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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
A man presents with flu-like symptoms and a bullseye rash. He likes hiking and camping. What is the most likely cause?
Lyme disease
26
Which histological finding in neurons is pathognemonic for rabies?
Negri bodies
27
If food poisoning causes gas gangrene, what is the cause?
C perfringens
28
What are the main abx that cause pseudomembranous colitis?
Cephalosporins Ciprofloxacin Clindamycin
29
Which type of inflammatory diarrhoea is particularly associated with MSM?
Shigella
30
Give two associated syndromes with campylobacter
GBS | Reactive arthritis
31
What pathogen causes secretory diarrhoea in children <2?
Adenovirus
32
What is the incubation period for typhoid?
1-2w
33
What are the symptoms of enteric fever?
Constipation (note, NOT diarrhoea!) Fever, headache, myalgia Rose spots on trunk Hepatosplenomegaly
34
How do you manage typhoid?
IV ceftriaxone and PO azithromycin
35
Why does typhoid sometimes cause GI perforation?
Bevause it affects the Peyer's patches in the intestine
36
Which type of mosquito spreads Dengue?
Ades mosquito
37
What is the cause of dengue haemorrhagic fever/ dengue shock syndrome?
When someone is RE-INFECTED with a slightly different serotype to the first time they were infected
38
What type of mosquito spreads malaria?
Female anopheles
39
What are the 4 non-falciparum types of malaria?
Knowlesi Ovale Vivax Malariae
40
What is a tertian fever?
48-hourly temperature spikes associated with malaria
41
What is the role of thick and thin blood films in malaria?
Thick diagnoses malaria | Thin determines type of maalria
42
What is the role of thick and thin blood films in malaria?
Thick diagnoses malaria | Thin determines type of maalria
43
How is falciparum malaria treated?
IV artesunate
44
How is falciparum malaria treated?
IV artesunate
45
How can you treat rabies if someone has been exposed to rabies and hasn't yet developed symptoms?
IgG PEP
46
What is the cause of Lyme disease?
Borellia burgoferi from Ixodes tick
47
What is the name of the bullseye rash in lyme disease?
Erythema chronicum migrans
48
How is the appearance of leptospirosis described?
? shape
49
Which zoonosis is associated with swimming and conjunctival haemorrhages?
Leptosporiasis
50
Which pathogen is the most common cause of UTI after E coli?
Staph saprophyticus
51
If someone has an abnormal urinary tract, which pathogens are most likely to cause a UTI?
Proteus | Klebsiella
52
How should you investigate a UTI with atypical symptoms?
MC&S
53
What is the length of abx course in UTI?
Uncomplicated: 3 days Complicated: 7 days
54
What is the length of abx course in UTI?
Uncomplicated: 3 days Complicated: 7 days
55
What is the typical cause of a UTI when MC&S shows mixed growth and squamous epithelium?
Contamination!
56
How do you manage pyelonephritis?
Admit and co-amox
57
On what type of agar can chlamydia be grown?
None - it cannot be cultured
58
Whaat is the cause of lympho-granuloma vereneum?
Chlamdia serovars L1-3
59
Recall the 2 treatment options for chlamydia
Azithromycin 1g stat Doxycycline 100mg BD 7d
60
What sign points towards cardiovascular syphilis rather than any other CV disease?
Aortic root dilatation
61
Recall 2 buzzwords for neurosyphilis
Tabes dorsalis (sensory symptoms and weakness) Argyll-Robertson pupil (accommodates but doesn't react)
62
Recall 2 buzzwords for neurosyphilis
Tabes dorsalis (sensory symptoms and weakness) Argyll-Robertson pupil (accommodates but doesn't react)
63
How do you diagnose primary syphilis?
Take a swab of chancre and do dark ground microscopy to visualise treponemes
64
How can you diagnose once the primary phase has passed?
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
How is syphilis treated?
IM benzathine penicillin STAT
66
You suspect bacterial meningitis in an elderly patient. What is the most appropriate initial management?
IV ceftriaxone and dexamethosone plus ampicillin
67
What are the most common bacterial causes of meningitis in all age groups?
Neisseria meningitidis S pneumoniae
68
What 2 pathogens are associated with neonatal and elderly meningitis?
GBS | Listeria monocytogenes
69
Which are the 3most likely causes of viral meningitis?
Enterovirus (coxsackie, echovirus) Mumps HSV2
70
What is the mian use of a VBG in meningitis?
Shows lactate which is a good marker of how unwell someone is
71
What is the treatment for bacterial meningitis?
IV ceftriaxone and corticosteroids | Add ampicillin if listeria suspected
72
How should viral meningitis be managed?
Supportive (it is self-limiting)
73
When would you add IV acyclovir to meningitis treatment?
If there is altered consciousness - could be encephalitis
74
What are Roth spots?
Small spots on retina
75
Recall the investigations for infective endocarditis
Blood cultures - at least 3 from different sites at different times before abx Echo to look at the valves and see vegatation
76
What is the treatment for infective endocarditis?
IV Abx for 6w - often flucloxaciliin
77
What is the abx of choice in all wound, bone and joint infections?
Flucloxacillin IV
78
What is the abx of choice for c diff?
Vancomycin
79
Wht is the abx of choice for mrsa?
vancomycin
80
What is the difference between antigenic shift and drift?
Drift = error prone DNA replication --> point mutation Shift = mixture of two different viruses to make a new virus
81
What are the components of the seasonal flu vaccine?
Either haemagluttinin or neuraminidase
82
Which are the dead vaccines?
``` Polio Rabies Hep B Infleunza HPV Foot and mouth ```
83
What is the receptor for viral entry of SARS-Cov2?
ACEII receptor
84
What is the MOA of remdesivir in covid treatment?
RNA polymerase inhibitor
85
Which hepatitis viruses are faeco-orally transmitted?
A and E
86
For which type of hepatitis virus does a cure exist?
C
87
Name 2 fusion-inhibiting HIV drugs
Maraviroc and enfuvirtide = anti-CCR5 (stops viral fusion for entry)
88
What is the MOA of zidovudine?
NRTI
89
What is the MOA of raltegravir?
Integrase inhibitor
90
What type of microbe is pneumocystis jirovecii and how is it transmitted?
Yeast | Aerosol transmission
91
What is the MOA of antifungals ending in "azole"?
Inhibitors of ergosterol synthesis
92
What class of drug do amphotericin and nystatin belong to?
Polyenes
93
What does CMV cause in HIV+ patients?
Retinitis | Colitis (really nasty)
94
What does JCV virus cause in HIV+ patients?
Progressive Multifocal Leukoencephalopathy
95
Which malarial symptoms are specific to falciparum?
Vaso-occlusive crises in the brain
96
What is the mainstay of treatment for neurocysticerosis?
Steroids Anti-convulsants Anti-parasitics (obendazole) Surgery
97
What parasite is very likely to be found in Lake Malawi?
Schistosoma mansoni (causing schistosocosis)
98
What is "clay pipe stem fibrosis" in the liver pathognemonic for?
End stage liver failure from schistosocosis
99
What is the treatment for schistosocosis?
Prasiquantel
100
What is the role of neuraminidase
Cleaves sialic acid to allow viral exit
101
What is the leading cause of anaemia in the developing world?
Hookworm

Year 5 Pathology Overview (4 decks)

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