Micro Man

Question 1

Gram negative ‘coliforms’

Answer 1

E coli, Klebsiella, Enterobacter, Proteus

Question 2

Gram negative ‘coliforms’ sensitivity

Answer 2

Gentamicin

Question 3

Extended Spectrum Beta Lactamases (ESBL) sensitivities

Answer 3

Temocillin, pivmecillinam (& meropenem)

Question 4

Why is metronidazole not needed with pip-tazobactam or co-amoxiclav

Answer 4

they have anaerobic cover

Question 5

Temocillin & aztreonam have no ______ or gram ______ cover

Answer 5

Temocillin & aztreonam have no anaerobic or gram positive cover

Question 6

Anaerobes are generally sensitive to =

Answer 6

metronidazole (and co-amoxiclav, clindamycin, pip-tazobactam & meropenem)

Question 7

Gram positives like Staph aureus (MSSA, MRSA), streps & enterococci are sensitive to

Answer 7

vancomycin (except VREs): use restricted to penicillin allergy or penicillin resistant strains

Question 8

MRSA is resistant to all

Answer 8

beta-lactams (penicillins, flucloxacillin, pip-tazobactam,

cephalosporins & meropenem)

Question 9

Beta-haemolytic streps (groups A C G) are sensitive to

Answer 9

penicillin & flucloxacillin

Question 10

Pathogens in meningitis

Answer 10

pneumococcus, meningococcus and if > 60 listeria

Question 11

pathogens in encephalitis

Answer 11

herpes simplex

Question 12

what are pneumococci and meningococci similar sensitive to?

Answer 12

penicillin

Question 13

why is ceftriaxone chosen in meningitis?

Answer 13

need for high CSF levels to maintained and the ease of dosing (twice a day) provides better cover for the rare strain that might have borderline sensitivity to penicillin

Question 14

what is listeria resistant to?

Answer 14

cephalosporins

Question 15

what is listeria sensitive to?

Answer 15

amoxicillin: high dose and frequent dosing

Question 16

what is herpes simplex sensitive to?

Answer 16

IV aciclovir

Question 17

pathogens in epiglottitis?

Answer 17

haemophilus influenzae, streptococci

Question 18

pathogens in tonsilitis

Answer 18

group a streptococci

Question 19

pathogens in sinusitis

Answer 19

pneumococcus

Question 20

pathogens in acute otitis media

Answer 20

pneumococcus, haemophilus influenzae

Question 21

amoxicillin has better absorption when given

Answer 21

orally

Question 22

what are haemophilus influenzae sensitive to

Answer 22

amoxicillin (not penicllin)

Question 23

why are life threatening haemophilus influenzae treated with ceftriaxone

Answer 23

for the rare cases of amoxicillin resistance

Question 24

organisms in CAP

Answer 24

CAP Mild/moderate: pneumococcus, Haemophilus influenzae

CAP Severe: as above but possible coliforms and atypicals such as Legionella, Mycoplasma, Chlamydia pneumoniae,
Coxiella ;

Remember Staph aureus pneumonia post influenza and the PVL producing strains of Staph aureus that can produce severe pneumonia in children and young adults especially please contact micro/make clear on form to add extra tests for this

Question 25

acute exacerbation of COPD organisms

Answer 25

Pneumococcus, haemophilus influenzae

Question 26

HAP organisms

Answer 26

pneumococcus, Haemophilus influenzae and coliforms.

Legionella can be hospital acquired.

Question 27

Co-amoxiclav provides cover for most…..

Answer 27

Haemophilus influenzae & coliforms for those with severe infection (not
ESBLs or CPEs though)

Question 28

why is doxycycline used in pneumonia

Answer 28

for atypical cover

Question 29

native valve acute

Answer 29

Staph aureus: take 2 sets blood cultures & start antibiotic within the hour

Question 30

Native valve subacute

Answer 30

viridans streptococci, enterococci :3 sets blood cultures 6 hours apart if patient stable

Question 31

Prosthetic valve

Answer 31

MRSA (resistant to flucloxacillin and all beta lactams); coagulase negative staphylococc

Question 32

Indolent presentation________/_____ more likely: synergistic ____/_____ (1mg/kg bd) pending culture results

Answer 32

Enterococci/streps

amox/gent

Question 33

Coagulase negative staphylococci sensitivity

Answer 33

vancomycin, gentamicin (1mg/kg bd) & rifampicin (started 3-5 days after vancomycin) is used to
ensure cover, killing & penetration

Question 34

most enterococci are sensitive to ______

Answer 34

amoxicillin

Question 35

peritonitis/biliary tract sepsis/intrabdominal organisms

Answer 35

polymicrobial coliforms
anaerobes
enterococci

Question 36

Spontaneous bacterial peritionitis

Answer 36

coliforms +/- anaerobes, sometimes strep pneumonia

Question 37

anaerobe sensitivity

Answer 37

metronidazole

Question 38

coliform sensitivity

Answer 38

gentamicin and aztreonam

Question 39

ESBLs sensitivity

Answer 39

> resistant to most penicillins & cephalosporins including aztreonam, co-amoxiclav & pip-tazobactam

> sensitive to temocillin (& meropenem available on infection specialist advice only)

> Sensitivity of ESBLs to co-trimoxazole is unpredictable

Question 40

organisms in female uncomplicated lower UTI

Answer 40

coliforms

enterococci

Question 41

male (no catheter) organisms

Answer 41

coliforms

enterococci

Question 42

complicated UTI

Answer 42

coliforms
pseudomonas aeruginosa
enterococci

Question 43

why isnt nitro used in complicated UTI

Answer 43

no kidney tissue penetration & is not excreted in urine in renal impairment

Question 44

cellulitis organisms

Answer 44

Staph aureus, group A & other beta-haemolytic streptococci

Question 45

Diabetic foot acute

Answer 45

Staph aureus

Question 46

Diabetic foot acute on chronic polymicrobial

Answer 46

Staph aureus, coliforms & anaerobes

Question 47

Flucloxacillin will cover …..; so ….. is not required in addition

Answer 47

beta-haemolytic streptococci ( A C &G)

penicillin