Microbiology Flashcards
Final year med student gets a needle stick injury. Not immune to Hep B despite vaccinations. Blood shows hep B positive. What treatment would you give?
a) Hep B immunoglobulin only
b) Hep B immunisation only
c) Hep B immunisation + immunoglobulin
d) Wait 3 months and recheck
Hep B immunisation + immunoglobulin
Man came back from Cambodia on business a week ago, fevers of 40, headache, muscle aches, given amoxicillin 3 days ago, no help, now has yellow sclera, measured temp of 39. Peeing less, mild derangement of LFTs, high bilirubin 120, anaemia Hb 110, low lymphocytes, Band cells, low platelets 110, and a palpable tender liver 5cm below costal margin. Dx?
a) Malaria
b) HepA
c) Dengue fever
Dengue fever
Fitness model recently been to Sri Lanka, comes back with watery diarrhoea. Stool culture shows S. typhi. Management?
a) Cotrimoxazole b) Ciprofloxacin c) Gentamicin
d) Metronidazole e) Amoxicillin
Ciprofloxacin - Typhoid
- Tx: abx depending on severity and resistance
o Uncomplicated: ciprofloxacin o Severe: ceftriaxone
Chef diagnosed with salmonella. What do you do?
a) Notify public health
b) Investigate source
c) Contact precautions
Notify public health
Guy with 5 days scanty thin yellow penile discharge with casual partner sex 10 days ago. No hx travel. What treatment while awaiting swab results?
a) Ceftriaxone IM
b) Azithromycin PO
c) Augmentin PO
d) Ciprofloxacin
Chlamydia –> doxy or azithromycin
Gonorrhoea – IM ceftriaxone + STAT PO azithromycin =
- Coinfection w/ chlamydia common – give chlamydia tx before results (empiric)
Female has white ‘adherent’ discharge with stable partner, itchy and a bit burny. External genitalia normal on examination. Dx?
a) Candida
b) Trichomoniasis
c) BV
d) Chlamydia
e) Atrophic vaginitis
Candida
IVDU has cough for a while then has a chest x-ray with one abscess and bilateral patchy consolidation. What is the most likely causative organism?
a) Aspergillus
b) Pneumocystis jirovecii
c) Strep pneumoniae
d) Staph aureus
e) Pseudomonas aeruginosa
f) Klebsiella
g) Mycoplasma
?Mycoplasma
Pneumocystis jirovecii
Organism associated with cystic fibrosis?
a) Aspergillus
b) Pneumocystis jirovecii
c) Strep pneumoniae
d) Staph aureus
e) Pseudomonas aeruginosa
f) Klebsiella
g) Mycoplasma
Pseudomonas aeruginosa
Pneumonia not responding to amoxicillin and involving more lobes. What is the most likely causative organism?
h) Aspergillus
i) Pneumocystis jirovecii
j) Strep pneumoniae
k) Staph aureus
l) Pseudomonas aeruginosa
m) Klebsiella
n) Mycoplasma
Mycoplasma
Man presents with a rash, which of these would need to be notified?
a) Varicella
b) Measles
c) Pityriasis rosea
d) Drug reaction
Measles
Women came into hospital with symptoms of CAP. Started on antibiotics (IV amoxicillin + PO roxithromycin), improved over 3 days becoming afebrile then on 5th day got worse, became febrile again with mild general headaches, nausea and rigors plus lower L lobe creps, was tachycardic and hypotensive (shock). What is the most likely cause?
a) Hospital acquired pneumonia
b) IV line bacteremia
c) Empyema
d) Reaction to penicillin
Empyema
Man in his 30’s with wife presented for medical check for his insurance. Both him and wife have never other sexual partners, done drugs or travelled overseas. Tested for HIV, ELISA +ve, Western blot -ve. Diagnosis?
a) False positive ELISA
b) Acute HIV infection
c) Chronic infection
d) Window period of HIV infection
e) HTLV-1
False positive ELISA
You use western blot to confirm ELISA
Which combination of vaccines are used/recommended in pregnancy
a) Influenza and pertussis
b) Varicella and influenza
c) Measles and pertussis
d) Influenza and MMR
e) MMR and Varicella
Influenza and pertussis
Girl with listeria brainstem encephalitis. What antibiotic do you add to gentamicin?
a) Azithromycin
b) Metronidazole
c) Erythromycin
d) Flucloxacillin
e) Other antibiotics
f) Ampicillin
Ampicillin
Listeria tx = ampicillin (IV form amoxicillin) + gentamicin
What is the antibiotic used for bacterial vaginosis? a) Vancomycin
b) Ceftriaxone
c) Metronidazole
d) Erythromycin
e) Flucloxacillin
Metronidazole
25 year old male came back from business trip in North Africa with 3 days of very watery diarrhoea and abdo pain. Examination normal. Most likely pathogen?
a) Campylobacter
b) Enterotoxic E. coli
c) Rotavirus
d) Giardia
e) Schistosomiasis
Enterotoxigenic E. coli = classic cause of traveller’s diarrhoea
- Incubation: 1-3 days
- Sources: faecally contaminated food and water, travel to resource limited settings
- Sx = malaise, anorexia, abdominal cramps and watery diarrhoea
Patient returned from India 3 weeks ago with profuse non-bloody diarrhoea aand some vomiting. Most likely pathogen?
a) Campylobacter
b) Enterotoxic E.coli
c) Rotavirus
d) Giardia
e) Schistosomiasis
Enterotoxic E.coli
Farmer got small cut 5 weeks ago and was given a single dose of tetanus/dip toxoid. Now presents with deep gash in leg/arm. What is best prophylaxis for tetanus?
a) Tetanus
b) Tetanus Ig and tetanus/dip toxoid
c) IM ceftriaxone
d) IV penicillin
e) Tetanus/dip toxoid
Post exposure prophylaxis = tetanus Ig + 3-dose immunisation (if unsure status)
If the tetanus primary course is incomplete, provide tetanus vaccination. If the wound is dirty, also give tetanus immunoglobulin (TIG).
33 year old pregnant lady in third trimester, cut with dirty metal gardening tool. Had tetanus booster at age 26. What do you need to do?
a) ADT at 36 years old
b) ADT now
c) ADT after birth
d) DTaP now
e) DTap after birth
f) No immunisation
DTaP now
Student returns from Malaysia/India with “rose spot” rash on trunk, headaches, myalgia and constipation. What is likely to cause this?
a) Salmonella enterica subtype typhii
b) Bacteriodes
c) Enterococcus
d) Clostridium perfringens
Salmonella enterica subtype typhii
Pregnant teacher 7/40 exposed to rubella and concerned. Given rubella vaccine at 12 years old. Read about teratogenicity on internet. What do you do to reassure?
a) Give vaccine
b) Give acyclovir
c) Ask detailed history about exposure
d) Estimate rubella IgG + IgM
e) Chorionic villus sampling for rubella PCR
Estimate rubella IgG + IgM
Pregnant woman. Her 5 year old child has varicella and has a fever and lots of lesions. Lesions only appeared 24h ago. Woman gets tested and is negative for Varicella Ig. What is the most appropriate course of action?
a) Oral acyclovir
b) Give mum Zoster Igs
c) MMR + Varicella vaccine
d) Varicella vaccine
e) No action
Give mum Zoster Igs
Guy who had noticed some vesicular lesions and shallow ulcers on his penis. His girlfriend gets recurrent cold sores. What investigation would you choose?
a) Swab base of ulcer for bacterial culture
b) Swab base of ulcer for HSV PCR
c) Serology of HSV
d) Take biopsy
e) Girlfriend’s HSV serology
Swab base of ulcer for HSV PCR
HSV is a virus lol
Old guys wife diagnosed with cancer. About to commence chemo and radiation therapy. What vaccination should he get to protect her?
a) Polio
b) Rotavirus
c) Varicella zoster
d) HepA
e) Tetanus toxoid
I guess varicella
COVID + flu
17 year old presents with fever, rubbery lymph nodes in her neck, very sore throat. Spleen palpable under the subcostal margin. Dx?
a) Strep throat
b) Infectious mononucleosis
Infectious mononucleosis
Pregnant lady 8/40 wondering about the flu vaccine.
a) Vaccinate now
b) Defer until 3rd trimester
Vaccinate now
Campers get bulky foul smelling stools, bouts of watery diarrhoea, cramps. What caused this?
a) Giardia
b) Salmonillus or something
c) Shigella
d) Campylobacter
Giardia
Doctor
a) Antiretrovirals
gets needlestick after taking blood from suspected HIV+ patient. What do?
b) Gammaglobulin
c) Check both of their bloods for HIV
tenofovir disoproxil 28 day course - PEP
Dude with AIDS not on antiretrovirals. Presents with headache and seizures. Has a solitary brain lesion. What’s the organism?
a) Toxoplasma gondii
b) Cryptococcus neoformans
Toxoplasmosis
Dude with AIDs has meningitis. CSF high cell count, predominantly neutrophils, low-normal glucose, normal-high protein. Yeast like. Which organism?
a) Toxoplasma gondii
b) Cryptococcus neoformans
Cryptococcal meningitis
23 year old Maori pregnant lady who has had varicella vaccines at pre-pregnancy check 6 months ago. Presents with a rash: scattered vesicles on hands and feet. Fever and sore throat for 3/7. Organsim?
a) Coxsackie A16
b) Syphilis
c) Varicella Zoster
d) Parvovirus
e) Enterococcus
f) CMV
g) HIV
h) Parvovirus B19
a) Coxsackie A16
Woman with pain in band from anterior chest to the back, pain and tingling when touched (hyperaesthesia). Dx?
a) Herpes zoster
b) Eczema
c) Urticaria
Herpes zoster
Herpes zoster oticus
Treatment of uncomplicated UTI?
a) Nitrofurantoin 100mg BD 5/7
b) Trimethoprim 300mg OD 3/7
c) Cefalexin 500mg BD 3/7
Nitro first line before trimeth
Hydatid disease = parasitic infection caused by tapeworm that primarily affects the liver, endemic in many parts of the world – tapeworm lodge in in the liver form multi-lobed hydatid cysts (grow up to 5-10cm)
- Tapeworms live in sheep + dogs humans eat/drink infected food/water Simple hepatic cyst common but lack septa
Most common organism causing pyelonephritis?
a) E. coli
b) Proteus
c) Klebsiella
d) Enterobacter
E. coli
Meningitis. Gram -ve bacilli cultured. Treatment?
a) Ceftriaxone
b) Cefotaxime
c) Vancomycin
Ceftrizone + gentamycin
Viral meningitis. Treatment?
a) Supportive treatment only
b) Vancomycin
c) Cefriaxone
Supportive treatment only
Adult not fully immunized presents with paroxysmal cough. Dx?
a) Pertussis
b) Measles
c) Bronchitis
Pertussis
Man from Zimbabwe. Cervical lymphadenopathy, weight loss, fatigue, night sweats. Dx?
a) HIV
b) TB
c) Lung cancer
HIV
Erythema multiforme
Post splenectomy, which organism are you not at risk of?
a) H influenzae
b) Staphylococcus aureus
c) Streptococcus pneumoniae
d) Neisseria meningitidis
e) E. coli
f) Klebsiella pneumoniae
g) HIV
h) Malaria
Pneumococcus, meningococcus, H influenza
20 year old Maori woman came in 7 day history of non-productive cough, fever and dyspnoea with bilateral patchy consolidation on X-ray. What is the most likely cause?
a) Sarcoidosis
b) Community acquired pneumonia (CAP)
c) Pneumoconiosis
d) TB
CAP
Indian woman with cough and haemoptysis, fever, weight loss and night sweats. CXR showed consolidation and hilar enlargement. Diagnosis?
a) Tuberculosis
b) Lung cancer
c) Pneumonia
TB
Alcoholic woman with SOB and rusty brown sputum. X-Ray showing RLL consolidation. Which organism?
a) Streptococcus pneumoniae
b) Klebsiella pneumoniae
Streptococcus pneumoniae
Pneumonia with hyponatremia. Organism?
b) Aspergillus
c) Pneumocystis jirovecii
d) Strep pneumoniae
e) Staph aureus
f) Pseudomonas aeruginosa
g) Klebsiella
h) Mycoplasma
i) Legionella longbeachae
Legionella longbeachae
Man injured foot 2 days ago, now infected with erythematous line up to the groin, tender inguinal lymph nodes. What organism is responsible?
a) Staph aureus
b) Clostridium perfringens
Staph aureus
Patient from South East Asia has hepatitis B serology. Positive IgG Hbc and anti-Hbs.
a) Current infection
b) Chronic infection
c) Previous infection (cleared)
d) Vaccinated
cleared hbv
