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From Flashcardlet > Microbiology & Infectious Diseases > Flashcards

Microbiology & Infectious Diseases Flashcards

1
Q

2 types of Staphylococcus and where do they colonise?

A

S.aureus (nasal flora) & coagulase neg staph (skin flora)

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2
Q

Where does HSV remain dormant?

A

Dorsal root ganglion of spinal nerves

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3
Q

When would topical acyclovir be given?

A

cold sores for HSV infection

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4
Q

What infection gives rise to a dermatomal distribution presentation?

A

Herpes Zoster Virus (shingles)

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5
Q

To what type of patient would IV acyclovir be given to?

A

Severely immunosuppressed patients

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6
Q

What common infection is caused by Poxvirus?

A

Molluscum Contagiosum

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7
Q

2 most common bacterial causative agents to infect skin?

A

S.aureus & group A Beta-haemolytic streptococci (aka S.pyogenes)

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8
Q

Which one is catalase negative out of S.aureus & group A Beta-haemolytic streptococci?

A

group A Beta haemolytic streptococci

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9
Q

Is teichoic acid a virulence factor for S.aureus or S.pyogenes?

A

S.aureus

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10
Q

Hyaluronic acid capsule and adhesins are virulence factors for which bacterial organism?

A

S.pyogenes

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11
Q

What type of infection is impetigo - deep or superficial?

A

superficial - only infects the epidermis

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12
Q

What infection gives Honey crusted lesions?

A

Impetigo

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13
Q

Complication of impetigo due to epidermolytic toxin production?

A

Staphylococcal scalded skin syndrome

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14
Q

Fever, malaisem lymph node enlargement are features of what bacterial skin infection?

A

Eryseipelas

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15
Q

Why would cellulitis generally occur unilaterally?

A

It’s generally caused where there has been skin penetration

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16
Q

What causative agent is most likely to give rise to orbital cellulitis?

A

Haemophilus influenzae

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17
Q

What is also known as Fournier’s or synergistic gangrene?

A

Perineal necrotising fasciitis

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18
Q

Type Necrotising fasciitis is due to what organism?

A

Polymicrobial - enteric gram neg bacilli and anaerobes

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19
Q

What condition is treated using Surgical debridement?

A

Necrotising fasciitis & Gas gangrene

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20
Q

IV antibiotics used to treat NF?

A

meropenem and clindamycin

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21
Q

Metronidazole used to treat which skin infection?

A

Gas gangrene

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22
Q

What antibiotics would you use if the patient was allergic to flucloxacillin in the treatment of S.aureus or S.pyogenes infections?

A

erythromycin, clarithromycin, Vancomycin, linezolid

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23
Q

Drug used to treat impetigo?

A

Fusidic acid or mupircon

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24
Q

What is a dermatophyte infection of the nails called?

A

onychomycosis

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25
Q

Dermatophyte infections are subject to what layer of the epidermis?

A

Stratum corneum

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26
Q

Terbinafine is used to treat what?

A

Both skin, scalp and nail dermatophyte infections

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27
Q

Antifungal agent to treat skin dermatophyte infections?

A

Clotrimazole & Terbinafine

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28
Q

Is T.pallidum a common STI causing bacteria in the UK?

A

No - uncommon

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29
Q

Is mycoplasma a common STI causing bacteria in the UK?

A

Yes

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30
Q

Is N.gonorrhoea a common STI causing bacteria in the UK?

A

Yes

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31
Q

Is Pox virus a common STI causing virus in the UK?

A

Yes

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32
Q

Is Hepatitis B a common STI causing virus in the UK?

A

No

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33
Q

What is PID?

A

Pelvic inflammatory disease (STI)

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34
Q

60% of women are asymptomatic in which STI?

A

Gonorrhoea

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35
Q

Fitz-Hugh-Curtis syndrome is a complication of what STI?

A

Gonorrhoea

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36
Q

Treatment of gonorrhoea: a) initially what beta lactams were used? b) what cephalosporins? c) what fluoroquinolones? d) other antibiotics ?

A

a) amoxicillin & benzylpenicillin b) oral cefixime & IV/IM ceftriaxone c) ciprofloxacin d) spectinomycin & azithromycin

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37
Q

Which antibiotic to treat gonorrhoea now has widespread resistance?

A

Tetracycline

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38
Q

Why is there a national chlamydia screening programme?

A

A lot of patients are asymptomatic

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39
Q

Reiter’s syndrome is a complication of what STI & what are its features?

A

Chlamydia - arthritis, conjunctivitis, urethritis, skin lesions

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40
Q

Increase in the number of episodes of PID, increases the risk of what?

A

infertility (PID = Pelvic inflammatory disease)

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41
Q

Does HPV give you genital warts or genital herpes?

A

Genital warts

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42
Q

Which strains of HPV does Cervarix vaccinate against?

A

HPV 16 & 18

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43
Q

HPV 6 & 11 give rise to what?

A

Genital warts

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44
Q

Complications of genital herpes?

A

dissemination, meningitis, encephalitis, sacral nerve parasthesiae, urinary retention

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45
Q

What is meant by constitutional symptoms?

A

Fever, malaise, weight loss, fatigue

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46
Q

What is tabes dorsalis and what STI is it a symptom of?

A

The demylination of posterior column of spinal cord resulting in lightening pains in the legs. Tertiary syphilis.

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47
Q

What reaction can occur as a result of treatment in secondary syphilis?

A

Jarish-Herxheimer reaction - fever, chills, myalgia, hypersensitivity

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48
Q

Is Trichomonas vaginalis a spirochete, protozoan or prion?

A

Protozoan

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49
Q

What is the most common type of Candidiasis?

A

Candida albicans

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50
Q

In HIV, what CD4 count is classed as AIDS?

A

<200 cells/uL

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51
Q

A nucleoside reverse transcriptase inhibitor for HIV?

A

Zidovudine or lamivudine

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52
Q

To which two drugs is MDR-TB resistant to?

A

Isoniazid and rifampicin.

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53
Q

What are the two clinical manifestations of infection with mycobacterium leprae?

A

Tuberculoid and lepromatous leprosy.

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54
Q

SSPE is a complication of which disease?

A

Measles.

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55
Q

What type of animal carries schistosoma parasites?

A

Snail.

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56
Q

What is the most common causative organism in osteomyelitis?

A

Staph. aureus.

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57
Q

What is the major risk factor for septic arthritis?

A

Prosthetic joint/s.

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58
Q

Which bacterium causes whooping cough?

A

Bordetella pertussis.

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59
Q

What informal term is used to describe persistent otitis media?

A

‘Glue ear’.

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60
Q

What organ is vulnerable to damage in glandular fever?

A

Spleen.

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61
Q

Which virus is the most frequent cause of the common cold?

A

Rhinovirus.

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62
Q

Neutrophil defects, what are the qualitative defects?

A

Loss of chemotaxis Loss of ability to kill - deficient in NADPH oxidase so hydrogen peroxidase is not formed.

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63
Q

Febrile neutropenia is a medical emergency. >50% of those with what infection will die in 24 hours if not treated?

A

Pseudomonal infections

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64
Q

Name a gram neg bacilli

A

E.coli

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65
Q

2 common fungal causative agents that cause infections in neutropenic patients?

A

Candida spp and aspergillus spp

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66
Q

Listeria monocytogenes is a a cause of what w.r.t opportunistic infections?

A

Bacterial cause of T cell deficiency

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67
Q

Low antibodies due to them not working properly is called?

A

Hypogammaglobulinaemia

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68
Q

Giardia lamblia is a cause of what w.r.t antibodies?

A

Hypogammaglobulinaemia

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69
Q

Acquired causes of Hypogammaglobulinaemias?

A

Multiple myeloma, CLL, burns

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70
Q

Which complement factors does Neisseria meningitidis make deficient?

A

C5-C8

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71
Q

What organs removes opsonised bacteria from blood?

A

spleen

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72
Q

What does anti-rejection treatment in organ transplantation suppress? (type of immunity)

A

cell - mediated immunity

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73
Q

In immunocompromised patients, live vaccines should be avoided to what patients?

A

T cell deficient patients

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74
Q

What is the difference between immunosuppression & immunocompromised?

A

Immunosuppression = the immune system is suppressed by drugs. e.g from rejecting an organ transplant, treating graft-versus-host disease after a bone marrow transplant, or for the treatment of auto-immune diseases such as rheumatoid arthritis or Crohn’s disease. Immunocompromised = can result from immunosuppression. Reduction in Ig. AKA immunodeficiency

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75
Q

What are the different types of agents available for passive immunisation?

A

Pooled products specific Abs

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76
Q

What agents are available for active immunisation?

A

whole cell vaccines live attenuated vaccines toxins toxoids adjuvants

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77
Q

Why should we immunise?

A

Halt the carriage and transmission of disease to eliminate and eradicate it in order to protect communities from serious infections

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78
Q

Which immune response is faster and more powerful?

A

Secondary

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79
Q

What is specific memory a hallmark for?

A

Adaptive immune response

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80
Q

Which type of immunisation is donating some IgG?

A

Passive

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81
Q

What type of immunisation is given for MMR?

A

Live attenuated bug = active

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82
Q

What type of immunisation is given as a toxin?

A

Tetanus

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83
Q

Who was responsible for the invention of vaccinations?

A

Louis Pasteur - immunises against rabies, cholera and diptheria

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84
Q

Is BCG a live vaccine?

A

Yes

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85
Q

Pathogenic organism, reservoir, mode of exit and of transmission, portal of entry & susceptible host are the stages in what?

A

Chain of infection

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86
Q

Main aim of infection prevention and control is to…?

A

Break the chain of infection at any point

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87
Q

Complete killing or removal of all types of micro-organisms is what? Sterilisation? Disinfection? Washing?

A

Sterilisation

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88
Q

What method of sterilisation is autoclave?

A

Moist heat - delivery of steam under high pressure in specific cycles

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89
Q

What is the Bowie-DICK test used for?

A

Steam PENETRATION test for the monitoring of autoclaves (doubt we need to know this but its funnay)

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90
Q

What is disinfection?

A

Removal or destruction of sufficient numbers of harmful micro-organisms to make an item safe

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91
Q

Difference between disinfection and antisepsis?

A

An antiseptic is a disinfectant used on damaged skin or living tissue as it requires minimal toxicity

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92
Q

What is the least hazardous method of decontamination?

A

Heating

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93
Q

What decontamination method should be used for surgical instrument reprocessing?

A

Moist heat sterilisation due them being a high risk group

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94
Q

Flexible endoscope decontamination would involve what?

A

High level disinfection. It’s classed as a high risk group but due to the sensitive and plastic parts it cannot undergo sterilisation

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95
Q

What happens to syringe needles prior to use to decontaminate it?

A

Gamma irradiation

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96
Q

What happens to syringe needles after use?

A

Disposal

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97
Q

What risk group are surgeon’s hands classed as?

A

Low risk. It is the clothes that they wear which will be high risk

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98
Q

Measles can rarely give rise to what slow viral infection?

A

Subacute sclerosing panencephalitis

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99
Q

What virus causes the fatal progressive multifocal leukoencephalopathy?

A

JC papovirus

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100
Q

What infection was due to ritual canabalism?

A

Kuru - transmissible spongiform encephalopathy

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101
Q

Mean age of onset in sporadic CJD?

A

50-60 years

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102
Q

List 4 iatrogenic causes of CJD?

A

contaminated surgical instruments corneal transplants GH from human pituitaries Blood transfusion

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103
Q

Gertsmann-Straussler-Scheinker syndrome is an inherited form of what?

A

CJD

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104
Q

Which has a longer survival - vCJD or sCJD?

A

vCJD = 14 mnths. sCJD = 6 mnths

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105
Q

High homozygosity for what amino acid is seen in both sCJD and vCJD at codon 129?

A

methionine

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106
Q

What is scrapie?

A

Animal (sheep) infection with spongiform encephalopathy

107
Q

How did humans get vCJD?

A

Ingestion of contaminated beef with BSE

108
Q

Clinical feature of CJD?

A

pre-senile dementia, focal CNS signs

109
Q

Which antifungals require therapeutic drug monitoring?

A

Itraconazole 5-fluorocytosine ( + voriconazole)

110
Q

What class of antifungal is Terbafine, and what does it treat?

A

Allyamine For athlete’s foot (tinea pedis)

111
Q

Two classes of Azoles with an example of each …

A
  1. Imidazole (eg clotrimazole) 2. Triazoles (eg flucanozole)
112
Q

What does HAART stand for and what does it consist of?

A

Highly active antiretroviral therapy Either: 2 NRTIs and 1 NNRTI Or 2 NRTIs and a boosted PI

113
Q

Which phase of viral replication does Oseltamivir and Zanamivir target?

A

“Release phase” of virus

114
Q

Name 4 classes of Protein Synthesis Inhibitors

A

Oxazolidinomes, tetracyclines, aminoglycasides, MLS

115
Q

Most common causative organism in viral conjunctivitis

A

Adenovirus

116
Q

Why is gonorrhoea not treated with quinolones ?

A

Increasing resistance

117
Q

Which antibiotic can be used to eradicate H pylori ?

A

Amoxicillin (In combo with omeprazole)

118
Q

What type of equipment would ionising radiation be used to sterilise?

A

Disposable

119
Q

Term used to describe the reduced virulence of a pathogen that can be used as a vaccine

A

Attenuated

120
Q

If first line treatment with amoxicillin has failed to resolve an infection (e.g. Sinusitis) what would the second line treatment be, why ?

A

Amoxicillin-clavulanate (co-amoxiclav) as has a broader range, adding gram negative cover,an d often treats infections resistant to amoxicillin

121
Q

People allergic to penicillins are also likely to be allergic to which other class of antibiotics ?

A

Cephalosporins (first generation) Some cross reactivity between the two classes

122
Q

Why is erythromycin not commonly used ?

A

Significant GI side effects

123
Q

Two most commonly used macrolides ?

A

Azithromycin Clarithromycin E.g. In mild to moderate pneumonia

124
Q

Which part of the malaria life cycle does sexual reproduction take place?

A

In the mosquito (Human = asexual)

125
Q

Which beta-lactams are wide spectrum ?

A

Carbapenems e.g. Meropenem Amoxicillin Co-amoxiclav (even more than amoxicillin)

126
Q

Why should co-amoxiclav never be used in CNS infections ?

A

The clavulinic acid doesn’t cross blood brain barrier (Can use amoxicillin instead e.g. In listerial meningitis)

127
Q

Give an example of a flagellate Protozoa

A

Giardia lamblia

128
Q

How is ascariasis treated?

A

Single dose of albendazole, which prevents the worm from absorbing glucose, so it detaches and you poop it out

129
Q

Post transplant patients are particularly at risk of infection by this virus…

A

CMV

130
Q

For which bacterial meningitis cause is chemoprophylaxis currently unavailable?

A

Streptococcus pneumoniae

131
Q

Define “trismus”

A

Spasm of muscles of mastication in tetanus

132
Q

Define pleocytosis

A

Presence of white cells in CSF

133
Q

Most common cause of viral meningitis

A

Enterovirus (eg echovirus, coxsachie, parecho, poliovirus)

134
Q

Clinical presentation of viral meningitis in children

A

Nuchal rigidity, bulging anterior fontanelle due to ⬆️ICP. (Meningeal signs may be absent - to little to talk)

135
Q

Most common cause of brain abscess?

A

Streptococci

136
Q

Possible complications of gastroentiritis

A

Dehydration, renal failure, HUS, toxic mega colon, GBS, disseminate to other parts of body

137
Q

Most common cause of brain abscess AS A RESULT OF TRAUMA

A

S. Aureus

138
Q

What is the function of the integrate enzyme ?

A

Incorporate new DNA created by reverse transcriptase (virus) into host cell genome - becoming a provirus *unique to retroviruses! good anti-viral target*

139
Q

If a turtle loses its shell, is it naked or homeless?

A

Naked

140
Q

Which classes if antivirals can treat influenza ?

A

M2 inhibitors Neurosminidase inhibitors

141
Q

What strain of influenza M2 inhibitors (e.g. Amantadine) treat ?

A

Influenza A ONLY

142
Q

Which antivirals can treat ALL strains of influenza ?

A

Neuroaminidase inhibitors E,g. Zanamivir, osteltamivir

143
Q

What is the use of ritonavir ?

A

Boost levels of other protease inhibitors

144
Q

Uses of acyclovir ?

A
  • HSV - VZV - CMV - EBV
145
Q

Uses for gancyclovir ?

A

CMV

146
Q

Side effects of gancyclovir?

A

Haematological adverse effects

147
Q

Antiviral that may be used to Treatment respiratory syncytial virus?

A

Ribavirin (NRTI)

148
Q

In what cases would INF-alpha be used as treatment ?

A

Hep B,C Hairy cell leukaemia Kaposi’s sarcoma

149
Q

HIV HAART therapy consists of:

A

2 NRTIs + protease inhibitors Or 2 NRTIs + NNRTI

150
Q

What are the 3 classes of newer HIV drugs ?

A

Integrase inhibitors CCR5 inhibitors Fusion inhibitors

151
Q

4 clinical settings in which brain abscesses can develop:

A

direct spread (from adjacent Suppuration focus) Haematogenous spread (from distant focus) Trauma Cryptogenic (no focus recognised)

152
Q

Why is Gentamycin not effective against anaerobic organisms?

A

aminoglycosides require an oxygen dependent active transport mechanism

153
Q

Mechanism by which strains of s. Aurues have become resistant e.g. to flucloxacillin (MRSA)

A

altered penicillin binding protein (PBP2’, encoded by MecA gene) DOES NOT bind B-lactams

154
Q

mehcanism by which vancomycin resistant enterbacteriae have developed

A

altered peptide sequence in Gram +ve peptideoglycan (D-ala D-ala -> D-ala D-lac)

This reduces binding of vancomycin 1000-fold

155
Q

Name the 6 mechanisms of developing antibiotic resistance:

A
  1. No target
  2. reduced permeability
  3. altered target
  4. over-expression of target (effect diluted)
  5. enzymatic degradation
  6. Efflux pump
156
Q

Process by which resistance genes are transmitted between microorganisms

A

conjugation (mainly)

157
Q

other name for cestodes ?

A

tape worm

158
Q

cestodes (tape worm) and trematodes (flukes) are both subdivisions of which type of helminth ?

A

platyhelminth (flatworm)

159
Q

what is the other name for roundworm ?

A

nematode

160
Q

Name the 4 subdivisions of protozoa:

A
  • flagellates
  • amoeboids
  • sporosoans
  • trypanosomes
161
Q

Giardia Lamlia is an example of which type of protozoa subdivision ?

A

flagellates

162
Q

Leishmania is an example of which subdivision of protozoa ?

A

trypanosomes

163
Q

Schistomiasis is what type of parasite ?

A

Macroparasite: trematode/fluke (platyhelminth, helminth)

164
Q

chronic infection with schistomiasis results in what conditions ?

A
  • bladder cancer
  • liver cirrhosis
165
Q

what is the causative agent of ‘river blindness’

A

Onchocerca volvulus (nematode)

(leads to onchocerciasis, transmitted by bite of the black fly)

166
Q

infection that can lead to amoebic dysentry/colitis + Liver abscesses (if gets into blood)

A

Amoebiasis (caused by amoeba entamoeba histolytica)

167
Q

explain the trasmission of toxoplasma gondii

A
  • food chain
  • cat faeces
168
Q

common anti-protozoal drug treatments:

A
  • metronidazole
  • pentamidine
  • antimalarials
  • nitazoxanide
169
Q

Common anti-helminthic drug treatments:

A
  • albendazole
  • mebendazole
  • ivermectin
  • praziquantel
170
Q

What is the distinguishing factor between presentations of meningitis and encephalitis ?

A

level of consciousness:

Meningitis = fully conscious, no focal neurological signs

encephalitis = altered conscious level, seizures +/- focal neurological signs

171
Q

A presentation of:

  • Insidious fever onset, headache, +/- neck stiffness
  • +/- altered conscious level, seizures, focal neurological signs

is suggestive of what condition ?

A

Brain abscess

172
Q

Treatment for bacterial meningitis (neisseria meningitidis)?

A

Ceftriaxone, cefotaxime (cephalosporin)

+ penicillin

173
Q

What would treatment shoudl be given to individuals who have been in close contact (e.g. kissed) a patient with a neisseria meningitidis infection ?

A

Rifampicin (RNA syntehsis inhibitor)

Ciprofloxacin (quinolone)

174
Q

What are the virulence factors of H. influenzae ?

A

Type b capsule

Fimbriae

IgA proteases (outer membran proteins/LPS)

175
Q

Name the 3 common causative agents in neonatal meningitis

A
  • Group B beta-haemolytic streptococci
  • E. coli
  • listeria monocytogenes
176
Q

2 common viruses causing meningitis ?

A
  • Enteroviruses
  • Herpes simplex
177
Q

which type of meningitis is distinguished from others by an insidious onset ?

*Cryptococcus meningitis also insidious onset, but only common in patients in late stage HIV*

A

TB meningitis

178
Q

Most common viral cause of encephalitis?

A

HSV

179
Q

Clinical presentation of viral meningitis ?

A
  • Fever
  • meningism
  • ~Viral prodome

in infants meningeal signs may be absent - nuchal rigidity + bulging ant. fontanelle

*usually impossible to distinguish between viral + bacterial*

180
Q

Lumbar puncture + bloods findings in viral meningitis:

A
  • pleocytosis (white cells in CSF)
  • lymphocytic <500
  • protein= normal/mildly elevated
  • glusoce= normal/slightly low
181
Q

what is acute disseminated encephalomyelopathy (ADEM)

A
  • immune-mediated CNS demyelination
  • similar clinical features to encephalitis
  • CFS findins = viral meningitis
  • can follow viral illness or vaccination
182
Q

Treatment for Herpes simplex encephalitis ?

A

MEDICAL EMERGENCY

Treat with high dose IV acyclovir

183
Q

Bacteria implicated in acute bronchitis?

A
  • Bordetella pertussis
  • mycoplasma pneumoniae
  • chlamydia pneumoniae
184
Q

Features of bronchitis:

A
  • cough in the absence of fever, tachypnoea, tachycardia
  • reduced pulmonary function
185
Q

Classical presentation of community acquired pneumonia ?

A

sudden onset chills, followed by fever, pleuritic chest pain and productive cough (sputum can be rusty coloured)

  • chest x ray shows parenchymal involvement
186
Q

most common cause of communitiy ac

A
187
Q

Most common cause of community accquired pneumonia (CAP) ?

A

S pneumoniae (pneumococcal pneumonia)

188
Q

what viruses are likely to cause pneumonia in children?

A
  • paraunfluenza
  • RSV
189
Q

viruses likely to cause pneumonia in adults ?

A
  • Influenza A and B
  • Adenovirus
190
Q

Viruses that may cause pneumonia in an immunocompromised host ?

A
  • Measles
  • HSV
  • HHV-6
  • CMV
191
Q

Presentation of atypical pneumonia ?

A
  • Tracheobronchial-interstital inflammation (instead of alveolar)
  • Central (substernal) pain (opposed to peripheral/pleuritic)
  • Scanty, non-purulent sputum
  • Normac WBC
192
Q

What is CURB-65 ?

A

Clinical prediction rule for mortality in CAP:

C = confusion

U = Urea >7mmolL

R = Resp. rate >/=30 per min

B = BP systolic < 90mmHg or diastolic 60mmHg

65 = age

one pint scored for each present feature:

193
Q

What does a score of 2 of the CURB-65 suggest ?

A

Increased risk of death - consider short stay inpatient or hospital supervised outpatient treatment

194
Q

What is chlamydia Psittaci ?

A

Usually infect birds (asymptomatic)

  • results in non-specific flu like symptoms, typhoidal illness or productive cough with striking radiograph findings
195
Q

Which GI microorganism is Haemolytic Ureamic syndrome associated with ?

A

E. Coli

*toxic producing microbes*

196
Q

Most common cause of gastroenteritis in children ?

A

Rotovirus

197
Q

Outline the mechanism of action of the E. Coli toxin:

A
  1. toxin activates G protein - inc. levels of cAMP
  2. cAMP activates ion channels
  3. causes overexcretion of chloride ions
  4. water follow Cl- ions into lumen - DIARRHOEA
198
Q

Exception of gastroenteritis where antibiotic treatment may be used:

A
  • extremes of age
  • campylobacter (prolonged/severe symptoms)
  • invasion (e.g. +ve blood cultures)
199
Q

Causes of Cholecystitis ?

A
  • Associated with obstructuib if cystic duct
  • malignancy
  • surgery
  • parasitic worms

*Rarely due to none obstructive causes*

200
Q

Presentation of cholecystitis:

A
  • Fever
  • Right upper quadrant pain
  • mild jaundice (Common bile duct remains patent)
201
Q

Bacterial count considered’significant bacteriuria’ in UTI ?

A

105 cfu/mL

(104-105 = probable infection)

202
Q

Most common causative agent in bone and infections ?

A

S. Aureus

203
Q

complications of group A Streptococcal infection ?

A
  • acute glomerulonephritis
  • rheumatic fever
  • scarlet fever
204
Q

What is quinsy ?

A

peritonsillar abscess

205
Q

Reaction caused by giving ampicillin in EBV infection ?

A

Mac-pap rash (not true allergy)

*therefore avoid ampicillin*

206
Q

Most common cause of epiglottitis ?

A

H. influenzae type B (before immunisation)

now very rare, variety of other causes, esp. resp. bacteria

207
Q

causative agent of whooping cough ?

A

bordetella pertussis

208
Q

Main organisms associated with otitis externa (acute) ?

A

S. Aureus

Pseudomonas

209
Q

treatment for otitis media ?

A

amoxicillin (ONLY if unwell - otherwise treat symptomatically)

210
Q

What is continuing bacteriuria associated with in pregnancy ?

A

premature delivery

increased perinatal mortality

211
Q

Clinical features of intra amniotic infection ?

A
  • maternal fever
  • uterine tenderness
  • malodorous amniotic fluid
  • materal/foetal tachycardia
  • raised WBC
212
Q

risk factors for puerperal endometritis/sepsis ?

A
  • prolonged labour
  • caesarean
  • prolonged rupture of membranes
  • multiple vaginal examinations
213
Q

causative agents of puerperal endometritis ?

A

E. Coli

Beta-haemolytic streptococci

anaerobes

214
Q

causative organisms of puerperal mastitis ?

A

S. Aureus

215
Q

Treatment for neonatal sepsis/meningitis ?

A

Amoxicillin + gentamicin

(broad spectrum)

216
Q

Describe the progression and characteristics of a measles rash

A
  • Starts at head & face then spreads down body over a few days ending on palms and soles
  • Starts macular-papular, then prgressive to become confluent (merge)
  • whitish-bluish papules near mouth
217
Q

Which disease is known as ‘first disease’ ?

A

Measles

218
Q

what is the incubation period for measles ?

A

10-12 days

219
Q

Clinical features of measles ?

A

remember the 2 c’s!

conjunctivitis, coryza, cough

+ prodome, fever + malaise

erthythematous, M-P rash

220
Q

where does the chicken pox rash begin on the body ? + what type of rash ?

A

the trunk

vesicular

221
Q

incubation period and infectivity of chicken pox ?

A
  • incubation: 14-15 days
  • infectivity: 2 days before onset of rash until after vesicles dry up
222
Q

what treatment may be given to adults with chicken pox ?

A

acyclovir

223
Q

Rubella is also know as ?

A

The THIRD disease

224
Q

what virus is rubella caused by ?

A

togavirus

225
Q

Which virus is characterised by an incubation period of 14-21 days, and infectivity one week before rash appears to 4 days after ?

A

rubella

226
Q

what are the teratogenic effects of rubella ?

A
  • cataracts + eye defects
  • deafness
  • cardiac abnormailities
  • microcephaly

CONGENITAL RUBELLA SYNDROME

227
Q

which virus causes ‘slapped cheek’?

A

parvovirus

228
Q

percentage of childhood respiratory infections caused by adenovirus ?

A

10%

229
Q

infectivity and incubation of mumps ?

A
  • infectivity: several days before parotid swelling to several days after
  • incubation: 16-18 days
230
Q

what is the most common extra salivary gland manifestation of mumps ?

A

CNS involvement (children + adults overall)

epidydymo-orchitis (adults alone)

231
Q

How are mycobacteria different to all other bacterial genera ?

A
  • Unusual waxy cell wall (high lipid content)
  • slow growing (different media requirements)
232
Q

What is ‘ghon focus’

A

Small area of granulomatous inflammation, usually in the the midzone of lung caused by primary TB infection (phagocytosed bacilli)

233
Q

What is ghon complex ?

A

When Ghon Focus involves the hilar lymph nodes

234
Q

First line Treatment for TB ?

A

2 months: Isoniazid, rifampicin, pyrazinamine, ethambutol

4 months: Isoniazid, rifampicin

235
Q

Second line agents for TB treatment ?

A
  • amikacin
  • ethionamide
  • cycloserine
  • fluoroquinolones (ciprofloxacin)
236
Q

Blood test for TB ?

A

Interferon-γ release assay (IGRA)

237
Q

What is mycobacterium avium complex ?

A

An Atypical mycobacterium, which usually infects people with low T-cells + CD4+ e.g. HIV patients

238
Q

Defining characteristics of necrotising fasiculitis?

A
  • Severe pain - out of proportion
  • rapid progression
  • systemic toxicity
  • necrosis
  • ecchymosis (subcut purpura)
239
Q

What is the causative agent of type 1 necrotising fasciculitis ?

A

polymicrobial : enteric gram -ve bacilli + anaerobes

240
Q

Causative agent of type 2 necrotising fasciculitis ?

A

S. pyogenes

241
Q

Causative organism of gas gangrene ?

A

C. perfringens

242
Q

Effects of a gonorrhoea infection during pregnancy ?

A

spontaneous abortion

premature labour

243
Q

Presentation of Gonorhoea in neonates:

A

Opthalmia neonatorum

acute purulent conjunctivitis

*can cause blindess if not appropriately treated)

244
Q

outline the unique lifecycle of chlamydia trachomatis

A
  • Extracellular infectious form: elementray body
  • intracellular replicative form: reticulate body
245
Q

What are the target cells of chlamydia trachomatis ?

A

Squamocolumnar epithelial cells of endcervix/ upper genital tract (females) and conjunctiva, urethra, rectum (both sexes)

246
Q

What is reiter’s syndrome and what is it a rare complication of ?

A
  • reactive arthritis, autoimmne response to infection
  • arthritis, conjunctivities, urethritis, skin lesions
  • complication of chlamydia infection
247
Q

what is condylomata accuminata?

A

genital warts

248
Q

what type of virus is herpes simplex ?

A

double stranded DNA virus

249
Q

causative agent of syphilis ?

A

Treponema pallidum (spirochaete, protozoa)

250
Q

Histological characteristics of syphilis

A
  • Obliterative endarteritis
  • concentric endothelial/ fibroblastic proliferation
  • microscopic vascular compromise
251
Q

presentation of the secondary phase of syphilis infection ?

A

skin:

  • rash: M-P trunk, limbs, palms, soles
  • condylomata lata - erythematous plaques
  • mucous patches - silver/grey erosions

generalised lymphadenopthy, fever, malaise, weight loss, CNS involvement

252
Q

describe the primary phase of syphilis infection

A

painless induration lesion, heals spontaneously in 3-6 weeks

253
Q

Late (tertiary) phase of syphilis involves what?

A
  • neurosphilis: seizures, general paresis, tabes dorsalis
  • CV: aortitis
  • non-specific granulomatous reaction
254
Q

outcomes of congenital syphilis ?

A

early = snuffles, rash, hepatospenomegaly

late = saddle nose, sabre shins, hutchinson’s incisors, frontal bosses

255
Q

what are the changes in normal flora leading to bacterial (anaerobic) vaginosis ?

A
  • reduced vaginal lactobacilli
  • increased gardnerella vaginalis + anaerobes
256
Q

treatment for bacterial vaginosis?

A

metronidazole (anaerobe) ~amoxycillin ~ topical clindamycin

257
Q

How does HIV gain access to host cells ?

A

The viral gylcoprotein **gp120 **interacts with cellular receptor CD4 and chemoking receptor CCR5

258
Q

Define each of the 4 stages in the WHO classification of HIV based on CD4 count:

A

stage 1: CD4 count >500cells/μL

stage 2: 349-499

stage 3 (Advanced HIV): 200-349

stage 4(AIDS): <200

259
Q

What is acute retroviral syndrome ?

A

flu-like symptoms occuring up to 6 weeks after initial infection, including:

  • fever
  • pharygnitis
  • lymphadenopathy
  • rash
260
Q

Outline the early symptoms of HIV

A
  • pulmonary TB
  • persistent oral candidiasis
  • unexplained chronic diarrhoea (>1 month)
  • unexplained persistent fever (>37.6 for >1 month)
  • severe bacterial infections (e.g. s. pneumoniae bacteraemia)
261
Q

name 3 slow virus infections:

A
  1. progressive rubella panencephalitis
  2. progressive multifocal leukoencephalopathy
  3. subacute sclerosing panencephalitis (SSPE)
262
Q

what is gerstmann-straussler-sheinker syndrome?

A

Rare, familial, fatal, neurodegenerative disease (TSE)

presents with:

  • progressive ataxia
  • pyramidal signs
  • adult onset dementia
263
Q

What is thought to be the cause of vCJD

A

thought to be the consumption of foods contaminated with prions (which also cause BSE)

From Flashcardlet (22 decks)

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