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Question Bank > Past papers 4 > Flashcards

Past papers 4 Flashcards

1
Q

What is the most appropriate treatment for campylobacter

When is therapy indicated?

A

Indications for antimicrobial therapy include high fever, systemic infection with sustained bacteraemia, grossly bloody diarrhoea, and persistence of symptoms for >1 week.

Antibiotics should also be used in immunocompromised patients.

Antibiotics are not indicated in uncomplicated cases

Give IV if complicated cases

azithromycin or cipro

5-7 days

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2
Q
  1. How is an open reading frame stopped?

a. stop codon
b. promoter
c. transposon
d. plasmid

A

stop codon - signals termination of translation

An open reading frame is a portion of a DNA molecule that, when translated into amino acids, contains no stop codons.

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3
Q
  1. How is CMV best diagnosed post renal transplant?

a. DEAFF urine
b. CMV igM
c. Renal Biopsy
d. DNA CMV
e. Paired sera antibody

A

Renal biopsy

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4
Q
  1. A detergent instead of chlorine is used to clean up after a spillage in the lab. Which virus is least likely to be removed?

a. influenza
b. polio
c. hsv
d. hep b
e. hiv

A

?

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5
Q
  1. A young woman presents with pharangitis and septic shock. What is likely organism?
A

Fusobacterium

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6
Q
  1. Match the Vectors
Leishmania
Malaria
Loa loa
Onchocerca
lyme
SA trypansomiasis
African trypanosomiasis
Anopheles
phlebotomus sp
chrysops
simulia
ixodes
reduvid
palpalis
A

Leishmania - phlebotomine sandfly

Malaria - anopheles

Loa loa - chrysops

Onchocerca - simulium black fly

lyme - ixodes

SA trypansomiasis - reduviid

African trypanosomiasis - Glossinia palpalis

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7
Q
  1. Match the mechanism
linezolid
aminoglycoside
moxifloxacin
zidovudine
ritonavir
Bind 30s
Bind 50s
RT inhibitor
protease inhibitor
gyrase inhibitor
A

linezolid - Bind 50s

aminoglycoside - Bind 30s

moxifloxacin - DNA gyrase inhibitor

zidovudine - NRTI

ritonavir - protease inhibitor

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8
Q
  1. Match the drug complication
AML with recurrent low platelet with therapy for VRE
Lipodystrophy
Red face after infusion
Confusion after prophylaxis for flu
Becoming pregnant on the pill
Rifampicin
amantadine
vancomycin
linezolid
ostelmavir
ritonavir
A

AML with recurrent low platelet with therapy for VRE - linezolid

Lipodystrophy - ritonavir

Red face after infusion - vancomycin

Confusion after prophylaxis for flu - amatadine

Becoming pregnant on the pill - rifampicin

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9
Q
  1. Match Symptom and disease in a HIV patient
Dry cough
limb weakness
blindness
meningitis
dysphagia
candida
cryptococus
cmv
toxoplasmosis
pcp
isospora
jc virus
A

Dry cough - PCP

limb weakness - JC/ cryptococcus/ toxo?

blindness - CMV

meningitis - cryptococcus

dysphagia - candida

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10
Q
  1. Match the mechanism
Antibody production
MHC1 Ag presentation recognition
APC and LN
Phagocytic cell with effector molecules
tissue monocytes
Macrophage
NK cells
PMN - polymorphonuclear leucocyte
CD8
B cells
plasma cells
A

Antibody production - plasma cells

MHC1 Ag presentation - CD8

APC and LN - B cell

Phagocytic cell with effector molecules - NK cell

Tissue monocyte - macrophage

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11
Q
  1. Match the organisms

Brazilian with earthworm
CLM in person returned from the Caribbean
Recurrent cholangitis
Diarrhoea and cholangitis

Ascaris
clonorchis
cryptosporidium
A. braziliensis

A

Brazilian with earthworm - Ascaris

CLM in person returned from the Caribbean - Ancylostoma braziliensis

Recurrent cholangitis - clonorchis

Diarrhoea and cholangitis - cryptosporidium

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12
Q
  1. Match the disinfectant collection

Endoscopes equipment
Floor and surface
Hands
Blood spillage in CAT 3

Heat H20 to 60, chlorhexadine, water and detergent, 1: 10000, paracetic acid, glutaraldehyde,

A

?

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13
Q

A man returns from Vietnam with cough and bibasal changes on CXR you suspect melioidosis.

What will show up on the sputum culture?

A

Gram neg rods

oxidase positive

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14
Q
  1. In the management of TBM, which is important with regards to crossing the BBB

a. ethambutol
b. isoniazid
c. pyrazinamide
d. streptomycin
e. cycloserine

A

Isoniazid has almost 100% concentration compared to blood

Pyrazinamide has very high concentrations too

Streptomycin/ ethambutol does not cross BBB

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15
Q

The haematology department has been putting together recommendations for patients who want to travel abroad, which vaccines would you not recommend?

A

Lives vaccines

live influenza vaccine (Fluenz Tetra)
Measles, Mumps and Rubella vaccine (Priorix, MMRVaxPro)
Rotavirus vaccine (Rotarix)*
Shingles vaccine (Zostavax)
BCG vaccine
Oral typhoid vaccine (Ty21a)
Varicella vaccine (Varilrix, Varilvax)
Yellow Fever vaccine

In this question - yellow fever, typhoid,

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16
Q

A neonate with meningitis. Gram positive bacteria have been isolated from blood cultures.

If you can perform only one test to identify species, what would you pick?

A

tumbling motility - listeria

Catalase/ coagulase tests will be useful, but will not speciate

17
Q

A gram negative coccus has been isolated from a patient with fever of unknown origin.

It is oxidase positive, can’t grow without blood and can ferment glucose but not maltose.

What is it likely to be?

Acinetobacter
Moraxella catarrhalis
N. meningitidis
N. gonorrhoea

A

Acinetobacter - oxidase negative, ferment glucose

Moraxella catharrhalis - oxidase positive, fermentation none

Neiserria meningidis - oxidase positive, ferment glucose and maltose

Neiserria gonorrhoea - oxidase positive, ferment glucose

Neisseria species are fastitidious, and can’t grow without blood. Normally use horse blood agar/ chocolate agar

18
Q

A mycobacterium grows on LJ slopes at 37ºC after 4 weeks and has bright yellow colonies. Which of the following is it likely to be?

M. fortuitum
M. chelonoae
M. kansasii
M. malmoense
M. paratuberculosis
A

M kansasii?

Runyon classification

19
Q

Which bacteria are you most likely to find extended spectrum B-lactamses? (E.coli not an option)

A

E. coli

Klebsiella

20
Q

What is prozone effect?

Sometimes called hook effect

A

immunologic phenomena

In an agglutination test, a person’s serum (which contains antibodies) is added to a test tube, which contains a particular antigen.

If the antibodies agglutinate with the antigen to form immune complexes, then the test is interpreted as positive. However, if too many antibodies are present that can bind to the antigen, then the antigenic sites are coated by antibodies, and few or no antibodies directed toward the pathogen are able to bind more than one antigenic particle.

Since the antibodies do not bridge between antigens, no agglutination occurs. Because no agglutination occurs, the test is interpreted as negative. In this case, the result is a false negative. The range of relatively high antibody concentrations within which no reaction occurs is called the prozone.

Can result in false negative results

  • prozone - excess antibody
  • postzone - excess antigen
21
Q

What would you do if a surgeon who was a non-responder to the Hep B vaccine had a needle stick injury from a patient who was Hep B positive?

A

Give vaccine and HBIG

22
Q

If a person is repeatedly HepBsAg pos, HepBeAg pos, IgM core antibody negative and IgG core antibody negative, they are what?

A

HBV positive

High infectivity

23
Q

Reason for not giving influenza vaccine?

A

Allergy to egg

Avoid live vaccine in immunocompromised. Give alternative inactivated injection

24
Q

Why is CJD not classified as a virus?

A

Does not contain nucleic acid

25
Q

How does CMV develop resistance to the following antivirals?

ganciclovir
foscarnet
cidofovir

change in pp66
mutation in UL97
mutation in UL54

A

UL54 - ganciclovir, foscarnet, cidofovir - DNA polymerase

UL97 - ganciclovir - impaired ganciclovir phosphorylation

26
Q

What is mechanism of action of fusidic acid?

A

Fusidic acid inhibits protein synthesis by binding EF-G-GDP, which results in the inhibition of both peptide translocation and ribosome disassembly.

27
Q

What is most common mechanism of resistance to aminoglycosides, but specifically staph aureus?

A

The three mechanisms of resistance to aminoglycosides are changes in the position of the ribosomal binding site for the drug, reduced permeability of the drug, and drug inactivation by enzymes.

The enzymatic inactivation by aminoglycoside-modifying enzymes (AMEs) is an important mechanism of resistance in staphylococcal species

28
Q

Pt presents with endocarditis, B/c grows gram pos cocci which grow on both blood agar and MacConkey and are ampicillin resistant:

Enterococcus Faecalis
Enterococcus faecium
Strep pneumo
Strep bovis

A

Enterococcus faecium

Enterococcus faecalis is sensitive to penicillin

Enterococci - two species are common commensal organisms in the intestines of humans: E. faecalis (90–95%) and E. faecium (5–10%)

an important feature of this genus is the high level of intrinsic antibiotic resistance. Some enterococci are intrinsically resistant to β-lactam-based antibiotics (penicillins, cephalosporins, carbapenems), as well as many aminoglycosides.[9] In the last two decades, particularly virulent strains of Enterococcus that are resistant to vancomycin (vancomycin-resistant Enterococcus, or VRE) have emerged in nosocomial infections

Streptococci do not grow on MacConkey agar, so useful for identifying enterococci

29
Q

What is definition of sterilisation?

A

Sterilization refers to any process that removes, kills, or deactivates bacteria/ fungi/ viruses/ prions/ protozoa

Sterilization can be achieved through various means, including heat, chemicals, irradiation, high pressure, and filtration

30
Q

What is mechanism of action of glycopeptides?

A

Prevents cell wall cross-linking

31
Q

Which of these is a risk factor for VRE bacteraemia?

Repeated enemas
Metronidazole use
Persistent diarrhoea
Urinary catheterisation
Inflammatory bowel disease
A

Identified risk factors for VRE bacteremia include:

prior intestinal colonization
prior long-term antibiotic use
increased severity of illness
hematologic malignancy
bone marrow transplant
mucositis
neutropenia
indwelling urinary catheters
corticosteroid treatment
chemotherapy
parenteral nutrition
32
Q

4yrs old child from Kenya presents with 3 months history of chicken pox unresponsive to acyclovir.

What are next steps?

A

HIV test

Viral swab for genotypic resistance testing

Question Bank (33 decks)

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