1.6.2013(infectious Diseases) 24 Flashcards
(113 cards)
0
Q
Nutrient agar appearance of staph.aureus
A
Oil paint appearance
Golden yellow pigment at 22 C
1
Q
Ludlam medium
A
Media containing 8-10% Nacl
2
Q
Coagulase + and mannitol fermentation
A
Staph.aureus
Virulence is determined
3
Q
Phosphatase positivity
A
Staph.aureus
4
Q
Reason for MRSA
A
Chromosome mediated MAC A gene
Altered pencillin binding protein
5
Q
Methicillin resistance is more at
A
30 C
6
Q
Staph.aureus resistance to beta lactams
A
Plasmid mediated beta lactamase
7
Q
Most common site of colonisation of staph
A
Anterior nares
8
Q
People with high carriage rate of staph
A
IDDM
pt on hemodialysis
9
Q
Toxin useful for invasion of staph
A
Leukocidin
10
Q
Virulence factor of staph.aureus
A
Clumping factor
11
Q
Super antigen activates
A
Lateral side
Betagamma subunit stimulation
12
Q
Super antigens
A
Enterotoxin
TSST
Pyrogenic exotoxin(strep)
13
Q
Variant of impetigo produced by staph
A
Bullous impetigo
Ecthyma
14
Q
DOC for oral and soft tissue infection due to staph
A
MSSA
Dicloxacillin
1st generation cephalosporin(cefazolin,cephalexin)
15
Q
Oral and soft tissue infections due to MRSA
A
Clindamycin
Co trimoxazole
16
Q
Most common cause of osteomyelitis in children
A
Staph.aureus
17
Q
Vertebral osteomyelitis pt presenting with weakness
A
Epidural abscess
18
Q
Commonest organism of septic arthritis in pt with OA or RA
A
Staph.aureus
19
Q
Necrotising pneumonia
A
Staph.aureus(MRSA)
Pseudomonas
20
Q
Most common cause of IE
A
Staph.aureus
21
Q
Staph.aureus producing IE
A
Rt sided IE in IV drug abusers(most common cause)
Lt sided IE-elderly-valvular insufficiency
Prosthetic IE
22
Q
Foods associated with staph aureus food poisoning
A
Custard
Potato
23
Q
Food poisoning <6hrs
A
Emetic toxin of bacillus cereus(fried rice)
Staph.aureus
24
Characteristics of s.aureus food poisoning
No fever
Self limiting
No need of antibiotic
25
Systemic MRSA
Vancomycin
26
VISA
```
Linezolid(thrombocytopenia)
Daptomycin
Streptogramins(quinpristin dalfopristin)
Tigecycline
Telavanacin
```
27
Early prosthetic valve endocarditis
Staph.epidermidis
28
Streptococci cell wall
Outer lipotechoic acid
Middle C carbohydrate -lancefield typing
Inner peptidoglycan layer
29
Strep pyogenes
Bacitracin sensitivity
PYR test positive
Failure to ferment ribose
30
Group B streptococci biochemical tests
CAMP
| Hippy rate hydrolysis
31
Streptococci culture media
Horse or sheep blood agar
32
Capsule of strep.pyogenes
Hyaluronic acid,antibodies against it are not protective
Cell wall proteins(M protein) are pathogenic
33
M protein crossreacts with
Myocardium
34
Capsule hyaluronic acid cross reacts with
Synovial fluid
35
Strep C carbohydrate cross reacts with
Cardiac valves
36
Oxygen and heat Labile streptolysin
Streptolycin O(pathogenic)
37
Streptolycin S
Heat and oxygen stable
| Detected
38
Pyrogenic exotoxin
| Synonyms
Erythrogenic
Dick
Scarlatiniform toxin
39
Thrombolysis
| Period for which a single drug can be used
<7 days
Only role for streptokinase
40
Antibody detection done for skin and soft tissue infection caused by strep
Anti DNAseB
41
Rx of acute pharyngitis
Penicillin V or benzathine pencillin for 10DAYS
42
Penicillin prophylaxis is useful only for
Acute rheumatic fever
Doesn't prevent glomerulonephritis
43
Strep pharyngitis not resolving with Rx
Peritonsillar or parapharyngeal abscess
44
Scarlet fever rash
Involves upper trunk
| Spares palms and soles
45
Scarlet fever rash
Occurs on second day
Increased skin marking in axilla-pastia lines
Sandpaper feel of skin
Strawberry tongue
46
Rx of streptococcal impetigo
Penicillin
47
Erysipelas
Dermal skin
Tender
Edematous
Systemic symptoms
48
Rx of strep.cellulitis
Procaine penicillin or penicillin G
Sx: only when crepitus,pain out of proportion to lesion,systemic symptoms-necrotising fasciitis
49
Rx of necrotising fasciitis
Penicillin for strep
Vancomycin for staph
Clindamycin for anaerobes
Sx debridement
50
SIRS
RR >24
HR>90
Temp >38 or 11000 or <4000
51
Vasopressor of choice in septic shock
Norepinephrine
52
Inability to maintain BP in septic shock..common cause
1.Sepsis induced adrenal insufficiency
Septic shock
ATN
DIC
53
Diff btw viridans and strep pneumo
Strep.pyogenes
Optochin sensitive
Bile solubility
Inulin fermentation
54
Intrinsically resistant to cephalosporin
Enterococci
Listeria
Drug that can be used: ampicillin
55
IE
```
Infection of
Valve
Mural endocardium
Low pressure side of VSD
Any Intracardiac device
```
Infection of AV shunt doesnt come under this
56
Community acquired native valve endocarditis
Strep viridans
57
Hospital acquired native valve endocarditis
Staph.aureus
58
Prosthetic valve endocarditis
Less than 1 year staph.epidermidis
| Greater than 1 year streptococcus
59
Low risk lesions for IE
ASD
| MVP without MR
60
High risk lesions for IE
```
AR
AS
MR
Prosthetic valve
PDA
VSD
coarctation of aorta
```
MS not included
61
Moderate risk for IE
```
MVP+MR
TS
TR
PS
MS
```
62
Pt with LV depression rate is not controlled with digoxin
| Drug to be added
Amiodarone
63
Specific investigations for IE
Transthoracic echocardiogram
64
Rx of enterococcal IE
Ampicillin+gentamycin
Pencillin allergy: vanco+gentamycin
65
Rx of native valve MRSA
Vancomycin alone
66
Rx of prosthetic valve IE
Vanco+gentamycin+rifampicin
67
Rx of streptococcal IE
Penicillin+gentamycin
68
Rx Culture negative IE
Vancomycin+gentamycin
Add ceftriaxone if HÁČEK group is also suspected
69
HÁČEK
```
H.parainfluenzae and H.aphrophilus
Aggregathibacter actinomyecetocomitans
Cardiobacterium hominis
Eikenella corrodens
Kingella kingae
```
70
High risk lesions for IE prophylaxis
Prosthetic heart valves
Prior endocarditis
Unrepaired congenital heart disease
Repaired congenital heart disease <6months
71
Doc for IE prophylaxis
Amoxicillin
Penicillin allergy: cephalexin,clindamycin,clarithromycin
72
Shape of pneumococci
Flame or lanceolate shaped
73
Appearance of pneumococci colonies
Draughtsman or carrom coin appearance
74
Abnormal protein which precipitates with the somatic C antigen pneumococci
CRP
75
Causes of CAP
1. Strep.pneumo
2. H.influenza
3. Chlamydia pneumonia
4. Legionella pneumonia
76
New onset hiccups
Inferior wall MI
basal pneumonia
Hyponatremia
77
Electrolyte abnormality in legionnaire disease
Hyponatremia
78
DOC for newly diagnosed young (<50yrs) hypertensive
Thiazides(chlorthalidone)
79
Sputum in legionella
Numerous neutrophils but no organism
80
Culture media for mycoplasma
Heart infused peptone broth PPLO
81
Extra pulmonary manifestations in mycoplasma pneumoniae
```
Erythema multiforme
Hemolytic Anemia
Cerebellar ataxia
GBS
SJS
encephalitis
```
82
Direct coomb test is positive for
Warm antibody hemolytic anemia
83
X-ray in mycoplasma pneumonia
Patchy consolidation starting at the hilum and fanning to periphery
84
Only infection that predisposes to atherosclerosis
Chlamydia pneumonia
85
Peri bronchial thickening and sub-segmental collapse
Mycoplasma pneumoniae
86
HAP
Hospital acquired -after 48hrs
| Ventilator associated pneumonia after 48-72 hrs after intubation
87
CURB score 1
Admit in non ICU setting
Rx betalactam+ macrolide or respiratory fluroquinolones
88
CURB score 2 or more
Rx with betalactam + macrolides
| ICU
89
Rx of HCAP
Vancomycin
| Piptaz(or ceftazidime)+gentamycin
90
Only FQ active against pseudomonas
Ciprofloxacin
91
Rapid progression to type 1 respiratory failure occurs in which pneumonia
PcP pneumonia
92
Ground glass opacities seen in which pneumonia
Pcp
| Also perihilar infiltrates
93
Stain for pcp
Methanamine silver
| Toludine blue
94
Most common cause for meningitis
Pneumococci
95
Biochemistry of meningococcus
Catalase and oxidase positive
96
Rx of penicillin allergy in meningococi
Chloramphenicol
97
Pleocytosis
Increased cellularity of CSF
98
Meningitis cause <1month
Enterobactericeae
Strep.agalctiae
Listeria
99
Most common cause of meningitis in 2yrs
H.influenzae
100
Meningitis cause adult male <50yrs
Strep.pneumo
| Neisseria meningitidis
101
Meningitis cause adult male >50yrs
Strep.pneumo
Neisseria meningitidis
Listeria
Pseudomonas
102
Post neurosurgery meningitis cause
S.aureus
103
Infection of CSF by organisms
Bacteria- through choroid plexus
| Virus -through macrophages
104
Cranial nerve palsies are common in which meningitis
TBM
105
Commonest cause of viral meningitis
Enterovirus
106
Bacteria causing aseptic meningitis
Listeria
107
Non infectious causes of meningitis
```
Drugs@
SLE
craniopharyngioma
Dermoid cyst
Post seizure
```
108
Seizures in meningitis
Focal seizures
109
LEFT sided IE in injection drug users cause
Enterococci
110
Candida endocarditis is common in
Heroin abusers
111
Most common deformity associated with type 1 Lepra reaction
Claw hand
112
Novobiocin resistant staph
S.saprophyticus
| S.xylosus
