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Ladies (+ Bradley) Path 2016 > Microbiology > Flashcards

Microbiology Flashcards

1
Q

A 28 year old MSM presenting with painless, non-indurated penile ulcer. He also complains of rectal pain and bleeding, and on examination there is enlargement of the prostate.

  1. Chlamydia trachomatis
  2. Trichomonas vaginalis
  3. Human Papillomavirus
  4. Treponema Pallidium
  5. Neisseria gonorrhoea
  6. Candida albicans
  7. Haemophilus ducreyi
  8. Hepatitis C virus
  9. HIV
  10. Hepatitis B virus
A

1 - Chlamydia trachomatis.

This is lymphogranuloma venereum, from serovars L1, L2 and L3.

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2
Q

A 24 year old woman presenting with vaginal discharge, on wet prep microscopy a flagellated pathogen is seen

  1. Chlamydia trachomatis
  2. Trichomonas vaginalis
  3. Human Papillomavirus
  4. Treponema Pallidium
  5. Neisseria gonorrhoea
  6. Candida albicans
  7. Haemophilus ducreyi
  8. Hepatitis C virus
  9. HIV
  10. Hepatitis B virus
A

2 - Trichomonas vaginalis.

Flagellated protozoan, diagnosed with wet prep microscopy or PCR

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3
Q

A 29 year old man returns from travel abroad with several painful ulcers on his genitals. The pathogen is cultured on chocolate agar

  1. Chlamydia trachomatis
  2. Trichomonas vaginalis
  3. Human Papillomavirus
  4. Treponema Pallidium
  5. Neisseria gonorrhoea
  6. Candida albicans
  7. Haemophilus ducreyi
  8. Hepatitis C virus
  9. HIV
  10. Hepatitis B virus
A

7 - Haemophilus ducreyi

Gram -ve coccobacillus (like Haemophilus influenzae), tropical ulcer, diagnosed on culture of chocolate agar

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4
Q

A person presents with positive VDRL and RPR tests, RPR titre falls after treatment with benzathine penicillin

  1. Chlamydia trachomatis
  2. Trichomonas vaginalis
  3. Human Papillomavirus
  4. Treponema Pallidium
  5. Neisseria gonorrhoea
  6. Candida albicans
  7. Haemophilus ducreyi
  8. Hepatitis C virus
  9. HIV
  10. Hepatitis B virus
A

4 - Treponema Pallidium (syphilis)

Detect antibody with VDRL - can get biological false positives
RPR is a modified VDRL test, more specific, titre falls in response to treatment so can use it to monitor the response.

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5
Q

A gram negative STI is picked up in a routine sexual health screen, using a NAAT (nucleic acid amplification test).

  1. Chlamydia trachomatis
  2. Trichomonas vaginalis
  3. Human Papillomavirus
  4. Treponema Pallidium
  5. Neisseria gonorrhoea
  6. Candida albicans
  7. Haemophilus ducreyi
  8. Hepatitis C virus
  9. HIV
  10. Hepatitis B virus
A

1 - Chlamydia trachomatis.

Chlamydia is often asymptomatic, and cannot be cultured on agar, so diagnosed with a NAAT.

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6
Q

An alcoholic comes in to A&E with a cough productive of thick, purulent, red-stained sputum, and a fever. He is very unwell, and upper lobe changes are found on his chest x ray

  1. Streptococcus pneumoniae
  2. Staphylococcus aureus
  3. Klebsiella pneumoniae
  4. Moraxella catarrhalis
  5. Legionella pneumophila
  6. Mycobacterium tuberculosis
  7. Pneumocystis jiroveci
  8. Haemophilus influenza
  9. Influenza
  10. Mycoplasma pneumoniae
A

3 - Klebsiella pneumoniae

Gm -ve rod-shaped bacillus -
Cause atypical pneumonia, typically alcoholics - sudden, severe, systemic upset in these pts
Production thick, purulent and sometimes blood-stained sputum = red-currant jelly
Haemoptysis occurs more frequently than with other bacteria
Radiological = upper lobe consolidation, marked cavitation

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7
Q

A man presents with sudden onset jaundice when he watched a football game in the cold. He is Coombs test positive, and also complains of a cough and joint pain, and is found to be anaemic

  1. Streptococcus pneumoniae
  2. Staphylococcus aureus
  3. Klebsiella pneumoniae
  4. Moraxella catarrhalis
  5. Legionella pneumophila
  6. Mycobacterium tuberculosis
  7. Pneumocystis jiroveci
  8. Haemophilus influenza
  9. Influenza
  10. Mycoplasma pneumoniae
A

10 - Mycoplasma pneumoniae

Atypical pneumonia, organism has no cell wall.
Commonly systemic symptoms, joint pain, erythema multiforme.
One of the causes of COLD Autoimmune Haemolytic Anaemia

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8
Q

A woman who has had a renal transplant complains of a persistent fever, non-productive cough, weight loss and night sweats. Sputum investigation with silver stain reveals “boat shaped” cysts

  1. Streptococcus pneumoniae
  2. Staphylococcus aureus
  3. Klebsiella pneumoniae
  4. Moraxella catarrhalis
  5. Legionella pneumophila
  6. Mycobacterium tuberculosis
  7. Pneumocystis jiroveci
  8. Haemophilus influenza
  9. Influenza
  10. Mycoplasma pneumoniae
A

7 - Pneumocystis jiroveci

PJP linked to immunosuppression
Yeast-like fungus, fever, non-productive cough, wt loss, night sweats
CXR = diffuse bilateral pulmonary infiltrates
Dx = histological exam sputum, or BAL
Gomori’s methenamine silver stain = “flying saucer”/”boat shaped” shaped cysts on microscopy

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9
Q

A middle aged man complains of a 2 week long “flu” with muscle aches and coryzal symptoms, now with a cough productive of sputum. Sputum microscopy shows b haemolytic gram positive cocci

  1. Streptococcus pneumoniae
  2. Staphylococcus aureus
  3. Klebsiella pneumoniae
  4. Moraxella catarrhalis
  5. Legionella pneumophila
  6. Mycobacterium tuberculosis
  7. Pneumocystis jiroveci
  8. Haemophilus influenza
  9. Influenza
  10. Mycoplasma pneumoniae
A

2 - Staph. Aureus

Typically post-viral illness.
B haem gm+ve, cocci, clusters, catalase +ve
Consolidation, cavitation lungs, e

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10
Q

An elderly man with a long history of COPD and smoking presents with fever, chills, and pleuritic chest pain. A gram negative cocco bacilli is found on sputum microscopy

  1. Streptococcus pneumoniae
  2. Staphylococcus aureus
  3. Klebsiella pneumoniae
  4. Moraxella catarrhalis
  5. Legionella pneumophila
  6. Mycobacterium tuberculosis
  7. Pneumocystis jiroveci
  8. Haemophilus influenza
  9. Influenza
  10. Mycoplasma pneumoniae
A

8 - Haemophilus influenzae

Associated with smoking, COPD
Gram -ve cocco-bacilli

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11
Q

Treatment for young man presenting with neck stiffness, photophobia and fever, with true penicillin allergy

  1. Cryptococcus neoformans
  2. Neisseria meningitidis
  3. Listeria monocytogenes
  4. IM benpen
  5. Streptococcus pneumoniae
  6. Ceftriaxone
  7. Coxsackie virus
  8. Ceftriaxone + amoxicillin
  9. Cefotaxime
  10. Chloramphenicol
A

10 - Chloramphenicol

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12
Q

HIV +ve man presenting with meningism and focal neurology, on LP, high protein and high WCC with mononuclear cells

  1. Cryptococcus neoformans
  2. Neisseria meningitidis
  3. Listeria monocytogenes
  4. IM benpen
  5. Streptococcus pneumoniae
  6. Ceftriaxone
  7. Coxsackie virus
  8. Ceftriaxone + amoxicillin
  9. Cefotaxime
  10. Chloramphenicol
A

1 - Cryptococcus neoformans

This CSF shows up in TB and cryptococcus infections

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13
Q

70 year old presenting with neck stiffness, photophobia and fever, 1st line treatment

  1. Cryptococcus neoformans
  2. Neisseria meningitidis
  3. Listeria monocytogenes
  4. IM benpen
  5. Streptococcus pneumoniae
  6. Ceftriaxone
  7. Coxsackie virus
  8. Ceftriaxone + amoxicillin
  9. Cefotaxime
  10. Chloramphenicol
A

8 - Ceftriaxone and amoxicillin

> 50 more susceptible to Listeria, E. Coli etc, need to add in amoxicillin.

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14
Q

2 month old presenting with irritability, neck stiffness, photophobia, and fever of no known source. This pathogen is not successfully treated with a B lactam alone.

  1. Cryptococcus neoformans
  2. Neisseria meningitidis
  3. Listeria monocytogenes
  4. IM benpen
  5. Streptococcus pneumoniae
  6. Ceftriaxone
  7. Coxsackie virus
  8. Ceftriaxone + amoxicillin
  9. Cefotaxime
  10. Chloramphenicol
A

3 - Listeria monocytogenes

Neonates susceptible to Listeria, GBS, E.Coli etc, all of which need treatment with amoxicillin/ampicillin.

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15
Q

Teenager presenting to GP with neck stiffness, photophobia and fever, and non-blanching rash, immediate treatment

  1. Cryptococcus neoformans
  2. Neisseria meningitidis
  3. Listeria monocytogenes
  4. IM benpen
  5. Streptococcus pneumoniae
  6. Ceftriaxone
  7. Coxsackie virus
  8. Ceftriaxone + amoxicillin
  9. Cefotaxime
  10. Chloramphenicol
A

4 - IM Ben pen

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16
Q

A 23 year old woman returns from visiting her family in Russia and presents with several painless round black lesions surrounded by oedema. She says that she visited a petting zoo with her younger sister

  1. Yersinia pestis
  2. Bacillus anthracis
  3. Leptospirosis interrogans
  4. Bartonellosis
  5. Influenza
  6. Brucella melitensis
  7. Leishmania tropica
  8. Borrelia burgdorferi
  9. Rabies
  10. Coxiella burnettii
A

2 - Bacillus anthracis.

This is cutaneous anthrax.
Pulmonary anthrax (Woolsorters disease) is the deadly one
17
Q

A 23 year old man competed in a triathlon 2 weeks ago and presents to A&E with high spiking temperatures, fatigue and muscle aches. He is found to have a gram negative, motile spirochaetes

  1. Yersinia pestis
  2. Bacillus anthracis
  3. Leptospirosis interrogans
  4. Bartonellosis
  5. Influenza
  6. Brucella melitensis
  7. Leishmania tropica
  8. Borrelia burgdorferi
  9. Rabies
  10. Coxiella burnettii
A

3 - Leptospirosis interrogans

Leptospirosis/Weil’s disease. From water contaminated with dog/rat urine.

18
Q

A 23 year old woman presents to the infectious diseases department with pyrexia of unknown origin. She has a long history of fluctuating fevers, arthralgia, myalgia, fatigue and lymphadenopathy. On taking a proper travel history, the ID department realises she has recently returned from the Middle East, where she milked goats

  1. Yersinia pestis
  2. Bacillus anthracis
  3. Leptospirosis interrogans
  4. Bartonellosis
  5. Influenza
  6. Brucella melitensis
  7. Leishmania tropica
  8. Borrelia burgdorferi
  9. Rabies
  10. Coxiella burnettii
A

6 - Brucella melitensis

This is Brucellosis, get it from unpasteurised dairy products/meat/dairy animals.

Classically called “undulating” fever (worse in evening, better in morning)
Also has a funny smell (like wet hay)

19
Q

A group of uni students return from hiking in the New Forest and present with flu-like symptoms and fever. On examination, they all have a rash, described in the notes as Erythema chronicum migrans.

  1. Yersinia pestis
  2. Bacillus anthracis
  3. Leptospirosis interrogans
  4. Bartonellosis
  5. Influenza
  6. Brucella melitensis
  7. Leishmania tropica
  8. Borrelia burgdorferi
  9. Rabies
  10. Coxiella burnettii
A

8 - Borrelia burgdorferi

Lyme disease

20
Q

A 25 year old man returns from travelling in South America with a crusty ulcer with raised edges on his leg. The pathogen is cultured on Novy-Macneal-Nicolle medium.

  1. Yersinia pestis
  2. Bacillus anthracis
  3. Leptospirosis interrogans
  4. Bartonellosis
  5. Influenza
  6. Brucella melitensis
  7. Leishmania tropica
  8. Borrelia burgdorferi
  9. Rabies
  10. Coxiella burnettii
A

7 - Leishmania tropica

Cutaneous leishmaniasis

21
Q

Anti-toxin vaccine against an upper-respiratory tract bacterial infection

  1. Botulinum vaccine
  2. Pneumococcal vaccine
  3. MMR vaccine
  4. Hepatitis A vaccine
  5. Neisseria meningitidis vaccine
  6. Tetanus vaccine
  7. Diphtheria vaccine (single)
  8. Rotavirus vaccine
  9. Pertussis vaccine
  10. Hepatitis B vaccine
A

7 - Diphtheria vaccine

Caused by Corynebacterium diphtheriae, has both an anti-toxin and a toxoid vaccine (toxoid is given in pentavalent one)

22
Q

Live attenuated vaccine that is given against a gastrointestinal pathogen, important in children

A

8 - Rotavirus

23
Q

Vaccine given in a combination with others, against a pathogen that causes the “100 day cough”

  1. Botulinum vaccine
  2. Pneumococcal vaccine
  3. MMR vaccine
  4. Hepatitis A vaccine
  5. Neisseria meningitidis vaccine
  6. Tetanus vaccine
  7. Diphtheria vaccine (single)
  8. Rotavirus vaccine
  9. Pertussis vaccine
  10. Hepatitis B vaccine
A

9 - Pertussis vaccine

24
Q

Toxoid vaccine used to treat bacterial infection that can cause umbilical cord stump infections

  1. Botulinum vaccine
  2. Pneumococcal vaccine
  3. MMR vaccine
  4. Hepatitis A vaccine
  5. Neisseria meningitidis vaccine
  6. Tetanus vaccine
  7. Diphtheria vaccine (single)
  8. Rotavirus vaccine
  9. Pertussis vaccine
  10. Hepatitis B vaccine
A

6 -Tetanus vaccine

Sorry, this is a bit mean. In developing countries neonatal tetanus is a big thing, it causes umbilical cord stump infections

25
Q

Live attenuated vaccine given to prevent extremely contagious coryzal exanthema caused by a morbillivirus

  1. Botulinum vaccine
  2. Pneumococcal vaccine
  3. MMR vaccine
  4. Hepatitis A vaccine
  5. Neisseria meningitidis vaccine
  6. Tetanus vaccine
  7. Diphtheria vaccine (single)
  8. Rotavirus vaccine
  9. Pertussis vaccine
  10. Hepatitis B vaccine
A

3 - MMR vaccine

Measles - very contagious exanthema, gives you coryzal symptoms. Caused by morbillivirus.

Ladies (+ Bradley) Path 2016 (5 decks)

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