Microbiology Flashcards

1
Q

Which is the best specimen to send
to the Microbiology Lab to screen for sexually transmitted infections in a 20 year old asymptomatic female who attends her GP Practice?

A

A vulvovaginal swab for chlamydia/gonococcal PCR

Endocervical swabs are done during a pelvic exam and not really done otherwise

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2
Q

Metronidazole is the treatment of choice for which of infections?`

A

Bacterial vaginosis

Trichomons vaginalis

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3
Q

What are the L1-L3 serotypes associated with in chlamydia infection?

A

Lymphogranuloma Venereum infection in MSM

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4
Q

Which genital infection is indicated by the presence of “Clue cells” on microscopy?

A

Bacterial vaginosis

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5
Q

The increase in antimicrobial resistance for patients with gonorrhoea has resulted in what change of management?

A

Test of cure for all patients at 2 weeks

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6
Q

What is the current recommended treatment for Neisseria gonorrhoeae infection?

A

IM ceftriaxone

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7
Q

Most coliforms are sensitive to which antibiotic?

A

Gentamicin

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8
Q

What type of organism is a coliform?

A

Gram negative bacilli

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9
Q

Enteroccoci are sensitive to which antibiotic?

A

Amoxicillin

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10
Q

Gram negative anaerobes are sensitive to which antibiotic?

A

Metronidazole

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11
Q

What is the recommended empirical antibiotic treatment for a patient with suspected intra-abdominal sepsis who has normal renal function and is NOT hypersensitive to penicillin?

A

Amoxicillin
Metronidazole
Gentamicin

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12
Q

What is the recommended empirical antibiotic treatment for a patient with suspected intra-abdominal sepsis who has normal renal function and IS hypersensitive to penicillin?

A

Co-trimoxazole
Metronidazole
Gentamicin

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13
Q

Define what is meant by septic shock

A

Low blood pressure that does not come back up when IV fluids are given

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14
Q

What is a well recognised side effect of gentamicin?

A

Dizziness

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15
Q

Which is the MOST likely cause of bacterial meningitis in a previously healthy young adult in the UK?

A

Neisseria meningitidis

Healthy young person just gone into halls as a fresher with non-blanching maculopapular rash

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16
Q

What should be given with or just before the first dose of antibiotics if they are indicated in a patient with bacterial meningitis? Why?

A

Steroids (dexamethasone)

help reduce the morbidity associated with inflammation.

17
Q

Listeria is associated with the consumption of which foodstuff?

A

Soft cheese

18
Q

Why is ceftriaxone chosen for empirical treatment for suspected bacterial meningitis instead of penicillin?

A

Ceftriaxone has a longer half-life than penicillin

The longer half-life means patients can be treated with twice daily dosing

19
Q

What should be done if a patient does not want to tell their partner they have been infected?

A

Advise to tell him to get treated on the first instance

Next step would be referral to sexual services

20
Q

How long should you advise someone with an STI to abstain from sex?

A

Abstain for one week after both have been treated

21
Q

Chlamydia can remain in the system indefinitely in an asymptomatic state. True/False?

A

True

This can be the reason why a person with a long term partner can test positively for infection

22
Q

A test of cure is required for patients after treatment of chlamydia. True/ False?

A

False

23
Q

What type of urine sample is used to test for STI’s in men?

A

First pass urine for GC/CT PCR

24
Q

What type of urine sample is used to test for a UTI?

A

Mid-stream urine sample

25
Q

HSV should be tested for in a routine STI screen in a patient who is asymptomatic for this virus. True/False?

A

False
HSV should only be tested for in a symptomatic patient with active infection. Leaflets should be given advising the patient of symptoms.

26
Q

What is the SIRS criteria for sepsis?

A

Temp <36 or >38
Respiratory rate >20
Pulse >90bpm
WCC >12,000 or <4,000

27
Q

What is classed as severe sepsis?

A

Sepsis + organ dysfunction

28
Q

How is septic shock differentiated from sepsis?

A

Septic shock is sepsis + hypotension

29
Q

List the parts of the Sepsis 6 bundle?

A
Administer oxygen
Take blood cultures
Give IV antibiotics
Give IV fluids
Check serum lactate
Measure urine output
30
Q

List antibiotics that are at risk causing a C. difficile infection

A

Co-amoxiclav
Cephalosporins
Clindomycin
Ciprofloxacin

31
Q

List advice to give to a patient with recurrent UTI

A

Encourage better hydration (1.6l/day)
Encourage post-coital urination
Advise trying cranberry juice or supplements

32
Q

What is the first line treatment for bacterial meningitis?

A

Ceftriaxone IV
Dexamethasone IV
Amoxicillin IV for listeria cover

33
Q

What is the first line treatment for encephalitis?

A

Aciclovir IV

34
Q

What is characteristic of partially treated bacterial meningitis?

A

High lymphocytes