Clinical Microbiology Flashcards

1
Q

give me some facts about M.tuberculosis

A

weakly gram positive
Gene X-pert can identify TB directly from samples

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2
Q

what part of the TB infection does isoniazid target

A

actively growing organisms

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3
Q

what part of the TB infection does pyrazinamide target

A

semi-dormant organisms inhibited by an acid environment

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4
Q

what part of the TB infection does Rifampicin target

A

semi-dormant organisms with spurts of active metabolism

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5
Q

symptoms of TB

A

cough
sputum
haemoptysis
fever
weight loss
night sweats

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6
Q

what is the test for latent TB

A

Mantoux

and interferon gamma release assays such as t-spot-TB and quantiferon

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7
Q

what is the treatment for active TB

A
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8
Q

adverse reaction rifampicin

A
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9
Q

adverse reaction to isoniazid

A

liver injury DILE

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10
Q

ethanbutol adverse reaction

A

toxic optic neuropathy

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11
Q

pyrazinamide adverse reaction

A

liver injury and raised lactate

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12
Q

drugs used in drug resistant TB

A

BDQ
Delamanid
pretomanid

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13
Q

what questions do you need to ask in relation to travel history

A

where did they go
how long were they there
did they take any anti-malarials

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14
Q

why is there often an incubation period in malaria

A

this is due to the fact that sporozoites enter the liver and become schizonts that are stored in the liver until they are released into the circulation

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15
Q

what do thick blood films in malaria test for

A

these provide a diagnosis of malaria

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16
Q

what do thin blood films in malaria test for

A

this confirms what type of malaria a patient is experiencing

17
Q

What are the other tests used in the diagnosis of malaria

A

antigen testing
PCR

18
Q

what are the two types of malaria

A

non falciparum malaria and falciparum malaria

19
Q

What is the management of non-falciparum malaria

A

oral chloroquine (this treats the blood stages of the disease)
Artemether containing therapies
Oral primaquine (this treats the hypnozoites which aids in preventing reoccurrence)

REMEMEBER that viva and vale are the ones that have the ability to cause relapse due to hypnozoites

20
Q

what are some features of severe falciparum malaria

A

these often reflect the sludge up of the microcirculation
- impaired consciousness and seizures
- renal impairment
- acidosis
- hypoglycaemia
- pulmonary oedema or ARDS
- shock
- spontaneous bleeding

21
Q

how do we manage uncomplicated falciparum malaria

A
22
Q

how do we manage severe falciparum malaria

A
23
Q

what is the prognosis of malaria

A

early treatment and diagnosis

the cause of any deaths related to malaria are usually due to:
- lack of antimalarial prophylaxis
- late diagnosis
- even cerebral malaria has a mortality of 15-20%

24
Q

what are the two bacteria associated with enteric fever

A

S.typhi and S.paratyphi

25
Q

how is enteric fever transmitted

A
  • human to human
  • contained food/water

humans are the only reservoir

ONLY NEEDS 1000 TO CAUSE DISEASE

26
Q

what is the pathogenesis of enteric fever

A

the organisms are ingested from the contaminated water, the organism then moves through the peyers patches in the small bowel to then infect the reticuloendothelial system and this then effects the liver and blood products

27
Q

what are the clinical features of enteric fever

A

fever
myalgia
headache
cough
abdo pain
constipation
diarrhoea

28
Q

how do you diagnose enteric fever

A

travel history
blood cultures
stool samples
serology

29
Q

what is the treatment for enteric fever

A
30
Q

dengue fever

A

caused by day biting and an incubation time of 5-14 days

31
Q

what are the clinical features of dengue fever

A

headache
fever
retro-orbital pain
Myalggia
rash

31
Q

what are the clinical features of dengue fever

A

headache
fever
retro-orbital pain
Myalggia
rash

32
Q

what lab tests indicate gengue fever

A

leucopenia
thrombocytopenia
transaminitis
liver inflammation

33
Q

what defines haemorrhagic fever

A

increased vascular permeability
thrombocytopenia
fever
bleeding

34
Q

What marker is raised in inflammatory bowel disease

A

faecal calprotectin