Microbiology Flashcards

1
Q

Significance of HIV viral load <50 copies

A

??

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2
Q

Suprapubic pain and leucocytosis

A

UTI (q says PID, prob wrong)

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3
Q

Patient pregnant in 2nd trimester.
Lower abdo pain, offensive PV discharge, 2 days later presents with still birth.
What is the causative organism?

A

Chlamydia (check answer?)

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4
Q

Rate of transmission of hepatitis in HBsAg positive mother

A

70-90% without intervention
(CDC online)

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5
Q

A woman in 2nd trimester goes into premature labour- chorioamnionitis, what is the most likely organism

A

Streptococcus
GBS

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6
Q

Hepatitis serology - what is the patient’s infection status?

HBsAg
anti-HBc
anti-HBs
IgM anti-HBc

A

HBsAg: currently infective
anti-HBc ‘caught it’
anti-HBs: immune ‘s for shield’ (infection/vaccination)
IgM anti-HBc: recent/current infection

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7
Q

After disinfection, which organism survives?

A

My guess/google - Spores

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8
Q

Treatment of chlamydia

A

Azithromycin stat (safe in pregnancy)
Doxycyline 7/7

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9
Q

What antibiotic can be used to treat UTI in 1st/2nd trimester, but is not safe in 3rd trimester

A

Nitrofurantoin

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10
Q

In a HIV +ve woman in Labour, at what viral load will you allow vaginal delivery?

A

VL <50 copies/ml

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11
Q

HIV Ag/Abx ratio =1.5
1 confirmatiry test = negative
2 cimfirmatiry test specimen not adequate

A patient in her first trimester of pregnancy found to have HIV Ab weakly positive, the first confirmative was negative while the second was inconclusive. Your next step would be:

A

Refer her to GUM clinic for further testing

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12
Q

Pregnant lady with fever, loin pain, tenderness, GUE +++ pus cell. How do you manage?

A

Admit for intravenous fluid and iv cephalosporin

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13
Q

Management of a severe caesarian section wound infection

A

Admit and cover with IV antibiotics

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14
Q

A wound infection caused by this microorganism shows sulfur granules under microscopy

A

Actinomycosis israelii

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15
Q

What is the antibiotic treatment for MRSA?

A

Vancomycin

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16
Q

Varicella Zoster Ig interpretation:
IgG positive
IgM negative

A

Previously infected, now immune

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17
Q

Pregnant 24 wks with vulval soreness
+ve candida
+ve B streptococci

A

(give fluconazole)
vs
Don’t give anything - will get abx at time of delivery (this one chosen in recall paper)

I think give clotrimazole pessary but not listed

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18
Q

A pregnant woman plans to go to Middle East. What vaccination can’t be given to her?

A

BCG
Live attenuated

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19
Q

The thick white vaginal discharge

A

Candida?

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20
Q

What is the most common microorganism that causes UTI in a patient with a catheter

A

Pseudomonas

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21
Q

Treatment in acutely unwell patient with vaginal discharge and MRSA+ culture

A

IV vancomycin

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22
Q

Hpv 16 and 18 responsible for ___ % of infections

A

70%
(google - not confident)

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23
Q

Streptococci may cause

A

toxic shock syndrome

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24
Q

Which of the following antibiotics can be given orally
A)- tetracycline
B)- chloramphenicol
C)-streptomycin
D)-Gentamycin

A

A)- tetracycline
B)- chloramphenicol

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25
Q

What is the highest risk time for vertical HIV transmission?

A

During Labour and delivery

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26
Q

What organism has four flagella

A

Trichomonas has several flagella

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27
Q

Drug of choice for treatment of severe malaria in pregnancy

A

Artesunate

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28
Q

Which test is most sensitive in detecting pelvic inflammatory disease (PID)

A

Nucleic acid amplification test

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29
Q

Patient 2/52 post-op develops red swelling/itching/warmness around abdominal hysterectomy surgical wound scar. Abx treatment?

A

co-amoxiclav
(?)

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30
Q

Under what circumstances is GBS treated during the pregnancy (and before labour)

A

UTI with bacteria on MSU

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31
Q

What GBS risk factors lead to antibiotic treatment?
6

A

(3 about ROM and 3 others)
GBS in previous pregnancy
GBS dx in this pregnancy (incidental)
Intrapartum temp >38 degrees

Term PROM >18h
P-PROM with known GBS
?P-PROM now in labour (<37/40)

PROM = pre-labour rupture of membranes
P-PROM = preterm pre-labour rupture of membranes

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32
Q

Pregnant 16 weeks, Rubella IgM: +ve and IgG: -ve. Next step?

A

Give vaccine after delivery

(an acute infection)

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33
Q

Varicella infection IgM positive.

A

Acute infection

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34
Q

VDRL+ & TPPA -

A

False +ive

TPPA stays positive for life

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35
Q

What is the function of a PCR?

A

Make multiple copies of a segment of DNA

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36
Q

What is the most common type of nosocomial infection in hospitals?

A

UTI
(catheter associated)

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37
Q

Which single organism is the most common cause of sepsis in pregnancy?

A

Group A Streptococcus
aka
Streptococcus pyogenes

No 1 cause is ‘polymycrobial’

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38
Q

A 16-year-old has recently become sexually active. She complains of intensely irritating greenish frothy vaginal discharge. The organism is seen under microscope with peri nuclear halo. What is the most likely causative organism?

A

Trichomonas vaginalis

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39
Q

Chest x ray findings of a tuberculosis patient showing T.B granuloma at the apex of the lung. Which of the following cells is responsible for caseous (? granulomatous) necrosis?

A

macrophages

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40
Q

A pregnant woman presents at booking. No UTI sx. Urine analysis shows : wbc 10×10, 6 and E. coli growth. Sensitive to trimethoprim, nitrofurantoin, cephalexin and resistant to ampicillin. Treatment?

A

Nitrofurantoin 7/7

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41
Q

Which group of viruses cause 1Tmolluscum contagiosum?

A

Pox virus

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42
Q

Which is the commonest commensal organism that form common flora in vagina?

A

Doderlin lactobacilli

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43
Q

Which antibiotic is effective against staphylococcus exotoxin?

A

Clindamycin

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44
Q

Which congenital infections is most characteristically associated with fetal hydrops?

A

Parvovirus B19

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45
Q

Which bacteria produces an exotoxin causing ‘toxic shock syndrome’ associated with tampon usage?

A

Streptococcus pyogenes (Group A)
OR
Staphylococcus aureus

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46
Q

Fever, abdo pain, cervical motion tenderness. Gram negative intracellular diplococci. Organism?

A

Neisseria gonorrhoeae

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47
Q

A 33-year-old woman with an intrauterine contraceptive device develops symptoms of acute salpingitis. On laparoscopy, sulfur granules appear at the fimbria of the tubes. Organism?

A

Actinomyces species

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48
Q

Woman with white vaginal discharge. She is 7 weeks pregnant. Chlamydia swab is positive. Treatment?

A

Azithromycin OR Erythromycin
(Bashh guideline)

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49
Q

A patient presents with condyloma lata. At what stage of syphilis does this feature occur?

A

secondary syphilis

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50
Q

What STD is caused by Haemophilus ducreyi?

A

Chancroid

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51
Q

The vaccine for measles, mumps and rubella (MMR) is best characterized as

A

live (attenuated)

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52
Q

Hep B serology interpretation

HBsAg; POSITIVE
Anti-HBc; POSITIVE
Anti-HBcIgM; NEGATIVE
HBeAg; NEGATIVE
Anti-HBe; POSITIVE
HBV DNA; 203 iu/ml

A

Chronic infection

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53
Q

Pearly-white, non-tender dome-shaped ulcers around 3 mm in diameter

A

molluscum contagiosum

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54
Q

Which of the following human papilloma virus (HPV) subtypes cause genital warts?

A

6 & 11

55
Q

Lancefield grouping of streptococci is based on the presence of___

A

Carbohydrate antigen on the cell wall

56
Q

Two days after undergoing total abdominal hysterectomy and bilateral salpingo- oophorectomy a 60-year-old woman develops high temperature and confusion. On examination; She has a temperature of 38.2°C, a respiratory rate of 28/min, a pulse of 103 beats/min, a blood pressure of 130/80 and a urine output of 10 ml/hr after catheterization. Diagnosis?

A

Severe sepsis

57
Q

UTI at 37/40, previously had cefuroxime. Growing E coli
Co-amoxiclav; sensitive Nitrofurantoin; sensitive Trimethoprim; sensitive
Gentamicin; sensitive
Cefuroxime; resistant
Which abx?

A

Trimethoprim
(No nitrofurantoin in 3rd trimester)

58
Q

What antibiotic used during pregnancy causes grey discolouration of teeth in the foetus

A

Tetracycline / doxycyline

59
Q

Without treatment, asymptomatic bacteriuria at 32 weeks gestation increases risk of what complication?

A

Preterm labour

60
Q

What percent of untreated individuals move on to the third stage of syphilis?

A

35%

61
Q

A 34 yr old woman has just returned to the UK following missionary work in the northern part of South America. She is delighted to be pregnant and presents for booking at 12 wks of gestation. After counseling she agrees to have routine blood investigations including screening for syphilis. The results are returned as following:
Venereal Disease Research Lab. (VDRL) test: reactive
Traponema Pallidum particle agglutination (TP-PA): non reactive
Fluorescent Traponemal Ab absorption (FTA-Abs) : non reactive

A

Likely biological false positive

62
Q

23-year-old woman presents with fishy foul smelling vaginal odour. ‘Clue cells’ are found in the smear. What is the most likely causative organism?

A

Gardenerella vaginalis

63
Q

Which type of vaccine is contraindicated during pregnancy? Give 3 examples

A

Live attenuated

MMR
Polio
BCG

64
Q

A 64-year-old woman undergoes a total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometrial carcinoma. This procedure will be placed in which of the following wound classifications?

A

clean/contaminated

65
Q

What is the most appropriate treatment for pelvic inflammatory disease (PID)?

A

Ceftriaxone 1g IM stat +
Doxycycline 100mg (14/7) +
Metronidazole 400 mg (14/7)

66
Q

The bacteria Neisseria gonorrhoeae can be described as what?

A

Gram-negative AEROBIC cocci

67
Q

Which fungi is most commonly found in catheter-related infection?

A

Candida

68
Q

VZV IgG : Negative
VZV IgM: Negative
What is the most likely diagnosis?

A

Non-immunity to chicken pox

69
Q

A 26y/o at 25/40 presents with a vesicular rash on her back and abdomen. Her GP confirms the diagnosis of chickenpox. What is the most appropriate action?

A

Oral acyclovir

Has chickenpox with rash for <24h and >20/40 = give oral acyclovir

Has chickenpox exposure and IgG negative (not immune) = give VZIG

70
Q

A 30-year-old woman underwent lower segment caesarean section. Two weeks into the postpartum period, she has experienced nausea and vomiting for three days. On examination, she has a temperature of 390C, a respiratory rate of 30/min, and a blood pressure of 90/50 mmHg. The patient has warm peripheries with normal capillary refill time. What is the most likely diagnosis?

A

Septic shock

71
Q

A 19-year-old married female complains of vaginal discharge, odor, and itching. Speculum examination reveals a homogeneous grey discharge, vulvar and vaginal erythema, and a “strawberry” cervix. The most likely causative organism is

A

Trichomonas

72
Q

Is there routine antenatal screening for GBS?

A

No routine antenatal screening for GBS

Note will be treated if other RF

73
Q

The most common in uetro infection causing fetal anemia in the UK is

A

Parvovirus B19

74
Q

A 15-year-old girl attends the genitourinary medicine clinic complaining of frothy yellow vaginal discharge. She is sexually active with her 17-year-old boyfriend and uses the oral contraceptive pill. Speculum examination reveals haemorrhages on her cervix. A urine pregnancy test is negative. Considering the most likely diagnosis, what is the most appropriate first line antibiotic?

A

Metronidazole

75
Q

Which HPV subtypes are high-risk for the development of cervical intraepithelial neoplasia?

A

16 & 18

76
Q

25-year-old woman patient presents with number of small genital blisters. A swab results reveals a diagnosis of genital herpes. Which of the following is the best drug to be used to treat this patient?

A

Topical acyclovir

(oral acyclovir not an option)

77
Q

Surgical wound infection after caesarean section. Culture: (MRSA). Treatment?

A

Clindamycin and vancomycin

78
Q

What type of vaccine is the influenza vaccine

A

Organism subunit vaccine

79
Q

Which of the following organisms Colonize copper IUD?

A

Actinomyces

80
Q

Bacterial vaginosis is diagnosed with depletion in numbers of which
organism?

A

Lactobacillus

81
Q

20/40 woman with h/o recent travel to India, presents with fever, chills. Blood test falciparum Vivax +VE. Best treatment?

A

Chloroquine

??falciparum AND vivax

82
Q

Regarding Genital herpes infection , what is the best management?

A

Acyclovir

83
Q

14/40 exposed to chicken pox.
Can’t recall whether had as child
IgG negative
IgM negative
Interpretation?

A

Not immune to chicken pox

84
Q

What is Varicella Zoster’s infectivity period?

A

2 days before rash until crusts appear

85
Q

A 55 year old presents to clinic due to vulval itch and discolouration. examination reveals pale white discoloured areas to the vulva.
A biopsy shows epidermal atrophy with subepidermal hyalinization and deeper inflammatory infiltrate.

A

Lichen sclerosus

86
Q

11/40 with UTI. Treatment?

A

Nitrofurantoin

87
Q

The HPV vaccine is what type of vaccine?

A

Recombinant / subunit vaccine

88
Q

28/40. Diarrhoea and flu like symptoms. A blood culture: listeria. Treatment?

A

Amoxicillin

89
Q

Indian origin, lives in London. History Of Low Grade Fever Weight Loss and Cough 5/12 .She is pregnant. CXR image

A

TB

90
Q

Less common HPV types high risk for cervical ca.

A

33

31, 35

91
Q

Classic HPV high risk cervical ca types

A

16
18

92
Q

HIV positive patient came with ruptured membranes 38 weeks. Already on HAART. Viral copies 1450. Recommended MOD and any other treatment?

A

Cat 3 Caesarean section with IV zidovudine

93
Q

A woman was injured while walking in the garden barefoot. After that she developed cellulitis. What’s the possible cause?

A

Staph aureus

94
Q

VIN3 is caused by which organism

A

HPV 16

95
Q

What type of virus is Zika virus?
ss/ds etc

A

Ss RNA

96
Q

Patient presented with heavy vaginal discharge but no itching, PH 6. What is the cause?

A

Bacterial vaginosis

97
Q

Most common protozoan causing zoonotic infection (cerebral calcification, retinitis)

A

Toxoplasma

98
Q

Congenital conjunctivitis organism. Purulent discharge 36 hours after birth

A

Chlamydia trachomatis

99
Q

18 y/o non penetrative intercourse, + painful ulcers in the vagina

A

Behchets disease

100
Q

What type of virus is Herpes simplex?
ds/ss etc

A

Ds DNA

101
Q

Tetanus vaccine type

A

Toxoid

102
Q

USS anomaly, baby with microcephaly, most common infection?

A

CMV
(vs toxoplasmosis)

103
Q

When does the influenza vaccine become effective after the dose is given

A

?2 weeks

104
Q

Stable relationship with IUD for 11 years, has PID, most likely organism

A

?Actinomyces

105
Q

Early onset neonatal infection - most common organism

A

Streptococcus agalactia
(aka GBS)

106
Q

Patient with RIF pain and tenderness, has history of chlamydial infection that was treated, ultrasound reports a tubular echogenic mass superior to rt ovary, both ovaries look normal.

A

Mucinous appendix
(mucocele)

107
Q

80 y/o came in for pessary change then with profuse vaginal discharge. Culture result moderate beta hemolytic streptococcus with coliform and anaerobic bacteria. Treatment?

A

Metronidazole + Clindamycin PO 7/7

108
Q

23-year-old woman presents with fishy foul smelling vaginal odour. ‘Clue cells’ are found in the smear. What type of cells are ‘clue cells’?

A

Epithelial cells

109
Q

Trichomonas Vaginalis is what kind of pathogen

A

Flagellated protozoan

110
Q

Parvo + in first trimester. What is the risk of miscarriage

A

10%

111
Q

Test of cure for chlamydia in how many days?

A

21 days?

112
Q

GBS treatment for women who are penicillin allergic?

A

Vancomycin (confirmed answer)

113
Q

Abnormal LFTs,
HbsAg -ve, HbeAg -ve, HbeAb +ve, HbsAb 3miu/hr
HbcAb +ve

A

Chronic infection, low infectivity

114
Q

6 hours post laparoscopic tubal ligation, patient c/o pain abdomen. Not relieved by analgesia. On examination a tender cystic mass felt under umbilicus with oozing pus from one of the port sites.
Hb 11, WBC 17

VS

Post lap ligarion as daycare surgery pt was admitted for pain management. Given morphine. After 6 hrs pt cmpls of pain.
A cystic swelling present upto umbilicus. Tender with oozing from port sites….

A

Port site infection

vs

Urinary retention??

115
Q

Transmission of chlamydia to baby

A

During labour and delivery, when passing through birth canal

116
Q

Treatment for gonorrhoea in pregnant patient (X OR Y?)

A

IM Ceftriaxone
OR
Azithromycin (Bash)

117
Q

Mother has flu sx and myalgia
Foetus has hepatosplenomegaly

A

CMV

118
Q

Malaria Prophylaxis

A

Proguanil (malarone) - any time
Mefloquine -Trimester 2 and 3

119
Q

What colour does pseudomonas go on MacConkey agar?

A

Yellow (no reaction)

MacConkey - lactose fermenters pink
MacConkey - non fermenters stay yellow

120
Q

What is Lancefield grouping?

A

Categorisation of G+ cocci
Streptococcae
On basis of the antigens found on the cell wall

120
Q

What is Lancefield grouping?

A

Categorisation of G+ cocci
Streptococcae
On basis of the antigens found on the cell wall

121
Q

What is a key element of both NAAT and PCR tests?

A

Taq polymerase

122
Q

What % of foetuses infected with CMV will be symptomatic at birth

A

20%

123
Q

Define exotoxin

A

Toxin secreted out (exo) of G+ and G- cells

Endotoxin is part of membrane of G- cells

124
Q

What type of vaccine is influenza vaccine

A

Inactive

125
Q

When should ART be commenced in new HIV dx

A

First trimester if VL >100,000 or CD4 <200
Then all on ART by 24/40

126
Q

What is the virus type of Ebola virus?
DNA/RNA etc

A

SS RNA
single stranded RNA

127
Q

Treatment of GBS in labour

A

Benzylpenicillin STAT and then 4 hourly

128
Q

What kind of vaccine is the MMR / Rubella

A

Live attenuated

129
Q

Most common cause of malaria

A

P Falciparum

130
Q

What shape are mycoplasma genitalium under the microscope?

A

flask shaped

131
Q

What type of lancefield is group A strep

A

beta haemolytic

132
Q

What family of viruses does varicella zoster belong to?

A

Herpes virus

133
Q

What arrangement is HSV1
ds/ss/dna/rna

A

Double stranded DNA