Microbiology and Infectious Disease Flashcards
define pathogen
an organism that is capable of causing disease
define commensal
organism which colonises the host but does not cause disease in normal circumstances
define opportunist pathogen
microbe that only causes disease if host defences are compromised
define virulence/pathogenicity
the degree to which a given organism is pathogenic
define asymptomatic carriage
when a pathogen is carried harmlessly at a tissue site where it causes no disease
describe the structure of a Gram negative bacterial cell envelope
inner cell membrane, thin peptidoglycan layer, outer cell membrane, lipopolysaccharide layer, outer capsule.
describe the structure of a Gram positive bacterial cell envelope
thick layer of peptidoglycan between the outer capsule + inner cell membrane.
what is a bacterial endotoxin? describe features
a component of the cell wall that is released when the bacteria is damaged.
less specific actions than an exotoxin e.g. septic shock
what is a bacterial exotoxin? describe features
mainly excreted by Gram +ve bacteria. actively secreted toxins with specific actions.
how might bacterial genes be transferred between bacteria?
transformation e.g. via plasmid.
transduction e.g. via phage.
conjugation e.g. via sex pilus.
describe the process of Gram staining
- heat fix sample to slide
- add methyl violet (blue/purple)
- add iodine - fixes methyl violet to gram +ve samples
- add alcohol to decolorize Gram -ve samples
- counterstain with basic fuchsin (red)
what is the normal habitat of staphylococcus spp?
nose and skin
how is S aureus spread?
aerosol and touch
what agar is used to grow enterobacteria?
MacConkey - bile salts, lactose, pH indicator
How do you distinguish Salmonella/Shigella from E coli on a MacConkey-lactose agar?
E.coli = pink, as it is lactose fermenting Shigella/salmonella = yellow, non-lactose fermenting
how would you distinguish between Salmonella and Shigella?
serology, as both are non-lactose fermenting so appear the same on MacConkey agar
what are the main infections caused by pathogenic E coli strains?
wound infections (surgical). UTIs. gastroenteritis. travellers' diarrhoea. bacteraemia. meningitis.
what 3 infections are caused by salmonella?
- gastroenteritis - food poisoning (localised infection)
- enteric fever - typhoid (systemic infection)
- bacteraemia - uncommon
what agar must H influenzae be grown on and why?
fastidious - requires haem and NAD - will not grow on blood agar, only chocolate agar (blood agar that has been heated so haem and NAD are released by RBCs).
non-motile.
describe the main features of Legionella pneumophila and Legionnaires’ disease
seen in immunocompromised (elderly, alcoholics, smokers).
severe.
culture on charcoal agar.
found in man-made aquatic environments - replicates within freshwater protozoa.
can infect alveolar macrophages.
induces phagocytosis.
what are the clinical features of an infection with campylobacter?
mild to severe diarrhoea, often with blood.
self-limiting (up to 1 wk).
campylobacter shed in faeces for 3wks.
describe the features of bacteroides? where are they typically found as commensals?
non-motile rods.
strict anaerobes.
commensal flora of large intestine (also commensal in vagina/cervix).
what shape are bacteroides?
bacilli
what shape are spirochaetes?
spiral/helical
describe the cell wall of fungi and how it stains?
rigid. polysaccharides and chitin.
stain with Gomorra methenamine silver, and periodic acid-Schiff.
lack a capsule.
describe the features of yeasts
unicellular.
round/oval.
asexual - reproduce by budding.
what are dimorphic fungi?
fungi which grow as yeasts in tissue, but as moulds in-vitro.
describe the features of moulds
composed of tubular structures (hyphae).
grow by longitudinal extension and branching - interwoven mycelium.
reproduce by spore formation (sexual/asexual).
what type of fungi is candida albicans?
yeast
give some examples of moulds
aspergillus spp.,
fusarium spp.
mucoraceous moulds.
dark-walled fungi.
what are the 3 types of fungal infection?
- superficial mycoses
- subcutaneous mycoses
- systemic mycoses
name some common sites for superficial mycoses
skin, hair, nails, mucous membranes
what are the two main kinds of infection seen in superficial mycoses?
ringworm.
yeast infections.
what pathogens cause ringworm (dermatophytosis, tinea - athletes foot, swimmers crotch etc)?
tricophyton spp.
microsporum spp.
epidermophyton spp.
describe the transmission of ringworm infections
direct or indirect transfer of infected keratin - e.g. communal bathing facilities.
describe the different types of aspergillus infection
- invasive aspergillosis - neutropaenic patients. treat with amphotericin.
- allergic aspergillosis - ABPA
- aspergilloma - fungus ball in pre-existing cavity of lung.
describe the basic idea behind the treatment of fungal infections, and give examples of drugs used.
use drugs that target sterols in their cell membranes. topical - nystatin, ketoconazole. systemic: oral - fluconazole/other azoles parenteral - amphotericin.
give some examples of mycobacteria of medical importance, and the diseases they cause
M. tuberculosis = TB M. leprae = leprosy M. kansaii = chronic lung infection M. marinum = fish tank granuloma M. ulcerans = buruli ulcer
why will immunocompromised patients show disseminated mycobacterial disease, instead of characteristic granulomas?
they don’t have enough T cell function to form granulomatas
describe the microbiological features of mycobacteria
aerobic, non-spore forming, non-motile bacilli.
cell walls contain a lot of high molecular weight lipids - weakly gram-positive/colourless.
slow growing.
what does the thick lipid coating of mycobacteria allow them to do?
survive inside macrophages, even in low pH environment
what are the key cell wall components of mycobacteria?
mycolic acids.
lipoarabinomannan
describe Koch’s postulates for a disease to be defined as caused by bacteria (/mycobacteria etc)
- bacteria should be found in all people with disease
- bacteria should be isolated from infected lesions
- a pure culture inoculated into a susceptible person should produce disease symptoms
- same bacteria should then be isolated from that individual
what stain is used for mycobacteria and why?
Ziehl-Neelsen stain for acid fast bacilli - high lipid content in cell wall makes mycobacteria resistant to Gram stain
what type of granuloma is typically seen in TB?
caseating
what are the main principles of mycobacterial treatment?
- slowly replicating bacteria - so need prolonged treatment
- multiple drug combinations to combat resistance
- compliance is essential - directly observe therapy used
describe the standard drug regime for tuberculosis
isoniazid, rifampicin, pyrazinamide and ethambutol for 2mths.
then isoniazid and rifampicin for 4 further months.
what makes up the primary complex of primary TB?
granuloma + lymphatics + lymph node
where in the lung are tuberculosis bacilli most likely to form a granuloma and why?
apex - there is more air and less blood supply, so fewer defending WBCs to fight
what is latent TB?
cell-mediated immune response from T cells manages to contain primary infection, but it persists.
no clinical disease (normal CXR).
what is pulmonary TB?
follows after primary disease, or after latent reactivation.
necrosis in lesion. caseous material coughed up, leaving cavity. TB may spread in lung causing other lesions.
where, apart from the lungs, may TB spread?
GU TB peritoneal TB TB meningitis widespread = miliary TB. pleural TB bone and joint TB
what are the three groups of helminths?
- nematodes (round worms)
- trematodes (flatworms, flukes)
- cestodes (tapeworms)
what do adult worms need before they can reproduce?
a period of development outside the body
what is the “pre-patent” period in relation to helminth disease?
the interval between infection and the appearance of eggs in the stool
how are intestinal nematodes transmitted?
faecal-oral route.
transmitted from person to person via eggs/larvae - these are only infectious after a period of development in the soil.
what organism causes pinworm/threadworm? what is the pre-patent period?
enterobius vermicularis
40d.
v common in UK!
describe the lifecycle of enterobius vermicularis (pinworm/threadworm)
- adult is resident in large bowel
- female emerges from anus at night to lay eggs on perineum
- eggs are infectious after 4hrs, ingested by next host
what are the clinical features of pinworm/threadworm?
- pruritis ani
- appendicitis
- vaginal penetration - endometriosis, salpingitis, infertility
how would you diagnose pinworm/threadworm?
microscopy of sellotape strip from perianal region
what is the general way to diagnose worms?
stool microscopy for eggs
what drug is used to treat a lot of worm infections? available in pharmacies for threadworm
Mebendazole
what causes schistosomiasis?
Schistosoma - an adult fluke. penetrate skin while swimming, mature in abdominal cavity.
what is schistosomiasis (katayama fever)? what are the clinical features?
initial immune-complex mediated illness 2-4wks after exposure.
fever; urticaria; eosinophilia; diarrhoea; hepatomegaly; splenomegaly; cough and wheeze; cachexia.
what are protozoa?
single-celled eukaryotes.
consume bacteria, algae, microfungi
what are the two main stages in the general life cycle of protozoa?
proliferative TROPHOZOITE stage - feed and reproduce.
dormant CYST stage - can survive outside host.
what are the 5 major groups that protozoa are divided into?
- flagellates
- amoebae
- cilliates
- microsporidia
- sporozoa
what are the 4 species of plasmodia that cause human disease?
P. falciparum
P. ovale
P. vivax
P. malariae
how is malaria transmitted?
bite of female Anopheles mosquitoes
how does the Anopheles mosquito become affected?
feeding from infected human. then they are infected for life (3-4wks). night-biting. bite indoors. lifecycle depends on water (to lay eggs)
describe the basic stages of the plasmodia lifecycle
in human host has exo-erythrotic cycle (in liver), and erythrotic cycle (in blood). (P ovale/vivax also have hypnozoite stage - lie dormant).
matures in RBCs.
taken up from blood into female anopheles - sporogonic cycle.
describe the pathogenesis of falciparum malaria
fatal.
parasite matures in RBCs - ‘knobs’ on RBC surface.
bind to receptors on endothelial cells in capillaries + venules.
sequestration in small vessels.
obstruction of microcirculation - tissue hypoxia.
what are the acute clinical features common to all 4 species of malaria?
FEVER.
chills and sweats; headache; myalgia; fatigue; nausea and vomiting; diarrhoea.
anaemia; jaundice; hepatosplenomegaly; ‘black water fever’
describe the clinical features of P falciparum malaria in adults
coma; ARDS; hypoglycaemia; renal failure (hypovolaemia, microvascular blockade).
SHOCK.
describe the clinical features of P falciparum malaria in children
non-specific - stop crying/playing/eating.
tachypnoea.
anaemia.
hypoglycaemia.
cerebral malaria can cause encephalopathy/coma - raised ICP, varied presentation - rule out meningitis.
how is malaria diagnosed?
thick AND thin blood films - 3 separate films at different times of day, examined under light microscopy.
how do you treat complicated falciparum malaria?
IV artesunate or IV quinine
how do you treat uncomplicated falciparum malaria?
oral riamet or oral quinine (±doxycycline)
how do you treat non-falciparum malaria?
oral chloroquine
describe the stages of viral replication
- attachement
- cell entry - only viral ‘core’ enters host cytoplasm
- interaction with host cells - use cell materials for their replication etc
- replication
- assembly - may occur in nucleus/cytoplasm or at cell membrane
- release - by lysis of cell, or by exocytosis
list the different ways in which viruses can cause disease
- direct destruction of host cells
- modification of host cell structure/function
- immuno-pathological damage
- damage through cell proliferation/immortalisation
- evasion of host defences
what determines the defence mechanism employed against bacterial infection?
no. organisms/virulence.
low = phagocytes active
high = immune response
what types of immunoglobulin are produced in response to worm infection?
IgG and IgE
what is the most widely used antiviral agent? what is it’s mode of action?
aciclovir
nucleoside analogue
how do nucleoside analogue antiviral agents work?
phosphorylated within cells to an active triphosphate and inhibit viral DNA synthesis
what is septicaemia?
“blood poisoning” - when an infection is found in the circulating blood
what are “notifiable diseases”? who should be notified?
diseases/infections/conditions that are specifically listed as notifiable.
local health authorities/Public Health England
define “anti-microbial”
agents produced by microorganisms that kill or inhibit the growth of other micro-organisms in high-dilution
what is the target site of beta lactams?
cell wall - inhibition of cell wall synthesis.
include penicillins, carbapenems and cephalosporins
give examples of antibiotics that work by interference with nucleic acid synthesis/function
metronidazole
rifampicin
how do metronidazole/rifampicin work?
interfere with nucleic acid synthesis or function
how do fluoroquinolones work?
inhibit DNA gyrase
what types of antibiotics work by inhibiting ribosomal activity and protein synthesis?
aminoglycosides.
tetracyclines.
macrolides.
chloramphenicol.
what is the difference between bacteriostatic and bactericidal bacteria?
bacteriostatic = prevent growth of bacteria. bactericial = kills the bacteria
what are the two major determinants of anti bacterial effect
concentration and time that the antimicrobial remains on binding sites
what antibiotics put the patient at risk of C diff? (the 5Cs of C diff)
Ciprofloxacin; Clindamycin; Cephalosporins; Co-amoxiclav; Carbapenems
what are 4 ways a bacteria may resist an antimicrobial?
- target site mutation
- destruction/inactivation of antimicrobial
- prevent antimicrobial access
- remove antimicrobial from bacteria
how does beta lactamase confer resistance to penicillins and cephalosporins?
beta lactam ring is hydrolysed by this bacterial enzyme. antimicrobial is now unable to bind to the bacteria.
give some examples of carbapenems and their uses
imipenem, meropenem, ertapenem.
broad spectrum - severe hospital acquired infections.
give some examples of cephalosporins
cefradine
cefuroxime
cefotaxime
give examples of glycopeptides, and how they are used
vancomycin , teicoplanin.
gram +ve agents.
IV only.
reserved for serious/resistant gram +ve, e.g. MRSA
how does chloramphenicol work? how is it used?
it’s a protein synthesis inhibitor.
very broad spectrum (except pseudomonas).
toxicity - little used today.
give examples of macrolides, and what they are used for
erythromycin, clarithromycin.
good for staph/strep. alternatives to penicillins. no gram-ve cover.
what type of antibiotic is clindamycin? what is it used for?
lincosamides.
active against staph, strep and anaerobes
give examples of aminoglycosides and what they are used for
gentamicin, tobramycin.
enterobacteriaceae, pseudomonas and staphylococci.
what type of antibiotic is ciprofloxacin? what is it used for?
quinolones.
used against enterobacteriaceae, pseudomonas and staph.
what types of organism is metronidazole active against?
anaerobic.
bacteria and protozoa.
what does the catalase test differentiate between?
staphylococci - catalase +ve
strep and enterococci - catalase -ve
what does the coagulase test differentiate between?
staph areus - coagulase +ve
other staph - coagulase -ve
is staph aureus coagulase negative or positive?
positive
what does the oxidase test aim to identify?
oxidase positive bacteria - pseudomonas spp. and neisseria spp.
what does the optochin test do?
differentiates Strep pneumoniae from other alpa haemolytic strep.
strep pneumoniae shows a zone of inhibition around the optochin disc
What types of bacteria form red/pink colonies on MacConkey agar?
E coli and Klebsiella - lactose fermenting
What types of bacteria form a clear colony on MacConkey agar?
Salmonella, shigella, pseudomonas - lactose non fermenting
what type of agar differentiates between alpha and beta haemolytic strep?
blood agar
how do you identify alpha haemolytic strep (strep viridans) on blood agar?
green pigment due to partial breakdown of blood
how do you identify beta haemolytic strep on blood agar?
clear zones around the colonies - complete breakdown of blood
what is Lancefield grouping?
differentiates between beta haemolytic Strep spp. by detecting surface antigens
which bacteria are in Lancefield groups A, B and D
A = strep pyogenes B = strep agalactiae D = enterococci
what are the 6 key Gram +ve staining bacterial groups?
remember - Sexy Students Can Look Bad Come morning
Streptococcus Staphylococcus Corynebacterium Listeria Bacillus Clostridium
are the 6 key groups of Gram +ve bacteria aerobic or anaerobic?
aerobic, apart from Clostridium spp which are anearobes
describe the key features of streptococcus spp
chains or diplococci.
gram +ve.
catalase negative.
aerobic.
describe the features of strep pneumoniae and what diseases it can cause
gram +ve diplococci. alpha haemolytic. droplet transmission.
community-acquired pneumonia, sinusitis, bacterial meningitis.
what antibiotics would be given to treat strep pneumoniae infection?
penicillin or erythromycin
what diseases are caused by alpha haemolytic strep (strep viridans)
bacterial endocarditis + dental caries.
how would you treat an alpha haemolytic strep infection?
penicillin/amoxicillin (erythromycin if allergic).
bacterial endocarditis - penicillin and gentomycin.
give the features of strep pyogenes, and the diseases it causes?
group A beta-haemolytic.
transmission is airborne and hands.
cellulitis, necrotising fasciitis, pharyngitis (strep throat), tonsillitis etc
what are the features of enterococcus spp and what diseases do they cause?
group D, non-haemolytic, MacConkey growth. GI tract commensal.
infective endocarditis, UTIs, would infections, IV catheter infections.
how would you treat an enterococcus infection?
pencillin/vancomycin. serious infection (e.g. IE) - penicillin/vancomycin + getamicin
describe the key features of staphylococcus spp.
cocci in clumps, Gram +ve.
catalase positive. coagulase used to differentiate staph aureus (+ve) from the others. aerobic.
name two coagulase -ve staphylococcus spp.
staph epidermidis
staph saprophyticus
give some diseases caused by staph aureus
Impetigo, cellulitis, wound infection. osteomyelitis, septic arthritis. conjunctivitis. bacterial endocarditis (in IVDU) pneumonia.
how would you treat a staph aureus infection?
flucloxicillin.
MethicillinRSA isn’t sensitive to flucloxacillin - use vancomycin instead.
give a disease caused by staph saprophyticus and its treatment?
UTI in sexually active young women.
trimethoprim, flucloxacillin.
what is the important species of Corynebacterium? how is it spread? what disease does it cause?
Corynebacterium diphtheriae.
droplet spread.
diphtheria.
how would you treat diphtheria?
erythromycin.
diphtheria antitoxin.
are Clostridium spp aerobic or anaerobic?
anaerobic
what bacteria causes tetanus? how is it spread? how would you treat it?
clostridium tetani.
spore-forming - spores enter open wounds.
human tetanus Ig + benzodiazepines.
what disease does C difficile cause? how does it spread?
transmission = spores via faecal-oral route.
causes pseudomembranous colitis - diarrhoea following antibiotic therapy.
how would you treat C diff diarrhoea?
vancomycin
what are the 6 important Gram -ve bacterial groups?
Neisseria Coliforms (also Enterobacteriaceae) Parvobacteria Helicobacter Vibrio Pseudomonas
Are the key Gram -ve bacterial groups aerobic or anaerobic?
aerobic
describe the features of Neisseria spp.
diplococci. gram -ve. oxidase positive. aerobic.
Neisseria meningitidis - give its transmission, diseases caused and treatment
transmission is by droplets/direct mucosal contact.
Causes meningitis and septicaemia (with purpuric skin rash).
treatment - benzylpenicillin or cefotaxime.
what disease does Neisseria gonorrhoea cause? transmission? treatment?
gonorrhoea. (opthalmia neonatorum, Reiter’s syndrome).
transmission is direct mucosal contact.
treatment = ciprofloxacin or cefixime.
List the coliforms (/enterobacteriaceae) according to colour on MacConkey agar
red/pink colony = E coli and Klebsiella penumoniae.
clear colony = Salmonella typhi, paratyphi (A, B, C) and enteritidis
E coli: transmission? diseases caused?
faecal-oral.
diarrhoea. UTIs, hospital-acquired pneumonia.
Klebsiella pneumoniae: diseases caused? treatment?
hospital acquired pneumonia. UTIs.
cephalosporins.
what diseases do Salmonella typhi and paratyphi cause? transmission and treatment?
typhoid and paratyphoid (enteric fever).
faecal-oral.
ciprofloxacin.
what disease does Salmonella enteritidis cause? transmission? treatment?
gastroenteritis (food-poisoning). transmitted in under-cooked food contaminated with infected animal faeces. no treatment - self-limiting disease.
what disease does Shigella dysenteriae cause? transmission and treatment?
bacillary dysentery. faecal-oral. ciprofloxacin.
give some examples of parvobacteria
Haemophilus influenzae, Bordatella pertussis, Legionella pneumophila, Campylobacter jejuni.
what diseases does Haemophilus influenzae cause?
meningitis, osteomyelitis, cellulitis, otitis media, septic arthritis, pneumonia.
how would you treat an H influenzae infection?
cefotaxime or ceftriaxone
what disease does Bordatella pertussis cause? transmission and treatment?
whooping cough. airborne droplets. erythromycin.
what disease does Legionella pneumophila cause? transmission and treatment?
Legionnaires disease (severe pneumonia, high fever). transmitted by aerosolised droplets - found in warm water such as air con units, water tanks. treat with erythromcyin.
what does Campylobacter jejuni cause? transmission? treatment?
gastroenteritis ± dysentery - food poisoning.
reactive arthritis.
Guillain-Barre.
transmitted in contaminated poultry or unpasteurised milk.
no treatment - self-limiting.
what diseases does H pylori cause? how would you treat?
chronic gastritis. duodenal and gastric ulcers. increased gastric cancer risk.
treat - clarithromycin and amoxicillin or metronidazole.
PPI (omeprazole).
what disease does Vibrio cholerae cause? transmission and treatment?
cholera - rice water diarrhoea, 25l/day.
faecal-oral / seafood.
treat - rehydration.
what diseases does pseudomonas aeruginosa cause?
pneumonia (esp. in CF patients).
IV catheter infections.
folliculitis.
UTIs, esp. with catheters.
how would you treat a patient with a Pseudomonas aeruginosa infection?
severe cases - gentamicin or ceftazidime (IV).
in CF/bronchiectasis - ciprofloxacin.
what 8 important bacterial groups stain poorly/not at all with Gram stain?
Chlamydia spp. Coxiella spp. Ricksettia spp. Mycobacteria spp. Trepnonema spp. Borrelia spp. Leptospira spp. Mycoplasma spp.
What diseases are caused by Chlamydia trachomatis?
chlamydia.
trachoma - chronic follicular keratoconjunctivitis.
Reiter’s syndrome/
PID.
what is the route of transmission of Chlamydia trachomatis?
mucosal contact
how would you treat a patient infected with Chlamydia trachomatis?
doxycycline or azithromycin
what disease is caused by Chlamydia psittaci? treatment?
pigeon fanciers lung. tetracylcine.
what culture medium is used for Mycobacteria? how long should the culture be grown for?
Lowenstein-Jensen culture medium. up to 12 weeks.
what disease is caused by Mycobacterium leprae? transmission and treatment?
Leprosy. aerosol droplet spread.
Rifampicin and dapsone.
what disease is caused by Treponema pallidum? transmission and treatment?
Syphillis. tramission is through broken mucosa during sexual contact, or blood transfusion.
treatment - penicillin or doxycycline.
give some examples of spirochaete bacteria
Treponema spp.
Borrelia spp.
Leptospira spp.
what type of virus is the herpes simplex virus? what diseases does it cause?
DNA virus.
HSV1 = cold sores.
HSV2 = genital herpes.
how would you treat a herpes simplex infection?
aciclovir, famciclovir or valciclovir
what type of virus is the varicella-zoster virus? what diseases does it cause?
DNA virus.
chicken pox.
reactivation = shingles.
how would you treat someone infected with varicella zoster?
child - calamine lotion.
adolescents/adults - aciclovir.
what type of virus is cytomegalovirus?
DNA virus.
what type of virus is Epstein-Barr virus? what diseases does it cause?
DNA virus.
infectious mononucleosis (Glandular fever).
Burkitt’s lymphoma/Hodgkin’s disease.
what type of virus is the influenza virus? how is it transmitted?
RNA virus.
droplet spread.
what type of virus is the mumps virus? how is it transmitted?
RNA virus.
droplet spread.
what are the clinical features of mumps?
prodrome - headache, malaise, fever.
enlarged parotid gland.
orchitis.
what type of virus is the measles virus? how is it spread?
RNA virus.
droplet spread.
what are the clinical features of measles?
Prodromal illness.
fever. rash - erythematous and maculopapular.
what type of virus is the coronavirus? what does it cause? how it is spread?
RNA virus.
common cold.
droplet spread.
what type of virus is the rotavirus? what does it cause? how is it spread?
RNA virus.
gastroenteritis.
faeco-oral + direct spread.
name two groups of yeasts
candidia spp. and cryptococcus spp.
where is Candida albicans found? how is it transmitted?
oropharynx, vagina, GI tract.
disruption of normal bacterial flora leads to Candida overgrowth.
what diseases does Candida albicans cause?
vaginal and oral candidiasis (thrush).
skin/nail infections.
UTIs.
what type of protozoa is entamoeba histolyica? what disease does it cause?
an amoeba.
causes amoebic dysentry - faeco-oral transmission.
what are the clinical features of amoebic dysentery?
abdo pain.
severe diarrhoea with blood and mucus.
tenesmus.
hepatomegaly.
how would you treat amoebic dysentery?
metronidazole.
what type of protozoa is giardia lamblia? what disease does it cause?
flagellate.
causes diarrhoea, including travellers diarrhoea.
faeco-oral.
give an example of a cestode
taenia solium - pork tapeworm
give an example of a trematode
schistosomes
what colour do Gram +ve bacteria stain?
Purple (Positive = Purple)
what colour do Gram -ve bacteria stain?
red/pink
what worm is the most common cause of iron-deficiency anaemia worldwide?
hookworm