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Passmed Medicine > Microbiology > Flashcards

Microbiology Flashcards

1
Q

What antibiotic is recommended for animal or human bites?

A

Co-amoxiclav

If the patient is penicillin allergic: metranidazole + doxycycline

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2
Q

What pathogen can cause circular areas of dense consolidations, other than TB?

A

Aspergillus can cause aspergillomas. These are mycetomas (mass-like fungus balls) which often colonise existing lung cavities (e.g. 2° to TB, lung cancer, CF).

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3
Q

What are the symptoms of an aspergilloma?

A

Often asymptomatic, but can cause:

  • Cough
  • Haemoptysis
    *
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4
Q

What is the commonest pathogen causing msalaria?

A

Falciparum malaria is the commonest cause.

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5
Q

What is the antimicrobial treatment for Lyme disease?

A

ORAL doxycycline is the treatment of choice for skin-bound Lyme disease (amoxicillin if cpontraindicated, e.g. in pregnancy).

If there are focal signs, such as neruological, cardiac, opthtalmic of rheumatic symptoms, then use IV cerftriaxone

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6
Q

What is the rash seen in Lyme disease?

What are other symptoms that may occur with Lyme disease?

A

Erythema chronica migrans. (bull’s eye rash).

Non-dermatological features include:

  • Cardiovascular: heart block, myocarditis
  • Neurological: facial nerve palsy, meningitis
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7
Q

Which organism is responsible for Lyme disease?

A

Borrelia burgdorferi

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8
Q

What are clinical features of amoebiasis?

A

Amoebic dysentry:

  • Profuse, bloody diarrhoea
  • Trophozoites on “hot stool” microscopy

Amoebic liver abscess (can also cause colonic abscess):

  • Single mass in right lobule
  • Contents described as “anchovy sauce”
  • Presents with fever, RUQ pain
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9
Q

How is amoebiasis treated?

A

Dysentry: metranidazole

Abscess/invasive amoebiasis: amoebicide.

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10
Q

What are the 3 forms of Leishmaniasis, and what are the respective causative organisms?

A

Cutaneous Leishmaniasis:

  • Tropicana and Mexicana
  • Crusted lesion at site of bite

Mucocutaneous leishmaniasis

  • Braziliensis
  • Skin lesion may spread to involve mucosae of nose, pharynx etc.

Visceral leishmaniasis:

  • Donovani
  • Fevers, sweats, rigors
  • Massive splenomegaly, hepatomegaly
  • Grey skin -> Black sickness (kala-azar)
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11
Q

What can happen when EtOH is consumed whilst on metranidazole?

A

The combination of metronidazole and ethanol can cause a disulfiram-like reaction. Clinical features of this include head and neck flushing, nausea and vomiting, sweatiness, headache and palpitations.

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12
Q

Summarise the NICE guidelines for tetanus-rpone wounds.

A

If there is an unclear history of tetanus vaccination ALWAYS give a booster.

If the wound is tetanus-prone, then tetanus immunoglobulin is also required.

In addition, antibacterial prophylaxis such as co-amoxiclav, may be given.

In clean wounds, give the tetanus vaccine booster if the history is unclear.

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13
Q

Which antibiotics can cause a black hairy toungue

A

Tetracycline antibiotics - this is a temporary reaction and harmless.

This results from defective desquamation of the filiform papillae.

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14
Q

What blood image would an infection with hookworm show?

A

Hookworms may cause an iron deficiency anaemia in patients returning from travel to endemic areas e.g. the Indian subcontinent. There may also be an eosinophilia.

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15
Q

What are potential causes for a false negative mantoux test?

A
  • Immunosuppression, e.g. AIDS, steroid therapy
  • Sarcoidosis
  • Lymphoma
  • Extremes of age
  • Fever
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16
Q

Describe the Mantoux test-

A

Injection of small amount of PPD (purified protein derivative) into the skin.

48-72 hours later:

  • Area of redness >10mm -> previous exposure (including BCG)
  • Rea of redness smaller: not exposed to TB
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17
Q

When, after possible exposure, should you test for HIV?

A

4 weeks. The Ab against p24 antigen are not positive until after this time.

Tests are also usually done immediately (in case it was contracted earlier) and after 12 weeks (to confirm a negative result).

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18
Q

What are the live attenuated vaccines?

A
  • Yellow Fever
  • BCG
  • MMR
  • Oral Polio
  • Oral Tyhoid
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19
Q

Which antibiotic is used empirically to treat neutropenic sepsis?

A

Tazocin - this is piperacillin and tazobactam.

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20
Q

What is neutropenic sepsis?

A

This is a neutrophil count of < 0.5 * 109 in a patient who is on BM suppressing therapy and has:

  • Temperature >38°
  • other signs/symptoms consistent with sepsis
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21
Q

Summarise the managment of neutropenic sepsis.

A
  • ABx must be started immediately, do not start for the WCC.
  • This is usually tazocin. May add vancomycin or meropenem.
  • If not responding after 4-6 days investigate for fungal infection and add antifungal therapy.
  • In some patients, G-CSF may play a role, but this is extremely specialist.
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22
Q

Which organism is commonly implicated in peritonitis 2° to peritoneal dialysis?

A

Staph epidermidis.

Staph aureus is another common cause.

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23
Q

How can Kaposi’s present in children?

A

Unlike adults, it’s much rarer to find the characteristic skin lesions in a paediatric population, with the most common symptom being lymphadenopathy.

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24
Q

What is the treatment for syphillis?

A

IM benzathine penicillin is the first-line management.

Alternatively, doxycycline can be given.

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25
Q

What is the treatment for bacterial vaginosis?

Also quickly tell me what BV is.

A

Oral metranidazole for 5-7 days.

BV is the overgrowth of organsism including Gardnerella vaginalis. This leads to a fall in lactic-acid producting lactobacilli, resulting in raised pH (>4.5). There are clue cells and the Whiff test is positive.

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26
Q

What is the most common cause for an IECOPD?

A

Haemophilus influenzae is the most common

Strep pneumoniae and maroxella are other cuases.

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27
Q

What is the antibiotic of choice for otitis media and otitis externa?

A

Media: amoxicillin (as URTI)

Externa: flucloxacillin (as skin)

28
Q

ABx treatment for PID?

A

Oral ofloxacin + oral metronidazole or intramuscular ceftriaxone + oral doxycycline + oral metronidazole

29
Q

Which pneumonia organism is commonly associated with the reacitvation of cold sores

A

Strep pneumoniae

30
Q

What antibiotics are used to treat MRSA?

A
  • Vancomycin
  • Teicoplanin
  • Linezolid
31
Q

How can Leginella pneumonia be confirmed?

A

Urinary antigen.

32
Q

What is the managmeent of a liver abscess?

A

Most liver abscesses are bacterial in origin, and the managmenet is IV antibiotics and image-guided percutaneous drainage. (amoxicillin, ciprofloxacin, mtranidazole).

If a hydatid cyst is suspected (echinococcus), then surgical removal is first-line treatment.

33
Q

Summarise the management of tetanus?

A
  • Supportive therapy including ventilatory support and muscle relaxants
  • IM Human tetanus Ig (in high-risk wounds)
  • Metranidazole (or benzylpenicillin)
34
Q

Describe the symptoms you might see in someone with PJP .

A

Gradual onset, days to weeks:

  • Low grade fever and malaise
  • Non-productive cough
  • Dyspnoea
35
Q

What is the most common organism implicated in pyelonephritis?

A

E. coli

36
Q

What advice should you give patients with glandular fever?

A

Avoid contact sports for 8 weeks, as there is increased risk of splenic rupture.

37
Q

Summarise the management of a suspected rabies wound.

A
  • Wash wound
  • If already immunised: give 2 further booster vaccinations (+ ABx)
  • Of mot immunised, give vaccination (inject near wound) and give rabies Ig
38
Q

What are the symptoms of infectious mononucleosis?

A

Classic triad:

  • Sore throat
  • Lymphadenopathy: widespread in the neck
  • Pyrexia

Other features:

  • Malaise, anorexia,
39
Q

How long should PEP be given for after a needle stick injury with an HIV postivie needle?

A

4 weeks.

40
Q

What is the treatment of toxoplasmosis?

A

Treatment is usually reserved for those with severe infections or patients who are immunosuppressed

  • pyrimethamine plus sulphadiazine for at least 6 weeks
41
Q

What chest infection is common among alcoholics?

A

Klebsiella. It is more common in diabetic and alcoholics. Can also occur following aspiration.

Features include:

  • Currant Jelly sputum
  • Empyema can develop following infection
  • Abscess formation can also occur
  • Often affects upper lobest
42
Q

Which pneumonia is commonly seen after infection with influenza?

A

Staphylococcus aureus.

43
Q

What HPV types are implicated in cervical cancer?

A

16, 18, 33

6 and 11 are implicated in warts, but not in cancer.

44
Q

How does leptospirosis present?

A

Clinical features:

  • Fever
  • Fllu-like symptoms
  • Renal failure
  • Jaundice
  • Subconjunctival haemorrhages
  • Headache
45
Q

What are the risk factors for leptospirosis?

A
  • Being a farmer
  • Sewage worker
  • Abattoir workers

-> contact with rat urine

46
Q

What is the treatment for genital warts?

A
  • Multiple, non-keratinised warts: topical podophyllum
  • Solitary, keratinised warts: cryotherapy
47
Q

is breastfeeding contraindicated in Hep C positive mothers?

A

No! They can still breasfeed.

48
Q

How long after glandular fever do contact sports need to be avoide for?

Why?

A

For 8 weeks.

This is due to the potential risk of splenic rupture after EBF infection

49
Q

Who should receive the HPV vaccine and at what age?

A

All boys and girls aged 12-13 are now offered the HPV vaccine.

Gardasil protects against 6,11 (warts) and 16, 18 (cancer)

50
Q

What is the most common cause for infections of central lines?

A

Staphylococcus epidermidis

51
Q

What is the name for a single calcified lymph node often found in latent TB?

A

Ghon Complex.

52
Q

What is the management of genital herpes?

A

Oral aciclovir is indicated.

53
Q

How long until a negative ELISA Ab test for HIV has definitely ruled out HIV?

A
54
Q

Which organism is implicated most commonly in spontaneous bacterial peritonitis?

A

E. coli.

This is followed by Klebsiella

(Gram positive organsisms can also cause SBP: Strep pneumo, Strep viridans, Staph).

55
Q

What is the first line treatment for amoebiasis?

A

Metranidazole

56
Q

What conditions are associated with EBV?

A

Malignant:

  • Burkitt’s lymphoma
  • Hodkin’s lymphoma
  • Nasopharyngeal carcinoma
  • HIV-associated CNS lymphomas

Non-malignant:

  • Oral hairy leukoplakia (esp. in HIV positive) - can’t be scraped off
57
Q

What is the incubation period of Hep A?

A

2-4 weeks

58
Q

Tell me the nucleic acid status of each of the hepatitis viridae.

A

Hep A: RNA

Hep B: DNA

Hep C: RNA

Hep D: RNA

Hep E: RNA

59
Q

What are potential symptoms of enteric fever?

A

Enteric fever, caused by typhoid or paratyphoid, can present with:

  • Systemic upset
  • Relative bradycardia
  • Abdominal pain/distension
  • Constipation (more common) or diarrhoea
  • Rose spots (more common with paratyhpoid)

If left untreated, it can lead to:

  • Osteomyelitis
  • GI Bleed
  • Meningitis
  • Cholecystitis
  • Chronic Carriage (~1%)
60
Q

Which orgamisms are most commonly implicated in aspiration pneumonia?

A

Most often aerobic:

  • Streptococcus pneumoniae
  • Staphylococcus aureus
  • Haemophilus influenzae
  • Pseudomonas aerigunosa

Can also be anaerobic, but less common.

61
Q

What is the treatment of hospital acquired pneumonia?

A
  • Within 5 days of admission: co-amoxiclav or cefuroxime
  • More than 5 days after admission: piperacillin with tazobactam OR a broad-spectrum cephalosporin (e.g. ceftazidime) OR a quinolone (e.g. ciprofloxacin)
62
Q

What is the PEP treatment for Hep B?

A
  • HBsAg positive source: if the person exposed is a known responder to HBV vaccine then a booster dose should be given. If they are in the process of being vaccinated or are a non-responder they need to have hepatitis B immune globulin (HBIG) and the vaccine
  • unknown source: for known responders the green book advises considering a booster dose of HBV vaccine. For known non-responders HBIG + vaccine should be given whilst those in the process of being vaccinated should have an accelerated course of HBV vaccine
63
Q

What is the managment for chlamydia?

A

Doxycycline (7 days) or azithromycin (single dose)

In oregnancy, avoid doxycycline.

64
Q

What is the prophylactic treatment of contacts of a patient with meningogoccal meningitis?

A

Ciprofloxacin. This is now preferred over rifampicin.ö

65
Q
A
66
Q

What is the treament for someone who has been screene positive for MRSA and is in a pre-surgery screen?

A

Nasal mupirocin + chlorhexidin for skin

Passmed Medicine (10 decks)

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