy reveals a squamous cell carcinomatous lesion.
Schistosoma haematobium
An African woman and her 33 year-old husband come to their doctor because she is worried that he is not as alert as he used to be. On examination, he has non-tender lymphadenopathy, hepatomegaly and marked CNS abnormalities. He is noted to be quite lethargic.
Trypanosoma brucei gambiense
A thin peripheral blood film from a 59 year-old female demonstrates eosinophilia and microfilariae. On examination, the skin overlying her superficial lymph nodes is streaky red and tender.
Wuchereria bancrofti
A 43 year-old Asian male with AIDS presents with a prolonged fever, dizziness and a persistent cough. On examination, he is found to have marked splenomegaly and rough, dry skin. Blood results reveal pancytopenia.
Leishmania donovani (visceral leishmaniasis)
A 20 year-old man presents with a persisting intermittent fever which began whilst he was travelling in South America the previous week. He has a dry cough and a massively enlarged spleen. Sandfly parasites are detected in a spleen aspirate.
Visceral leishmaniasis (kala-azar)
A 55 year-old Gambian man presents with a low-grade fever which has been coming and going for about 2 months. He says it started when visiting his family in Gambia when he was also feeling weak and sleeping a lot.
Trypanosomiasis
A 16 yr old boy complains of a one week history of fever, muscle aches, nausea/vomiting/diarrhoea with general malaise following a trip to Zimbabwe visiting relatives. On further questioning he remembers developing an itchy rash on his right thigh following wading in Lake Kariba whilst on holiday. O/E He has generalised lymphadenopathy with hepatosplenomegaly. Initial blood tests reveal raised WCC with eosinophillia.
Schistosoma mansoni
A 25 yr old female humanitarian volunteer complaining of swinging fever, profound abdominal pain with severe malaise. On further questioning she reveals a history of self limiting diarrhoeal illness 3/52 ago during which she passed mucus and some blood. You are also informed she recently returned from a humanitarian mission to Ghana 6/52 ago. O/E she is unwell with exquisitely tender hepatomegaly. You also find increased breath sounds and a dull percussion note in the lower region of the right lung.
Entamoeba histolytica
A 24 yr old male complaining of 3/52 history of fever/chills with muscular aches and spasms. On further questioning he reveals the he also an episode of diarrhoea/vomiting with a headache lasting 48hrs. This followed his participation in an amateur eating competition 1/12 ago, during which he may have eaten some improperly cooked pork. O/E he has marked periorbital oedema with conjunctivitis. Blood tests reveal a marked eosinophillia, while gastrocnemius biopsy demonstrates the presence of encysted larvae.
Trichinella spiralis
A 25 year old man presents with weight loss and diarrhoea. He has recently been on holiday in India. On examination of his stool cysts and “tear-drop” shaped trophozoites are present.
Giardia lamblia
A 10 year old girl presents with fever, hepatomegaly, splenomegaly and anaemia. She recently emigrated from the Sudan. Her mother tells you that 6 months ago the girl developed dark patches on her hands and forehead.
Leishmania donovani
An 18 month old girl from Brazil sees you whilst on a short holiday in Britain. Her parents are worried because she appears to have had fever for the last few weeks, seems more tired and out of spirits than usual, has loss of appetite, vomiting and diarrhoea and complains of pains in her legs. On examination she has general lymphadenitis and non-pitting oedema in her legs and feet. Her Machado-Guerreiro test is positive.
Trypanosoma cruzi
A 2 week old female had an enlarged liver and spleen and her skin was tinged yellow. She was not eating much nor was she vomiting. She also suffered from regular seizures. Investigation revealed intra-cranial calcification.
Congenital toxoplasmosis
What organism Causes haemorrhagic cystitis in children?
Adenovirus
A cephalosporin used for treating pseudomonal infections in cystic fibrosis?
Ceftazidime
A 35 year old Asian gentleman has recently migrated to the United Kingdom. He presents with urinary frequency, dysuria and loin tenderness. Urine culture is negative, however he has pyuria.
Renal tuberculosis
A 32 year old male recently underwent a kidney transplant procedure. During his time in hospital he was continually disturbed by the noise of building work. He started to develop fever, dyspnoea an dslight confusion.
Aspergillus Fumigatis
A 35 year old woman receiving chemotherapy for high grade lymphoma develps SOB and dry cough. CXR shows bilateral reticulonodular shadowing. A transbronchial biopsy shows alveoli filled with foamy eosinophilic material and numerous boat-shaped organisms staining positively with silver stain. Sputum culture is negative.
Pneumocystis pneumonia
A patient with 20% burns with open wounds is awaiting skin grafting. The wound swab grew gram-negative bacilli that produced a green pigment and was oxidase-positive. A similar organism was isolated from other patients on the same unit. Bacteriological typing subsequently proved all the isolates were of the same type.
Pseudomonas aeruginosa
What is the first line antibiotic for the treatment of a bacterial sore throat in a patient with no known allergies?
Phenoxymethylpenicillin
To the nearest 10%, what is the lifetime risk of latent TB reactivation in an immunocompetent individual?
10%
What subtype of Herpes Simplex Virus is typically implicated in encephalitis?
HSV1
A 15 year old swimmer present with a month long history of itching and scaling between the toes on his right foot.
On examination there is macerated skin between the 3rd and 4th toes on the right foot, associated with erythema and scaling. What organism is most likely responsible for this presentation?
Trichophyton rubrum
What is the first line antibiotic for the treatment of a bacterial sore throat in a patient with a penicillin allergy?
Clarithromycin
A 18 year old is seen in a dermatology clinic about painless areas of skin hypopigmentation on his trunk.
Examination of skin under Wood’s lamp shows faint orange fluorescence. What is the condition?
Tinea versicolor
What test can be used to check for fungal infection like ringworm?
Wood’s lamp - fluoresces
A 60 year old farmer presents to the emergency department feeling unwell with what he thinks is the flu. He said there was a sudden onset 4 days ago of chills, severe muscle aches and abdominal pain.
Today he is visibly jaundiced and is complaining of muscle pains. He says that he has a headache behind his eyes. He is mildly photophobic. There is a subconjunctival haemorrhage in the right eye.
You take a full history and find he has long standing arthritis of his knees but no other medical history of note. He has a fever of 38.5C and an ECG is normal. His observations are otherwise within normal limits. Dx?
Leptospirosis
What type of virus is covid-19?
RNA virus
What protein allows covid to bind to ACE2?
S protein
What class of organisms are classically the hosts for Coxiella Burnetii?
Mammals
How long are the cycles of fevers in malaria?
48 hours
What are the 5 main groups of antimicrobial agents that work by inhibiting bacterial protein synthesis in ribosomes? TAMCO
Tetracyclines (e.g. Doxycycline) Aminoglycosides (e.g. Gentamicin) Macrolides (e.g. Erythromycin) Chloramphenicol Oxazilidinediones
Which 2 types of Abx act on 30s subunit of ribosome?
Tetracyclines
Aminoglycosides
Which 2 types of Abx act on 50s subunit of ribosome?
Macrolides
Chloramphenicol
Which type of abx acts on the 23S component of the 50S subunit of ribosomes?
Oxazilidinediones
What assay is currently used to identify if someone has previously been infected with SARS-CoV-2?
Enzyme Linked Immunosorbent Assay
A Löwenstein-Jensen medium is used to facilitate growth of what respiratory pathogen?
Mycobacterium tuberculosis
Side effects of all TB meds?
Rifampicin: Hepatotoxicity (deranged LFTs), Drug interactions (induces cytochrome P450), Orange secretions
Isoniazid: Hepatotoxicity, Peripheral neuropathy
Pyrazinamide: Hepatotoxicity, Hyperuricaemia
Ethambutol: Optic neuritis
What is the first line antimicrobial for treatment of limited impetigo?
Fusidic acid
What is the primary infective lesion produced by Mycobacterium tuberculosis called in the lungs?
Ghon focus
What is the treatment of choice in a woman with offensive yellow-green discharge and a flagellated protozoan visible on wet prep microscopy?
Metronidazole
What is the treatment for human tapeworms in adults?
Praziquantel
A 34 year old is admitted to the respiratory ward due to a severe chest infection. There are crepitations in the right mid zone and this is associated with consolidation on X ray. Past medical history is unremarkable. The patient says that he is recovering from the flu, which he had last week. Sputum culture showed Gram Positive Cocci in clusters.
What organism is responsible for his chest infection?
Staph aureus
A sexually active homosexual man received treatment two hours ago for genital primary syphilis. He was given a single of dose of IM benzylpenicillin. He presents to the emergency department reporting he has become unwell, with a fever, headache and muscle aches. He is concerned he is having an allergic reaction. He is pyrexial at 38C and his blood pressure is 98/76.
What syndrome is he suffering from?
Jarisch Herxheimer reaction
What is the most common cause of diarrhoea in returning travellers to the UK?
Escherichia coli
What is the first line antibiotic for the treatment of sinusitis in a systemically well patient with no known allergies, assuming there has been no improvement of symptoms for at least 10 days?
Phenoxymethylpenicillin
A pregnant woman at term (38+3) has her urine dipped which shows the presence of nitrites and leukocytes. However, she denies any dysuria or other symptoms. She is diagnosed with an asymptomatic bacteriuria.
If indicated, what is the first line antibiotic for the treatment of this patient?
Amoxicillin
What is the recommended antibiotic prophylaxis for bites by either cat, dog or human in a patient with no known allergies?
Co-amoxiclav
What organism is responsible for the sexually transmitted infection Chancroid, which causes multiple painful ulcers?
Haemophilus ducreyi
Which malarial species presents with a 72 hour fever pattern?
Plasmodium malariae
All others are every 48 hours
What is the full scientific name of the organism responsible for Cat Scratch Disease?
Bartonella Henselae
Sputum culture showed Gram Negative Rods in clusters.
What organism is responsible for his chest infection?
Klebsiella pneumoniae
What antibiotic would you prescribe first line for an infective exacerbation of COPD with a suspected bacterial etiology?
Amoxicillin
A patient is suspected to have a community acquired pneumonia. Their CRB 65 is 3 and they have no known allergies.
In addition to clarithromycin, what is the other first line antibiotic that should be prescribed for this patient?
Co-amoxiclav
A 72 year old man with COPD and poorly controlled HIV presents to the emergency department following a severe episode of haemoptysis. He reports no other symptoms. A high resolution CT scan reveals multiple large bullae and a large left upper lobe rounded mass surrounded by a crescent of air. Serum galactomannan is positive. What is the diagnosis?
Aspergilloma
What 2 viruses are blood products routinely screened for before allogenic stem cell transplant?
HIV
CMV
What is the first line antimicrobial for treatment of Lyme Disease?
Doxycycline
A 33 year old man presents to their GP with multiple elevated, small, pink lesions with a dimple in the center over his abdomen. He denies any pain, itching or bleeding. They are not obviously infected. He has no history of cold sores and had chickenpox as a child.
What infection must be ruled out in a person presenting with this characteristic rash?
HIV
Severe malaria is defined as parasitaemia of more than?
2%
What antimicrobial is first line for severe, widespread fungal nail infection in a an elderly patient with no known allergies?
Terbinafine
What gram positive organism is associated with tumbling motility and rockets?
Listeria monocytogenes
Presence of atypical lymphoycytes on a peripheral blood film suggests what diagnosis?
Infectious Mononucleosis
What does Gomori’s methenamine silver stain test and what are the findings?
PCP
Flying saucer shaped cysts
What shape is a giardia trophozoite?
Pear
How does staph aureus lead to shock?
Produces exotoxin TSST-1 which acts as a superantigen
Complications of campylobacter?
Guillain Barre
Reiter’s syndrome
What is the gold standard test for diagnosing leptospirosis?
Microscopic agglutination test
What can haemophilus ducreyi be cultured on?
Chocolate agar
Causative organism in donovanosis? How is it diagnosed?
Klebsiella granulomatis
Giemsa stain
MOA of oseltamivir?
neuraminidase inhibitor (exit)
MOA of amantidine?
M2 ion channel inhibitor (entry)
What do you see on microscopy of psityriasis versicolor?
Spaghetti with meatballs appearance
Causative organism in rose gardener’s disease?
Sporothrix schenkii
Wheal in mantoux test >5mm considered positive in? How big does wheal need to be for everyone else?
HIV, recent TB contact, organ transplant, immunosuppressed
Everyone else 15mm
What is optochin sensitivity used to determine?
Strep pneumoniae from strep viridans
Which organism more likely to cause pneumonia in alcoholics?
Klebsiella
pneumonia in copd organism?
Moraxella catarrhalis
Classic feature in entamoeba histolytica?
Flask shaped ulcers in bowel
Cysts have 4 nuclei
Features of kala azar (visceral leishmaniasis)
Fever
Splenomegaly
Sometimes hepatomegaly and skin hyperpigmentation
Most common form of leishmaniasis? Organisms?
cutaneous leishmaniasis
L. tropica
L. major
Vector for lyme disease? Tx?
Ixodes tick
Doxycycline
Tx for C difficile colitis?
PO metronidazole 14 days
Features of sporadic CJD?
Dementia 65yrs LMN signs Akinetic mutism Myoclonus Cortical blindness
Autopsy feature of CJD?
EEG findings?
LP findings?
Spongiform vacuolation
Generalised triphasic sharp wave complexes
Looking for 14-3-3
Tx for SBP?
IV cefotaxime
Consider follow up with spirinolactone
Most significant influencer in Hep C clearance?
Genotype of virus
Vector for sleeping sickness?
Organism?
tsetse fly
Trypanosoma brucei gambiens (chronic)/rhodens (acute)
Chagas disease?
Swollen eyes
D&V
Chronic - Difficult swallow, weight loss
Which TB drugs does renal function matter for?
Ethambutol
45 y/o man attends GP with fatigue and easy bruising. He has recently returned from India where he had a self-resolving episode of jaundice and malaise. Blood tests show a pancytopenia with low reticulocytes. What is the most likely diagnosis?
Aplastic anaemia
Which organism causes pneumonia with ‘red currant jelly sputum’ in alcoholics and diabetics?
Klebsiella pneumoniae
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?
Aspergillus fumigatus
64y/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?
Amphotericin B
Which of the following tests is useful in diagnosing invasive Candida albicans infection?
Beta-D-Glucan
Which abx for legionella pneumonia?
Azithromycin
Which virus is associated with severe hepatic disease and potentially death if it infects a pregnant patient?
Hep E
Streptobacillus moniliformis causes which infection?
Rat bite fever
