Microbiology

Question 1

What is the gold standard investigation for suspected STI in a

a) man
b) woman?

Answer 1

a) First pass urine sample

b) Vulvourethral swab

both for chlamydial/gonococcal PCR

Question 2

What are the antibiotics of choice for

a) chlamydia
b) gonorrhoea
c) bacterial vaginosis
d) trichomonas?

Answer 2

a) Doxycycline

b) Ceftriaxone

c) Metronidazole

d) Metronidazole

Question 3

What are three subtypes of Chlamydia trachomatis which causes disease in men who have sex with men?

Answer 3

L1, 2 and 3

Lymphogranuloma venerum

Question 4

Clue cells on microscopy is a finding in which condition?

Answer 4

Bacterial vaginosis

Question 5

What is done after antibiotic treament for Neisseria gonorrhoeae infection?

Why?

Answer 5

Test of cure

Gonorrhoea is becoming resistant to all known antibiotics

Question 6

What is adjuvant treatment alongside IM ceftriaxone for gonorrhoea in some trusts?

Answer 6

Oral azithromycin

Question 7

Which organisms are targeted by

a) amoxicillin

b) metronidazole

c) gentamicin

in intra-abdominal sepsis?

Answer 7

a) Gram positives

b) Anaerobes

c) Coliforms

Question 8

How is intra-abdominal sepsis treated?

Answer 8

Amoxicillin

Metronidazole

Gentamicin

Question 9

What causes hypotension in septic shock?

Answer 9

Widespread inflammation => Leaky vessels => Fluid becomes “unavailable” in the interstitium

Question 10

How does septic shock respond to fluids?

Answer 10

Reduced response

Because administered fluids escape through leaky vessels

Question 11

Gentamicin toxicity damages which cranial nerve?

Answer 11

CN VIII - Vestibulocochlear nerve

Causing hearing loss and dizziness (vertigo)

Question 12

What are the most common causes of bacterial meningitis?

Answer 12

Strep. pneumoniae - children and general population, give rifampicin as prophylaxis and benzylpenicillin + dexamethasone as treatment

Neisseria meningitidis - adolescents / young adults, give IV ceftriaxone + dexamethasone

Listeria monocytogenes - elderly & immunosuppressed + dodgy cheese

Question 13

Which drug is often given alongside antibiotics in bacterial meningitis?

Answer 13

Dexamethasone

Question 14

Listeria monocytogenese infection is associated with the consumption of what?

Answer 14

Soft cheese

Especially amongst pregnant women

Question 15

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

Answer 15

Ceftriaxone has a longer t1/2 than penicillin

So doses can be less frequent