Microbiology Extra Questions

1.  A 50-year-old woman has ongoing pelvic pain; she has had a coil in situ for the last8 years. She has a pelvic mass; histological sampling of the mass at laparoscopyshows a suppurative and granulomatous inflammatory process with the presenceof sulphur granules.
Which is the most likely causative agent?

2. An 18-year-old woman presents to a sexual health clinic requesting a sexuallytransmitted infection screen; she is asymptomatic, however she is concerned asher new boyfriend is complaining of dysuria, penile discharge and scrotal pain.
What is the most likely cause of his symptoms?

3. A 35-year-old man presents at a sexual health clinic with a new painless roundlesion on his penis; he also has non-tender inguinal lymphadenopathy.
What is the most likely causative agent of his symptoms?

4. A 63-year-old man with an open fracture of the femur develops the rare complication of gas gangrene and requires leg amputation.
What is the most likely causative agent?

5. A 28-year-old primiparous woman who is 16 weeks pregnant reports mild dysuria; otherwise she is well. Urine dipstick shows leucocytes ++ and is positive for nitrites. She is prescribed appropriate antibiotics.
What is the most likely causative organism of her urinary tract infection?

6. Which of the following is the causative agent of Kaposi’s sarcoma?

7. A 32-year-old primiparous school teacher is 16 weeks pregnant. She is seen in theantenatal clinic, where she reports a maculopapular rash and coryzal symptoms.The general practitioner has already sent serology and you review the result.
Rubella IgG: positive
Rubella IgM: negative
Parvovirus B19 IgG: negative
Parvovirus B19 IgM: positive
What is the most likely diagnosis?

8. A 35-year-old multiparous woman has presented to labour ward in spontaneous labour. You see from her antenatal notes that she is HIV positive. She is currentlyusing highly active antiretroviral therapy and has a viral load of 43 copies/mL.
Which of the following is associated with increased risk of vertical transmission of HIV?

9. Antenatal screening of a 25-year-old patient is suggestive of hepatitis B infection.
The results of her serology are as follows:
HBsAg Positive
HBeAg Positive
Anti-HBeAb Negative
Anti-HBsAb Negative
Total anti-HBc Positive (IgM anti-core Ab negative, IgG anti-core Ab positive)
Which of the following is most likely to represent her hepatitis B status?

10. A 23-year-old woman attends antenatal clinic at 22 weeks’ gestation. This is her second pregnancy and she is very concerned as during her first pregnancy she had an ‘infection’, which led to the permanent disability of her child. He is deaf, with delayed development and is small for his age. He became jaundiced shortly after birth.
What was the most likely cause of her son’s condition?

11. A 38-year-old woman from Sri Lanka attends her general practitioner at 10 weeks’ gestation. She is complaining of fever and has pains in her joints. She developed a rash yesterday. On examination, she has a temperature of 38.1°C, postauricular lymphadenopathy and a maculopapular rash over her torso. Rubella is diagnosed.
What is the most likely fetal abnormality to occur as a result of this acute infection?

12. A 15-year-old girl attends the genitourinary medicine clinic complaining of vaginal itching and green vaginal discharge. She is sexually active with her 17-year-old boyfriend and uses the oral contraceptive pill. Speculum examination reveals haemorrhages on her cervix. A urine pregnancy test is negative.
Considering the most likely diagnosis, what is the most appropriate first lineantibiotic?

13. Which of the following is an obligate anaerobic organism?

14. A 23-year-old woman attends her general practitioner complaining of numbness and tingling in both feet. She recently started treatment for pulmonary tuberculosis.
Which drug is most likely to be responsible for these symptoms?

15. A 38-year-old woman is readmitted via the emergency department 10 days
postemergency caesarean section complaining of vaginal bleeding, abdominal pain and foul-smelling vaginal discharge. Abdominal examination reveals suprapubic tenderness and the uterus is palpable 2 cm below the umbilicus. You suspect endometritis.
Which of the following is the most likely causative organism?

16. A woman presents at 28 weeks’ gestation with vomiting, headache, night sweats and abdominal pain. She has recently returned from the African country of Mali. Urgent blood films show the presence of Plasmodium falciparum, with a parasitaemia of 3%. After a diagnosis of malaria has been made she is treated with intravenous quinine.
The presence of which haematological characteristic is associated with increasedincidence of malaria?