HD2 Revision6 Flashcards by patrick ellis

Describe pathophysiology caused by Corynebacterium diphtheriae

What process does the A-B subunit inhbit? [1]
What are the pathological consequences for the heart [2] & nerves? [3]
What structural change occurs in mouth? [1]

Diphtheria toxin: A and B subunits inhibits protein synthesis:

Heart implications:
- Myocarditis
- Heart block

Nerve implications:
- Difficulty swallowing
- Paralysis
- Diplopia

Get pseudomembrane in mouth

How well did you know this?

Not at all

Perfectly

What are the three cocci gram +ve organsims need to know? [3]

Staphylococcus
Streptococcus
Enterococcus

How well did you know this?

Not at all

Perfectly

What are the four bacilli gram +ve organsims need to know? [3]

Corynebacterium
Listeria
Bacillus: cereus (food pois); anthracis (anthrax)
Clostridium: tetani botulinum, difficile

How well did you know this?

Not at all

Perfectly

Which part of the LPS membrane of bacteria is toxic? [1]

When is this released? [1]

Lipid A

Released during lysis of organsim

How well did you know this?

Not at all

Perfectly

Meningococcal disease refers to any illness caused by bacteria called []

Pneumococcal disease is a name for any infection caused by bacteria called []

Meningococcal disease refers to any illness caused by bacteria called Neisseria meningitidis.

Pneumococcal disease is a name for any infection caused by bacteria called Streptococcus pneumoniae

How well did you know this?

Not at all

Perfectly

Describe the pathogenesis of meningococcal disease

How well did you know this?

Not at all

Perfectly

Which two molecules are activated by LPS that cause inflammatory cascade for meningococcal disease? [2]

IL-6
TNF-α

How well did you know this?

Not at all

Perfectly

Name three most common causes of septicaemia and meningitis [3]

Streptococcus pneumoniae

Neisseria meningitidis
* Group B and C
* Increase in Group W since 2009
* Teenagers, university students

Haemophilus influenzae B (HiB)

How well did you know this?

Not at all

Perfectly

Describe what would indicate on a gram stain that have a Streptococcus pneumoniae infection? [1]

Diplococci (come in pairs)

How well did you know this?

Not at all

Perfectly

What are the three cocci gram +ve organsims need to know? [3]

Staphylococcus
Streptococcus
Enterococcus

How well did you know this?

Not at all

Perfectly

Which of the following causes “Pneumococcus”

Staphylococcus
Streptococcus
Enterococcus

Staphylococcus
Streptococcus
Enterococcus

How well did you know this?

Not at all

Perfectly

Explain three immune defects that could predispose an individual to an pneuomococcal infection [3]

HIV infection
Hypogammaglobulinaemia (low levels of IgG due to B cells not being able to mature)
Absent / non-functional spleen

How well did you know this?

Not at all

Perfectly

Give three reasons for an absent / non-functional spleen [3]

Congenital asplenia
Traumatic removal
Hyposplenism (eg sickle cell)

How well did you know this?

Not at all

Perfectly

Name 4 invasive features of Streptococcus pneumoniae infection

Meningitis
Sepsis
Osteomyelitis
Septic arthritis
Peritonitis
Lobar pneumonia
Empyema

How well did you know this?

Not at all

Perfectly

Name the two most common presentations of Pneumococcal pneumonia (Streptococcus pneumoniae) [2]

Lobar pneuomonia
Empyema (a serious complication characterized by pus and bacteria in the pleural)

How well did you know this?

Not at all

Perfectly

How would you manage empyema caused by pneuomococcal pneuomonia? [2]

Chest drain
Video-assisted thoracoscopic surgery (VATS)

How well did you know this?

Not at all

Perfectly

Name two rheumatological implications of pneuomococcal pneuomonia infection

Osteomyelitis (inflammation in a bone and bone marrow, usually caused by bacterial infection)

Septic arthritis

How well did you know this?

Not at all

Perfectly

Name the two vaccinations for Streptococcus pneumoniae [2] and how many serotypes they protect agaisnt [2]

Pneumococcal polysaccharide vaccine (PPV): Penuomax - covers 23 serotypes

Pneumococcal conjugate vaccine (PCV): Prevenar protects against 13 serotypes

How well did you know this?

Not at all

Perfectly

Meningococcal disease describes infections caused by the bacterium []

Meningococcal disease describes infections caused by the bacterium Neisseria meningitidis

How well did you know this?

Not at all

Perfectly

Which pathogen causes A? [1]

Corynebacterium dipetheria

How well did you know this?

Not at all

Perfectly

Which pathogen cauese this symptom? [1]

Neisseria meningitidis - septic patient

What is the most common cause of lobal pneumonia?

Streptococcus pneumoniae

What is the most common organism responsible for infective endocarditis?

Streptococcus bovis
Staphylococcus epidermis
Staphylococcus aureus
Streptococcus viridans

What is the most common organism responsible for infective endocarditis?

Streptococcus bovis
Staphylococcus epidermis
Staphylococcus aureus
Streptococcus viridans

A 6-year-old child presents to your clinic unwell with a fever and sore throat. Upon further history taking you discover he has not had any vaccinations. On examination, there is a grey-white coloured membrane covering his tonsils.

What is the most likely diagnosis?

Diphtheria
Mumps
Rubella
Measles
Scarlet Fever

What is the most likely diagnosis?

Diphtheria
Mumps
Rubella
Measles
Scarlet Fever

Which pathogen is most likely to have caused this symptom? Diphtheria Mumps Rubella Measles Scarlet Fever

Which pathogen is most likely to have caused this symptom? Diphtheria Mumps Rubella **Measles** Scarlet Fever

Which pathogen is most likely to have caused this symptom? Diphtheria Mumps Rubella Measles Scarlet Fever

Which pathogen is most likely to have caused this symptom? Diphtheria Mumps Rubella Measles **Scarlet Fever**

Which pathogens cause A & B? [2]

A: **measles** B: **scarlet fever**

Which pathogen is most likely to have caused this symptom? Diphtheria Mumps Rubella Measles Scarlet Fever

Which pathogen is most likely to have caused this symptom? Diphtheria Mumps Rubella Measles **Scarlet Fever** - looks a little bit like sunburn

Which pathogen is most likely to have caused this symptom? Diphtheria Mumps Rubella Measles Scarlet Fever

Which pathogen is most likely to have caused this symptom? Diphtheria Mumps Rubella Measles **Scarlet Fever** Scarlet fever: white strawberry tongue (left) and red strawberry tongue (right)

Which of types of malaria can lie dormant? [2]

F. vivax, F. ovale

What type of virus is enterovirus, Hep A & rotavirus? Enveloped RNA Envelopoed DNA Non-enveloped RNA Non-enveloped DNA

What type of virus is enterovirus, Hep A & rotavirus? Enveloped RNA Envelopoed DNA **Non-enveloped RNA** Non-enveloped DNA

Name this symptom [1] What causative agent is most likely to have caused this infection?

**Herpetic whitlow** Caused by HSV-1 (60% of cases, HSV-2 in 40%)

Name the most likely causative agent of this symptom [1]

**Epstein-Barr Virus** - causing **infectious mononucleosis** (glandular fever)

What causative agent is most likely to have caused this? [1]

Congenital CMV infection

Which pathogen is most likely to have caused this symptom? Diphtheria Mumps VZV Measles Scarlet Fever

Which pathogen is most likely to have caused this symptom? Diphtheria Mumps **VZV** Measles Scarlet Fever

What is this infection? [1] Name the two most likely causative agents? [1]

**Impetigo** Agents: **group A Streptococcus and Staphylococcus aureus**.

Label the causative agents of A-C

A: VZV B: Scarlet Fever C: Measles

Name the most likely causative agent of this symptom [1]

**Epstein-Barr Virus** - causing **infectious mononucleosis** (glandular fever)

Which is the most severe form of malaria? [1]

Plasmodium falciparum

Explain pathophysiology of malaria life cycle

Malaria is spread by mosquitoes Infected blood is sucked up by feeding **female Anopheles mosquito**. Malaria in the blood reproduces in the **gut of the mosquito** producing thousands of **sporozoites** (malaria spores). The mosquito bites another human or animal the **sporozoites are injected** by the mosquito. These **sporozoites travel to the liver** of the newly infected person **Sporozoites mature** in the **liver** into **merozoites** which enter the blood and **infect red blood cells.** merozoites reproduce **over 48 hours**, after which the red blood cells **rupture** releasing loads more **merozoites** into the blood and **causing a haemolytic anaemia**

What are severe consequences of malaria? [4]

* Haemolytic Anaemia * Respiratory distress * Cerebral malaria (coma, seizures) * Hypoglycaemia

Treatment for malaria? [3]

* **Artesunate**. * Combination treatment (eg Coartem: **artemether-lumefantrine** * **Quinine** **dihydrochloride**

What are the important enveloped RNA viruses need to know? [10]

Measles, mumps, rubella (MMR) RSV, influenza, parainfluenza SARS-CoV-2 Hepatitis C HIV | Often respiratory viruses

What are the important not-enveloped RNA viruses need to know? [3]

Rotavirus Enteroviruses (includes polio) Hepatitis A | All enteric viruses

What are the important enveloped DNA viruses need to know?

**Herpes viruses** * Herpes simplex * Varicella zoster * CMV * Epstein-Barr * HHV 6/7/8 **Hepatitis B** **Poxviruses** | Learn all lol

What are the non-enveloped DNA viruses need to know? [3]

Papillomavirus Adenovirus Parvovirus (ssDNA) PAPs

Explain the differences in the presentations of Herpes simplex in older children and adults [3] compared to very young children [2]

**Older children and adults**: relatively benign * Herpes labialis * Herpetic whitlow * Cold sore **Neonates**: causes perncious effects via two presentations: * **Disseminated HSV** * **HSV encephalitis**:

Treatment of congenital CMV? [2] How does it work agaisnt CMV [1] How long should treatment last? [1]

**IV ganciclovir** or **oral valganciclovir** (pro-drug) :**inhibits DNA synthesis** **6 months of treatment** reduces hearing loss and improves neurodevelopment

What are potential secondary bacterial infections of VZV? [1] Name a consequence of this secondary bacterial infection [1]

Strep. infection (specifically Strep A) Causes Necrotizing fasciitis

Name a virus that is usually asymptomatic in early life but is typically worse in 15-25 years old [1]

Epstein-Barr virus: **causes infectious mononucleosis** (glandular fever)

Which virus has differing chronicty depending on age at infection? [1]

Hep. B

How does Hepatitis B chronicity depend on age at infection?

Chronic HBV infection occurs in approximately 90% of newborns infected perinatally, 30% of children aged under 5 years, and <5% of immunocompetent adults.