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Path - HANIN > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What lesion do you see in TB?

A

Caseating granuloma

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2
Q

When TB multiples at pleural surface and involves lymph nodes

A

Ghon focus

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3
Q

When TB goes systematic?

A

Miliary TB - haematogenous spread

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4
Q

Ix for TB

A 
CXR - upper lobe cavitation
Sputum culture - bronchoaveolar lavage if needed 
PCR/NAAT on sputum culture 
Mantoux test 
Acid fast bacilli with Ziehl-Neelsen
IGRA
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5
Q

What are the features of TB meningitis?

A 
Weight loss
Fever 
Night sweats 
Headache 
Stiff neck 
Photophobia 
Low GCS 
Focal neurological deficit
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6
Q

How to diagnose TB meningitis?

A

CT

LP

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7
Q

Tx of TB meningitis

A

12 months anti-TB medication and steriods

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8
Q

Manifestation of spinal TB

A

All the TB symptoms and back pain
Discitis leads to vertebral destruction + collapse
Iliopsoas abscess

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9
Q

Ix of spinal TB + Tx

A

MRI/CT + biopsy/aspirate + one year anti-TB tx

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10
Q

What kind of vaccine is the BCG?

A

Attenuated

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11
Q

What kind of strain does the BCG use?

A

M.bovis

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12
Q

Who cant have the BCG vaccine?

A

HIV patients

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13
Q

What causes leprosy?

A

M.leprae + M.lepromatosis

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14
Q

Manifestations of leprosy?

A

Skin : depigmentation that lacks sensation, macules, nodules, ulcers
Neuro: thickened nerves causing neuropathy
Eyes: iridocyclitis, keratitis
Bone: periositis aseptic necrosis

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15
Q

Types of leprosy

A

Paucibacillary –> Multibacillary

TT - tuberculoid
BT - borderline tuberculoid
BB - borderline 
BT - borderline lepromatous 
Lepromatous BT
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16
Q

Tx of leprosy

A

Rifampicin, dapsone, clofazimine

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17
Q

Tx of TB

A

Initiation phase: 8 weeks

  • Rifampicin - hepatoxiticy and drug interactions
  • Isoniazid - hepatoxicity + peripheral neuropathy
  • Ethambutol - optic neuritis and visual disturbances
  • Pyrazinamide - dont give to gout patients. hepatoxicity
  • Pyrodixone (B6) - give to pregnant, alcoholics, HIV+, neuropathy patients

Continuation phase: 16 weeks

  • Rifampicin
  • Isoniazid
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18
Q

Tx of latent TB

A

6 months of isoniazid

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19
Q

Tx of resistant TB

A

mono - one drug only
MDRTB - RIF + INA
XDRTB - RIF + INA + injectables (amikacine) + quinolones

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20
Q

CURB65

A 
Confusion 
Urea > 7 
Resp rate >30 
BP <90
65 - age +

Score more than 2+ = hospitalisation, more than 3+ = severe pneumonia

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21
Q

Types of pneumonia

A

CAP + HAP
Bronchopneumoniae
Lobar
Atypical - usually in the interstium so outside the alveoli

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22
Q

Red hepatisation

A

Liver-like appearance of the lung tissue due to exudate filling the air spaces. Day 3-5

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23
Q

Gray hepatisation

A

Happens after red hepatisation when the RBC in the exudate start to break down. Day 5-7

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24
Q

Reticular CXR ?

A

Atypical pneumonia

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25
Q

Organisms associated with pneumoniae

A

Typical:

Strep pneumoniae +
Staph aureus  +
H. influenzae - 
K. pneumonia - 
M. catarrhalis  -

Atypical: look for extrapulmonary features and weird CXR or no signs

Klebsiella 
Mycoplasma pneumonia 
Legionella pneumophilia 
Chlamydia pneumonia 
Chlamydia psittaci 
Bordatella pertussis 
TB
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26
Q

Legionella pneumophilia

A

Airconditioning, water towers, hepatitis, hyponatremia

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27
Q

Mycoplasma pneumonia

A 
THINK COLD AGGLUTININ TEST 
JOINT PAIN 
SJS 
Erythema multiforme 
Systemic symptoms
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28
Q

Chlamydia psittaci

A

Birds

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29
Q

Strep pneumonia

A

Lobar pneumoniae

Rusty-coloured sputum

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30
Q

H.Influenzae

A

COPD and smokers

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31
Q

M.Catarrhalis

A

Smokers

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32
Q

S.Aureus

A

Think recent viral infection

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33
Q

K.pneumonia

A

Alcoholics
Old people
Haemoptysis

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34
Q

ok bmt, what is the treatment for CAP? (mild)

A

outpatient amoxicillin

If allergic/2nd line - erythomycin (macrolide)

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35
Q

Supportive care for pneumonia

A

O2 therapy (careful COPD patients - aim for 92%)
IV fluids
OBs

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36
Q

Tx for CAP (moderate)

A

Amoxicillin + Erthyromycin/clarithyromycin

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37
Q

Tx for atypical pneumonia

A

Macrolide/Tetracyline

AKA - clarithomycin + doxycycline (?)

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38
Q

Tx for HAP ?

A

Cipro + vancomycin

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39
Q

Tx for aspiration pneumonia

A

Cefuroxime + metro

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40
Q

Tx for s.aureus

A

Flucloxacillin

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41
Q

Tx for legionella pneumonia

A

Macrolide + rifampicin

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42
Q

Tx for MRSA pneumonia

A

Vancomycin

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43
Q

Tx for pseudomonas spp

A

Cipro + gentamicin

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44
Q

Reid index in chronic bronchitis

A

> 40%

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45
Q

Blue bloaters

A

Chronic bronchitis

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46
Q

What infections are patients with chronic bronchitis at risk of?

A

Chest:

  • Viral
  • Strep pneumonia
  • M. Cattahalis
  • H. influenzae
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47
Q

What kind of pneumonia would HIV patients get?

A

P. Jiroveci
TB
Cryptococcus neoformans

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48
Q

What kind of risk do patients with splenectomy

A

Encapsulated organisms:

  • H.influenzae
  • N.meningitiditis
  • S.pneumonia
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49
Q

Which organism do cystic fibrosis patients get?

A

Pseudomonas aeruginosa

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50
Q

Which organism can cause bone marrow suppression?

A

Aspergillus + CMV

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51
Q

Tx of bronchitis

A

Bronchodilators
Physiotherapy
Antibiotics if secondary infection as well

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52
Q

Types of fungal infections

A

Superficial vs deep

Yeast vs mould

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53
Q

How to diagnose superficial fungal infection

A

wood’s lamp

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54
Q

Types of superficial fungal infection

A

Tinea - athletes foot, ringworm

Pityriasis - seborrhoeic dermatitis, t.vesicolour (weird depigmentation)

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55
Q

Types of deep fungal infections

A

Candida - esp immunocompromised
Aspergillus - allergy, pneumonia in immunocompromised
Cryptococcus - immunocompromised (meningitis)

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56
Q

How to diagnose deep candida infection?

A

Culture, antibodies, mannan

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57
Q

How to diagnose deep aspergillus infection ?

A

ELISA, PCR, beta-glucan test

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58
Q

How to diagnose deep crytococcus infection?

A

Crytococcal antigen in serum/CSF

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59
Q

How do you treat cryptococcus meningitis?

A

Amphotericin B

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60
Q

Which antifungal target cell membrane synthesis

A

Fluconazole

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61
Q

Which antifungal targets cell membrane integrity

A

Amphotericin

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62
Q

Which antifungal targets DNA synthesis

A

Flucytosine

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63
Q

Which antifungal targets cell wall

A

Caspofungin

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64
Q

What causes clostridium botulinum?

A

Canned/vacuum packed food esp honey and beans

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65
Q

How does clostridium botulinum affect the body? (Anaeorbic)

A

Blocks Ach release from peripheral nerves

Leads to descending paralysis (opposite of GBS)

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66
Q

What causes clostridium perfringens? (Anaerobic)

A

Reheated meat, super antigen enterotoxin
Leads to massive cytokine production by CD4
Acts on small bowel - think watery diarrhoea + cramps. Lasts 24 hours

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67
Q

What causes clostridium difficile? (Anaerobic)

A 
2 exotoxins (A,B) 
Results in pseudomembranous colitis 
CAUSED BY ABX - meeeeeee ciproooo
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68
Q

Virulence factors in s.aureus

A

Protein A
Catalase
Coagulase +ve

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69
Q

Symptoms of s.aureus (aerobic) GI infection?

A

Persistent vomting and diarrohea. No blood

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70
Q

What would you see on the blood agar - s.aureus?

A

Beta haemolytic

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71
Q

Different types of E.Coli infections?

A

EPEC - infantile diarrhoea (Paeds)
EHEC - haemorrhagic
ETEC - Toxigenic, Traveller’s diarrhoea. Acts on jejeunum, heat labile LT, ST?
EIEC - Invasive dystentry
HUS - anaemia, thrombocytopenia and renal failure (0157:H7 toxin)

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72
Q

How to treat e.coli GI infections?

A

Self-limiting or use ciproflaxcilin

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73
Q

How to treat Clostridia (perfrigens, difficile, botulinum)

A

Antitoxin. Metro/vanc for difficile - PO

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74
Q

How to treat s.aureus GI infections?

A

Self-limiting

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75
Q

Different types of salmonella?

A

Typhi
Paratyphi

  • Multiples in the peyers patches
  • Slow onset fever + constipation with bradycardia
  • Splenomegaly
  • Rose spots
  • Anaemia
  • Leukopenia
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76
Q

Tx of salmonella

A

Cipro or Ceftriaxone

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77
Q

Where does shigella attack?

A

Distal ileum and colon causing mucousal inflammation

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78
Q

Symptoms of shigella?

A

Bloody diarrhoea
Fever
Pain
Caused by the shigella enterotoxin

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79
Q

da fuck is Yersinia entercolitis

A

Animals shitting in food or something
So bad - you get reactive arthritis, erythema nodosum, mesentric adenitis, enterocolitis, necrotising granulomas. Likes a cold environment 4 degrees

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80
Q

How do you tx shigella?

A

Avoid antibiotics. Use cipro if you have to

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81
Q

What is the mechanism in cholera?

A

increased cAMP opens Cl- channel at apical membrane of enterocytes –> efflux of Cl- to lumen. Lose a lot of water and electrolytes

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82
Q

Why would me and yaz have 3 day hx of diarrhoea in japan?

A

parahaemolyticus and you get it from undercooked seafood

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83
Q

Tx of vibrio 1parahaemolyticus

A

Doxycycline

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84
Q

Tx of vibrio cholera

A

supportive

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85
Q

What is vibrio vulnificus?

A

cellulitis in peeps that handle shellfish handlers

Fatal septiciaemia with D+V in HIV patients

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86
Q

What causes campylobacter jejuni?

A

drinking unpastuerised milk, food

First you get headache, fever and the you get the tummy pain and foul, bloody diarrhoea

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87
Q

How do you treat campylobacter jejuni?

A

Erythomycin

88
Q

Symptoms of listeria

A

Watery diarrhoea, fever but little vomiting

Neonates and immunocompromised at risk

89
Q

Tx of listeria

A

Ceftriaxone

90
Q

Who gets Entamoeba histolytica

A

gay dudes

Its a motile trophozoite in diarrhoea

91
Q

Symptoms of entamoeba histolytica

A

Tenesmus, wind, dysentery, weight loss, RUQ due to liver abscess

92
Q

Dx of entamoeba histolytica

A

Stool microscopy and histology shows flask shaped ulcer on histology

93
Q

Who gets Giardia lamblia

A

Mental hospital patients, MSM, travellers

94
Q

Symptoms of Giardia lamblia

A

you get malabsorption of proteins + fats so you get foul smelling non-bloody diarrhoea

95
Q

Dx of Giardia lamblia

A

ELISA string test

96
Q

Tx of both Giardia lamblia and entamoeba histolytica

A

Metro

97
Q

What are the viral causes of secretory diarhorrea

A 
Rotavirus - kids under 6 years 
Adenovirus - non bloody diarrhoea. Think kids under 2 years 
Norovirus 
Enterovirus 
Poliovirus
98
Q

Good way to remember what triggers clostridium difficile diarrhoea

A

3Cs : cipro, clindamycin, cephalosporins

99
Q

when can we say someone has pyrexia of unknown origin?

A

More than 3 weeks and over 38.3 degrees without a diagnosis despite intensive investigations

100
Q

Classic PUO - what causes it

A

Mneumonic : Infections can make undergraduates die

Infection - TB, EBV, abscess
Connective tissue disorder - SLE, RA
Malignancy 
Undiagnosed - 
Drugs - phenytoin (rare)
101
Q

Nosocomial PUO

A

Happens in patients after 24 hours in hospital

Surgery 
Drugs - vanc, serotonergics 
Medical devices - lV line, catheter 
C.diff 
Immobilisation 
LRTI - esp ventilator-associated in ITU
102
Q

Neutropenic PUO (less than 500)

A

MEDICAL EMERGENCY

Look for:

  • Chemotherapy
  • Haematological malignancies
  • GVHD
  • Fungal and bacterial sepsis
  • Mycobacteria
103
Q

HIV associated PUO

A 
Seroconversion 
TB 
Kaposi sarcoma 
CMV 
PCP 
Lymphoma 
Drug fever 
Cryptococcus
104
Q

Ix PUO

A

Rule out foreign travel
Vasculitis screen : pANCA, cANCA, Rho, La
Urine dip
Bence-jones proteins/protein electrophoresis
Familial diseases: cyclic neutropenia, fabry’s disease

105
Q

What causes fever in a returning traveller?

A 
Dengue 
Typhoid 
Malaria 
HIV seroconversion 
Viral haemorrhagic fever (ebola) 
Brucella
106
Q

Different types of malaria species

A

P. Falciparum - most common and most severe
P. Vivax
P. Ovale
P. Malariae

107
Q

Duffy antigen

A

P. Vivax. Reason for SCD immunity cos they lack this receptor

108
Q

Which malaria species goes dormant? (hypnozites)

A

P.Ovale + P.Vivax

109
Q

What do you see under the microscope in early P.Falciparum erythocytic phase?

A

Young trophozites (ring form)

110
Q

Schizonts

A

P.Falciparum (seen in the later stage) - brown smudge

111
Q

Quartan fevers (every 72 hours)

A

P.Malariae

112
Q

Tertain fevers (every 48 hours)

A

P.falciparum, p.ovale, p.vivax

113
Q

Ischaemic damage in malaria

A

P.falciparum (organ failure - sticky so adheres and blocks vessels ‘knobs’)

114
Q

Complications of malaria

A 
Cerebral malaria - seizures, coma etc 
Bilous malaria - involving the liver causing jaundice 
Spleen infarction 
Anaemia 
Shock 
Pulmonary oedema 
Acidosis 
Renal impairment 
Hypoglycaemia
115
Q

Ix of malaria

A 
Thick blood film - to find parasites 
Thin blood film - to identify the species 
LFTs 
Plt count - low 
Normocytic normochromic anaemia - low Hb
116
Q

Tx of malaria

A

P. falciparum - quinine (mild) for 7 days then doxycycline

P. Vivax and P.ovale - chloroquine and then primaquine

117
Q

Symptoms of malaria

A 
Fever
Splenomegaly 
Anaemia 
Vomiting 
Rigors 
Myalgia 
Jaundice
118
Q

Prion protein gene - which chromosome?

A

Chr20

119
Q

Pathology of prion disease

A

PrP –> PrP^sc

Accumulation of misfolded proteins

120
Q

Delaying prion disease

A

Tetracycline
Pentosan
Quinacrine

121
Q

symptomatic relief of prion disease

A

clonazepan for myoclonus

122
Q

Different types of CJD

A

Sporadic
Variant
Iatrogenic
Inherited prion disease

123
Q

Sporadic CJD

A 
PRNP mutation (129 codon) 
EEG - periodic triphasic changes 
Raised CSF 14-3- protein +ve
124
Q

14-3-3 protein

A

Helps with apoptosis of neurones esp in prion disease

125
Q

Variant CJD

A

From eating infected cows

Diagnosed from tonsillar biopsy

126
Q

Pulvinar sign

A

Posterior thalamus highlighted on MRI-T2

127
Q

Symptoms of sporadic CJD

A

Rapid, progressive dementia with myoclonus, lower motor neuron signs, akinetic mutism

128
Q

Symptoms of variant CJD

A

Pyschiatric symptoms and then neuro symptoms then dementia

129
Q

Gerstmann-Straussler-Scheinker syndrome

A

Autosomal dominant

Dysarthia progressing to cerebellar ataxia ending in dementia

130
Q

Fatal familial insomnia

A

Autosomal dominant
Insomnia, paranoia progressing to hallucinations and weight loss
Mute period
Death 8 weeks post symptoms

131
Q

Brucellosis - gram stain and how do you get it

A

Gram -ve

From eating/drinking untreated dairy products

132
Q

Symptoms of Brucellosis

A 
Undulant fever
malaise 
rigors 
sweating
myaliga 
fatigue
133
Q

Ix of brucellosis

A

High Anti-O-polysaccharide antibody
WCC normal
Neutropenia

134
Q

Tx of brucellosis

A

4-6 wks of tetracycle + streptomycin

135
Q

Negri bodies

A

Pathognomonic for Rabies

136
Q

What cauases plague?

A

Yersinia pestis

Gram -ve

137
Q

Tx of plague

A

Streptomycin
Doxycycline
Gentamicin
Chloramphenicol (meningitis)

138
Q

Leptospirosis- how do you get it?

A

Swimming in water with dog/rat piss

Gram -ve, L.interrogans

139
Q

Anthrax- how do you get it?

A

Farm animals

Gram -ve Bacillus anthracis

140
Q

What does Anthrax look like?

A

Painless round black lesion + rim of oedema

141
Q

Lyme disease? - causes

A

Borrelia Burgdoferi via ticks

142
Q

Lyme disease - dx

A

Biopsy edge of ECM + ELISA for lyme abs

143
Q

Tx of lyme disease

A

Doxy 2 wks

144
Q

What does Q fever look like?

A

Atypical pneumonia

145
Q

What organism causes Q fever?

A

Coxiella burnetii

146
Q

What animal causes Q fever

A

Cattle

147
Q

What do you give in Influenza A?

A

Amantadine (targets M2 ion channel)

148
Q

Up to when can you give antivirals for influenza?

A

48 hours
Oseltamivir
Zanamivir

149
Q

Antigenic drift

A

mutuations occur to NA/HA to give new strains of influenza virus

150
Q

Antigenic shift

A

Complete change of HA/NA so that strains can infect humans or animals when it couldnt before

151
Q

How does acyclovir (guanosine analogue) work

A

Blocks viral DNA replication via activation by viral thymidine kinase

152
Q

Why doesnt acyclovir work in CMV?

A

CMV doesnt have thymidine kinase so acyclovir wont work

153
Q

What do you give in CMV?

A

Ganciclovir

154
Q

Side effects of Ganciclovir?

A

Bone marrow suppression

155
Q

What does CMV infection do?

A 
Retinitis 
Colitis
Hepatitis
Encephalitis
Pneumonitis
156
Q

Owl eye inclusions

A

CMV cells

157
Q

Used in prophylaxis post organ transplant and resistant CMV

A

Foscarnet (nephrotoxic)

158
Q

Used in CMV retinitis

A

Cidofovir (nephrotoxic)

159
Q

when do you treat varicella zoser virus?

A

Pregnant women
Immunocompromised
Adults with pneumonitis

160
Q

Tx of Hep B

A

Interferon alpha 2a - upregulates MHC expression and direct antiviral effect
Lamivudine and entecavir - inhibits viral polymerase
Tenefovir - inhibits reverse transcriptase

161
Q

Tx of Hep C

A

Interferon alpha 2a/2b + Ribavirin

162
Q

SE of ribavirin

A

Haemolytic anaemia

163
Q

Treatment is more successful in which HCV genotype?

A

2 + 3

164
Q

What else can you use ribavirin for apart from HCV?

A

RSV and parainfluenza infection

165
Q

3 origiins of opportunisitic viral infections post transplant?

A

Reactivation of latent infection : herpes
Graft brought infection with it: Hep B
Post transplant oppurtunistic infection: measles etc

166
Q

Where do EBV and CMV remain dormant?

A

Leucocytes

167
Q

What is post-transplant lymphoproliferative disease?

A

EBV infection causes loss of control over latently infected b-cells

168
Q

How do you treat post-transplant lymphoproliferative disease

A

Reduce immune suppression + rituximab (anti-CD20)

169
Q

What virus causes kaposi sarcoma?

A

HHV 8

170
Q

What does a biopsy of kaposi sarcoma show?

A

Spindle cells and KSHV proteins

171
Q

Complications of measles

A

Giant cell pneumonia and encephalitis

172
Q

Ix of septic arthritis

A

Blood cultures before Abx
Joint aspiration
Inflammatory markers

173
Q

Abx for septic arthritis

A

Flucloxacillin - s.aureus IV

Can also be caused by strep. pneumoniae

174
Q

Tx of pyelonephritis

A

IV co-amoxiclav

175
Q

Inhibits cell wall synthesis

A

B-lactams - pencillin, ceph

Glycopeptides - vancomycin

176
Q

inhibits protein synthesis abx

A 
Macrolides - erythromycin (gram +ve)
Aminoglycoside - gentamicin (gram -ve)
Tetracyclines - doxy (dont give to pregger or kids) 
Chloramphenicol 
Oxazolidinones - linezoid (gram +ve)
177
Q

Inhibits DNA synthesis

A

Fluoroquinolones - cipro (gram -ve)

Nitroimidazoles - metro (anaerobes)

178
Q

Inhibit RNA synthesis

A

Rifampicin

179
Q

Inhibit folate metabolism

A

Trimethoprim

Sulphamethoxazole (PCP)

180
Q

Broad spectrum Abx

A

Cipro, co-amoxiclav, tazocin and meropenem

181
Q

Narrow spectrum

A

Metro, Gent, fluclox.

182
Q

Septic screen in neonatal sepsis

A

FBC, CRP, CSF, swabs, blood culture, CXR

183
Q

When is early onset neonatal sepsis?

A

Before 48 hours after birth

184
Q

Symptoms of late onset sepsis

A

poor feeding, irritability, resp distress, acidosis, bradycardia, jaundice, focal inflammation (umbilicus), convulsions,

185
Q

Causes of late onset sepsis

A

Coagulase negative staph, listeria, GBS and ecoli

186
Q

Dx of late onset sepsis

A

Septic screen: FBC, CRP, Swabs, CXR, CSF, blood culture

Urine dip

187
Q

Abx for late onset sepsis

A

BenPen + Gent - 1ST LINE

Tazocin + vanco - 2nd line

188
Q

Causes of meningitis - kids

A

Less than 3 months: GBS, ecoli, listeria, h.influenzae
More than 3 months: neisseria menigitidis
Less than 2 years : strep pneumonia

189
Q

What would you see in CSF of someone with bacterial meningitis?

A

High protein, high WCC and low glucose

190
Q

Tx of bacterial meningitis

A

Ceft and steriods

+ Amoxicilin for listeria cover

191
Q

When is CSF normal?

A

Viral encephaltitis - herpes

Cerebral abscess

192
Q

How do you treat meningoencephalitis

A

Acyclovir and ceft.

193
Q

Painful ulcers

A

Herpes > chancroid

194
Q

Painless ulcers

A

Syphilis> LGV

195
Q

Tx of gonorrhoea (SINGLE DOSE)

A

Ceft 250mg IM

Cefixime 400mg PO

196
Q

Tx of chlamydia

A

Doxycycline - 100mg BD 7/7

or azithromycin 1g single dose

197
Q

Rectal symptoms

A

Think LGV - chlamydia trachomatis, serovars L1,2,3

198
Q

Tx of LGV

A

Same as chlamydia

Doxy 1 wk 100mg BD

199
Q

Dx of syphilis

A

Non-treponemal tests: VDRL and RPR

Treponemal tests: Enzymes immunoassay

200
Q

Argyll-Roberston pupil

A

Syphillis

Prostititue pupil - accomodates but doesnt react

201
Q

Tx of syphillis

A

single dose Benzathine Pencillin

202
Q

Jarisch-Heimer reaction

A

Seen 4 hours post abx administration with fever, headache, myalgia and sometimes worsening of the syphillis symptoms

203
Q

Chancroid organism?

A 
Haemophilus ducreyi (-) 
Painful
204
Q

Donovanosis

A

Klebsiella granulomatis

205
Q

Dx of donovanosis

A

Giemsa stain of biopsy - donovan bodies

206
Q

Organism - molluscum contagiosum?

A

Pox virus

207
Q

Which HPV causes genital warts?

A

HPV 6 + 11 - podophyllotoxin cream (not suitable for pregnant women)

208
Q

Neonatal Herpes

A

Risk more at 3rd trimester and during delivery

209
Q

Tzanck cells

A

VZV cytology

210
Q

Paul bunnel/monospot - heterophil Abs

A

CMV

211
Q

Rose spots

A

Typhoid

212
Q

Tx of typhoid fever

A

Cipro

213
Q

Live vaccine

A

MMR
VZV
Yellow fever

214
Q

Inactivated vaccine

A

Rabies

Hep A

215
Q

Recombinant proteins vaccine

A

HBV

216
Q

Subunit vaccine

A

Influenza

Typhoid

217
Q

Conjugate vaccine

A

Meningitis C

Path - HANIN (5 decks)

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