Questions From Drive. Codename:PAIN

Question 1

Mention some capsulated bacteria like Strep.pneumonia

Answer 1

Capsule is made by polysaccharides to evade host’s immune system.
Haemophilus influenzae: hib types. Pneumonia and meningitis.
Neisseria meningitidis: several serogroups. Meningitis and septicemia.
Some strains of Escheria coli
Typhoidal Salmonella.

Question 2

Patient with dysentery after a trip to Kenya?

Answer 2

Vibrio cholera.

Question 3

Give 3 examples about antifungal drugs?

Answer 3

Azoles: Flucanazole and micanazole.(inhibit ergosterol synthesis)
Polyenes: Amphotercin B and nystatin.(Bind to ergosterol to disrupt cell membrane)
Other: Flucytosine(inhibit nucleic acid synthesis, used in systemic infection.)
Echinocandis: inhibit glucan synthesis. Used in systemic fungal infections. Like caspofungin and macofungin.

Question 4

CS1: Lung auscultation shows infection in the lower lobes of the lungs?

Answer 4

Legionnaire’s disease because pneumonia generally affecting upper lobes where the O2 concentration is higher. Legionella pneumophila affects lower lobes and it can be transmitted.

Question 5

Child with unilateral lymphadenopathy. What could it be?

Answer 5

Ask about if there is a cat at home. Cat scratch disease.
Bartonella henselae (BH)

Question 6

Antibiotics targeting nucleic acid synthesis?

Answer 6

RNA: rifamycin group: rifampin.
DNA: Fluoroquinolones acting on topoisomerase. Crucial enzymes on DNA replication and repair. Levofloxacin, ciprofloxacin and moxifloxacin.
Sulfonamides: inhibit folic acid synthesis which is a precursor of nucleic acids. Sulfamethoxazole.

Question 7

What is the toxicity of the Fluoroquinolones?

Answer 7

Stick to the cartilage and degrade it. Tendon rupture. Prolonged QT waves in ECG.

Question 8

Baby with strawberry like tongue and Scarlet fever, which bacteria is the cause of it ? Is Scarlet fever common in Adults?

Answer 8

Streptococcus pyogenes. (GAS)
No it can be seen in pediatrics.
Treat with penicillin
If not responding macrolides such as azithromycin.

Question 9

What are the skin infections of streptococcus? Treatment?

Answer 9

Stretococcus pyogenes can cause
Impetigo: topical mupirocin and oral penicillin
Erysipelas, oral or IV penicillin or cephalosporins.
Cellulitis penicillin or cephalosporins. Oral or IV
Scarlett fever penicillin or azithromycin if necessary.
Necrotizing fasciitis(NF): no treatment, death.

Question 10

What is Active TB’s treatment?

Answer 10

INF: Isoniazid
IRF: Rifampin
EMB:Ethambutol
PZA: pyrazinamide
Used for 2 months then for 6 months INH and RIF.

Question 11

You have the rash in the palm and all over the body, what is the disease and its stage?

Answer 11

Secondary syphilis. Life expectancy is low. Treponema pallidum attacking to the liver, spleen, heart and lungs.
IV cephalosporins.
High killing of the bacteria causing inflammation called Jarisch-Herxheimer Reaction. High fever, chills, hypotension, headache, tachycardia and hyperventilation can be seen.

Question 12

What is the mechanism of the Fluoroquinolone?

Answer 12

Topoisomerase block which helps unwinding of DNA before replication.

Question 13

To where does Rifampicin’s toxicity apply?

Answer 13

Hepatotoxicity (ChatGPT)

Question 14

How do you diagnose duodenal and gastric ulceration

Answer 14

Blood, stool or breath(urease) test.
Endoscopy
Ask: vomiting if yes gastric
Immediate pain after a meal gastric ulcers
Also if eating alleviate the pain it is duodenal.

Question 15

Why Melena occurs?

Answer 15

Because of bleeding in the upper GI tract for example nose.
Blood get digested and bilirubin causing black color of the feces.

Question 16

How do you treat Meningitis? And How do you diagnose?

Answer 16

Symptoms of meningitis: photophobia, phonophobia, sepsis symptoms, neck stiffness, alteration of mental status, headache. A distinct type of rash in case of neisseria meningitis. Brudzinski’s neck sign in children. We need to the lumbar puncture and collect CSF then we can deduce if it is bacterial,viral or fungal.
For the treatment we use cephalosporins(ceftriaxone) which are the atomic bombs and cause inflammation in the body thus we can inject steroids.
In case of listeria monocytogenes use ampicillin penicillin.
If fungal like crytococcus Neoformans which is quite rare use Amphotercin B and flucanazole.

Question 17

Can we also use rifampin for the meningitis?

Answer 17

Yes it is acting on BBB but for the prophylactic measures.

Question 18

What is mononucleosis, symptoms and treatment?
Kissing disease.

Answer 18

Caused by Epstein-Barr virus or in rare cases CMV.
Causing lymphoadenopathy specifically in the neck and armpits and also tonsils are swollen, white patches might be present. Symptoms like fever, headache, fatigue and sore throat.
Most importantly swollen spleen and liver.
For therapy painkillers and resting important.

Question 19

What is Gonococcal arthritis?
More commonly affecting women.

Answer 19

Neisseria gonorrhea which also cause PID in women cause arthritis which is the inflammation of the joints especially wrist, finger, toes and ankles.
Pain in the joints and rash.
Treated with ceftriaxone and azithromycin.

Question 20

Pregnant woman with cystitis.

Answer 20

Cystitis is the inflammation of the bladder generally caused by E.coli. Can be treated with nitrofurantoin or some special cephalosporins.

Question 21

Endocarditis patient in the emergency room.

Answer 21

Symptoms: Fever, heart murmur, fatigue, shortness of breath, joint and muscle pain.
Echocardiogram and electrocardiogram(ECG) is very important to asses info about condition.
Collect hemoculture.
It can be caused by Streptococcus(viridans) or Staphyloccocus.
IV penicillin or cephalosporins + gentamicin (for strep infections)
Vancomycin especially for MRSA.
High mortality rate
Bacteria gain entry through dental procedures, surgical interventions or trauma.

Question 22

Why do we need vaginal swab test in case of pregnancy?

Answer 22

To get information about genital and rectal area. Some problematic species as follows:
Group B streptococcus(GBS)
Bacterial Vaginosis (BV)
Vaginal yeast infections candida
Chlamydia and gonorrhea
Even Lyme and listerosis.

Question 23

Cat scratch disease what is the agent and treatment?

Answer 23

Bartonella henselae
Resolves on its own without ABs generally but in some cases azithromycin.

Question 24

Conditions causing swollen lymph nodes?

Answer 24

Infections such as strep throat, mono, diphtheria, TB, cold,flu.
AIDS, cancer, allergies or insect bites such as ticks.

Question 25

Brucellosis? Malta fever.

Answer 25

Brucella melitensis can be seen in farmers. Unpasteurized milk, cheese or undercooked meat. Causing lymphadenopathy, and night sweats and most importantly undulant fever.

Question 26

Symptoms of GI tract infections in general?

Answer 26

Diarrhea Abdominal pain and cramps Nausea and vomiting Fever Dehydration and loss of appetite Fatigue.

Question 27

Clostridium difficile?

Answer 27

Affecting colon and making pseudomembranous colitis (white patches all around the colon) Symptoms: diarrhea or dysentery, abdominal pain,fever ,loss of appetite and nausea. Stool test(presence of C.difficile toxins) or colonoscopy Caused by prolonged usage of ABs. Generally treated with fecal transplantation.

Question 28

Vaccine types

Answer 28

Inactivated or killed vaccines: Microbe is killed or inactivated cannot cause the disease. Live attenuated vaccines: weakened forms of microbes. Protein vaccines: use sugars or proteins to stimulate immune response. mRNA vaccines: instruct cells in the body to produce a protein similar to the viral protein to trigger immune response. Like Pfizer covid-19 vaccine.

Question 29

SSSS? Methicillin

Answer 29

Staphylococcus caused Scalded Skin Syndrome. A condition common in children <6yo. Babies are more susceptible because they produce IgG not IgA. S.aureus produce exfoliative toxin which accumulates in the skin. Therapy IV augmentin or B-lactams, painkillers, creams for the raw exposed skin and hydration.

Question 30

Skin infections?

Answer 30

Skin infections can be caused by bacteria, virus, fungal or parasites. Bacterial Strep.pyogenes can cause erysipelas, cellulitis and abscess. S.aureus is another usual suspect. It infects hypodermic tissue which is rich in fat and cause abscess. For the therapy we use starvation therapy which is the removal of excess fat from the skin by soaps containing sulfurs or azoles(antifungal) they intervene the androgen production.

Question 31

Infections causing death in newborns?

Answer 31

Sepsis: GBS, E.coli, S.aureus Meningitis: Strep.agalactiae (GBS), E.coli and Listeria monocytogenes. Pneumonia: Respiratory syncytial virus(RSV), strep.pneumoniae, Haemophilus influenzae. Herpes simple virus HSV Congenital: CMV, Toxoplasma gondi. Streptococcus pyogenes.

Question 32

clinical scenario: description of a patient under sepsis/septic shock → what do we do? (all steps from diagnosis to treatment)

Answer 32

1-Track vital signs. Temperature, heart rate, respiratory rate, blood pressure and oxygen levels. 2-obtain hemoculture send it to the laboratory 3-Administer crystalloids to restore blood volume and improve perfusion. For kidney and brain. Use adrenaline shots to restore 65mmHg BP at least. 4-Empirical AB treatment: Use ABs in combination, for broad spectrum. Quinolones for DNA, azithromycin for ribosome, rifampin for RNA, Streptomycin for cell membrane. We can also use Ceftriaxone or Vancomycin(MRSA)

Question 33

My question: Why sepsis causing low BP?

Answer 33

Because of the cytokines released in case of inflammation, cause vasodilation, fever and increased permeability in the vessels. Vessels are enlarged, fluid in the blood pass to the tissues. So the volume of blood reduced and vessels are enlarged in the end hypotension. That is why we need to inject fluids and epinephrine.

Question 34

Toxic antibiotics

Answer 34

1-Tetracyclines: stain teeth and bones. Doxycycline, tetracycline. 2-Fluoroquinolones: Tendon rupture, cartilage damage. Levofloxacin, Moxifloxacin and Ciprofloxacin 3-Chloramphenicol cause grey baby syndrome. Hepatotoxic. 4-Aminoglycosides: Gentamicin ototoxic. Can cross the placenta and cause damage in the fetal ears and kidneys. 5-Sulfonamides: block folic acid synthesis which is crucial for the baby. Sulfomethoxazole. Brain damage.

Question 35

Meningitis caused by Crytococcus neoformans?

Answer 35

Fungal can be transmitted by pigeons. Use Amphotercin B and Flucanazole.

Question 36

Clear CSF in case of which bacterial infections?

Answer 36

Listeria monocytogenes Treponema pallidum(syphilis) Mycobacterium tuberculosis.

Question 37

Lymphogranuloma venerum caused by what?

Answer 37

Chlamydia trachomatis. Is a STD. In the primary stage; painless genital ulcers Secondary; swelling of lymph nodes in the pubic area. Tertiary stage; fistulas and elephantiasis.

Question 38

Mycobacterium -> everything theoretical (bacterial characteristics, pathogenesis, diagnostics, pathogenic forms)

Answer 38

Neither gram +/- Special(waxy) cell wall: mycolic acid and arabinogalactan which contribute to the resistance against antibiotics. They are growing slowly in culture. Pathogenesis: Primarily affecting lungs through inhalation of air droplets containing bacteria. Granuloma formation meaning phagocytes eat them up but cannot kill the bacteria because they need CD4 T cells. This vicious cycle causing caseous lesions in the upper lobes of the lung and causing necrosis of the lung tissue. Accumulation of dead monocytes make pus-like formations in the lungs. First sign is the pulmonary cavitation in the X-rays. Bacteria can stay dormant within the granuloma(çember) for years. After people get aids or because of aging it become active TB. So yes TB can get activated by time. Diagnostics: Tuberculin skin test is injecting a purified protein derivative into skin and measuring the hypersensivity of the response or interferon gamma test which is a blood test basically. Mycobacterium tuberculosis, bovis and leprae is pathogenic.

Question 39

My question: what can we use in case of mycobacterial infection?

Answer 39

Isoniazid inhibit mycolic acid Rifampin inhibits RNA synthesis Ethambutol impairs cell wall Pyrazinamide attack membrane

Question 40

Tuberculosis case (investigation, considerations, diagnostics, treatment, vaccines)

Answer 40

Symptoms: persistent cough, hemoptysis(rusty sputum), night sweats weight loss and fatigue. Make contact tracing Tuberculin test and QuantiFERON(interferon gamma assay) Chest xray see cavitation or caseous lesions. BCG vaccine used in developing countries protection in children, also used for bladder cancer.

Question 41

Salmonella Enterica case (investigation, considerations, diagnostics, treatment, vaccines)

Answer 41

Clinical history: diarrhea, abdominal cramps, fever, nausea and vomiting. Ask about recent food intake such as undercooked egg, poultry or exposure to the contaminated food/water. Travel history. Montezuma’s revenge. Consideration: evaluate the patient’s hydration status in case of severe diarrhea especially in babies. For diagnostics: stool and blood culture and PCR for rapid diagnosis. For the treatment: do not use ABs, rehydration is important and bismuth subsalicylate which is an over the counter anti diarrheal drug. Vaccine: there are inactivated typhoid vaccine which is IV and live typhoid vaccine which is taken orally. Latter is used for patient >6. Salmonella as other GI tract infections can cause cutaneous rash in the babies.

Question 42

Listeria monocytogenes or listerosis?

Answer 42

Primarily affecting GI tract. Commonly found in soil, water and some animals. Be careful with raw milk, raw meats, raw fish, home- made cheese and sausages. Patients: pregnant women,newborns,elderly and immunocompromised patients. Symptoms: fever, muscle pain, nausea and diarrhea but IT CAN CAUSE SEPSIS AND MENINGITIS. IV penicillin

Question 43

Which type of pneumonia caused by streptococcus pneumonia

Answer 43

Lobar pneumonia.

Question 44

Legionella pneumonia causing

Answer 44

Bilateral pneumonia affecting both lungs.

Question 45

Safe antibiotics in the pregnancy?

Answer 45

Amoxicillin/ augmentin (amoxicillin+clavulanic acid) Penicillin Azithromycin cephalosporins

Question 46

Antibiogram

Answer 46

An antibiogram is a laboratory test that shows the effectiveness of different antibiotics against a specific bacterial strain isolated from a patient. It helps healthcare providers choose the most appropriate antibiotic for treating a bacterial infection based on the observed susceptibility or resistance of the bacteria to various antimicrobial drugs.

Question 47

In case of bacterial meningitis why do we have turbid CSF?

Answer 47

Because of the presence of high numbers of WBC mainly neutrophils and bacteria causing turbidity.

Question 48

In case of legionnaires disease’s do we have bloody sputum or not?

Answer 48

No bloody sputum. High fever, respiratory distress, cough and headache.

Question 49

Legionella may affect one or both lungs. T/F?

Answer 49

True. It may affect only one or both of them. Primarily affecting lower lobes. It likes hot environments such as AC’s carbon filters.

Question 50

Characteristics of staphylococcus aureus disease, MRSA and so on

Answer 50

It is gram positive, coagulase and catalase positive. It causes conditions like; skin infections, SSSS, sepsis, pneumonia, endocarditis, joint infections and catheter related infections. Important: generally not causing meningitis. Treatment: penicillin and cephalosporins For MRSA vancomycin(glycopeptide),daptomycin

Question 51

S.aureus caused skin infections?

Answer 51

Impetigo: Red sores that quickly rupture and then form a yellow crust. It is contagious with scratch etc. Folliculitis: Hair follicle infection leading to small pustules. Cellulitis: inflammation of deeper layers of the skin causing redness and swelling Abscesses or boils: painful, pus-filled lumps that form under the skin. SSSS: affecting children, widespread skin redness and blistering.

Question 52

Lyme disease?

Answer 52

Caused by Borrelia burgdoferi transmitted by ticks. May-September. Erythema migrans which is a distinct type of rash. Facial palsy, neuropathy, problems with memory and concentration. Fever, nausea and vomiting. Heart problems. Treat with Doxcycline if pregnant amoxicillin or azithromycin.

Question 53

Microbiology diagnosis: serology, light microscope, hemoculture, proteomic analysis, PCR (everything!)

Answer 53

Serology: Detection of antibodies and antigens in the blood to diagnose the condition. Light microscopy: Visualization of the microbes with gram staining and so on. Hemoculture: isolation of microbes from blood, making culture and test ABs. Proteomic analysis: studying the proteins expressed by microbe. PCR: amplification of DNA for detection and identification of microbes. Also consider; urea breath test, tuberculin skin test and quantiFERON test.

Question 54

Why does PSGN occurs? Cola urine

Answer 54

After an infection of GAS such as Strep.pyogenes immune system produces immunecomplexes(antigen+antibody) in the blood. Then this immunocomplexes goes to the kidneys and there activate the complement system because they are stuck in the kidneys. Complement system destroy kidney cells and causing microhematuria. If streptococcus not treated there is a higher risk for PSGN

Question 55

Neisseria gonorrhea can lead to

Answer 55

PID: infection of the female reproductive organs including uterus, fallopian tubes and ovaries. Infertility:untreated gonorrhea can lead to infertility both men and women especially when it leads to PID. Ectopic pregnancy: conditions which the egg implants outside uterus. Joint inflammation: Gonococcal arthritis, an inflammatory condition affecting joints can occur as a result of dissemination. Generally seen in women. Men:infertility and pus from penis. If not treated in the pregnant women it can lead to neonatal conjunctivitis in the baby even blindness is possible. Treat with ceftriaxone IM doxycycline/azithromycin IV

Question 56

Can Mycobacterium cause Meningitis?

Answer 56

Yes it can cause meningitis and we ended up with clear CSF. Other 2 are Listeria monocytogenes and Treponema pallidum

Question 57

Mechanism of endocarditis?

Answer 57

1-Bacteria enter to the bloodstream: it can be due to trauma or dental procedures or surgery. 2- Bacteria tend to adhere damaged areas of the heart such as valves. 3-Formations of vegetations: Bacteria multiply and forming masses of microbes,platelets and fibrin known as vegetations. Vegetations can disrupt normal valve function and cause inflammation. Inflammatory response contributes to the formation and growth of vegetations. -Valve dysfunction -Clinical manifestations: Fever, fatigue and sepsis symptoms.

Question 58

Farmer’s disease?

Answer 58

Brucellosis. Undulant fever, night sweats. Transmitted by animals or undercooked meat.

Question 59

Generally treatment of UTIs made with

Answer 59

Sulfamethoxazole Nitrofurantoin Cephalosporins Fluoroquinolones

Question 60

Neuroborreliosis treatment

Answer 60

Doxycycline In case of pregnancy use amoxicillin/azithromycin.

Question 61

Agents causing meningitis in children younger than 5 yo

Answer 61

Escheria coli- neonates Strep.pneumonia(40%) Strep.agalactiae-neonates Haemophilus influenzae Listeria monocytogenes Neisseria meningitis(40%) Crytococcus neoformans(fungal)

Question 62

Diphtheria in children

Answer 62

Bacterial infection caused by Corynebacterium diphtheriae. Symptoms: fever, sore throat, swollen lymph nodes in the neck. White patches in the back of the throat. It can lead to severe complications such as heart and nerve damage due to the toxin In the treatment we can use antitoxins and penicillin/erythromycin.

Question 63

2 bacteria species that makes spores?§

Answer 63

Bacillus(cereus) and clostridium(tetanus, difficile,botulinum)

Question 64

Pathogenic mechanism of tetanus toxin?

Answer 64

Inhibits recapture of acetylcholine making muscles to stay in a contracted position. Most significant symptoms is the lockjaw. Jaw is locked you can’t open that. Painful muscles spasms that tear muscles and break bones.

Question 65

Hodgkin’s lymphoma

Answer 65

A type of cancer that originates from lymphocytes. Cancer starts in the lymph nodes than spreads to the spleen, bone marrow and other organs. Cause is unknown it can occur at any age. Symptoms: painless swelling of lymph nodes,fever, weight loss and night sweats.

Question 66

Farmer’s disease (brucellosis): what animals carry it, symptoms, differential diagnosis with Hodgkin’s lymphoma.

Answer 66

Last known as undulant fever caused by livestocks such as cattle, goats, sheep and pigs or unpasteurized dairy products. Symptoms: undulant fever, night sweats, chills, muscle pain and fatigue. Joint pain Differences between two diseases; pattern of fever, joint pain(present in brucellosis) and lymph node swelling(not present in the brucellosis) Gentamicin and Doxycycline IV.

Question 67

Treatment of PSGN?

Answer 67

Penicillin to kill leftover bacteria. Managing hypertension and edema with diuretics. Monitor electrolytes.

Question 68

Effects of Clostridium botulinum’s toxin also known as Botox

Answer 68

Blocks the acetylcholine release from presynaptic neuron causing muscle paralysis. Used in aesthetic medicine. It can be used to treat migraines. But its effects are not permanent it should be repeated over time.

Question 69

Diseases spread by tick bites?

Answer 69

Lyme: borrelia burgdoferi Rickettosis bacteria Tick bite encephalatis virus

Question 70

Nosocomial infections, ESKAPE group.

Answer 70

Six bacteria that generally exhibit multidrug resistance -Enterococcus faecium(UTIs and sepsis,endocarditis) -Staphylococcus aureus(skin and soft tissue,pneumonia,sepsis.) -Klebsiella pneumonia(UTIs, pneumonia,sepsis) -Acinobacter baumannii(pneumonia, sepsis) -Pseudomonas aeruginosa(UTIs, pneumonia and sepsis) -Enterobacter spp (pneumonia, sepsis and UTIs) They generally escape from the antimicrobial treatments and survive in the healthcare settings.

Question 71

Antibiotics targeting the nucleic acids, what do we use them against, their toxicity

Answer 71

Fluoroquinolones: acting on topoisomerase enzyme which unwinds DNA. Toxicity; cartilage damage, tendon rupture avoid in pregnant woman. Rifamycins: block bacterial RNAP, consequently bacterial protein synthesis Toxicity; generally well tolerated.

Question 72

Vibrio cholera

Answer 72

Produce toxin that causing uncontrolled secretion of electrolytes and water in the small intestine. Symptoms; diarrhea, dehydration and electrolyte imbalance. For the treatment; use doxycycline or azithromycin It generally spread by feces so proper sanitation of drinking water is very important.

Question 73

Vibrio vulnificus

Answer 73

Associated with seafood, particularly raw or undercooked shellfish. Coming in contact with contaminated water through open wound can be the reason for the infection. Symptoms are fever, chills, diarrhea and vomiting. Use doxycycline or fluoroquinolones,

Question 74

Croup or laryngobronchitis?

Answer 74

Primarily affects under 5yo. Characterized by inflammation of the trachea and larynx. Barking cough and stridor(high-pitched sound when breathing in) and difficulty in breathing. Caused by viral infections. Costal retractions and no sufficient oxygen. Babies must be vaccinated in the first year.

Question 75

Salmonella

Answer 75

Contaminated food; undercooked egg,poultry, meat and unpasteurized dairy products. Diarrhea, abdominal cramps, nausea, vomiting and fever. Typhoidal salmonella can penetrate colon and cause sepsis. Salmonella cause cutaneous rash! In case of typhoidal use ciprofloxacin or azithromycin.

Question 76

Shigella

Answer 76

Cause gastrointestinal infections. Diarrhea, abdominal cramps, and fever. In case of shigella dysentery might be present which is watery stools+blood+mucus. HUS: 1 kidney stop functioning and urea levels elevated in the blood which is highly toxic. Generally seen in the babies. HUS can be caused by salmonella or E.coli

Question 77

Antimycotics

Answer 77

To treat fungal infections. Azoles and allylamines: inhibit ergosterol synthesis, which is an essential compound of the fungal cell membranes. Example; Fluconazole, ketoconazole. Polyenes: Bind to ergosterol, disrupt cell membranes. Amphotercin B and nystatin. Flucytosine: Disrupting nucleic acid synthesis.

Question 78

For what infections do we use intravaginal ovuli?

Answer 78

Vaginal yeast infections(candidiasis): Antifungal such as clotrimazole, miconazole. Bacterial Vaginosis: metronidazole or clindamycin. Restore and balance the vaginal flora.

Question 79

Advice for pregnant women, food intake, dietary, serology tests, etc

Answer 79

Avoid eating; raw or undercooked seafood, meat, egg, unpasteurized milk, homemade cheese. Always wash the vegetables before eating. Avoid touching baby’s body fluids such as saliva. Avoid touching cat’s feces. Supplements such as folic acid, iron and calcium. Take serology test for CMV, toxiplasma gondii, STDs(gonococcal, chlamydia, syphilis or Herpes. Hepatitis B and C and HIV.

Question 80

How to diagnose syphilis?

Answer 80

Serological tests; looking for IgM and IgG. TPHA-Treponema pallidum hemoagglutenin. VDRL-Venereal disease research laboratory blood test to detect syphilis.

Question 81

Helicobacter pylori?

Answer 81

Extracellular gram negative pathogen with flagella. Major cause of the ulcers in stomach and duodenum. It produces toxins that destroy epithelial cells in the stomach that produces mucus then it forms ulcers. Also associated with stomach cancer if left untreated. Produce 2 types of toxins; Cytotoxin associated gene A And vacoulating cytotoxin A. With urease enzyme it breaks down urea to ammonia and CO2. Ammonia makes a buffer in the stomach causing a neutralized area for H.pylori. For diagnosis; Endoscopy, urease test, antigen test or stool test. Treatment with: OAC Omeprazole Amoxicillin Clarithromycin Bismuth subsalicylate can be used which is an over the counter anti-diarrheal agent.

Question 82

Prazoles how do they work and why are they effective against H.pylori?

Answer 82

They inhibit proton pumps in the parietal cells thus the pH in the stomach is elevated causing a not favorable environment for the H.pylori.

Question 83

Acne vulgaris?

Answer 83

Caused by clogged hair follicles. Excess sebum and dead skin cells can clog hair follicles, leading to formation of acne vulgaris. Bacteria in the can multiply in clogged pores and contribute to inflammation. Symptoms: blackheads, whiteheads, pimples and painful nodules under the skin. Severe cases of acne can cause cysts and nodules to form under the skin and can result in scarring, which can be permanent. But bacteria also play a role. Cutibacterium acnes, or C. acnes, is a type of gram-positive bacteria that normally lives on the skin. When the sebaceous glands produce lots of sebum, C. acnes thrives and reproduces, which further clogs the hair follicles and leads to skin inflammation. We generally use starvation therapy to drain the excess sebum from the skin by soaps containing sulfur or antimycotic creams such as ketoconazole. Antimycotics reduces the production of androgens.

Question 84

Furunculosis

Answer 84

Boils are painful, pus-filled lumps formed under the skin when one or more hair follicles become infected by bacteria usually S.aureus. Generally found in places where friction or sweat happens. Treatment with good wound care and in severe cases ABs can be used. Dicloxacillin and cephalexin.

Question 85

Bacterial croup?

Answer 85

Inflammation of the upper RT. Caused by S.aureus, Strep.pyogenes/pneumonia. Also caused by C.diptheria Ceftriaxone and augmentin can be used to treat. There is no vaccine for the bacterial croup And it can be deadly because of diminished breathing.

Question 86

All bacteria causing pneumonia and what other diseases they cause?

Answer 86

1. Streptococcus pneumonia. Also cause otitis media and meningitis. 2. Haemophilus influenzae. Respiratory tract infections and ear infections. 3. Mycoplasma pneumonia. Walking pneumonia. 4. Chlamydophila pneumonia. Walking pneumonia 5. Legionella pneumonia. Pontiac fever 6. Klebsiella pneumonia. 7. Pseudomonas aeruginosa Staphylococcus aureus. Skin infections or sepsis.

Question 87

Endotoxins vs exotoxins

Answer 87

Endotoxins: LPS found in the outer membrane of Gram negative bacteria. Heat stable and can cause systemic inflammatory response in the host. Exotoxins. Proteins produced and actively secreted by the bacteria. Denatured presence of the heat. Specific effects. Act specific cells such as muscles or nerves.

Question 88

Neurotoxins vs enterotoxins

Answer 88

Neurotoxins target nervous system. Such as botulinum produced by Clostridium botulinum. Enterotoxins: primarily affecting intestine leading to diarrhea and vomiting. Examples include toxins produced by S.aureus or E.coli.

Question 89

Cytotoxins

Answer 89

Damage host cells. Such as streptococcus which cause cell lysis.

Question 90

Hemolysins

Answer 90

Causing lysis of red blood cells. Streptococcus pyogenes.

Question 91

Superantigens

Answer 91

Toxin causes an exaggerated immune response by activating a large number of T-cells. Example, Staphylococcus aureus, leading the conditions such as toxic shock syndrome.

Question 92

Conditions causing babies to turn all red

Answer 92

SSSS caused by S.aureus Streptococcal and staphylococcal infections may lead to skin redness or rashes. Viral infections such as common cold or flu can cause fever and redness. Allergy such as penicillin allergy.

Question 93

Erysipelas vs cellulitis

Answer 93

Skin layer: Erysipelas affecting more superficial layers particularly dermis whereas cellulitis can extend into subcutaneous tissues. Erysipelas has defined borders whereas cellulitis don’t Erysipelas burning sensation. Erysipelas; strep pyogenes Cellulitis; staphylococcus and streptococcus spp. Erysipelas commonly seen in the face, around the eyes cheeks and nose Cellulitis can occur on the legs, arms and other areas

Question 94

To treat streptococcus

Answer 94

Penicillin or amoxicillin

Question 95

To treat Staphylococcus aureus

Answer 95

Cephalexin or Dicloxacillin in case of not resistant S.aureus Clindamycin or Sulfamethoxazole in case of MRSA