Microbiology Flashcards
What is the best sample and test type for an asymptomatic female presenting for an STI screen?
Vulvovaginal swab for chlamydia/ gonococcal PCR
Bloods for HIV and syphilis
(PCR rather than culture as you can’t culture chlamydia and vulvovaginal over endocervical swab as it is less invasive and can be self taken)
When would you do an endocervical swab over a vulvovaginal swab for STI testing?
If a smear was being done anyway
Oral metronidazole is the treatment for which repro conditions?
Bacterial vaginosis
Trichomonas vaginalis
Serotypes L1,2,3 of chlamydia trachomatis are associated with which condition?
Lymphogranuloma venereum infection in MSM
Which repro condition is associated with clue cells on microscopy?
Bacterial vaginosis
A test of cure is advised for all patients with which STI?
Neisseria gonorrhoea
This is because of the increase in antimicrobial resistance
What is the first line treatment for neisseria gonorrhoea?
IM ceftriaxone
oral azithromycin was previously also used but has been removed because of issues of resistance
What the heck are coliforms?
Most coliforms are sensitive to which antibiotic?
Coliforms are gram negative bacteria
Gentamicin is active against most gram negatives (coliforms)
Amoxicillin, gentamicin and metronidazole are used for intra-abdominal sepsis.
Which antibiotics acts against which bacterias?
Amoxicillin acts against enterococci
Gentamicin acts against gram negatives (coliforms)
Metronidazole acts against anaerobes
What is septic shock?
Sepsis which doesn’t respond to resuscitation
E.g BP which doesn’t come back up after IV fluids are given
What side effect is gentamicin associated with?
Dizziness
Gentamicin causes ototoxicity
Which type of meningitis should you be particularly aware of in healthy young people that present with bacterial meningitis?
Neisseria meningitides
Steroids are given with or just before the first dose of antibiotics if they are indicated in a patient with bacterial meningitis. Why is this?
Steroids help to reduce the inflammation that is associated with the infection
Listeria infection is associated with the consumption of which food types?
Dairy foods
Why is ceftriaxone used as empirical treatment for suspected bacterial meningitis rather than penicillin?
Ceftriaxone has a longer half-life than penicillin
What is ceftriaxone (BAD THING)
IT’S A 4C
WHY HAVEN’T YOU MEMORISED THESE YET
When should a test of cure be done for chlamydia?
It’s not routine but should be done in pregnancy
For which tests should a male patient give a first pass Vs a mid stream urine sample?
First pass urine sample for gonococcal/ chlamydia PCR
Mid stream sample for UTI testing
When should a patient be tested for herpes? How is this done?
The patient can only be tested when symptoms appear (give them a leaflet about the symptoms in the meantime)
Tested by taking swabs of the de-roofed blisters for PCR
Taking bloods for antibodies can be done to identify if the patient has ever been infected in the past
A NEWS score of what indicates sepsis in a patient with an infection?
5+
Coliforms are not generally contaminants, so if they are found in blood it is a sign of infection and they should be treated before waiting for the test results…
True
Gentamicin should only be given for 3 days, after this it should be substituted for which drug?
Aztreonam
What is the step-down option for patients being treated for intra-abdominal sepsis with metronidazole, gentamicin and amoxicillin?
Co-trimoxazole
What is the advice for female patients who have had 3+ UTIs in 12 months?
Keep hydrated
Consume cranberry products
Postcoital voiding (pee after sex)
May need antibiotics (e.g trimethoprim taken within 2 hours of intercourse)
If a patient presents with a history which is suggestive of bacterial meningitis but the results look clear/ viral, what should you be thinking?
Consider partially treated bacterial meningitis if they have already been given antibiotics
Usually neutrophils are high in bacterial meningitis and lymphocytes in viral, bit high lymphocytes are also classic of partially treated bacterial meningitis
When should the healthcare protection team be notified in cases of suspected meningitis?
Need to inform them within 24 hours of patient admission
Don’t need to wait for test confirmations
