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Other MRCEM part 1 > Microbiology > Flashcards

Microbiology Flashcards

1
Q

1st line treatment for severe falciparum malaria?

A

Artesunate

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2
Q

Diarrhoeal illness species which is most likely to develop into a chronic state

A

Typhoid

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3
Q

Complications of MUMPS

A

Meningitis / post meningitis deafness / encephalitis / pancreatitis / orchitis / oophoritis

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4
Q

Which infection is subacute sclerosing panecephalitis associated with?

A

Measles

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5
Q

FBC result in whooping cough

A

Lymphocytosis

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6
Q

Acute hepatitis B serology

A

HBsAg, HBeAg, Anti-HBc IgM

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7
Q

Chronic hepatitis B serology

A

HBsAg, anti-HBe, anti-HBc IgG

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8
Q

Cleared infection Hep B serology

A

Anti-HBs, anti-HBe, anti-HBc IgG

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9
Q

Vaccinated against HepB serology

A

Anti-HBs

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10
Q

Which drugs are used in each phase of TB tx

& timeframe

A

Initial - Isoniazid, rifampicin, ethambutol, pyrazinamide (2 MONTHS)

Continuation - Isoniazid & rifampicin (4 MONTHS)

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11
Q

Herpes simplex encephalitis, which region of the brain is abnormalities seen on imaging?

A

Temporal lobe

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12
Q

Infective endocarditis in IV drug users most commonly caused by which pathogen?

A

Staph. areus

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13
Q

First line treatment for typhoid fever?

A

Cefotaxine / ceftriaxone

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14
Q

How does N.gonorrhoea adhere to genital mucosa?

A

Using fimbriae

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15
Q

Most common cause of gastroenteritis …

  1. Adults
  2. Children
A

Norovirus
Rotavirus

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16
Q

Define incubation periods

A

the period between the infection of an individual by a pathogen and the manifestation of the illness or disease it causes

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17
Q

Incubation period for rubella

A

2-3 weeks

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18
Q

How does Giardia attach to gut mucosa?

A

Sucking discs

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19
Q

How to E.coli attach to host epithelial cells in the urinary tract

A

Pili

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20
Q

When is Hep B given in the childhood vacc schedule?

A

2,3,4 months

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21
Q

N. Goborrhoeae mechanism of attachment

A

Fimbriae

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22
Q

Deficiency in what makes you particularly susceptible to herpes simplex?

A

T cell deficiency

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23
Q

What causes T cell deficiency (4)

A

HIV infection
Chemo
Corticosteroid therapy
Organ transplant

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24
Q

Which malaria pathogen causes the most severe and progressive illness?

A

Falciparum

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25
Q

What % of Hep B infections become chronic?

A

10%

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26
Q

Rheumatic fever is…

A

Post infectious immune-mediated reaction secondary to Streptococcus pyogenes

Characterised by myocarditis, endocarditis, reactive arthritis, chroea and skin complaints

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27
Q

Tx for F.malariae which can be used in those pregnant in all trimesters? (2)

A

IV artesunate

OR

Quinine with clindamycin

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28
Q

1st line in osteomyeletitis

A

Flucloxacillin

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29
Q

Commonest helminth in the UK

A

Threadworm

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30
Q

Where do the threadworm ova hatch

A

Upper GI tract (digestive juices activate)

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31
Q

Tx for threadworm

A

Combined family hygiene methods

+ mebendazole

(single dose, second dose can be given after 2 weeks).

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32
Q

Cysticercosis

A

Larvae of tape worms enter the blood stream and dissemintate forming cyst like lesions in muscles / skin / eyes and brain (neurocysticercosis)

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33
Q

Tx for tapeworms

A

Niclosamide / Praziquantel

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34
Q

Complications of roundworm infection

A

Pneumonitis
Intestinal obstruction
Malnutrition
Hepatic abscess

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35
Q

Tx for round worm

A

Mebndazole

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36
Q

How is hookworm usually acquired?

A

Walking barefoot in soil contaminated with human faeces

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37
Q

Tx for hook worm

A

Mebendazole

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38
Q

Define malaria

A

Ix of RBC caused by a protozoan parasite

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39
Q

Which RBC defects confer some protection against P.falciparum

A

Sickle cell
Thalassaemia
G6PD deficiency

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40
Q

Where do malarial sporozoites replicate / mature

A

Liver

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41
Q

What is released into the blood steam following maturation of sporozoites in the liver?

Which invade what?

Forming what?

A

Merozoites which invade erythrocytes forming erythrocytic schizonts

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42
Q

What causes the clinical features of malaria

A

erythrocytic schizonts RUPTURE -> release merozites and desctruct RBC -> acute inflamm response -> cytokines

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43
Q

Uncomplicated malaria sx

A

Fever, chills, sweats, headaches, muscle pains, N&V

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44
Q

Severe malaria sx

A

Confusion, coma, focal neurological sx, severe naeamia, reap difficulties

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45
Q

Common cause of severe malaria

A

Plasmodium falciparum

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46
Q

When should a dx of malaria be considered?

A

Acutely unwell / pyrexic travellers returning from endemic areas

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47
Q

What is required to exclude a malaria diagnosis?

A

3 negative malaria smears 12-24hrs apart

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48
Q

In context of malaria…

Thick blood film used for what ?

Thin?

A

Confirm malaria diagnosis

Diagnose species of plasmodium

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49
Q

Which malarial sporozites can become latent hynozoites and reactivate months / years later?

A

P. ovale and P. vivax

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50
Q

Recommended tx for uncomplicated P. falciparum malaria

A

Artemisinin combo therapy

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51
Q

How is specific causes of GI viral infections diagnosed?

A

NAAT of stool sample

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52
Q

Why can norovirus ccur in people of all ages?

A

Because immunity is not long lasting

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53
Q

Most common cause of gastroenteritis in children?

A

Rotavirus

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54
Q

When is the rotavirus vaccine given in children?

A

2 & 3 MONTHS

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55
Q

Where is candida spp. found naturally in the body?

A

Skin, GI tract, female genital tracr

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56
Q

What does candida look like on microscopy?

A

Gram +ve spores and pseudohyphae

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57
Q

Intense exposure to what can put you at risk of cryptococcus?

A

Pigeons

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58
Q

Cryptcoccus neoformans transmission

A

Inhalation of spores from bird drppings

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59
Q

Diagnosis of Cryptcoccus

A

Direct microscopy of CSF, antigen detection of latex-agglutination test or culture

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60
Q

Tx of cryptococcus meningitis

A

Amphotericin or flucytosine

then oral fluconazole for 8 weeks or unti cultures -ve

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61
Q

Oral tx for dermatophytes?

A

Terbinafine

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62
Q

Klebsiella spp. bacterial properties

A

Anaerobic
Gram neg
Rods

OPPORTUNISTC

63
Q

Klebsiella spp. found where in the body ?

A

GI and URT

64
Q

Klebsiella spp. typically cause what type of infection?

A

Noscomal ix

65
Q

Common infections caused by Klebsiella spp.

A

Ventilator associared pneumonia

Catheter associated UTI

Device related / wound infectin

Septiicaemia

Neonatal meningitis

66
Q

Characterisation of Klebsiella spp. CAP

A

Rare
Severe
Red current jelly sputum

67
Q

Salmonella spp. characteristics?

A

Anaerobic
Gram -ve
Bacilli

68
Q

Presentation of enteric (typhoid) fever?

A

Fever, systemic upset, abdominal pain, alteration of bowel habit, splenomegaly, rash of rose spots

69
Q

What happens to typhoid chronic carrier?

A

Gall bladder and bowel colonisation

70
Q

Tx of salmonella entercolitis?

A

Self limiting usually

If severe - cipro or cefotaxime

71
Q

First line tx for typhoid fever?

A

Cefotaxime

72
Q

E. coli characteristics?

A

Anaerobic
Gram negative
Bacilli

73
Q

Pathogenic mechanisms of E.coli strains

A

Pili (particularly in urinary tract)
Capsule
Endotoxin
Exotoxins

74
Q

Why are newborns exposed to E.coli?

A

Colonisation in the the vaginal canal

75
Q

Types of diarrhoea caused by E.coli strains

A

Exotoxin mediated watery (travellers)

Enteroinvasive disease

Haemorrhagic dysentery

76
Q

Characteristics of H. pylori

A

Motile
Gram neg
Spiral bacillus

77
Q

Where doea H. pylori exclusively live?

A

Gastric mucosa

78
Q

What does H. pylori secrete to protect itself?

A

Urease, raises gastric pH

79
Q

Characteristics of Campylobacter jejuni

A

Gram -ve
Rod

80
Q

Typical clinical features of Campylobacter ix

A

Fever
Flu like illness
Abdo pain / cramps
Profuse / occasionally blood diarrhoea
N&V

81
Q

Tx of Campylobacter ix

A

Usually self limiting

1st line clarithromycin

82
Q

Complication of Campylobacter ix (2)

A

Reactive arthritis

Gullain-Barre syndrome

83
Q

Clostridium perfringens characteristics

A

Gram postivie rod, obligate anaerobe, spore forming and produces an exotoxin

84
Q

Clostridium perfringens typically causes

A

Gas gangrene / food poisoning

Gas gangrene is a form of necrotising fasciitis caused by Clostridium species (most commonly C. perfringens), resulting in gas being produced by the bacteria within the tissue.

85
Q

Clostridium tetani characteristics?

A

Gram +ve, rod, obligate anaerobe, spore forming, produces tetanospasim

86
Q

What disease does Clostridium tetani cause?

87
Q

C.diff characteristics

A

Gram +ve, rod, obligate anaerobe, spore forming, produces Toxin A (enterotoxin) and B (cytotoxin)

88
Q

C.diff causes

A

Pseudomembranous colitis

89
Q

What do c.diff toxins do

A

Cause intestinal fluid secretion, tissue damage resulting in profuse watery diarrhoea, abdo cramps, fever, rigors and sepsis

90
Q

Complications
of pseudomembranous colitis

A

Toxic megacolon
Bowel perforation
Dehydration
AKI
Electrolyte disturbance
Systemic toxicity

91
Q

Pseudomembranous colitis tx

A

Stop implicated abx

1st line - vancomycin orally QDS for 10 days

2nd line Fidaxomicin

Fluid and electrolyte management

Strict barrier / isolation, hand washing

92
Q

Management of gas gangrene

A

Rapid surgical debridement of necrotic tissue
Fasciotomy
Removal of FB
Wound cleansing and packing

Abx - penicillin, gentamicin, metronidazole

Consider hyperbaric O2 therapy

93
Q

MOA of tetanospasmin

A

Impaires the the membrane of syntaptic vesicles, presents release of GABA at pre-synaptic membrane, nil inhib control -> spasm

94
Q

Incubation period of C. tetani

A

Av 10 days (3 - 22)

95
Q

Tx for C.tetani

A

Wound debridement

Abx - metronidazole

IV TETANUS IMg

Tetatnus toxid immunisation

Benzos, non dpol NMB and baclofen for spasms

Supportive care

96
Q

Immunisation schedule for tetanus

A

2 months
3 months
4 months

3.5 - 5 years

13 - 18 years

97
Q

N. meningitidis characteristics

A

Gram negative cocci, aerobe, encapsulated

98
Q

What doe N. meningitidis cause

A

Meningitis and meningococcal sepsis

99
Q

Why do those with complement deficiencies have an increased of developing meningococcal bacteriaemia?

A

Immunity is dependent on compliment activation

100
Q

CSF in meningitis:

A

Cloudy and turbid
Raised WCC - mainly neutrophils
High protein
Low glucose
Gram -ve diplococci on microscopy

101
Q

Vaccines against N.meningitidis

A

Men B - 2,4,& 12 months
MenC - 1yr
Men ACWY - 14yrs

102
Q

N. Gonorrhoeae characteristics

A

-VE Gram stain
Cocci
Aerobe

103
Q

N. Gonorrhoeae can cause…

A

Urethritis, epidiidymo-orchitis, PID, septic arthritis, endocarditis, neonatal conjunctivitis

104
Q

How does N. Gonorrhoeae adhere to epithelium

105
Q

1st line tx for N. Gonorrhoeae

A

STAT IM Cef

Azithromycin as a single dose

106
Q

Typical CXR findings in TB

A

Upper lobe involvement with cavitation / consolidation / fibrosis

107
Q

Initial phase of TB tx

A

2 months

Isoniazid
Rifampicin
Pyrazinamide
Ethambutol

108
Q

MOA of quinolones

A

Interfere with bacterial nucleic acid synthesis

109
Q

CSM warning re quinolones

A

May induce convulsions, increased risk if take an NSAID with it
(GABA antagonists)

110
Q

Caution with use of quinolones over which age?

111
Q

Caution with use of quinolones due to risk of tendon damage, taking which medication alongside?

A

Corticosteroids

112
Q

Ciprofloxacin dose in uncomplicated gonorrhoea

A

500mg 1 dose

113
Q

Within what timeframe should an antiviral be started in shingles?

114
Q

Who may require post-exposure prophylaxis of varicella zoster infection?

A

Neonates
Pregnant women
Immunocompromised individuals

115
Q

What can be given to tx severe or complicated falciuparum malaria if artesunate not available?

A

Quinine IV, should complete the course

Add doxy when able to swallow

116
Q

Quinine potential SE in pregnancy?

A

Increase risk of uterine contractions and hypoglycaemia

117
Q

Legionella characteristics

A

Gram -ve, rod, obligate aerobes

118
Q

Characteristics of legionella?

A

Gram neg, rod, obilgate aerobes

119
Q

Host risk factors for legionella pneumonia?

A

Male
Older
Previous lung disease
Smoking
High alcohol intake
Immunosupression

120
Q

Systemic features associated with legionnaires disease

A

Nausea, vomiting, diarrhoea, headache, malaise, confusion and renal failure

121
Q

Characteristics of pseudomonas?

A

Gram negative rod, obligate aerobe

122
Q

Risk factors for pseudomonas

A

CF
Burns
IV drug users
Diabetes mellitus
Neutropenia
Immunosuppression
Indwelling catheter

123
Q

Chlamydia trachomatis characteristics

A

Gram negative obligate intracellular organisms

124
Q

Chlamydia peripartum transmission can caused what Ix in the neonates?

A

Neonatal opthalmic infection / pneumonias

125
Q

What can be given to pregnant women who are not immune to VSZ virus who have had significant contact with an infected person?

A

varicella-zoster immunoglobulin (VZIG) within first 10 days of contact

(in the case of continuous exposures, this is defined as 10 days from the
appearance of the rash in the index case). 3

126
Q

Obligate pathogen =

A

Require a host to fulfil their life cycle. All viruses are obligate pathogens as they are dependent on the cellular machinery of their host for their reproduction.

127
Q

Giemsa stain used to identify?

128
Q

Fluorescent
microscopy used to identify?

129
Q

Which antibodies are diagnostic for Hep A?

A

Anti- HAV IgM antibodies

130
Q

When is faecal shedding demonstrated in Hep A infection (in relation to jaundice sx)

A

For 2-3 weeks before and a week after

131
Q

Measles:

transmission

incubation period

A

Respiratory droplet route

9 - 12 days

132
Q

Measles - relation of infectivity to rash

A

Patients are infectious from about 3 days before rash emerges to 4 days after

133
Q

Measles, key exam finding in the mouth

A

Koplik spots (white papules on buccal mucosa),

134
Q

Measles rash

A

Maculopapular rash appearing first behind the ears and spreading to whole body, rash resolves after 7 - 10 days

135
Q

When is the MMR vaccine given?

A

1 y/o AND at pre school age (3 yrs + 4 months)

136
Q

Mumps:

Transmission

Incubation

A

Respiratory droplet

14 - 24 days

137
Q

Key distinguishing features in Mumps

A

Bilateral tender parotitis, usually resolves after about 7 - 10 days

138
Q

Measles secondary complications:

A

Secondary bacterial infection (pneumonia, bronchitis, otitis media), encephalitis, subacute sclerosing panencephalitis

139
Q

Rubella secondary complications:

A

Arthritis, encephalitis, congenital rubella syndrome (deafness, cataracts, cardiac defects, microcephaly, cognitive impairment, intrauterine growth restriction)

140
Q

Congenital rubella syndrome

  • which trimester has highest risk?
  • Potential complications of maternal ix
A

1st

Foetal death
Severe abnormalities - sensorineural deafness / cataracts / cardiac / microcephaly / IUGR / cognitive impairment

141
Q

Complications of Mumps

A

Meningitis, post meningitis deafness, encephalitis, orchitis (+ infertility), oophoritis, pancreatitis

142
Q

What organisms are most common causes of neonatal meningitis?

A

Group B strep (+ve cocci) and E. Coli (-ve rods)

143
Q

Characteristics of streptococcus pneumoniae

A

Gram +ve, cocci, anaerobe

144
Q

Most common cause of CAP

A

streptococcus pneumoniae

145
Q

Characteristics of streptococcus pyogenes

A

Gram +ve, cocci, anaerobe

146
Q

Streptococcus pyogenes also know as?

A

Group A beta-haemolytic streptococci

147
Q

How is Streptococcus pyogenes spread?

A

Respiratory droplets or direct contact with infected wounds on the skin

148
Q

How is streptococcus pneumoniae spread?

A

Respiratory droplet

Ix can be endogenous also

149
Q

Staph Aureus characteristics?

A

Gram +ve, cocci, anaerobe

150
Q

What is beta haemolysis ?

A

Beta-hemolysin breaks down the red blood cells and hemoglobin completely. This leaves a clear zone around the bacterial growth. Such results are referred to as β-hemolysis (beta hemolysis).

151
Q

What is alpha haemolysis ?

A

Alpha-hemolysin partially breaks down the red blood cells and leaves a greenish color behind.

152
Q

Staph epidermis characteristics?

A

Gram +ve, cocci, anaerobe

153
Q

Staph epidermis usually involved in infections.

A

Devices (cardiac / lines / prosthetic)

Other MRCEM part 1 (5 decks)

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