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Part B- Answer two (2) questions only (50 marks) For Part B, please indicate the number of the question you are answering. This assessment is for 25% of your final grade. · Please enter your answers...

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Part B- Answer two (2) questions only (50 marks)
For Part B, please indicate the number of the question you are answering.
This assessment is for 25% of your final grade.
· Please enter your answers in this document.
· Diagrams or tables may also be used as part of your answer. A photograph of a hand drawn diagram is also fine.
· Please type your name and student number in the box above.
· There is no word limit for your answers.
· you can submit your document to Turnitin before the due date to check the score if you wish. (Don’t be concerned if the score is over 20%- all students are submitting the exam paper so this will be the same- just check your report- click on the number % value to see the highlighted areas of similarity. If the similarity for the answers you have written is low, there is no problem)
· Please save your answers in either Word or PDF format.
· Your completed document should be submitted using the Turnitin submission link on the course Canvas Site.
· There is no need to add separate cover sheets with electronic submissions.
B. Research Task- Essays
(50 marks) 12.5% of final grade
For this task you are required to research and write an essay on any two (2) of the following topics. Your essay should include references to peer-reviewed scientific literature (for example research or review articles in Scientific journals).
References should be in Vancouver style.
As a guide, 5-10 references will be sufficient for each question. A single combined reference list is acceptable. (Separate reference lists for each essay is also fine, but may be more difficult manage in a single document if using a reference software)
Select two (2) only of the following questions:
1. Write an essay on the mechanisms by which microorganisms can cause pneumonia. Include specific examples of bacterial, viral and fungal pathogens.
For each pathogen, your discussion should include:
· role of virulence factors in the pathogenesis of the disease.
· Usual source of infection, patient groups affected
· Are there any common aspects of these mechanism?     (25 marks)
2. Write an essay on the management of wound infections. Include specific examples of bacterial pathogens. You should include a discussion of the following in your essay:
· Different type of wound infections and their clinical significance
· Examples of organisms for each type of infection, and why and how these organisms are of concern
· Treatment and management .                (25 marks)
3. Discuss the pathogenesis, management and vaccine development against Streptococcus pneumoniae infections. Include a discussion of the following points in your essay:
· The types of infections caused by this pathogen and how they are acquired
· Explain the roles of pneumococcal virulence factors and explain how they contribute to the pathogenesis of infection.
· The challenges for the vaccines that are cu
ently in use, and future approaches for new vaccines.                 (25 marks)
4. Discuss why influenza epidemics and pandemics occur. Include a discussion of the following points in your essay:
· The characteristics of the virus that prevent humans from developing long-term immunity to infection.
· Important considerations regarding influenza vaccination programmes
· Limitations of cu
ent seasonal influenza vaccines and approaches to development of a pan- influenza A vaccines.             (25 marks)
Part B- start your essays here

Ru
ic essays
Marking Ru
ic Final Theory Task- Essays 25 marks each.
Scales Note that gradations between these scales will be used as appropriate.
Criterion
Possible
marks
Excellent
Good Attempt Fair attempt, needs improvement Poor attempt, needs more effort Very poor or partial attempt Nil
Coverage of topic 20
20-A good and complete coverage of
the questions topic, sufficient specific
examples have been given to support
arguments, appropriate reference to
the scientific literature has been
made. Evidence of a good
understanding of the topic
15-A reasonable attempt at addressing all
or most of the question. At least some
specific examples have been used, some
eferences to the literature have been
made, but there is insufficuent evidence
that the topic has been addressed fully
10 A fair attempt at addressing the
question, with some ommisions or
inco
ect statements. Some evidecen of
understanding of the topic.A few
specific examples are given, some or
little reference to apporpriate literature
has been done
5-Only part of the question has been
answered, answer is confuding, or has many
inco
ect statements, statements are not
supported by examples or references to
literature
1-Little evidence that topic has been
addressed, only a small part of the
question addressed,
not submitted
Writing style 2.5
2.5 Writing is clear and essay is well
structured. Subheadings used. Co
ect
use of scientific terms and notation,
few or no typographical or spelling
e
ors.
1.5 Writing is of a fair standard, but
essay structure could be improved.
Mostly co
ect use of scientific terms
and notation, some or few typographical
or spelling e
ors.
0.5 Writing unclear or confusing, essay is
not well structured. Many e
ors inuse of
scientific terms and notation, many
typographical or spelling e
ors.
not submitted
Referencing 2.5
2.5 References are appropriate, and a
sufficient number have been used to
support arguments. References are in
co
ect format and are complete.
1.5-References are mostlyappropriate,
and at least some have been used to
support arguments. References are
mostly in co
ect format and are
complete.
0.5-References are not of appropriate
type, insufficient references have been
used to support arguments. References
are inco
ect format and/or are not
complete.
not submitted
TOTAL 25

RMIT Classification: Trusted
RMIT Classification: Trusted
Medical Microbiology 1 - Final Theory Assessment Task
Final Assessment Task ONPS2118             Undergraduate
    Name:
    Please enter your name here
    Student number:
    Please enter your student number here
    Available Date:
    May 27, 2021, 9:00
    Due date:
    May 29, 2021, 23:59
INSTRUCTIONS
Part A- 1 Answer all questions (50 marks)
Part B- Answer two (2) questions only (50 marks)
For Part B, please indicate the number of the question you are answering.
This assessment is for 25% of your final grade.
· Please enter your answers in this document.
· Diagrams or tables may also be used as part of your answer. A photograph of a hand drawn diagram is also fine.
· Please type your name and student number in the box above.
· There is no word limit for your answers.
· you can submit your document to Turnitin before the due date to check the score if you wish. (Don’t be concerned if the score is over 20%- all students are submitting the exam paper so this will be the same- just check your report- click on the number % value to see the highlighted areas of similarity. If the similarity for the answers you have written is low, there is no problem)
· Please save your answers in either Word or PDF format.
· Your completed document should be submitted using the Turnitin submission link on the course Canvas Site.
· There is no need to add separate cover sheets with electronic submissions.
Page
Part A- Case studies    2
Case 1.    2
Case 2.    4
Case 3    5
B. Research Task- Essays    7
Part A- Case studies
(50 marks) 12.5% of final grade.
Case 1.
(20 marks, answer parts a-f below)
Case history. Da
en, a 19 year-old university student with a 20 cigarette a day habit, contracted a respiratory tract infection and recovered after 2 weeks.
One week later, he began to feel unwell again and developed fever, a productive cough and shortness of
eath. The fever resolved after 2 days and he did not seek medical attention. His cough did not resolve and 2 weeks later, he finally visited his general practitioner.
A sputum sample was taken for microbiology. The appearance of the Gram-stained preparation is shown below.
a. Describe the sputum preparation as you would for a clinical report. (3 marks)
. Based on the case history, and the appearance of the Gram stain, what condition does the patient have, and what pathogen do you suspect? (3 marks)
c. Describe the workflow, media and test you would use to confirm a diagnosis of the organism you suspect. (6 marks)
Case history continued.
Da
en is allergic to penicillin. His GP prescribed a 5-day course of erythromycin. The culture results revealed a beta-haemolytic organism that was macrolide resistant. Da
en felt better after 3 days and didn’t bother to take the rest of his antibiotics.
Five days later he felt unwell again and his cough was worse. His GP prescribed a 10- day course of Doxycycline. Da
en’s symptoms improved, but 2 weeks later, he still had not fully recovered. His GP ordered a second sputum sample to be taken, and prescribed a 10 day -course of Cefalocor. Da
en’s symptoms had resolved 2 weeks later.
The Gram-stain of the second sputum is shown below. The culture of the second sputum revealed no suspected pathogens.
d. Why did Da
en’s infection not respond to the first treatment with erythromycin? (2 marks)
e. Is the negative culture result for the second sputum specimen expected? Explain your answer. (3 marks)
f. Why did the infection also not respond to Doxycycline, but did finally respond to Cefalocor? (3 marks)
Case 2.
(15 marks, answer parts a-e below)
Case History. A male patient with leukaemia underwent a bone ma
ow transplant. After 1.5 months in hospital the patient developed respiratory symptoms including: persistent fever, cough and chest pain. The patient was empirically treated with antibiotics but did not respond. Five days after onset of symptoms, a gram stain of a sputum from the patient is shown in A.
The sputum sample was cultured on Sabou
aud’s Dextrose agar (SDA), 3 days later the culture had the appearance shown in B.
A
B
a. Describe the sputum specimen using appropriate terms. (3 marks)
. Based on the case history, and gram stain appearance, what infectious agent do you suspect? Explain your answer? (4 marks)
c. Describe how you would confirm the identity of the pathogen you suspect? (4 marks)
d. How might this patient have acquired this infection? (2 marks)
e. What drugs would be recommended for treatment of this infection? (2 marks)
Case 3
(15 marks answer parts a-d)
Case History. A 25 year-old woman presented to her GP with itchy follicular papules and pustules on the skin of her lower back and abdomen, an image is shown below.
She had used a spa pool at a party a few days earlier and several of her friends reported the same symptoms. A
Answered 4 days After May 27, 2021 ONPS2118

Solution

Poulami answered on May 29 2021
164 Votes
MEDICAL MICROBIOLOGY
Part A
Case 1
a) The sputum from the lungs should be collected in a sample cup. After
ushing the teeth and do not take any antiseptic mouthwash, the sputum sample should be
ought following a deep
eath and cough and spitted into the sample collecting cup. The sputum samples should be sent for culture thereafter. The sample cup should be
ought sterilized, otherwise it should be rinsed with ethyl alcohol. After collection, sample should be grown for culture-on-culture media.
) The patient might have pneumonia with chest infected by Streptococcus pneumoniae. Streptococcus pneumoniae is a Gram-positive organism that causes the majority of respiratory tract infections. Streptococcus pneumoniae is the common Gram-positive organism found in the sputum sample of persons with chest infections. The growth of the microorganism has been substantial, thus the patient had massive symptoms and the culture media shows extensive growth of the organism.
c) Streptococcus pneumoniae can be identified by Gram-staining and catalase test. Following Gram-staining if the inoculum takes the color of stain, then it can be ascertained the organism is a Gram-positive one. A catalase test can be done thereafter. Optochin test can be conducted as well for confirmation. The workflow is presented below:
d) The Streptococcus species is macrolide-resistant among all of the hemolytic bacteria. The strain was resistant to Erythromycin. In recent years Erythromycin is not indicated for the treatment of Streptococcal infections as the species is resistant to this antibiotic. Erythromycin being the 1st generation antibiotic has become susceptible to most of the bacterial strains. The Streptococcus species is especially resistant to the antibiotic. Thus, the patient did not get cured by this antibiotic. Moreover, his infection aggravated due to an extended course of the disease.
e) there is a higher resistance rate of Streptococcus pneumoniae towards the tetracycline group of antibiotics such as Doxycycline. However, Cefalocor has not been reported yet as for resistance to the streptococcal species. Moreover, this antibiotic can be considered as a drug of last resort for streptococcal infections. Thus, the second sputum report came negative and Da
en got cured.
f) there is a higher resistance rate of Streptococcus pneumoniae towards the tetracycline group of antibiotics such as Doxycycline. Most of the infections do not respond well towards Doxycycline due to increased resistance rates. Streptococcal infections often require a more recent antimicrobial agent i.e. Cefalocor which is a 3rd generation antibiotic. The resistance of Streptococcus pneumoniae towards different antibiotics are described below:
Case 2
a) Sabouraud dextrose agar (SDA) is one of the types of agar growth medium that contains peptones. This is utilised for the cultivation of dermatophytes as well as other types of fungal species, and this medium is also favorable for the growth of filamentous bacteria like Nocardia. Inhalation of this bacteria causes pulmonary disease. Smears are prepared from the sputum sample and stained as well as cultured thereafter.
) the infectious agent can be the filamentous bacterium Nocardia. Nocardia weakly takes the gram-stain and a catalase-positive bacterium. This bacterium forms filamentous growth similar to fungal species. Nocardia is found in dust, water, soil, and vegetables. Inhalation of any of these particles may lead to pulmonary involvement usually triggered by Nocardia asteroides complex. 
c) the confirmation tests may include paraffin baiting technique and paraffin agar. The growth of species can be observed in lysozyme
oth. Nocardia can be directly demonstrated from sputum,
onchial aspirate,
onchoalveolar lavage, and endotracheal aspirate. Gram-stain smear would show Gram-positive, finely beaded, right angled
anches filaments of <1 μm in diameter that may get fragmented to produce rods as well as coccoid forms of different sizes. Most isolates of the Nocardia species are acid fast that can be tested by modified Kinyoun technique to differentiate this species from Actinomyces, which is not acid fast. Silver methenamine stain is considered to be equally useful as well and dependable for modified Ziehl-Neelsen technique of staining.
d) Nocardia infection is a common secondary source of infections in patients with cancer. Nocardiosis especially occurs in immunocompromised patients. Cancer patients receiving radiation therapy or chemotherapy become immunocompromised, thus, enhancing the chances of secondary infection with Nocardia. Inhalation of this bacteria causes pulmonary disease. Smears are prepared from the sputum sample and stained as well as cultured thereafter. Nocardia is found in dust, water, soil, and vegetables. Inhalation of any of these particles may lead to pulmonary involvement usually triggered by Nocardia asteroides complex. 
e) Trimethoprim-sulfamethoxazole is considered as the first-line therapy for patients with Nocardia infections. In patients allergic to a sulfa group, Ceftriaxone, Imipenem, or Linezolid can be prescribed as the first-line therapy.
Case 3
a) the isolated pathogen did not take the color of Gram-stain. Hence it is possible that the isolated pathogen is a Gram-negative bacterium. Gram-negative bacilli usually grow in pus cells.
) Gram-negative bacilli are usually cultured in blood samples and there are some confirmatory tests such as oxidase test, nitrate
oth test, motility agar, and others. The biochemical tests for its detection are presented in the flowchart below:
c) the woman was recovered by polymyxin B as this is effective in controlling infection of Gram-negative bacilli. However, this may increase the chances of secondary infection with other bacteria. The chance of secondary infection with Staphylococcus aureus is high in this case. Based on the Gram-staining it...
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