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Pathology and final year > Microbiology > Flashcards

Microbiology Flashcards

1
Q

describe the appearance of listeria monocytogens

A

β-haemolytic anaerobic Gram-positive rod/ bacillus

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2
Q

common cause of travellers diarrhoea

A

e. coli

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3
Q

casues of non-bloody diarrhoea

A

giardia
vibrio cholera
bacillus cereus

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4
Q

pt develops sudden diarrhoea and non bloody diarrhoea after eating re-heated rice

A

Bacillus cereus

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5
Q

pear-shaped trophozite containing two nuclei, four flagellae and a suction disc is…

A

Giardia lamblia

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6
Q

anaemia, thrombocytopenia and renal failure

A

haemolytic uraemic syndrome casued by 0157:H7 toxin from E. coli

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7
Q

Examples of live attenuated vaccination

A

live pathogen but made less pathogenic (is grown in non human tissue)

(MMR-VBOY)
MMR
VZV
BCG
oral- polio, typhoid
yellow fever

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8
Q

examples of inactivated vaccines

A

quadravalent influenze
polio
cholera
bubonic plague
hepA
Rabies
Pertussis

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9
Q

examples of conjugate vaccines

A

(NHS-T)
N meningitidis
H influenzae
Strep pneumonia
Tetanus

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10
Q

examples of DNA/RNA vaccines

A

Sars-CoV-2 (mRNA)
adenovirus

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11
Q

examples of adjuvents

A

alum (most common)
CpG
complete freunds adjuvent

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12
Q

mechanism of alum as an adjuvent

A

antigens absorbed into alum as a means of slowly releasing the antigen
activates Gr1+ cells produce IL4 –> primes naiive B cells

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13
Q

mechanism of CpG as an adjuvent

A

activates TLR on APCs

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14
Q

causes of bloody diarrhoea

A

shigella
campylobacter jejuni
E.coli
entamoeba hystolytica
salmonella
yersinia

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15
Q

comma shaped bacteria

A

vibrio cholera

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16
Q

what is the difference in pattern of paralysis between GBS and clostridium botulinum

A

GBS- ascending paralysis
C. botulinum- descenting paralysis

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17
Q

Rose spots are pathopneumonic for what infection

A

Salmonella typhi

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18
Q

flask shaped ulcer is caused by what infection?

A

Entamoeba hystolytica

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19
Q

CSF analysis shows very high protein, low glucose and high lymphocytes is likely to be…

A

mycobacterium tuberculosis meningitis

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20
Q

what kind of media is best for culturing neisseria meningitidis

A

grown best on Thayer–Martin VCN media as only allows n. meningitidis to grow

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21
Q

what is the causative organism of lyme disease

A

borrelia burgdorferi

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22
Q

Gram-negative coccobacillus that causes a painful ulcer

A

Haemophilus ducreyi

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23
Q

differential diagnosis for genital ulcer

A

PAINFUL:
Herpes simplex
haemophilis ducreyi

PAINLESS:
primary syphilis
lymphogranuloma venerum

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24
Q

what STI can be cultured on chocolate agar?

A

haemophilus ducreyi

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25
Q

drug of choice in cases of methicillin-resistant Staphylococcus aureus infections (MRSA)

A

vancomycin

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26
Q

side effects of chloramphenicol

A

aplastic anaaemia

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27
Q

complications of human herpes virus 8

A

Kaposi’s sarcoma
multicentric castleman disease
primary effusion lymphoma

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28
Q

antiviral used in the treatment of influenza

A

oseltamivir

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29
Q

causative organisms of encephalitis

A

HSV1, west nile virus, flavivirus

listeria monocytogens encephalitis (worse than listeria meningitis)

Amoebic: naegleria fowleri, habitat, acanthoemeba

toxoplasma gondii (cats)

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30
Q

bacterial causative organisms of meningitis

A

direct bacterial toxicity or indirect inflammatory reponse

N. meningitidis , strep pneumoniae, H influenzae

neonate and elderly: GBS, listeria, E.coli

Chronic: TB

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31
Q

causative organisms of

A
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32
Q

causative organisms of

A
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33
Q

common viral casues of meningitis

A

enteroviruses (coxsackie, echovirus), mumps, HSV2, measles, VZV

(usually asceptic meningitis)

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34
Q

brain abscess pathology

A

otitis media/mastoiditis/paranasal sinuses
endocarditis/haematogenously

Microbiology:
Streptococci (both aerobic and anaerobic)
Staphylococci,
Gram-negative organisms. (particularly in neonates)
Mycobacterium tuberculosis
fungi
parasites
Actinomyces and Nocardia species

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35
Q

causes of viral hepatitis

A

hepatitis A-E
EBV
CMV

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36
Q

describe Hepatitis A

A

faecal-oral transmission
only ever acute
2-6wks incubation period

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37
Q

symptoms of acute hepatitis

A

Non-specific systemic Sx:
fever, malaise, fatigue, loss appetitte
Abdo pain

Acute raised bilirubin:
Jaundice
dark urine
(pale grey or white stool)
puritis

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38
Q

Investigations for HAV

A

anti-HAV IgM- acute infection
may be neg first week
anti-HAV IgG- immunity

If ALT>500- order IgM as IgG will not be high yet so will give a false negative

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39
Q

Managament of hep A

A

mainly supportive

vaccination is available but not in UK

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40
Q

describe Hepatitis B

A

parental, vertical, sexual
2-6 months incubation

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41
Q

what defines chronic HBV and what are the complications

A

HBsAg reactivity persisting >6months

comp:
Cirrhosis
hepatocellular carcinoma
extra hepatic manifestations

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42
Q

describe HBV serology

A

HBsAg- if positive= active infeciton
E antigen- denotes viral replication and will be high with a high viral load

HBcAg- acute infection
AntiHBc Ab- past or present exposure
antiHBs- immune either from infection or immunisation

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43
Q

radiological findings of cirrhosis

A

coarse echotexture, nodularity, portal HPTN- splenomegaly

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44
Q

tumour marker for hepatocellular carcinoma

A

alfa fetoprotein

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45
Q

when is HBV vaccine given

A

2,3,4 months

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46
Q

screening in pregnancy

A

HBsAg positive, eAg negative: vaccine at birth + routine
schedule

HBsAg positive, eAg positive: vaccine at birth PLUS
HBIG within 48 hours

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47
Q

Describe Hep C

A

ssRNA, flavivirdae
transmission through blood products, sharing needles, sharing snorting
2wk-6month incubation
40-60%
progress to
chronicity

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48
Q

Investigations for HCV

A

Hep C RNA PCR should be requested if acute infection suspected

If RNA is negative then it means pt does not have infection

if anti-HCV Ab positive- exposure

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49
Q

managament of HCV

A

Acute infection:
treated with direct acting antivirals
12wk Tx course OD

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50
Q

describe hepatitis D

A

Only co-infects with hepatitis B leading to severe acute disease

vaccination agains hep B will protect against hep D

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51
Q

describe hepatitis E

A

hepeviridae ssRNA virus
2-8wks incubation
never chronic infection except in immunocompromised

30% mortality in pregnant women

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52
Q

extrahepatic manifestations of hepatitis E

A

thrombocytopenia, red cell aplasia

proximal myopathy, necrotising myositis

encephalitis, ataxia, brachial neuritis

membranoproliferative glomerulonephritis, IgA nephropathy

53
Q

extrahepatic manifestations of hepatitis B

A

polyarteritis nodosa
sick serum syndrome
arthritis
cryoglobulinaemia

54
Q

extrahepatic manifestations of hepatitis C

A

cryoglobulinaemia
glomerulonephritis

55
Q

in what situations would a viral infection required treatment with antivirals

A

COVID- resp failure
chicken pox- varicella pneumonitis
herpes- encephalitis
viral hep- chronic hep C
monkey pox - eye lacerations

56
Q

general rule of Acute vs chronic infection in terms of DNA and RNA viruses

A

RNA viruses- acute and generally cleared by immune system (exception to retroviruses)

DNA viruses - chronic infections as they find ways to hide within human body

57
Q

treatment for HSV encephalitis

A

Start empiric treatment immediately with iv Acyclovir 10mg/kg tds without waiting for test results

If confirmed, treat for 14 - 21 days *

58
Q

MOA of acyclovir

A

guanasine analogue
inhibits DNA synthesis

59
Q

what metabolises acyclovir to make it active

A

viral thimadine kinase

60
Q

complications of CMV in immunocompromised

A

Colitis
Pneumonitis
Hepatitis
Retinitis
Bone marrow suppression

only treat CMV with signs of complications not just infection

61
Q

what are owls eyes inclusions a sign of

A

CMV colitis

62
Q

complications of congenital CMV infection

A

ears: sensorineural deafness
eyes: chorioretinitis
heart: myocarditis
neurology: microcephaly, encephalitis
lung: pneumonitis

63
Q

complication of chronic EBV infection

A

Chronic infection in immunocompromised->Post-Transplant Lymphoproliferative

DiseaseLatently infected B cells – polyclonal expansion

Predisposes to lymphoma

64
Q

most common cause of bronchiolitis

A

Respiratory syncytial virus

65
Q

Treatment of bronchiolitis in severe cases

A
  • mostly untreatable
  • ribavirin
  • IgG
66
Q

What is used as propylaxis for RSV infection

A

prevention- palivizumab

67
Q

antiviral drugs in COVID

A

early infection- antivirals:
-Nirmatrelvir, remdisivir

Late
- steroids
Baricitinib (requiring O2) – JAK inhibitor
IL-6 inhibitors (Tocilizumab / Sarilumab) – advanced respiratory support

68
Q

complications of BK virus

A

haemorrhagic cystitis
BK Nephritis & ureteric stenosis

69
Q

what is the main mechanism of resistance for acyclovir

A

thymidine kinase mutation
- enzyme involved in metabolising acyclovir to an active form to stop viral DNA synthesis

70
Q

3 taxonomic families of parasites

A

Cestodes (hydatid, tapeworm)

Trematodes (lung, liver and intestinal fluke, schisto

Nematodes (roundworms- hookworm, ascarids, strongyloids)

71
Q

treatment of worms

A

praziquantel

72
Q

example of a hydatid disease and what is the definitive host?

A

echinococcus
dogs

73
Q

what is the life cycle of schistosomiasis

A

Cercariae invade human skin when in contact with contaminated water.

Worms develop in venous plexus

Eggs excreted in faeces or urine

Hatch into miracidia, which parasitise snails

Snails release cercariae

Adult schistosomes lay eggs:
Migration of eggs through bladder or bowel causes damage
Retrograde passage of eggs into the liver causes “cirrhosis”

74
Q

diagnosis of schisto

A

microscopy:
Urine: S. haematobium
Stool: S. mansoni, S. japonicum

serology
biopsy

75
Q

signs and symptoms of schisto

A

fevers, chills

chronic: cirrhosis

76
Q

examples of soil transmitted helminths

A

ascaris lumbricoides
trichuris trichiura
hookworm
strongyloids stercoralis

77
Q

incubation period of p falciparum malaria

A

1wk-3months

78
Q

incubation period of viral haemorrhagic fever

A

3-21 days

79
Q

treatment for p falciparum

A

SEVERE: IV artesunate
MILD: oral artemisinin combination therapy eg. riamet,
malerone

80
Q

what investigation do you need to determine severe from non severe maleria

A

parasitaemia

81
Q

examples of malarial prophylaxis

A

malarone
mefloquine
doxycycline

82
Q

presentation of malaria

A

~15 days after bite (vivax several months, falciparum ~10-30days)

fevers- cyclical or ontinuous with spikes
chills, sweats
altered GCS
resp distress
AKI
hepatic failure
coagulopathy
haemolytic anaemia
hypoglycaemia

83
Q

schiznot : spot diagnosis

A

maleria

84
Q

treatment of non-falciparum

A

3 days oral chloroquine + primaquine 14 days after

CHECK G6PD deficiency

85
Q

spot diagnosis:
can leave palm print on rash, thrombocytopenia

A

dengue

86
Q

what is dengue spread by

A

ades aegypti mosquito

(bites during the day)

87
Q

symptoms of dengue

A

can be asymptomatic

retro-orbital headache
myalgia
nausea, vomiting
sunburn rash- palm print

severe abdo pain
ecchymoses
organ impairment
shock

88
Q

anorexia, constipation, abdo pain
vacant expression
T39 (himalaya peak temps), HR90
normal Plts

returned from india
gram negative rod on culture

A

salmonella typhi

89
Q

management of salmonella thyphi

A

fluids
IV ceftriaxone with oral azithromycin follow on

90
Q

Abx of choice for MRSA

A

vancomycin

91
Q

what is the cell targeted by EBV and what does it bind to

A

B cells
binds to complement receptor

92
Q

opportunistic infections / AIDS defining

A

pneumocystis jerovecii
TB
JC virus- progressive multifocal leukoencephalopathy
cryptococcus neoformans
Candida
toxoplasmosis
oral hairy leukoplakia
shingles

93
Q

causes of a ring enhancing lesion with oedema on brain MRI

A

toxoplasmosis
TB
Bacterial brain abscess
primary CNS lymphoma

94
Q

uveitis, genital ulcer, oral ulcer
japanese

A

Bechets

95
Q

Cancer of what organ is commonly associated with schistosomiasis infection?

A

bladder

96
Q

lancfield grouping used to classify which type of pathogenic organism

A

streptococci

97
Q

what is the treatment for visceral leishmaniasis

A

Liposomal amphotericin B

98
Q

treatment of tapeworms

A

praziquantel

99
Q

What is the primary infective lesion produced by Mycobacterium tuberculosis called in the lungs?

A

ghon focus
caseating granuloma

100
Q

Give an example of a scoring system which can be used in primary care to guide if antibiotics may be beneficial for a sore throat?

A

CENTOR

fever, tonsillar exudate, anterior cervical lymphadenopathy, and absence of cough

101
Q

A Löwenstein-Jensen medium is used to facilitate growth of what respiratory pathogen?

A

TB

102
Q

Most common cause of aseptic meningitis

A

Enteroviruses eg. Coxackie or echovirus

103
Q

how is cellulitis classified for treatment

A

Eron classification
I- systemically well and no comorbitities
II- comorbidities either systemically well or unwell
III- significant systemic upset including confusion, hypotension, tachycardia and comorbidities
IV- sepsis or nec fasciitis

admission for IV antibiotics
- class III or IV
- rapidly progressing
- <1year
- periorbital/ orbital cellulitis

104
Q

most common organism found on central line infections

A

staph epidermidis

105
Q

features of legionairres pneumonia and how is it diagnosed and treated ?

A

flu-like symptoms including fever (present in > 95% of patients)
dry cough
relative bradycardia
confusion
lymphopaenia
hyponatraemia
deranged liver function tests
pleural effusion: seen in around 30% of patients

diagnosis:
urinary antigen test

Rx:
erythromycin/ clarythromycin

106
Q

features of leptospirosis, RFs and Rx

A

RFs:
sewage workers, farmers, returning travellers

features:
the early phase is due to bacteraemia and lasts around a week
may be mild or subclinical
fever
flu-like symptoms
subconjunctival suffusion (redness)/haemorrhage

second immune phase may lead to more severe disease (Weil’s disease)
acute kidney injury (seen in 50% of patients)
hepatitis: jaundice, hepatomegaly
aseptic meningitis

Rx:
benzylpenicillin or doxycycline

107
Q

describe the CURB 65 score

A

Confusion- 1
Urea >7mmol/L -1
RR >30 - 1
BP <90/60 -1

score 0-1: can be managed in community with amoxicillin PO for 5 days

score 2- amoxicillin PO 5-7 days + clarythromycin
consider admission

score 3-5 - admission, consider ITU, IV co-amoxiclav + clarythromycin 7d

108
Q

mechanisms of antimicrobrial resistance and examples of each

A

BEAT

Bypass antibiotic sensitive step- eg. MRSA

Enzyme- mediated drug inactivation eg. beta-lactamases

Accumulation of drug impairment eg. tetracycline resistance

Target modification - eg. quinolone resistance

109
Q

HIV positive, multiple ring-enhancing lesions on CT scan and a negative thallium SPECT scan.

A

toxoplasmosis

110
Q

single, homogenous-enhancing lesion and a positive (rather than negative) thallium SPECT scan

A

CNS lymphoma

111
Q

treatment for CNS toxoplasmosis infection in immunocompromised

A

sulfadiazine and pyrimethamine

112
Q

antibiotics used for MRSA

A
  1. vancomycin
  2. teicoplanin
  3. linezolid
113
Q

what infection is commonly associated with post gastroenteritis lactose intolerance?

A

giardia lamblia

114
Q

dry cough, arthralgia, cold agglutanin test/ AIHA, erythema multiforme

A

mycoplasma pneumoniae

115
Q

treatment for genital warts

A

multiple, non-keratinised warts: topical podophyllum

solitary, keratinised warts: cryotherapy

116
Q

post exposure prophylaxis for HBV

A

positive HBV-Ag
known responder to vaccine - give vaccine booster
known non responder or no vaccine- give IVIg and vaccine booster

117
Q

features of HIV seroconversion

A

3-12 weeks post infection

lymphadenopathy
malaise, myalgia, arthralgia
diarrhoea
maculopapular rash
mouth ulcers
rarely meningoencephalitis

118
Q

what should be done if an HIV+ person has a CD4+ count of <200/mm3

A

prescribe co-trimoxazole prophylaxis for PCP

119
Q

which antibiotic is commonly associated with a disulfiram- like reaction when consumed with alcohol

A

metronidazole
Sx: nausea, vomiting and flushing

120
Q

what is cushings triad

A

Sign of raised ICP

hypertension with a widened pulse pressure
bardycardia
irregular breathing

as a result of cerebrum compression

therefore LP contraindicated

121
Q

what are some causes of a false positive non-treponemal test for syphilis (eg. VDRL, rapid plasma reagin test)

A

Some Times Problematic Mistakes Happen

SLE
TB
Pregnancy
maleria
HIV

122
Q

Negative non-treponemal test + positive treponemal test :

A

consistent with sucessful treatment of syphilis

123
Q

Positive non-treponemal test + negative treponemal test

A

consistent with a false-positive syphilis result e.g. due to pregnancy or SLE

124
Q

Positive non-treponemal test + positive treponemal test

A

consistent with active syphilis infection

125
Q

prophylaxis for animal bites

A

co-amoxiclav
or
doxy + metronidazole if penicillin allergic

126
Q

antibiotics used for cellulitis

A

Eron I
flucloxacillin
erythromycin if penicillin allergic

Eron class II-IV
IV co-amoxiclav, clindamycin, erythromycin, ceftriaxone

127
Q

lab features of pseudomonas aeruginosa

A

Gram-negative rod
non-lactose fermenting
oxidase positive

128
Q

toxins produced by pseudomonas

A

produces both an endotoxin (causes fever and shock) and exotoxin A (inhibits protein synthesis by catalyzing ADP-ribosylation of elongation factor EF-2)

129
Q

what antibiotic can cause a black hairy tongue after discontinuation

A

tetracyclines

Pathology and final year (21 decks)

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