microbiology/ID

Question 1

What is the first line abx for c.diff infection without sepsis? What is second line abx?

Answer 1

Oral vancomycin is the first line treatment option for C. difficile. A 10-day course is recommended. Intravenous metronidazole would be added if there was a life-threatening infection
Oral fidaxomicin is a second line therapy for C difficile infection. It may also be used for recurrent C. difficile cases.

Question 2

What abx are used in pregnancy for UTI? how long?

Answer 2

first-line: nitrofurantoin (should be avoided in third trimester)
second-line: amoxicillin or cefalexin

Need 7 day course

Question 3

What is first line abx for meningitis and what do you add in if elderly/ immunocomp?

Answer 3

IV cefotaxime (first line)

IV amoxicillin is reserved for scenarios where there is suspicion of Listeria monocytogenes

Question 4

First line abx for non-dessimated lyme diseae and length of course? Second line? In dessimated disease?

Answer 4

First line treatment of non-disseminated Lyme disease is a 21 day course of oral doxycycline,

Amoxicillin is 2 nd line

Ceftriaxone is used in disseminated disease.

Treatment should be started based on clinical suspicion as serology can take 3-8 weeks to become positive.

Question 5

What is the most common cause of bronchiectasis exacerbations?

Answer 5

Haemophilus influenzae

Question 6

What are the features of discitis? What is the most common causitive agent?

Answer 6

back pain
fever/ gen unwell
neurological features

Most common agent is bacterial (S.aureus)

Question 7

What is used as prophylaxis for contacts of patients with meningococcal meningitis?

Answer 7

Oral ciprofloxacin or rifampicin

Question 8

How do you treat latent TB? What is it?

Answer 8

Latent TB - asymptomatic and non-infectious. Have a positive tuberculin skin test/ Interferon-Gamma Release Assay (IGRA) combined with a normal CXR (can have calcified ghon complex)

3 months of isoniazid (with pyridoxine) and rifampicin, or
6 months of isoniazid (with pyridoxine)

Question 9

1st line vs 2nd line abx for lyme disease?

Answer 9

1st line - doxycycline
2nd line - amoxicillin

Question 10

management of Campylobacter jejuni?

Answer 10

usually self-limiting
the BNF advises treatment if severe or the patient is immunocompromised eg high fever, bloody diarrhoea, >8 stools a day or sx lasted >7 days
1st line = clarithromycin

Question 11

What are the most common micro organisms responsible for otitis media?

Answer 11

Streptococcus pneumonaie, Haemophilus influenzae and Moraxella catarrhalis

Question 12

1st line abx for msra?

Answer 12

vancomycin

Question 13

microorganism responsible for epiglottitis?

Answer 13

Hib - haemophilus influenza b

Question 14

What is diptheria?

Answer 14

Diphtheria is a bacterial infection caused by Corynebacterium diphtheriae which primarily infects the throat and upper airways, leading to difficulty in breathing and swallowing. A grey coating surrounding the tonsils, fever, and cervical lymphadenopathy are classic symptoms of this disease

Question 15

What is dengue fever?

Answer 15

viral illness
transmitted via mosquitoes
high fever, headache, pain behind the eyes, joint pain, rash, mild bleeding.

Question 16

What is typhoid/ paratyphoid? (enteric fever)

Answer 16

caused by different strains of Salmonella. Typhoid and Paratyphoid fevers present with prolonged high-grade fever associated with relative bradycardia, malaise, headache, cough, constipation, rose spots

Question 17

What is the most common causitive agent of COPD exacerbation

Answer 17

Haemophilus influenzae

Question 18

Mycoplasma pneumonia presentation?

Answer 18

Stereotypical history of mycoplasma pneumonia: worsening flu-like symptoms and a dry cough. Erythema multiforme is associated

Question 19

Legionella presentation?

Answer 19

Classic exam q - pick up on holidy via A/C
lymphopaenia
hyponatraemia
pleural effusion

Question 20

What commonly causes pneumonia post influenza?

Answer 20

Staphylococcus aureus

Question 21

Treatment can vary

What protozoan infections are associated with cat litter? Mx of this?

Answer 21

Toxoplasma gondii
Immunocompetent patients with toxoplasmosis don’t usually require treatment
metronidazole if immunocomp

Question 22

What features would you expect from campylobacter infection? mx of this?

Answer 22

Campylobacter infection is the most common bacterial cause of infectious intestinal disease in the UK. Typically have prodrome and bloody diarrhoea. The incubation period for Campylobacter is 1-6 days
Associated with bbqs

clarithromycin

Question 23

What GI infection causes fat malabsorption (greasy stools)?

Answer 23

giargia

Question 24

What causes infectious mono?

Answer 24

AKA glandular fever is caused by EBV

Question 25

Which malarial prophylaxis can cause neuropsychiatric issues?

Answer 25

Mefloquine

Question 26

What is used as a prophylactic abx in recurrent COPDE?

Answer 26

azithromycin

Question 27

Mx of legionella?

Answer 27

Macrolides such as clarithromycin are used to treat Legionella

Question 28

What is the abx of choice for pregnant women if they are penicillin allergic and being treated for eg cellulitis

Answer 28

Erythromycin is the antibiotic of choice for cellulitis in pregnancy if the patient is penicillin allergic

CLarithromycin is CI!!!

Question 29

How does leptospirosis infection present?

Answer 29

presents with fever, headache, chills, muscle aches and vomiting. It can also cause jaundice due to liver involvement. It is associated with exposure to contaminated water or soil eg sewage worker

Question 30

What is in co-trimaxazole?

Answer 30

Co-trimoxazole contins trimethoprim and therefore should never be prescribed with methotrexate

used for Pneumocystis jiroveci

Question 31

abx for shigella and salmonella?

Answer 31

ciprofloxacin

Question 32

Which gastrointestinal infection has the shorted incubation period?

Answer 32

staph aureus

Question 33

Characterisitics of shigella infection?

Answer 33

Salmonella enteritidis has an incubation period of 12 - 48 hours and is usually associated with severe vomiting and a high fever. It can cause bloody diarrhoea.