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Clinical > Microbiology/Infection > Flashcards

Microbiology/Infection Flashcards

1
Q

Staphylococcus Aureus appears as what on a gram stain? What do we usually use to treat it?

A

Coagulase +ve ,Gram +ve, cocci.
Flucloxacillin.

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2
Q

Enterococcus appears as what on gram stain?

A

Gram +ve anaerobic cocci

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3
Q

Name some gram +ve rods

A

ABCDL (anthrax, bacillus, clostridium, diptheria, listeria)

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4
Q

Neisseria meningitidis and Neisseria gonorrhoea are what on gram stain?

A

Gram -ve diplococci

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5
Q

Name the most common gram -ve rod

A

E.coli

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6
Q

What antibiotics is pseudomonas often resistant to?

A

ampicillin, sulphonamides, tetracyclines, chloramphenicol and first- and second-generation cephalosporins.

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7
Q

Haemophilus influenza is what on gram stain?

A

Gram -ve coccobacilli

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8
Q

What is a +ve ASO titre indicative of?

A

recent strep infection (e.g., rheumatic fever)

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9
Q

Neutrophil count <0.5 x 10^9 AND fever >38.5 or 2 readings >38 is indicative of what? How should it be managed?

A

Neutropenic sepsis.
Mx: pip-taz

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10
Q

Parvovirus B19 causes what childhood associated illness? What are the sx?

A

Slapcheek (erythema infectiosum).
- prodrome: fever, coryza, diarrhoea
- followed by lace-like rash on the trunk and bright red rash on cheeks

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11
Q

How does parvovirus B19 in adults?

A

Arthralgia and paraesthesia

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12
Q

Until what point is a child with slapped cheek (PB19) infective?

A

Until rash appears

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13
Q

What are the most common causes of otitis media?

A

Strep pneumonia, moraxella catarrhalis, haemophilus influenza.

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14
Q

When is the infectious period of measles? How is it transmitted? How does it present?

A

4-5 days after initial infection - spread by respiratory droplets.
- Koplik spots (white spots) on inside of cheek
- High fever
- Sore eyes (conjunctivitis)
- Coryza
- Rash appears 2-5 days after sx onset

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15
Q

What is a common complication of measles?

A

Otitis media.

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16
Q

Paromyxovirus causes which childhood associated illness? How does it present? How is it diagnosed? For how long should a patient be isolated?

A

Mumps.
- unilateral or bilateral parotitis
- fever
- potential sensorineural hearing loss
Measure salivary IgM mumps antibodies.
5 days post parotid sx.

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17
Q

What causes whooping cough? How does it gram stain? How does it present? How is it managed?

A

Bordetella pertussis - gram -ve coccobacilli
- flu-like sx
- barking cough (associated with vomiting, cyanosis, and syncope)
If sx persist past 21 days prescribe macrolide (clarithromycin).

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18
Q

Having whooping cough increases long-term risk of developing which respiratory pathology?

A

Bronchiectasis

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19
Q

Bacillus cereus gastroenteritis is associated with which food? How long is the onset?

A

Vomiting/diarrhoea associated with eating rice, onset is usually within 6 hours of consumption.

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20
Q

What is ‘traveller’s diarrhoea’? How long is the onset?

A

E.coli gastroenteritis (watery diarrhoea, abdominal cramps).
Onset within 12-48 hours.

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21
Q

What is Threadworm? How is it managed?

A

Itchy bottom worse at night (when the females lay eggs).
Parasitic infection of large bowel.
Mx: oral mebendazole and hygiene measures.

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22
Q

How does an Entamoeba Histolytica infection present? What is it associated with?

A

Parasitic amoebozoa infection causing:
- Bloody diarrhoea
- RUQ pain (liver abcess)
- swinging fevers and sweats
Associated with travel to endemic areas (India), MSM, and faecal oral transmission.

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23
Q

Bloody diarrhoea and abdo pain presenting within 24-48 hour incubation period is what?

A

Salmonella typhi

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24
Q

Diarrhoea (bloody or not) and abdo pain presenting within 48-72 hour incubation period is what?

A

Campylobacter

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25
Q

What is the most common cause of D+V in children?

A

Rotavirus: vomiting, diarrhoea, decreased oral intake, lethargy, etc.

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26
Q

D+V illness can lead to what type of acidosis?

A

Raised anion gap metabolic acidosis.

27
Q

What is the most common cause of gas gangrene? How does this present? What type of kidney injury does this cause? Why?

A

Clostridium perfringens releases alpha and theta toxins - swelling, discolouration, blistering, subcutaneous emphysema around surgical site/incision. As well as pyrexia, tachycardia, hypotension.
Acute tubular necrosis: microvascular thrombosis and necrosis lead to localised gas production and rhabdomyolysis (ATN) leading to renal failure, RBC haemolysis, sepsis, and shock.

28
Q

What is the most common cause of bacterial septic arthritis of prosthetics? What do you see if you aspirate?

A

Staph A (gram +ve cocci in grape-like clusters).
Aspirate = WCC >10000mm3 and neutrophils >90%, synovial fluid has a yellow appearance.

29
Q

What is most commonly given for a Hospital Acquired Pneumonia?

A

Piperacillin-tazobactam

30
Q

Someone presenting with muscle aches, headaches, non-bloody diarrhoea, fatigue and hepatosplenomegaly with a recent travel history should raise suspicions for what? What investigations should you perform?

A

Malaria - diagnose with thick (parasite density) and thin blood (species identification) films.

31
Q

How might an infection of tropheryma whipplei present? How is it diagnosed and managed?

A

Systemic features: joint pain, diarrhoea, abdo pain, weight loss, etc often in male farmers.
Duodenal biopsy - periodic acid-schiff (PAS) positive macrophages. Managed with a year long course of co-trimoxazole.

32
Q

What is the presentation of scarlet fever? How is it managed?

A

Strep throat - coryza, fever, cervical lymphadenopathy - followed by a rash on chest, abdo, and cheeks and strawberry tongue 12-48 hours later.
Manage with phenoxymethylpenicillin.

33
Q

What is the most common cause of bacterial meningitis? How does this gram satin?

A

Neisseria meningitidis - gram -ve intracellular diplicocci

34
Q

What will be seen on LP for bacterial meningitis?

A

Increased protein, low glucose, white cells predominantly leukocytes.

35
Q

What is 1st line for bacterial meningitis in primary care?

A

IM benpen and transfer to secondary care

36
Q

What is first line for bacterial meningitis in secondary care?

A

IV ceftriaxone + amoxicillin (in age extremities only to cover for listeria too)

37
Q

What is waterhouse-friedrichson syndrome?

A

Adrenal failure (due to bleeding of glands) secondary to meningococcal sepsis and DIC.
HoTN, altered mental status, multi-organ dysfunction.
Often fatal.

38
Q

What might be seen on LP for viral meningitis?

A

normal glucose, raised protein, white cells predominantly lymphocytes

39
Q

Where are Hepatitis A, B, C, and E transmitted from?

A

A - faeco-oral route poor food hygiene (shellfish and water)
B - IVDU, sex workers, MSM
C - IV or nasal DUs, HIV infection, organs transplants and blood transfusions
E - endemic areas (East and South Asia),faeco-oral transmission e.g., contaminated water

40
Q

What causes typhoid fever? What are the sx?

A

Salmonella typhia:
- headache,
- fatigue,
- aches/pains,
- cough,
- maculopapular ‘rose spots’ rash that blanches under pressure,
- GIT sx,
- hepatosplenomegaly

41
Q

How do you diagnose typhoid fever? How do you manage it? What is a common complication?

A

Bone marrow/blood/stool culture to detect bacteria OR widal test (to check for antibodies).
IV ceftriaxone - cipro/azithromycin if resistant.
Cx: GI ulceration and perforation.

42
Q

What causes Lyme disease? How is it transmitted?

A

Borreliosis, transmitted through ixodes tick.

43
Q

What are the sx of Lyme disease? How is it managed? What is the complication on the nervous system?

A
  • Erythema migrans
  • fever
  • myalgia
    2-3 weeks of doxycycline.
    Neuroborreliosis - pain and weakness due to affect on PNS, can occur 4-6 weeks later.
44
Q

What is the classic presentation of schistosomiasis? How is it managed?

A
  • Swimmer’s itch
  • Eosinophilia
  • Uticaria
  • hepatosplenomegaly
  • Systemic features (2-8 weeks after infection, known as Katameya fever)
    Mx: praziquantel - if developed into katameya fever then give in combo with corticosteroids
45
Q

What is brucellosis? How is it managed?

A

Gram -ve aerobic, intracellular bacillus.
Unspecific sx:
- fever
- myalgia
- sweats
- headaches
- fatigue
Transmitted through unpasteurised milk and livestock to humans.
Mx: dual therapy doxycycline and streptomycin for 2-3 weeks.

46
Q

What causes scarlet fever? How does it present? How is it managed?

A

group A strep, presents with flu-like sx followed by sandpaper rash and strawberry tongue 48 hours after prodrome.
Manage with phenoxymethylpenicillin.

47
Q

What causes glandular fever?

A

EBV

48
Q

What are the most common culprits for neutropenic sepsis?

A

gram -ve bowel infections and gram +ve line infections

49
Q

In who might you see a fungal chest infection? What is usually the culprit? How do you diagnose this?

A

Immunocompromised pts who are neutropenic for a long period of time (e.g., AML pts) may present with signs of a chest infection but no signs of CXR and are unresponsive to abx.
In this case think aspergillus
Needs high res CT chest.

50
Q

Which viruses pose an increased risk to the immunocompromised?

A
  • shingles (can be Multidermatomal)
  • purulent varicella
  • CMV (can be an issue with stem cell transplants)
  • EBV reactivation
  • hepatitis
51
Q

What pneumonia affects immunocompromised only? What sign is seen on CXR?

A

PCP - batwing hilar shading.

52
Q

Splenectomy pts are at increased risk when it comes to what type of organisms?

A

Encapsulated e.g., haemophilus and Neisseria

53
Q

What virus causes chicken pox/shingles? How does it present?

A

Varicella-zoster (HHV3) - febrile syndrome with maculopapular rash starting on head and trunk which spreads, papules become vesicles and then crust.

54
Q

What virus causes cold sores?

A

HSV1

55
Q

What is the underlying cause of eczema Herpeticum? How does it present? How is it managed?

A

HSV infection of eczema causing monomorphic blisters and erosions alongside general malaise.
Mx: acyclovir

56
Q

What is Impetigo most commonly caused by? What is classically seen?

A

Staph aureus - golden crusting

57
Q

At what point is someone with impetigo no longer infectious? How is it managed?

A

Once wounds have crusted or 48 hours after commencing abx.
Non-bullous: topical fusidic acid
Bullous: systemic abx

58
Q

What is the incubation period for Hep A? How do you manage it? How long does it take to resolve?

A

2-6 week incubation period.
Supportive management.
6 months.

59
Q

What is Black water fever?

A

Malaria leading to intravascular haemolysis and AKI causing passage of dark coloured urine.

60
Q

What causes Leprosy?

A

Mycobacterium leprae - spread in endemic countries (India, Indonesia, Brazil) by animals (squirrels, armadillos) and through respiratory route/nasal discharge.

61
Q

What are the two types of leprosy?

A
  • Multibacillary (lepromatous) - poor Th1 response causes more manifestations
  • Paucibacillary (tuberculoid) - robust Th1 response means milder sx
62
Q

What are the symptoms of Leprosy?

A
  • Skin: Coppery, hypopigmented lesions (<5 for paucibacillary and >5 in multibacillary)
  • Face: Nasal destruction and ear swellings
  • Peripheral neuropathy
  • Thickening of nerves (medial, radial, ulnar, common peroneal, posterior tibial, greater auricular)
63
Q

How does EBV present? How can we test for it?

A

Sore throat, exudative tonsils, fatigue, lymphadenopathy, hepatosplenomegaly.
Monospot test: +ve heterophile antibodies in 2nd week of illness (may have false -ve in the 1st week).

64
Q
A

Clinical (27 decks)

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