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Microbiology Flashcards

1
Q

Purple gram stain

A

Gram positive (wall/membrane)

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2
Q

Pink gram stain

A

Gram negative (membrane/wall/membrane)

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3
Q

Classes of antibiotics which inhibit cell wall synthesis

A 
Beta lactams (penicillins, cephalosporins, carbapenems)
Glycopeptides
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4
Q

Benzylpenicillin

A

Beta lactam - penicillin (inhibits cell wall synthesis)

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5
Q

Ceftriaxone

A

Beta lactam - cephalosporin (inhibits cell wall synthesis)

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6
Q

Meropenem

A

Beta lactam - carbapenem (inhibits cell wall synthesis)

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7
Q

Vancomycin and teicoplanin

A

Glycopeptides (inhibit cell wall synthesis); gram +ves only

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8
Q

Classes of antibiotics which inhibit protein synthesis

A 
Aminoglycosides
Tetracyclines
MSL group - macrolides, lincosamides, streptogramins
Chloramphenicol
Oxazolidinones
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9
Q

Gentamicin, amikacin and tobramycin

A

Aminoglycosides (inhibits protein synthesis)

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10
Q

Doxycycline

A

Tetracycline (inhibits protein synthesis)

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11
Q

Erythromycin

A

Macrolide (inhibits protein synthesis)

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12
Q

Synercid

A

Streptogramin (inhibits protein synthesis)

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13
Q

Clindamycin

A

Lincosamide (inhibits protein synthesis)

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14
Q

Chloramphenicol

A

Eye drops for bacterial conjunctivitis (inhibits protein synthesis)

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15
Q

Linezolid

A

Oxazolidinones

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16
Q

Antibiotics which inhibit DNA synthesis

A

Fluoroquinolones

Nitroimidazoles

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17
Q

Ciprofloxacin, levofloxacin, moxifloxacin

A

Fluoroquinolones (inhibit DNA synthesis)

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18
Q

Metronidazole

A

Nitroimidazole (inhibit DNA synthesis)

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19
Q

Antibiotics which inhibit RNA synthesis

A

Rifamycin

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20
Q

Rifampicin

A

Rifamycin (inhibits RNA synthesis)

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21
Q

Antibiotics which produce cell membrane toxin

A

Polymyxin e.g. colistin

Cyclic lipopeptide e.g. daptomycin

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22
Q

Colistin

A

Polymyxin (cell membrane toxin)

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23
Q

Daptomycin

A

Cyclic lipopeptide (cell membrane toxin)

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24
Q

Antibiotics which inhibit folate metabolism

A

Sulfonamides

Diaminopyrimidines

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25
Sulphamethoxazole
Sulfonamide (inhibits folate metabolism)
26
Trimethoprim
Diaminopyrimidine (inhibits folate metabolism)
27
Antibiotic for gram negative sepsis
Aminoglycosides e.g. Gentamicin 3rd generation cephalosporins e.g. ceftriaxone Carbapenems e.g. meropenem
28
Antibiotic for intracellular organisms e.g. chlamydia
Tetracyclines e.g. doxycycline
29
Treatment of gram positive infections
Penicillins or macrolides
30
Antibiotic for anaerobes and protozoa
Metronidazole
31
Treatment of PCP
Co-trimoxazole (trimethoprim + sulphamethoxazole)
32
Penicillins are ineffective against which bacteria?
Bacteria which lack cell walls e.g. Mycoplasma or Chlamydia
33
1st generation cephalosporin
Cephalexin
34
2nd generation cephalosporin
Cefuroxime
35
3rd generation cephalosporin
Cefotaxime Ceftriaxone Ceftazidime
36
How do beta-lactams work?
Weakened cell wall --> bactericidal against rapidly dividing bacteria
37
Mechanism of action of aminoglycosides e.g. gentamicin
Bind to 30S ribosomal subunit --> prevents elongation of peptide cahin and causes misreading of codons along mRNA --> bactericidal
38
Side effects of ototoxicity and nephrotoxicity
Aminoglycosides e.g. gentamicin
39
Mechanism of action of tetracyclines e.g. doxycycline
Binds reversibly to ribosomal 30S subunit --> bacteriostatic
40
Side effects of photosensitive rash and teeth discolouration of unborn children
Tetracyclines e.g. doxycycline
41
Mechanism of action of macrolides e.g. erythromycin
Binds to ribosomal 50S subunit --> interferes with translocation --> bacteriostatic
42
Chloramphenicol mechanism of action
Binds to 50S subunit of irbosome, inhibits peptide bond formation during translocation --> bacteriostatic
43
Side effects of aplastic anaemia and grey baby syndrome
Chloramphenicol
44
Side effect of orange secretions
Rifampicin
45
Mechanism of resistance to beta-lactam antibiotics in Staph. aureus and Gram negative bacilli (coliforms)
Inactivation: Beta lactamases
46
Mechanism of resistance to beta-lactam antibiotics in MRSA
Altered target: mecA gene encodes a novel PBP (2a). Low affinity for binding beta-lactams.
47
Mechanism of resistance to beta-lactam antibiotics in Strep. pneumoniae
Altered target: Acquisition of a series of stepwise mutations in PBP genes
48
Mechanism of resistance to cephalosporins in E.coli and Klebsiella
ESBLs
49
Mechanism of resistance to macrolides
Altered targets: modification of 23s RNA redues binding of antbiotics
50
Broad spectrum antibiotics
Co-amoxiclav, Tazocin, Ciprofloxacin, Meropenem
51
Narrow spectrum antibiotics
Flucloxacillin, Metronidazole, Gentamicin
52
Four mechanisms of antibiotic resistance
BEAT: Bypass antibiotic-sensitive step in pathway e.g. MRSA Enzyme-mediated drug inactivation e.g. beta-lactamases Impairment of Accumulation of the drug e.g. tetracycline resistance Modification of the drug's Target in the microbe e.g. quinolone resistance
53
Antibiotic for skin infections
Flucloxacillin (S. aureus)
54
Antibiotic for pharyngitis
Benzylpenicillin 10 days (group A beta haemolytic strep aka Strep. pyogemes)
55
Antibiotic for invasive Group A Strep.
Clindamycin + early debridement + IVIG
56
Antibiotic for mild CAP
Amoxicillin
57
Antibiotic for severe CAP
Co-amoxiclav + clarithromycin
58
Antibiotic for HAP
Cephalosporin e.g. cefurozime
59
Antibiotic for bacterial meningitis
Ceftriaxone | Add amoxicillin if Listeria likely (young/old)
60
Antibiotic for meningitis
Cefotaxime + Amoxicillin
61
Antibiotic for simple community cystitis
Trimethoprim 3 days
62
Antibiotic for hospital acquired UTI
Cephalexin or augmentin
63
Antibiotic for severe sepsis
Cefuroxime, metronidazole +/- gentamicin
64
Antibiotic for neutropenic sepsis
Tazocin + gentamicin
65
Antibiotic for C. diff
PO Metronidazole first line | PO Vancomycin second line
66
Organisms causing UTI
E. coli Proteus mirabilis Klebsiella Staphylococcus saprophyticus
67
Treatment of pyelonephritis
IV cefuroxime +/- gentamicin | IV co-amoxiclav +/- gentamicin
68
Infection indicated by what amount of bacteria in urine?
>10^5 cfu/mL
69
Acid fast, non-motile, bacilli
Mycobacteria
70
Auramine or Ziehl-Neelsen staining
Mycobacteria
71
Swimming pool granuloma
Mycobacteria marinum
72
Chronic progressive painless ulcer
Mycobacteria ulcerans
73
Slow-growing non-tuberculous (atypical) mycobacteria
Mycobacterium avium intracellulare M. marinum M. ulcerans
74
Fast-growing non-tuberculous (atypical) mycobacteria
M. abscessus M. chelonae M. fortuitum
75
Multifocal bronchiectasis with multiple small nodules
Mycobacterium avium intracellulare
76
Culture medium for TB
Lowenstein Jensen
77
TB treatment regime
RIPE for 2 months: rifampicin, isoniazid (+ pyridoxine), pyrazinamide, ethambutol RI for 4 months: rifampicin + isoniazid
78
Rifampicin side effects
Orange secretions Raised transaminases Induces cytochrome P450
79
Isoniazid side effects
``` Peripheral neuropathy (give B6 pyridoxine) Hepatotoxicity ```
80
Pyrazinamide side effects
Hepatotoxicity, hyperuricaemia
81
Ethambutol side effects
Visual disturbance
82
Treatment of TB meningitis
Continue rifampicin and isoniazid for additional 2-4 months
83
Latent TB treatment
6 months isoniazid
84
What is BCG vaccine?
Attenuated M. bovis
85
Causative organism of leprosy
Mycobacterium leprae | Mycobacterium lepromatosis
86
Infective cause of flaccid paralysis
Clostridium botulinum
87
Causes of meningitis in neonates
Group B Strep. E. coli Listeria monocytogenes
88
Cause of meningitis
Haemophilus influenza B
89
Causes of meningitis >5 yo
``` Neisseria meningitidis Streptococcus pneumoniae (leading cause in adults in UK) ```
90
Causes of aseptic meningitis
Coxsackie group B | Echoviruses
91
India ink stain
Cryptococcus neoformans
92
Encephalitis with gram +ve rod
Listeria
93
ARVs for pregnant & BF women
Tenofovir Lamivudine Efavirenz
94
ARVs for BF infants
Nevirapine
95
ARV for untreated women with HIV at childbirth
Nevirapine
96
Treatment for hep. B
Interferon alpha 2a Lamivudine Tenofovir
97
Used to prevent RSV in children with heart and lung disease
Ribavirin (guanosine analogue)
98
Treatment of CMV
Gancyclovir
99
Treatment of influenza A
Amantadine
100
Treatment of influenza A and B
Zanamivir
101
Nucleoside analogue which inhibits reverse transcriptase
Zidovudine
102
Rusty coloured sputum
Streptococcus pneumoniae
103
Atypical pneumonia + cold agglutinins
Mycoplasma pneumoniae
104
Rose spots in pneumonia
Chlamydia psittaci
105
Most common triggers of erythema multiforme
1. HSV | 2. Mycoplasma pneumoniae
106
GI infection + descending paralysis
Clostridia botulinum (give antitoxin)
107
Vacuum packed / canned foods --> GI infection
Clostridia botulinum
108
Watery diarrhoea and cramps, systemic illness, 8-16 hours after eating reheated meat.
Clostridia perfringens
109
Gas gangrene
Clostridia perfringens
110
Reheated rice --> sudden vomiting (4 hrs) +/- watery diarrhoea
Bacillus cereus
111
Prominent vomiting + watery diarrhoea. Virulence factor protein A. Catalse, coagulase +ve. Tetrads, clusters on gram stain. Beta haemolytic on blood agar. Enterotoxin --> IL-1 and IL-2.
Staph. aureus
112
Gram -ve, toxigenic, travellers diarrhoea acting on jejunum and ileum
Enterotoxigenic E. coli (ETEC)
113
Gram -ve, invasive dysentery
Enteroinvasive E. coli (EIEC)
114
Gram -ve, haemorrhagic dysentery, caused by verotoxin
EHEC
115
Anaemia, thrombocytopenia and renal failure
HUS
116
HUS
E. coli 0157:H7
117
Gram -ve, infantile diarrhoea
EPEC (E. coli)
118
Treatment of E. coli
Self-limiting but can treat with ciprofloxacin
119
Facultative anaerobes, oxidase negative
E. coli
120
Slow onset fever + constipation + relative bradycardia. Splenomegaly, rose spots, anaemia and leukopenia.
Salmonella typhi / paratyphi
121
Treatment of Salmonella
Ceftriaxone or ciprofloxacin
122
Self-limiting diarrhoea after poultry, eggs, meat
Salmonella enteritides
123
Painful bloody diarrhoea, mucosal inflammation and fever, distal ileum and colon
Shigella (shiga enterotoxin)
124
Entercolitis, mesenteric adenitis w/ necrotising granulomas, reactive arthritis and erythema nodosum.
Yersinia enterocolitis
125
4C cold enrichment
Yersinia enterocolitis
126
Poo from domestic animals
Yersinia enterocolitis
127
Rice water stool
Vibrio cholerae
128
Shellfish
Vibrio cholerae
129
Comma shaped, late lactose fementers, oxidase positive
Vibriosis
130
Massive diarrhoea without inflammation. Cl- efflux.
Vibrio cholerae
131
Cellulitis in shellfish handlers. Fatal septicaemia wiht D&V in HIV pts.
Vibrio vulnificus (treat with doxycycline)
132
Ingestion of raw undercooked seafood (Japan). 3 days of diarrhoea. Often self-limiting.
Vibrio parahaemolyticus (treat with doxycycline)
133
Unpasteurised milk
Campylobacter jejuni
134
Headache and fever, abdo cramps, bloody (foul smelling) diarrhoea
Campylobacter jejuni
135
Curved, s-shaped, microaerophilic, oxidase +ve, motile, sensitive to nalidixic acid
Campylobacter jejuni
136
Associated with Guillain Barre and Reiter's
Campylobacter jejuni
137
Treatment of Campylobacter jejuni
Erythromycin or cipro if first 4-5 days
138
GI watery diarrhoea, cramps, headache, fever, little vomiting
Listeria monocytogenes
139
Refrigerated food (veg) and unpasteurised dairy
Listeria monocytogenes
140
Treatment of Listeria monocytogenes
Ampicillin, Ceftriaxone, Cotrimoxazole
141
V or L shaped, beta haemolytic, aesculin +ve, tumbling motility
Listeria monocytogenes
142
Mobile trophozoite in diarrhoea (protozoa)
Entamoeba histolytica
143
Flask-shaped ulcer on histology
Entamoeba histolytica
144
MSM, RUQ pain (liver abscess), chronic weight loss
Entamoeba histolytica
145
Treatment of entamoeba histolytica
Metronidazole + paromomycin if luminal disease
146
Pear-shaped trophozoite (protozoa)
Giardia lamblia
147
Travellers, hikers, MSM, with foul smelling non-bloody diarrhoea
Giardia lamblia
148
Treatment of Giardia
Metronidazole
149
Severe diarrhoea in immunocompromised, infects jejunum
Cryptosporidium parvum
150
Oocysts seen in stool by modified Kinyoun acid fast stain
Cryptosporidium parvum
151
Treatment of Cryptosporidium parvum
Paramomycin
152
Anaerobic GI infection
Clostridia
153
Aerobic GI infecion
B. cereus | S. aureus
154
Lactose fermenters
E. coli
155
Non-lactose fermenters
Salmonella Shigella Yersinia
156
Protozoa
``` Entamoeba histolytica Giardia lamblia Cryptospordium Malaria Trpyanosomiasis Leishmaniasis ```
157
Causes of secretory diarrhoea (no fever, no WBC in stool sample)
``` Vibrio cholerae ETEC EAEC EPEC EHEC ```
158
Causes of inflammatory diarrhoea (fever, neutrophils in stool sample)
Campylobacter jejuni Shigella spp. Salmonella EIEC
159
Causes of enteric fever (fever, mononculear cells in stool sample)
Salmonella typhi Yersinia Brucella
160
Cleaves sialic acid residues, allows virion to exit host cell
Neuraminidase activity
161
Binds sialic acid receptors, membrane fusion and virus entry. Endosomal-viral envelope fusion = release.
Haemogluttinin activity
162
Mutation of HA/NA to give new strains
Antigenic drift
163
Complete change of HA/NA (can only occur with influenza A)
Antigenic shift
164
Cleavage of influenza HA by what causes extended tropism / growth for H5 and H7
Clara tryptase
165
Antiviral for influenza A
Amantadine (targets M2 ion channel)
166
Neuraminidase inhibitors (for influenza A and B)
Oseltamivir (Tamiflu) Zanamivir (Relenza) Sialic acid
167
Split or subunit flu vaccine. High risk groups. Short term strain-specific immunity.
Inactivated flu vaccine
168
Cold adapted virus limited to URT given to children. Broader more cross reactive immunity.
Live attenuated flu vaccine
169
Treatment for hepatitis C
Interferon alpha 2b | Ribavirin
170
Hepatitis causing raised AST and ALT
Hepatitis B
171
Hepatitis causing raised ALT
Hepatitis C
172
HBsAg
Indicates viral replication in the liver. Active infection (acute or chronic).
173
HBeAg
Secreted protein. Indicates high level of viral replication and infectivity.
174
HBcAg
Found only in infected liver cells. Not in blood.
175
Anti-HBs
Indicates immunity (previous infection or vaccination). Not found in chronic carriers.
176
Anti-HBe
Indicates low infectivity and reduced viral load
177
Anti-HBc IgM
Indicates recent infection
178
Anti-HBc IgG
Indicates previous exposure to HBV (chronic carriers and those who clear it)
179
Most reliable marker of infectivity in hepatitis B
HBV viral load
180
Pneumococcal vaccine given to babies
Pneumococcal conjugate vaccine (Prevenar 13)
181
Pneumococcal vaccine given to 65yo
Purified polysaccharide vaccine (Pneumovax)
182
Triad of measles presentation
Cough/coryza, conjunctivitis and rash
183
Koplik's spots
Measles
184
Complications of measles
``` Pnuemonitis Otitis media Severe diarrhoea Convulsions Encephalitis Subacute sclerosing panencephalitis (after 7 yrs) ```
185
Measles virus
Morbillivirus
186
Mumps virus
Paramyxovirus
187
Complications of mumps
Pancreatitis 4% Oophoritis 5% Orchitis 25% of post-pubertal men Meningitis and deafness
188
Rubella virus
Togavirus
189
Rubella presentation
Mild illness, swollen lymph glands, low grade fever, malaise and conjunctivitis. Maculo-papular discreet rash on face/neck/body. Swollen joints and arthritis.
190
Congenital rubella syndrome triad (first trimester)
Sensorineural deafness, eye abnormalities and congenital heart disease
191
Guanosine analogue
Aciclovir
192
Aciclovir used to treat
HSV1 HSV2 VZV
193
Causes of aciclovir resistance
Mutations in thymidine kinase 95% (Aciclovir not phosphorylated) Mutations in DNA polymerase 5%
194
Treatment for ACV-resistant HSV
Foscarnet or Cidofovir
195
Cause of interstitial pneumonia, retinal exudate and haemorrhage, and owl's eye inclusions
CMV
196
Congenital CMV
RCHEP: retinitis, colitis, hepatitis, encephalitis, pneumonitis
197
Treatment of CMV
IV ganciclovir IV foscarnet Cidofovir
198
Ganciclovir side effect
BM suppression
199
Foscarnet (pyrophosphate analogue) side effects
Renal impairment and electrolyte disturbance
200
Cidofovir (nucleoside analogue) side effects
Nephrotoxic
201
HHV6 causes?
Sixth disease aka exanthem subitum; v. high fever, coryza, sudden rash
202
HHV8 causes?
Kaposi's sarcoma and Castleman's disease
203
Oseltamivir
Neuraminidase inhibitor (oral)
204
Zanamivir
Neuroaminidase inhibitor (dry powder inhaler)
205
Antiviral for influenza A and B
Neuraminidase inhibitors
206
Amantidine
Inhibits influenza A matrix protein M2
207
First line treatment regime for Hep B
Peginterferon 2alpha, entecavir, and tenofovir
208
Entecavir and lamivudine
Inhibitors of viral polymerase (nucleotide analogues)
209
Tenofovir
Inhibitor of reverse transcriptase (nucleotide analogue)
210
'Flying saucer' shaped cysts on microscopy with Gomori's methanimine silver stain
PCP
211
Fever, non-productive cough, weight loss, night sweats. Widespread pulmonary infiltrates.
PCP
212
Alpha haemolytic gram +ve cocci arranged in pairs
Strep. pneumoniae
213
Optochin sensitive
Strep. pneumoniae
214
Optochin insensitive
Strep. viridans
215
Beta haemolytic gram positive cocci arranged in grape-like clusters. Catalase positive.
Staph. aureus
216
Headache, myalgia, confusion, rhabdomyolysis, abdominal pain, hyponatraemia, hypophosphataemia, deranged LFTs
Legionella pneumophila
217
COPD infective exacerbation organism; aerobic gram -ve diplococci.
Moraxella catarrhalis
218
Chocolate agar
Haemophilus influenzae
219
Tumbling motility
Listeria
220
Profuse watery diarrhoea + enterotoxin. cAMP activation.
Vibrio cholerae
221
Rose spots in gastroenteritis
Salmonella typhi
222
GI infection, multiples in Peyer's patches
Salmonella typhi
223
Meningitis after contact with animals
Leptospirosis (Weil's syndrome)
224
Microscopic agglutination test +ve
Leptospirosis
225
Lymphogranuloma venereum causative organism
Chlamydia trachomatis
226
Gummatous lesions
Tertiary syphilis
227
Donovan bodies
Klebsiella granulomatis
228
Treatment of MRSA
Vancomycin
229
Treatment for infective exacerbation of COPD
Doxycycline
230
Spaghetti with meatballs appearance
Pityriasis versicolore
231
Aspergillosis / aflatoxin cancer association
HCC
232
Rose gardener's disease
Sporothrix schenkii (sporotrichosis)
233
Rocky mountain fever
Rickettsia
234
Cerebral negri bodies
Rabies
235
Treatment of EBV-related post-transplant lymphoproliferative disease
Reduce immunosupression | Rituxmab (anti-CD20; B cells)
236
Spindle cells on biopsy
Kaposi's sarcoma (HHV8)
237
Progressive multifocal leukoencephalopthy virus
JC virus
238
Giant cell pneumoniae
Measles in immunocompromised pt
239
Serious infections in pregnancy
``` TORCH: Toxoplasmosis Other: syphilis, parvovirus B19, VZV, influenza Rubella CMV HSV ```
240
12 week booking infection screening
Syphilis, Hep B, HIV, rubella
241
Commonest infectious cause of developmental delay and congenital abnormalities
CMV
242
Congenital varicella syndrome
VZV limb hypoplasia, microcephaly, scarring | Cf. neonatal varicella (around parturition) - severe disseminated infection
243
Management of infant of HBsAg +ve mother
HBV vaccine within 12 hours of delivery
244
Management of infant of HBeAg +ve mother
HBV vaccine within 12 hours of delivery + HBIG at birth
245
Management of mother with HBV viral load >10^6 copies
Antenatal antiviral therapy (lamivudine or tenofovir) for 6-8 weeks prior to delivery + HBV vaccine for infant within 12 hours of delivery and HBIG at birth
246
Parvovirus B19 in first 20 weeks
3% risk hydrops fetalis
247
3 biggest Abx leading to C. diff
3C's: Clindmycin, Cephalosporins, Ciprofloxacin
248
Brodies abscess
Subacute osteomyelitis
249
Definitive host of parasite
Where sexual reproduction takes place
250
Intermediate host
Parasite in asexual stage
251
Protozoa
Malaria Trypanosomiasis Leishmaniasis
252
Chagas disease
Trypanosoma cruzi (protozoan)
253
Treatment for oral thrush
Nystatin
254
Lobar pneumonia organism
Strep. pneumoniae
255
Mantoux test >5mm +ve in:
􀁳􀀀 Patients with HIV 􀁳􀀀 A recent contact of a person with TB disease 􀁳􀀀 People with fibrotic changes on chest radiograph consistent with prior TB 􀁳􀀀 Patients with organ transplants 􀁳􀀀 People who are immunosuppressed for other reasons (for example taking the equivalent of >15 mg/day of prednisone for 1 month or longer)
256
Mantoux test >10mm +ve in:
􀁳􀀀 Recent immigrants (
257
Mantoux test >10mm +ve in:
Anyone
258
Pneumonia + red-currant jelly sputum
Klebsiella
259
Cystic pneumonia following influenza
Staph. aureus
260
Boat-shaped organisms, silver stain
PCP
261
Bat's wings appearance
PCP
262
UTI in catheterised pt
Klebsiella
263
Septic arthritis in young person
Neisseria gonorrhoeae
264
Threadworm treatment | NB: --> pruritis ani
Mebendazole
265
Negri bodies
Pathognomonic of rabies
266
Treatment of typhoid
IV ceftriaxone +/- gentamicin
267
Myalgia, 'breakbone fever', retro-orbital pain, sunburn-like rash
Dengue

Jess (8 decks)

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