Mikrobiologi

Question 1

Gram+ endosporedannende stave (aerob)

Answer 1

Bacillus anthracis

- beh: ciprofloxacin

Question 2

Gram+ endosporedannende stave (anaerob)

Answer 2

Clostridium: 
- Tetani: G-penicillin
- Botulinum: symptomatisk
- Difficile: vancomycin eller metronidazol
- Perfringes: Kirurgi + G-penicillin
Antitoksin!

Question 3

Gram+ stave (andre)

Answer 3

Lactobacillus

Listeria monocytogenes: ampicillin

Corynebacterium diphertiae: antistof + azithromycin

Propionibacterium acnes:

Question 4

Gram+ forgrenede stave

Answer 4

Actinomyces israelii: G-penicillin

Question 5

Gram+ syrefaste stave

Answer 5

Mycobacterium tuberculosis: kombinationsbehandling for at sikre minimum resistens: rifampicin + isoniazid + pyrazinamid + ethambutol

Question 6

Gram+ kokker (streptokokker)

Answer 6

Beta-hæmolyse:

• A: s. pyogenes: penicillin V (+ clindamycin) -> allergi: makrolider
• B: s. agalacticae: penicillin

Alfa-hæmolyse:

• • optocin: s. pneumoniae: Penicillin eller ceftriaxon
• • optocin: s. orales: G-penicillin

Question 7

Gram+ kokker (enterokokker)

Answer 7

E. faecalis: G-penicillin - ellers vancomycin

S. bovis:

Question 8

Gram+ kokker (anaerob)

Answer 8

Peptostreptokokker

Question 9

Gram+ kokker (staphylokokker)

Answer 9

Koagulase +:
- s. aureus: dicloxacillin

Koagulase -:

• s. epidermidis: vancomycin
• s. albus: penicillin

Question 10

Gram - kokker (aerobe)

Answer 10

Neisseria meningitidis: G-penicillin

Neisseria gonorrhoeae: ceftriaxon eller ciprofloxacin

Moraxella catarrhalis: cefalosporin

Question 11

Gram - stave (aerob)

Answer 11

Store:

• Pseudomonas aureginosa: aminoglykosid + piperacillin
• Legionella pneomophila: ciprofloxacin + makrolid

Små:

• Bordetella (para)pertussis: makrolider (tidligt)
• Brucella (melitensis/abortus/suis): tetracyklin + rifampicin

Question 12

Gram - stave (anaerob)

Answer 12

Bacteroides fragilis:

Question 13

Gram - stave (fakultativt anaerob) - store (+ laktose)

Answer 13

Store:

• • laktose:
• E. coli: ciprofloxacin /UVI: mecillinam /meningitis: ampicillin + gentamycin
• Klebsiella: ciprofloxacin

Question 14

Gram - stave (fakultativt anaerob) - store (- laktose)

Answer 14

• • laktose:
• krumme:
• Campylobacter jejuni: makrolid
• H. pylori: metronidazol + amoxicillin
• Vibrio cholera eller el tor: ciprofloxacin
• ikke-krumme: ciprofloxacin
• Shigella (dysenteriae/flexneri/boydii/sonnei)
• Salmonella (para)typhi, typhimurium eller enterididis
• Proteus

Question 15

Gram - stave (fakultativt anaerob) - små

Answer 15

Små:

• H. influenzae: ampicillin
• Y. pestis: tetracyclin
• Y. enterocolitica: ciprofloxacin
• Gardnerella vaginalis: metronidazol
• Pasteurella multocida: penicillin

Question 16

Andre (scirochaetaceae)

Answer 16

Treponema pallidum: G-penicilli
Borrelia burgdoferi eller recurrentis: G-penicillin
Leptospira interrogans: Penicillin + tetracyklin

Question 17

Andre (de små)

Answer 17

Chlamydia trachomatis, psittaci eller pneumoniae: makrolid eller tetracyklin
Rickettsia: tetracyklin
Mycoplasma pneumoniae: makrolid eller tetracyklin

Question 18

Enkeltstrenget RNA virus (-) segmenteret

Answer 18

Orthomyxovirus: influenzavirus

- amantasin og rimantadin

Question 19

Enkeltstrenget RNA virus (-) ikke segmenteret

Answer 19

Rhabdovirus: rabies

Filovirus: Marburgs + ebola

Paramyxovirus:

• Parainfluenza
• RSV
• Morbilli
• Parotis

Question 20

Enkeltstrenget RNA virus (+) ikke segmenteret (kappe)

Answer 20

Togavirus: rubella

Flavivira:

• Gul feber:
• Japansk encephalitis
• Dengue feber
• Thick borne encephalitis
• West-nile
• HCV: interferon + ribavirin

Question 21

Enkeltstrenget RNA virus (+) ikke segmenteret (ingen kappe)

Answer 21

Calicivirus: HEV
- ribavirin

PicoRNAvirus:

• HAV
• Rhinovirus
• Enterovirus

Question 22

Enkeltstrenget RNA virus (+) retrovira

Answer 22

HTLV

HIV: lamivudin + efavirenz + lopinavir (+ elvitegravir)

Question 23

Enkeltstrenget RNA virus (læses i begge retninger)

Answer 23

Arenavirus: lassafeber

Bunyavirus: hantavirus

Question 24

Diverse RNA

Answer 24

Astrovirus

HDV

Question 25

Dobbeltstrenget RNA virus

Answer 25

Reovirus: rotavirus

Question 26

Dobbeltstrenget DNA (kappe)

Answer 26

``` Herpes: Alfa: aciclovir - HSV 1+2 - VZV Beta: - CMV: ganciclovir - HHV6+7 Gamma: - HHV 8 - EBV ``` Poxvirus

Question 27

Dobbeltstrenget DNA (ingen kappe)

Answer 27

Adenovirus: ribavirin, ganciclovir eller cidofovir Papovavirus: - papilloma: - polyoma:

Question 28

Enkeltstrenget DNA

Answer 28

Parvovirus: humant parvovirus B19

Question 29

Partieltstrenget DNA

Answer 29

HBV: lamavudin, adefovir, dipivoxil eller entecavir

Question 30

Bændelorme

Answer 30

Eschinococcus multilocularis Eschinococcus granulosus - kirurgisk fjernelse + albendazol Diphyllobothrium latum - praziquantel Tenia saginata: + steroid Tenia solium - praziquantel

Question 31

Ikter

Answer 31

Shistosoma: praziquantel - mansoni - haematobium - japonicum

Question 32

Rundorme

Answer 32

Strangyloides stercoralis: albendazol Wuchereria bancrofti: albendazol Ancylostoma duedenale Nectar americanus - mebendazol Trichuris triciura: mebendazol Trichinella spiralis: albendazol Ascaris lumbricoides: mebendazol Enterobius vermicularis: mebendazol

Question 33

Gærsvampe

Answer 33

Candida albicans: - mukokutan: fluconazol - Invasiv: echinocandin + fluconazol Cryptococcus neoformans: ketoconazol

Question 34

Skimmelsvampe

Answer 34

Dermatofytter: - Epidermophyton - Microsporum - Trichophyton - hudinfektion: ketoconazol Aspergillus fumigatus: voriconazol

Question 35

Amøber

Answer 35

Entamoeba histolytica: nitroimidazoler Pneumocystis carinii: sulfamethoxazol + trimetoprim

Question 36

Sporozoer

Answer 36

Toxoplasmosis gondii: spiramycin Plasmodium - vivax/ovale/malariae: klorokin - falciparum: malarone Cryptosporidum parvum: nitazoxanid

Question 37

Mikrospora

Answer 37

Enterocytozoon bieneusi

Question 38

Flagelatter

Answer 38

Giardia lamblia: methronidazol - patologi: To parasitstadier, trofozoiter og cyster. Cysterne udskilles med fæces og smitter gennem oral indtagelse. Cysterne passerer ventriklen og omdannes til trofozoiter, som deler sig i tyndtarmen. Trichomonas vaginalis: methronidazol Leishmaniasis: amfotericin B Trypanosomas - brucei: pentamidin - cruzi: benznidazol

Question 39

Lus

Answer 39

Æg -> nymfe -> moden lus (4-5 æg dagligt) - overlever ca. 1 måned Behandling: Shampoo der indeholder pyretrum eller malathion. Igen efter 8 dag. Balsam + lussekam

Question 40

Streptococcus pyogenes

Answer 40

Sygdomme: impetigo, erysipilas, nekrotiserende fasciitis, scarlagens feber, sepsis Senfølger: glomerulonefritis + febris reumatica

Question 41

Streptococcus agalactica

Answer 41

Sygdomme: sepsis + meningitis (nyfødte) + puerperalfeber + UVI

Question 42

E. coli

Answer 42

Opdeling: Agglutination vha. antistoffer mod O-, H- og K-antigener Virulensfaktorer: pili (UVI) og enterotoxiner + cytotoxin (GE)