June 2010--Bacterial disease: CPD questionnaires must be completed online via www.cpdjournals.org.za. After submission you can check the answers and print your certificate. Questions may be answered up to 6 months after publication of each issue.
1. Which one of the following statements about smear microscopy for TB is incorrect?
A. Sample centrifugation improves sensitivity
B. LED light sources are a useful alternative to standard fluorescent bulbs
C. Fluorescent microscopy improves sensitivity over standard microscopy
D. Smear microscopy is highly sensitive for the diagnosis of HIV-associated TB.
2. Which of the following statements regarding nucleic acid amplification (NAA) assays for TB is correct?
A. The results of 'in-house' NAA assays should be interpreted with caution
B. Commercial NAA assays are nonspecific for TB
C. NAA assays do not depend to any large degree on the experience of the person performing the test
D. Commercial NAA assays are generally more sensitive for smear-negative than smear-positive TB.
3. True (A) or false (B)--fill in only block A or B:
Serological testing may be helpful in confirming a diagnosis of pulmonary TB in adults.
BACTERIAL MENINGITIS IN THE ERA OF PAEDIATRIC VACCINATION AGAINST THE ENCAPSULATED PATHOGENS
4. Which polysaccharide-protein conjugate vaccine has recently been introduced into the Expanded Programme on Immunisation (EPI) in South Africa?
A. Haemophilus influenzae serotype b
B. Oral polio
C. Parenteral polio
D. 7-valent pneumococcal vaccine
E. 13-valent pneumococcal vaccine.
5. Vaccines currently available to prevent disease due to Haemophilus influenzae serotype b (Hib), Streptococcus pneumoniae (the pneumococcus), and Neisseria meningitidis (the meningococcus) are based on (choose one):
A. Live, attenuated bacteria
B. Polysaccharide capsules
C. Outer membrane vesicles
D. Killed bacteria
E. Cell walls.
6. Polysaccharide-protein conjugate vaccines currently available to prevent disease due to Haemophilus influenzae serotype b, Streptococcus pneumoniae and Neisseria meningitidis elicit an indirect effect at a population level due to (choose one):
A. Excretion of bacteria in faeces
B. Increased spread of bacteria via respiratory droplets
C. Reduced nasopharyngeal carriage
D. Transmission of live, attenuated bacteria
E. Reduced bacteria in animals.
SEPSIS: AT-RISK PATIENTS, CLINICAL MANIFESTATIONS AND MANAGEMENT
7. True (A) or false (B)--fill in only block A or B:
Alcoholics, the elderly, neonates and people who are severely immunosuppressed may present with a normal temperature and sepsis.
8. True (A) or false (B)--fill in only block A or B:
Abnormal liver enzymes are a common finding in sepsis.
9. True (A) or false (B)--fill in only block A or B:
Appropriate antimicrobial therapy has a significant impact on survival in sepsis if started within 1 hour of diagnosis.
SKIN AND SOFT-TISSUE INFECTIONS
10. True (A) or false (B)--fill in only block A or B:
To cause SSTIs, invading organisms must penetrate the skin barrier through a breach caused by direct trauma or an underlying process such as ischaemia.
11. True (A) or false (B)--fill in only block A or B:
Pain not in proportion to the appearance of the lesion may indicate a developing necrotising infection.
12. True (A) or false (B)--fill in only block A or B:
One of the cardinal factors in managing severe, complicated soft-tissue infections is the early recognition of the need for surgical drainage and/or debridement.
BACTERIAL INFECTIONS IN TRAVELLERS
13. Which of the following statements concerning treatment of travellers' diarrhoea is correct (choose one):
A. Bismuth subsalicylate should be used for treatment of travellers' diarrhoea in India
B. Rifaximin is a standard antibiotic used to treat travellers' diarrhoea
C. Campylobacter jejuni is still universally sensitive to fluoroquinolones
D. Azithromycin 1 g po stat is acceptable empiric treatment
E. Loperamide should not be administered to patients with travellers' diarrhoea.
14. Which of the following statements is true concerning African tick-bite fever (ATBF) (choose one):
A. Patients may present with multiple eschars
B. Vesicular rash is NOT a feature
C. R. africae is carried by the brown tick
D. The Weil-Felix test is sensitive and specific
E. Amoxycillin is the drug of first choice for treatment of ATBF.
15. Which one of the following statements is true concerning leptospirosis?
A. Leptospirosis is caused by Treponema pallidum
B. Transmission is via human-to-human aerosol droplet spread
C. Myalgia is a common symptom
D. Leptospira urinary antigen is the investigation of choice in the first week
E. Mortality from Weil's disease averages 50%.
DURATION OF ANTIMICROBIAL THERAPY
16. True (A) or false (B)--fill in only block A or B:
No statistical difference was found between the 5-day and the 8-10-day regimens in acute otitis media.
17. True (A) or false (B)--fill in only block A or B:
Community-acquired pneumonia can be successfully treated using 3-7 days of antibiotics.
18. True (A) or false (B)--fill in only block A or B:
Infections such as endocarditis, osteitis and septic arthritis require extended duration of antimicrobial therapy.
IMPORTANCE OF MINIMUM INHIBITORY CONCENTRATION (MIC) VALUES
19. True (A) or false (B)--fill in only block A or B:
The MIC of an isolate is the lowest concentration of an antimicrobial agent that prevents visible growth of that particular micro-organism in an agar or a broth-dilution susceptibility test.
20. True (A) or false (B)--fill in only block A or B:
The MIC can guide the choice of antimicrobial used in treatment by predicting efficacy.
Accreditation number: MDB001/002/01/2010