Past papers 5 Flashcards
Ventriculitis secondary to a CNS prosthesis. Which drug which will be a useful adjunct in treatment?
clindamycin gentamicin erythromycin moxifloxacin rifampicin
intrathecal gentamicin?
Rifampicin also useful for prosthesis and biofilms
Person goes surfing, develops wound infection and sepsis, GNB isolated from wound
Mycobacteriym marinum
Vibrio vulnificus
pseudomonas
Vibrio vulnificus
Patient presents with iron deficiency anaemia.
Stool OCP shows 300micron size thin shelled eggs in faeces
What is the cause?
roundworm trichuris strongyloides enterobius ancylostoma
anyclostoma - hookworm
What infections is Acanthamoeba associated with?
Contact lens kerratitis
Scaly rash with skin depigmentation, microscopy shows yeasts and small hyphae
Trichophyton
Microsporum
candida
M. furfur
malassezia furfur - pityriasis versicolor
Child with NSI from a needle lying in a park frequented by IVDUs. What is course of action
accelerated course of Hep B vaccine send needle for HBV testing give PEP for HIV HBIG Do nothing
Do nothing - according to new guidelines
Child with enlarged axillary LNs,recently given kittens as gift. What is most likely cause?
Bartonella hensleae
Bartonella quintana causes trench fever
Bartonella bacilliformis - oroya fever
Mother gives birth to a child with microcephaly. Has 3 cats. What is most likely cause?
Toxoplasma
Pregnant lady in contact with a child with rubella. Course of action:
Check childs Rubella IgG check childs rubella IgM check mums rubella IgG check mums rubella IgM give immunoglobulin
Check mums rubella IgG + take history for MMR
If mum immune, then that is end of investigation
32wks pregnant lady with confirmed rubella. Advice:
termination of pregnancy
child likely to be born with severe deformities
no risk of infection to fetus
risk of infection present, but deformities rare
risk of infection present, but deformities rare - infections after 20 weeks
There is a well known single step mutation leading to a high level resistance with loss of catalase activity.
Choose right combination:
MTB - izoniazid
S.aureus - cipro
Gp A strep - erythromycin
Pseudomonas- Imipenem
MTB- isoniazid
What is Vincent’s angina?
acute necrotising ulcerating gingivitis - sloughing of gums
Usually poor dentition, or immunocompromised
Diptheria or normal flora can be causes
Link the chemicals/ enzyme/ growth with the organism?
A. Black pigment
B. Phenylalanine deaminase
C. Growth in 6.5% NaCl
D. Lecithinase (α-toxin)
Clostridium perfringenes Streptococcus pneumoniae Proteus species Streptococcus agalctiae Saphylococcus aureus Enterococcus Bacteroides melanogenicus (also known as prevotella melaninogenica)
Black pigment - bacteroides melanogenicus/ prevotella. Normal upper respiratory tract flora. Grow on blood agar forming dark black colonies, which darken over a few weeks
Proteus - phenylalanine deaminase. Test used to see if organism has this enzyme, which removes amine group from phenyalanine, producing green colour. This helps identify Proteus, Morganella, Providencia
Staphylococcus aureus - can grow in 6.5%NaCal
Clostridium perfringens - lecinthinase alpha-toxin. Type A strains produce toxin which causes gas gangrene. Which is a life-threatening infection with fever, pain, edema, myonecrosis and gas production.
1. Clinical presentation A. Rose spots B. Risus sardonicus C. Black eschar D. Asymmetrical paralysis E. Descending symmetrical paralysis
Options:
i. Lymes disease
ii. Typhoid
iii. Anthrax
iv. Tetanus
v. Botulism
vi. Polio
vii. Rabies
Options:
i. Lymes disease
ii. Typhoid = A
iii. Anthrax = C
iv. Tetanus = B
v. Botulism = E
vi. Polio = D
vii. Rabies = symmetrical ascending paralysis
Mode of transmission
A. Shigella enteritis B. Listeria meningitis C. CMV pneumonitis D. Crptosporidial diarrhoea E. Lymes disease
i. Drinking contaminated water
ii. Faeco-oral route
iii. Vertical transmission
iv. Sexual contact
v. Spread by health care workers
vi. Swimming in contaminated water
vii. Endogenous infection
viii. Air borne spread
ix. Tick bite
A. Shigella enteritis - faecal-oral
B. Listeria meningitis - vertical?
C. CMV pneumonitis - sexual contact? Endogenous infection?
D. Cryptosporidial diarrhoea -drinking contaminated water
E. Lymes disease - tick bite