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Microbiology Flashcards

1
Q

Site of Campylobacter jejuni infection

A

Usually infects caecum and terminal ileum.

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2
Q

Relation of lymph with campylobacter jejuni

A

Local
lymphadenopathy is common

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3
Q

Extra intestinal manifestations of campylobacter jejuni

A

lymphadenopathy,
Reactive arthritis is seen in 1-2% of cases

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4
Q

What are Enterobacteriaceae organisms?

A

The Enterobacteriaceae are a large family of Gram-negative bacteria, including many of the more familiar pathogens, such as Salmonella, Shigella and Escherichia coli. Members of the Enterobacteriaceae are bacilli (rod-shaped), facultative anaerobes, fermenting sugars to produce lactic acid

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5
Q

Treatment of shigella

A

Usually self limiting, ciprofloxacin may be required if
individual is in a high risk group

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6
Q

Disease by shigella

A

Clinically causes dysentery

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7
Q

Transmission of salmonella

A

usually transmitted by infected meat
(especially poultry) and eggs

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8
Q

Types and disease of E coli

A

Enteropathogenic
Enteroinvasive: dysentery, large bowel
necrosis/ulcers
Enterotoxigenic: small intestine, travelers diarrhoea
Enterohaemorrhagic: 0157, cause a haemorrhagic
colitis, haemolytic uraemic syndrome and thrombotic
thrombocytopaenic purpura

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9
Q

Cause of travellers diarrhoea and site

A

Enterotoxigenic E coli
Small intestine

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10
Q

Which E coli causes TTP

A

Enterohemorrhagic E coli O157

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11
Q

Shape of Yersinia
enterocolitica

A

coccobacilli

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12
Q

Gram test of iYersinia
enterocolitica

A

Negative

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13
Q

Disease of Yersinia enterocolitica

A

Typically produces a protracted terminal ileitis that
may mimic Crohns disease

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14
Q

Treatment of Yersinia
enterocolitica

A

Usually sensitive to quinolone (inhibits DNA gyrase and topoisomerase IV, to prevent DNA replication -nalidixic acid, ciprofloxacin, levofloxacin and moxifloxacin) or tetracyclines (binding to the 30S inhibits protein synthesis-Doxycycline,Minocycline)

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15
Q

Severe complication of Yersinia enterocolitica

A

Septicemia

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16
Q

Surgical DD of Yersinia enterocolitica

A

Appendicitis

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17
Q

Symptoms of cholera

A

Symptoms include sudden onset of effortless
vomiting and profuse watery diarrhoea

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18
Q

What is the mechanism of action of macrolides?

A

Inhibits protein synthesis

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19
Q

What is P450 inhibitor

A

A cytochrome P450 (CYP450) inhibitor is a substance that prevents the activity of enzymes in the liver and intestines that metabolize drugs, hormones, and other substances. CYP450 inhibition is a common cause of drug-drug interactions

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20
Q

What does the P450 enzyme do?

A

The cytochrome P450 family is a group of enzymes found mainly in the liver which perform oxidation and reduction reactions using iron. These reactions are part of phase 1 metabolism enhancing water solubility thus aiding excretion.

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21
Q

Adverse effects of erythromycin

A

•gastrointestinal upset
•cholestatic jaundice: risk may be reduced if erythromycin stearate is used
•P450 inhibitor

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22
Q

Antibiotics Inhibit cell wall formation

A

penicillins
cephalosporins

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23
Q

Antibiotics Inhibit protein synthesis

A

aminoglycosides (cause misreading of mRNA)
chloramphenicol
macrolides (e.g. erythromycin)
tetracyclines
fusidic acid

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24
Q

Antibiotics Inhibit DNA synthesis

A

Queen’s DNA in a Sulphur containing Metro
quinolones (e.g. ciprofloxacin)
metronidazole
sulphonamides
trimethoprim

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25
Q

Antibiotics Inhibit RNA synthesis

A

rifampicin

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26
Q

Examples of protein synthesis inhibitors aminoglycosides

A

gentamicin, tobramycin, amikacin, plazomicin, streptomycin, neomycin, and paromomycin

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27
Q

Benefits of protein synthesis inhibitor chloramphenicol

A

Chloramphenicol is a widely used topical ointment applied routinely to suture lines and skin grafts, particularly those on the face and around the eyes (bacterial conjunctivitis),otitis externa,also been used for the treatment of typhoid and cholera.

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28
Q

Examples of protein synthesis inhibitor. Macrolides

A

Erythromycin
Clarithromycin
Azithromycin

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29
Q

Examples of protein synthesis inhibitor tetracycline

A

Doxycycline
Minocycline
Along with tetracycline itself

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30
Q

Something about protein synthesis inhibitor fusidic acid

A

Fusidic acid is most effective against gram-positive organisms, such as staphylococcus aureus and staphylococcus epidermidis, including methicillin-resistant staphylococcus aureus (MRSA).

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31
Q

some examples of sulfonamides with caution

A

Sulfamethoxazole/trimethoprim
Sulfasalazine
Furosemide

Caution
They can interact dangerously with other drugs, including prescription and over-the-counter medications, and PABA sunscreens.

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32
Q

Which organism is transported to humans through eating watercress.

A

Fasciola hepatica

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33
Q

What is Fasciola hepatica

A

(parasitic trematode)

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34
Q

illness phase of fasciola hepatica

A

2 acute and chronic

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35
Q

Acute symptoms of fasciola hepatica

A

during the acute phase, the immature worms
begin penetrating the gut, causing symptoms of fever, nausea, swollen liver,
skin rashes, and extreme abdominal pain.

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36
Q

Chronic symptoms of fasciola hepatica

A

The chronic phase occurs when
the worms mature in the bile duct, and can cause symptoms of intermittent
pain, jaundice, and anemia.

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37
Q

Treatment of Fasciola hepatica

A

Treatment is with triclabendazole. Some patients may need ERCP

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38
Q

common cause of food borne illness

A

C. Perfringens
its ability to form
spores may make it relatively resistant to cooking

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39
Q

Basis of MRSA

A

mec Operon

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40
Q

toxic shock syndrome causing bacteria

A

Staphylococcus aureus

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41
Q

Protector of staphylococcus aureus against antibiotics

A

Beta lactamase
mec Operon

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42
Q

By what does streptococcus pyogens destroy tissue

A

Streptokinase
Hyaluronidase

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43
Q

Importance of superantigen released by streptococcus pyogens

A

superantigens such as pyogenic exotoxin A which results in
scarlet fever

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44
Q

Urease secreting bacteria

A

Helicobacter pylori

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45
Q

Bacteria a

Which bacterial septicaemia is associated with carcinoma of the colon

A

Streptococcus bovis

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46
Q

both aerobic and anaerobic organisms must be present In which infection

A

Fournier’s gangrene

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47
Q

What is advancing soft tissue infection associated with fascial necrosis

A

Necrotising fasciitis

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48
Q

Haemorrhagic bullae mostly found in which type of infection

A

Necrotising fascitis

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49
Q

Dirty Dishwater fluid discharge from Which infection

A

Necrotising fascitis

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50
Q

Treatment of necrotising fascitis

A

Radical surgical debridement
Sterile dressing
Reconstructive surgery

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51
Q

Diarrhea of immunocompromised

A

Mostly by cryptosporidium
Also
Salmonella
Shigella
Campylobacter

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52
Q

Which infection may complicate administration of broad spectrum antibiotics and produce foul smelling diarrhea

A

Clostridium deficile

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53
Q

Contamination of Salmonella

A

Food
Poultry, eggs

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54
Q

Contamination of vibrio cholerae

A

Contaminated water
Sea food

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55
Q

painless penile ulcer and marked inguinal
lymphadenopathy. lesion is sent for microscopy.

A

Treponema pallidum

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56
Q

What lesions characteristically affect the proximal aspect of the
aorta and can result in atypical aneurysms

A

Syphilic

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57
Q

typical lesion of primary syphilis

A

chancre which appears after
10-90 days. It is an indurated papule that breaks down to form an ulcer.

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58
Q

How syphilis can mimic carcinoma

A

The appearances of a hard ulcer with enlarged
regional lymph nodes can mimic carcinoma.

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59
Q

Jarisch- Herxheimer reaction associated with Which disease

A

Treatment of syphilis can precipitate a Jarisch- Herxheimer reaction with fever and
malaise occurring after treatment has been started and is due to the release
of antigens as the organisms die.

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60
Q

Precautions to prevent SSI (surgical site infection)

A

Preoperatively
Don’t remove body hair routinely
If hair needs removal, use electrical clippers with single use head (razors
increase infection risk)
Antibiotic prophylaxis if:
- placement of prosthesis or valve
- clean-contaminated surgery
- contaminated surgery
Use local formulary
Aim to give single dose IV antibiotic on anaesthesia
If a tourniquet is to be used, give prophylactic antibiotics earlier
Intraoperatively
Prepare the skin with alcoholic chlorhexidine (Lowest incidence of SSI)
Cover surgical site with dressing
A recent meta analysis has confirmed that administration of supplementary
oxygen does not reduce the risk of wound infection. In contrast to previous
individual RCT’s(1)
Wound edge protectors do not appear to confer benefit (2)
Post operatively
Tissue viability advice for management of surgical wounds healing by secondary
intention

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61
Q

statement relating to actinomycosis

A

gram positive bacilli
may be a cause of chronic multiple abscesses
Abdominal cases may develop in the appendix
Open biopsy of the lesions is the best diagnostic test
They are facultative anaerobes
difficult to culture

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62
Q

easiest way to
make a diagnosis of actinomycosis infection

A

Direct visualisation
of organisms and sulphur granules from lesions themselves

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63
Q

Which lessons contain Sulphur granules

A

Actinomycosis

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64
Q

DD of actinomycosis

A

hydradenitis
supprativa,
particularly if it is occurring in odd locations and with deeper
abscesses than usual.

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65
Q

Which infection has evidence of both worms and eggs in the stool.

A

Ascaris lumbricoides

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66
Q

Enterobiasis treatment

A

Mebendazole

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67
Q

Site of infection of hookworm

A

proximal small bowel

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68
Q

Stool findings difference between round and hook worn

A

Round has both larva and eggs
Hook has only larva

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69
Q

Treatment of hookworm

A

Mebendazole

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70
Q

Infection of hookworm

A

Infection occurs as a result of cutaneous
penetration

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71
Q

Infection of roundworms

A

Infections begin in gut following ingestion,

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72
Q

Which nematode may cause autoinfection

A

Strongyloidiasis

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73
Q

Cryptosporidium type

A

Protozoa

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74
Q

Spread of Cryptosporidium

A

Organisms produce cysts which are excreted and
thereby cause new infections

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75
Q

Which hepatic disease will have pain, fever and jaundice

A

Cholangitis

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76
Q

Courvoisier’s Law

A

painless
jaundice with
palpable
gallbladder

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77
Q

Mirizzi syndrome

A

In Mirizzi syndrome
the stone may compress the bile
duct directly- one of the rare
times that cholecystitis may
present with jaundice

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78
Q

Most common cause of cholangitis

A

Ascending infection of the bile
ducts usually by E. coli and by
definition occurring in a pool of
stagnant bile.

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79
Q

Basis of TPN jaundice

A

hepatic dysfunction
and fatty liver which may occur
with long term TPN usage.

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80
Q

severe peritoneal infections, pus has a pungent aroma. Which organism

A

Bacteroides fragilis

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81
Q

Echogenicity of amebic liver? Haemangioma

A

hyperechoic

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82
Q

Which liver disease is Linked to use of oral contraceptive pill

A

Liver cell
adenoma

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83
Q

Liver cell
adenoma consistency in CT

A

hypodense

84
Q

Liver abscess echogenicity

A

fluid filled cavity,
hyperechoic walls may be seen in chronic abscesses

85
Q

most common extra intestinal
manifestation of amoebiasis

A

Liver abscess

86
Q

anchovy paste consistency found in which lesion

A

Amoebic
Liver abscess

87
Q

Treatment of amebic liver abscess

A

Metronidazole

88
Q

intense fibrotic reaction occurs around
sites of Which infection

A

Hyatid cysts of liver

89
Q

Treatment of Hyatid cysts

A

sterilisation of the cyst with
mebendazole and may be followed by surgical
resection. Hypertonic swabs are packed around the
cysts during surgery

90
Q

Genetic relation of Polycystic liver
disease

A

Autosomal dominant

91
Q

Reason of pain inPolycystic liver
disease

A

as a result of capsular stretch

92
Q

Cystadenoma of liver

A

solitary multiloculated lesion ,large anechoic,
fluid filled area with irregular margins. Internal echos
may result from septa

93
Q

Why hepatic Cystadenoma is serious and what to do

A

Rare lesions with malignant potential
Surgical resection is indicated in all cases

94
Q

incubation period of double stranded HBV

A

6-20 weeks

95
Q

Which microorganism is needed to produce vaccine for HBV

A

prepared from yeast cells using recombinant DNA technology

96
Q

Unit of Anti-HBs
level

A

mIU/ml

97
Q

What to do for Non-responder to HBV vaccine

A

Test for current or past infection.
3 doses again
If still
fails to respond then HBIG

98
Q

Complications of hepatitis B infection

A

Chronic hepatitis (5-10%)
Fulminant liver failure (1%)
Hepatocellular carcinoma
Glomerulonephritis
Polyarteritis nodosa
Cryoglobulinaemia

99
Q

Management of hepatitis B

A

Pegylated interferon-alpha used to be the only treatment available
Because due to its side-effects
Oral antiviral medication is increasingly used

100
Q

Antivirals for HBV

A

lamivudine, tenofovir and entecavir

101
Q

Organisms of necrotizing fasciitis

A

Bacteroides
E coli
MRSA

102
Q

Causative organism for cellulitis surrounding leg ulcer with treatment

A

group A streptococcal infection
penicillin

103
Q

Example of alpha hemolytic streptococcus

A

S. pneumoniae
S. viridans

104
Q

Example of group A beta hemolytic streptococcus

A

S. pyogenes

105
Q

Example of group B beta hemolytic streptococcus

A

S.agalacticae

106
Q

Pneumococcus is a common cause of

A

pneumonia,meningitis and otitis media

107
Q

Streptococcus pyogenes responsible for

A

erysipelas, impetigo, cellulitis, type 2 necrotizing fasciitis
and pharyngitis/tonsillitis

108
Q

immunological reactions of streptococcus pyogenes

A

rheumatic fever or post-streptococcal
glomerulonephritis

109
Q

scarlet fever indicates what

A

erythrogenic toxins of streptococcus pyogenes

110
Q

vegetations on the mitral valve with previous rheumatic fever indicates which organism

A

Streptococcus viridans

111
Q

most common organism affecting previously ABNORMAL heart valves.

A

Streptococcus viridans

112
Q

feature of Campylobacter jejuni infection

A

A prodromal period of fever and generalised malaise precedes abdominal pain
(which may mimic appendicitis) and diarrhoea.

113
Q

Relation of Campylobacter jejuni with Guillain-Barre syndrome

A

Infection accounts for 26% case of Guillain-Barre syndrome

114
Q

commonest cause of infective diarrhoea arising from non viral
causes

A

Campylobacter jejuni

115
Q

Most common cause of acute bacterial infective diarrhoea

A

Campylobacter
jejuni

116
Q

Organisms May mimic appendicitis

A

Campylobacter
jejuni
Yersinia
enterocolitica

117
Q

Which bacterial infection may mimic Crohns disease?

A

Yersinia
enterocolitica

118
Q

bile spill is an indication for what

A

broad spectrum intravenous
antibiotics

119
Q

Gram test of Clostridium difficile

A

Positive

120
Q

pseudomembranous colitis a feature of which infection

A

Clostridium defficile

121
Q

Cause of pseudomembranous colitis.

A

exotoxin

122
Q

Risk factors of infection with clostridium defficile

A

Broad spectrum antibiotics
Use of PPI and H receptor antagonists
Contacted with persons infected with c.difficile

123
Q

Features of infection with clostridium defficile

A

Diarrhoea
Abdominal pain
A raised white blood cell count is characteristic
If severe, toxic megacolon may develop

124
Q

toxic megacolon may develop in which infection

A

Severe case of clostridium defficile

125
Q

Diagnosis of clostridium defficile

A

CDT in the stool
(Clostridium difficile toxin)

126
Q

Management of clostridium defficile
(Specially when intervened by surgeons)

A

First-line therapy is oral METROnidazole for 10-14 days
If severe, or not responding to metronidazole, then oral VANCOmycin may be
used
Patients who do not respond to vancomycin may respond to oral
FIDAXOmicin
Patients with SEVERE and UNREMITTING colitis should be considered for
colectomy

127
Q

Which organism has risk of transfer in swimming pools and why?

A

Giardia lamblia
It is resistant
to chlorination

128
Q

Macroscopic identification of giardiasis diarrhoea

A

greasy stool

129
Q

Effect on absorption by giardia lamblia
(took away the lamb - lamb lia)

A

causes fat malabsorption

130
Q

Differ acute and chronic diarrhoea

A

Acute diarrhoea < 14 days
Chronic diarrhoea > 14 days

131
Q

Example of acute diarrhoea

A

Gastroenteritis
Diverticulitis
Antibiotic therapy
Constipation causing
overflow

132
Q

Example of chronic diarrhea

A

IBS
Ulcerative
colitis
Crohn’s
disease
Colorectal
cancer
Coeliac
disease

133
Q

Classical feature of diverticulitis

A

Classically causes LEFT lower quadrant pain,diarrhoea and fever

134
Q

Associated Features of IBS

A

lethargy, nausea, backache and bladder
symptoms

135
Q

most consistent features of IBS

A

abdominal pain, bloating and change in bowel habit

136
Q

features of Crohn’s disease

A

Crampy abdominal pain
diarrhoea.
malabsorption,
mouth ulcers
perianal disease
intestinal
obstruction

137
Q

Features of ulcerative colitis

A

Bloody diarrhoea
Crampy abdominal pain
weight loss
Faecal urgency and tenesmus

138
Q

How can appendicitis cause diarrhea

A

Appendicitis with pelvic abscess or pelvic appendix

139
Q

Which thyroid dysfunction may cause diarrhoea

A

Thyrotoxicosis

140
Q

anti endomysial antibodies used to diagnose which disease

A

Endomysial antibodies (EMA) are a marker for celiac disease and dermatitis herpetiformis. They are produced by the body in response to gluten, which is found in wheat, barley, and rye products.

141
Q

most common organism causing Septic arthritis

A

Staphylococcus aureus
In young adults who are sexually active Neisseria gonorrhoeae should also
be considered

142
Q

Treatment of septic arthritis

A

Penicillin
flucloxacillin
clindamycin
For several weeks
Needle aspiration should be used to decompress the joint
Arthroscopic lavage may be required

143
Q

reservoir of campylobacter.

A

Birds are a recognised reservoir of campylobacter.

144
Q

Which organism will cause diarrhea with local lymphadenopathy

A

Campylobacter jejuni (from birds)

145
Q

Treatment of shigellosis

A

Ciprofloxacin

146
Q

Relation of salmonella and campylobacter

A

Salmonella from dead bird(poultry meat)
Campylobacter from bird BEAK contamination

147
Q

Most common organism to invest prosthetics and why with treatment

A

Staphylococcus epidermidis
This tends to colonise plastic devices and forms a biofilm which allows
colonisation with other bacterial agents. It is notoriously difficult to eradicate once
established and the usual treatment is removal of the device.

148
Q

Most common route of osteomyelitis

A

Is the result of haematogenous spread in most cases

149
Q

Most common cause of osteomyelitis

A

Is due to Staphylococcus aureus in 50% cases

150
Q

Why Plain radiographs are of less importance in case of osteomyelitis

A

Plain radiographs may be normal in the early stages

151
Q

Effect of septic joint on osteomyelitis

A

The presence of associated septic joint involvement will significantly alter
management
Conservative vs washout

152
Q

Management of osteomyelitis

A

It is managed medically in the first instance (with an antistaphylococcal antibiotic).
This differs from the situation in septic joints where early joint washout is
mandatory.

153
Q

Causes of osteomyelitis

A

S aureus and occasionally Enterobacter or Streptococcus species
In sickle cell: Salmonella species

154
Q

Clinical features of osteomyelitis

A

Erythema
Pain
Fever

155
Q

X-ray of late case of osteomyelitis

A

Lytic centre with a ring of sclerosis

156
Q

Role of surgery in case of osteomyelitis

A

1.If associated with septic arthritis
2.Sequestra may need surgical removal

157
Q

What is Quinsy

A

Peritonsillar abscess
accumulation of pus due to an infection behind the tonsil.
Complications may include blockage of the airway or aspiration pneumonitis.

158
Q

Cause of Quinsy

A

This can happen when a bacterial infection spreads from an infected tonsil to the surrounding area.

159
Q

Acute tonsillitis features

A

pharyngitis, fever, malaise and lymphadenopathy.

160
Q

DD of bacterial tonsillitis

A

Infectious mononucleosis

161
Q

What is Infectious mononucleosis

A

Infectious mononucleosis, also known as glandular fever/Pfeiffer’s disease/ Filatov’s disease/kissing disease, is an infection usually caused by the Epstein–Barr virus. Most people are infected by the virus as children, when the disease produces few or no symptoms.

162
Q

What is Monospot test and when to do

A

A monospot test is a blood test that detects antibodies in the blood that indicate an infection with the Epstein-Barr virus (EBV), which causes infectious mononucleosis (mono). The test is a type of heterophile antibody test that uses equine erythrocytes as a substrate.

The test is performed when symptoms of mononucleosis, or mono, are present, such as:
Fatigue
Fever
Large spleen
Sore throat
Tender lymph nodes along the back of the neck

163
Q

What is HIV seroconversion

A

Seroconversion is the period when the body’s immune system responds to HIV infection by producing antibodies that can be detected by an HIV test. It usually occurs within a few weeks of infection, but can take up to three months.

164
Q

Time for HIV seroconversion

A

It typically occurs 3-12 weeks after infection

165
Q

Features of HIV seroconversion

A

typically presents as
a glandular fever type illness.
Features
sore throat
lymphadenopathy
malaise, myalgia, arthralgia
diarrhoea
maculopapular rash
mouth ulcers
rarely meningoencephalitis

166
Q

Early test for HIV

A

antibodies to HIV may not be present
HIV PCR and p24 antigen tests can confirm diagnosis
p24 antigen test
usually positive from about 1 week to 3 - 4 weeks after infection with HIV
sometimes used as an additional screening test in blood banks

167
Q

Late test for HIV

A

HIV antibody test
most common and accurate test
usually consists of both a screening ELISA (Enzyme Linked Immuno-Sorbent
Assay) test and a confirmatory Western Blot Assay
most people develop antibodies to HIV at 4-6 weeks but 99% do by 3
month

168
Q

Relation of shaving with surgical incision

A

Shaving one day prior to surgery will increase the risk.

169
Q

Treatment of surgical drape

A

Iodophor impregnated drapes have been demonstrated to reduce the risk of wound
infection

170
Q

Importance of Charcots triad and what to do

A

Surgical emergency.
Patients need: Biliary decompression and broad spectrum antibiotics.

171
Q

Reynolds pentad

A

Fever
Right upper quadrant pain
Jaundice
confusion
hypotension

172
Q

Treatment if Charcot’s triad/?Reynolds pentad

A

Treatment
ERCP -usually after 72 hours of antibiotics
Percutaneous transhepatic cholangiogram and biliary drain

173
Q

Best antibiotic for MRSA

A

Vancomycin+Rifampicin(resistance may develop)
Relatively new antibiotics such as linezolid, quinupristin/dalfopristin combinations
and tigecycline have activity against MRSA but should be reserved for resistant
cases

174
Q

MRSA is acquired mostly where

A

Hospital

175
Q

How to Suppress of MRSA from a carrier once identified

A

nose: mupirocin 2% in white soft paraffin, tds for 5 days
skin: chlorhexidine gluconate, od for 5 days. Apply all over but particularly to
the axilla, groin and perineum

176
Q

Some strains may be sensitive to the antibiotics listed below but they should not
generally be used alone because resistance may develop against MRSA

A

rifampicin
macrolides
tetracyclines
aminoglycosides
clindamycin

177
Q

Disease of salmonella

A

Enteric fever
Typhoid & paratyphoid

178
Q

Features of enteric fever

A

initially systemic upset as above
relative bradycardia
abdominal pain, distension
constipation: although Salmonella is a recognised cause of diarrhoea,
constipation is more common in typhoid
rose spots: present on the trunk in 40% of patients, and are more common in
paratyphoid

179
Q

complications of enteric fever

A

osteomyelitis (especially in sickle cell disease where Salmonella is one of
the most common pathogens)
GI bleed/perforation
meningitis
cholecystitis
chronic carriage (1%, more likely if adult females)

180
Q

commonest cause of lactational mastitis.

A

Staphylococcus aureus
carried in the infants oropharynx

181
Q

Complication of mastitis

A

mammary duct
fistula from. underlying abscess

182
Q

Rapid cause of vomiting from bacterial food poisoning

A

Staphylococcus aureus

183
Q

What infection can cause spontaneous splenic rupture?

A

Epstein - Barr Virus may cause generalised lymphadenopathy. This may be
associated with splenomegaly. This enlargement has been associated with
spontaneous rupture.

184
Q

Development of spleen

A

It
develops from the upper dorsal mesogastrium

185
Q

Destination of splenic artery

A

to the white pulp transporting plasma then branches off to go into red pulp

186
Q

Site of Production of properdin, and tuftsin

A

Spleen

187
Q

Causes of Massive splenomegaly

A

Myelofibrosis
Chronic myeloid leukaemia
Visceral leishmaniasis (kala-azar)
Malaria
Gaucher’s syndrome

188
Q

What will happen to spleen in Sickle-cell

A

initialy spleenomegally then autosplenectomy (due to
repeated infarction)

189
Q

causes of splenomegaly

A

Myelofibrosis
Chronic myeloid leukaemia
Visceral leishmaniasis (kala-azar)
Malaria
Gaucher’s syndrome
Portal hypertension e.g. secondary to cirrhosis
Lymphoproliferative disease e.g. CLL, Hodgkin’s
Haemolytic anaemia
Infection: hepatitis, glandular fever
Infective endocarditis
Sickle-cell*, thalassaemia
Rheumatoid arthritis (Felty’s syndrome)

190
Q

commonest cause of wound infection following cardiac or colonic surgery

A

enterobacter

191
Q

Most common cause of SSI of skin

A

Staphylococcus aureus

192
Q

Epstein-Barr virus related cancers

A

Burkitt’s lymphoma
Hodgkin’s lymphoma
Post transplant lymphoma
Nasopharyngeal carcinoma

193
Q

Human papillomavirus 16/18 related cancers

A

Cervical cancer
Anal cancer
Penile cancer
Vulval cancer
Oropharyneal cancer

194
Q

Human herpes virus 8 related cancer

A

Kaposi’s sarcoma

195
Q

Nervous lesion by Human T-lymphotropic virus 1

A

Tropical spastic paraparesis
a slowly progressive viral immune-mediated disorder of the spinal cord

196
Q

Percentage of SSI

A

Surgical site infections (SSI) comprise up to 20% of all healthcare
associated infections and at least 5% of patients ( a clean procedure and carries the lowest risk of SSI) undergoing surgery will
develop an SSI as a result.

197
Q

feature of enteroinvasive E.coli.

A

Necrosis and ulcers of the large bowel
dysentery type illness similar to shigellosis.

198
Q

Ascending infection of the genitourinary tract is most commonly caused by

A

E-Coli.
(Like sepsis with a history
of a UTI that was treated)

199
Q

features of malignant otitis externa

A

Severe pain, headaches and granulation tissue within the external auditory meatus

200
Q

commonest risk factor for malignant otitis externa

A

Diabetes mellitus
(immunocompromised
individuals)

201
Q

Infective organism of malignant otitis externa

A

Pseudomonas aeruginosa

202
Q

Progression of malignant otitis externa

A

Infection commences in the soft tissues of the external auditory meatus,
then progresses to involve the soft tissues and into the bony ear canal
Progresses to temporal bone osteomyelitis

203
Q

Key features of Malignant otitis externa

A

immunosuppression (illness or treatment related)
Severe, unrelenting, deep-seated otalgia
Temporal headaches
Purulent otorrhea
Possibly dysphagia, hoarseness, and/or facial nerve dysfunction

204
Q

Treatment of Malignant otitis externa

A

Treatment
Anti pseudomonal antimicrobial agents
Topical agents
Hyperbaric oxygen is sometimes used in refractory cases

205
Q

Antipseudomonal antibiotics

A

penicillins-with beta-lactamase inhibitors
cephalosporins-ceftazidime, cefepime
Aminoglycosides - Amikacin
Piperacillin/tazobactam, -Piperacillin is a fourth-generation β lactam antimicrobial that is enhanced by the addition of tazobactam, a β lactamase inhibitor.

MTM (12 decks)

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