Micropath Flashcards
1
Q
Cytomegalovirus retinitis antiviral tx?
A
Ganciclovir
2
Q
Herpes Simplex virus meningitis antiviral tx?
A
Aciclovir
3
Q
Varicella-Zoster virus in an adult antiviral tx?
A
Aciclovir
4
Q
Child with co-morbidities with Respiratory Syncytial virus antiviral tx?
A
Ribavirin
5
Q
Asthmatic with flu antiviral tx?
A
Oseltamivir
6
Q
Most common mechanism of HSV resistance to aciclovir?
A
Mutation in viral thiamidine kinase
7
Q
Drug for aciclovir-resistant HSV
A
Forscanet or cidofovir
8
Q
Cause of pneumonia in HIV patient
A
Pneumocystis jirovecii
9
Q
Pneumonia in girl receiving chemotherapy for leukaemia with ‘Halo’ sign on CXR
A
Aspergillus fumigatus
10
Q
Lower lobe pneumonia in a 22 year-old who is coughing up rusty coloured sputum
A
Strep pneumoniae
11
Q
Upper lobe cavitation on CXR in an alcoholic
A
Klebsiella pneumonia or TB
12
Q
Pneumonia - Smoker back from holiday in Spain, also hyponatraemic and confuse
A
Legionella pneumophillia
13
Q
HIV patient with CD4+ count of 150 with meningitis
A
Cryptococcus neoformans
14
Q
Water polo player with itchy scaly rash on lateral toe which then moved along lateral side of foot
A
Trichophytum rubrum (athlete’s foot)
15
Q
Pityriasis versicolor
A
Malassezia Furfur
16
Q
A soldier returning from Afghanistan has a small ulcer on right ring finger that won’t heal and keeps getting bigger
A
Leishmaniasis
17
Q
Snail trail oral ulcer in a homosexual man
A
Treponema pallidum
18
Q
A South American man presents to a doctor in the UK with fever and bloody diarrhoea, and investigations detect a cyst in the right lobe of the liver
A
Entamoeba histolytica
19
Q
A Nigerian man presenting with fever and chills, has just returned from Nigeria, did not take prophylaxis, and was bitten a lot
A
Malaria
20
Q
A woman returning from travel in Asia presents with abdo pain, headache, and constipation. A
Gram- rod is later cultured from her blood
A
Salmonella typhi
21
Q
Infective causes of bloody diarrhoea
A
SEECSY
Shigella
Entamoeba histolytica
E coli
Campylobacter
Salmonella
Yersinia Enterocollitica
22
Q
Virus that require C-section if mother has an outbreak at 34wks or later due to risk of transmission
vaginally
A
HSV
23
Q
Virus which if transmitted to baby: they can initially be symptomless but then come down with
long term sequelae
A
CMV
24
Q
A ward sister gets diarrhoea, and patients on the ward have been ill recently with similar symptoms
A
Norovirus
25
The most common cause of traveller’s diarrhoea
Entero-toxigenic Escherichia coli
26
Norovirus vs Rotavirus (demographic)
Rotavirus more common in kids
27
Included in meningitis treatment to cover Listeria monocytogenes
ampicillin
28
Antibiotic for Group A Strep pharyngitis
Benzylpenicillin
29
Young women with cystitis and fully sensitive E-Coli - tx?
Nitrofurantoin or Trimethoprim
30
Which antibiotic would you use for cellulitis with MRSA
Vancomycin
31
Which antibiotic would you use to treat someone who has cellulitis with a Methicillin SENSITIVE strain of Staphylococcus aureus
Flucloxacillin
32
A girl has been noted by her parents to be acting strange lately. A Lumbar puncture is performed and the CSF shows high lymphocytes and a raised protein, but normal glucose, what organism is the cause?
HSV
33
An 18 year old student is found to have Gram negative diplococcus causing meningitis
Neisseria meningitidis
34
A man is found to have a Gram positive diplococcus causing meningitis
Streptococcus pneumoniae
35
Gram negative rod causing sepsis in a neonate
Escherichia coli
36
Gram positive rod causing meningitis in a 72 year-old
Listeria monocytogenes
37
Beta lactam with anti-pseudomonal activity
Ceftazidime
38
A DNA synthesis inhibitor used to treat Pseudomonal infections but poor against anaerobes
Ciprofloxacin
39
Abx of the Macrolide/lincosamide/streptogrammin group used to treat some atypical pneumonias
Clarithromycin
40
Lady with discharge, no other symptoms, and causative infection found on wet slide microscopy
Trichomonas Vaginalis
41
Lady with PID and positive urinary NAAT test
Chlamydia Trichomatis
42
Man with discharge- Gram negative diplococci found
Neisseria gonorrhoea
43
Woman with UTI - culture grows Gram positive cocci in clusters
Staphylococcus saprophyticus
44
19 year old rugby player with boils, members of his team have similar boils, as do members of his family
Staphylococcus aureus
45
Neonate has meningitis, Gram positive organism in chains
Group B Streptococcus
46
50 year old male smoker has meningitis with Gram positive diplococci
Streptococcus pneumoniae
47
Vaccine preventable virus that resides in pharynx and GIT - 1:100 encephalitis, 1:1000 destruction of motor neurons
Polio
48
Vaccine preventable bacterial infection that causes lockjaw
Tetanus
49
Receptor/ cytokine mutation that could be protective in HIV?
CCR5/ MIP-1a/b
50
Cat scratch disease full name (genus and species) of bacteria?
Bartonella henselae
51
Which stain would be used to confirm infection with acid-fast bacilli?
Ziehl-Neelsen
52
What is the definition of herd immunity threshold?
The proportion of immune healthy people needed within a population to stop a
pathogen’s spread: 1- (1/R0)%
53
Name 1 of the 3 characteristics of Influenza A that could cause a pandemic
Novel antigenicity
Efficient replication in human airway
Efficient transmission between humans
54
Alcoholic man is on ceftriaxone for meningitis, what organism is he at risk of which this does not cover for?
Listeria Monocytogenes
55
Returning traveller with fever and constipation (salmonella typhi) - what abx do you give if she hasn’t been started on them already?
Ceftriaxone
56
Which bacterial species causes scarlet fever?
Streptococcus pyogenes
57
What is the most common cause of viral meningitis?
Non-polio enteroviruses (Echoviruses and Coxsackie viruses)
58
What does JC virus cause?
Progressive Multifocal Leukoencephalopathy
59
Q fever bacteria
Coxiella Burnetii
60
What is the treatment for pseudomembranous colitis?
Oral vancomycin + IV metronidazole
Basically a severe C diff infection
61
Name an infectious organism which is a common cause of meningitis in a child older than 3 months
Neiserria Meningitidis
62
What drug is used to treat severe falciparum malaria?
I.V. Artesunate (I.V. Quinine if Artesunate unavailable)
63
Name the main class of drugs used to treat HIV
Nucleoside reverse transcriptase inhibitors
64
Which would be the most useful test in confirming acute EBV infection 2 weeks after possible exposure in an immunocompetent patient?
IgM
65
What cell type is raised in the blood in schistosomiasis?
Eosinophils (parasitic infections raise eosinophils)
66
What cell type is raised in bacterial infection? What about viral?
Bacteria - Neutrophils
Viral - Lymphocytes
67
Boy visits grandparents in Wiltshire, comes back with 5 days of diarrhoea, no vomiting, and unexplained bruises all over body, which organism has most likely triggered this?
Escherichia coli 0157:H7
68
Natural antibodies against what can confer protective immunity against HIV?
HIV-GP120
69
Which vector transmits Trypanosoma brucei rhodesiense?
A. Anopheles mosquito
B. Sandfly
C. Tsetse Fly
D. Aedes mosquito
E. Ixodes tick
Tsetse fly (sleeping sickness)
70
What is the most common cause of fever in a returning traveller?
A. Malaria
B. Hepatitis
C. HIV seroconversion D. Typhoid
E. Dengue
Malaria
71
Which class of antibiotics has concentration dependent killing (i.e. the goal of therapy is to maximise peak > MIC)
Aminoglycosides (eg gentamicin, amikacin)
72
Elderly woman has 24 hour history of headache, confusion, photophobia, fever. Gram stain of CSF shows gram+ve rods. What is the causative organism?
Listeria monocytogenes
73
Which human herpes virus is associated with post transplant lymphoproliferative disorder
EBV
74
This vaccine preventable disease causes headache, fever, parotid swelling (unilateral or bilateral). Complications include epididymo-orchitis in postpubertal males and more rarely meningitis. What is the causative organism?
Mumps virus
75
Patient receiving chemotherapy for leukaemia. She has prolonged neutropenia and ongoing fever, raised inflammatory markers despite broad antibacterial therapy with meropenem and amikacin. CT scan shows multiple nodules with surrounding hypo-attenuation (halo sign). What is the most likely organism?
Aspergillus
76
Poorly controlled person with T2DM has headache, sinus pain, periorbital oedema and orbital cellulitis. His symptoms have progressed rapidly. He has purulent discharge from his nose. ENT surgeons bring him to theatre as an emergency. What antifungal therapy should be started ASAP?
Amphotericin-B (used for all invasive fungal diseases)
btw this patient probably has mucormyosis according to chatgpt but thats not in the path guide - EDIT: its in the 2022 paper wtf
77
4 year old goes on school trip to petting farm, later has bloody diarrhoea and HUS. What is the causative organism?
Escherichia coli O157:H7
78
Young man has headache, neck stiffness and photophobia. He was not confused, did not have features of encephalitis. HSV1 was detected on PCR of CSF obtained from LP. What antiviral should be given?
Aciclovir
79
Elderly woman has fever and productive cough in GP. She has pleural rub. Spleen is not palpable, no lymphadenopathy. Her WBC is 15x10^9 with neutrophilia. The Hb concentration is slightly low and platelet count is normal. Blood film - toxic granulation, left shift. CRP is high. What is the diagnosis?
a) AML
b) Aplastic anaemia
c) CML
d) Infectious mononucleosis
e) Reactive neutrophilia
Infectious mononucleosis
80
Bleeding patient has prolonged APTT and PT, but normal platelet count and normal fibrinogen. What is the most suitable blood component for treatment?
a) Albumin
b) Anti-D
c) Cryoprecipitate
d) Fresh frozen plasma
e) Platelets
Fresh frozen plasma
81
55 year old male smoker, on long term frusemide. Investigations - high Hb, high Hct, normal red cell mass. Plasma volume is low. What is the most likely diagnosis?
a) Polycythaemia vera
b) Primary polycythaemia
c) Secondarypolycythaemia
d) Relative polycythaemia
e) High affinity haemoglobinopathy
Relative - no change in red cell mass
82
72 year old man has returned from a 7 day holiday in Italy. He has signs of pneumonia and Legionella urinary antigen is positive. Which abx to use?
Azithromycin
83
Which serological test is useful in the diagnosis of invasive Candida albicans infections?
Beta-D-Glucan
84
Infants under 12 months should not be fed honey due to an increased risk of food poisoning caused by?
Clostridium Botulinum
85
Malaria tx?
Severe/ falciparum - IV artesunate
Non falciparum - Chloroquine then primaquine
86
Hep B tx
Interferon alpha
Lamivudine
Entecavir
Telbivudine
Tenofovir
87
Streptobacillus moniliformis is the causative organism of what infection?
Rat bite fever
88
What is the commonest form of prion disease?
Sporadic Creutzfeldt-Jakob disease
89
A 54yo woman has been in hospital for 7 days, receiving treatment for meningitis. She initially responded well, but has developed profuse watery diarrhoea over the last day and now feels dizzy whenever she tries to stand. She has never previously experienced anything like this. Basic obs show: HR 110 BP 85/51 RR 14 SpO2 98% on room air Temp. 38.1oC.
Tx?
Oral vancyomycin + IV metronidazole
note: path guide is wrong, this is from NICE guidelines
90
Infection of prosthetic joint, which organism?
Staph epidermidis
91
Serology for what polysaccharide is used for the diagnosis of invasive Aspergillus infection?
Galactomannan
92
A 26 year old woman presents with fever, headache and confusion. She has an HIV infection and has refused to take antiretroviral therapy for the past four years. What rapid test should you ask the microbiology laboratory to perform on her serum sample to confirm the likely diagnosis?
Cryptococcal antigen
93
What double stranded DNA virus is associated with nephritis in renal transplant recipients immunosuppresive therapy?
cytomegalovirus
94
Which vaccine preventable disease presents initially with mild fever, swollen neck glands, anorexia, malaise and cough. After 2-3 days a membrane of dead cells forms in the throat, tonsils, larynx or nose which may narrow or occlude the airway leading to respiratory distress?
Diphtheria - can have swollen neck, buzzword seems to be membrane of dead cells / grey or white patch in the throat
95
Which helminth is capable of autoinfection in humans via the following life cycle? Infective filariform larvae penetrate intact skin and migrate to the small intestine where they become adults. Eggs hatch into rhabditifom larvae which mature into filariform larvae which can autoinfect via perianal skin
Strongyloides stercoralis (roundworm) - autoinfection would be specific for this i think
96
A 72 year old woman has signs and symptoms consistent with meningitis. She is not confused and has no features suggestive of encephalitis. She has been commenced her on ceftriaxone 2g i.v. twice daily. There are no known drug allergies. Given this clinical picture what one antimicrobial should be be given in addition?
Ampicillin - cover for listeria esp in elderly
won't be acyclovir as they ask for antimicrobial, plus no encephalitis
97
A 67-year-old woman presents with a chronic cough, haemoptysis and fevers particularly at night. She states she has lost 10 kg of weight over the past 3 months and her chest X-ray shows left upper zone shadowing. Her son reports she has a history of excess alcohol consumption. What is the most likely causative organism?
Mycobacterium tuberculosis
98
What Hepatitis virus typically causes a brief, self-limiting infection but is associated with more severe disease and mortality in pregnant women and can cause chronic infection in immunocomromised patients?
Hep E
99
Name the most common parasitic infection in the duodenum causing malabsorption
Giardia lamblia
100
What 3 infections are checked in pregnant women according to UK screening program?
HIV, Hep B, Syphilis
101
Which fungus that can cause respiratory disease in immunocompromised cannot be treated using a certain type of antifungal (cos it doesn’t have ergosterol in its cell wall), it’s normally treated with co-trimoxazole?
Pneumocystis jirovecii
102
A poorly controlled T2DM pt has oozing infection of eyes and sinuses, ENT surgeons taking for debridement surgery, what’s the immediate pharm Tx?
Amphotericin B - its mucormyosis (poorly controlled DM, eye goop)
103
What type of bacteria is haemophilus
gram negative cocobacilli
104
what type of bacteria is klebsiella
gram negative rod
105
Neonatal meningitis (2 days old), gram negative bacilli
E. coli
106
The following antimicrobials can be used for the treatment of community acquired pneumonia. Which has activity against Mycoplasma pneumoniae?
Amoxicillin
Ceftriaxone
Co-amoxiclav
Doxycycline
Vancomycin
Doxycycline
107
Which antimicrobial would be the most appropriate empiric therapy for ESBL producing e coli?
Aztreonam
Ceftriaxone
Meropenem
Piperacillin/tazobactam
Trimethoprim
Meropenem
108
Which antiviral agent is used for the treatment of Influenza A?
Cidofovir
Foscarnet
Ribavirin
Tenofovir
Zanamivir
Zanamivir
