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Micropath Flashcards

1
Q

Cytomegalovirus retinitis antiviral tx?

A

Ganciclovir

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2
Q

Herpes Simplex virus meningitis antiviral tx?

A

Aciclovir

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3
Q

Varicella-Zoster virus in an adult antiviral tx?

A

Aciclovir

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4
Q

Child with co-morbidities with Respiratory Syncytial virus antiviral tx?

A

Ribavirin

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5
Q

Asthmatic with flu antiviral tx?

A

Oseltamivir

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6
Q

Most common mechanism of HSV resistance to aciclovir?

A

Mutation in viral thiamidine kinase

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7
Q

Drug for aciclovir-resistant HSV

A

Forscanet or cidofovir

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8
Q

Cause of pneumonia in HIV patient

A

Pneumocystis jirovecii

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9
Q

Pneumonia in girl receiving chemotherapy for leukaemia with ‘Halo’ sign on CXR

A

Aspergillus fumigatus

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10
Q

Lower lobe pneumonia in a 22 year-old who is coughing up rusty coloured sputum

A

Strep pneumoniae

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11
Q

Upper lobe cavitation on CXR in an alcoholic

A

Klebsiella pneumonia or TB

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12
Q

Pneumonia - Smoker back from holiday in Spain, also hyponatraemic and confuse

A

Legionella pneumophillia

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13
Q

HIV patient with CD4+ count of 150 with meningitis

A

Cryptococcus neoformans

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14
Q

Water polo player with itchy scaly rash on lateral toe which then moved along lateral side of foot

A

Trichophytum rubrum (athlete’s foot)

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15
Q

Pityriasis versicolor

A

Malassezia Furfur

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16
Q

A soldier returning from Afghanistan has a small ulcer on right ring finger that won’t heal and keeps getting bigger

A

Leishmaniasis

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17
Q

Snail trail oral ulcer in a homosexual man

A

Treponema pallidum

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18
Q

A South American man presents to a doctor in the UK with fever and bloody diarrhoea, and investigations detect a cyst in the right lobe of the liver

A

Entamoeba histolytica

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19
Q

A Nigerian man presenting with fever and chills, has just returned from Nigeria, did not take prophylaxis, and was bitten a lot

A

Malaria

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20
Q

A woman returning from travel in Asia presents with abdo pain, headache, and constipation. A
Gram- rod is later cultured from her blood

A

Salmonella typhi

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21
Q

Infective causes of bloody diarrhoea

A

SEECSY

Shigella
Entamoeba histolytica
E coli
Campylobacter
Salmonella
Yersinia Enterocollitica

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22
Q

Virus that require C-section if mother has an outbreak at 34wks or later due to risk of transmission
vaginally

A

HSV

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23
Q

Virus which if transmitted to baby: they can initially be symptomless but then come down with
long term sequelae

A

CMV

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24
Q

A ward sister gets diarrhoea, and patients on the ward have been ill recently with similar symptoms

A

Norovirus

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25
Q

The most common cause of traveller’s diarrhoea

A

Entero-toxigenic Escherichia coli

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26
Q

Norovirus vs Rotavirus (demographic)

A

Rotavirus more common in kids

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27
Q

Included in meningitis treatment to cover Listeria monocytogenes

A

ampicillin

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28
Q

Antibiotic for Group A Strep pharyngitis

A

Benzylpenicillin

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29
Q

Young women with cystitis and fully sensitive E-Coli - tx?

A

Nitrofurantoin or Trimethoprim

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30
Q

Which antibiotic would you use for cellulitis with MRSA

A

Vancomycin

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31
Q

Which antibiotic would you use to treat someone who has cellulitis with a Methicillin SENSITIVE strain of Staphylococcus aureus

A

Flucloxacillin

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32
Q

A girl has been noted by her parents to be acting strange lately. A Lumbar puncture is performed and the CSF shows high lymphocytes and a raised protein, but normal glucose, what organism is the cause?

A

HSV

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33
Q

An 18 year old student is found to have Gram negative diplococcus causing meningitis

A

Neisseria meningitidis

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34
Q

A man is found to have a Gram positive diplococcus causing meningitis

A

Streptococcus pneumoniae

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35
Q

Gram negative rod causing sepsis in a neonate

A

Escherichia coli

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36
Q

Gram positive rod causing meningitis in a 72 year-old

A

Listeria monocytogenes

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37
Q

Beta lactam with anti-pseudomonal activity

A

Ceftazidime

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38
Q

A DNA synthesis inhibitor used to treat Pseudomonal infections but poor against anaerobes

A

Ciprofloxacin

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39
Q

Abx of the Macrolide/lincosamide/streptogrammin group used to treat some atypical pneumonias

A

Clarithromycin

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40
Q

Lady with discharge, no other symptoms, and causative infection found on wet slide microscopy

A

Trichomonas Vaginalis

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41
Q

Lady with PID and positive urinary NAAT test

A

Chlamydia Trichomatis

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42
Q

Man with discharge- Gram negative diplococci found

A

Neisseria gonorrhoea

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43
Q

Woman with UTI - culture grows Gram positive cocci in clusters

A

Staphylococcus saprophyticus

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44
Q

19 year old rugby player with boils, members of his team have similar boils, as do members of his family

A

Staphylococcus aureus

45
Q

Neonate has meningitis, Gram positive organism in chains

A

Group B Streptococcus

46
Q

50 year old male smoker has meningitis with Gram positive diplococci

A

Streptococcus pneumoniae

47
Q

Vaccine preventable virus that resides in pharynx and GIT - 1:100 encephalitis, 1:1000 destruction of motor neurons

A

Polio

48
Q

Vaccine preventable bacterial infection that causes lockjaw

A

Tetanus

49
Q

Receptor/ cytokine mutation that could be protective in HIV?

A

CCR5/ MIP-1a/b

50
Q

Cat scratch disease full name (genus and species) of bacteria?

A

Bartonella henselae

51
Q

Which stain would be used to confirm infection with acid-fast bacilli?

A

Ziehl-Neelsen

52
Q

What is the definition of herd immunity threshold?

A

The proportion of immune healthy people needed within a population to stop a
pathogen’s spread: 1- (1/R0)%

53
Q

Name 1 of the 3 characteristics of Influenza A that could cause a pandemic

A

Novel antigenicity
Efficient replication in human airway
Efficient transmission between humans

54
Q

Alcoholic man is on ceftriaxone for meningitis, what organism is he at risk of which this does not cover for?

A

Listeria Monocytogenes

55
Q

Returning traveller with fever and constipation (salmonella typhi) - what abx do you give if she hasn’t been started on them already?

A

Ceftriaxone

56
Q

Which bacterial species causes scarlet fever?

A

Streptococcus pyogenes

57
Q

What is the most common cause of viral meningitis?

A

Non-polio enteroviruses (Echoviruses and Coxsackie viruses)

58
Q

What does JC virus cause?

A

Progressive Multifocal Leukoencephalopathy

59
Q

Q fever bacteria

A

Coxiella Burnetii

60
Q

What is the treatment for pseudomembranous colitis?

A

Oral vancomycin + IV metronidazole

Basically a severe C diff infection

61
Q

Name an infectious organism which is a common cause of meningitis in a child older than 3 months

A

Neiserria Meningitidis

62
Q

What drug is used to treat severe falciparum malaria?

A

I.V. Artesunate (I.V. Quinine if Artesunate unavailable)

63
Q

Name the main class of drugs used to treat HIV

A

Nucleoside reverse transcriptase inhibitors

64
Q

Which would be the most useful test in confirming acute EBV infection 2 weeks after possible exposure in an immunocompetent patient?

A

IgM

65
Q

What cell type is raised in the blood in schistosomiasis?

A

Eosinophils (parasitic infections raise eosinophils)

66
Q

What cell type is raised in bacterial infection? What about viral?

A

Bacteria - Neutrophils
Viral - Lymphocytes

67
Q

Boy visits grandparents in Wiltshire, comes back with 5 days of diarrhoea, no vomiting, and unexplained bruises all over body, which organism has most likely triggered this?

A

Escherichia coli 0157:H7

68
Q

Natural antibodies against what can confer protective immunity against HIV?

A

HIV-GP120

69
Q

Which vector transmits Trypanosoma brucei rhodesiense?
A. Anopheles mosquito
B. Sandfly
C. Tsetse Fly
D. Aedes mosquito
E. Ixodes tick

A

Tsetse fly (sleeping sickness)

70
Q

What is the most common cause of fever in a returning traveller?
A. Malaria
B. Hepatitis
C. HIV seroconversion D. Typhoid
E. Dengue

A

Malaria

71
Q

Which class of antibiotics has concentration dependent killing (i.e. the goal of therapy is to maximise peak > MIC)

A

Aminoglycosides (eg gentamicin, amikacin)

72
Q

Elderly woman has 24 hour history of headache, confusion, photophobia, fever. Gram stain of CSF shows gram+ve rods. What is the causative organism?

A

Listeria monocytogenes

73
Q

Which human herpes virus is associated with post transplant lymphoproliferative disorder

A

EBV

74
Q

This vaccine preventable disease causes headache, fever, parotid swelling (unilateral or bilateral). Complications include epididymo-orchitis in postpubertal males and more rarely meningitis. What is the causative organism?

A

Mumps virus

75
Q

Patient receiving chemotherapy for leukaemia. She has prolonged neutropenia and ongoing fever, raised inflammatory markers despite broad antibacterial therapy with meropenem and amikacin. CT scan shows multiple nodules with surrounding hypo-attenuation (halo sign). What is the most likely organism?

A

Aspergillus

76
Q

Poorly controlled person with T2DM has headache, sinus pain, periorbital oedema and orbital cellulitis. His symptoms have progressed rapidly. He has purulent discharge from his nose. ENT surgeons bring him to theatre as an emergency. What antifungal therapy should be started ASAP?

A

Amphotericin-B (used for all invasive fungal diseases)

btw this patient probably has mucormyosis according to chatgpt but thats not in the path guide - EDIT: its in the 2022 paper wtf

77
Q

4 year old goes on school trip to petting farm, later has bloody diarrhoea and HUS. What is the causative organism?

A

Escherichia coli O157:H7

78
Q

Young man has headache, neck stiffness and photophobia. He was not confused, did not have features of encephalitis. HSV1 was detected on PCR of CSF obtained from LP. What antiviral should be given?

A

Aciclovir

79
Q

Elderly woman has fever and productive cough in GP. She has pleural rub. Spleen is not palpable, no lymphadenopathy. Her WBC is 15x10^9 with neutrophilia. The Hb concentration is slightly low and platelet count is normal. Blood film - toxic granulation, left shift. CRP is high. What is the diagnosis?
a) AML
b) Aplastic anaemia
c) CML
d) Infectious mononucleosis
e) Reactive neutrophilia

A

Infectious mononucleosis

80
Q

Bleeding patient has prolonged APTT and PT, but normal platelet count and normal fibrinogen. What is the most suitable blood component for treatment?
a) Albumin
b) Anti-D
c) Cryoprecipitate
d) Fresh frozen plasma
e) Platelets

A

Fresh frozen plasma

81
Q

55 year old male smoker, on long term frusemide. Investigations - high Hb, high Hct, normal red cell mass. Plasma volume is low. What is the most likely diagnosis?
a) Polycythaemia vera
b) Primary polycythaemia
c) Secondarypolycythaemia
d) Relative polycythaemia
e) High affinity haemoglobinopathy

A

Relative - no change in red cell mass

82
Q

72 year old man has returned from a 7 day holiday in Italy. He has signs of pneumonia and Legionella urinary antigen is positive. Which abx to use?

A

Azithromycin

83
Q

Which serological test is useful in the diagnosis of invasive Candida albicans infections?

A

Beta-D-Glucan

84
Q

Infants under 12 months should not be fed honey due to an increased risk of food poisoning caused by?

A

Clostridium Botulinum

85
Q

Malaria tx?

A

Severe/ falciparum - IV artesunate
Non falciparum - Chloroquine then primaquine

86
Q

Hep B tx

A

Interferon alpha
Lamivudine
Entecavir
Telbivudine
Tenofovir

87
Q

Streptobacillus moniliformis is the causative organism of what infection?

A

Rat bite fever

88
Q

What is the commonest form of prion disease?

A

Sporadic Creutzfeldt-Jakob disease

89
Q

A 54yo woman has been in hospital for 7 days, receiving treatment for meningitis. She initially responded well, but has developed profuse watery diarrhoea over the last day and now feels dizzy whenever she tries to stand. She has never previously experienced anything like this. Basic obs show: HR 110 BP 85/51 RR 14 SpO2 98% on room air Temp. 38.1oC.

Tx?

A

Oral vancyomycin + IV metronidazole

note: path guide is wrong, this is from NICE guidelines

90
Q

Infection of prosthetic joint, which organism?

A

Staph epidermidis

91
Q

Serology for what polysaccharide is used for the diagnosis of invasive Aspergillus infection?

A

Galactomannan

92
Q

A 26 year old woman presents with fever, headache and confusion. She has an HIV infection and has refused to take antiretroviral therapy for the past four years. What rapid test should you ask the microbiology laboratory to perform on her serum sample to confirm the likely diagnosis?

A

Cryptococcal antigen

93
Q

What double stranded DNA virus is associated with nephritis in renal transplant recipients immunosuppresive therapy?

A

cytomegalovirus

94
Q

Which vaccine preventable disease presents initially with mild fever, swollen neck glands, anorexia, malaise and cough. After 2-3 days a membrane of dead cells forms in the throat, tonsils, larynx or nose which may narrow or occlude the airway leading to respiratory distress?

A

Diphtheria - can have swollen neck, buzzword seems to be membrane of dead cells / grey or white patch in the throat

95
Q

Which helminth is capable of autoinfection in humans via the following life cycle? Infective filariform larvae penetrate intact skin and migrate to the small intestine where they become adults. Eggs hatch into rhabditifom larvae which mature into filariform larvae which can autoinfect via perianal skin

A

Strongyloides stercoralis (roundworm) - autoinfection would be specific for this i think

96
Q

A 72 year old woman has signs and symptoms consistent with meningitis. She is not confused and has no features suggestive of encephalitis. She has been commenced her on ceftriaxone 2g i.v. twice daily. There are no known drug allergies. Given this clinical picture what one antimicrobial should be be given in addition?

A

Ampicillin - cover for listeria esp in elderly

won’t be acyclovir as they ask for antimicrobial, plus no encephalitis

97
Q

A 67-year-old woman presents with a chronic cough, haemoptysis and fevers particularly at night. She states she has lost 10 kg of weight over the past 3 months and her chest X-ray shows left upper zone shadowing. Her son reports she has a history of excess alcohol consumption. What is the most likely causative organism?

A

Mycobacterium tuberculosis

98
Q

What Hepatitis virus typically causes a brief, self-limiting infection but is associated with more severe disease and mortality in pregnant women and can cause chronic infection in immunocomromised patients?

A

Hep E

99
Q

Name the most common parasitic infection in the duodenum causing malabsorption

A

Giardia lamblia

100
Q

What 3 infections are checked in pregnant women according to UK screening program?

A

HIV, Hep B, Syphilis

101
Q

Which fungus that can cause respiratory disease in immunocompromised cannot be treated using a certain type of antifungal (cos it doesn’t have ergosterol in its cell wall), it’s normally treated with co-trimoxazole?

A

Pneumocystis jirovecii

102
Q

A poorly controlled T2DM pt has oozing infection of eyes and sinuses, ENT surgeons taking for debridement surgery, what’s the immediate pharm Tx?

A

Amphotericin B - its mucormyosis (poorly controlled DM, eye goop)

103
Q

What type of bacteria is haemophilus

A

gram negative cocobacilli

104
Q

what type of bacteria is klebsiella

A

gram negative rod

105
Q

Neonatal meningitis (2 days old), gram negative bacilli

A

E. coli

106
Q

The following antimicrobials can be used for the treatment of community acquired pneumonia. Which has activity against Mycoplasma pneumoniae?
Amoxicillin
Ceftriaxone
Co-amoxiclav
Doxycycline
Vancomycin

A

Doxycycline

107
Q

Which antimicrobial would be the most appropriate empiric therapy for ESBL producing e coli?

Aztreonam
Ceftriaxone
Meropenem
Piperacillin/tazobactam
Trimethoprim

A

Meropenem

108
Q

Which antiviral agent is used for the treatment of Influenza A?
Cidofovir
Foscarnet
Ribavirin
Tenofovir
Zanamivir

A

Zanamivir

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