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MRCOG - PART 1 > Microbiology > Flashcards

Microbiology Flashcards

1
Q

All DNA viruses are double stranded except

A

Parvovirus (single stranded)

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2
Q

All DNA viruses replicates in the nucleus except

A

Poxvirus (Cytoplasm)

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3
Q

All DNA viruses are has icosahedral capsid except

A

Poxvirus (complex)

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4
Q

All DNA viruses has linear genome except

A

Papillomavirus
Polyomavirus
Hepadnavirus
(circular)

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5
Q

A mnemonic for DNA viruses

A

PARdon PAPa As HE Has POX DNA

(naked)
PARvovirdea
PAPovavirdea
Adenovirdea

(enveloped)
HErpesvirdea
Hepadnavirdea
POXvirdea

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6
Q

Treatment of Genital Herpes

A

Doesn’t have any. if you have it, you have it for life.

Symptomatic relief regimen:
Acyclovir 400 mg TID for 5 days (4-3-5)

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7
Q

HSV incubation period

A

2-7 days

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8
Q

Target or Bull’s eye lesion is specific for

A

Erythema Multiform (HSV1-2)

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9
Q

Steven Johnson Syndrome

A

Is Eryhtema Multiform Major (HSV1-2)
-Fever
-Extensive Oral Lesions
-Desquamating lesions

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10
Q

Histological feature of CMV

A

Owl’s eye

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11
Q

Most commonly available serologic test for measuring antibodies to CMV.

A

ELISA

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12
Q

Varicella Zoster Virus Incubation Period

A

1-3 Weeks (7-21 days)

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13
Q

CMV incubation period

A

3-12 Weeks

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14
Q

Congenital defects associated with CMV

A

IUGR
Microcephaly
Hepatosplenomegaly
Sensory neural hearing loss

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15
Q

Most common cause of sensory neural hearing loss

A

CMV

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16
Q

Materno fetal transmission rate of CMV

A

40%

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17
Q

CMV causes a disease called

A

Mononucleusis Syndrome

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18
Q

Most common cause of Infectious mononucleosis

A

Ebstein-Barr Virus

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19
Q

HIV primarily infects which cells?

A

CD4 cells
Dendritic cells
Macrophage

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20
Q

Perinatal Transmission rates of HIV

A

with treatment <1%
Without treatment =15%

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21
Q

Perinatal Transmission rates of HIV

A

with treatment <1%
Without treatment =15%

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22
Q

Risk factors of HIV Perinatal transmission

A

High maternal viral load
Low CD4 count
Prolonged rupture membrane
Chorioamnionitis
Co morbidity (HCV, malaria)
Breastfeeding
Preterm birth

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23
Q

What disease does rubella cause?

A

German Measles

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24
Q

Feto- maternal Transmission Rate of Rubella virus

A

1st trimester = 90%
2nd trimester = 30%
Risk of transmission is decreased after 16 weeks

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25
Q

Obligate Aerobes

A

Pseudomonas
Mycobacterium
Nocardia

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26
Q

Facultative Anerobes

A

E. Coli
Staphylcoccus
Enterococcus

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27
Q

Obligate Anerobes

A

Colistridia
Bacteroids
Prevotella

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28
Q

Which one of the following bacteria produces an exotoxin causing ‘toxic shock syndrome’ associated with tampon usage

A

Staph aureus

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29
Q

Features of Strept. Pneumonia

A
  1. alpha hemolytic strept.
  2. G+ve diplococci
  3. Optochin sensitive
  4. Bile soluble
  5. Quellung reaction (spelled capsules)
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30
Q

Clinical features of Strept. Pneumonia

A

MOPS
Meningitis
Otitis media
Pneumonia
Sepsis (in sickle cell disease/ splenic patients)

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31
Q

DOC in treating Strept. Pneumonia

A

Penicillin
then ceftriaxione and Macrolides

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32
Q

Features of Staph aureus

A
  1. G+ve cocci
  2. Catalase +ve
  3. Urease -ve
  4. Coagulase +ve
  5. Ferments mannitol
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33
Q

Clinical features of Staph aureus

A

Skin infections
Osteomylitis –> septic arthritis
Endocarditis
Toxic shock syn. (with tampon usage)
Food poisoning
Staph scalded skin syndrome SSSS

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34
Q

Toxin by Staph aureus causes Toxic shock syndrome

A

TSST-1 Enterotoxin F (superantigen)

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35
Q

Toxin by Staph aureus causes Staph Scalded Skin Syn.

A

Exfoliate toxin A & B (superantigen)

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36
Q

Most common cause of UTI

A

E.coli

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37
Q

Most common cause of UTI in sexually active women

A

Staph. Saprophyticus

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38
Q

Group F streptcocci

A

Strept. anginosus

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39
Q

Group D streptococci

A

Enterococci
Strept. Bovis

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40
Q

Most pathogenic beta hemolytic strept

A

Strept pyogens GAS

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41
Q

GAS is commensal in

A

Nasopharynx

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42
Q

Features of GAS

A

Has M protein and Hyaluronic acid capsule
Bactricin Sensitive
Catalase negative
produce different endotoxins & extoxins

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43
Q

Symptoms of GAS

A

Pyogenic:
- Pharyngitis
-impetigo
-erysipales
-cellulitis

Immungenic:
-Rhemuatic fever
-Glomerulonephritis

Toxogenix:
-toxic shock-like syn.
- Scarlet fever (strawberry tongue

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44
Q

GAS produce three important inflammatory enzymes

A
  1. Hyalorunidase-> degrades hyaluronic acid -> Skin infection
  2. Streptokinase (fibrinolysin)
  3. DNAse-> degrades DNA in exudates and necrotic tissue
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45
Q

GAS produce important toxins

A
  1. Erythrogenic toxin A (pyrogenic toxin A)
  2. Streptolysin O
  3. Streptolysin S
  4. Exotoxin B
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46
Q

Scarlet Fever

A
  • Fever
  • Flushed Cheeks
  • Endometritis
    -Strawberry tongue
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47
Q

Cause of Necrotizing fasciitis type 2

A

GAS

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48
Q

M Protein virulence factor:

A
  • Fimbrial protein
    -Involve in capsule formation
  • Anti phagocytic
    -Involve in destroying c3 convertas and prevents opsonization by c3b
  • Responsible for organ adhesion and invasion
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49
Q

What type of hypersensitivity is Rheumatic fever

A

Type II

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50
Q

What type of hypersensitivity is Glomerulonephritis

A

Type III

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51
Q

Which is the single most appropriate treatment of Chlamydia vaginal infection in pregnancy

A

Erythromycin 500 mg BID/14 days

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52
Q

Early onset neonatal infection of GBS

A

before 7 weeks - presented by neonatal sepsis

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53
Q

Late onset neonatal infection of GBS

A

7 weeks to 3 months - presented by meningitis (capsular serotype III) most common

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54
Q

GBS clinical features in neonates

A

Neonatal Sepsis
Meningitis
Pneumonia

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55
Q

GBS clinical features in adults

A

Endocarditis
Arthritis
Pneumonia
Osteomyelitis
Postpartum endometritis

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56
Q

Main predisposing factor of GBS transfer to neonates

A

Prolonged Rupture of membranes in women who are colonized with the organism

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57
Q

Main predisposing factor of GBS in Adults

A

Diabetes Mellitus

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58
Q

risk factors for neonatal GBS

A
  • Preterm Delivery (<37 w)
  • Prolonged ROM (>18 before time of delivery)
  • Prolonged Labour
    -Choriamnionitis
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59
Q

Antibiotic Regimen to treat GBS

A
  • Benzylpenicilin G 3 gm IV then 1.5 gm IV/4 hrs until delivery
  • Clindamycin 800 mg IV/ 4hrs until delivery
  • Erythromycin 500 mg IV/ 6hrs until delivery
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60
Q

Most Enterococci species to cause infection

A

E. faecalis 85-90%

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61
Q

How is Enterococci are hardy organisms

A

They are commensals of normal flora of the colon.

They can grow in hypertonic (6.5%) saline or in bile

They are not killed by Penicillin G

62
Q

Important Risk factors of Enterococci infection

A

Nosocomaila Infection:
Indwelling urinary Catheter
Urinary tract instrumentation

63
Q

Important Risk factors of Enterococci infection

A

Nosocomaila Infection:
Indwelling urinary Catheter
Urinary tract instrumentation

64
Q

Treatment of Enterococci infection

A

synergetic combination of penicillin G and amino glycoside (gentamycin)

65
Q

N. Meningitides has three important virulence factors:

A
  1. Polysaccharride capsule. It is antiphagocytic in nature.
  2. The endotoxin of N. Meningitidis is a lipopolysaccharide (LPS). It induces septic shock by causing release of cytokines.
  3. IgA protease. It cleaves the IgA antibodies present in respiratory mucosa.
66
Q

Method of transmission of N. Meningitides

A

The organisms are transmitted by airborne droplets

67
Q

most common cause of meningitis in persons between the ages of 2 and 18 years.

A

N. Meningitidis

68
Q

What is waterhouse friderichsen syndrome

A

Is a group of symptoms caused when the adrenal glands fail to function normally. This occurs as a result of bleeding into the glands. Caused by Meningococci

69
Q

Different methods for laboratory diagnosis of N. Meningitidis are

A

-Gram staining: G-ve bean shaped diplococci
-Culture: grows on blood and chocolate agars
-Oxidase test: Oxidase +ve
-Fermentation tests: ferment maltose & mannitol
-Latex agglutination test: detects capsular polysaccharide in the spinal fluid.

70
Q

features of meningitis caused by N. Meningitidis

A
  1. headache
  2. fever
  3. neck stiffness
  4. photophobia
  5. phonophobia
71
Q

N. Gonorrhoeae causes

A
  • gonorrhea
  • neonatal conjunctivitis (ophthalmia neonatorum)
  • pelvic inflammatory disease (PID).
72
Q

Most important virulence factor of N. gonorrhea

A

Pili
Piliated gonococci are usually virulent, whereas non piliated strains are avirulent.

73
Q

Different methods for laboratory diagnosis of N. Gonorrhea are

A

-Gram staining: G-ve bean shaped diplococci
-Culture: grows on Thayar-Martin Agar or Mueller-Hinton agar (chocolate Agar)
-Oxidase test: Oxidase +ve
-Fermentation tests: ferment mannitol {not maltose}

74
Q

Clinical picture of gonorrhea in males

A
  1. Urethritis
  2. Prostatitis
  3. Epidedimitis
75
Q

PID Clinical Picture

A
  1. Fever
  2. Lower Abdominal Pain
  3. Abnormal menstrual bleeding
  4. Cervical motion tenderness
76
Q

Comiication of PID

A
  1. Infertility
  2. Scarring Ectopic pregnancy
  3. Peritonitis
  4. Violin string adhesions
  5. Fitz-Hugh-Kurtis synd.
77
Q

difference between conjunctivitis of gonorrhea and chlamydia

A

Both Purulent
If infection before 4 days of delivery: gonorrhea
If infection after 5 days of delivery: chlamydia

78
Q

Treatment of Gonorrhea

A

Ceftriaxone + Azithromycin

79
Q

What sexually transmited disease (STD) is caused by Haemophilus ducreyi?

A

Chancroid

80
Q

Syphilis caused by which organism

A

Treponema Pallidum

81
Q

Mode of transmission of Syphilis

A
  1. Acquired (direct contact)
    - MSM 35%
    - Oral 15%
  2. Vertical from mother to fetus
    (transplacental passage only occurs when placenta fully developed at 14 weeks)
82
Q

1ry stage of Syphilis

A

1-3 weeks after infection

Chancer (painless ulcer)
Regional lymphadenopathy

83
Q

2ry stage of Syphilis

A

6-12 w after infection (4-10 w after chancer appears)

Maculopapular rash
Chondyloma Lata

84
Q

Neurosyphilis features

A

from 15-30 years of infection

  • Ascending aorta (aortitis, aortic aneurysm)
    -Endartritis (info. of vasa vasorum
85
Q

Features of early onset congenital syphilis

A

within 2 years

  • IUFD
  • Rhagades (linear cracks at the angle of the mouth)
    -Hemorrhagic Rhinitis (Bloody snuffles)
86
Q

Features of late onset congenital syphilis

A

After 2 years

  • saber shins
  • saddle nose
  • hutshingson’s disease
    -Mulberry molars
87
Q

Syphilis Antigens

A
  1. Group specific antigen (all treponema)
  2. Species specific antigen (specific to T. palladium)
  3. Cardiolipin (lipoprotein present in spirochetes)

Antibodies appear 4-8 weeks after infection

88
Q

Sexual history in primary syphilis

A

History of partners for the last 3 months

89
Q

Sexual history in early 2ry and late latent syphilis

A

History of partners for the last 2 years

90
Q

VDRL to assess syphilis serological activity

A

> 1:8 –> Positive
1:16 –> Active disease
<1:6 –> doesn’t exclude active disease particularly if symptoms are present

91
Q

VDRL to assess response to treatment of syphilis

A

After treatment with penicillin –> Repeat VDRL after 4 weeks –> 4 folds decrease means treated

92
Q

Donovan bodies’ are associated with?

A

Granuloma inguinale

93
Q

What is the incubation period for Rubella?

A

12-23 days

94
Q

Chlamydia trachomatis causes

A
  • urogenital infection
  • trachoma
  • conjunctivitis
  • pneumonia
  • Lympogranuloma venerium
95
Q

What kind of Organism is chlamydia

A

Obligate intracellular parasites

96
Q

Chlamydia trachomatis serovars

A

L1, L2, L3

97
Q

What virus family does HIV belong to?

A

Retroviridae

98
Q

What kind of organism is Toxoplasma Gondii?

A

intracellular protozoan

99
Q

What is the most common type of nosocomial infection in uk hospitals?

A

UTI

100
Q

Which group of viruses cause molluscum contagiosum ?

A

Pox virus

101
Q

congenital infections is most characteristically associated with fetal hydrops?

A

Parvovirus-B19

102
Q

What is the causative organism of Toxoplasmosis?

A

Toxoplasma Gondii

103
Q

which infection is most commonly associated with an increased risk of ectopic pregnancy?

A

Chlamydia trachomatis

104
Q

What is the primary causative organism in Bacterial Vaginosis?

A

Gardnerella vaginalis

105
Q

Which kind of organism is Neisseria Gonorrhoeae?

A

Gram Negative Cocci

106
Q

What stage of syphilis infection is gumma?

A

tertiary stage

107
Q

What is the causative organism of gas gangrene?

A

Clostridia perfringens

108
Q

Which species of candida is the most common cause of genital candida infection in pregnancy?

A

Candida albicans

109
Q

Which group of beta haemolytic streptococci isassociated with chorioamnioitis?

A

GBS

110
Q

What is the approximate risk of HIV transmission during a single episode of vaginal unprotected sexual intercourse with a known HIV positive person?

A

0.05%

111
Q

REGARDING URINARY TRACT INFECTIONS, WHICH MICRO-ORGANISM IS MOST LIKELY TO BE ASSOCIATED WITH BLADDER CATHETERISATION?

A

PSEUDOMONAS AERUGINOSA

112
Q
  1. Which of the following cell types lyses cells that have been infected with viruses?
A

CD8+T CELLS

113
Q

Causative organism of granuloma inguinale

A

Klebssiella Granulomatous

114
Q

Structure of mycoplasma genitalium

A

Flask shaped

115
Q

Which HPV causes genital warts

A

HPV 6 & 11

116
Q

When is the highest risk of maternal-fetal transmission of Toxoplasma gondii

A

24-26 weeks

117
Q

Percentage of women develop antibodies to human papilloma virus following infection

A

50-60%

118
Q

Routine antenatal screen is usually for

A
  1. HIV
  2. HBV
  3. Syphilis
119
Q

Tubal Infertility rate after 1 episode of PID

A

12%

120
Q

Tubal Infertility rate after 3 episode of PID

A

50%

121
Q

Mortality rate in patients with Septic shock

A

60%

122
Q

Prevalence of HIV in the UK obstetric population

A

2 per 1000 live births

123
Q

GBS Antibiotic Prophylaxis in elective CS

A

No AB prophylaxis needed in planned CD with no labor and intact membranes

124
Q

Mortality rate of treated disseminated neonatal herpes

A

30%

125
Q

Percentage of CMV infected infants are symptomatic

A

10%

126
Q

Leading cause of surgical site infections

A

Staphylococcus aureus

127
Q

What percentage of HPV infections will be cleared by the host within one year

A

70%

128
Q

What percentage of HPV infections will be cleared by the host within 2 year

A

90%

129
Q

Which group of beta hemolytic streptococci is associated with liver abscess formation

A

Group F: S. anginosus

130
Q

Fetal case mortality rate associated with listeria infection during pregnancy

A

20-30%

131
Q

What percentage of trichomoniasis cases would you expect to a strawberry cervix

A

2%

132
Q

HPV Vaccine Gardasil is of what type

A

Recombinant vaccine of virus-like particles

133
Q

The risk of FVS to babies born to mother who have chickenpox in first 20 weeks of gestations

A

1-12 weeks = 0.4%
13-20 weeks= 2%

134
Q

Features of fetal varicella syndrome

A
  • hypoplasia of one limb
  • cicatricial lesions with a dermatomal distribution
  • CNS abnormalities
  • Eye abnormalities
135
Q

What percentage of trichomoniasis cases is asymptomatic

A

50%

136
Q

What percentage of trichomoniasis cases has yellow frothy discharge

A

20%

[total patients with vaginal discharge 70%]

137
Q

What epithelium cell type lines in the endometrium

A

Columnar

138
Q

Congenital rubella syndrome

A
  • Cataract
  • Bluberry muffin rash
  • PDA
  • deafness
139
Q

1st line TTT of Listeria

A

Amoxicillin or Penicillin

140
Q

What is the first line treatment of trichomoniasis

A

Metronidazole 400 mg TDS 7 days

(HIV +ve 500 mg BD)

141
Q

Most common causative organism of Fitz Hugh Curtis syndrome

A

Chlamydia trachomatis

142
Q

TTT of toxoplasmosis

A

W/O fetal infection: Spiramycin
W/ Fetal infection: primethamine, sulfadiazine and folinic acid

143
Q

Incidence of listeriosis in pregnancy

A

1 per 10,000

144
Q

What are the two major onco proteins associated with high risk HPV

A

E6 and E7

145
Q

Most common cause of sepsis in puerperium

A

Genital tract infections (endometritis)

146
Q

Most common causative organism of puerperal sepsis

A

GAS

147
Q

Which type of cells are clue cells

A

Epithelial cells

148
Q

Lancefield grouping of streptococci is based on the presence of

A

Carbohydrate antigen on cell wall

149
Q

What do these signs refer to:
- green vaginal discharge
- erythematous cervix
- perinuclear halo by microscope

A

Trichomonas vaginalis

150
Q

Organism subunit vaccine

A

Pertissis
Hepatitis B
Influenza
Neisseria meningitides

151
Q

Which organism colonize copper IUD

A

Actinomyces species

MRCOG - PART 1 (15 decks)

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