microbiology

Question 1

colonisation

Answer 1

the presence of a microbe in the human body without an inflammatory response

Question 2

community bacteraemia sources

Answer 2

e.coli (urine, abdomen)
s.pneumoniae (resp)
s.aureus (mssa- skin)

Question 3

hospital bacteraemia sources

Answer 3

e.coli (catheter related or abdo)
s.aureus (MRSA-line or wound)
CNS
enterococci (urine, wound, line)
klebsiella (urine, wound)
pseudomonas spp.

Question 4

upper respiratory tract alpha haemolytic streptococci

Answer 4

strep penumoniae

Question 5

upper respiratory tract beta-haemolytic strep

Answer 5

strep pyogenes

Question 6

examples of gram neg upper respiratory tract colonisers

Answer 6

h.influenzae
moraxella catarrhalis

Question 7

most common cause of community acquired pneumonia

Answer 7

streptococcus pneumoniae

Question 8

common cause of skin infections

Answer 8

s.aureus

Question 9

cause of impetigo, cellulitis, necrotising fasciitis

Answer 9

strep pyogenes

Question 10

common causes of sore throat in primary care

Answer 10

common cold
influenza
streptococcal infection
infectious mononucleosis

Question 11

complications of sore throat

Answer 11

otitis media
peritonsillar abscess
parapharyngeal abscess
lemierre syndrome

Question 12

most common causes of otitis media

Answer 12

Haemophilus influenzae, Streptococcus pneumonaie and strep pyogenes

Question 13

treatment of otitis media

Answer 13

wait as most resolve in 4 days
amoxicillin
second line: erythromycin

Question 14

causes of acute sinusitis

Answer 14

h.influenzae
strep pneumoniae
strep pyogenes

Question 15

treatment of acute sinusitis

Answer 15

antibiotics for severe/deteriorating cases of >10 days duration.
1ST LINE phenoxymethylpenicillin
2ND LINE doxycycline – NOT IN CHILDREN!!!

Question 16

causes of bacterial conjunctivitis

Answer 16

staph aureus
strep pneumoniae
h.influenzae

Question 17

management of bacterial conjunctivitis

Answer 17

most cases are self limiting only treat if severe
1st line: bathe/clean eyelids regularly to remove crusting
2nd line: Chloramphenicol 0.5% eyedrops
3rd line: Send swab prior to treatment. Fusidic acid 1% eye drops applied bd

Question 18

when to avoid chloramphenicol for severe conjunctivitis

Answer 18

aplastic anaemia or allergy

Question 19

causes of viral conjunctivitis

Answer 19

adenovirus
herpes simplex
herpes zoster

Question 20

presentation of candida infection

Answer 20

intensely itchy white vaginal discharge

Question 21

treatment of candida infection

Answer 21

topical clotrimazole pessary or cream
oral fluconazole

Question 22

normal vaginal flora

Answer 22

lactobacillus spp

Question 23

average life span of pubic lice

Answer 23

22 days male
17 days female

Question 24

treatment of pubic lice

Answer 24

malathion lotion

Question 25

treatment of bacterial meningitis

Answer 25

Ceftriaxone IV 2g bd + Dexamethasone IV 10mg qds (started with or just before first dose of antibiotics for 4 days) Duration: refer to guidance
 Aciclovir IV (10mg/kg tds) if encephalitis suspected (oral treatment never appropriate)  Add Amoxicillin IV 2g 4 hourly if ≥ 60 years or immunocompromised

Question 26

pneumococcus meningitis

Answer 26

10 days ceftriaxone

Question 27

listeria spp meningitis

Answer 27

21 days amoxicillin + stop dexamethasone

Question 28

management of orbital cellulitis

Answer 28

Ceftriaxone IV 2g bd + Flucloxacillin IV 2g qds + Metronidazole IV 500mg tds

Question 29

management of impetigo

Answer 29

Localised lesions: topical hydrogen peroxide 1% cream or fusidic acid 2% cream tds (5 days)
If more widespread lesions: 1
st LINE Flucloxacillin 500mg qds 2nd LINE Clarithromycin 500mg bd (5 days)