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Pathology BB quizzes > Microbiology > Flashcards

Microbiology Flashcards

1
Q

anti-retroviral given to UNTREATED pregnant woman presenting late in order to prevent HIV vertical transmission

A

nevirapine

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2
Q

what immunomodulation therapy is used in hepatitis B?

what are 2 antivirals used along side this?

A

PEGylated-interferon alpha 2A or 2B

tenofovir & entecavir

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3
Q

the final metabolite of the antiviral used to treat herpes simplex

A

aciclovir triphosphate

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4
Q

aerosolised antiviral to prevent RSV in children with heart and lung disease

A

ribavirin - nucleoside analog. similar in structure to GUANOSINE

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5
Q

if aciclovir doesn’t work on HSV, what is the next antiviral?

A

foscarnet

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6
Q

what antiviral has action against influenza A but not influenza B?

A

amantadine - blocks a channel on virion that is required for the onset of viral replicaiton. influenza B has a structurally distinct channel that does not become blocked by amantadine

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7
Q

thymidine kinase is a specific requirement for the action of which antiviral?

A

aciclovir

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8
Q

an antiviral similar to oseltamavir that can be given inhaled. what is the benefit?

A

zanamivir - inhaled drug has lower systemic levels meaning it is safer in pregnancy

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9
Q

atypical pneumonia - Dry cough, new infiltrates on CXR, dyspnoea and target shaped lesions on the palms. No recent history of herpes. What is the causative organism?

A

mycoplasma pneumoniae

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10
Q

besides p. aerugenosa, name another bug that causes persistent pneumoniae in cystic fibrosis

A

burkholderia cepacia

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11
Q

A 35 year old clown who is a specialist in bird/clown comedy is found to have an atypical pneumonia which is treated with Augmentin and Clarythromicin. What is the causative organism?

A

chlamidophilia psittici

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12
Q

what is the treatment for standard HCV?

A

INF-alpha 2B, ribavirin

changes depending on the genotype of HCV under specialist guidance

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13
Q

which are the live attenuated vaccines?

A

MMR

yellow fever

Rotavirus

BCG

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14
Q

which are the inactivated/subunit vaccines?

A

HAV

HBV

pneumovax (PPV-23) (polysaccheride)

HPV

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15
Q

which are the conjugate vaccines? (5)

A

diptheria, tetanus, pertussis

HiB

5 in 1 (DTaP/IPV/Hib)

pneumococcal conjugate vaccine

meningococcal

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16
Q

which are the inactivated toxin vaccines?

A

tetanus

diptheria

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17
Q

the contraindication valid for all vaccines?

A

confirmed anaphylactic reaction to a previous dose of the vaccine or component of the vaccine

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18
Q

a precaution for consideration for DTaP vaccine

A

evidence of evolving neurological condition (e.g. epilepsy)

postpone until condition under control

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19
Q

a contraindication only for influenza vaccine

A

confirmed allergy/hypersensitivity to egg

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20
Q

what are the added contraindications to live vaccines?

(on top of previous anaphylaxis and egg allergy)

A

immunocompromising treatment or condition

pregnancy

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21
Q

which vaccines should and should not be given in HIV?

A

SHOULD give - MMR, 5 in 1

SHOULD NOT give - yellow fever, BCG

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22
Q

what vaccinations are given at 8 weeks?

A

5 in 1

PCV

Men B

Rotavirus

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23
Q

what vaccinations are given at 12 weeks?

A

5 in 1

Rotavirus

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24
Q

what vaccines are given at 16 weeks?

A

5 in 1

PCV

MenB

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25
Q

what vaccines are given at 1 year?

A

MMR

Hib booster

PCV booster

MenB/C

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26
Q

what vaccines are given at 3 years 4 months?

A

MMR

DTaP/IPV

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27
Q

what vaccines are given at 12-13 years old?

A

HPV quadravalent

repeated 6-24 months apart

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28
Q

what vaccines are given at 14 years?

A

tetanus, diptheria and polio (Td/IPV)

MenAWCY

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29
Q

at what ages are the influenza vaccine given?

A

2-7

>65

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30
Q

what is a naturally occuring cytokine that inhibits HIV fusion to CD4+ cells?

A

MIP-1alpha

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31
Q

antibiotic for MRSA

A

vancomyin or ticoplanin

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32
Q

treatment for hairy leukoplakia?

A

aciclovir, EBV is implicated organism

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33
Q

treatment for VRE?

A

amoxillin (if susceptable), gentamicin, linezolid

doxycyclin

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34
Q

which of RIPE is given as TB prophylaxis?

A

isoniazid

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35
Q

This microbes affects mainly the distal colon, producing acute mucosal inflammation and erosion. It is spread by person-to-person contact, and its clinical features include fever, pain, diarrhoea and dysentery.

A

Shigella

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36
Q

This microbe affects the ileum, appendix and colon. Its peyer patch invasion leads to mesenteric lymph node enlargement with necrotising granulomas. Complication can include peritonitis, pharyngitis and pericarditis.

A

Yersinia enterocolitica

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37
Q

how do you contract brucellosis?

A

ingestion of unparteurised milk or undercooked meat

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38
Q

cyclical fever, arthralgia, sacoiliac pain, anorexia, weakness and malaise

should make you think of what infection?

A

brucellosis

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39
Q

Q fever is caused by which bug?

A

coxiella burnetii

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40
Q

fever, dry cough, headache, animal exposure in southern france or spain

A

Q fever - coxiella burnetii

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41
Q

typhus is caused by …

typhoid is caused by…

A

typhus = rickettsia spp.

typhoid = salmonella typhi/paratyphi

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42
Q

what bug causes psittacosis?

A

Chalmidophila psittaci

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43
Q

An ornithologist presents to his GP with fever, arthalgia and cough and dyspnoea

diagnosis?

A

psittacosis

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44
Q

what is the animal vector for leptospirosis?

A

rodents

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45
Q

a flu-like illness followed by diarrhoea and jaundice

zoonosis

what bug?

A

leptospira

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46
Q

flu-like illness, jaundice, haemorrhage, red eyes…

A

leptospirosis

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47
Q

how do you make the diagnosis of leptospirosis?

A

microscopic agglutination test

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48
Q

what is the other cancer caused by HHV8 in HIV+ patients?

A

primary effusion lymphoma

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49
Q

what is the bug in rat-bite fever? Commonly in Asia

A

spirillium minor

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50
Q

A student who presented with two day history of bloody diarrhoea, vomiting, fever, headache and myalgia. He has just returned from camping in the country side near a farm where he had fresh cow’s milk for breakfast everyday.

What bug?

A

Campylobacter jejuni

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51
Q

A 2 year old boy living in the slums who has a one day history of profuse watery diarrhoea, fever and abdominal cramps. His family’s main source of water is the river near their squatters.

What bug?

A

cryptosporidium parvum

52
Q

A zoonosis associated with hepatitis, jaundice, conjunctival injection and renal impairment. Transmission normally occurs by direct contact with either the urine or tissues of an infected animal.

disease/bug?

A

leptospirosis

leptospira interrogans

53
Q

A 22 year old student, who returned from a holiday in the Mediterranean 3 weeks ago, presents with an undulant fever, malaise, weakness and generalized bone pain. Upon examination lymphadenopathy and hepatosplenomegaly are also noted.

disease?

A

Brucellosis

54
Q

Brucella is a ..

A

small, gram -ve facultative intracellular bacteria

55
Q

how do you get brucellosis?

A

from ingestion or contact with contaminated food (usually milk and dairy products)

also from animal/environmental contact

56
Q

classically a fever that undulates

peaks in the evening and normal by morning

A

brucellosis

57
Q

what is the incubation period of brucellosis?

A

3-4/52

58
Q

anti-O-polysaccheride antibody is the serological test for what disease?

what would you find on FBC?

A

brucellosis

WCC normal/neutropaenic

59
Q

what is the treatment of brucellosis?

duration of treatment

A

Tetracycline/doxycycline + streptomycin

duration: 4-6/52

60
Q

fatel encephalitis with Negri bodies suggests…

A

rabies

61
Q

leptospira is a..

how do you classically get this bug?

A

spirochete

swimming in contaminated water

62
Q

conjunctival haemorrhage with jaundice suggests…

A

leptospirosis

63
Q

lyme disease

how can you confirm the diagnosis?

A
  1. skin biopsy at edge of ECM
  2. ELISA for anti-Lyme antibodies
64
Q

first line treatment for lyme?

with CNS involvement?

A

doxycycline 2-3/52

CNS = IV ceftriaxone 2-4/52

65
Q

Skin ulcer at site of bite
multiply in dermal macrophages
Heals after 1yr leaving depigmented scar
May be single or multiple painless nodules which grow + ulcerate

A

cutaneous leishmaniasis

66
Q

what is the difference between cutaneous and diffuse cutaneous leishmaniasis?

A

C = single nodule that ulcerates and heals over

DC = diffuse nodular skin lesions that do not ulcerate or heal and spread over the body in immunocompromised patients

67
Q

what bug is likely to cause prostatic valve endocarditis?

A

CoNS

68
Q

what are the major Dukes Criteria? (3)

A
  • persistent bacteraemia (>2 cultures +ve)
  • echo findings suggestive of IE
  • +ve serology for bartonella, coxiella or brucella
69
Q

what are the minor Dukes criteria? (6)

A
  1. predisposing RF - new murmur, IVDU
  2. fever >38 degC or elevated CRP
  3. evidence of immune complex deposition
  4. vascular phenomena
  5. Positive echo that doesn’t meet major criteria
  6. Positive blood culture that doesn’t meet major criteria
70
Q

what is the empirical antibiotic treatment for IE with native or prosthetic valve?

A

native - fluclox

prosthetic - vanc, gent and rif

71
Q

what animal has brucella abortis? and what animal has brucella melitensis?

A
  • b. abortis* - cattle
  • b. melitensis* - goat (people from med/europe)
72
Q

A 55 year old farmer is seen in the Oncology clinic with a diagnosis of hepatocellular carcinoma. He is a lifelong teetotal and his virology has all been negative. Which fungus may have indirectly been a cause of his cancer?

A

aspergillus falvus

73
Q

which inhaled pathogenic fungus is associated especially with pigeon?

A

cryptococcus neoformans

74
Q

what are the pnaeumoina bugs that CF patientes get?

A
  • pseudomonas aeruginosa*
  • burkholderia cepacia*
75
Q

Can be used as monotherapy for acute pyelonephritis and should always be prescribed orally because its bioavailability is near 100% and iv dosing is 30 times more expensive

A

ciprofloxacin

76
Q

bug that causes haemorrhagic cystitis in children

A

adenovirus

77
Q

In combination with iv ampicillin, this drug is used iv for very sick patients with obstructed infected upper UTIs and gram negative septicaemia

A

gentamicin

78
Q

why do you avoid nitrofurantoin at term in pregnancy?

A

haemolysis in the foetus/newborn

79
Q

a sterile pyuria suggests what organism?

A

tuberculosis

80
Q

A 35 year old woman receiving chemotherapy for high grade lymphoma develps SOB and dry cough. CXR shows bilateral reticulonodular shadowing. A transbronchial biopsy shows alveoli filled with foamy eosinophilic material and numerous boat-shaped organisms staining positively with silver stain. Sputum culture is negative.

what bug?

A

PCP

don’t forget that all immunocompromised patients are at risk, not just AIDS

81
Q

what is the timing for antibiotic prophylaxis for colorectal surgery?

A

cef & met 2 hours before and for 24 hours after surgery

82
Q

gram positive cocci in chains, which is aesculin-positive and resistant to the conventional anti-streptococcal antibiotics

A

VRE

83
Q

what is the treatment for EBSL?

A

carbapenems

84
Q

what is the treatment for MRSA?

A

vancomycin

85
Q

microfilariae and eosinophilia suggests…

A

wuchereria bancrofti

86
Q

how do you treat entamoeba?

A

metronidazole

if luminal disease, add paromomycin

87
Q

bloody diarrhoea, weight loss, tenesmus and RUQ pain

A

entamoeba histolytica

88
Q

Slow onset fever + constipation, relative bradycardia
Splenomegaly and rose spots, anaemia and leukopaenia

A

typhoid fever (salmonella typhi and paratyphi)

89
Q

you should give antibiotics to shigella or salmonella?

which one?

A

salmonella - ceftriaxone/ciprofloxacin

90
Q

who gets vibrio parahaemolyticus?

A

people eating raw/undercooked seafood

common in Japan

91
Q

which bug is associated with muco-cutaneous leishmeniasis?

A

L. braziliensis

92
Q

An acutely unwell 42 yr old male presents to A&E with high fever accompanied by chills, sweats and vomiting with a 24 hour history. O/E he is clinically jaundiced with cool clammy skin. He is tachypnoeic and tachycardic. You note hepatosplenomegaly and that he is producing small amounts of dark brown urine in his catheter bag. His wife tells you that they recently returned from safari in Tanzania 10 days ago

A

plasmodium falciparum

93
Q

A French mother brings her 2 month old daughter with fever to hospital. The infant is shown to have elevated hepatic enzymes and is treated with pyrimethamine, sulphadiazine and folic acid for a year after appropriate investigations are performed

A

congenital toxoplasmosis

94
Q

A neonate is referred and presents with skin lesions, lymphadenopathy and failure to thrive. The mother had an infection

A

syphilis

95
Q

how do you diagnose PCP?

A

sputum/BAL –> Gomori’s stain looking for flying saucer shaped cysts

96
Q

A 34-year-old HIV-positive woman is seen in the GP clinic due to 3 days of diarrhoea, headaches and fever. History reveals the patient had recently drunk unpasteurized milk. The causative organism is found to be beta haemolytic with tumbling motility.

A

listeria monocytogenes

97
Q

miscroscopic agglutination test …

A

leptospirosis

98
Q

what is Mollaret’s meningitis?

what are the findings on CSF?

A

recurrent, aseptic meningitis caused by HSV-1/-2

clear CSF, high lymphocytes, high protein, normal glucose

99
Q

blood culture on Castaneda medium means what?

A

Brucella spp.

100
Q

what is the diagnostic test for CJD?

how do you proceed from there?

A

EEG - abnormal in 2/3 patients..

Then LP looking for 14-3-3 protein

if negative, can continue to tonsilar biopsy if you suspect vCJD (100% sensitivity and specificity)

101
Q

what are the symptoms of CJD?

A

‘demented LAMB’

Lower motor neuron signs, Akinetic mutism, Myoclonus, cortical Blindness

102
Q

on CSF analysis, what is the differentiating factor between viral and TB meningitis?

A

TB = VERY high protein

viral = very high lymphocytes, all else quite normal

103
Q

what is the diagnostic criteria for SBP on ascitic tap?

A
  1. WCC >500 cells/mm^3
  2. neuts >250 cells/mm^3
104
Q

what is the treatment for hepatitis C?

what does this depend on?

A

interferon and ribavirin

genotype 1, 4, 5, 6 = 48 weeks

genotype 2, 3 = 24 weeks

105
Q

what is the difference between trypanosoma brucei subspecies?

what is the bug that bites to give this infection?

A
  • gambiense* = gradual (95% of cases)
  • rhodesiense* = gradual (5% of cases)

Tse-tse fly

106
Q

what disease is transmitted by sandfly?

A

leishmaniasis in afria, america and middle east

107
Q

which TB drug needs monitoring in a certain patient setting? which patients? what is the potential consequence?

A

ethambutol in renal failure

renally excreted so will increase chances of optic neuritis

108
Q

what must not be missed when starting anti-malarials?

A

G6PD deficiency

109
Q

Maurer’s clefts on thin blood film…

A

falciparum

110
Q

Schuffer’s dots on thin blood film…

A

vivax and ovale

111
Q

what is amantadine?

A

anti-influenza A

targets M2 ion channel, resistance easily aquired

112
Q

what is the main use of cidofovir?

A

CMV retinitis

113
Q

what must be given with foscarnet and cidofovir?

A

both nephrotoxic so maintain positive fluid balance

add probenecid

114
Q

what gives hydrops fetalis? what gestation is foetus at risk?

A

parvovirus B19

first 20 weeks

115
Q

a gram +ve rod that give meningitis…

A

listeria monocytogenes

116
Q

how do you treat cephalosporin resistant N gonorrhoaea?

A

spectinomycin

117
Q

how is the treatment different for LGV versus chlamydia?

A

needs doxy

118
Q

silver stain, boat shaped cells…

A

PCP pneumonia

119
Q

gram negative coccus pneumonia associated with smoking

A

M catarrhalis

120
Q

what is the treatment for CAP? Mild/moderate+/atypical

A

mild - amoxicillin or macrolide (at home)

moderate/severe - coamox/cefuroxime or clarithromycin (hospital)

atypical - macrolide or tetracycline (hospital)

121
Q

campylobacter treatment

A

erythromycin

122
Q

what medication do you give to CF patients for anti-pseudomonas lung cover?

A

nebs ceftazidime

123
Q

fish tank granuloma - slinge or clusters of papules/plaques

seen in swimming pool/aquarium workers

A

mycobacterium marinarum

124
Q

returning from tropics/australia

painless nodule, progresses to ulceration, grossly disfiguring scarring and contracture

A

mycobacterium ulcerans

125
Q

what disease do you get with infection from microsporum canis?

A

tinea capitis and corporis

126
Q

what is the treatment for JC virus PML?

A

dexamethasone and HAART

127
Q

which UTI is associated with renal calculus?

A

proteus

Pathology BB quizzes (5 decks)

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