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Year 5 Pathology Overview > Microbiology > Flashcards

Microbiology Flashcards

1
Q

When is a pneumonia considered to be hospital-acquired?

A

After you’ve been in hospital for ?48 hours

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2
Q

What does ‘typical’ vs ‘atypical’ pneumonia mean?

A

Typical = classic CXR changes, respond to penicillin

Atypical: no/atypical symptoms (eg dry cough rather than productive, flu symptoms). not in keeping with CXR, don’t respond to penicillin as organisms don’t have a cell wall, may have extra-pulmonary features

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3
Q

Recall two buzzwords for S pneumoniae pneumonia?

A

Rusty coloured sputum

Lobar on CXR

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4
Q

Which type of typical pneumonia is associated with smoking/COPD?

A

Haemophilus

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5
Q

Recall 2 buzzwords for S aureus pneumonia

A
  • Post-influenza infection

- Cavity on CXR rather than normal consolidation

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6
Q

Recall 3 associations of klebsiella pneumonia

A

Alcoholism
Elderly
???

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7
Q

Recall 3 associations of klebsiella pneumonia

A

Alcoholism
Elderly
Haemoptysis

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8
Q

Recall 2 extrapulmonary features of legionella pneumonia

A

Hyponatraemia

Hepatitis

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9
Q

Describe the typical presentation of mycoplasma pneumonia

A

Haemolytic anaemia

Erythema multiforme

Unis/ boarding schools

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10
Q

Which type of pneumonia is associated with birds

A

Chlamydia psittaci

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11
Q

What is the BP limits in the CURB 65 score?

A

SBP<90 or DBP <60

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12
Q

At which CURB-65 score do you give IV amixicillin?

A

3

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13
Q

At which CURB-65 score do you consider admitting?

A

2

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14
Q

What is the urea limit in the CURB 65 score?

A

> 7

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15
Q

What is the urea limit in the CURB 65 score?

A

> 7

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16
Q

What is Pott’s disease?

A

Spinal TB - causing back pain, discitis, vertebral destruction, iliopsoas abscess

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17
Q

What is miliary TB?

A

Haematogenously disseminated TB infection

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18
Q

What are the symptoms of TB meningitis?

A

Subacute headache, personality change, meningism and confusion

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19
Q

What medium is used to culture TB?

A

Lowenstein-Jensen medium - grown for 6w

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20
Q

When would an IGRA TB test be positive?

A

In active or latent TB - but not following a BCG vaccine

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21
Q

What is the typical case of someone with mycobacterium ulcerans?

A

Someone with an ulcerating lesion from Australia

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22
Q

If someone starts vomming 4 hours after having a Chinese, what is the most likely cause?

A

Bacillus cereus

Key here is 4 hours

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23
Q

Which type of food poisoning is most likely to cause bloody diarrhoea?

A

Campylobacter

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24
Q

What sort of test would reveal the species of a malaria infection?

A

Thin blood film

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25
Q

A man presents with flu-like symptoms and a bullseye rash. He likes hiking and camping. What is the most likely cause?

A

Lyme disease

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26
Q

Which histological finding in neurons is pathognemonic for rabies?

A

Negri bodies

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27
Q

If food poisoning causes gas gangrene, what is the cause?

A

C perfringens

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28
Q

What are the main abx that cause pseudomembranous colitis?

A

Cephalosporins
Ciprofloxacin
Clindamycin

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29
Q

Which type of inflammatory diarrhoea is particularly associated with MSM?

A

Shigella

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30
Q

Give two associated syndromes with campylobacter

A

GBS

Reactive arthritis

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31
Q

What pathogen causes secretory diarrhoea in children <2?

A

Adenovirus

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32
Q

What is the incubation period for typhoid?

A

1-2w

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33
Q

What are the symptoms of enteric fever?

A

Constipation (note, NOT diarrhoea!)
Fever, headache, myalgia
Rose spots on trunk
Hepatosplenomegaly

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34
Q

How do you manage typhoid?

A

IV ceftriaxone and PO azithromycin

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35
Q

Why does typhoid sometimes cause GI perforation?

A

Bevause it affects the Peyer’s patches in the intestine

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36
Q

Which type of mosquito spreads Dengue?

A

Ades mosquito

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37
Q

What is the cause of dengue haemorrhagic fever/ dengue shock syndrome?

A

When someone is RE-INFECTED with a slightly different serotype to the first time they were infected

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38
Q

What type of mosquito spreads malaria?

A

Female anopheles

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39
Q

What are the 4 non-falciparum types of malaria?

A

Knowlesi
Ovale
Vivax
Malariae

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40
Q

What is a tertian fever?

A

48-hourly temperature spikes associated with malaria

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41
Q

What is the role of thick and thin blood films in malaria?

A

Thick diagnoses malaria

Thin determines type of maalria

42
Q

What is the role of thick and thin blood films in malaria?

A

Thick diagnoses malaria

Thin determines type of maalria

43
Q

How is falciparum malaria treated?

A

IV artesunate

44
Q

How is falciparum malaria treated?

A

IV artesunate

45
Q

How can you treat rabies if someone has been exposed to rabies and hasn’t yet developed symptoms?

A

IgG PEP

46
Q

What is the cause of Lyme disease?

A

Borellia burgoferi from Ixodes tick

47
Q

What is the name of the bullseye rash in lyme disease?

A

Erythema chronicum migrans

48
Q

How is the appearance of leptospirosis described?

A

? shape

49
Q

Which zoonosis is associated with swimming and conjunctival haemorrhages?

A

Leptosporiasis

50
Q

Which pathogen is the most common cause of UTI after E coli?

A

Staph saprophyticus

51
Q

If someone has an abnormal urinary tract, which pathogens are most likely to cause a UTI?

A

Proteus

Klebsiella

52
Q

How should you investigate a UTI with atypical symptoms?

A

MC&S

53
Q

What is the length of abx course in UTI?

A

Uncomplicated: 3 days
Complicated: 7 days

54
Q

What is the length of abx course in UTI?

A

Uncomplicated: 3 days
Complicated: 7 days

55
Q

What is the typical cause of a UTI when MC&S shows mixed growth and squamous epithelium?

A

Contamination!

56
Q

How do you manage pyelonephritis?

A

Admit and co-amox

57
Q

On what type of agar can chlamydia be grown?

A

None - it cannot be cultured

58
Q

Whaat is the cause of lympho-granuloma vereneum?

A

Chlamdia serovars L1-3

59
Q

Recall the 2 treatment options for chlamydia

A

Azithromycin 1g stat

Doxycycline 100mg BD 7d

60
Q

What sign points towards cardiovascular syphilis rather than any other CV disease?

A

Aortic root dilatation

61
Q

Recall 2 buzzwords for neurosyphilis

A

Tabes dorsalis (sensory symptoms and weakness)

Argyll-Robertson pupil (accommodates but doesn’t react)

62
Q

Recall 2 buzzwords for neurosyphilis

A

Tabes dorsalis (sensory symptoms and weakness)

Argyll-Robertson pupil (accommodates but doesn’t react)

63
Q

How do you diagnose primary syphilis?

A

Take a swab of chancre and do dark ground microscopy to visualise treponemes

64
Q

How can you diagnose once the primary phase has passed?

A

Antibody tests

Treponemal are most specific - so all positive non-treponemal tests are confirmed by treponemal test

Non-treponemal test is useful for tracking treatment progress as it falls when the person is treated - whereas treponemal test will stay positive for ages

65
Q

How is syphilis treated?

A

IM benzathine penicillin STAT

66
Q

You suspect bacterial meningitis in an elderly patient. What is the most appropriate initial management?

A

IV ceftriaxone and dexamethosone plus ampicillin

67
Q

What are the most common bacterial causes of meningitis in all age groups?

A

Neisseria meningitidis

S pneumoniae

68
Q

What 2 pathogens are associated with neonatal and elderly meningitis?

A

GBS

Listeria monocytogenes

69
Q

Which are the 3most likely causes of viral meningitis?

A

Enterovirus (coxsackie, echovirus)
Mumps
HSV2

70
Q

What is the mian use of a VBG in meningitis?

A

Shows lactate which is a good marker of how unwell someone is

71
Q

What is the treatment for bacterial meningitis?

A

IV ceftriaxone and corticosteroids

Add ampicillin if listeria suspected

72
Q

How should viral meningitis be managed?

A

Supportive (it is self-limiting)

73
Q

When would you add IV acyclovir to meningitis treatment?

A

If there is altered consciousness - could be encephalitis

74
Q

What are Roth spots?

A

Small spots on retina

75
Q

Recall the investigations for infective endocarditis

A

Blood cultures - at least 3 from different sites at different times before abx

Echo to look at the valves and see vegatation

76
Q

What is the treatment for infective endocarditis?

A

IV Abx for 6w - often flucloxaciliin

77
Q

What is the abx of choice in all wound, bone and joint infections?

A

Flucloxacillin IV

78
Q

What is the abx of choice for c diff?

A

Vancomycin

79
Q

Wht is the abx of choice for mrsa?

A

vancomycin

80
Q

What is the difference between antigenic shift and drift?

A

Drift = error prone DNA replication –> point mutation

Shift = mixture of two different viruses to make a new virus

81
Q

What are the components of the seasonal flu vaccine?

A

Either haemagluttinin or neuraminidase

82
Q

Which are the dead vaccines?

A 
Polio
Rabies
Hep B
Infleunza
HPV
Foot and mouth
83
Q

What is the receptor for viral entry of SARS-Cov2?

A

ACEII receptor

84
Q

What is the MOA of remdesivir in covid treatment?

A

RNA polymerase inhibitor

85
Q

Which hepatitis viruses are faeco-orally transmitted?

A

A and E

86
Q

For which type of hepatitis virus does a cure exist?

A

C

87
Q

Name 2 fusion-inhibiting HIV drugs

A

Maraviroc and enfuvirtide = anti-CCR5 (stops viral fusion for entry)

88
Q

What is the MOA of zidovudine?

A

NRTI

89
Q

What is the MOA of raltegravir?

A

Integrase inhibitor

90
Q

What type of microbe is pneumocystis jirovecii and how is it transmitted?

A

Yeast

Aerosol transmission

91
Q

What is the MOA of antifungals ending in “azole”?

A

Inhibitors of ergosterol synthesis

92
Q

What class of drug do amphotericin and nystatin belong to?

A

Polyenes

93
Q

What does CMV cause in HIV+ patients?

A

Retinitis

Colitis (really nasty)

94
Q

What does JCV virus cause in HIV+ patients?

A

Progressive Multifocal Leukoencephalopathy

95
Q

Which malarial symptoms are specific to falciparum?

A

Vaso-occlusive crises in the brain

96
Q

What is the mainstay of treatment for neurocysticerosis?

A

Steroids
Anti-convulsants
Anti-parasitics (obendazole)
Surgery

97
Q

What parasite is very likely to be found in Lake Malawi?

A

Schistosoma mansoni (causing schistosocosis)

98
Q

What is “clay pipe stem fibrosis” in the liver pathognemonic for?

A

End stage liver failure from schistosocosis

99
Q

What is the treatment for schistosocosis?

A

Prasiquantel

100
Q

What is the role of neuraminidase

A

Cleaves sialic acid to allow viral exit

101
Q

What is the leading cause of anaemia in the developing world?

A

Hookworm

Year 5 Pathology Overview (4 decks)

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