Pass med Qs

Question 1

A middle-aged man presents with numbness in his feet. Examination reveals decreased sensation and a positive Romberg’s test. The cause is found to be a sexually transmitted infection. What is the likely cause?

Answer 1

Syphillis
in its tertiary stage, is associated with dorsal column dysfunction called tabes dorsalis. This involves a positive Romberg’s test, where the patient may fall backwards when standing up straight with their eyes closed.

Question 2

A 26-year-old woman presents to her GP with a 5-day history of lower abdominal pain and dysuria.

The GP requests cultures, the results of which are shown below:

Culture results visible organism growth on Thayer-Martin agar plate

What is the likely causative organism?

Answer 2

Neisseria gonorrhoeae is correct.

This patient has organism growth on Thayer-Martin agar, a heated blood agar plate (also known as chocolate agar) that facilitates the growth of Neisseria species whilst also inhibiting the growth of contaminating bacteria and fungi.

Question 3

An elderly man is admitted to the emergency department with abdominal pain and signs of sepsis. A diagnosis of perforated diverticulitis is made.

Which of the following groups of bacteria are most likely to be found on a blood culture taken from this man?

Answer 3

Infections originating from bacterial translocation from gut contents will be due to Gram-negative bacilli (rods) as these are the commensal bacteria of the gut and those found in greatest numbers.

Surgical infections originating from the gut are usually due to Gram-negative rods

Question 4

An 8-year-old boy is brought to his GP by his mum with severe throat pain, and is diagnosed with a likely bacterial throat infection. He is prescribed an antibiotic by his GP which targets the protein synthesis in bacteria.

What antibiotic has he prescribed?

Answer 4

Erythromycin targets protein synthesis in bacteria