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Phase 2a > microbiology > Flashcards

microbiology Flashcards

1
Q

cocci vs bacilli?

A

cocci - sphere-shaped bacteria
bacilli - rod shaped bacteria

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2
Q

examples of gram positive cocci?

A

Staphylococci
Streptococci.
Enterococci

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3
Q

examples of gram negative cocci?

A

Neisseria gonorrhoeae
Neisseria meningitis

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4
Q

examples of gram-negative bacilli?

A

E.coli
Pseudomonas aeruginosa
Salmonella spp.
Shigella spp

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5
Q

method to detect MRSA?

A

PCR method

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6
Q

classfication of bacteria?

A

gram positive
gram negative
mycobacteria - tb
unculturables - chlamydia

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7
Q

features of gram negative bacteria ?

A

lipopolysaccharide
outer membrane
peptidoglycan
cytoplasmic membrane

colourless under microscope
pink with safranine

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8
Q

features/ strcuture of gram positive bacteria ?

A

peptidoglycan
cytoplasmic membrane

retain crystal violet
purple under microscope

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9
Q

structure of mycobacteria membrane?

A

mycolic acid
peptidoglycan
plasma membrane

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10
Q

gram positive bacilli examples?

A

Bacillus e.g. B. anthrancis
Corynebacteria e.g. C diptheriae
Listeria monocytogenes

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11
Q

hemolytic properties of bacteria?

A

abilty to break down RBC in agar

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12
Q

3 hemolytic streptococci bacteria ?

A

alpha hemolytic
beta hemolytic
gamma hemolytic

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13
Q

hemolysis of the different types of streoptoccci?

A

alpha - partial hemolysis - green
beta - complete hemolysis - clearing of red blood cells
gamma - do not hemolyse - all red

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14
Q

two main alpha streptococci?
how to distinguish?

A

s. pnuemonia - capsule
s. viridans
optochin disk

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15
Q

optochin disk?

A

s. pnuemonia - space on disk becuase bacteria has died
s. viridans - still exists resistance to optochin

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16
Q

differential of beta streptococci?

A

serological test on detection of carb antigen

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17
Q

most important human bacterial pathogen?

A

s. pyogenes - group a streptococci

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18
Q

gamma strepcocci examples?

A

enterococcus feacilis

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19
Q

role of ziehl neelsen stain?

A

mycobacteria
mycolic acid in the cell wall does not absorb normal gram-staining: requires Ziehl-Neelsen stain to identify acid-fast bacilli

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20
Q

two forms of mycobacteria?

A

leprosy
TB

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21
Q

acid fast bacilli

A
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22
Q

time to replicate culture growth of mycobacteria?

A

at least 24 days because one replication is 24 hours - very slow

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23
Q

how does tb work in the body?

A

gradual onset of presentation due to slow growth
thick lipid-rich cell wall making immune cell killing difficult

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24
Q

mycobacteria in ziehl neelsen stain?

A

red - acid fast bacilli
blue is ecoli

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25
Q

side effects of Rifampicin

A

treats mycobacterial infections
red/orange urine is side effect

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26
Q

why is tb common in HIV patients?

A

preious tb infection before hiv
hiv breaks down immune system and tb becomes active

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27
Q

WHICH VIRUSes BUD OUT ?

A

hiv

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28
Q

how does rota virsu cause diarrhea ?

A

atrophies villi
sugars cant be absorbed
hypersosmotic = diarhheas

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29
Q

how does hep b cause disease?

A

over reactivty of immune system ?

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30
Q

how long can viruses survive outside hosts?

A

depends on virus and host

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31
Q

which virus are oncogenic?

A

EBV CMV

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32
Q

latency?

A

vzv can lay dormant and reactivate after a couple years due to successful latency via evasion

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33
Q

pharmacodynamics?

A

action of the drug on the body (it’s use!)

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34
Q

receptors for natural endorphens and enkephalins?

A

g coupled receptors μ-opioid receptor

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35
Q

Kappa agonists role?

A

cause depression not euphoria

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36
Q

POTENCY ?

A

Whether a drug is ‘strong’ or ‘weak’ relates to how well the drug binds to the receptor,
the binding affinity

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37
Q

efficancy?

A

Is it possible to get a maximal response with the drug or not?
Or even if all the receptor sites are occupied do you get a ceiling response?
The concept of full or partial agonists

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38
Q

tolerance?

A

Down regulation of the receptors with prolonged use
Need higher doses to achieve the same effect

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39
Q

opioid side effects?

A

Respiratory Depression
Sedation
Nausea and Vomiting
Constipation
Itching
Immune Suppression
Endocrine Effects

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40
Q

antagonist of opioids

A

naloxone

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41
Q

pharmacokinetics?

A

action of the body on the drug (how it’s broken down)

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42
Q

what group is s. pyogenes ?

A

group A strep beta heamolyitc
rapid spread and highly invasive infection.

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43
Q

classic history of TB>?

A

Night sweats, weight loss, a cough and haemoptysis is classic history of
TB. Epidemiology –

44
Q

TEST FOR POSITIVE MYCOBACTERIA?

A

mycobacteria have a waxy, lipid cell wall that is impenetrable
to the Gram stain.
Positive Mycobacterium = pink bacilli (just one is enough). with ZN stain

45
Q

growth plate for Neisseria gonorrhoeae ?

A

chocolate agar

46
Q

virus of common cold?

A

rhinovirus

47
Q

virus of measles?

A

paramyxoviridae

48
Q

limitations of mantoux test?

A

positive of previous exposure not if currently infectious or dormant and doesn’t distinguish between BCG vaccine or infectious.

49
Q

4 drugs against TB ?

A

Isoniazid
Rifampicin
Ethambutol
Pyrazinamide

50
Q

isoniazid side effects?

A

peripheral neuropathy
hepatitis

51
Q

rifampicin side effects

A

renal failure, orange urine, rash , hepatitis

52
Q

pyrazinamide side effects?

A

Hepatitis, rash, hyperuricaemia/gout

53
Q

ethambutol side effects?

A

Optic neuritis [EYE] (Sx’s of colour blindness, decreased visual acuity…etc)

54
Q

csf fluid results for bacterial meningitis?

A

turbid yellow colour, neutrophil polymorphs (WBC elevated) , raised protein, low glucose

55
Q

csf fluid results for viral meningitis?

A

lymphocytes, elevated protein, normal glucose
clear

56
Q

csf fluid results for TB meningitis?

A

lymphocytes, raised protein, low/normal glucose

57
Q

viral causes of meningitis

A

enterovirus
HSV
poliovirus

58
Q

bacterial causes meningitis in neonates?

A

e. coli
group B - Strep. agalactaie
Listeria monocytogenes

59
Q

bacterial causes meningitis in infants ?

A

neisseria meningitis (G- diplococc)
H. Influenzae
S. Pneumonia (alpha haemolysis)

60
Q

bacterial causes meningitis in adults?

A

Neisseria meningitidis

Streptococcus pneumoniae (alpha haem)

61
Q

bacterial causes meningitis in elderly ?

A

Streptococcus pneumoniae

Neisseria meningitidis

Listeria monocytogenes

62
Q

investigations for meningitis?

A

CSF - gin clear
- protein
- glucose
- WBC
- PCR
- Blood agar or chocolate agar
- gram film

blood - cultures and pcr
nose swab - enterovirus
stool - stool pcr for enterovirus

63
Q

why is glucose low during bacterial infection?

A

neutrophils and the bacteria are metabolically active and ‘use up’ the glucose as a source of energy. Dying bacteria, the acute phase antibacterial proteins and antibodies all contribute to the elevating the protein in the CSF.

64
Q

antibiotic for bacterial meningitis?

A

IV Cefotaxime

65
Q

h. influenzae blood agar, chocolate agar and V+Z?

A

No bacterial growth on BA
small white colonies on chocolate agar Nutrient agar shows growth around the combined X&V disc onl

66
Q

alternative meningitis treatment apart from antibiotics?

A

Intravenous dexamethasone (corticosteroids

67
Q

most likely cause infants get meningitis from group B strep ?

A

maternal genital tract. Up to 25% of women of child-bearing age may asymptomatically carry Group B strep in their genital tract.

68
Q

blood agar of listeria?

A

gram positive bacilli
small, semi transparant colonies with narrow haemolytic zone on Blood Agar

69
Q

antibiotic for listeria?

A

Intravenous amoxicillin

70
Q

strong clinical suspicion of meningococcal septicaemia and meningitis?

A

rash along with stiff neck, fever

71
Q

treatment of herpes simplex encephalitis?

A

Intravenous acyclovir is required to treat a probable herpes simplex encephalitis

72
Q

symptoms of upper vs lower uti?

A

upper: haematuria, fever, rigor
lower: dysuria, frequency

73
Q

antibiotics for uti?

A

trimethoprim, ampicillin, cephalosporins and ciprofloxacin

74
Q

antibiotics for lower uti ?

A

Trimethoprim 200mg twice daily for 3 days

or

Nitrofurantoin 50mg four times a day for 3 days

75
Q

E. coli pyelonephritis with bacteraemia with uti symptoms treatment?

A

iv antibiotic for 7 days or try
trimethoprim for 14 days

76
Q

urinalysis of csu ?

A

The urinalysis cannot be interpreted on a CSU (catheter urine sample) as both white cells and bacteria will be present in any urethral catheter sample irrespective of active infection

77
Q

spread out cloudy growth on BA could indicate?

A

Swarming colonies of Proteus - UTI

78
Q

reason for urinalysis during antenatal check up ?

A

preeclampsia - protein in urine
high bp during and after pregnancy

79
Q

antibiotics for upper uti?

A

gentamycin + cefuroxime, co-amoxiclav

80
Q

investigations for upper uti?

A

uss kub
ULTRASOUND - kidney ureter and bladder

81
Q

treatment for hbv, hcv and hdv?

A

peg inf alpha with ribavirin

82
Q

dx criteria for IE?

A

dukes criteria

2 major or 1 major, 3 minor

major
- ● Positive blood culture with typical IE microorganism ( s. epidermis, s.aureus, α-haemolytic streptococci, s penumonae)
● New partial dehiscence of prosthetic valve or new valvular regurgitation

minor
● Predisposing factor: known cardiac lesion, recreational drug injection
● Fever >38°C
● Embolism evidence: arterial emboli, pulmonary infarcts, Janeway lesions,
conjunctival hemorrhage
● Immunological problems: glomerulonephritis, Osler’s nodes, Roth’s spots,
Rheumatoid factor
● Microbiologic evidence

83
Q

presentation of eisenmeger syndrome?

A

Eisenmenger syndrome can present clinically with clubbing, cyanosis, and tiring easily (due to underlying VSD)

84
Q

common crdiac conditions in down syndrome

A

VSD VENTRICULAR SEPTAL DEFECT - HOLE IN SEPTUM

85
Q

when is s4 heard

A

before the first heart sound occuring during late diastole
S4 is caused by the atria contracting forcefully in an effort to overcome an abnormally stiff ventricle
Stiff ventricles are associated with low compliance and generally occur in patients with heart failure, ventricular hypertrophy or ischemia.

86
Q

red thorn ulcers

A

Rose-thorn ulcers are seen in Crohn’s disease following a barium swallow. They appear as deep linear ulcers in the terminal ileum.

87
Q

role of gliptins ? example

A

alogliptin.
inhibit dpp4 which allows GLP1 to increase in production and to increase glucose uptake by releasing glucose dependant insulin secretion

88
Q

where is BNP secreted from?

A

ventricular myocardium

89
Q

hypertrophic obstructive cardiomyopathy (HOCM inheritance risk?

A

autosomal dominant

90
Q

diarrhoea in ETEC?

A

Secretory diarrhoea

91
Q

3 signs or symptoms of immune thrombocytopenia purpura

A

purpura - red blotches under skin
mennoragia
nose bleeds
easy brusiing

92
Q

tx for immune thrombocytopenia purpura?

A

corticosteroids
Corticosteroids e.g. Prednisolone
o IV immunoglobulin e.g. IV IgG - raises platelet count more rapidly than
steroids

2nd line - o Splenectomy
o If splenectomy fails then immunosuppression e.g. Oral/IV azathioprine

93
Q

campylo bacc infection caused by and symptoms

A

meat consumption
24 - 72 hours
severe diarrhoea
bad abdominal pain

94
Q

TLR 2?

A

TB
two tb
lipoteichoic acid on the surface of Gram positive bacteria

95
Q

tlr 3 intracellular or extracellular?

A

TLR-3 is an intracellular receptor. The way to remember is that
TLRs 3, 7,8,9 are intracellular so it can work to remember 7 is then
the two after that and then 3 is a multiple of 9.

96
Q

target of macrolide abx?

A

50S ribosomal subunits are targeted by
macrolide antibiotics.

97
Q

role of desmopressin?

A

can produce vWF in Vwf disease

98
Q

role of furosimide
thiazide
spirolactone

A

thick loop of henle on NA+/CA2+/CL- transporter
Thiazide
diuretics inhibit NaCl transport at the distal convoluted tubules.
Spironolactone act as aldosterone antagonists, causing Na
+ excretion
and a decrease in K
+ and H
+ excretion in the collecting tubules.

99
Q

what ig confronts foreigner first?

A

The initial humoral response is IgM mediated, which are low affinity but
can bind multiple different antigen sites due to their pentameric
structure.

100
Q

principle molecule in viral response ?

A

INF-α is the principle molecule in viral responses, they bind target
innate cells such as macrophages and NK cells and induce an
antiviral state. S

101
Q

best APC in lymph nodes and are in close prixmity to t cells

A

Dendritic cells monitor lymph nodes for antigen. They present
antigen to T cells and are the most efficient and powerful antigen
presenting Cell. R

102
Q

most common infection assosciated with AIDS ?
tx?
ix?

A

Pneumocystis jirovecii pneumonia. This infection is the most
common presentation of AIS and comprises ~40% of all
AIDS-Defining illnesses. Ix includes CXR, showing bilateral mid and
lower-zone interstitial shadowing. Tx with Co-Trimoxazole or IV
pentamidine for 21d.

103
Q

organism to cause chronic diarrhoea in HIV pts ?

A

Chronic diarrhoea is common in HIV infection and Cryptosporidium
is most commonly isolated.

104
Q

1st line tx for bacterial tonsillitis ?

A

The antibiotic of choice would be Phenoxymethylpenicillin (Penicillin V) 4 times daily for 10
days.
clarithromycin if pencillin allergy

105
Q

empyema vs emphysema ?

A

empyema is infection !
empyema; an infection of the pleura resulting in purulent fluid in the pleural
space. This can cause shortness of breath and chest pain due to the pressure increase in
the chest, and fever and night sweats due to the infections. Risk factors for empyema
include pneumonia, chest surgery, chest abscesses etc.
Emphysema would have a more chronic, less infective picture and would generally involve a
thin, cachexic patient with a long history of smoking and a barrel-chest.

106
Q

aneamia from menorrhagia (abnormally heavy or prolonged menstrual bleeding).

A

Low Hb due to blood loss; MCV reduced due to iron deficiency.

107
Q

A 45-year-old male patient with sickle-cell anaemia has had 2 previous sickle-cell crises
this year and is currently experiencing a third with acute chest pain. They are producing
green sputum and their chest x-ray shows right lower lobe consolidation. What medication
can be given to reduce risk of sickle-cell crises in this patient?

A

hydroxycarbmide
Hydroxycarbamide
(hydroxyurea) increases the proportion of foetal haemoglobin and therefore reduces the
proportion of RBCs with haemoglobin S. This reduces the risk of small cell blockage.

Phase 2a (9 decks)

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