Microbiology

Question 1

Haemophilus influenza B

Answer 1

Common in infanthood
Cause meningitis, epiglottitis
Treatment: ceftriaxone

Question 2

Burkholderia cepacia

Answer 2

Present in more long term CF

Worse prognosis

Question 3

Pseudomonas aeruginosa

Answer 3

Causes lung damage in CF

Difficult to clear as produces gel, ciliotoxins, and proteases to cleave immunoglobuins

Question 4

Rabies

Answer 4

Hydrophobia, photophobia, areophobia, pyrexia

Question 5

Giardia lamblia

Answer 5

Watery diarrhoea

Cysts in stool samples
Treatment: metronidazole

Question 6

Hepatitis E

Answer 6

Waterborne infection

20% mortality in pregnant women

Question 7

Herpes simplex virus type 1

Answer 7

Herpes simplex encephalitis: temporal lobe, fever, headache, vomiting, seizures
Cold sores

Question 8

Herpes simplex virus type 2

Answer 8

Genital herpes: painful, shallow ulcers

Question 9

Epstein Barre virus

Answer 9

Glandular fever - infectious monocytosis, fever, hepatosplenomegaly, lymphadenopathy, leukoplakia
Hodgkin’s lymphoma, Burkitt’s lymphoma, gastric cancer, nasopharyngeal carcinoma

Question 10

Candida albicans

Answer 10

Thrush, dysphagia
Vaginal thrush, in diabetics
Treatment: fluconazole

Question 11

Treponema pallidum

Answer 11

Syphilis

Treatment: benzyl penicillin injections

Question 12

Coxsackie A virus

Answer 12

Hand foot and mouth disease

Question 13

Coxsackie B virus

Answer 13

Pericardial effusion

Question 14

Measles

Answer 14

Coryza, fever, cough, Koplick spots (premolars), macular confluent rash beginning on face

Question 15

Rotavirus

Answer 15

Watery gastroenteritis, vomiting, dehydration

Question 16

TORCH infections

Answer 16

Toxoplasmosis
Others: listeria, syphilis, parovirus B19, varicella zoster
Rubella
CMV: microcephaly, seizures, neonatal jaundice, hepatosplenomegaly, deafness and mental retardation
Herpes

Question 17

Candidal intertrigo

Answer 17

Red, itchy pustular rash in skin folds

Question 18

Gardnerella

Answer 18

Bacterial vaginosis: thin, foul smelling vaginal discharge, irritating, increase pH
Treatment: metronidazole

Question 19

Bartonella henselae

Answer 19

Cat scratch disease: red papule, regional lymphadenopathy

Question 20

Neisseria gonorrhea

Answer 20

Gonococcal urethitis: dysuria, reactive arthritis
Conjunctivitis: newborn in positive mother

Gram neg diplococci
Treatment: IM ceftriaxone and azithromycin

Question 21

Borrelia burgdorferi

Answer 21

Lymes disease: tick bite, erythema migrans

Question 22

Mycoplasma pneumoniae

Answer 22

Atypical pneumonia: cold agglutinins, autohaemolytic anaemia, mild hepatitis, renal failure, erythema multiforme

Diagnosis: anti-mycoplasma antibodies

Question 23

E. coli

Answer 23

Bloody gastroenteritis
Haemolytic uraemic syndrome: hemolytic anaemia, renal failure

Gram neg bacilli

Question 24

Strept pyogenes (GAS)

Answer 24

Strept throat: sore throat, fever
Impetigo: skin infection, golden crusting
Necrotising fascilitis/cellulitis
Scarlet fever: fever, erythematous blanching rash
Rheumatic fever post infection: heart murmur, sore joints
Post-streptococcal glomerulonephritis: haematuria, hypertension

Gram pos cocci, beta haemolytic

Question 25

Respiratory syncytial virus

Answer 25

Bronchiolitis: wheeze, cough

Question 26

Human herpesvirus-8

Answer 26

Kaposi sarcoma: in immunocompromised patients, blue-black raised lesions and well demarcated

Question 27

Legionella pneumophila

Answer 27

Legionaire's disease: pneumonia, hyponatraemia Serum antibody titre Treatment: macrolide, ciprofloxacin

Question 28

Clostridium difficile

Answer 28

Pseudomembranous colitis: watery diarrhoea, post abx therapy Treatment: metronidazole

Question 29

Herpes zoster

Answer 29

Shingles: painful vesicles in dermatome distribution Ramsey-Hunt syndrome (geniculate nucleus infection): acute facial paralysis, blisters in ear canal and ear Post-herpetic neuralgia: amitryptiline for neuropathic pain Treatment: aciclovir

Question 30

Pneumocystis jirovecii

Answer 30

Dypnoea, dry cough, worse on exertion

Question 31

H. pylori

Answer 31

Peptic ulcers, gastric cancer, gastric B cell lymphoma Treatment: erythromycin, metronidazole, omeprazole

Question 32

Gram positive cocci

Answer 32

Staphlococcus Streptococcus Enterococcus

Question 33

Gram positive bacilli

Answer 33

Bacilus anthrax Listeria Clostridium

Question 34

Gram negative diplococci

Answer 34

Neisseria | Moraxella catarrhalis

Question 35

Gram negative bacilli

Answer 35

Enterobacteriacea: E.coli, Salmonella, Shigella, Campylobacter, Yersinia Klebsiella Pseudomonas Haemophilus

Question 36

Acid fast

Answer 36

Mycobacteria: TB, bovis

Question 37

Obligate intracellular

Answer 37

Chlamydia | Rickettsiae

Question 38

No cell wall

Answer 38

Mycoplasma

Question 39

Spirochaete

Answer 39

Treponema pallidum

Question 40

Meningitis

Answer 40

``` 0-4wks - GBS - E. coli - Listeria - Klebsiella Rx: ampicillin + cefotaxime +/- gentamicin IV ``` ``` 1-23 months - GBS - E. coli - S. pneumoniae - N. meningitidis - H. influenxa Rx: vancomycin + ceftriaxone IV ``` ``` >2 yrs - S. pneumoniae - N. meningitidis - Listeria (>50 yrs) Rx: vancomycin + ceftriaxone IV (+ ampicillin for listeria) ``` Immunisation - H. influenza, S pneumoniae, N. meningitidis Contact prophylaxis: rifampicin, ciprofloxacin, or ceftriaxone Complications - headache, seizures, cerebral oedema, hydrocephalus, SIADH, deafness, death

Question 41

Encephalitis

Answer 41

Most commonly viral etiology Rx: supportive care, IV acyclovir for HSV

Question 42

Generalised tetanus

Answer 42

Clostridium tetani - painful spasms of masseters "lockjaw" - sustained contration of skeletal muscle with periodic painful muscle spasm - paralysis descend to involve large muscle groups - apnea, respiratory failure, contraction of pharyngeal muscles Rx: - wound debridement and IV metronidazole - Neutralise unbound toxin with TIg Prevention - clean wound, fully immunised = no treatment - clean wound, not fully immunised = tetanus vaccine - unclean wound, fully immunised, last vaccine >5 yrs = tetanus vaccine - unclean wound, not fully immunised = tetanus vaccine, TIg