Infectious disease

Question 1

What are the categories bacteria can fall in to

Answer 1

Aerobic and anaerobic
Gram positive and negative

Question 2

Define aerobic and anaerobic bacteria

Answer 2

Aerobic bacteria require oxygen to respire. Anaerobic do not.

Question 3

Define gram positive and gram negative bacteria

Answer 3

Gram positive bacteria have a thick peptidoglycan cell wall that stains with crystal violet stain.
Gram negative bacteria do not have this thick wall and don’t satin violet.

Question 4

Examples of gram positive cocci

Answer 4

Staphylococcus
Streptococcus
Enterococcus

Question 5

Examples of gram positive rods

Answer 5

Corney Mike’s list of basic cars
Corneybacteria
Mycobateria
Listeria
Bacillus
Nocardia

Question 6

Examples of Gram positive anaerobes

Answer 6

CLAP
Clostridium
Lactobacillus
Actinomyces
Propionibacterium

Question 7

Examples of gram negative bacteria

Answer 7

Most of them
Neisseria meningitis
Neidderia gonorrhoea
Haemophilia influenza
E. coli
Klebsiella
Pseudomonas aeruginosa
Moraxella catarrhalis

Question 8

Define atypical bacterria

Answer 8

Bacteria that cannot be cultures or detected using gram staining.

Question 9

Examples of atypical bacteria

Answer 9

Legions of psittaci MCQs
Legionella pneuophila
Chlamydia psittaci
Mycoplasma pneumoniae
Chlamydydophila pneumoniae
Q fever (coxiella burneti)

Question 10

Define MRSA

Answer 10

Methicillin resistant staphylococcus aureus
Bacteria that have become resistant to beta-lactam antibiotics such as penicillin’s, cephalosporins and carbapenems.

Question 11

Antibiotic treatment options for MRSA

Answer 11

Doxy
Clindamycin
Vancomycin
Teicoplanin
Linezolid

Question 12

Define ESBLs

Answer 12

Extended spectrum beta lactamase bacteria
Bacteria that have developed resistance to beta-lactam antibiotics as they produce beta-lactamase enzymes that destroy it.

Question 13

Abx options for ESBLs

Answer 13

Carbapenems - meropenem or imipenem

Question 14

What are the main types of antibiotic

Answer 14

Bacteriostatic
Bacteriocidal

Question 15

Define bacteriostatic

Answer 15

Abx that stop the reproduction and growth of bacteria

Question 16

Define bacteriocidal

Answer 16

Abx that kill the bacteria directly.

Question 17

Examples of antibiotics that inhibit cell wall synthesis

Answer 17

Beta-lactams - Penicillin, carbapenems (meropenem), cephaosporins ()
Not beta-lactams - Vancomycin, teicoplanin

Question 18

Examples of antibiotics that inhibit folic acid metabolism

Answer 18

Trimethoprim
Sulfamethoxaole
Co-trimoxazole

Question 19

What is the action of metronidazole

Answer 19

Nucleic acid synthesis inhibition - effective against anaerobes

Question 20

Examples of antibiotics that inhibit protein synthesis by targeting ribosomes

Answer 20

Macrolides - erythromycin, clarithromycin, azithromycin
Clindamycin
Tetracyclines - Doxycycline
Gentamicin
Chloramphenicol

Question 21

What other classes of abx can penicillin allergic patients not have

Answer 21

Cephalosporins
Carbapenems

Question 22

Common causes of pneimonia

Answer 22

Streptococcus pneumonia - 50%
Haemophilus influenzae - 20%

Question 23

Antibiotics of choice in pneumonia

Answer 23

Amoxicillin

Erythromycin/clarithromycin
Doxycycline

Atypicals - macrolides (clarithromycin), quinolones (levofloxacin), tetracyclines (doxy)

Question 24

Most common causes of UTI

Answer 24

E. coli!

Question 25

Antibiotics of choice in UTI

Answer 25

Trimethoprim Nitrofurantoin Pivmecilinam Amoxicillin Cefalexin

Question 26

Define cellulitis

Answer 26

Infection of the skin and soft tissue underneath.

Question 27

Presentation of cellulitis

Answer 27

Erythema Red Hot Swollen Tense Oedematous Bullae - fluid filled blisters Golden yellow crust - can indicate staph aureus

Question 28

Most common causes of cellulitis

Answer 28

Staphylococcus aureus Group A STREPTOCOCCIS Group C Sterptococcus (MRSA)

Question 29

Most common causes of cellulitis

Answer 29

Staphylococcus aureus Group A STREPTOCOCCIS Group C Sterptococcus (MRSA)

Question 30

Antibiotics of choice in cellulitis

Answer 30

Flucloxacillin Clarithromycin Clindamycin Co-amoxiclav

Question 31

Who should get influenza vaccine

Answer 31

Aged >65 Young children Pregnant women Chronic health conditions - asthma, COPD, HF, Diabetes Healthcare workers and carers

Question 32

Most common cause of bacterial meningitis

Answer 32

Neisseria meningitidis (meningococcus) Streptococcus pneumoniae (pneumococcus) Neonates - Group B strep

Question 33

Management of bacterial meningitis in the community

Answer 33

IM benzylpenicillin <1 year - 300mg 1-9 years - 600mg >10 years - 1200mg Send to hospital!

Question 34

Management of bacterial meningitis in hospital

Answer 34

<3 months - cefotaxime plus amoxicillin >3 months - ceftriaxone Steroids reduce the frequency of hearing loss - dexamethasone

Question 35

What should close contacts of bacterial meningitis receive

Answer 35

Post exposure prophylaxis - prolonged contact within prior 7 days Single doe ciprofloxacin

Question 36

Most common cause of viral meningitis

Answer 36

Herpes simplex virus Entero virus Varicella zoster virus

Question 37

What would the CSF sample show in bacterial meningitis

Answer 37

Appearance - cloudy Protein - high Glucose - low WCC - High (neuts) Culture - bacterial growth

Question 38

What would the CSF sample show in viral meningitis

Answer 38

Appearance - clear Protein - mildly raised or normal Glucose - normal WCC - high (lymphocytes) Culture - negative

Question 39

What colour does mycobacterium tuberculosis turn under what stain.

Answer 39

Bright red un Zeihl-Neelsen stain

Question 40

What test can be used to identify previous immune response to TB

Answer 40

Mantoux test

Question 41

Management of acute pulmonary TB

Answer 41

RIPE Rifampicin - 6 months Isoniazid - 6 months Pyrazinamide - 2 months Ethambutol - 2 months

Question 42

What should be additionally prescribed alongside isoniazid

Answer 42

Pyridoxine - vit B6 Causes peripheral neuropathy

Question 43

Side effects of rifampacin

Answer 43

Changes colour of secretions red P450 induce!

Question 44

Side effects of isoniazid

Answer 44

Peripheral neuropathy - pyridoxine

Question 45

Side effects of pyrazinamide

Answer 45

Hyperuricaemia - gout!

Question 46

Side effects of ethambutol

Answer 46

Colour blindness and reduced visual acuity

Question 47

Define HIv

Answer 47

Human immunodeficiency virus

Question 48

Define AIDS

Answer 48

Acquired immunodeficiency syndrome

Question 49

Examples of AIDS defining illnesses

Answer 49

Associated with end stage HIV - low CD4 count allows atypical infection Kaposi's sarcoma Pneumocystis jirovecii penumonia Cytomegalovirus infection Candidiasis Lymphomas Tuberculosis

Question 50

Examples of AIDS defining illnesses

Answer 50

Associated with end stage HIV - low CD4 count allows atypical infection Kaposi's sarcoma Pneumocystis jirovecii penumonia Cytomegalovirus infection Candidiasis Lymphomas Tuberculosis

Question 51

Examples of AIDS defining illnesses

Answer 51

Associated with end stage HIV - low CD4 count allows atypical infection Kaposi's sarcoma Pneumocystis jirovecii penumonia Cytomegalovirus infection Candidiasis Lymphomas Tuberculosis

Question 52

Management of HIV

Answer 52

Highly active anti-retrovirus therapy (HAART) Protease inhibitors Integrase inhibitors Nucleoside reverse transcriptase inhibitors Non-nucleoside reverse transcriptase inhibitors Entry inhibitors

Question 53

When can PEP be started

Answer 53

Less than 72 hours post exposure

Question 54

Most common cause of malaria

Answer 54

Plasmodium falciparum - also most sever