Clinical Microbiology (Week 7)

Question 1

Name three groups of people of highest risk of gastroenteritis

Answer 1

Under 5s, elderly and immunocompromised

Question 2

Which family does norovirus belong to?

Answer 2

Calciviridae

Question 3

Which feature of rotavirus gives it the potential for antigenic variation?

Answer 3

It’s 11 strands of RNA

Question 4

Which strains of Adenovirus cause gastroenteritis?

Answer 4

Adenovirus 40 and 41

Question 5

Which two types of hepatitis are spread by face-oral route?

Answer 5

Hepatitis A and E

Question 6

What is the function of selective media?

Answer 6

Suppresses growth of background flora while allowing pathogen growth

Question 7

Which media type shows lactose fermenting and non-lactose fermenting colonies?

Answer 7

MacConkey’s Agar

Question 8

Give three examples of gram negative bacilli which cause gastroenteritis

Answer 8

Salmonella 
Campylobacter 
E. coli 
Shigella 
Vibrio Cholerae

Question 9

What is the main transmission route of campylobacter?

Answer 9

Animals but also food, milk and water

Question 10

Which type of E. coli is commonly seen in developing world infants and travellers diarrhoea?

Answer 10

Enterotoxigenic E. coli

Question 11

What feature of enteropathogenic E. coli allows it to disrupt microvilli?

Answer 11

Bacteria adheres via pili and forms lesion by intimin protein and Tir

Question 12

Which bacteria produces a toxin which damages epithelium and can cause renal failure?

Answer 12

Shigella (Shiga toxin)

Question 13

What feature of Vibrio Cholerae allows intestinal mucosa penetration?

Answer 13

Flagella which causes diarrhoea due to protein exotoxin

Question 14

What is the incubation time of staphylococcus aureus?

Answer 14

30 minutes - 6 hours

Question 15

What are the 2 types of disease associated with Bacillus Cereus?

Answer 15

Emetic and diarrhoeal disease

Question 16

Name 2 spore forming gram positive bacilli?

Answer 16

Clostridium Perfringens

Clostridium Botulinum

Question 17

What is the antibiotic treatment for listeria monocytogenes?

Answer 17

IV Ampicillin and Gentamicin

Question 18

Which gram negative bacteria can cause outbreaks of septic arthritis in children?

Answer 18

Kingella

Question 19

What does the acronym DAIR stand for in terms of surgical joint infection treatment?

Answer 19

Debride
Antibiotics
Implant Retained

Question 20

Briefly describe the condition osteomyelitis

Answer 20

Bone infection characterised by bone death and sequestra (dead bone tissue)

Question 21

Name three contraindications to lumbar puncture in suspected bacterial meningitis

Answer 21

Brain shift
Raised ICP
Decreased GCS
Clotting disorder

Question 22

In which circumstance should corticosteroids be given with antibiotics in meningitis?

Answer 22

When the meningitis is definitively known to be pneumococcal

Question 23

What is the most common antibiotic given in meningitis?

Answer 23

Ceftriaxone

Question 24

What is the treatment of viral meningitis?

Answer 24

No treatment unless patient is immunocompromised (then give Aciclovir)

Question 25

Intra-cerebral TB can cause lesions in which 4 cranial nerves?

Answer 25

III, IV, VI and IX

Question 26

How does neutropenia occur?

Answer 26

Less proliferation of haemopoietic progenitor cells and less marrow reserve

Question 27

In chronic granulomatous disease, the gene coding which enzyme is defective?

Answer 27

NADPH oxidase

Question 28

In febrile neutropenic patients, what is thought to cause infection if no site can be identified?

Answer 28

Translocation of bacteria across a compromised mucous membrane

Question 29

Name two causative viruses of the common cold

Answer 29

Rhinovirus and Coronavirus

Question 30

Define croup

Answer 30

Inspiratory stridor leading to increased RR, mainly in 6 month olds - 3 year olds

Question 31

Which two glycoproteins does influenza contain on its surface?

Answer 31

Hemagglutinin and Neurominidase

Question 32

What are the two types of flu which circulate each year, with one always being more dominant than the other?

Answer 32

H3N2 and H1N1

Question 33

What is the only type of influenza able to cause a pandemic of flu?

Answer 33

Influenza A

Question 34

Name 4 features of a baby/infants behaviour to ask a parent about during a history?

Answer 34

Feeding Crying Sleeping Smiling

Question 35

Name three routes of transmission in HIV

Answer 35

``` Anal or vaginal sex IV drug use Vertical transmission Health care setting Contaminated blood products ```

Question 36

When CD4+ cells fall below what number is a person more likely to have an opportunistic infection?

Answer 36

200

Question 37

What two features does 4th generation testing for HIV look for?

Answer 37

p24 antigen and HIV antibody

Question 38

What is Scotland's viral load target for HIV patients?

Answer 38

<40 viral copies/ml blood

Question 39

What is the main treatment of HIV?

Answer 39

Highly Active Antiretroviral Therapy (HAART) - triple therapy

Question 40

Name the components of a sexual health screen and what tests would be carried out

Answer 40

Chlamydia and Gonnorrhoea (NAAT test) HIV and syphilis (blood test)

Question 41

What is the treatment of gonorrhoea?

Answer 41

Ceftriaxone

Question 42

What is the treatment of Chlamydia?

Answer 42

Doxycyline

Question 43

What type of bacteria is syphilis?

Answer 43

Gram positive spirochete

Question 44

How long does tertiary syphilis take to develop?

Answer 44

8-15 years

Question 45

Which types of virus cause anogenital warts?

Answer 45

HPV 6 and 11

Question 46

Which bacteria causes TB and what kind of bacteria is it?

Answer 46

Mycobacterium tuberculosis, a weakly gram positive

Question 47

What is the clinical presentation of TB?

Answer 47

Cough +/- haemoptysis and SOB

Question 48

What is the hallmark of TB?

Answer 48

Granuloma formation (as well as Ghon complexes)

Question 49

What is the test for latent TB?

Answer 49

Mantoux test

Question 50

Multi-resistant TB is resistant to which 2 treatments?

Answer 50

Rifampicin and Isoniazid

Question 51

Extensively drug-resistant TB is resistant to which 4 treatments?

Answer 51

Rifampicin Isoniazid Fluroquinilone One injectable