DIT review - Micro 4

Question 1

What pathogens cause rash on hands and soles

Answer 1

• THINK: CARS
  
  • Coxsackie A virus
  • Rocky mountain spotted fever
  • Secondary Syphilus
• Also Kawasaki

Question 2

Pathogens that cause atypical aneumonia

Question 3

Describe the 2 forms of chlamydia

Answer 3

• Elementary body is infectious form (elementary enters)
• Reticular body is active replicating (reticular replicates)

Question 4

Why is Chlamydia a poorly staining bacteria

Answer 4

Obligate intracellular

Lacks classic peptidoglycan wall due to reduced muramic acid

Question 5

Presentation of Chlamydia A-C

Answer 5

Blindness due to follicular conjunctivitis

Question 6

Presentatino of chlamydia D-K

Answer 6

Urethritis, PID, ectomic pregnany

Neonatal disease can be acquired during birth (neonatal conjunctivitis, pneumonia)

Question 7

Presentation of chlamydia L1-L3

Answer 7

Lympogranulosum venereum

Painless genital ulcer with painful inguinal lymph nodes that ulcerate (buboes)

Question 8

Treatment of Chlamydia

Answer 8

Macrolides (Azithromycin)

Tetracyclines

Question 9

Transmission of Coxiella

Answer 9

Spores form in animal droppings and get inhaled

Question 10

Presentation of Q fever

Answer 10

Pneumonia, headache, fever, hepatitis

Question 11

MOA of gardnerella vaginalis

Answer 11

Overgrowth of normal vaginal flora

Question 12

Diagnostic features of gardnerella vaginalis

Answer 12

pH > 4.5

Positive Whiff test with 10% KOH prep (fishy smell worsens when adding KOH)

Clue cells - epithelial cells coated with bacteria)

Question 13

Treatment of gardnerella vaginalis

Answer 13

Metronidazole

Question 14

Treatment of mycoplasma pneumoniae

Answer 14

macrolides

Question 15

Why is Chlamydia obligate intracellular

Answer 15

Cannot produce its own ATP

Question 16

Why are Rickettsia spp obligate intracellular

Answer 16

• Unable to produce CoA, gets it from eukaryotic cells
• NAD+ important for bacterial growth and replication
  
  • Sketchy = Coach (CoAch) holding energy drink (NAD+) and basket of tennis balls

Question 17

Classic triad of symptoms in all Rickettsia species

Answer 17

HA, fever, rash (vasculitis)

Question 18

Diagnostic test of Rickettsia

Answer 18

Weil Felix test = will agglutinate if antibodies against Rickettsia are present

Question 19

Treatment of Rickettsia

Answer 19

Doxycline

Question 20

Transmission of Rickettsia Prowazeki

Answer 20

Lice - louse feeds on blood and defecates near feeding sites and it’s the scratching that infects patients from the lice feces

Question 21

Describe the rash of Rickettsia prowazeki

+ other sx

Answer 21

• Rash starts at trunk and moves out towards the extremities
  
  • Rash spares the hands feet and head
• Myalgia and arthralgia
• Pneumonia
• Encephalitis with dizziness and confusion
• Can cause COMA if really serious

Question 22

Transmission of Rickettsia typhi

Answer 22

No sketchy

fleas

Question 23

Which rickettsia causes endemic vs. epidemic outbreak (typhi vs. prowazeki)

Answer 23

Typhi = endemic (localized to a region)

Prowazeki = epidemia (widespread rampant outbreak)

Question 24

What organism causes Rocky mountain spotted fever

Answer 24

Rickettsia ricketsii

Question 25

Transmission of Rickettsia rickettsii

Answer 25

Dermacenter tick

Question 26

Describe rash and other sx of rocky mountain spotted fever

Answer 26

Rash (starts at extremities and moves centrally)

HA, fever, myalgias

Question 27

Clinical use of Penicillin

Answer 27

• Mostly gram +
• Spirochetes
• Neisseria meningitides

Question 28

What are the Aminopenicillin drugs and what extended spectrum action do they have

Answer 28

Amoxicillin, Ampicillin

Are still penicillinase sensitive

• Uses:
  
  • Gram +
  • Gram (-): HHEELPS
    
    • H. Flu, H. Pylori, E. Coli, Enterococci, Listeria, Proteus, Salmonella, Shigella

Question 29

Describe the setting in which aminopenicillins may cause rash

Answer 29

In the setting of viral illness (EBV)

Question 30

What are the penicillinase-resistant penicillins and how do they have resistance

Answer 30

Nafcillin, Oxacillin, Dicloxacillin

Bulky R group blocks access of beta-lactamase to beta-lactam ring

Question 31

Why don’t Penicillinase-resistant penicillins work against MRSA

Answer 31

Because MRSA has altered PBPs (resistance has nothing to do with beta-lactamase)

Question 32

What are the anti-pseudomonal penicillins

Answer 32

Ticarcillin, Piperacillin

Question 33

What are the beta-lactamase inhibitors

Answer 33

Clavulanic acid, Sulbactam, Tazobactam

Question 35

What generation is Cefuroxime

Answer 35

2nd

Question 36

What generation is Cefepime

Answer 36

4th

Question 37

What generation is Cefazolin

Answer 37

1st

Question 38

What generation is Cephalexin

Answer 38

1st

Question 39

What generation is Ceftazidime

Answer 39

3rd

Question 40

What generation is Ceftaroline

Answer 40

5th

Question 41

What generation is Cefotaxime

Answer 41

3rd

Question 42

What generation is Cefaclor

Answer 42

2nd

Question 43

Uses of first generation cephalosporins

Answer 43

• Uses:
  
  • Gram +
  • PEcK = Proteus, E. Coli, Klebsiella (UTI bugs)
  • Surgical prophylaxis

Question 44

Uses of 2nd generation cephalosporins

Answer 44

• Uses:
  
  • Gram +
    
    • HENS PECK = H. Flu, Enterobacter, Neisseria, Serratia + PECK

Question 45

Uses of 3rd generation Cephalosporins

Answer 45

• Uses:
  
  • Serious gram negative infections (meningitis, pneumonia, endocarditis, gonorrhea, Lyme disease)
  • Ceftazidime treats pneumonia

Question 46

Uses of 4th generation Cephalosporins

Answer 46

• Broad spectrum, meningitis
• Pseudomonas

Question 47

Uses of 5th generation cephalosporins

Answer 47

• Broad spectrum
• MRSA

Question 48

Bugs not covered by Cephalosporins

Answer 48

• THINK: LAME
  
  • Listeria, Atypicals (Chlamydia, Mycoplasma), MRSA (except 5^th gen), Enterococci