Microbiology Flash cards

Question 1

Definition of UTIs by WCC in urine?

Answer 1

> 10^5 - if mixed sample
10^4 - if isolated organism in sample
10^3 - if E.coli or S. Saprophticus

Question 2

What is the most common cause of sterile pyuria?

Answer 2

Previous antibiotic treatment

Question 3

Order the following in terms of immunocompromise (most to least)

• Solid organ transplant
• Cytotoxic chemo
• Stem cell transplant
• DMARD/ steroids
• Monoclonal antibody treatment
• HIV with a low CD4 count
• HIV with a normal CD4 count

Answer 3

MOST IMMUNOCOMPROMISED:

1) Stem cell transplant
2) HIV with low CD4
3) Solid organ transplant (+prophylaxis)
4) Monoclonal antibody treatment
5) Cytotoxic chemotherapy
6) DMARD/ Steroid tx
7) HIV with a normal CD4 count

LEAST IMMUNOCOMPROMISED

Question 4

What are the following also called:

HHV1, HHV2, HHV3, HHV4, HHV5, HHV8

Answer 4

HHV 1 - oral herpes
HHV2 genital herpes
HHV3 - VZV
HHV4 - EBV
HHV5 - CMV
HHV8 - Kaposi sarcoma

Question 5

Post transplantation malignancy:

Answer 5

Kaposi sarcoma and EBV (post-transplant lymphoproliferative disease)

Question 6

Post transplantation infections:

Answer 6

CMV: retinitis, encephalitis + anywhere else
BK: haemorrhagic cystitis (post HSCT), glomeulonephritis (post solid organ transplant)
JC: Progressive multifocal Leukoencephalopathy

Question 7

What does PML stand for (JC virus)

Answer 7

progressive multifocal leukoencephalopathy

Question 8

Which pneumonias cause cavitation lesions

Answer 8

• Haemophilus Influenza
• Staph Aureus
• Klebsiella

Question 9

Which pneumonias are community acquired and which is most common

Answer 9

SMH
Strep - most common
Moraxella
Haemophilus

Question 10

Which pneumonias are hospital acquired and which is the most common

Answer 10

Please Stop Killing (me)
Pseudomonas (most common)
Staph
Klebsiella

Question 11

What is the first-line treatment for a HAP?

Answer 11

Ceftazidime (if MRSA then vancomycin)

Question 12

What are glycopeptides bad at killing, why?

Answer 12

Bad at killing gram negative because LARGE molecules so can’t access through the cell wall layers

Question 13

EBV testing:

Answer 13

Monospot ; heterophile antibody test for IgM
- not useful in the first week or LATE (post 3 months)
(paul bunnel is the same)

Question 14

Which virus increases the chance of Nasopharangeal cancer?

Answer 14

EBV

Question 15

CMV D+/R- or CMV D-/R+

which combination makes infection more likely in

1) solid organ transplant
2) Bone marrow transplant

Answer 15

1) D+/R-
2) D-/R+

• in BM transplant the immunosuppression will reactivate the virus that the recipient already had
• in solid organ transplant you are giving them CMV

Question 16

Which immunosuppressive therapies increase the risk of PML?

Answer 16

Natalizumab and Mycophenalate Mofetil

Question 17

Complication of shingles?

Answer 17

Post herpatic neuralgia

- think HHV3 (herpes) and affects dermatomes anyway

Question 18

Which is the only dsDNA in the Hepatitis family

Answer 18

Hep B

Question 19

Which is the only Hepatitis that doesnt have the potential to become chronic

Answer 19

Hep A

Question 20

What is the best diagnostic criteria for Hep C

Answer 20

RNA levels

Question 21

Someone has vacuum-packed honey and shits themselves and paralysed? What is the management?

Answer 21

Clostridium botulinum - antitoxin

Question 22

What is the presentation of B.Cereus infection

Answer 22

early; vomiting
late; diarrhoea
(post reheated rice)

Question 23

What are the CHESS organisms

Answer 23

Campylobacter jejuni
Haemorrhagic E.Coli (EHEC = STEC)
Entamoeba histolytica
Shigella
Salmonella (typhi vs enteritidis)

Question 24

Paediatric transplant patient with multiorgan damage

Answer 24

Adenovirus

Question 25

most common organism causing encephalitis in uk? and worldwide

Answer 25

HSV 2 | worldwide - arbovirus

Question 26

Most common organism causing meningitis?

Answer 26

Enteroviruses (echo + coxsackie)

Question 27

Genotypic resistance assay

Answer 27

CMV, HIV, HBV, HCV

Question 28

Phenotypic resistance assay

Answer 28

HSV

Question 29

Pathogneumonic histological feature of CMV

Answer 29

Owl's eyes inclusion

Question 30

Spinal TB

Answer 30

Potts disease

Question 31

CMV treatment

Answer 31

1) Gancyclovir (for solid organ transplant) | 2) Foscarnet (for HSCT)

Question 32

TB meningitis on MRI

Answer 32

leptomeningeal enhancement, basal cistern enhancement, dilatation of ventricles

Question 33

RSV treatment and prophylaxis

Answer 33

Ribavirin --> IVIG | Paviluzumab

Question 34

What is the vector in Lyme disease

Answer 34

Ixodes tick

Question 35

What is the vector in Leishmania

Answer 35

Sand fly

Question 36

'Negri bodies” in nerve cells

Answer 36

Rabies

Question 37

Purple eyelids (Romana’s sign)

Answer 37

Chagas

Question 38

Crampy abdominal pain?

Answer 38

Campylobacter from Chicken, treat with Clarithromycin

Question 39

Drain a liver abscess to find anchovy paste consistency

Answer 39

Entamoeba Histolytica

Question 40

Flask shaped ulcer in the caecum

Answer 40

Entamoeba Histolytica

Question 41

Outbreak of diarrhoea + vomiting in a carehome

Answer 41

Norovirus

Question 42

Man with HIV gets severe diarrhoea, shows up on a kinyoun stain

Answer 42

``` Cryptosporidium Parvum (last protozoa) - treat with paromycin ```

Question 43

Diagnosis and treatment for a halo sign on CXR

Answer 43

Aspergillosus | Amphotericin

Question 44

Diagnosis and treatment for an anaerobic pneumonia

Answer 44

Aspiration pneumonia | Metronidazole

Question 45

What is present in aspergillosus cell wall

Answer 45

Galactomannan

Question 46

What is present in candida cell wall

Answer 46

Beta D Glucan

Question 47

What is present in all fungal cell walls

Answer 47

Chitin

Question 48

What is the treatment for Oral Candidiasis? Vaginal candidiasis? Pregnant candidiasis?

Answer 48

Nystatin, oral fluclox (or topical-->), topical clotrimazole

Question 49

Investigations for TB at different stages?

Answer 49

1) if active; GOLD STANDARD: sputum culture on Lowenstein-Jenson media (takes 6 weeks) - more immediate is the ziehl nielson stain 2) if latent: GOLD STANDARD: IGRA - mantoux test is also positive for BCG

Question 50

Dermatophytes are what? How to treat?

Answer 50

Tineas with terbafine

Question 51

Facial cellulitis + DM

Answer 51

Mucormycoses (rhinopus virus) | can also cause nasal pus and black eschars

Question 52

Leishmaniasis presentation and vector

Answer 52

cutaneous (common) - ulcers | transmitted by the sand fly

Question 53

What is trypansoma disease

Answer 53

Trypansoma (sleeping sickness) imagine zzzzzzzzz when sleeping also TsetSe fly (ZZZZ) transmission

Question 54

Cat scratch disease vs cat poo disease

Answer 54

Bartonella henslea vs toxoplasmosis

Question 55

What are the 3 features of influenza A which means it could cause a pandemic?

Answer 55

- novel antigenicity (antigenic drift) - easy transmission between humans - efficient replication in human airway

Question 56

What is the main class of drugs used to treat HIV

Answer 56

Nucleoside reverse transcriptase inhibitors

Question 57

which e.coli cause HUS

Answer 57

E. coli 0157:H7

Question 58

What are the most common organisms in cellulitis

Answer 58

S. pyogenes (group A strep) Staph S. pneumoniae

Question 59

What is the most common oppourtunistic infection in AIDS

Answer 59

PCP | Treat with co-trimoxazole

Question 60

condyloma acuminate

Answer 60

syphilis - secondary

Question 61

Argyll robertson pupil

Answer 61

neurosyphilis

Question 62

treatment for influenza

Answer 62

oseltamivir, zanamivir