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Andrews/Bolognia Review questions > 04-Gram Negative Bacterial Infections > Flashcards

04-Gram Negative Bacterial Infections Flashcards

1
Q
  1. What produces the blue pigment in pseudomonas? Yellow/green pigment? Black pigment?
A
  1. blue pigment (pyocyanin); yellow-green pigment (fluorescein); black (Pyomelinin)
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2
Q
  1. What causes Ecthyma gangrenosum?
A
  1. pseudomonas
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3
Q
  1. What causes Ecthyma?
A
  1. Ulcerative staph or strep pyoderma
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4
Q
  1. What causes Ecthyma dipthericum?
A
  1. Corynebacterium diphtheria
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5
Q
  1. What causes Ecthyma contagiosum?
A
  1. Orf
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6
Q
  1. How do you treat Hot tub folliculitis with systemic symptoms, and what is the cause?
A
  1. Cipro; pseudomonas
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7
Q
  1. What cells do you see in Malakoplakia and what is the cause?
A
  1. foamy eosinophilic von Hansemann cells (macrophages) containing calcified, concentrically laminated, intracytoplasmic bodies called Michaelis–Gutmann bodies a. Sheets of histiocytes (von Hansemann cells) with foamy eosinophilic granular cytoplasm and small, usually eccentric nuclei b. Michaelis-Gutmann bodies: Calcified, concentrically laminated intracytoplasmic basophilic bodies
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8
Q
  1. Other name for granuloma inguinale, and cause? a. Clinically? b. 3 types? c. Histo cells? d. Treatment?
A
  1. Donovanosis; Klebsiella granulomatis a. painless BEEFY RED ULCERATIVE LESION b. Ulcerovegetative type, cicatricial, nodular c. Donovan bodies- Intracytoplasmic bipolar staining, safety pin-shaped, inclusion bodies seen in pale histiocytes d. Doxycycline x 3 wks or until healed
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9
Q
  1. Parastized macrophage DDX?
A
  1. HIS Pen GiRL: Histoplasmosis, Penicillium marfenii. Granuloma Inguinale, Rhinoscleroma, Leishmaniasis … Blasto, Paracoccidio, trypanosomiasis, toxoplasma
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10
Q
  1. What causes a Chancroid? a. Clinically? b. TX? c. Gram stain?
A
  1. Haemophilus ducreyi a. Unilateral PAINFUL adenitis; May suppurate➠ bubo b. Azithro 1gm x 1 c. SCHOOL OF FISH PATTERN” gram negative rods
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11
Q
  1. What does Chlamydia trachomatis cause? a. Which serotypes? b. What are the 3 stages? c. TX?
A
  1. Lymphogranuloma Venereum a. L1, L2, L3 b. Painless ulcer; bubo (+ groove sign); ano-genital-rectal syndrome c. Doxycycline 100mg BID x 3 wks
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12
Q
  1. What is the m/c cause of purulent urethritis in men?
A
  1. Neisseria gonorrhoeae a. MYCOPLASMA & CHLAMYDIA both cause URETHRITIS, but usually NOT purulent
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13
Q
  1. What is Fitz-Hugh-Curtis syndrome?
A
  1. Acute perihepatitis with hepatic capsular adhesions (untreated PID)
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14
Q
  1. What is a risk factor for Gonococcemia? a. m/c site for septic arthritis? b. Culture medium?
A
  1. C5-C9 deficiency a. knee b. Thayer martin agar (gold standard)
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15
Q
  1. TX for uncomplicated gonorrhea?
A
  1. Ceftriaxone 125mg IM x 1 a. Disseminated : Ceftriaxone1g IM or IV q 24hrs, then PO Cephalosporins x 1 wk b. Cover chlamydia: Azithro 1gm PO x 1, or Doxy 100mg PO BID x 7 days
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16
Q
  1. How does meningococcemia appear clinically? a. TX?
A
  1. Angular infarcts with erythematous rim and gun-metal gray interior a. Pen G 300,000 U/kg/day IV x 10-14days i. Px all contacts: Rifampin 600mg PO BID x 2 days
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17
Q
  1. What is “Waterhouse-friderichsen syndrome”
A
  1. “Waterhouse-friderichsen syndrome” (adrenal hemorrhage/ infarct) may occur 2* hypotension
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18
Q
  1. How does one get vibrio vulnificus?
A
  1. Raw/Undercooked Fish, shellfish, Raw oyster ingestion (V. cholera = watery diarrhea)
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19
Q
  1. What are rose spots, and what causes them?
A
  1. Rose spots in 50-60% after 7-10 days of fever/diarrhea➠ 2-5mm rose-colored macules or papules on the ant trunk between the nipples and umbilicus. Caused by Salmonella typhi
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20
Q
  1. What causes Hebra nose?
A
  1. Hebra nose: nasal enlargement, deformity, and destruction of the nasal cartilage; Rhinoscleroma- Klebsiella rhinoscleromatis- subspecies of Klebsiella pneumoniae (gram (-) rod)
21
Q
  1. What cells help aide in the diagnosis of this?
A
  1. Mikulicz’s cells (parasitized histiocytes) ; Russell bodies: plasma cells with eosinophillic aggregates of Immunoglobulins
22
Q
  1. What do dog bites give you?
A
  1. Pasteurella multocida- Capnocytophaga canimorsus (DF-2 gram neg rod)
23
Q
  1. Human bites? Tx?
A
  1. Eikenella corrodens- Augmentin
24
Q
  1. What causes Glanders?
A
  1. Burkholderia (Pseudomonas) mallei a. Direct contact w/ Horses, mules, donkeys
25
Q
  1. What is the Sporotrichoid spread DDX?
A
  1. SLANT: Spototrichosis; Leishmaniasis; Atypical mycobacterium; Nocardiosis; Tularemia
26
Q
  1. What causes Melioidosis (whitmore disease)?
A
  1. Burkholderia pseudomallei
27
Q
  1. What is the m/c cause of chronic LAN in children? a. Cause? b. What spreads it? c. What causes Oculoglandular syndrome of Parinaud?
A
  1. Cat scratch disease a. Bartonella henslae b. Cat flea (Ctenocephalides felis) c. Oculoglandular syndrome of Parinaud: chronic granulomatous conjunctivitis and preauricular adenopathy from conjunctival innoculation site (affects 5% of pts)
28
Q
  1. What causes bacillary angiomatosis? a. What mediates the Jarisch-herxheimer Reaction?
A
  1. B henselae, B Quintana a. IL-6 and TNF-alpha
29
Q
  1. What causes Peliosis hepatitis?
A
  1. B. henselae
30
Q
  1. What causes Carrion’s disease? a. What is acute vs. chronic, and what are the associated problems? b. TX?
A
  1. B. Bacilliformis a. Oroya fever: ACUTE 2-6 wks after bite. Problem- hemolytic anemia.; Verruga peruana (peruvian wart): CHRONIC (after latency: wk-mos) Angiomatous PG like lesions b. Chloramphenicol 2g qd (+) Beta lactam
31
Q
  1. When do you see Rocha-Lima bodies?
A
  1. Verruga peruana- Rocha-Lima bodies: purple cytoplasmic inclusion bodies in endothelial cells
32
Q
  1. What causes trench fever?
A
  1. B. Quintana a. body louse infection (pediculus humanus corporis)
33
Q
  1. What causes the bubonic plague? a. What transmits it? b. Comb or no comb? c. TX?
A
  1. Yersinia pestis a. Xenopsylla cheopis (rat flea) b. Rat flea has no comb c. Streptomycin 2g/day IM x 10d
34
Q
  1. Cause of Haverhill fever? Other name?
A
  1. Streptobacillus moniliformis; Rate Bite Fever (fever + arthritis + rash)
35
Q
  1. Other name for icteric leptospirosis and cause?
A
  1. Icteric (Weil Syndrome), Leptospira interrogans, serotype icterohaemorrhagiaea. F/C, profound jaundice, purpura, RENAL dysfunction, hemorrhagic diathesis, pulmonary and liver dysfunction, encephalitis
36
Q
  1. Other name for nonicteric leptospirosis and cause?
A
  1. Nonicteric (Fort Bragg fever): L. autumnalis a. pre-tibial exanthem, fever (3-7 days followed by 1-2 day absence), conjunctival form; severe HA
37
Q
  1. What causes Ohara’s disease? a. Source?
A
  1. Tularemia- Francisella tularensis a. M/c source: handling wild rabbits
38
Q
  1. TX of Rickettsial Diseases?
A
  1. Doxycycline 100mg BID x 7 days
39
Q
  1. Cause of Epidemic typhus? a. Vector? b. Host?
A
  1. R. prowazekii a. Pediculus humanus var corporis (body louse) b. Humans and Flying squirrels
40
Q
  1. Cause of endemic (murine) typhus? a. Vector?
A
  1. Rickettsia typhi a. (rat flea) Xenopsylla cheopis
41
Q
  1. Pezh and I got bit by chiggers. What are we going to get now? a. Cause?
A
  1. Scrub typhus - tsutsugamushi fever a. Rickettsia tsutsugamushi
42
Q
  1. Rocky Mountain Spotted Fever cause? a. Vectors and resovoir?
A
  1. Rickettsia ricketsii a. Wood tick = D. andersoni (west US) b. Dog tick = D. variabilis (east US) c. Lone star tick = Amblyomma americanum d. Reservoir: dogs, small animals
43
Q
  1. What causes Boutonneuse fever (Mediterranean fever) a. Vector? b. indurated papule produced by tick bite?
A
  1. R. conorii a. Brown dog tick = Rhiphicephalus sanguineus b. Tache noir
44
Q
  1. Rickettsial pox cause? a. Vector? b. Resovoir? c. WEIL-FELIX positive of negative?
A
  1. R. akari a. Rodent mite = Allodermanyssys sanguineus (blood mite) b. Mus musculus (house mouse reservoir) c. Negative
45
Q
  1. Cause of human monocytic erlichiosis? a. Vector? b. What is seen on Wright-Giemsa stain of leukocytes (PMNs)?
A
  1. Ehrlichia chafeensis a. Amblyomma americanum (lonestar tick) b. mulberry inclusions (morula)
46
Q
  1. Cause of HUMAN GRANULOCYTOTROPIC ANAPLASMOSIS? a. Vector?
A
  1. Ehrlichia phagocytophilia
47
Q
  1. Cause of lyme disease in the US? a. Vector? b. 3 stages? c. 10% of untreated pts get what?
A
  1. Borellia burgdorderi a. Ixodes i. Ixodes scapularis and I. dammini (northwest/midwest) ii. I. pacificus (west) iii. I. ricinus (europe) b. Stage 1: early localized; flu-like symptoms i. Erythema migrans c. Stage 2: early disseminated disease—Hematogenous spread i. Lymphocytic meningitis, cranial neuropathy, carditis and rheumatological changes ii. Borrelial lymphocytoma: B-cell proliferation-bluish/red nodular swelling on the ear lobe (children) or the areola of the nipple or scrotum (adults) d. Stage 3: late Lyme disease–Inflammatory phase i. Acrodermatitis chronica atrophicans (ACA )ii. Neurologic changes (meningitis, encephalitis) e. 10% of untreated pt get carditis– AV block = m/c finding
48
Q
  1. Cause of Acrodermatitis Chronica Atrophicans “Herxheimer dz”? a. Transmitted by what? b. Seen where?
A
  1. B. afzelii a. Ixodes ricinus b. Europe

Andrews/Bolognia Review questions (9 decks)

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