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Phase 2A Medicine > Microbiology > Flashcards

Microbiology Flashcards

1
Q

boil with pus on child’s forehead

purple cocci in clusters

A

S. aureus

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2
Q

20yo student fever headache
CSF sample
pink diplococci

A

N. meningitidis

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3
Q

Blood culture from febrile 62yo woman with pain and burning on passing urine
gram negative rods

A

E.coli

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4
Q

CSF sample from neonate febrile and irritable

purple rods

A

Listeria

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5
Q 
57yo woman went to dentist 2 months ago
night sweats and malaise
chains of purple cocci
green halo on culture
grows around optochin
A

strep viridans

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6
Q

What do the organisms usually cause depending on their Lancefield group?

A

A, C, G- tonsillitis, skin infections
B- neonatal sepsis and meningitis
D- UTIs

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7
Q

what is the purpose of the optochin disc?

A

to differentiate between alpha haemolytic strep

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8
Q

what is the purpose of the Lancefield test?

A

to differentiate between beta-haemolytic strep by detecting surface antigens

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9
Q

What are the sterile sites in the body?

A 
lungs- pleural fluid
blood
CSF
peritoneal cavity
Lower resp tract
urinary tract
joints
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10
Q

Where are commensal bacteria found in the body?

A 
skin
mouth
vagina
large intestine
urethra
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11
Q

Which bacteria can cause bloody diarrhoea?

A 
Shigella dysenteriae
E. coli
Campylobacter jejuni
Yersinia spp
Salmonella spp
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12
Q

Which viruses can cause bloody diarrhoea?

A

rotavirus
norovirus
adenovirus

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13
Q

Which protozoa can cause bloody diarrhoea?

A

Entamoeba histolytica

giardia lamblia

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14
Q

Which agar can be used to isolate identify salmonella and shigella?

A

XLD and MacConkey (non-lactose fermenting)

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15
Q

How do you distinguish between salmonella and shigella?

A

oxidase test
positive = salmonella
negative = shigella

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16
Q

Which viruses would you test for when doing a respiratory PCR?

A 
influenza A/B
parainfluenza 1-4
respiratory syncytial virus
rhinovirus
adenoavirus
coronavirus
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17
Q

What 3 different markers are searched in an HIV blood test?

A

viral RNA
COBAS antigen
COBAS antibody

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18
Q

Which viruses cause viral meningitis?

A

enterovirus
herpes simplex
varicella zoster
adenovirus

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19
Q

When is retesting for HIV indicated?

A

clinical suspicion of seroconversion illness

high risk exposure in last 3 months

20
Q

22yo woman 24hr hx of severe pleuritic chest pain, breathlessness, productive rusty sputum, very unwell.
blood and sputum culture show Strep pneumoniae
what is the final diagnosis and which antibiotic is first line for this organism?

A

invasive pneumococcal pneumonia

amoxicillin

21
Q

List the atypical pathogens that can cause community acquired pneumonia.

A

chlamydophila psittaci
mycoplasma pneumoniae
coxiella burnetti
legionella pneumophila

22
Q

Which antibiotics would you use against atypical pathogens causing community acquired pneumonia?

A

macrolides (clarithromycin, erythromycin)
fluoroquinolones (ciprofloxacin, levofloxacin)
tetracycline (doxycycline)
amoxicillin does not work
clarithromycin is first line for legionella

23
Q

Which bacterium grows on chocolate agar but not blood?

A

H. influenzae

24
Q

What antibiotics should be used to treat a H. influenzae infection?

A

amoxicillin, doxycycline

25
Q

What is the first line antimicrobial used to treat a pneumocystis jirovecii infection?

A

co-trimoxazole

with prednisolone if significant type 1 failure

26
Q

Which antibiotics would you use to treat an exacerbation of bronchiectasis caused by P. aeruginosa?

A

antipseudomonal beta lactam like ceftazidime

fluoroquinolone like ciprofloxacin

27
Q

What marks would you expect to see on the nails of a patient with infective endocarditis?

A

splinter haemorrhages

28
Q

What is the standard antibiotic treatment for endocarditis caused by Strep viridans and for how long?

A

benzyl penicillin high dose for 6 weeks

synergistic gentamicin

29
Q

What is the standard antibiotic against staph aureus?

A

flucloxacillin (beta lactam penicillin)

30
Q

Which medium is specific to campylobacter?

A

charcoal cefazolin sodium decarboxylate agar

31
Q

List diarrhoea-causing pathogens that can be detected with stool microscopy.

A

cryptosporidium parvum
entamoeba histolytica
giardia lamblia
schistosoma mansoni

32
Q

Which bacterium is responsible for antibiotic-associated diarrhoea?

A

Clostridium difficile

33
Q

Which antibiotics would you use to treat a clostridium infection?

A

metronidazole (because it is anaerobic)

oral vancomycin

34
Q

What empirical antibiotics would you start a patient on who is suspected to have an enteric bacterial infection?

A

cefuroxime/co-amoxiclav and metronidazole

35
Q

A 48yo woman unwell with fever, jaundice, severe RUQ pain and tenderness. Blood test reveals neutrophil leucocytosis with raised alkaline phosphatase and bilirubin. US of abdomen shows thick walled gall bladder with gall stones and dilated common bile duct.
What is the probably surgical diagnosis and which empirical antibiotic would be appropriate?

A

acute cholecystitis

co-amoxiclav

36
Q

What additional tests would you perform in someone with (MRSA) bacteraemia?

A

echocardiogram to check for IE

MRI spine to check for discitis

37
Q

Which antibiotics would you use to treat UTI caused by amoxicillin-resistant E.coli/klebsiella?

A

trimethoprim

nitrofurantoin or co-amoxiclav

38
Q

Which bacteria are likely to cause meningitis in neonates?

A

E.coli
Group B strep
listeria monocytogenes

39
Q

Which bacteria are likely to cause meningitis in infants?

A

N. meningitidis
H. influenzae
S. pneumoniae

40
Q

Which bacteria are likely to cause meningitis in young adults?

A

N. meningitidis

S. pneumoniae

41
Q

Which bacteria are likely to cause meningitis in the elderly?

A

S. pneumoniae
N. meningitidis
Listeria

42
Q

What are the viral causes of meningitis?

A 
mumps virus
echo virus
coxsackie virus
other enteroviruses
herpes simplex virus
lymphocytic chorio meningitis virus
poliovirus
43
Q

How would you manage a patient with meningitis caused by strep pneumoniae?

A 
IV cefotaxime
IV dexamethasone (pneumococcal infections cause a lot of inflammation which can increase the risk of long term sequelae like deafness)
44
Q

What groups are at risk of meningitis due to Listeria monocytogenes?

A 
immunocompromised
alcohol dependency
diabetes
pregnancy
HIV
long-term steroids
children
elderly
45
Q

Why should a lumbar puncture not be performed in someone with suspected meningitis back rash?

A

No. The presence of a characteristic rash and the presentation raises a strong clinical suspicion of meningococcal septicaemia and meningitis. There is no need to do a lumbar puncture and may be harmful in the event of coagulation abnormalities secondary to the meningococcal sepsis. The diagnosis can often be confirmed by either peripheral blood culture or peripheral blood molecular testing for N.meningitis (ie. PCR).
bacteria can get into sterile CSF

46
Q

What actions (other than treating the pt) need to be taken when someone has confirmed meningitis?

A

notify public health England
prophylaxis in close contacts- single dose ciprofloxacin/rifampicin
vaccinate others

47
Q

In a drowsy and confused elderly patient with suspected meningitis, what therapy should be started whilst awaiting lab results?

A

IV antibiotics for possible bacterial meningitis

IV acyclovir to treat possible herpes simplex virus

Phase 2A Medicine (16 decks)

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