Microbiology Flashcards
If you want to test for chlamydia in a patient, what is the correct method and why?
Endocervical swab for PCR
Vulvovaginal swab for PCR
Vulvovaginal swab for culture
Vulvovaginal swab for PCR
It is not possible to culture chlamydia
Endocervical swab for PCR
Vs
Vulvovaginal swab for PCR
What is more invasive?
Endocervical swab
- this is not used routinely
- this is why vulvovaginal swab is used for diagnosis of chlamydia/gonorrhoea
Single dose azithromycin is treatment for which STI ?
NONE
- was previously used as a treatment
- not used anymore due to resistance
Describe, in microbiological terms, enterococcus faecalis?
Gram +ve cocci
How do you define septic shock
Give IV fluid resuscitation but this doesn’t improve the hypotension
Major side effect of gentamicin
Autotoxicity
- dizziness
In terms of bacterial meningitis, which organism is most common:
Neisseria meningitides
Strep pneumonia
Strep pneumonia
Healthy young person with neck stiffness and a non-blanching rash. What is the likely causative organism?
Neisseria meningitides
Why are steroids used in the treatment of meningitis? and for what organism are they used in?
Used for strep pneumonia
Steroids help reduce inflammation as there is a lot of inflammation in strep pneumo
Which food products is listeria found on?
Soft cheese
Deli meats
Why is ceftriaxone used to treat meningitis over penicillin?
Ceftriaxone has a longer half life
More reliable
Lasts longer in the CSF
Why is azithromycin no longer used to treat STIs
Concerns in resistance
- peoples infections were not being eliminated
Patient comes to the GP and is subsequentally diagnosed with chlamydia. She is given 7 day treatment of Doxycycline. She asks you the following question: “How long do I need to wait until I can resume having unprotected sex with my partner”?
Abstain from sex for 1 week
- wait until completion of treatment
A test of cure must be done for both chlamydia and gonorrhoea. True or false?
False
Test of cure is required for gonorrhoea
No test of cure is needed for chlamydia
Why is a test of cure not required for chlamydia?
Confident enough that the treatment works so no test of cure needed
Asymptomatic male for chlamydia. Which test will he be offered
First pass urine sample - For GC/CT PCR Blood for - syphilis - hepatitis - HIV
It is impossible to investigate an asymptomatic person for herpes. True or false?
True
- wen investigating for herpes simplex virus, you need to deroof the blisters. Therefore, the patient needs to be symptomatic
You are in a GP setting and a patient’s STI test results have returned. The patient has gonorrhoea. Should you
- treat the patient in GP setting
- refer patient to sexual health clinic?
Refer patient to sexual health clinic
- then give IM ceftriaxone
You are in a GP setting and a patient’s STI test results have returned. The patient has chlamydia. Should you
- treat the patient in GP setting
- refer patient to sexual health clinic?
Treat the patient in the GP setting
- oral doxycycline 7 days
Patient on IV AMG treatment for sepsis but it is now day 4 and the patient is still febrile. What do you do in terms of management?
A – drug therapy is OK because amoxicillin will treat most coliforms
B – write another dose of gentamicin
C – write her up for another few days of gentamicin
D – prescribe aztreonam as substitute for gentamicin as this is day 4
D - prescribe aztreonam as substitute for gentamicin as this is day 4
+ stop the amoxicillin and metronidazole as there is no benefit in continuing it
Patient has come to A+E with suspected meningitis. She is started on IV ceftriaxone. She later gets a lumbar puncture for CSF analysis and the results are as follows:
150 WBC/mm3 90% lymphocytes 10% polymorphs 2000 RBC/mm3 Gram stain – no organisms seen CSF glucose is 3.3mmol/L and the blood glucose is 4.2 mmol/L The CSF protein is raised. How do you interpret these results?
This is classic picture of a partially treated bacterial meningitis
- high lymphocyte count
- raised CSF protein
This is also a similar clinical picture to viral meningitis.
It is important to remember the story you are presented with. Remember that the patient was started on antibiotics before LP
If you had strongly suspected meningococcal infection, WHEN would it be appropriate to inform the health protection team?
A – within 24 hours of admission
B – when gram film shows meningococci
C – lab confirms Neisseria meningitides has bee cultured
D – reference lab confirms serotype of N meningitides
E – when N meningitides PCR result is confirmed
A
