Microbiology

Question 1

Complications of sore throat (4)

Answer 1

1) Otitis media
2) Quinsy
3) Abscess
4) Mastoiditis

Question 2

What is Lemierre’s Syndrome?

Answer 2

Infection of posterior compartment of pharyngeal space with jugular vein involvement

Question 3

T/F: Throat swabs are routine in general practice for sore throat.

Answer 3

False - isolation yield is poor and most are viral

Question 4

What are the Centor criteria (4)

Answer 4

1) Tonsilar exudate
2) Tender anterior cervical nodes
3) History of fever
4) Absence of cough

Higher = more likely to be bacterial

Question 5

How should viral sore throat initially be managed (no red flags)

Answer 5

Fluid intake, hot drinks, warm-salty water mouthwash

Question 6

Most common bacterial cause of sore throat

Answer 6

S. pyogenes (Group A beta haemolytic strep)

Question 7

A patient has a Centor criteria of 4, how should they be treated?

Answer 7

Penicillin

Question 8

What infection controls need to be taken in confirmed S. pyogenes throat infections?

Answer 8

SICPs, contact and droplet

Question 9

S. pyogenes Gram stain.

Haemolysis pattern

Answer 9

Gram positive cocci in chains

Beta haemolytic

Question 10

Complications of strep throat

Answer 10

Rheumatic fever, glomerulonephritis

Question 11

A patient comes in with a severe sore throat and a grey-white pseudomembrane across the pharynx. Spot diagnosis?

Answer 11

C. diptherhiae infection

Question 12

C. diphtheriae produces exotoxin/ endotoxin?

Answer 12

Exotoxin (very cardio and neurotoxic)

Question 13

The diptherhia vaccine is what type?

Answer 13

Toxoid

Question 14

How is diphtheria treated?

Answer 14

Antitoxin + penicillin or erythromycin

Question 15

A patient comes in with sore throat and white patches on their mouth/throat, which have become red and raw, spot diagnosis?

Answer 15

Thrush (C. albicans)

Question 16

How is oral thrush treated?

Answer 16

Nystatin

Question 17

AOM is a common secondary infection to what

Answer 17

URTI

Question 18

AOM is commonly due to what organism type?

Answer 18

Virus

Question 19

Most common bacteria isolated from AOM?

Answer 19

S. pneumoniae, H. influenzae, S. pyogenes.

Question 20

Can swabs be taken in AOM?

Answer 20

Yes, if the ear-drum has ruptured and there is discharge.

Question 21

When should AOM be given antibiotics?

Answer 21

If infection >4 days, or if they are systemically unwell.

Question 22

What antibiotics should be given in AOM?

Answer 22

Amoxicillin (1st)

Erythromycin (2nd)

Question 23

When should antibiotics be given in acute sinusitis?

Answer 23

If infection >10 days

Question 24

What is the first and second line antibiotic for acute sinusitis?

Answer 24

Penicillin V

2nd line is doxycycline (but NOT in children)

Question 25

Potential complication of AOE?

Answer 25

Malignant otitis (extension into bone surrounding the ear canal, e.g. mastoid and temporal bones). A fatal condition.

Question 26

Most common otitis externa bacterial isolates? (2)

Answer 26

S. aureus, P. aeruginosa

Question 27

Common fungal causes of otitis externa?

Answer 27

Aspergillus niger, C. albicans

Question 28

How is otitis externa managed, first-line?

Answer 28

Topical aural toilet, acetic acid drops

Question 29

Mono is caused by what

Answer 29

EBV

Question 30

How is mono diagnosed?

Answer 30

Atypical lymphocytes in film + IgM EBV test

Question 31

Spot diagnosis: Patient with lymphadenopathy, palatal petichae?

Answer 31

IM

Question 32

Splenic rupture can result from what infection?

Answer 32

EBV

Question 33

EBV belongs to which viral family?

Answer 33

Herpes

Question 34

T/F: Primary infection with EBV in youth (<10) commonly leads to IM symptoms

Answer 34

False - often only causes symptoms in those >10 years old

Question 35

How is EBV treated?

Answer 35

Bed rest, paracetamol, avoid sport. | NOT antivirals

Question 36

Which HSV type causes oral lesions?

Answer 36

HSV1

Question 37

How is primary gingiviostomatitis treated?

Answer 37

Aciclovir

Question 38

T/F: Aciclovir eliminates HSV1.

Answer 38

False

Question 39

How should HSV be diagnosed?

Answer 39

Swab lesion, send in viral medium for PCR

Question 40

Potential serious complication of HSV?

Answer 40

Herpes Simplex Encephalitis

Question 41

Hand, Foot and Mouth is caused by which family of viruses?

Answer 41

Coxsackie. Diagnosed with PCR.

Question 42

Chancre is buzzword for what

Answer 42

Primary syphilis (T. pallidum)

Question 43

How is genital syphilis treated?

Answer 43

Benzylpenicillin