Microbiology

Question 1

Are gram +ve usually rods or cocci?

Answer 1

Cocci

Question 2

Which bacteria are exceptions to +ve cocci (are positive rods) (2)?

Answer 2

• C. difficile
• Listeria

Question 3

Are gram -ve bacteria usually rods or cocci?

Answer 3

Rods

Question 4

What are some exceptions to gram -ve rods (are usually -ve diplococci) (2)?

Answer 4

• Neisseria (meningitidis/ gonorrhoea)

Question 5

How is staph aureus differentiated from other staphylococcus?

Answer 5

It is coagulase positive

Question 6

What are 4 aids defining illnesses?

Answer 6

• Pneumocystis jirovecii pneumonia
• CMV colitis
• Lymphoma
• Oral candida albicans

Question 7

What is a defining feature of CMV colitis?

Answer 7

Owl eye inclusion bodies

Question 8

What are the most common bacteria to cause meningitis in those aged over 3 months?

Answer 8

• S. Pneumoniae
• N. Meningitidis

Question 9

What bacteria most commonly cause meningitis in those under 3 months?

Answer 9

• Group B beta haemolytic strep
• E. coli
• Listeria

Question 10

Why is group B beta haemolytic strep common in neonates?

Answer 10

It colonises the vagina

Question 11

What is group B beta haemolytic strep?

Answer 11

S. agalactiae

Question 12

As well as neonates who else is often affected by listeria monocytogenes?

Answer 12

• Elderly
• Pregnant women (or men)
• HIV infected

Question 13

What bacteria often causes meningitis in infants but is becoming increasingly rare?

Answer 13

H. influenzae (more rare, due to vaccination)

Question 14

What viruses commonly cause meningitis (3)?

Answer 14

• Enteroviruses (coxackie, echovirus)
• HSV-2
• CMV

Question 15

Is viral or bacterial meningitis more common?

Answer 15

Viral

Question 16

How is suspected meningitis treated in GP?

Answer 16

IM benzylpenicilin

Question 17

How is meningitis treated in hospital?

Answer 17

• IV Ceftriaxone or cefotaxime
• IV dexomethasone

Question 18

How is close contacts of those with meningitis treated?

Answer 18

Single dose ciprofloxacin

Question 19

How soon do you have to notify PHE of a meningitis case?

Answer 19

IMMEDIATELY

Question 20

What rash is seen with N. meningitidis?

Answer 20

Non-blanching purpuric rash

Question 21

How is viral meningitis treated?

Answer 21

Acyclovir

Question 22

What is a hospital acquired pneumonia?

Answer 22

Pneumonia picked up/ symptoms >48 hours after admission

Question 23

What bacteria cause CAP?

Answer 23

• S. Pneumoniae = MC
• H. influenziae
• Mycoplasma Pneumoniae
• Legionella Pneumoniae

Question 24

What bacteria commonly cause HAP?

Answer 24

• P. aeruginosa
• E. coli
• Klebsiella pneumoniae
• MRSA

Question 25

What bacteria are atypical pneumonia?

Answer 25

* M. pneumoniae * Legionella pneumoniae * Chlamydia pneumoniae

Question 26

What virus cause pneumonia?

Answer 26

* Influenza A virus * CMV * SARS-COV-2

Question 27

What fungi cause pneumonia?

Answer 27

P. jirovecii

Question 28

How is pneumocystis pneumonia (caused by P. jirovecii) treated?

Answer 28

Co-trimoxazole

Question 29

How are CAP treated?

Answer 29

CURB-65 = * 2 or less then **amoxicillin** * 3 or more then **co-amoxiclav** + **clarythromycin**

Question 30

How are atypical pneumonia treated?

Answer 30

Clarythromycin (amoxicillin resistant)

Question 31

Which bacteria commonly cause infection in bronchiectasis and CF?

Answer 31

* S. aureus * H. Influenziae * P. aeruginosa

Question 32

Why is P. aeruginosa particularly problematic?

Answer 32

It is resistant to a lot of antibiotics (treat with ciprofloxacin)

Question 33

What causes TB?

Answer 33

* **M. tuberculosis** = MC * M. bovis *+ 2 others don't need to know*

Question 34

How is TB diagnosed?

Answer 34

Ziehl Neelsen stain = acid fast bacteria, stains bright red

Question 35

What organisms commonly cause cellulitis?

Answer 35

* Staph aureus * Strep A (s. Pyogenes)

Question 36

How is cellulitis treated?

Answer 36

Flucoxacillin

Question 37

How is MRSA treated?

Answer 37

Vancomycin

Question 38

What causes whooping cough?

Answer 38

Bordelia pertussis

Question 39

What bacteria causes UTIs?

Answer 39

* **K**lebsiella * **E**nterobacter * **E**. coli = MC (80%) * **P**roteus mirabilis * **S**. saprophyticus

Question 40

How are UTIs treated?

Answer 40

* Trimethoprim * Nitrofurantoin *3 days if simple*

Question 41

When can trimethoprim and nitrofurantoin not be used?

Answer 41

* Trimethoprim = not in 1st trimester as anti folate * Nitrofurantoin = not in 3rd trimester as increases risk of haemolytic disease of newborn

Question 42

What is sometimes used for UTIs in pregnant women?

Answer 42

Amoxicillin

Question 43

How is pyelonephritis treated?

Answer 43

* Co-amoxiclav * Cefalexin if preggo

Question 44

How is neisseria gonorrhoea treated?

Answer 44

* IM ceftriaxone

Question 45

How is chlamydia trachomatis treated?

Answer 45

Doxycycline *7 days*

Question 46

What bacteria cause infective endocarditis?

Answer 46

* Staph aureus (very common in IVDU) * Strep viridans (poor dental hygiene) * HACEK * Enterococci

Question 47

What fungi can cause IE?

Answer 47

Candida albicans

Question 48

How is Staph aureus IE treated?

Answer 48

Vancomycin + rifampicin

Question 49

How is strep viridans treated?

Answer 49

Benzylpenicillin + gentamicin

Question 50

What extra antibiotic is used for s. aureus infection if the patient has a prosthetic heart valve?

Answer 50

Gentamicin

Question 51

Which valve is more commonly affected by IE?

Answer 51

Overall **tricuspid** valve (in non IVDU it is mitral valve as bacteria less commonly staph aureus, so has come from lungs)

Question 52

What viruses cause diarrhoea in kids vs adults?

Answer 52

* Kids (under 3) = **rotavirus** * Adults = **norovirus**

Question 53

What are some bacterial causes of diarrhoea?

Answer 53

* Campylobacter jejuni = mc * E. coli * C. difficile * Salmonella * Shigella * Cholera

Question 54

What parasite can infect the gut?

Answer 54

Giardiasis

Question 55

How is campylobacter jejuni treated?

Answer 55

Azithromycin

Question 56

What often causes an infection with C. difficile?

Answer 56

Antibiotics

Question 57

How is C. diff treated?

Answer 57

Vancomycin

Question 58

How are the other bacteria causing diarrhoea treated (not C.diff or campylobacter jejuni)?

Answer 58

Co-amoxiclav

Question 59

What bacteria often cause appendicitis?

Answer 59

* E.coli * Klebsiella * Enterobacter * Enterococci

Question 60

What infection does c. diff sometimes cause in the gut?

Answer 60

Pseudomembranous colitis

Question 61

How is H. pylori treated?

Answer 61

* Omeprazole (or other PPI) * Clarythromycin * Amoxicillin

Question 62

What bacteria most commonly infects bones and joints?

Answer 62

Staph aureus

Question 63

What bacteria commonly infects bones in those with sickle cell disease?

Answer 63

Salmonella

Question 64

What bacteria commonly infects prosthetic joints?

Answer 64

Staph epidermidis

Question 65

What commonly causes reactive arthritis?

Answer 65

* Chlamydia * Intestinal (salmonella, shigella, campylobacter)

Question 66

What commonly causes GBS?

Answer 66

* C. jejuni = mc * CMV * EBV

Question 67

What commonly causes rheumatic fever?

Answer 67

Group A strep (strep Pyogenes)

Question 68

Which valve is most commonly affected by RHD?

Answer 68

Mitral valve

Question 69

How is sepsis treated?

Answer 69

* Piperacillin * Tazobactam