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Microbiology Flashcards

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1
Q

What antibiotic is recommended for animal or human bites?

A

Co-amoxiclav

If the patient is penicillin allergic: metranidazole + doxycycline

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2
Q

What pathogen can cause circular areas of dense consolidations, other than TB?

A

Aspergillus can cause aspergillomas. These are mycetomas (mass-like fungus balls) which often colonise existing lung cavities (e.g. 2° to TB, lung cancer, CF).

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3
Q

What are the symptoms of an aspergilloma?

A

Often asymptomatic, but can cause:

  • Cough
  • Haemoptysis
    *
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4
Q

What is the commonest pathogen causing msalaria?

A

Falciparum malaria is the commonest cause.

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5
Q

What is the antimicrobial treatment for Lyme disease?

A

ORAL doxycycline is the treatment of choice for skin-bound Lyme disease (amoxicillin if cpontraindicated, e.g. in pregnancy).

If there are focal signs, such as neruological, cardiac, opthtalmic of rheumatic symptoms, then use IV cerftriaxone

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6
Q

What is the rash seen in Lyme disease?

What are other symptoms that may occur with Lyme disease?

A

Erythema chronica migrans. (bull’s eye rash).

Non-dermatological features include:

  • Cardiovascular: heart block, myocarditis
  • Neurological: facial nerve palsy, meningitis
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7
Q

Which organism is responsible for Lyme disease?

A

Borrelia burgdorferi

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8
Q

What are clinical features of amoebiasis?

A

Amoebic dysentry:

  • Profuse, bloody diarrhoea
  • Trophozoites on “hot stool” microscopy

Amoebic liver abscess (can also cause colonic abscess):

  • Single mass in right lobule
  • Contents described as “anchovy sauce”
  • Presents with fever, RUQ pain
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9
Q

How is amoebiasis treated?

A

Dysentry: metranidazole

Abscess/invasive amoebiasis: amoebicide.

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10
Q

What are the 3 forms of Leishmaniasis, and what are the respective causative organisms?

A

Cutaneous Leishmaniasis:

  • Tropicana and Mexicana
  • Crusted lesion at site of bite

Mucocutaneous leishmaniasis

  • Braziliensis
  • Skin lesion may spread to involve mucosae of nose, pharynx etc.

Visceral leishmaniasis:

  • Donovani
  • Fevers, sweats, rigors
  • Massive splenomegaly, hepatomegaly
  • Grey skin -> Black sickness (kala-azar)
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11
Q

What can happen when EtOH is consumed whilst on metranidazole?

A

The combination of metronidazole and ethanol can cause a disulfiram-like reaction. Clinical features of this include head and neck flushing, nausea and vomiting, sweatiness, headache and palpitations.

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12
Q

Summarise the NICE guidelines for tetanus-rpone wounds.

A

If there is an unclear history of tetanus vaccination ALWAYS give a booster.

If the wound is tetanus-prone, then tetanus immunoglobulin is also required.

In addition, antibacterial prophylaxis such as co-amoxiclav, may be given.

In clean wounds, give the tetanus vaccine booster if the history is unclear.

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13
Q

Which antibiotics can cause a black hairy toungue

A

Tetracycline antibiotics - this is a temporary reaction and harmless.

This results from defective desquamation of the filiform papillae.

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14
Q

What blood image would an infection with hookworm show?

A

Hookworms may cause an iron deficiency anaemia in patients returning from travel to endemic areas e.g. the Indian subcontinent. There may also be an eosinophilia.

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15
Q

What are potential causes for a false negative mantoux test?

A
  • Immunosuppression, e.g. AIDS, steroid therapy
  • Sarcoidosis
  • Lymphoma
  • Extremes of age
  • Fever
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16
Q

Describe the Mantoux test-

A

Injection of small amount of PPD (purified protein derivative) into the skin.

48-72 hours later:

  • Area of redness >10mm -> previous exposure (including BCG)
  • Rea of redness smaller: not exposed to TB
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17
Q

When, after possible exposure, should you test for HIV?

A

4 weeks. The Ab against p24 antigen are not positive until after this time.

Tests are also usually done immediately (in case it was contracted earlier) and after 12 weeks (to confirm a negative result).

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18
Q

What are the live attenuated vaccines?

A
  • Yellow Fever
  • BCG
  • MMR
  • Oral Polio
  • Oral Tyhoid
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19
Q

Which antibiotic is used empirically to treat neutropenic sepsis?

A

Tazocin - this is piperacillin and tazobactam.

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20
Q

What is neutropenic sepsis?

A

This is a neutrophil count of < 0.5 * 109 in a patient who is on BM suppressing therapy and has:

  • Temperature >38°
  • other signs/symptoms consistent with sepsis
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21
Q

Summarise the managment of neutropenic sepsis.

A
  • ABx must be started immediately, do not start for the WCC.
  • This is usually tazocin. May add vancomycin or meropenem.
  • If not responding after 4-6 days investigate for fungal infection and add antifungal therapy.
  • In some patients, G-CSF may play a role, but this is extremely specialist.
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22
Q

Which organism is commonly implicated in peritonitis 2° to peritoneal dialysis?

A

Staph epidermidis.

Staph aureus is another common cause.

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23
Q

How can Kaposi’s present in children?

A

Unlike adults, it’s much rarer to find the characteristic skin lesions in a paediatric population, with the most common symptom being lymphadenopathy.

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24
Q

What is the treatment for syphillis?

A

IM benzathine penicillin is the first-line management.

Alternatively, doxycycline can be given.

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25
What is the treatment for bacterial vaginosis? Also quickly tell me what BV is.
**Oral metranidazole** for **5-7 days.** BV is the overgrowth of organsism including Gardnerella vaginalis. This leads to a fall in lactic-acid producting lactobacilli, resulting in raised pH (**\>4.5**). There are **clue cells** and the **Whiff test** is positive.
26
What is the most common cause for an IECOPD?
**Haemophilus** **influenzae** is the most common Strep pneumoniae and maroxella are other cuases.
27
What is the antibiotic of choice for otitis media and otitis externa?
Media: amoxicillin (as URTI) Externa: flucloxacillin (as skin)
28
ABx treatment for PID?
Oral ofloxacin + oral **metronidazole** or **intramuscular** **ceftriaxone** + oral **doxycycline** + oral **metronidazole**
29
Which pneumonia organism is commonly associated with the reacitvation of cold sores
Strep pneumoniae
30
What antibiotics are used to treat MRSA?
* Vancomycin * Teicoplanin * Linezolid
31
How can Leginella pneumonia be confirmed?
Urinary antigen.
32
What is the managmeent of a liver abscess?
Most liver abscesses are bacterial in origin, and the managmenet is **IV antibiotics** and **image-guided percutaneous drainage**. (amoxicillin, ciprofloxacin, mtranidazole). If a **hydatid cyst** is suspected (echinococcus), then **surgical removal** is first-line treatment.
33
Summarise the management of tetanus?
* Supportive therapy including ventilatory support and muscle relaxants * **IM Human tetanus Ig** (in high-risk wounds) * Metranidazole (or benzylpenicillin)
34
Describe the symptoms you might see in someone with PJP .
Gradual onset, days to weeks: * Low grade fever and malaise * **Non-productive cough** * Dyspnoea
35
What is the most common organism implicated in pyelonephritis?
E. coli
36
What advice should you give patients with glandular fever?
Avoid contact sports for 8 weeks, as there is increased risk of splenic rupture.
37
Summarise the management of a suspected rabies wound.
* Wash wound * If already immunised: give 2 further booster vaccinations (+ ABx) * Of mot immunised, give vaccination (inject near wound) and give rabies Ig
38
What are the symptoms of infectious mononucleosis?
Classic triad: * Sore throat * Lymphadenopathy: widespread in the neck * Pyrexia Other features: * Malaise, anorexia,
39
How long should PEP be given for after a needle stick injury with an HIV postivie needle?
4 weeks.
40
What is the treatment of toxoplasmosis?
Treatment is usually reserved for those with severe infections or patients who are immunosuppressed * pyrimethamine plus sulphadiazine for at least 6 weeks
41
What chest infection is common among alcoholics?
Klebsiella. It is more common in diabetic and alcoholics. Can also occur following aspiration. Features include: * Currant Jelly sputum * Empyema can develop following infection * Abscess formation can also occur * Often affects upper lobest
42
Which pneumonia is commonly seen after infection with influenza?
Staphylococcus aureus.
43
What HPV types are implicated in cervical cancer?
16, 18, 33 6 and 11 are implicated in warts, but not in cancer.
44
How does leptospirosis present?
Clinical features: * Fever * Fllu-like symptoms * Renal failure * Jaundice * Subconjunctival haemorrhages * Headache
45
What are the risk factors for leptospirosis?
* Being a farmer * Sewage worker * Abattoir workers -\> contact with rat urine
46
What is the treatment for genital warts?
* Multiple, non-keratinised warts: **topical podophyllum** * Solitary, keratinised warts: cryotherapy
47
is breastfeeding contraindicated in Hep C positive mothers?
No! They can still breasfeed.
48
How long after glandular fever do contact sports need to be avoide for? Why?
For 8 weeks. This is due to the potential risk of splenic rupture after EBF infection
49
Who should receive the HPV vaccine and at what age?
All **boys and girls** aged 12-13 are now offered the HPV vaccine. Gardasil protects against 6,11 (warts) and 16, 18 (cancer)
50
What is the most common cause for infections of central lines?
Staphylococcus **epidermidis**
51
What is the name for a single calcified lymph node often found in latent TB?
Ghon Complex.
52
What is the management of genital herpes?
Oral aciclovir is indicated.
53
How long until a negative ELISA Ab test for HIV has definitely ruled out HIV?
54
Which organism is implicated most commonly in spontaneous bacterial peritonitis?
E. coli. This is followed by Klebsiella (Gram positive organsisms can also cause SBP: Strep pneumo, Strep viridans, Staph).
55
What is the first line treatment for amoebiasis?
Metranidazole
56
What conditions are associated with EBV?
Malignant: * Burkitt's lymphoma * Hodkin's lymphoma * Nasopharyngeal carcinoma * HIV-associated CNS lymphomas Non-malignant: * Oral hairy leukoplakia (esp. in HIV positive) - can't be scraped off
57
What is the incubation period of Hep A?
2-4 weeks
58
Tell me the nucleic acid status of each of the hepatitis viridae.
Hep A: RNA Hep B: **D**NA Hep C: RNA Hep D: RNA Hep E: RNA
59
What are potential symptoms of enteric fever?
Enteric fever, caused by typhoid or paratyphoid, can present with: * Systemic upset * Relative bradycardia * Abdominal pain/distension * Constipation (more common) or diarrhoea * Rose spots (more common with paratyhpoid) If left untreated, it can lead to: * Osteomyelitis * GI Bleed * Meningitis * Cholecystitis * Chronic Carriage (~1%)
60
Which orgamisms are most commonly implicated in aspiration pneumonia?
Most often aerobic: * Streptococcus pneumoniae * Staphylococcus aureus * Haemophilus influenzae * Pseudomonas aerigunosa Can also be anaerobic, but less common.
61
What is the treatment of hospital acquired pneumonia?
* **Within 5 days** of admission: **co-amoxiclav or cefuroxime** * **More than 5 days** after admission: **piperacillin** with **tazobactam** OR a **broad-spectrum cephalosporin** (e.g. ceftazidime) OR a **quinolone** (e.g. **ciprofloxacin**)
62
What is the PEP treatment for Hep B?
* HBsAg positive source: if the person exposed is a known responder to HBV vaccine then a **booster dose should be given**. If they are in the process of being vaccinated or are a non-responder they need to have **hepatitis B immune globulin** (HBIG) and the vaccine * unknown source: for known responders the green book advises considering a **booster dose of HBV vaccine**. For **known non-responders HBIG + vaccine** should be given whilst **those in the process of being vaccinated** should have an **accelerated course of HBV vaccine**
63
What is the managment for chlamydia?
**Doxycycline** (7 days) or **azithromycin** (single dose) In oregnancy, avoid doxycycline.
64
What is the prophylactic treatment of contacts of a patient with meningogoccal meningitis?
**Ciprofloxacin**. This is now preferred over rifampicin.ö
65
66
What is the treament for someone who has been screene positive for MRSA and is in a pre-surgery screen?
Nasal mupirocin + chlorhexidin for skin
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