microbiology

Question 1

what is the most common PNS manifestation in a late stage aids patient

Answer 1

distal symmetric polyneuropathy

Question 2

in IDP the patient will suffer from?

Answer 2

weakness in an ascending pattern

Question 3

IDP, polyradiculopathies, mononeuritis complex occur at (early/late) stages in aids patients ?

Answer 3

early stages

Question 4

true or false

in some rare cases the herpes virus can move trans–neuronally to the CNS and cause encephalitis

Answer 4

true

Question 5

most commonly reported PNS complication ( related to herpes virus)

Answer 5

post-herpetic neuralgia

note: we try to prevent it by giving acyclovir for 7 days during VZV infection

Question 6

herpes zoster ophthalmicus presents with?

Answer 6

retro-orbital pain, rash on the forehead, double vison developed diplopia

note: treatment: acyclovir and gabapentin

Question 7

what is the percentage of polio infections which are asymptomatic

Answer 7

72

note: polioviruses are enteroviruses, they are transmitted feco-oraly

Question 8

what type of microscope do we use in borrelia burgdorferi

Answer 8

darkfield microscope

note: treatment is doxycycline
clinical presentation is erythema migrans
remember: radiculopathies and cranial neuropathies area strong indicator of Lyme disease

Question 9

the vaccine for clostridium tetani is a ?

Answer 9

toxoid vaccine

note: an example on the spastic paralysis that occurs is sardonic smile
treatment :primary treatment is: wound debridement and passive immunity
secondary treatment: antimicrobial treatment (metronidazole and penicillin G for 7-10 days)

Question 10

clostridium botulinum always begins in ?

Answer 10

the cranial nerves

causes bilateral descending flaccid paralysis

Question 11

treatment of C.botulinum?

Answer 11

supportive care and the use of antitoxins, however the use of antitoxins in inhaled C. botulinum hasn’t been proven.

Question 12

the main points regarding campylobacter.jejuni

Answer 12

causes gastroenteritis ( bloody diarrhea ),causes molecular mimicry will lead to Gillian barre syndrome
it is zoonotic ( mostly from contaminated poultry )

Question 13

GBS ?

Answer 13

immune-mediated demyelinating polyneuropathy
symmetrical ASCENDING motor weakness
treatment : intensive care, ventilator support, you can also perform Plasmapheresis or give IVig

note: corticosteroids are largely ineffective

Question 14

true or false

culture is not used in leprosy ( Hansen’s disease ) instead we use acid fast stain

Answer 14

true

Question 15

what is the most common form of suppurative CNS infection ?

Answer 15

bacterial meningitis

Question 16

what are the skin petechia caused by N. meningitis called

Answer 16

meningococcemia

Question 17

the leading causes of bacterial meningitis in the Middle East and North Africa (MENA) region ?

Answer 17

Neisseria meningitidis

Question 18

true or false

if Kernigs Sign and Brudzinski͛s sign are negative then this means that we can exclude meningitis

Answer 18

false

note: in the diagnosis of meningitis we should perform a lumbar puncture before administrating the antibiotics

Question 19

how do we treat bacterial meningitis?

Answer 19

1) empirical treatment is given(ampicillin and cefotaxime(0-3yrs0/cefotaxime +ceftriaxone(<3)) 2)corticosteroid (dexamethasone) to lessen the inflammation if present
3) reduce the intracranial pressure
4) chemoprophylaxis is given to household contacts

Question 20

sequalae of meningitis?

Answer 20

1) focal neurological deficits
2) epilepsy
3) hearing loss
4) cognitive impairment

Question 21

true or false

after getting infected with S.pneumonia you should take the S.pneumonia vaccine

Answer 21

true, to prevent recurrence

Question 22

in case of syphilis what test should be performed ?

Answer 22

Venereal Disease Laboratory Test/ or the unspecific anti-cardiolipin test

Question 23

true or false chronic meningitis caused by Cryptococcus neoformans is associated with immunosuppression

Answer 23

true

note: we perform a WET mount of the CSF

Question 24

if we have recurrent chronic meningitis ?

Answer 24

it is probably herpes simplex type 2

Question 25

Cysticercosis is ?

Answer 25

infection with cysts of Taenia Solium ,from uncooked meat(not undercooked) ,high PNC (due to high eosinophils )