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Deck 1 > Microbiology > Flashcards

Microbiology Flashcards

1
Q

Gummas can occur in various locations with syphilis infection. n what stage of the infection are gummas first found?

A

Gummas are the defining characteristic of tertiary syphilis. There is usually a latency period between secondary and tertiary syphilis of 2–20 years.

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2
Q

Which bacteria are Gram-negative aerobic rods?

A

The answer is pseudomonas aeruginosa.

Gram-negative aerobic rods are rare, with the exception of Pseudomonas.

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3
Q

Neisseria gonorhea is what kind of bacteria?

A

Gram-negative diplococcus.

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4
Q

Streptococcus pyogenes is what kind of bacteria?

A

pherical Gram-positive bacteria.

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5
Q

Treponema pallidum is what kind of bacteria?

A

Gram-negative spirochaetes

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6
Q

Haemophilus influenzae îs what kind of bacteria?

A

Gram-negative, pleomorphic, coccobacilli bacteria

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7
Q

Which organisms contain ribosomes, do not have a rigid cell wall but cannot be grown on inanimate culture?

A

Chlamydia

Viruses do not have ribosomes.

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8
Q

Name some herpes viruses:

A

Epstein-Barr virus, cytomegalovirus, roseolovirus, Kaposi’s sarcoma-associated herpes virus

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9
Q

Which organism causes lymphogranuloma venereum?

A

The answer is chlamydia trachomatis L1–L3.

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10
Q

Which organism causes causes cervicitis, pelvic inflammatory disease and urethritis.?

A

Chlamydia trachomatis D–K

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11
Q

Which organism causes ocular trachoma?

A

Chlamydia trachomatis A–C

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12
Q

What is the potential cause of small white umbilicated white papules on the labia majora?

A

Molluscum contagiosum

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13
Q

What presents with multiple painful genital ulcers and lymphadenopathy?

A

Haemophilus ducreyi

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14
Q

Which infection is known to produce an aplastic crisis in people with sickle cell disease?

A

Parvovirus B19 infections lead to an aplastic crisis if there is a marrow strain, and hydrops fetalis and fetal death are complications of intrauterine parvovirus B19 infection.

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15
Q

What is the incubation period for varicella infection?

A

10–20 days.

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16
Q

Which pathogen is commonly responsible for cellulitis?

A

Streptococcus pyogenes

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17
Q

Which organism is associated with clue cells?

A

Gardnerella vaginalis

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18
Q

Which organism is associated with koilocytes?

A

Human papillomavirus

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19
Q

A pregnant woman is diagnosed with toxoplasmosis.

What is the drug of choice for reducing the risk of fetal infection?

A

Spiramycin

Toxoplasmosis gondii is an obligate intracellular protozoan.
Spiramycin is a macrolide antibiotic and has been shown to reduce the risk of mother-to-child transmission in pregnant woman by up to 70%

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20
Q

A 30-year-old woman presents to the antenatal clinic with a history of cytomegalovirus (CMV) infection.

Which test would be the most sensitive for diagnosis of congenital infection in pregnancy?

A

Amniotic fluid PCR

Serological diagnosis of primary CMV infection during pregnancy can be difficult because CMV IgM, while suggestive of recent infection, can remain positive for many months and can also represent reactivation of past infection.

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21
Q

A 30-year-old woman presents to the antenatal clinic after a visit to her home country in Africa. She is suffering from flu-like symptoms, myalgia and her posterior cervical lymph nodes are found to be enlarged. Her temperature is 38.4°C.

Diagnosis?

A

The answer is toxoplasmosis.

Acute toxoplasmosis may be present with the above symptoms. The lymphadenopathy is characteristic. The white blood count, ESR and CRP are usually normal

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22
Q

A 29-year-old woman who is 39 weeks pregnant presents to the delivery suite in labour. Her previous child was affected by group B streptococcus (GBS) infection. She is allergic to penicillin.

Which antibiotic should be prescribed for her as a prophylaxis for GBS?

A

Clindamycin

Vancomycin and erythromycin can potentially be used when clindamycin is not recommended.

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23
Q

If meticillin-resistant Staphylococcus aureus is suspected, which antibiotics should be used?

A

vancomycin or teicoplanin.

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24
Q

What type of fungus is Candida albicans?

A

The answer is yeast-like fungus.

Unlike true yeasts, candida forms long-branching filaments and therefore, it is classified as a yeast-like fungus.

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25
Q

What is the incubation period of rubella?

A

The answer is 13–20 days.

Rubella is caused by a single-stranded RNA togavirus.

26
Q

Which organism is not classically associated with bacterial vaginosis?

A

Histoplasma capsulatum

27
Q

What are the four causes of bacterial vaginosis?

A

Gardnerella vaginalis
Mobiluncus species
Mycoplasma hominis
Bacteroides species

28
Q

A pregnant woman at 18 weeks of gestation presents with bloody diarrhoea. Stool microscopy and culture identifies Gram-negative, facultative anaerobic rods.

Which organism is most likely to be responsible?

A

Salmonella

29
Q

A patient presents with condyloma lata.

At what stage of syphilis does this feature occur?

A

Secondary syphilis

30
Q

Which white blood cell type is elevated in an acute cytomegalovirus infection?

A

lymphocytes are elevated in a viral infection.

31
Q

A 25-year-old, para 2, attended the antenatal clinic at 20 weeks of gestation. She was concerned as in her previous pregnancy she had an infection that caused deafness and delayed the development of her child. The baby had become jaundiced shortly after birth.

What infection did she have in her previous pregnancy?

A

cytomegalovirus.

In about 10–20% of cases, follow-up shows neurological damage. Sensorineural hearing loss is the most frequent long-term consequence and in many cases does not become clinically apparent until later childhood. Other sequelae that may be evident only after the neonatal period can include chorioretinitis, neurodevelopmental delay with mental or motor impairment, and microcephaly.

32
Q

A woman who is 16 weeks pregnant calls the clinic for advice. She is a primary school teacher and there is an outbreak of chickenpox in her class.
Her GP sent some blood for testing and the VZV-IgG result was positive, VZV-IgM result negative.

Select the best management plan:

A

Expectant management

If the woman’s immunity to chickenpox is unknown and if there is any doubt about previous infection, or if there is no previous history of chickenpox or shingles, serum should be tested for VZV IgG. This can usually be performed within 24–48 hours and often within a few hours if the laboratory can access serum stored from an antenatal booking blood sample. At least 80% of women tested will have VZV IgG and can be reassured.

33
Q

Which HPV types are contained in the quadrivalent vaccine?

A

6 11 16 18

34
Q

Cytomegalovirus (CMV) infection can be primary or as a result of reactivation.

In which cells does CMV lie dormant?

A

Monocytes

35
Q

In genito-urinary medicine clinics, a technique where the microscope condenser causes the bacteria to appear brightly lit is especially useful for visualising very thin organisms such as Treponema pallidum.

Which microscopic technique fits this description?

A

Darkfield microscopy

36
Q

baby is being treated for meningitis on the neonatal intensive care unit.

What is the most likely infecting organism?

A

Group B streptococcus

37
Q

Do we treat all BV?

A

Treatment of asymptomatic non-pregnant women with an incidental finding of BV is not recommended in current UK guidelines.

38
Q

A woman visits the antenatal clinic at 39 weeks’ gestation with ulcers on her labia majora. Viral swabs prove that this is a primary herpes simplex type 2 infection.

What is the risk of her baby acquiring the infection if delivered vaginally?

A

40–50%

If the herpes is recurrent at the onset of labour, the risk of neonatal herpes is much lower (0-3%).

39
Q

Which antibiotic is associated with c. difficile?

A

Cefuroxime

40
Q

A primary school teacher attends for an anomaly scan at 20 weeks’ gestation and the baby is unexpectedly found to be hydropic. Which is the most likely causative organism?

A

Parvovirus B19

Children with’ slapped cheek syndrome’ due to parvovirus do not feel ill and are therefore sent to school where the parvovirus poses a risk to the pregnant teacher. It causes fetal anaemia, which is why the baby looks hydropic on the scan - high output cardiac failure.

41
Q

After a visit to A&E with bleeding at 7 weeks’ gestation, a teenager attends the Early Pregnancy Unit for a scan, which shows a viable pregnancy. The swab result taken in A&E is positive for chlamydia. What is the best management option?

A

Contact trace partner(s) and offer her immediate treatment

First-line treatment is doxycycline 100 mg twice a day for 7 days (contraindicated in pregnancy). In women who are pregnant or breastfeeding, treatment with azithromycin, amoxicillin, or erythromycin may be considered.

42
Q

Surgical infections at hysterectomy can be reduced by the use of single-dose prophylactic antimicrobials given at induction of anaesthesia. In which situation would re-dosing of prophylactic antibiotics be recommended?

A

Major intraoperative haemorrhage

43
Q

What is the most common heritable thrombophilia?

A

Factor V Leiden

Though uncommon, antithrombin III deficiency has a very high risk of recurrence.

44
Q

A 30-year-old woman has been feeling generally unwell for 10 days since her caesarean section, and has been admitted to hospital because the pain has become intense. On examination, her temperature is 38.7°C. Swelling and redness is noticed around the scar, and blisters have developed at the margins.

A

Necrotising fasciitis

Erysipelas is more superficial but well defined.

45
Q

Degeneration of fibroids:

A
  • Hyaline degeneration (63%) is the most common degenerative change in fibroids.
  • If painful, means that the diagnosis is either red degeneration or sarcomatous degeneration.
  • Red is thought to be the most common form of degeneration of a leiomyoma during pregnancy.
  • Degenerative changes are considered to result from excessive growth that outmatches the blood supply, or mechanical compression of the feeder arteries.
46
Q

Failure of postpartum lactation and failure to resume menses after delivery are the most common presenting symptoms of what condition?

A

Sheehan’s syndrome occurs as a result of ischaemic pituitary necrosis due to severe postpartum haemorrhage.

47
Q

During an evacuation of uterus procedure at 8 weeks, the uterus was noted to be soft, bulky and larger than expected for the gestation.

The histopathology result shows “oedematous villi surrounded by hyperplasia of the trophoblastic tissue. No normal embryonic tissues are seen.”

What is the likely diagnosis?

A

Complete hydatidiform mole

  • A partial mole will have only some villi dilated and other villi are normal or small and fibrotic.
48
Q

Which ovarian cancer is associated with psammoma bodies?

A

Serous tumour

49
Q

Which type of necrosis occurs in acute pancreatitis?

A

Fat necrosis

50
Q

Which type of necrosis occurs in myocardial infarction?

A

Coagulative necrosis

51
Q

Which type of necrosis occurs in cerebral infarction?

A

colliquative necrosis

52
Q

What type of necrosis occurs in tuberculous infection?

A

caseous necrosis

53
Q

What type of necrosis occurs in clostridial infection?

A

gangrenous necrosis

54
Q

Which pathological process increases the production of uric acid?

A

Hodgkin lymphoma

55
Q

An endometrial biopsy is taken, and the histology report describes “focal areas of ulceration, caseous necrosis and haemorrhage”.

What diagnosis does this histological appearance suggest?

A

Genital tuberculosis

TB bacilli infect the genital tract by four routes: haematogenous (with lungs as the common primary focus); descending direct spread; lymphatic spread; and rarely, as primary infection of the genitalia through sexual transmission.

56
Q

Which organ is most commonly affected by genital TB?

A

Fallopian tubes

57
Q

A 19-year-old woman presents to her GP with lower abdominal pain, and on examination there is a large mass arising from the pelvis. Scan confirms that the mass is ovarian.

Which tumour marker blood tests would be appropriate?

A

ca-125, AFP, HCG, LDH

Guidelines from the UK recommend that a-FP and hCG should be measured in all women under 40 years of age with a complex ovarian mass, due to the possibility of germ cell tumours.

58
Q

What are the two most common cancers associated with endometriosis?

A

Clear cell carcinoma
Endometrioid carcinoma

59
Q

What is the most common cell type in Hodgkin’s disease?

A

B cells

60
Q

Lichen sclerosus features:

A
  • Auto-antibodies are produced for extracellular matrix protein I.
    Epidermal atrophy (or thinning)
    sub-epidermal hyalinisation
    Dermal inflammation.

Signs:
pale, white atrophic areas affecting the vulva
purpura (ecchymosis) is common
fissuring
erosions, but blistering is very rare

61
Q

Lichen planus features:

A

Violaceous plaques and papillose with white reticular pattern overlying (Wickham striae)
Erosive form has glazed areas of erythema and is common to genital and buccal mucosa (this form associated with pain)

62
Q

VIN features:

A

Epithelial nuclear atypia
Loss of surface differentiation
Increased mitosis

Deck 1 (12 decks)

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