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Flashcards in Microbiology Deck (48):
1

"Normal" vaginal flora (4)

Lactobacillus
+/- strep viridans
+/- group B strep
+/- candida

2

Diagnostic features of bacterial vaginosis (3)

Thin, fishy-smelling vaginal discharge
Raised vaginal pH
Clue cells (epithelial cells covered with bacilli)

3

What is Hay-Ison scoring?

Estimate of the proportions of clue cells to epithelial and lactobacilli

4

Cause of acute bacterial prostatitis (2)

Complication of UTI (E.coli usually)
STI in patients younger than 35

5

Difference in cell wall between Gram negative and Gram positive cells

Gram positive cells retain the purple dye because they have more peptidoglycan

6

Empirical treatment of
a) chlamydia
b) gononorrhoea

a) azithromycin 1g stat
b) azithromycin 1g stat + ceftriazome IM

7

Samples for diagnosis of chlamydia and gonorrhoea (4)

Male- first-pass urine
Female- Vulvo-vaginal swab
Rectal swabs
Throat swabs

8

Testing for syphilis (2)

PCR swab of lesions
Serology for specific and non-specific antibodies

9

Non-specific test that can be used for monitoring response to syphilis therapy

VDRL

10

Screening test for syphilis in Tayside

Combined IgM and IgG ELISA on clotted blood sample

11

Cause of genital warts

HPV, mainly serotypes 6 and 11

12

Treatment of pubic lice

Malathion lotion

13

Manifestations of chlamydyial transmission to neonate (2)

Conjunctivitis
Pneumonia

14

Microsocopic appearance of gonorrheoa

Gram negative diplococci

15

Signs of secondary syphilis (4)

Skin rashes (particularly palms + soles)
Mucous membrane lesions
Generalized lymphadenopathy
Condylomata lata

16

Pseudomonas sp. are...

strict aerobes

17

Clostridium sp. are...

strict anaerobes

18

Normal flora of the bowel

Small gut- small numbers of coliforms and anaerobes
Colon- large numbers of coliforms, anaerobes and enterococcus faecalis

19

Antibiotic treatment of intra-abdominal sepsis (and the targets of the drugs)

Gentamicin (coliforms)
Metronidazole (anaerobes)
Enterococcus (amoxicillin)

20

Potential causes of peritonitis (4)

Perforated:
tumour
appendix
diverticulum
duodenal ulcer

21

Why do large abscesses need drainage?

Because they lack blood supply, therefore antibiotics can't penetrate

22

What is sepsis?

The systemic inflammatory response to infection; SIRS with a presumed or confirmed infectious process

23

What is SIRS? (5)

Non-specific clinical response including 2 or more of:
temperature greater than 38/less than 36
Heart rate greater than 90bpm
RR greater than 20/min
WBC more than 12K/mm3, less than 4K/mm3 or more than 10% immature neutrophils

24

What is severe sepsis?

Sepsis with signs of at least one acute organ dysfunction due to hypoperfusion

25

Sepsis 6 bundle (6)

100% oxygen (unless COPD)
IV Fluid bolus
Blood cultures (+ other sites if clinically indicated)
IV antibiotics
Lactate + bloods
Monitor urine output

26

Acute CNS infections (2)

Encephalitis
Meningitis (viral and bacterial)

27

Common causes of viral encephalitis (2)

Herpes simplex
Varicella zoster

28

Treatment of viral encephalitis

High dose aciclovir

29

Causes of bacterial meningitis (4)

Neisseria meningitides
Strep pneumonia
Haemophilus influenzae
Listeria

30

Agents of bacterial meningitis in immunocompromised patients

Conventional agents e.g. pneumococcal, meningococcal
Listeria
Tuberculosis

31

Agent of meningitis in AIDS patients

Cryptococcus neoformans

32

Commonest cause of meningitis in children under age of 4

Haemophilus influenzae B

33

Management of listeria meningitis

Amoxicillin

34

Management of tuberculous meningitis (2)

Isoniazid + rifampicin

35

Major clinical signs of bacterial meningitis (3)

Fever
Headache
Stiff neck
Mental state change
(95% have 2/4)

36

Microbiological samples in meningitis (4)

Blood culturres
Throat swab
Blood EDTA for PCR
CSF

37

Pre-hospital antibiotics for meningitis

Benzylpenicillin 1.2mg

38

Hospital antibiotic management of meningitis

Ceftriaxome IV 2g bd
+ amoxicillin if older than 55

39

Role of steroids in management of meningitis

Give with first dose of antibiotics; reduces mortality esp. in pneumococcal

40

How long can gentamicin be given for?

Three days (three doses)

41

Why is coliform growth in a blood culture bottle always significant?

Coliforms are very rarely a contaminant

42

Abstinent period following chlamydia treatment

At least a week until treatment is completed

43

Aztreonam is...

Narrow-spectrum antibiotic against coliforms, similar to gentamicin but less nephrotoxic

44

When should leg ulcers be treated?

Evidence of infection (i.e. red, hot, swollen, skin, pus)

45

For GI and GU infections which antibiotic should be stepped down to following IV therapy?

Co-trimoxazole

46

Which antibiotic should not be used for complicated UTI?

Nitrofurantoin

47

Risk of ciprofloxacin

C. diff

48

Alternative to penicillin for pre-hospital antibiotics

Chloramphenicol