Micro BB qs Flashcards
(205 cards)
1
Q
A
2
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A. Shigella B. Hepatitis A C. Escherichia Coli D. Aeromonas E. Clostridium difficile F. Vibrio cholera G. Salmonella H. Entamoeba histolytica I. Yersinia This microbe is spread by faecal-oral route, and often occurs in epidemics. Shellfish from seawater contained by sewage can harbour this microbe.
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B.Hepatitis A
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A. Shigella B. Hepatitis A C. Escherichia Coli D. Aeromonas E. Clostridium difficile F. Vibrio cholera G. Salmonella H. Entamoeba histolytica I. Yersinia Gram-negative curved rod, whose toxin affects adenyl cyclase. Its major cause of death is shock, metabolic acidosis and renal failure
A
F. Vibrio cholera
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A. Shigella B. Hepatitis A C. Escherichia Coli D. Aeromonas E. Clostridium difficile F. Vibrio cholera G. Salmonella H. Entamoeba histolytica I. Yersinia This microbes affects mainly the distal colon, producing acute mucosal inflammation and erosion. It is spread by person-to-person contact, and its clinical features include fever, pain, diarrhoea and dysentery.
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A. Shigella
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A. Shigella B. Hepatitis A C. Escherichia Coli D. Aeromonas E. Clostridium difficile F. Vibrio cholera G. Salmonella H. Entamoeba histolytica I. Yersinia Infection with this microbe produces pseudomembranous colitis.
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E. C.Diff
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A. Shigella B. Hepatitis A C. Escherichia Coli D. Aeromonas E. Clostridium difficile F. Vibrio cholera G. Salmonella H. Entamoeba histolytica I. Yersinia This microbe affects the ileum, appendix and colon. Its peyer patch invasion leads to mesenteric lymph node enlargement with necrotising granulomas. Complication can include peritonitis, pharyngitis and pericarditis.
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I. Yersinia
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A. Cholera B. Tuberculosis of the gut C. Giardiasis D. Clostridium difficile E. Ulcerative colitis F. Stress G. Rotavirus H. Verotoxin-producing E.coli I. Bacillus cereus J. Salmonella K.Bacterial Dysentry A 40 year old female, who is a ex-smoker, who has recently returned from a holiday in India, comes to A+E complaining of severe abdominal cramps and bloody diarrhoea. She mentions that her mother suffered from similar symptoms in the past.
A
e. Ulcerative Colitis
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A. Cholera B. Tuberculosis of the gut C. Giardiasis D. Clostridium difficile E. Ulcerative colitis F. Stress G. Rotavirus H. Verotoxin-producing E.coli I. Bacillus cereus J. Salmonella K.Bacterial Dysentry A 25 year old male student woke up in the middle of the night with sudden vomiting. He has been vomiting for the past few hours. The night before, him and his flatmate had had a Chinese takeaway. He ate rice whilst his friend had noodles.
A
i. Bacillus Cereus
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A. Cholera B. Tuberculosis of the gut C. Giardiasis D. Clostridium difficile E. Ulcerative colitis F. Stress G. Rotavirus H. Verotoxin-producing E.coli I. Bacillus cereus J. Salmonella K.Bacterial Dysentry A 30 year old male is brought into hospital. He is very dehydrated and is feeling very weak. He has had unrelenting diarrhoea, which came on suddenly. He describes the stools as looking like rice water. He has no abdominal pain.
A
A. Cholera
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A. Cholera B. Tuberculosis of the gut C. Giardiasis D. Clostridium difficile E. Ulcerative colitis F. Stress G. Rotavirus H. Verotoxin-producing E.coli I. Bacillus cereus J. Salmonella K.Bacterial Dysentry A 70 year old male who has been in hospital for 3 weeks develops profuse, watery diarrhoea and he has a fever. There is sometimes blood in the stool. On a sigmoidoscopy, the bowel appeared inflamed. He has been taking amoxicillin
A
D. C.Diff
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A. Cholera B. Tuberculosis of the gut C. Giardiasis D. Clostridium difficile E. Ulcerative colitis F. Stress G. Rotavirus H. Verotoxin-producing E.coli I. Bacillus cereus J. Salmonella K.Bacterial Dysentry A 34 year old female returned from Indonesia two weeks ago. She complains of diarrhoea, abdominal pain, weight loss, nausea and vomiting for the past few days. She has no fever. Investigation reveals steatorrhoea and stools appear to contain numerous cysts.
A
C. Giardiasis
12
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A. Salmonella B. Laxative abuse C. Clostridium Difficile D. Vibrio Cholera E. Typhoid F. Entamoeba Histolytica G. Giardia Lamblia H. Yersinia Enterocolitica I. Taenia Saginata J. Taenia Solium K. E. coli L. Shigella M. Campylobacter Jejuni 80 year old man develops severe, foul smelling watery diarrhoea following treatment in hospital for a chest infection.
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C. C Diff
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A. Salmonella B. Laxative abuse C. Clostridium Difficile D. Vibrio Cholera E. Typhoid F. Entamoeba Histolytica G. Giardia Lamblia H. Yersinia Enterocolitica I. Taenia Saginata J. Taenia Solium K. E. coli L. Shigella M. Campylobacter Jejuni Following a trip to Brazil, a patient develops bloody diarrhoea, with a high fever, sweating and on examination the patient is found to have RUQ pain.
A
F. Entamoeba Histolytica
14
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A. Salmonella B. Laxative abuse C. Clostridium Difficile D. Vibrio Cholera E. Typhoid F. Entamoeba Histolytica G. Giardia Lamblia H. Yersinia Enterocolitica I. Taenia Saginata J. Taenia Solium K. E. coli L. Shigella M. Campylobacter Jejuni Following a barbeque, a 41 year old develops watery diarrhoea and vomiting. On retrospect, he wondered whether he should have had that dodgy looking shish kebab…
A
A. Salmonella
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A. Salmonella B. Laxative abuse C. Clostridium Difficile D. Vibrio Cholera E. Typhoid F. Entamoeba Histolytica G. Giardia Lamblia H. Yersinia Enterocolitica I. Taenia Saginata J. Taenia Solium K. E. coli L. Shigella M. Campylobacter Jejuni Whilst on a backpacking trip to India, a 30 year old develops severe watery diarrhoea, whilst clearly in discomfort, he notices it has the look of rice water.
A
D. Vibro Cholera
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A. Salmonella B. Laxative abuse C. Clostridium Difficile D. Vibrio Cholera E. Typhoid F. Entamoeba Histolytica G. Giardia Lamblia H. Yersinia Enterocolitica I. Taenia Saginata J. Taenia Solium K. E. coli L. Shigella M. Campylobacter Jejuni A 40 year old homosexual man develops severe flatulence, accompanied by bloating and explosive diarrhoea.
A
G. Giardia Lambila
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Q
A. Campylobacter B. Bacillus cereus C. Staphylococcus D. Shigella E. Salmonella F. Clostridium botulinum G. Rotavirus H. Escherichia coli I. Entamoeba histolytica
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E. Salmonella
18
Q
A. Campylobacter B. Bacillus cereus C. Staphylococcus D. Shigella E. Salmonella F. Clostridium botulinum G. Rotavirus H. Escherichia coli I. Entamoeba histolytica
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B. Bacillus Cereus
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A. Campylobacter B. Bacillus cereus C. Staphylococcus D. Shigella E. Salmonella F. Clostridium botulinum G. Rotavirus H. Escherichia coli I. Entamoeba histolytica
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C. Staphylococcus
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A. Campylobacter B. Bacillus cereus C. Staphylococcus D. Shigella E. Salmonella F. Clostridium botulinum G. Rotavirus H. Escherichia coli I. Entamoeba histolytica
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A. Campylobacter
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A. Campylobacter B. Bacillus cereus C. Staphylococcus D. Shigella E. Salmonella F. Clostridium botulinum G. Rotavirus H. Escherichia coli I. Entamoeba histolytica
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F. Clostridium Botulinum
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Q
A. Bacillus cereus B. E. coli C. Cholera D. C. difficile E. Salmonella F. Giardia lamblia G. Shigella H. Clostridium botulinum I. Staphylococcus aureus An organism commonly linked to antibiotic-associated diarrhoea
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D. C. Diff
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Q
A. Bacillus cereus B. E. coli C. Cholera D. C. difficile E. Salmonella F. Giardia lamblia G. Shigella H. Clostridium botulinum I. Staphylococcus aureus Different geographical populations of this organism often give rise to traveller’s diarrhoea
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B. E.Coli
24
Q
A. Bacillus cereus B. E. coli C. Cholera D. C. difficile E. Salmonella F. Giardia lamblia G. Shigella H. Clostridium botulinum I. Staphylococcus aureus A toxin-mediated organism that does not damage or invade the gastrointestinal epithelium
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C. Cholera
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A. Bacillus cereus B. E. coli C. Cholera D. C. difficile E. Salmonella F. Giardia lamblia G. Shigella H. Clostridium botulinum I. Staphylococcus aureus An organism linked with food poisoning from Chinese fried rice
A. Bacillus Cereus
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A. Bacillus cereus B. E. coli C. Cholera D. C. difficile E. Salmonella F. Giardia lamblia G. Shigella H. Clostridium botulinum I. Staphylococcus aureus An organism that gives rise to ‘rice water stools’ upon infection
C. Cholera
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A. Campylobacter jejuni B. Spirillum minus C. Yersinia pestis D. Cryptosporidium parvum E. Francisella tularensis F. Borrelia burgdorferi G. Bartonella henselae H. Rickettsia prowazekii I. Brucella abortus J. Trypanosoma cruzi Bubonic plague
C. Yersinia pestis
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A. Campylobacter jejuni B. Spirillum minus C. Yersinia pestis D. Cryptosporidium parvum E. Francisella tularensis F. Borrelia burgdorferi G. Bartonella henselae H. Rickettsia prowazekii I. Brucella abortus J. Trypanosoma cruzi A student who presented with two day history of bloody diarrhoea, vomiting, fever, headache and myalgia. He has just returned from camping in the country side near a farm where he had fresh cow’s milk for breakfast everyday.
A. Campylobacter jejuni
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A. Campylobacter jejuni B. Spirillum minus C. Yersinia pestis D. Cryptosporidium parvum E. Francisella tularensis F. Borrelia burgdorferi G. Bartonella henselae H. Rickettsia prowazekii I. Brucella abortus J. Trypanosoma cruzi A 2 year old boy living in the slums who has a one day history of profuse watery diarrhoea, fever and abdominal cramps. His family’s main source of water is the river near their squatters.
D. Cryptosporidium parvum
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A. Campylobacter jejuni B. Spirillum minus C. Yersinia pestis D. Cryptosporidium parvum E. Francisella tularensis F. Borrelia burgdorferi G. Bartonella henselae H. Rickettsia prowazekii I. Brucella abortus J. Trypanosoma cruzi A man was bitten by a rat in Asia. Ten days later he complains of fever, malaise, headache and myalgia.
B. Spirillum minus
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A. Campylobacter jejuni B. Spirillum minus C. Yersinia pestis D. Cryptosporidium parvum E. Francisella tularensis F. Borrelia burgdorferi G. Bartonella henselae H. Rickettsia prowazekii I. Brucella abortus J. Trypanosoma cruzi Cat-scratch disease
G. Bartonella henselae
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A. Rheumatic fever B. Brucellosis C. Listeriosis D. Meningococcal Septicaemia E. Tularaemia F. Leptospirosis G. Lyme disease A 6 month old baby is brought to A&E with sudden onset fever, vomiting and diminished conciousness. A widespread haemorrhagic rash is also observed which does not blanch upon application of pressure.
D. Meningococcal Septicaemia
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A. Rheumatic fever B. Brucellosis C. Listeriosis D. Meningococcal Septicaemia E. Tularaemia F. Leptospirosis G. Lyme disease A 10 year old boy of Middle-Eastern origin presents with general malaise and loss of appetite. He also complains of fever and joint pain. A throat swab is taken, revealing the presence of Group A Streptococci.
A. Rheumatic fever
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A. Rheumatic fever B. Brucellosis C. Listeriosis D. Meningococcal Septicaemia E. Tularaemia F. Leptospirosis G. Lyme disease A zoonosis associated with hepatitis, jaundice, conjunctival injection and renal impairment. Transmission normally occurs by direct contact with either the urine or tissues of an infected animal.
F. Leptospirosis
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A. Rheumatic fever B. Brucellosis C. Listeriosis D. Meningococcal Septicaemia E. Tularaemia F. Leptospirosis G. Lyme disease A 22 year old student, who returned from a holiday in the Mediterranean 3 weeks ago, presents with an undulant fever, malaise, weakness and generalized bone pain. Upon examination lymphadenopathy and hepatosplenomegaly are also noted.
B. Brucellosis
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A. Rheumatic fever B. Brucellosis C. Listeriosis D. Meningococcal Septicaemia E. Tularaemia F. Leptospirosis G. Lyme disease A 45 year old male farmer presents with a raised, erythematous rash, with clearing in the centre. He also complains of headache, fever, athralgia and malaise.
G. Lyme disease
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A. Rickettsia typhi B. Brucella abortus C. Leishmania major D. Leptospira interrogans E. Bacillus anthracis F. Rabies G. Yersinia pestis H. Borrelia burgdorferi I. Brucella melitesansis A 30 year man presented with jaundice and conjunctival haemorrhages. He had recently been canoeing in the US and had felt ‘run-down’ upon his return to the UK.
D.Leptospira interrogans
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A. Rickettsia typhi B. Brucella abortus C. Leishmania major D. Leptospira interrogans E. Bacillus anthracis F. Rabies G. Yersinia pestis H. Borrelia burgdorferi I. Brucella melitesansis A 25 year old Maltese man presented to his GP with lethargy for a month and headaches and fever. On examination, he had a temperature of 39°C and one fingerbreadth splenomegaly. Small Gram-negative coccobacilli were seen on culture in Casteneda’s medium.
I. Brucella melitensis
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A. Rickettsia typhi B. Brucella abortus C. Leishmania major D. Leptospira interrogans E. Bacillus anthracis F. Rabies G. Yersinia pestis H. Borrelia burgdorferi I. Brucella melitesansis A 22 year old student presented to her GP upon return from a biology field trip, with a lesion on her leg which was 3” in diameter and flat, with a red edge and dim centre. She also mentioned feeling tired and suffering from headaches. On examination, the GP noted a fever of 38.0°C and an irregular heartbeat.
H.Borrelia burgdorferi
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A. Rickettsia typhi B. Brucella abortus C. Leishmania major D. Leptospira interrogans E. Bacillus anthracis F. Rabies G. Yersinia pestis H. Borrelia burgdorferi I. Brucella melitesansis A tanner on holiday from India presented to hospital with an ulcerating papule on his hand. On inspection of the ulcer, the centre was black and necrotic. Gram-positive rods grew on blood agar culture and responded to treatment with large doses of penicillin.
E. Bacillus anthracis
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A. Rickettsia typhi B. Brucella abortus C. Leishmania major D. Leptospira interrogans E. Bacillus anthracis F. Rabies G. Yersinia pestis H. Borrelia burgdorferi I. Brucella melitesansis A 49 year old man was admitted in A&E with a 3 day history of worsening right arm pain and a 1 day history of dysphagia, hypersalivation, agitation and generalised muscle twitching. Vital signs and blood tests were normal but he became confused. He developed renal failure and died 4 days later.
F. Rabies
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A. Epidermophyton floccosum B. Cryptococcus neoforms C. Candida albicans D. Corynebacterium minutissimum E. Pneumocystis carinii F. Aspergillus flavus G. Trichophytum rubrum H. Pityrosporum orbiculare I. Histoplasmosis capsulatum A 6 month old baby presents at his GP with nappy rash. Which is the most likely causative fungus?
C. Candida albicans
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A. Epidermophyton floccosum B. Cryptococcus neoforms C. Candida albicans D. Corynebacterium minutissimum E. Pneumocystis carinii F. Aspergillus flavus G. Trichophytum rubrum H. Pityrosporum orbiculare I. Histoplasmosis capsulatum A 21 year old man presents at his GP complaining of an itchy, scaly rash on the soles of his feet. Skin scrapings are taken and sent away for microscopic examination. Which fungi might be identified?
G. Trichophyton rubrum
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A. Epidermophyton floccosum B. Cryptococcus neoforms C. Candida albicans D. Corynebacterium minutissimum E. Pneumocystis carinii F. Aspergillus flavus G. Trichophytum rubrum H. Pityrosporum orbiculare I. Histoplasmosis capsulatum A 55 year old farmer is seen in the Oncology clinic with a diagnosis of hepatocellular carcinoma. He is a lifelong teetotal and his virology has all been negative. Which fungus may have indirectly been a cause of his cancer?
F. Aspergillus flavus
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A. Epidermophyton floccosum B. Cryptococcus neoforms C. Candida albicans D. Corynebacterium minutissimum E. Pneumocystis carinii F. Aspergillus flavus G. Trichophytum rubrum H. Pityrosporum orbiculare I. Histoplasmosis capsulatum A 27 year old lady from Botswana presents at A+E complaining of a dry cough and feeling feverish. A chest x-ray is normal, but fine crackles were heard on auscultation. Serology shows a CD4+ count of 50 and she is admitted. Later a high resolution CT of the chest shows a ground glass appearance of the lungs. What AIDS defining infection does this lady have?
E. Pneumocystis carinii
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A. Epidermophyton floccosum B. Cryptococcus neoforms C. Candida albicans D. Corynebacterium minutissimum E. Pneumocystis carinii F. Aspergillus flavus G. Trichophytum rubrum H. Pityrosporum orbiculare I. Histoplasmosis capsulatum A 17 year old Nigerian girl presents at her GP with patches of hypopigmentation on her trunk. After an initial trial of steroid cream, the girl returns complaining that the rash is spreading. Woods lamp examination of the rash produces a yellow fluorescence. What is the causative fungus?
H. Pityrosporum orbiculare
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A. Blastomyosis B .Aspergillosis C. Sporotrichosis D. Tinea cruris E. Cryptococcis F. Chromomycosis G. Mycetoma (Madura foot) H. Zygomycosis I. Coccidiodomyosis J. Candidiasis K. Tinea corporis L. Tinea pedis M. Pediculosis capitis A 23 year old female on a camping holiday used the local rowing club showers nearby. A few days later she noticed an itchy sensation between some her toes. What is the most likely diagnosis?
L. Tinea pedis
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A. Blastomyosis B .Aspergillosis C. Sporotrichosis D. Tinea cruris E. Cryptococcis F. Chromomycosis G. Mycetoma (Madura foot) H. Zygomycosis I. Coccidiodomyosis J. Candidiasis K. Tinea corporis L. Tinea pedis M. Pediculosis capitis A homosexual male presented with painful dyspagia and was noted to have whitish velvety plaques on the mucous membranes of the mouth and tongue. When his GP scraped away the whitish material pinpoint bleeding occurred. What is the most likely diagnosis?
J. Candidiasis
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A. Blastomyosis B .Aspergillosis C. Sporotrichosis D. Tinea cruris E. Cryptococcis F. Chromomycosis G. Mycetoma (Madura foot) H. Zygomycosis I. Coccidiodomyosis J. Candidiasis K. Tinea corporis L. Tinea pedis M. Pediculosis capitis A fertile woman presents to her GP with an itchy vaginal discharge. What is the most likely diagnosis?
J. Candidiasis
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A. Blastomyosis B .Aspergillosis C. Sporotrichosis D. Tinea cruris E. Cryptococcis F. Chromomycosis G. Mycetoma (Madura foot) H. Zygomycosis I. Coccidiodomyosis J. Candidiasis K. Tinea corporis L. Tinea pedis M. Pediculosis capitis A 47 year old man is admitted following lung transplantation three months ago with cough and breathlessness. He has a cavitating lesion on chest X-ray. At the time of his transplant, building work was being done on the hospital campus in close proximity to the surgical ward.
B. Aspergillosis
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A. Blastomyosis B .Aspergillosis C. Sporotrichosis D. Tinea cruris E. Cryptococcis F. Chromomycosis G. Mycetoma (Madura foot) H. Zygomycosis I. Coccidiodomyosis J. Candidiasis K. Tinea corporis L. Tinea pedis M. Pediculosis capitis A 45 year old female whose main hobby was pigeon racing was noted by her GP to an enlarged lymph node in her neck. What is the most likely diagnosis?
E. Cryptococcus
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A. Tuberculous osteomyelitis B. Gonococcal arthritis C. Viral hepatitis D. Infectious mononucleosis E. Staphylococcal arthritis F. Staphylococcal osteomyelitis G. Tuberculous arthritis H. Brodie's abscess I. Candidiasis J. Rubella K. Lyme disease An 8 year-old boy presents to casualty with a painful and swollen right thigh after being kicked in a football match. On examination a boil is found on the upper part of his right thigh and blood cultures are positive.
F.Staphylococcal osteomyelitis
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A. Tuberculous osteomyelitis B. Gonococcal arthritis C. Viral hepatitis D. Infectious mononucleosis E. Staphylococcal arthritis F. Staphylococcal osteomyelitis G. Tuberculous arthritis H. Brodie's abscess I. Candidiasis J. Rubella K. Lyme disease A 24 year-old woman presents to A&E a month after a trip to the New Forest with malaise, a migratory erythematous rash, and arthralgia. She also complains of being more forgetful in recent times.
K. Lyme disease
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A. Tuberculous osteomyelitis B. Gonococcal arthritis C. Viral hepatitis D. Infectious mononucleosis E. Staphylococcal arthritis F. Staphylococcal osteomyelitis G. Tuberculous arthritis H. Brodie's abscess I. Candidiasis J. Rubella K. Lyme disease A 19 year-old student presents to her GP with a macular rash and suboccipital lymphadenopathy. She also complains of pain on moving her hands and wrists.
J. Rubella Causes of reactive arthritis: post VIRAL rubella hepatitis B parvovirus B19 post BACTERIAL (includes Reiter's syndrome, which can be post-dysentery or post-urethritis) dysentery: Shigella, Salmonella, Yersinia, Camplyobacter (Camylobacter can also be a precedent of Guillain-Barre urethritis: Chlamydia (note: obligate intracellular), Ureaplasma other: Group A Strep, Neisseria gonorrhoea, Brucella, TB (Poncet's disease) peri-infectious Borrelia burgdorferi (Lyme arthritis: tertiary Lyme disease - treatment doxy and amoxicillin) Rheumatic fever
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A. Tuberculous osteomyelitis B. Gonococcal arthritis C. Viral hepatitis D. Infectious mononucleosis E. Staphylococcal arthritis F. Staphylococcal osteomyelitis G. Tuberculous arthritis H. Brodie's abscess I. Candidiasis J. Rubella K. Lyme disease A diabetic 78 year-old man with chronic arthritis presents to A&E with an acutely painful and swollen knee 2 days after he had been given an intra-articular steroid injection.
E. Staphylococcal arthritis
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A. Tuberculous osteomyelitis B. Gonococcal arthritis C. Viral hepatitis D. Infectious mononucleosis E. Staphylococcal arthritis F. Staphylococcal osteomyelitis G. Tuberculous arthritis H. Brodie's abscess I. Candidiasis J. Rubella K. Lyme disease A 30 year-old man presents to casualty with a painful, swollen and erythematous left forearm one week after sustaining a compound fracture in a motorcycle accident.
F. Staphylococcal osteomyelitis The BOIL is the buzz-word in this question. A boil is a localised source of infection usually caused by Staph aureus. The infection may spread to the bone shaft = osteomyelitis. It's possible that the boil (source of bacteraemia) was present before the football match and the kick exacerbated an on-going process, but minor trauma may also dictate the site of infection. However it's important to note that osteomyelitis can be very acute and serious, especially in children. In children, the infection usually begins in the metaphysis of a long bone, often the proximal end of the femur. T he metaphyses are prone to infection because the blood is supplied by terminal branches of the nutrient arteries. Notably, the radiographs may be normal for the first 10 days or so....which is really important to remember when you come to do paeds and A&E.
57
A. Painful crisis B. Clutton's joints C. Pott's disease D. Septic arthritis E. Tuberculous osteomyelitis F. Staphylococcus osteomyelitis G. Lateral epicondylitis H. Salmonella osteomyelitis I. Leukaemia J. Paget's disease K. Osteoporosis L. Brodie's abscess A 35 year old lady with a history of TB presents with collapsed cervical vertebrae, a marked kyphosis causing difficulty in moving.
C.Pott's disease
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A. Painful crisis B. Clutton's joints C. Pott's disease D. Septic arthritis E. Tuberculous osteomyelitis F. Staphylococcus osteomyelitis G. Lateral epicondylitis H. Salmonella osteomyelitis I. Leukaemia J. Paget's disease K. Osteoporosis L. Brodie's abscess Mr PD, a 26 year old musician, arrives in A&E with a warm, painful abscess on his inner upper forearm surrounded by puncture marks, he has a low grade fever. He reports no problem in playing his guitar, but does forget lyrics on stage.
F.Staphylococcus osteomyelitis
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A. Painful crisis B. Clutton's joints C. Pott's disease D. Septic arthritis E. Tuberculous osteomyelitis F. Staphylococcus osteomyelitis G. Lateral epicondylitis H. Salmonella osteomyelitis I. Leukaemia J. Paget's disease K. Osteoporosis L. Brodie's abscess Accompanying Mr PD, is a 17 year old female with a larger, redder, painful abscess on her inner upper forearm. She has almost no movement in her elbow.
D.Septic arthritis
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A. Painful crisis B. Clutton's joints C. Pott's disease D. Septic arthritis E. Tuberculous osteomyelitis F. Staphylococcus osteomyelitis G. Lateral epicondylitis H. Salmonella osteomyelitis I. Leukaemia J. Paget's disease K. Osteoporosis L. Brodie's abscess Your Consultant spotlights you to expand on the diagnosis of osteomyelitis in a gentleman with a history of sickle cell crises, presenting with bone pain and excessive sweating. On X-ray he informs you there is “cortical destruction, involucrum and sequestra”.
H.Salmonella osteomyelitis
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A. Painful crisis B. Clutton's joints C. Pott's disease D. Septic arthritis E. Tuberculous osteomyelitis F. Staphylococcus osteomyelitis G. Lateral epicondylitis H. Salmonella osteomyelitis I. Leukaemia J. Paget's disease K. Osteoporosis L. Brodie's abscess A 10 year old boy presents with moderate pain in his lower leg, little redness and swelling, remitting for 6 months. His mother gives you the X-ray report from the previous episode, which showed “a well defined ovoid shape with a surrounding sclerotic margin but little involucrum in his tibia”.
L.Brodie's abscess
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A. Staphylococcus aureus B. Campylobacter jejuni C. Neisseria meningitides D. Clostridium difficile E. Haemophilus influenzae F. Salmonella typhi G. Escherichia coli H. Streptococcus pneumoniae A 19 year old student presents with a short history of severe headache and photophobia. O/E he has a non-blanching rash over his abdomen. CSF is performed and shows gram- negative cocci
C. Neisseria meningitides
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A. Staphylococcus aureus B. Campylobacter jejuni C. Neisseria meningitides D. Clostridium difficile E. Haemophilus influenzae F. Salmonella typhi G. Escherichia coli H. Streptococcus pneumoniae A 30 year old builder develops abdominal pain and diarrhoea 48 hours after having Texa Fried Chicken. Faecal culture shows motile, oxidase-positive colonies and gram stain shows gram-negative rods.
B. Campylobacter jejuni
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A. Staphylococcus aureus B. Campylobacter jejuni C. Neisseria meningitides D. Clostridium difficile E. Haemophilus influenzae F. Salmonella typhi G. Escherichia coli H. Streptococcus pneumoniae A homeless man presents to St Mary’s A&E with history of cough and shortness of breath. Chest X-Ray was performed and showed consolidation. Sputum cultures were taken and showed gram positive diplocci and neutrophilia.
H. Streptococcus pneumoniae
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A. Staphylococcus aureus B. Campylobacter jejuni C. Neisseria meningitides D. Clostridium difficile E. Haemophilus influenzae F. Salmonella typhi G. Escherichia coli H. Streptococcus pneumoniae A teenager develops a post-operative wound infection after a road traffic accident. Cultures show coagulase-positive golden yellow colonies and gram positive cocci
A. Staphylococcus aureus
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A. Staphylococcus aureus B. Campylobacter jejuni C. Neisseria meningitides D. Clostridium difficile E. Haemophilus influenzae F. Salmonella typhi G. Escherichia coli H. Streptococcus pneumoniae A 27 year old teacher presents with symptoms of dysuria of 3 days duration. MSU gram stain shows neutrophils, erythrocytes and gram negative bacilli
G. Escherichia coli
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A. Haemophilus influenzae B. Oral administration of flucloxacillin C. Heart valve replacement D. I. V. injection of tetanus antitoxin E. Airborne contamination F. Removal of a breast carcinoma G. Staphylococcal aureus H. Drainage and evacuation of pus I. Escherichia coli J. Oral administration with penicillin G K. Implantation of a prosthetic hip L. Streptococcus pneumoniae M. Oral administration of ampicillin A 37 year old woman is complaining of pain a tenderness surrounding a recently sutured wound on her forehead. On examination you notice erythema and minimal serous discharge. Which pathogen is the most likely cause of this infection?
G. Staphylococcal aureus
68
A. Haemophilus influenzae B. Oral administration of flucloxacillin C. Heart valve replacement D. I. V. injection of tetanus antitoxin E. Airborne contamination F. Removal of a breast carcinoma G. Staphylococcal aureus H. Drainage and evacuation of pus I. Escherichia coli J. Oral administration with penicillin G K. Implantation of a prosthetic hip L. Streptococcus pneumoniae M. Oral administration of ampicillin A 55 year old man comes into A&E complaining of a increasing difficulty in opening is mouth and that the muscles on his face occasionally spasm. On examination you observe that his eyes are partially closed and that the angles of his mouth are stretched outwards and slightly downwards. You also note that he has a very rigid abdomen. Which treatment option should be carried out first for this patient?
D. I. V. injection of tetanus antitoxin
69
A. Haemophilus influenzae B. Oral administration of flucloxacillin C. Heart valve replacement D. I. V. injection of tetanus antitoxin E. Airborne contamination F. Removal of a breast carcinoma G. Staphylococcal aureus H. Drainage and evacuation of pus I. Escherichia coli J. Oral administration with penicillin G K. Implantation of a prosthetic hip L. Streptococcus pneumoniae M. Oral administration of ampicillin Which of the above is an example where prophylactic systemic antibiotic therapy should not be used.
F. Removal of a breast carcinoma
70
A. Haemophilus influenzae B. Oral administration of flucloxacillin C. Heart valve replacement D. I. V. injection of tetanus antitoxin E. Airborne contamination F. Removal of a breast carcinoma G. Staphylococcal aureus H. Drainage and evacuation of pus I. Escherichia coli J. Oral administration with penicillin G K. Implantation of a prosthetic hip L. Streptococcus pneumoniae M. Oral administration of ampicillin Postoperative inspection of a wound in the left axilla reveals the presence of an abscess. What is the appropriate treatment to resolve the abcess
H.Drainage and evacuation of pus
71
A. Haemophilus influenzae B. Oral administration of flucloxacillin C. Heart valve replacement D. I. V. injection of tetanus antitoxin E. Airborne contamination F. Removal of a breast carcinoma G. Staphylococcal aureus H. Drainage and evacuation of pus I. Escherichia coli J. Oral administration with penicillin G K. Implantation of a prosthetic hip L. Streptococcus pneumoniae M. Oral administration of ampicillin A man is recovering from surgery and inspection of the wound reveals that it has become infected. A swab is taken and the laboratory results show Staphylococcal aureus infection. What is appropriate treatment for this man?
B.Oral administration of flucloxacillin
72
A. Epstein-Barr virus B. Brucellosis C. Hepatitis C D. Sarcoidosis E. Mycobacterium tuberculosis F. Hepatitis B G. Mycobacterium avium complex H. Plasmodium malariae I. Escherichia coli J. Hodgkin’s lymphoma K. Drug induced fever L. SLE M. Hepatitis A A 35 year old HIV positive male presents with fever lasting a few weeks, night sweats and appetite loss.
E. Mycobacterium tuberculosis
73
A. Epstein-Barr virus B. Brucellosis C. Hepatitis C D. Sarcoidosis E. Mycobacterium tuberculosis F. Hepatitis B G. Mycobacterium avium complex H. Plasmodium malariae I. Escherichia coli J. Hodgkin’s lymphoma K. Drug induced fever L. SLE M. Hepatitis A A 15 year old girl consults her GP after experiencing a high temperature and several headaches over the last three weeks. She has no medical history of note and has recently begun a weekend job helping at a local farm.
B. Brucellosis
74
A. Epstein-Barr virus B. Brucellosis C. Hepatitis C D. Sarcoidosis E. Mycobacterium tuberculosis F. Hepatitis B G. Mycobacterium avium complex H. Plasmodium malariae I. Escherichia coli J. Hodgkin’s lymphoma K. Drug induced fever L. SLE M. Hepatitis A A 55 year old female school teacher presents at A&E with a high fever three days after her return from India. On admission, her temperature chart shows an intermittent pyrexia every 72 hours (quartan fever)
H.Plasmodium malariae
75
A. Epstein-Barr virus B. Brucellosis C. Hepatitis C D. Sarcoidosis E. Mycobacterium tuberculosis F. Hepatitis B G. Mycobacterium avium complex H. Plasmodium malariae I. Escherichia coli J. Hodgkin’s lymphoma K. Drug induced fever L. SLE M. Hepatitis A An 80 year old man returns to his GP two weeks after being prescribed co-trimoxazole for a UTI. His urinary symptoms have now eased, but he is still experiencing a fever. His blood count shows eosinophilia.
K.Drug induced fever
76
A. Epstein-Barr virus B. Brucellosis C. Hepatitis C D. Sarcoidosis E. Mycobacterium tuberculosis F. Hepatitis B G. Mycobacterium avium complex H. Plasmodium malariae I. Escherichia coli J. Hodgkin’s lymphoma K. Drug induced fever L. SLE M. Hepatitis A A 40 year old female intravenous drug user presents at A&E with a mild ongoing fever, nausea and vomiting. Her partner mentions that she is a bit yellow.
F. Hepatitis B
77
A. Infectious Mononucleosis (EBV) B. Hepatitis A virus C. Hepatitis C virus D. Hepatitis Delta virus E. Cytomegalovirus F. Hepatitis E virus G. Transfusion-transmitted virus H. Hepatitis B virus I. Yellow fever A 32 yr old intravenous drug user (IDU) presents with pyrexia, fever, jaundice and hepatomegaly. Most likely cause?
H. Hepatitis B virus
78
A. Infectious Mononucleosis (EBV) B. Hepatitis A virus C. Hepatitis C virus D. Hepatitis Delta virus E. Cytomegalovirus F. Hepatitis E virus G. Transfusion-transmitted virus H. Hepatitis B virus I. Yellow fever 18 yr old female presents with pyrexia, jaundice and a history of lymphadenopathy and sore throat. Most likely cause?
A.Infectious Mononucleosis (EBV)
79
A. Infectious Mononucleosis (EBV) B. Hepatitis A virus C. Hepatitis C virus D. Hepatitis Delta virus E. Cytomegalovirus F. Hepatitis E virus G. Transfusion-transmitted virus H. Hepatitis B virus I. Yellow fever 10 and 8 yr old brothers present with mild illness and mild hepatomegaly without jaundice after a recent trip to Bangladesh. Most likely cause?
B. Hepatitis A virus
80
A. Infectious Mononucleosis (EBV) B. Hepatitis A virus C. Hepatitis C virus D. Hepatitis Delta virus E. Cytomegalovirus F. Hepatitis E virus G. Transfusion-transmitted virus H. Hepatitis B virus I. Yellow fever 40 yr old male presents with jaundice, fever, hepatomegaly, and a positive past history of HBV. Most likely cause?
D. Hepatitis Delta virus
81
A. Infectious Mononucleosis (EBV) B. Hepatitis A virus C. Hepatitis C virus D. Hepatitis Delta virus E. Cytomegalovirus F. Hepatitis E virus G. Transfusion-transmitted virus H. Hepatitis B virus I. Yellow fever 60 yr old female presents with liver cirrhosis. PMH- non IDU, tee-total, post partum haemhorrage requiring transfusion with first child (aged 25 yr old). Most likely cause?
C. Hepatitis C virus
82
A. Viral Meningitis B. Streptococcus Pneumoniae C. Glandular Fever D. Neiserria Meningitidis E. Mycobacterium Tuberculosis F. Viral Encephalitis G. Meningioma H. Migraine I. Subdural haemorrhage J. Cerebral Abscess A 33 year old lady presents with headache, malaise and fever. She has a widespread macular rash. A lumber puncture reveals a clear CSF with a high number of lymphocytes and a protein of 0.7g/L. CSF glucose is normal.
A. Viral Meningitis
83
A. Viral Meningitis B. Streptococcus Pneumoniae C. Glandular Fever D. Neiserria Meningitidis E. Mycobacterium Tuberculosis F. Viral Encephalitis G. Meningioma H. Migraine I. Subdural haemorrhage J. Cerebral Abscess A 20 year old male presents with a sore throat and headache. He has a maculopapular and petechial rash on his hands and feet. The CSF sample grows Gram negative diplococcus.
D. Neiserria Meningitidis
84
A. Viral Meningitis B. Streptococcus Pneumoniae C. Glandular Fever D. Neiserria Meningitidis E. Mycobacterium Tuberculosis F. Viral Encephalitis G. Meningioma H. Migraine I. Subdural haemorrhage J. Cerebral Abscess A 49 year old male presents with fever, vomiting and seizures. His WCC is increased. He recently had a dental infection. The MRI of his brain shows a ring-enhancing lesion.
J. Cerebral Abscess
85
A. Viral Meningitis B. Streptococcus Pneumoniae C. Glandular Fever D. Neiserria Meningitidis E. Mycobacterium Tuberculosis F. Viral Encephalitis G. Meningioma H. Migraine I. Subdural haemorrhage J. Cerebral Abscess A 25 year old lady is brought to A&E. She complained earlier of headaches. She has a fever and speech disturbance. She starts to lose consciousness.
F.Viral Encephalitis
86
A. Viral Meningitis B. Streptococcus Pneumoniae C. Glandular Fever D. Neiserria Meningitidis E. Mycobacterium Tuberculosis F. Viral Encephalitis G. Meningioma H. Migraine I. Subdural haemorrhage J. Cerebral Abscess A 40 year old man presents with haemoptysis, neck stiffness and photophobia. He has been feeling unwell for the past week. CSF was turbid with a high level of protein.
E. Mycobacterium Tuberculosis
87
A. Eschericha Coli B. Poliovirus C. Neisseria meningitis D. Subdural haemorrhage E. Meningioma F. Mycobacterium tuberculosis G. Migraine H. Subarachnoid haemorrhage I. Streptococcus pneumoniae J. Viral meningitis K. Haemophilus influenzae A 30 year old gentleman presents with headache, fever and general malaise. He reports no neck stiffness or photophobia. A lumbar puncture revealed clear CSF with no bacteria present, a high number of lymphocytes and protein of 0.75g/L. CSF glucose was within normal range.
J. Viral meningitis
88
A. Eschericha Coli B. Poliovirus C. Neisseria meningitis D. Subdural haemorrhage E. Meningioma F. Mycobacterium tuberculosis G. Migraine H. Subarachnoid haemorrhage I. Streptococcus pneumoniae J. Viral meningitis K. Haemophilus influenzae A 42 year old East African woman presents with haemoptysis and neck stiffness and photophobia and subsequent impairment of consciousness. On questioning it is revealed that she has been feeling unwell for a couple of weeks. CSF from a lumbar puncture was turbid with a high level of protein (2.3g/L).
F. Mycobacterium tuberculosis
89
A. Eschericha Coli B. Poliovirus C. Neisseria meningitis D. Subdural haemorrhage E. Meningioma F. Mycobacterium tuberculosis G. Migraine H. Subarachnoid haemorrhage I. Streptococcus pneumoniae J. Viral meningitis K. Haemophilus influenzae A 3 year old girl with incomplete vaccinations presents with insidious symptoms of meningism over the course of a couple of days. Blood culture revealed presence of Gram negative coccibacilli.
K. Haemophilus influenzae
90
A. Eschericha Coli B. Poliovirus C. Neisseria meningitis D. Subdural haemorrhage E. Meningioma F. Mycobacterium tuberculosis G. Migraine H. Subarachnoid haemorrhage I. Streptococcus pneumoniae J. Viral meningitis K. Haemophilus influenzae A 73 year old gentleman presents with high fever and neck stiffness of acute onset. A complete history reveals that he is recovering from a recurrent pneumonia.
I. Streptococcus pneumoniae
91
A. Eschericha Coli B. Poliovirus C. Neisseria meningitis D. Subdural haemorrhage E. Meningioma F. Mycobacterium tuberculosis G. Migraine H. Subarachnoid haemorrhage I. Streptococcus pneumoniae J. Viral meningitis K. Haemophilus influenzae An 18 year old student presents to his GP with a sore throat and headache. He also admitted to being more irritable recently. A complete examination revealed a mixed petechial and maculopapular rash on his extremities. CSF sample showed infection with a Gram negative diplococcus
C. Neisseria meningitis
92
A. Cerebral abscess B. TB meningitis C. Acute viral meningitis D. Acute leptomeningitis E. Prion disease (CJD) F. Viral encephalitis G. Toxoplasmosis H. Myelitis I. Polio J. Acute bacterial meningitis K. Encephalomyelitis L. Septicaemia A 24 yr old male is brought to A&E by his distressed girlfriend. They had just returned from a 2 week stay in Scotland when her boyfriend began to feel generally unwell. Since then he has become hyperactive and becomes uncontrollable when he sees or even hears water with jerky head and body movements. On examination he is severely dehydrated and you notice a small bite mark on his shoulder. You also notice ptyalism.
F. Viral encephalitis
93
A. Cerebral abscess B. TB meningitis C. Acute viral meningitis D. Acute leptomeningitis E. Prion disease (CJD) F. Viral encephalitis G. Toxoplasmosis H. Myelitis I. Polio J. Acute bacterial meningitis K. Encephalomyelitis L. Septicaemia A 56 yr old male presents with fever, vomiting and seizures. Examination reveals a well established ear infection and there is a ‘ring-enhancing’ lesion on the MRI of his brain.
A. Cerebral abscess The differential for a ring-enhancing lesion includes cerebral abscess, tuberculoma, toxoplasmosis and sometimes CNS lymphoma. The ring usually represents vasogenic oedema. In this case, all roads lead to cerebral abscess. You need to interpret the radiological findings within the clinical context. The 'well-established ear infection' should make you think of this as a primary source of infection, which can spread and cause the cerebral abscess. Additionally there is no history that would make you think of toxoplasmosis - such as the ingestion of raw / undercooked meats (more common in France), contact with cat faeces or immunocompromised states e.g. HIV
94
A. Cerebral abscess B. TB meningitis C. Acute viral meningitis D. Acute leptomeningitis E. Prion disease (CJD) F. Viral encephalitis G. Toxoplasmosis H. Myelitis I. Polio J. Acute bacterial meningitis K. Encephalomyelitis L. Septicaemia A 1 yr old child is brought into A&E by his mother. She has noticed he has a fever and is now becoming increasingly restless and will not stop screaming. He has a non-blanching rash on his thigh.
J. Acute bacterial meningitis
95
A. Cerebral abscess B. TB meningitis C. Acute viral meningitis D. Acute leptomeningitis E. Prion disease (CJD) F. Viral encephalitis G. Toxoplasmosis H. Myelitis I. Polio J. Acute bacterial meningitis K. Encephalomyelitis L. Septicaemia An 18 yr old student comes in feeling ‘pretty lousy and aching all over’. She is wearing dark glasses and complains of a stiff neck. CSF examination reveals a normal CSF/blood glucose ratio and 0.7 g/L protein with a lymphocyte count of 15
C. Acute viral meningitis
96
A. Cerebral abscess B. TB meningitis C. Acute viral meningitis D. Acute leptomeningitis E. Prion disease (CJD) F. Viral encephalitis G. Toxoplasmosis H. Myelitis I. Polio J. Acute bacterial meningitis K. Encephalomyelitis L. Septicaemia A 70 yr old man presents with his wife. She complains that he has become increasingly forgetful and now she is unable to understand what he says. On examination you notice some ataxia and sudden spasms of his muscles. An EEG shows periodic sharp waves.
E. Prion disease (CJD)
97
A. Tuberculosis B. Ceftazidime C. Escherichia coli D. Trimethoprim E. Staph saprophyticus F. Pseudomonas G. Adenovirus H. Nitrofurantoin I. Ceftriaxone J. Klebsiella K. Candida L. Ampicillin M. Staph epidermidis N. Ciprofloxacin O. Gentamicin P. Piperacillin The cause of infections which are particularly common in sexually active, young females
K. Candida
98
A. Tuberculosis B. Ceftazidime C. Escherichia coli D. Trimethoprim E. Staph saprophyticus F. Pseudomonas G. Adenovirus H. Nitrofurantoin I. Ceftriaxone J. Klebsiella K. Candida L. Ampicillin M. Staph epidermidis N. Ciprofloxacin O. Gentamicin P. Piperacillin Used as antimicrobial treatment of UTIs during the initial stages of pregnancy. Concentrated in the urine.
H.Nitrofurantoin
99
A. Tuberculosis B. Ceftazidime C. Escherichia coli D. Trimethoprim E. Staph saprophyticus F. Pseudomonas G. Adenovirus H. Nitrofurantoin I. Ceftriaxone J. Klebsiella K. Candida L. Ampicillin M. Staph epidermidis N. Ciprofloxacin O. Gentamicin P. Piperacillin These infections are almost invariably associated with functional or anatomical abnormalities of the renal tract. Tip: also causes cavitating pneumonia.
J. Klebsiella
100
A. Tuberculosis B. Ceftazidime C. Escherichia coli D. Trimethoprim E. Staph saprophyticus F. Pseudomonas G. Adenovirus H. Nitrofurantoin I. Ceftriaxone J. Klebsiella K. Candida L. Ampicillin M. Staph epidermidis N. Ciprofloxacin O. Gentamicin P. Piperacillin The most common cause of uncomplicated UTI in young women
C.Escherichia coli
101
A. Tuberculosis B. Ceftazidime C. Escherichia coli D. Trimethoprim E. Staph saprophyticus F. Pseudomonas G. Adenovirus H. Nitrofurantoin I. Ceftriaxone J. Klebsiella K. Candida L. Ampicillin M. Staph epidermidis N. Ciprofloxacin O. Gentamicin P. Piperacillin Broad spectrum penicillin traditionally used in the treatment of UTIs.
L. Ampicillin
102
A. Tuberculosis B. Ceftazidime C. Escherichia coli D. Trimethoprim E. Staph saprophyticus F. Pseudomonas G. Adenovirus H. Nitrofurantoin I. Ceftriaxone J. Klebsiella K. Candida L. Ampicillin M. Staph epidermidis N. Ciprofloxacin O. Gentamicin P. Piperacillin One of the 1st line drugs for UTIs in non pregnant women but contra-indicated in pregnant women
D. Trimethoprim
103
A. Tuberculosis B. Ceftazidime C. Escherichia coli D. Trimethoprim E. Staph saprophyticus F. Pseudomonas G. Adenovirus H. Nitrofurantoin I. Ceftriaxone J. Klebsiella K. Candida L. Ampicillin M. Staph epidermidis N. Ciprofloxacin O. Gentamicin P. Piperacillin The most common cause of UTI in catheterized men
C. Escherichia coli E coli is the commonest cause of UTI in all patient groups. A similar trick question is to ask what is the commonest cause of vomiting blood in an alcoholic on a Friday night binge. The ans would be duodenal ulcer, NOT variceal bleed. For separate notes, see attached file.
104
A. Tuberculosis B. Ceftazidime C. Escherichia coli D. Trimethoprim E. Staph saprophyticus F. Pseudomonas G. Adenovirus H. Nitrofurantoin I. Ceftriaxone J. Klebsiella K. Candida L. Ampicillin M. Staph epidermidis N. Ciprofloxacin O. Gentamicin P. Piperacillin The 2nd commonest cause of uncomplicated UTI in young women
E.Staph saprophyticus
105
A. Tuberculosis B. Ceftazidime C. Escherichia coli D. Trimethoprim E. Staph saprophyticus F. Pseudomonas G. Adenovirus H. Nitrofurantoin I. Ceftriaxone J. Klebsiella K. Candida L. Ampicillin M. Staph epidermidis N. Ciprofloxacin O. Gentamicin P. Piperacillin Can be used as monotherapy for acute pyelonephritis and should always be prescribed orally because its bioavailability is near 100% and iv dosing is 30 times more expensive.
N. Ciprofloxacin
106
A. Tuberculosis B. Ceftazidime C. Escherichia coli D. Trimethoprim E. Staph saprophyticus F. Pseudomonas G. Adenovirus H. Nitrofurantoin I. Ceftriaxone J. Klebsiella K. Candida L. Ampicillin M. Staph epidermidis N. Ciprofloxacin O. Gentamicin P. Piperacillin Causes haemorrhagic cystitis in children.
G. Adenovirus
107
A. Tuberculosis B. Ceftazidime C. Escherichia coli D. Trimethoprim E. Staph saprophyticus F. Pseudomonas G. Adenovirus H. Nitrofurantoin I. Ceftriaxone J. Klebsiella K. Candida L. Ampicillin M. Staph epidermidis N. Ciprofloxacin O. Gentamicin P. Piperacillin A cephalosporin used for treating pseudomonal infections in cystic fibrosis
B. Ceftazidime
108
A. Tuberculosis B. Ceftazidime C. Escherichia coli D. Trimethoprim E. Staph saprophyticus F. Pseudomonas G. Adenovirus H. Nitrofurantoin I. Ceftriaxone J. Klebsiella K. Candida L. Ampicillin M. Staph epidermidis N. Ciprofloxacin O. Gentamicin P. Piperacillin In combination with iv ampicillin, this drug is used iv for very sick patients with obstructed infected upper UTIs and gram negative septicaemia.
O. Gentamicin
109
A. Tuberculosis B. Ceftazidime C. Escherichia coli D. Trimethoprim E. Staph saprophyticus F. Pseudomonas G. Adenovirus H. Nitrofurantoin I. Ceftriaxone J. Klebsiella K. Candida L. Ampicillin M. Staph epidermidis N. Ciprofloxacin O. Gentamicin P. Piperacillin Given IM as a single shot for gonococcal urethritis
I. Ceftriaxone
110
A. Acute Prostatitis B. Papillary Necrosis from Analgaesic Overdose C. Calculi D. Cystitis E. Intrarenal Abscess F. Polycystic Kidney G. Perinephric Abscess H. Acute Pyelonephritis I. Urethral Syndrome J. Inadequately treated UTI K. Bladder Tumour L. Interstitial Nephritis M. Renal Tuberculosis A 40-year-old Indian male presents to A&E with dysuria and back pain. He has recently noticed blood in his urine and his past medical history reveals that he has had hypertension for 5 years. After some initial reluctance, he admits to having HIV, which was diagnosed on his arrival in the UK 7 years previously.
M. Renal Tuberculosis
111
A. Acute Prostatitis B. Papillary Necrosis from Analgaesic Overdose C. Calculi D. Cystitis E. Intrarenal Abscess F. Polycystic Kidney G. Perinephric Abscess H. Acute Pyelonephritis I. Urethral Syndrome J. Inadequately treated UTI K. Bladder Tumour L. Interstitial Nephritis M. Renal Tuberculosis A 27-year-old Caucasian female, who is 7 months pregnant, presents to A&E with a 2 day history of vomiting, rigors and loin pain. On examination, she is found to be pyrexic (39oC). Urine dipstick indicates the presence of leucocytes, nitrite, proteinuria and haematuria.
H. Acute Pyelonephritis
112
A. Acute Prostatitis B. Papillary Necrosis from Analgaesic Overdose C. Calculi D. Cystitis E. Intrarenal Abscess F. Polycystic Kidney G. Perinephric Abscess H. Acute Pyelonephritis I. Urethral Syndrome J. Inadequately treated UTI K. Bladder Tumour L. Interstitial Nephritis M. Renal Tuberculosis A 23-year-old Caucasian women presents to her GP with urinary frequency, urgency and burning. She also complained of slow stream as well as suprapubic pain. She has had several UTIs in the past and analysis of her urine showed no significant bacteruria
I. Urethral Syndrome
113
A. Acute Prostatitis B. Papillary Necrosis from Analgaesic Overdose C. Calculi D. Cystitis E. Intrarenal Abscess F. Polycystic Kidney G. Perinephric Abscess H. Acute Pyelonephritis I. Urethral Syndrome J. Inadequately treated UTI K. Bladder Tumour L. Interstitial Nephritis M. Renal Tuberculosis A 50-year-old Caucasian male presents to his GP with sudden onset of painless, frank haematuria. He reports that the blood is of a deep red colour and has been treated for numerous UTIs in the past 6 months. He is a smoker, who admits to smoking 20 cigarettes/day since he was 18.
K. Bladder Tumour It is VERY important that you recognise the presentation of bladder cancer, which is usually PAINLESS frank haematuria, whereas stones generally cause PAINFUL haematuria.
114
A. Acute Prostatitis B. Papillary Necrosis from Analgaesic Overdose C. Calculi D. Cystitis E. Intrarenal Abscess F. Polycystic Kidney G. Perinephric Abscess H. Acute Pyelonephritis I. Urethral Syndrome J. Inadequately treated UTI K. Bladder Tumour L. Interstitial Nephritis M. Renal Tuberculosis A 42-year-old African American male presents to A&E with severe loin pain that radiates to the groin. He complains of painful urination, interrupted flow and increased urinary frequency. Urine dipstick reveals the presence of leucocytes, nitrites, haematuria and proteinuria. Intravenous uretogram shows a filling defect of the right kidney.
C. Calculi
115
A. Viral cystitis B. Urethral syndrome C. Acute bacterial cystitis D. Fungal cystitis E. Relapse of UTI F. Weber's syndrome G. Schistosomiasis of the bladder H. Pulmonary tuberculosis I. Abacterial cystitis J. Non-infective cystitis K. Eosinophilic cystitis L. Recurrent UTI M. Renal tuberculosis N. Bacterial prostatitis A 30 year old previously healthy lady presents to her GP complaining of urinary frequency and dysuria for the preceding three days. She uses diaphragm contraception. She is afebrile and has no loin pain, although she has suprapubic tenderness. Microscopy and culture revealed 3 x 105 Escherichia Coli per ml urine.
C. Acute bacterial cystitis
116
A. Viral cystitis B. Urethral syndrome C. Acute bacterial cystitis D. Fungal cystitis E. Relapse of UTI F. Weber's syndrome G. Schistosomiasis of the bladder H. Pulmonary tuberculosis I. Abacterial cystitis J. Non-infective cystitis K. Eosinophilic cystitis L. Recurrent UTI M. Renal tuberculosis N. Bacterial prostatitis
N. Bacterial prostatitis
117
A. Viral cystitis B. Urethral syndrome C. Acute bacterial cystitis D. Fungal cystitis E. Relapse of UTI F. Weber's syndrome G. Schistosomiasis of the bladder H. Pulmonary tuberculosis I. Abacterial cystitis J. Non-infective cystitis K. Eosinophilic cystitis L. Recurrent UTI M. Renal tuberculosis N. Bacterial prostatitis
E. Relapse of UTI
118
A. Viral cystitis B. Urethral syndrome C. Acute bacterial cystitis D. Fungal cystitis E. Relapse of UTI F. Weber's syndrome G. Schistosomiasis of the bladder H. Pulmonary tuberculosis I. Abacterial cystitis J. Non-infective cystitis K. Eosinophilic cystitis L. Recurrent UTI M. Renal tuberculosis N. Bacterial prostatitis
G. Schistosomiasis of the bladder
119
A. Viral cystitis B. Urethral syndrome C. Acute bacterial cystitis D. Fungal cystitis E. Relapse of UTI F. Weber's syndrome G. Schistosomiasis of the bladder H. Pulmonary tuberculosis I. Abacterial cystitis J. Non-infective cystitis K. Eosinophilic cystitis L. Recurrent UTI M. Renal tuberculosis N. Bacterial prostatitis
M. Renal tuberculosis
120
A. Aspergillus Fumigatis B. MRSA C. Endocarditis D. Legionella E. Pneumocystis pneumonia F. Cef. & Met. 6hrs before incision & for 2 days post-surgery G. Serotyping H. Cef. & Met. 0-2hrs before incision & no longer than 24 hrs post-surgery I. Staphylococcus aureus J. Hand hygiene K. Eschericia coli L. Clostridium difficile M. Amphotericin B
1
121
1
1
122
1
1
123
1
1
124
1
1
125
A. Aspergillus Fumigatis B. Hepatitis C C. Legionella D. Toxoplasma gondi E. Staph. aureus F. Clostridium difficile G. Endocarditis H. Amphotericin B I. Burkholderia cepacia J. MRSA K. Urinary Tract Infection L. Salmonella M. Pneumocystis pneumonia
1
126
1
1
127
1
1
128
1
1
129
1
1
130
A. Streptococcus Group A B. Pseudomonas aeruginosa C. Herpes Simplex, Type 1 D. Vancomycin-resistant enterococcus(VRE) E. Bacillus subtilis F. Salmonella enteridis G. Streptococcus viridans H. Rotavirus I. Respiratory syncytial virus J. Methicillin-resistant S. aureus (MRSA) K. Klebsiella pneumoniae
1
131
1
1
132
1
1
133
1
1
134
1
1
135
A. Legionalla B. Pneumocystis carinii C. Escherichia coli D. Clostridium difficile E. Rotavirus F. Bacillus cereus G. Klebsiella pneumoniae H. Streptococcus viridans I. Staphylococcus epidermidis J. Cryptococcus neoformans K. Vancomycin resistant enterococcus L. Aspergillus M. Pseudomonas aeruginosa N. Methicillin resistant Staphylococcus aereus O. Staphylococcus aureus
1
136
1
1
137
1
1
138
1
1
139
A. Non-gonococcal urethritis B. Chlamydiae Trachomatis C. Chancroid D. HIV E. Chlamidiae Psittacosis F. Disseminated gonococcal infection G. HSV type 2 H. Gonococcal conjunctivitis I. Gonorrhoea-associated salpingitis J. Chlamidiae Pneumoniae K. Syphilis L. Lymphogranuloma venereum
1
140
1
1
141
1
1
142
1
1
143
1
1
144
A. Cidofovir B. Ribavirin C. Nevirapine D. Interferon-b (beta) E. Neuraminidase inhibitor F. Aciclovir triphosphate G. Foscarnet H. Interferon-α (alpha) I. Ganciclovir J. Zidovudine K. Entecevir L. Interferon-g (gamma) M. Oseltamivir N. Aciclovir monophosphate O. Aciclovir The antiviral which is given to untreated pregnant women with HIV to prevent vertical transmission of the virus during childbirth.
C. Nevirapine
145
A. Cidofovir B. Ribavirin C. Nevirapine D. Interferon-b (beta) E. Neuraminidase inhibitor F. Aciclovir triphosphate G. Foscarnet H. Interferon-α (alpha) I. Ganciclovir J. Zidovudine K. Entecevir L. Interferon-g (gamma) M. Oseltamivir N. Aciclovir monophosphate O. Aciclovir An immunomodulatory therapy used in the treatment of hepatitis B
H. Interferon-α (alpha)
146
A. Cidofovir B. Ribavirin C. Nevirapine D. Interferon-b (beta) E. Neuraminidase inhibitor F. Aciclovir triphosphate G. Foscarnet H. Interferon-α (alpha) I. Ganciclovir J. Zidovudine K. Entecevir L. Interferon-g (gamma) M. Oseltamivir N. Aciclovir monophosphate O. Aciclovir An antiviral currently used to prevent and treat Influenza in the elderly and which has the potential to be used to prevent Avian influenza.
M. Oseltamivir
147
A. Cidofovir B. Ribavirin C. Nevirapine D. Interferon-b (beta) E. Neuraminidase inhibitor F. Aciclovir triphosphate G. Foscarnet H. Interferon-α (alpha) I. Ganciclovir J. Zidovudine K. Entecevir L. Interferon-g (gamma) M. Oseltamivir N. Aciclovir monophosphate O. Aciclovir The final metabolite of the antiviral used to treat Herpes Simplex
F. Aciclovir triphosphate
148
A. Cidofovir B. Ribavirin C. Nevirapine D. Interferon-b (beta) E. Neuraminidase inhibitor F. Aciclovir triphosphate G. Foscarnet H. Interferon-α (alpha) I. Ganciclovir J. Zidovudine K. Entecevir L. Interferon-g (gamma) M. Oseltamivir N. Aciclovir monophosphate O. Aciclovir An antiviral which can be used in aerosol form to prevent respiratory syncytial virus in children with heart and lung disease
B. Ribavirin
149
A. Aciclovir monophosphate B. Ribavarin C. Thymidine D. AIDS E. Guanosine F. Aciclovir triphosphate G. Cytomegalovirus H. Aciclovir diphosphate I. Varicella-zoster virus J. Famciclovir K. Influenza Which option is the product of the action of viral tyrosine kinase on aciclovir?
A. Aciclovir monophosphate
150
A. Aciclovir monophosphate B. Ribavarin C. Thymidine D. AIDS E. Guanosine F. Aciclovir triphosphate G. Cytomegalovirus H. Aciclovir diphosphate I. Varicella-zoster virus J. Famciclovir K. Influenza Which option inhibits the action of viral DNA polymerase?
F. Aciclovir triphosphate
151
A. Aciclovir monophosphate B. Ribavarin C. Thymidine D. AIDS E. Guanosine F. Aciclovir triphosphate G. Cytomegalovirus H. Aciclovir diphosphate I. Varicella-zoster virus J. Famciclovir K. Influenza The synthetic nucleoside analogue ganciclovir is the drug of choice against which infective virus?
G. Cytomegalovirus
152
A. Aciclovir monophosphate B. Ribavarin C. Thymidine D. AIDS E. Guanosine F. Aciclovir triphosphate G. Cytomegalovirus H. Aciclovir diphosphate I. Varicella-zoster virus J. Famciclovir K. Influenza Ribavirin, a synthetic nucleoside that acts as an RNA polymerase inhibitor, is similar in structure to which of the options given above?
E. Guanosine
153
A. Aciclovir monophosphate B. Ribavarin C. Thymidine D. AIDS E. Guanosine F. Aciclovir triphosphate G. Cytomegalovirus H. Aciclovir diphosphate I. Varicella-zoster virus J. Famciclovir K. Influenza Valaciclovir, a prodrug of aciclovir, is used to treat patients with which viral disease in the list, above?
I. Varicella-zoster virus
154
A. Foscarnet B. Citalapram C. Aciclovir D. Doxacyclin E. Ribavarin F. Interferon G. Loviride H. Adefovir I. Ibuprofen J. Abacavir K. Amantadine L. Gancyclovir M. Zidovudine An immunomodulator effective in HBV infection
F. Interferon
155
A. Foscarnet B. Citalapram C. Aciclovir D. Doxacyclin E. Ribavarin F. Interferon G. Loviride H. Adefovir I. Ibuprofen J. Abacavir K. Amantadine L. Gancyclovir M. Zidovudine Used for the treatment of severe, resistant herpes infections
A. Foscarnet
156
A. Foscarnet B. Citalapram C. Aciclovir D. Doxacyclin E. Ribavarin F. Interferon G. Loviride H. Adefovir I. Ibuprofen J. Abacavir K. Amantadine L. Gancyclovir M. Zidovudine The treatment of choice for CMV-induced hepatitis
L. Gancyclovir
157
A. Foscarnet B. Citalapram C. Aciclovir D. Doxacyclin E. Ribavarin F. Interferon G. Loviride H. Adefovir I. Ibuprofen J. Abacavir K. Amantadine L. Gancyclovir M. Zidovudine A drug that is effective against influenza A but not influenza B
K. Amantadine
158
A. Foscarnet B. Citalapram C. Aciclovir D. Doxacyclin E. Ribavarin F. Interferon G. Loviride H. Adefovir I. Ibuprofen J. Abacavir K. Amantadine L. Gancyclovir M. Zidovudine A purine nucleoside analogue that selects specifically for thymidine kinase
C. Aciclovir
159
A. Efavirenz B. Interferon C. Aciclovir D. Human specific immunoglobulin E. Amantadine F. Indinavir G. Zanamivir H. Ribavarin I. Nevirapine J. Zidovudine K. Enfuvirtide L. Ganciclovir M. Human normal immunoglobulin A nucleoside analogue which inhibits reverse transcriptase
J. Zidovudine
160
A. Efavirenz B. Interferon C. Aciclovir D. Human specific immunoglobulin E. Amantadine F. Indinavir G. Zanamivir H. Ribavarin I. Nevirapine J. Zidovudine K. Enfuvirtide L. Ganciclovir M. Human normal immunoglobulin The drug mechanisms which acts by stopping post-translational cleaving of polyproteins by inhibiting proteases
F. Indinavir
161
A. Efavirenz B. Interferon C. Aciclovir D. Human specific immunoglobulin E. Amantadine F. Indinavir G. Zanamivir H. Ribavarin I. Nevirapine J. Zidovudine K. Enfuvirtide L. Ganciclovir M. Human normal immunoglobulin The drug that is selectively toxic to virally infected cells through its selective phosphorylation using viral thymidine kinase
C. Aciclovir
162
A. Efavirenz B. Interferon C. Aciclovir D. Human specific immunoglobulin E. Amantadine F. Indinavir G. Zanamivir H. Ribavarin I. Nevirapine J. Zidovudine K. Enfuvirtide L. Ganciclovir M. Human normal immunoglobulin The drug which can be delivered by inhalation to treat both influenza A and B.
G. Zanamivir
163
A. Efavirenz B. Interferon C. Aciclovir D. Human specific immunoglobulin E. Amantadine F. Indinavir G. Zanamivir H. Ribavarin I. Nevirapine J. Zidovudine K. Enfuvirtide L. Ganciclovir M. Human normal immunoglobulin The drug which works by attenuating or preventing rabies or hepatitis, following a known exposure but before the onset of signs and symptoms.
D. Human specific immunoglobulin
164
A. M. tuberculosis B. P. aeuruginosa C. C. neoformans D.(none) E. M. pneumoniae F. S. aureus G. C. psittaci H. S. pneumoniae I. L. pneumophila J. K. pneumoniae K. B. pertussis A 40yr old female non-smoker presents with a one week history of fever, shortness of breath and a cough productive of rusty coloured sputum. She complains of a sharp chest pain which “catches” her on inspiration. On examination she has increased vocal resonance in the right middle zone on auscultation. The x-ray shows right middle lobe consolidation.
H. S. pneumoniae
165
A. M. tuberculosis B. P. aeuruginosa C. C. neoformans D.(none) E. M. pneumoniae F. S. aureus G. C. psittaci H. S. pneumoniae I. L. pneumophila J. K. pneumoniae K. B. pertussis A 37yr old American business man staying in a hotel presents with a headache, myalgia and a dry cough. He is also suffering with nausea, diarrhoea and abdominal pain. On examination he is tachypnoeic and has a pyrexia of 39ºC. Blood tests reveal lymphopenia and hyponatraemia.
I. L. pneumophila
166
A. M. tuberculosis B. P. aeuruginosa C. C. neoformans D.(none) E. M. pneumoniae F. S. aureus G. C. psittaci H. S. pneumoniae I. L. pneumophila J. K. pneumoniae K. B. pertussis A 19yr old medical student who lives in residential halls presents with a one week history of headache, malaise, shortness of breath and a cough. Her WBC is not raised but tests reveal the presence of cold agglutinins.
E. M. pneumoniae
167
A. M. tuberculosis B. P. aeuruginosa C. C. neoformans D.(none) E. M. pneumoniae F. S. aureus G. C. psittaci H. S. pneumoniae I. L. pneumophila J. K. pneumoniae K. B. pertussis A 30yr old lady presents with a three week history of tiredness, malaise, cough and weight loss. She feels her condition has worsened in the past week and she now also suffers from a fever and haemoptysis. In addition she complains of a “tender lump” in her supraclavicular region. Chest x-ray demonstrates nodular shadowing of the right upper zone.
A. M. tuberculosis
168
A. M. tuberculosis B. P. aeuruginosa C. C. neoformans D.(none) E. M. pneumoniae F. S. aureus G. C. psittaci H. S. pneumoniae I. L. pneumophila J. K. pneumoniae K. B. pertussis A forty year old ornithologist presents with malaise, muscular pains and a cough. On examination he has a fever and several distinctive rose spots on his abdomen. Chest x-ray reveals a diffuse pneumonia.
G. C. psittaci
169
A. M. tuberculosis B. P. aeuruginosa C. C. neoformans D.(none) E. M. pneumoniae F. S. aureus G. C. psittaci H. S. pneumoniae I. L. pneumophila J. K. pneumoniae K. B. pertussis Dry cough, new infiltrates on CXR, dyspnoea and target shaped lesions on the palms. No recent history of herpes.
E. M. pneumoniae
170
A. Chlamydia pneumoniae B. PCP/ P jiroveci C. MSSA or MRSA D. Burkholderia cepacia E. H. influenzae F. Legionella pneumophila G. MRSA H. M. Catarrhalis I. Chlamydia psittaci J. M tuberculosis K. S. pneumoniae L. MSSA M. Anaerobic infection An 80 year old clown appears at the GP having been discharged from hospital for a complicated bowel resection with a stint in the ITU. He has a cough and fever and is prescribed a macrolide antibiotic because he is penicillin allergic.
L. MSSA
171
A. Chlamydia pneumoniae B. PCP/ P jiroveci C. MSSA or MRSA D. Burkholderia cepacia E. H. influenzae F. Legionella pneumophila G. MRSA H. M. Catarrhalis I. Chlamydia psittaci J. M tuberculosis K. S. pneumoniae L. MSSA M. Anaerobic infection A 55 year old female clown, recovering from a cold, is found to have a cavitating lesion on CXR and a productive cough.
C. MSSA or MRSA
172
A. Chlamydia pneumoniae B. PCP/ P jiroveci C. MSSA or MRSA D. Burkholderia cepacia E. H. influenzae F. Legionella pneumophila G. MRSA H. M. Catarrhalis I. Chlamydia psittaci J. M tuberculosis K. S. pneumoniae L. MSSA M. Anaerobic infection An 18 year old trainee clown is being seen in the cystic fibrosis clinic and is found to be colonised with a particularly persistent organism.
D. Burkholderia cepacia
173
A. Chlamydia pneumoniae B. PCP/ P jiroveci C. MSSA or MRSA D. Burkholderia cepacia E. H. influenzae F. Legionella pneumophila G. MRSA H. M. Catarrhalis I. Chlamydia psittaci J. M tuberculosis K. S. pneumoniae L. MSSA M. Anaerobic infection A 40 year old clown specialist is found to have a lobar pneumonia which on culture grew Gram +ve diplococci.
K. S. pneumoniae
174
A. Chlamydia pneumoniae B. PCP/ P jiroveci C. MSSA or MRSA D. Burkholderia cepacia E. H. influenzae F. Legionella pneumophila G. MRSA H. M. Catarrhalis I. Chlamydia psittaci J. M tuberculosis K. S. pneumoniae L. MSSA M. Anaerobic infection A 35 year old clown who is a specialist in bird/clown comedy is found to have an atypical pneumonia which is treated with Augmentin and Clarythromicin
I. Chlamydia psittaci
175
A.HHV 6 B.Chicken Pox C.Glandular fever D.Shingles E.HHV 7 F.Roseola infantum G.Primary Genital Herpes H.Keratitis I.Herpes Labialis (Cold sores) J.Cytomegaloviruses K.Burkitt's lymphoma 5 year old boy comes to the GP and shows you small pustules over his face, scalp and trunk, which have progressed from small macules in a matter of hours. The previous day he had a fever, headache and malaise but has now subsided. Virology showed the presence of Varicella Zoster Virus.
B.Chicken Pox
176
A.HHV 6 B.Chicken Pox C.Glandular fever D.Shingles E.HHV 7 F.Roseola infantum G.Primary Genital Herpes H.Keratitis I.Herpes Labialis (Cold sores) J.Cytomegaloviruses K.Burkitt's lymphoma A 25 year old man with a latex allergy comes into GUM clinic with small grouped vesicles and papules on the shaft and glans of his penis. This was accompanied with severe pain in his groin, buttocks and upper thighs, a fever, and dysuria. Virology showed the presence of an alpha herpesvirus, HHV 2.
G.Primary Genital Herpes
177
A.HHV 6 B.Chicken Pox C.Glandular fever D.Shingles E.HHV 7 F.Roseola infantum G.Primary Genital Herpes H.Keratitis I.Herpes Labialis (Cold sores) J.Cytomegaloviruses K.Burkitt's lymphoma A 21 year old man came to hospital complaining of severe headache, fever, malaise and a sore throat. On examination he showed cervical lymphadenopathy, especially the posterior cervical nodes, and splenomegaly. Peripheral blood tests showed the presence of lymphocytosis with atypical mononuclear cells. The Paul Bunnell reaction was positive for heterophilic antibodies.
C.Glandular fever
178
A.HHV 6 B.Chicken Pox C.Glandular fever D.Shingles E.HHV 7 F.Roseola infantum G.Primary Genital Herpes H.Keratitis I.Herpes Labialis (Cold sores) J.Cytomegaloviruses K.Burkitt's lymphoma 67 year old man comes to A+E with lesions on the skin, that have a localised unilateral pattern that is concentrated in a dermatomal organisation. The previous days the patient complained of extreme pain in the same area. Virology the presence of Varicella Zoster virus.
D.Shingles
179
A.HHV 6 B.Chicken Pox C.Glandular fever D.Shingles E.HHV 7 F.Roseola infantum G.Primary Genital Herpes H.Keratitis I.Herpes Labialis (Cold sores) J.Cytomegaloviruses K.Burkitt's lymphoma On your elective in central Africa a 7 year old child comes to your clinic with a large mass on his jaw. You take a biopsy of the lump, which shows EBV positive large cell lymphoma B cells. Histology shows a starry sky appearance (isolated histiocytes on a background of abnormal lymphoblasts). Genetic testing shows the presence of a 14q/8q translocation. The consultant suggests treating with cyclophosphamide and a single dose leads to a spectacular remission.
K.Burkitt's lymphoma
180
A. Infectious Mononucleosis B. Infection associated with Kaposi’s sarcoma C. Exanthem Subitum D. Primary stomatitis E. Neonatal Infection associated with vaginal delivery F. Herpangina G. Shingles H. Pneumonitis I. Measles J. Mumps K. Rubella Herpes Simplex Type 1
D. Primary stomatitis
181
A. Infectious Mononucleosis B. Infection associated with Kaposi’s sarcoma C. Exanthem Subitum D. Primary stomatitis E. Neonatal Infection associated with vaginal delivery F. Herpangina G. Shingles H. Pneumonitis I. Measles J. Mumps K. Rubella Cytomegalovirus
H. Pneumonitis
182
A. Infectious Mononucleosis B. Infection associated with Kaposi’s sarcoma C. Exanthem Subitum D. Primary stomatitis E. Neonatal Infection associated with vaginal delivery F. Herpangina G. Shingles H. Pneumonitis I. Measles J. Mumps K. Rubella Herpes Simplex Type 2
E. Neonatal Infection associated with vaginal delivery
183
A. Infectious Mononucleosis B. Infection associated with Kaposi’s sarcoma C. Exanthem Subitum D. Primary stomatitis E. Neonatal Infection associated with vaginal delivery F. Herpangina G. Shingles H. Pneumonitis I. Measles J. Mumps K. Rubella Human Herpes Virus 8
B. Infection associated with Kaposi’s sarcoma
184
A. Infectious Mononucleosis B. Infection associated with Kaposi’s sarcoma C. Exanthem Subitum D. Primary stomatitis E. Neonatal Infection associated with vaginal delivery F. Herpangina G. Shingles H. Pneumonitis I. Measles J. Mumps K. Rubella Human Herpes virus 6
C. Exanthem Subitum
185
A. Herpes simplex virus type 2 (alpha) B. Human herpes virus 7 C. Herpes simplex virus type 1 (alpha) D. Cytomegalovirus (beta) E. Varicella zoster virus (alpha) F. Human herpes virus 8 (gamma) G. Human herpes virus 6 (beta) H. Epstein-Barr virus (gamma) I. HIV Pneumonitis after a bone marrow transplant
D. Cytomegalovirus (beta)
186
A. Herpes simplex virus type 2 (alpha) B. Human herpes virus 7 C. Herpes simplex virus type 1 (alpha) D. Cytomegalovirus (beta) E. Varicella zoster virus (alpha) F. Human herpes virus 8 (gamma) G. Human herpes virus 6 (beta) H. Epstein-Barr virus (gamma) I. HIV Endemic Burkitt's lymphoma
H. Epstein-Barr virus (gamma)
187
A. Herpes simplex virus type 2 (alpha) B. Human herpes virus 7 C. Herpes simplex virus type 1 (alpha) D. Cytomegalovirus (beta) E. Varicella zoster virus (alpha) F. Human herpes virus 8 (gamma) G. Human herpes virus 6 (beta) H. Epstein-Barr virus (gamma) I. HIV Roseola infantum
G. Human herpes virus 6 (beta)
188
A. Herpes simplex virus type 2 (alpha) B. Human herpes virus 7 C. Herpes simplex virus type 1 (alpha) D. Cytomegalovirus (beta) E. Varicella zoster virus (alpha) F. Human herpes virus 8 (gamma) G. Human herpes virus 6 (beta) H. Epstein-Barr virus (gamma) I. HIV Blistering rash in dermatomal distribution
E. Varicella zoster virus (alpha)
189
A. Herpes simplex virus type 2 (alpha) B. Human herpes virus 7 C. Herpes simplex virus type 1 (alpha) D. Cytomegalovirus (beta) E. Varicella zoster virus (alpha) F. Human herpes virus 8 (gamma) G. Human herpes virus 6 (beta) H. Epstein-Barr virus (gamma) I. HIV Acute necrotising encephalitis
C. Herpes simplex virus type 1 (alpha)
190
A. CD8 B. Viral load (PCR) C. Candidiasis D. Reverse transcriptase E. CD25 F. Hairy leukoplakia G. CCR5/CXCR4 H. CD4 I. Integrase J. Kaposi's sarcoma K. Gp120 L. Anti-HIV antibody (Western blot) M. MIP-1alpha A 43-year-old man with a known history of HIV presents to his doctor with creamy plaques coating his tongue and oral cavity. His symptoms subside after treatment with fluconazole.
C. Candidiasis
191
A. CD8 B. Viral load (PCR) C. Candidiasis D. Reverse transcriptase E. CD25 F. Hairy leukoplakia G. CCR5/CXCR4 H. CD4 I. Integrase J. Kaposi's sarcoma K. Gp120 L. Anti-HIV antibody (Western blot) M. MIP-1alpha A 37-year-old woman with a past history of intravenous drug use presents to her GP for her methadone prescription. On examination they note pale rigid lesions on the side of her tongue. Alongside her methadone the GP prescribes aciclovir.
F. Hairy leukoplakia
192
A. CD8 B. Viral load (PCR) C. Candidiasis D. Reverse transcriptase E. CD25 F. Hairy leukoplakia G. CCR5/CXCR4 H. CD4 I. Integrase J. Kaposi's sarcoma K. Gp120 L. Anti-HIV antibody (Western blot) M. MIP-1alpha In addition to CD4+ T-lymphocyte counts, HIV monitoring is typically assessed through which measurement?
B. Viral load (PCR)
193
A. CD8 B. Viral load (PCR) C. Candidiasis D. Reverse transcriptase E. CD25 F. Hairy leukoplakia G. CCR5/CXCR4 H. CD4 I. Integrase J. Kaposi's sarcoma K. Gp120 L. Anti-HIV antibody (Western blot) M. MIP-1alpha Which of the above is a naturally occurring cytokine that is able to inhibit HIV fusion to CD4+ T-lymphocytes?
M. MIP-1alpha
194
A. CD8 B. Viral load (PCR) C. Candidiasis D. Reverse transcriptase E. CD25 F. Hairy leukoplakia G. CCR5/CXCR4 H. CD4 I. Integrase J. Kaposi's sarcoma K. Gp120 L. Anti-HIV antibody (Western blot) M. MIP-1alpha Which viral protein is responsible for the binding or fusion of HIV to human CD4+ T-lymphocytes?
K. Gp120
195
A. Measles B. BCG C. Pertussis D. Rabies E. Diptheria F. Meningococcal G. MMR H. Tetanus I. Influenza J. Hepatitis B K. Varicella-Zoster Vaccine given at 12 – 18 months to prevent otitis media, parotitis, and cataracts in patients.
G. MMR
196
A. Measles B. BCG C. Pertussis D. Rabies E. Diptheria F. Meningococcal G. MMR H. Tetanus I. Influenza J. Hepatitis B K. Varicella-Zoster An immunocompromised HIV positive patient should not receive this vaccine.
B. BCG
197
A. Measles B. BCG C. Pertussis D. Rabies E. Diptheria F. Meningococcal G. MMR H. Tetanus I. Influenza J. Hepatitis B K. Varicella-Zoster Haemophiliacs and patients in receipt of regular blood transfusions should be vaccinated against this virus.
J. Hepatitis B
198
A. Measles B. BCG C. Pertussis D. Rabies E. Diptheria F. Meningococcal G. MMR H. Tetanus I. Influenza J. Hepatitis B K. Varicella-Zoster Toxoid given as part of ‘triple’ vaccine during first year of life to prevent cardinal features of the disease: muscle spasms and rigidity.
H. Tetanus
199
A. Measles B. BCG C. Pertussis D. Rabies E. Diptheria F. Meningococcal G. MMR H. Tetanus I. Influenza J. Hepatitis B K. Varicella-Zoster Vaccine recommended for high risk patients with chronic respiratory diseases, but contraindicated in patients hypersensitive to eggs.
I. Influenza
200
A. Vancomycin B. Benzyl Penicillin C. Metronidazole D. Flucloxacillin E. Erthyromycin F. Ceftriaxone G. Gentamicin H. Ciprofloxacin I. Linezolid 75 year old female has been diagnosed with MRSA bacteraemia secondary to an infected leg ulcer.
A. Vancomycin
201
A. Vancomycin B. Benzyl Penicillin C. Metronidazole D. Flucloxacillin E. Erthyromycin F. Ceftriaxone G. Gentamicin H. Ciprofloxacin I. Linezolid Treatment of an 18 year old with Meningitis.
F. Ceftriaxone
202
A. Vancomycin B. Benzyl Penicillin C. Metronidazole D. Flucloxacillin E. Erthyromycin F. Ceftriaxone G. Gentamicin H. Ciprofloxacin I. Linezolid 35 year old household wife presents with an infected insect bite. In the past she has been treated with Penicillin and responded with facial swelling and acute shortness of breath.
E. Erthyromycin
203
A. Vancomycin B. Benzyl Penicillin C. Metronidazole D. Flucloxacillin E. Erthyromycin F. Ceftriaxone G. Gentamicin H. Ciprofloxacin I. Linezolid Patient with an abdominal collection that contains gram –ve anaerobes.
C. Metronidazole
204
A. Vancomycin B. Benzyl Penicillin C. Metronidazole D. Flucloxacillin E. Erthyromycin F. Ceftriaxone G. Gentamicin H. Ciprofloxacin I. Linezolid 56 year old male with endocarditis caused by VRE.
I. Linezolid
205
A. Penicillin V B. Flucloxacillin C. Metronidazole D. Linezolid E. Gentamicin F. Trimethoprim G. Ciprofloxacin H. Erythromycin I. Vancomycin J. Cefuroxime K. Rifampacin Community-acquired UTI
F. Trimethoprim
