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Theo's Path > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What are the side effects of Rifampicin?

A

Hepatotoxicity, induces cP450, orange secretions

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2
Q

What are the side effects of Isoniazid?

A

Peripheral neuropathy (give B6/pyrodixine)

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3
Q

What are the side effects of Pyrazinamide?

A

Hyperuricaemia, hepatotoxicity

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4
Q

What are the side effects of Ethambutol?

A

Optic neuritis, visual disturbances

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5
Q

Which of the following is the standard drug therapy for pulmonary TB?

  1. Isoniazid for 6 months
  2. RIPE for 2 months, then RI for 8-10 months
  3. RIPE for 4 months, then RI for 4 months
  4. RI for 2 months, then PE for 6 months
  5. RIPE for 2 months, then RI for 4 months
A

A. 5. RIPE for 2 months, then RI for 4 months

  1. Latent TB regimen
  2. Spinal TB/ TB meningitis regimen
    3&4 are incorrect
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6
Q

Which of the following is NOT a feature of Leprosy (Hansen’s disease)?

  1. Caused by M. Leprae + M. Lepramatosis
  2. Skin depigmentation, macules, plaques and nodules
  3. Keratitis and Iridoscelritis
  4. Nerve sparing
  5. Periositis, aseptic necrosis
A

A. 4, Nerve sparing.

Most disability in Leprosy is secondary to nerve damage (thickened nerves and sensory neuropathy)

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7
Q

A 32 year old male presents to GP with a 2 month history of productive cough and breathlessness. He has a 20 pack year history. On examination he has a low grade fever, equal air entry bilaterally and no localising signs. What is the most likely diagnosis?

A

A. Bronchitis.

Organisms: Viruses, S. pneumoniae, H. influenzae, M. catarrhalis
Rx: Bronchodilation, physiotherapy +/- abx

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8
Q

Which of the following organisms is a Gram negative cocco-bacillus?

  1. S. pneumonia
  2. H. influenza
  3. M. catarrhalis
  4. S. aureus
  5. K. pneumonia
A

A. 2. H.influenza

  1. S. pneumonia is a Gram positive diplococcus
  2. M. catarrhalis is a Gram negative coccus
  3. S. aureus is a Gram positive coccus with ‘grape-bunch clusters’
  4. K. pneumonia is a Gram negative rod
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9
Q

A 13 year old boy is brought to the GP by his mother. He has a history of cough and tiredness with joint pain and a rash on his hands and elbows. He is otherwise well with no PMHx. On examination the rash has a mixture of dusky macules and target lesions. Which of the following organisms is the most likely culprit?

  1. Legionella pneumophilia
  2. Mycoplasma pneumonia
  3. Chlamydophila pneumonia
  4. Chlamydia psittaci
  5. M. catarrhalis
A

A. 2. Mycoplasma pneumonia.

The rash is suggestive of erythema multiforme. Other common extrapulmonary features of the infection are joint pain, autoimmune haemolytic anaemia (cold agglutinin) and systemic symptoms.

  1. Another atypical pneumonia associated with air conditioning, hepatitis and low sodium.
  2. Atypical pneumonia that is difficult to diagnose and may cause bronchitis, and coronary artery disease.
  3. Atypical pneumonia associated with birds. Causes psittacosis. First week mimics typhoid fevera and the second week severe pneumonia.
  4. This is a typical pneumonia associated with smoking.
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10
Q

A 72 year old has been on the ward for 3 days and develops a productive cough of yellow sputum with breathlessness and fever. You have requested a CXR and taken bloods, what is the first-line anitbiotic therapy?

  1. Penicillin e.g. Amoxicillin or Macrolide e.g. Erythromicin for 5-7 days
  2. Penicillin + Macrolide for 2-3 weeks
  3. Macrolide or Tetracycline e.g. Doxycycline
  4. Ciprofloxacin +/- Vancomycin
  5. Cefuroxime + Metronidazole
A

A. 4. Ciprofloxacin +/- Vancomycin

This is first line choice for a HAP (>48 hours into hospital stay with no pre-existing infection)

  1. This is appropriate for classical mild-moderate CAP, with a macrolide being chosen in penicillin allergic patients.
  2. This is the choice for classical moderate-severe CAP.
  3. This is appropriate for atypical CAP e.g. Mycoplasma.
  4. This would be the choice for an aspiration pneumonia as it provides Gram +ve, -ve and anaerobic cover.
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11
Q

Which of the following is not a feature of Chlamydia trachomatis infection?

  1. Gram +ve obligate intracellular pathogen
  2. Often asymptomatic
  3. Complications include PID, infertility and opthalmia neonatorum
  4. Diagnosis is via NAAT
  5. Treatment is with Azithromycin 1g STAT
A

A. 1. The organism is a Gram -ve obligate intracellular pathogen.

Another therapy option is Doxycycline 100mg BD for 7 days.

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12
Q

Which of the following is not a feature of Neisseria gonorrhoea infection?

  1. Obligate intracellular Gram -ve diplococcus
  2. Risk of opthalmia neonatorum if untreated
  3. Diagnosed via urethral and rectal swab
  4. Treatment is with Metronidazole 250mg IM
  5. Presents with mucopurulent discharge
A

A.4. Treatment is with Ceftriaxone 250mg IM or Cefixime PO 400mg

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13
Q

Which of the following is a sign of late stage Lymphogranuloma venerum (LGV)?

  1. Genital ulcer
  2. Inguinal buboes
  3. Balanitis
  4. Abscess formation
  5. Urethritis
A

A. 4. Abscess formation.

LGV is a lymphatic infection with Chlamydia (serovars L1, L2, and L3) endemic in the developing world.

Stage 1 (early) 3-12 days - painless, genital ulcer, balanitis, proctitis, cervicitis 
Stage 2 (early) 2-25 weeks - inguinal buboes, fever, malaise 
Late LGV - inguinal LNpathy, abscess formation, frozen pelvis, rectal strictures

Diagnosed by NAAT.
Rx Doxycline 100mg BD for 21 days.

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14
Q

Which of the following is not a feature of syphilis?

  1. Obligate Gram negative spriochaete
  2. Treponemas seen by dark-ground microscopy
  3. Treponemal tests are not diagnositic in treated syphillis
  4. Treated with IM Benzathine penicillin
  5. Risk of congenital syphillis
A

A. 3. Treponemal antibody tests e.g. enzyme immunoassay (EIA), fluorescence testing (FTA) or agglutination (TPPA) are useful for years after effective treatment.

NB. Jarisch-Heimer reaction (fever, headache, myalgia) common within hours of abx

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15
Q

Which of the following is a feature of tertiary syphilis?

  1. Painless indurated genital ulcer
  2. Systemic bacteraemia
  3. Uveitis
  4. Maculopapular rash
  5. Aortitis
A

A. 5. Features of tertiary syphilis include granuloma, aortitis and neurosyphilis (meningovascular, Argyll-Robertson pupil)

  1. Primary syphilis (1-12 weeks following infection)
    2, 3, 4. Secondary syphilis.

Latent syphilis is asymptomatic.

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16
Q

Which of the following is not a feature of genital warts?

  1. Treated by cryotherapy
  2. Associated with increased risk of cervical cancer
  3. Often asymptomatic
  4. Clinical diagnosis of lesions
  5. Can recur after treatment
A

A. 2. Genital warts are caused by HPV 6 or 11. Oncogenic types are 16 and 18.

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17
Q

Which fungus causes athlete’s foot?

  1. Tinea
  2. Pityriasis
  3. Candida
  4. Aspergillus
  5. Cryptococcus
A

A1. Tinea is a dermatophyte that is responsible for ringworm and athlete’s foot.

  1. Piyriasis: seborrhoeic dermatitis, T. versicolor
  2. Candida: thrush (fluconazole rx), deep infection (amphtericin-B rx) in immuncompromised
  3. Aspergillus: allergy, pneumonia in low immunity (voriconazole)
  4. Cryptococcus: presents as meningitis in HIV, associated with birds (amphotericin B)
18
Q

This class of antifungals targets cell membranes and is effective against moulds (dermatophytes e.g. tinea)

  1. Polyene e.g. amphotericin
  2. Azole
  3. Terbinafine
  4. Flucytosine
  5. Echinocandin e.g. capsofungin
A

A3. Terbinafine

  1. Polyenes target cell membranes, but are indicated against yeasts
  2. Azoles target synthesis of cell membranes and yeasts
  3. Flucytosines target DNA synthesis
  4. Echinocandins target cell walls and yeasts
19
Q

Which species of malaria shows young trophozites (rings) and crescent-shaped gametocytes?

  1. P. Falciparum
  2. P. Vivax
  3. P. Ovale
  4. P. Malariae
  5. P. Knowlesi
A

A1. P. Falciparum is the most common, acute and severe malaria. It has a 48hr rhythm and is treated with Riamet or IV artesunate in complicated cases.

  1. Chronic, 48hr, Schuffner’s dots (>20 merozites/schizont)
  2. Chronic, 48ht, Schuffner’s
    2&3 Chloroquine then primaquine
  3. Benign, 72hr
20
Q

Gram negative rod causing atypical pneumonia with hyponatraemia

A

A. Legionella

21
Q

Gram negative rod associated with travelers and lakes. Causes HUS.

22
Q

Beta-haemolytic Gram positive coccus. Has toxic superantigens that rapidly cause shock.

A

A. S. aureus

23
Q

Patient with meningism has turbid CSF with increased protein, low glucose and predominantly lymphocytes.

24
Q

Aseptic meningitis with clear CSF, raised protein and lymphocytes with normal glucose

A

A. Viral (HSV-2 most common)

25
Q

Known as tropical ulcer disease. This bacteria causes unilateral lymphadenopathy and is grown on chocolate agar. It is a Gram negative coccobacillus.

A

A. Haemophilus ducreyi

26
Q

Glycopeptide antibiotic used against Gram positive bacteria and MRSA

A

A. Vancomycin

27
Q

Virus prevalent in Sub-Saharan Africa. It has a 2-6 month incubation period and causes acute hepatitis.

A

A. Hepatitis B

28
Q

What is the standard HAART regimen?

A

A. 2NRTIs + NNRTI/ PI

NRTI - Zidovudine
NNRTI - Efavirenz
PI - Ritonavir

29
Q

A cytokine used in treatment of HBV in combination wiht an NRTI

30
Q

Viral neuraminadase inhibitor used to treat influenza.

A

A. Oseltamivir

31
Q

Rose gardener’s disease

A

A. Sporothrix

32
Q

This zoonotic condition is associated with a maculopapular rash and North and South America

A

A. Rocky-Mountain Spotted Fever

33
Q

Gram negative rod that causes atypical pneumonia, classically in alcoholics. Blood stained sputum looks like redcurrant jelly.

A

A. Klebsiella

34
Q

When is the polio vaccine given?

A

A. 2m, 3m, 4m, 3y4m and 13-18y

2m DTaP/IPV/Hib
3m "
4m "
3y4m DTaP/IPV
13-18y Td/IPV
35
Q

Which strains of Leishmania cause visceral (Kal-azar) leishmania with fever and splenomegaly?

A

A.
L. donovani and infantum - Africa, Asia, Europe
L. chagasi - South America

36
Q

Which strains of Leishmania cause cutaneous Leishmania?

A

A.

L major and L tropica

37
Q

Which strains of Leishmania cause mucocutaneous Leishmania?

A

A. L braziliensis (South America)

Rx. Sodium stibgluconate

38
Q

Presents with depression, arthralgia, myalgia and sacroilitis. Also hepatosplenomegaly, anorexia and undulating fever.

A

A. Brucellosis

From infected unpasteurised milk, cheese and meat.

DDx - TB (no back pain), typhoid (ABCDE)

Ix - serum agglutination of abs
Rx - Doxy + gent PO

39
Q

A patient presents with ?hepatitis. Serology shows HBsAg+, HbeAg+ and anti-HBc IgM, what is their status?

A

A. Acute infectious HBV

HBsAg - has HBV acute or chronic 
HBeAg - infectious 
Anti-HBs - recovery or vaccination 
Anti-HBc IgM - acute 
Anti-HBc IgG - chronic
40
Q

Treatment for C. diff

A

A. Metronidazole PO 10-14 days followed by Vancomycin PO 10-14 days if that fails

41
Q

Sleeping sickness is carried by which vector?

A

A. Tsetse fly

Theo's Path (9 decks)

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