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MicroB by Clinical Scenarios Flashcards

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Biology 101 flashcards
1
Q

Top 3 most common causes of UTI in males

A
  1. Escherichia Coli
  2. Proteus
  3. Klebsiella
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2
Q

Top 2 most common causes of UTI in females

A
  1. Escherichia Coli
  2. Staphylococcus Saprophyticus
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3
Q

Other (less common but) possible causes of UTI

A

Enterococci, Enterobacter, P. aeruginosa

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4
Q

Lower tract UTI symptoms include:

A

Frequency, urgency, small volumes, dysuria (painful urination), lower abdominal pain

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5
Q

Upper tract UTI symptoms include:

A

Pyelonephritis with flank pain, rigors, high fever, sepsis

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6
Q

UTIs are commonly found in:

A

Older women and (older) men with enlarged prostate
Patients with impaired urine flow
Sexually active women
Babies with congenital abnormalities of urinary tract
Pregnant women (due to anatomy)

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7
Q

Why might dipstick/culture be problematic for diagnosis of females’ UTI?

A

Urine is often contaminated with vulval flora

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8
Q

Why are UTIs more commonly found in females?

A

They have a shorter urethra

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9
Q

Treatment for E. Coli caused UTI

A

Co-amoxiclav, Cotrimoxazole, Ciprofloxacin, Cephalexin, Vancomycin (for Methicillin-resistant S. saprophyticus)

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10
Q

Complications that could follow E. Coli caused UTI?

A

Diarrhoeal disease

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11
Q

Complications that could follow Klebsiella caused UTI?

A

Friedlander’s pneumonia (chronic destruction and multiple abscess formation in lungs) / Nosocomial infections / Bacteraemic infections

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12
Q

Complications that could follow Enterococci caused UTI?

A

Endocarditis and bacteraemia nosocomial infection

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13
Q

Majority of wound infections are caused by ___ and ___

A

Staphylococcus Aureus (Open wound)
Streptococcus pyogenes (No obvious wound) -> Check toe webs

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14
Q

Treatment for MRSA caused wound infections?

A
  1. Wound debridement/incision and drainage
  2. Cloxacillin
    3.Erythromycin -> For penicillin allergic patients
  3. Vancomycin -> For MRSA
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15
Q

Complications of S. aureus wound infections?

A
  1. Toxic shock syndrome toxin-1
  2. Endocarditis (acute)
  3. Osteomyelitis
  4. Pneumonia
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16
Q

Complications of Strep. pyogenes wound infections?

A
  1. Scarlet fever (Exotoxins A and C)
  2. Acute Rheumatic Fever (ARF) (JONES criteria) -> Rheumatic Heart Disease
  3. Acute glomerulonephritis -> Acute renal failure
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17
Q

Skin and soft tissue infections associated with water can be caused by:

A

(Apart from most common Staph aureus and Strep pyogenes)
1. Pseudomonas aeruginosa (PAE)
2. Vibrio vulnificus
3. Aeromonas

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18
Q

Complications of Vibrio vulnificus?

A

Oedema, erythema and life-threatening necrosis

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19
Q

Complications for Aeromonas?

A

Septicaemia

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20
Q

Treatment for Strep pyogenes?

A

Benzylpenicillin (IV)

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21
Q

Treat Vibrios vulnificus with?

A

Ceftazidime

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22
Q

Necrotising fasciitis can be caused by?

A

Staphylococcus Aureus, Streptococcus pyogenes, Vibrio vulnificus, Aeromonas (with water exposure)

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23
Q

Investigations for necrotising fasciitis:
Check for myelitis and presence of gas and fluid with ___ (Better than ___)

A

MRI, CT

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24
Q

Gas gangrene with environmental interaction is caused by?

A

Clostridium perfringens

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25
Q

Treatment for Clostridium perfringens?

A

Debridement (VITAL) + Benzylpenicillin + Clindamycin (to inhibit toxin production)

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26
Q

Complications of Clostridium perfringens?

A

Skin discoloration with fluid-filled blebs. May be accompanied with smelly discharge.
Systemically unwell -> Unconsciousness

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27
Q

Organism that causes SSTIs after animal bite is ___. Could lead to ___ and requires checking of vaccination.

A

Pasteurella, Rabies

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28
Q

Organism that causes SSTIs in a farm animal worker with a black lesion is _____. Presents as _____. Treated with _____ and may progress to _____.

A

Bacillus anthracis, anthrax -> eschar surrounded by ring of vesicles and oedema, ciprofloxacin, septicaemia and death

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29
Q

SSTIs caused by Candida (yeast) is treated with?

A

Amphotericin B + Caspofungin + Ketoconazole

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30
Q

Most common cause and bacterial cause of acute pharyngitis is

A

Commonest cause: Viruses
Bacterial cause: Streptococcal pyogenes

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31
Q

Causes of acute otitis media / sinusitis?
Treatment?

A
  1. Viruses
  2. Streptococcus pyogenes
  3. Haemophilus influenzae
  4. Moraxella catarrhalis

Treatment: Coamoxiclav or vancomycin (if Strep pneumoniae is penicillin-resistant)

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32
Q

Complications of Strep. Pneumoniae?

A

Pneumonia and meningitis, pneumococcal endocarditis

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33
Q

Complications of Moraxella catarrhalis?

A

Chest infections (especially immunocompromised)

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34
Q

Causes of malignant otitis externa?

A

Pseudomonas aeruginosa

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35
Q

Treat of P. aeruginosa caused otitis externa?

A

Pip-tazo and amikacin

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36
Q

Acute epiglottitis is caused by

A
  1. Haemophilus influenzae
  2. Streptococcal pneumoniae
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37
Q

Treatment for acute epiglottitis?

A
  1. Alert anaesthetist (for intubation due to airway obstruction)
  2. IV Ceftriaxone
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38
Q

Walking pneumonia is caused by

A
  1. Streptococcal pneumoniae
  2. Mycoplasma pneumoniae
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39
Q

Mycoplasma pneumoniae is resistant to all ___ because ___

A

Beta lactams, Mycoplasma do not have cell walls (cannot be stained with Gram stain)

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40
Q

Complications of Mycoplasma pneumoniae?

A

Stevens-Johnson syndrome
(Together with joint pains, encephalitis, haemolytic anaemia, myocarditis)

41
Q

Causes of community acquired pneumonia?

A
  1. Streptococcal pneumoniae
  2. Influenza virus
  3. Mycoplasma pneumoniae
42
Q

Causes of community acquired pneumonia with travel history?

A
  1. Streptococcal pneumoniae
  2. Influenza virus
  3. Legionella
43
Q

Treatment for mycoplasma pneumoniae?

A

*NO CELL WALL INHIBITORS as Mycoplasma does not have a cell wall
Amoxicillin + Benzylpenicillin
Cannot prescribe macrolide alone as it is bacteriostatic

44
Q

Causes of acute severe community acquired pneumoniae in Asia with Diabetes Mellitus?

A
  1. Streptococcal pneumoniae
  2. Influenza virus
  3. Klebsiella pneumoniae
  4. Burkholderia pseudomallei (Has special association with DM)
45
Q

Hospital acquired infection in pneumonia in ICU?

A
  1. Staphylococcus aureus
  2. Klebsiella pneumoniae
  3. Pseudomonas aeruginosa
  4. Acinetobacter baumannii
  5. Legionella
  6. Mycobacterium TB
46
Q

Causes of cough, fever and weight loss over weeks to months?

A
  1. Burkholderia pseudomallei
  2. Mycobacterium TB
47
Q

Common typical causes of community acquired pneumonia?
Treatment?

A

Strep pneumoniae, Haemophilus Influenzae, Moraxella catarrhalis
Treated with penicillin / augmentin

48
Q

Common atypical causes of community acquired pneumonia?
Treatment?

A

Mycoplasma tuberculosis, Chlamydia pneumoniae, Legionella
Treated with tetracycline and macrolide erythromycin or azithromycin for Legionella)

49
Q

Causes of hospital acquired pneumonia and respective treatment?

A

Pseudomonas -> Piptazo
Gram negatives -> Gentamicin (aminoglycoside)
MRSA -> Vancomycin and tetracycline

50
Q

Causes of conjunctivitis? (No trauma/contact lens)

A
  1. Adenovirus -> Follicular conjunctivitis and keratoconjunctivitis
  2. Strep. pneumoniae
  3. Haemophilus Influenzae
51
Q

Complications of Adenovirus?

A
  • Pharyngoconjunctival fever
  • Pneumonia, pharyngitis (UTI), chronic tonsilitis
  • Haemorrhagic cystitis (bladder inflammation with blood in urine)
  • Enteritis (inflammation of lymph nodes)
52
Q

Treatment for Conjunctivitis caused by Adenovirus?

A

Fluoroquinolone

53
Q

Dendritic ulcer is caused by

A

Herpes Simplex (HSV1)

54
Q

Local zoster is caused by

A

Varicella-Zoster Virus

55
Q

Complications of Varicella/Zoster?

A

Varicella: Skin superinfections, aseptic meningitis, pneumonia, arthritis, haemorrhagic condition
Zoster: Encephalomyelitis, post-herpetic neuralgic, disseminated zoster

56
Q

Causes of eye infections in soft contact lens user is likely to be caused by

A

Pseudomonas aeruginosa
NOT treated with conjunctivitis drugs

57
Q

Complications of P. aeruginosa caused eye infections?

A

Pseudomonas keratitis (Small corneal ulcer -> Rapidly penetrate -> Perforate cornea -> Blindness)

58
Q

Cause of eye infection after swimming with contact lenses? How does it present itself?

A

Acanthamoeba
Presents with ocular pain and corneal lesions (Differential diagnosis: Herpes simplex)

59
Q

Red eye with trauma is caused by

A
  1. Pseudomonas Aeruginosa
  2. Bacillus Cereus
  3. Fungi -> Aspergillus, Candida (keratomycosis)
60
Q

Red eye after outdoor sports is caused by

A

Microsporidia

61
Q

Opthalmia neonatorum found in neonates in days 1-3 is caused by ___ and treated with ___

A

Neisseria gonorrhoeae, ceftriaxone

62
Q

Eye infections found in neonates from days 3-10 is caused by ___ and treated with ___. Complications include ___.

A

Chlamydia trachomatis, erythromycin, pneumonitis

63
Q

Trachoma is caused by ___ and can be treated with ___. Complications include ___.

A

Chlamydia trachomatis, azithromycin, pannus formation, chronic inflammation and scarring of eyelids leading to blindness

64
Q

Eye infections that are uncommon in Singapore
1. Ocular larva migrans caused by _____
2. Cornea opacity caused by _____
3. Irritated, swollen, painful eye caused by _____
4. Choroiditis retinitis caused by _____

A
  1. Toxocariasis
  2. Onchocerca volvulus
  3. Loa loa
  4. Toxoplasmosis
65
Q

Vomiting in an adult is likely to be caused by ___ from ___. Diarrhoea is described to be ___ and resistant to ___.

A

Norovirus, injested contaminated seafood. Watery, chlorination/drying

66
Q

Diarrhoea in children is often caused by ___ and can be prevented by ___ including ___ & ___. Can be avoided by ___.

A

Rotavirus
Rotarix, Rotateq
Not drinking bottled milk

67
Q

Acute diarrhoea in travellers is caused by ___. Treatment is ___.

A
  1. E. Coli (EPEC, ETEC) -> Ciprofloxacin
  2. Entamoeba histolytica -> Metronidazole
  3. Cryptosporidium -> Self-limiting, no treatment needed
68
Q

Cause of bloody diarrhoea with Haemolytic Uraemic Syndrome is caused by ___ with antigen ___.

A

Enterohaemorrhagic E. Coli
Antigen O157

69
Q

Acute to chronic diarrhoea with bloating and foul stools is caused by ___. Treated with ___.

A

Giardia, metronidazole

70
Q

Acute diarrhoea with fever and blood is caused by _____. Could lead to ___ and ___.

A

Campylobacter
Severe haemorrhage, Guillain Barre Syndrome (reactive arthritis)

71
Q

Campylobacter has an incubation period of 1-7 days where it presents as a flu-like illness with abdominal pain and diarrhoea. It is sometimes misdiagnosed as?

A

Appendicitis

72
Q

Cause of meningitis in immunocompromised (AIDS/organ transplant) with gradual onset?
Treated with?

A

Cryptococcus neoformans
Amphotericin B

73
Q

Patient presents with headache for 5 days, high protein, low glucose and WBC in 100s (high). What is patient likely to have?

A

Mycobacterium Tuberculosis

74
Q

Travel associated diarrhoea is likely to be ___ which presents as ___ with ___. It is typically caused by antigen ___.

A

Vibrio cholerae, rice water stools, fishy odour, O1

75
Q

How is outbreak/travel associated diarrhoea treated? (Vibrio cholerae)

A

Azithromycin or doxycycline + Rehydration

76
Q

What causes shellfish associated diarrhoea and vomiting?

A

Vibrio parahaemolyticus

77
Q

What is likely to cause antibiotic associated diarrhoea? How is it treated?

A

CDAD (Clostridium difficile associated diarrhoea)
Treatment: Oral vancomycin / metronidazole

78
Q

What causes food associated diarrhoea and vomiting? What are the accompanying treatment methods?

A
  1. Staphylococcus aureus
  2. Salmonella (poultry/eggs) -> Ciprofloxacin or ceftriaxone
  3. Campylobacter -> Erythromycin or ciprofloxacin
  4. Bacillus cereus (fried rice) -> Ciprofloxacin or azithromycin
79
Q

Blisters on genitals is likely to be caused by ___. (Assume no ulceration)

A

Herpes Simplex Virus 2

80
Q

Blisters on genitals with ulceration is caused by

A
  1. HSV2
  2. Treponema pallidum (primary syphilis)
  3. Haemophilus ducreyi
81
Q

Complications of syphilis?

A
  1. Meningovascular syphilis -> Stroke
  2. General paresis -> Dementia
  3. Tabes dorsalis -> Demyelination of spinal cord, proprioception lost and ataxic gait
  4. Gummatous syphilis -> Necrotic granulomatous lesions
  5. Cardiovascular syphilis -> Aortic aneurysm
82
Q

Dysuria is caused by

A
  1. Chlamydia trachomatis
  2. Mycoplasma
83
Q

How is Chlamydia and N. gonorrhoea tested for?

A

Morning urine PCR

84
Q

Purulent urethral discharge is caused by ___

A

Neisseria gonorrhoea

85
Q

N. gonorrhoea is resistant to ___ and ___ and can be treated with ___ and ___.

A

Resistant to penicillin and ciprofloxacin
Treated with ceftriaxone and azithromycin

86
Q

Chlamydia trachomatis can be treated with

A

Oral doxycyline and azithromycin

87
Q

Pruritus and cheesy vaginal discharge is caused by

A

Candida albicans yeast

88
Q

Malodourus (foul-smelling) vaginal discharge is caused by

A

Bacterial vaginosis

89
Q

Candida can be treated with

A

Clotrimazole and Amphotericin B

90
Q

Grain stain for bacterial vaginosis will show

A

Clue cells (Epithelial cells covered with small adherent bacteria)

91
Q

Treatment for bacterial vaginosis

A

Oral metronidazole

92
Q

Copious, foamy, purulent, frothy, yellow-greenish vaginal discharge is caused by ___ and can be treated with ___.

A

Trichomonas vaginalis, metronidazole (ping-pong infection)

93
Q

Condylomata acuminate (genital warts) is caused by

A

Human Papillomavirus (HPV)

94
Q

Scaly rash on skin, palms and soles is caused by ___. Occurs only in ___ and is transmitted through ___. It ___ be cultured and ___ must be used for visualisation.

A

Treponema pallidum
Men, sex
Cannot, Dark Ground illumination

95
Q

Small papule that grows in discrete waxy, smooth, dome-shaped, pearly nodules with semi-sold caseous material is caused by

A

Molluscum contagiosum virus

96
Q

Where are the papule lesions found in Molluscum contagiosum?

A

Trunk
Children: Proximal extremities
Adults: Pubic areas and thighs

97
Q

Molluscum contagiosum virus is a ___ infection and has ___.

A

Self-limiting, NO lifelong immunity

98
Q

Investigation method for Trichomonas vaginalis?

A

Wet mount microscopy

99
Q

Treatment for primary syphilis?

A

IM benzylpenicillin

Microbiology (9 decks)

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