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ms2 unit4 cardioresp > Micro > Flashcards

Micro Flashcards

1
Q

viral CNS inftn

CSF lab values for viral meningitis

  1. glucose
  2. protein
  3. total WBC
A
  1. glucose = 10-45 mg/dL
  2. protein = 50-250 mg/dL
  3. total WBC = cells/microL
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2
Q

viral CNS inftn

WNV meningeoencephalitis occurs in __% of WNV inftns (high risk popn = cancers, DM, htn, CKD)

A

1%

hint: recovery in wks-mo’s; permanent neuro effects

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3
Q

viral CNS inftn

Name the virus

  • transmitted by mosquito/ticks vectors
  • attenuated vax for yellow fever + japanese encephalitis
  • more common in summer
A

Flavivirus

hint: adesus = urban only; culex = forest, urban

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4
Q

viral CNS inftn

3 points of entry for ____ in CNS include:

  1. nasal vacity
  2. retrograde axonal travel
  3. intact transcytosis (endoth cells/leaky pores)
A

arborvirus

hint: humans= dead end, incidental host

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5
Q

viral CNS inftn

____ (virus) is chrs by the following patho phys

  • fecal oral transmission
  • esophageal/skin entry
  • serum Abs block spread –> viral shedding in GI tract
  • high asympto inftn rate
  • no vax/licensed antivirals
A

Enterovirus (Picornavirus)

hint: fecal-oral; exposure to poor sanitation; common in summer

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6
Q

viral CNS inftn

out 68, 70, 71 - which enterovirus causes:

severe resp dz?

A

enterovirus 68

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7
Q

viral CNS inftn

out 68, 70, 71 - which enterovirus causes:

paralutics dz, acute hemorr conjunctivitis?

A
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8
Q

viral CNS inftn

out 68, 70, 71 - which enterovirus causes:

paralytic dz, encephalitis, meningitis, hand-foot-mouth dz

A

enterovirus 71

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9
Q

viral CNS inftn

____ (virus) chrs include:

  • replication in muscle
  • wk-mo’s of incubation deps on distance from CNS
  • retrograde travels from peripheral nerves
  • prevention = post exposure vax (dt long incubation)
A

Rabies (rhabdovirus)

hint: spreads to non human salivary glands

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10
Q

viral CNS inftn

reproduction of _____ in the brain causes:

  • hydrophobia
  • seizures
  • hallucinations
  • paralysis
  • coma + death
A
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11
Q

viral CNS inftn

____(virus) encephalitis is chr by

  • trigeminal N spread
  • unilateral temporal lobal abn’s (see pic)
  • most common cause of sporadic viral enceph
A

HSV1

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12
Q

viral CNS inftn

Treat HSV + VZV aggressivley with _____

A

ayclovir

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13
Q

viral CNS inftn

HSVV1, HSV2, VZV are _____ which are neurotropic

A

alphaherpesviruses

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14
Q

viral CNS inftn

cytolytic enceph occurs ___ after inftn

A

1-2 weeks

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15
Q

viral CNS inftn

ddx meningitis from enceph - 2

A

encephalitis has

  1. intracerebral hemorrhage
  2. altered mental status (incl personality + poor judgement)
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16
Q

brudzinski sign (flexed knees when neck is flexed) is positive for

A

meningitis

hint: mental status intact

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17
Q

Pneumonia

These are all prevention for what inftn?

  1. Acellular vaccine
  2. whole heat killed vax
  3. prophx maroclide (erythromycin)
A

B. Pertussis

hint: both vax req 10 year boosters

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18
Q

Pneumonia

toxigenisis of the B. pertussis - 4

A
  1. PTX (AB toxin, 2˚ attachment, leukocytosis)
  2. Adenylate Cyclase toxin (mø apop, IR evasion)
  3. Tracheal cytotoxin (cough)
  4. LPS (inflamm)
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19
Q

Pneumonia

_____ is mainly responsible for atachment of B. pertussis to cilia (resp epith cells)

A

Filamentous hemagglutinin

hint: others responsb = PTX, fimbriae, pertactin, trach colonizn factor

20
Q

Pneumonia

Whats the bug?

  • highly contagious short G- rod with inadeq vax coverage
  • cultured on regan Lowe Media
A

B pertussis

hint: abroad vax (killed cell) >> US vax (short lived, acellular)

21
Q

Pneumonia

_____ causes

  • neonatal + p/partum sepsis
  • CF pneumonia
  • systemic complication p/local mucosal inftn (IMNS)
A

NTHi (Unencaps H flu)

hint: not vax covered

22
Q

Pneumonia

Hib and NTHi versions of H flu share what in common? - 3

A
  1. IgA protease
  2. pili
  3. adhesins
23
Q

Pneumonia

G- pleomorphic (cocci + rod) microbe with rapid bacteremia that leads to celluliltus epilogttis, septic arthritis and lethal meningitis

A

H. influenzae

24
Q

Pneumonia

lab Dx for what organism?

  • cultured on chocolate agar (heated-blood) ± factors V (hemin) and X (NAD)
  • quelung rxn ddx’s serotype
A

H. flu

25
Q

Pneumonia

Surgical drainage + batrim/cerfuroxime, axetil, cefixime, macrolides, or fluoroquinolones are used to treat ____(manifestation) of Hib inftn

A

Cellulitis, Pericarditis, Septic Arthritis

26
Q

Pneumonia

How would you tx the inftn below? - 3

A

Hib Meningitis

  1. ceftriaxone
  2. dexamethasone (if > 2 mo)
  3. supportive care

hint: monitor for sensitivity

27
Q

Pneumonia

Tx for upper resp Hib inftn? - 2 combos

A
  1. amoxicillin + clavulanate
  2. Bactrim (TMP-SMX)
28
Q

Pneumonia

Describe tx for Hib manifestations below:

  1. Epiglottitis
  2. Otitis Media
A
  1. inutbation/trach + ABx
  2. amoxicillin
29
Q

Pneumonia

Properties of what two bugs? - 2

  • human restricted and fastidious to culture
  • required factors X + V in vitro
  • resp droplet transmission
  • pediatric contagious resp intn
  • vax, abx, and supp care
A

H flu + Bordetella

30
Q

Pneumonia

Virulence factors that determine pathogenicity of _____?

  1. LOS endotoxin
  2. IgA protease
  3. meningococcus capsule
  4. gonococcus pilli
  5. porins
  6. Opa
A

Neisseria

hint: capsule resistts phagocytosis; VIP vax component

31
Q

Pneumonia

What should you use to culture Neisseria on mucosal sites vs sterile sites? -2

A
  1. Thayer-Martin medium for mucosal (GU, nasal)
  2. Blood agar for sterile (CSF, blood)
32
Q

Pneumonia

G- diplococci, facultative aerobe, human-restricted, oxidase + catalase pos; ferments maltose (malt liquor)

A

Neisseria Meningitidis

33
Q

Pneumonia

Host defenses against N. menigitidis? - 2

A
  1. IgG enh complement
  2. PMNs
34
Q

Pneumonia

____ predisposes pts to Neisseria complications

A

complement defc

hint: C5-9 VIP for poking holes

35
Q

Pneumonia

aysmpto/untreated ____ in women leads to PID

A

gonoccocus

36
Q

Pneumonia

even tho are neonates are passibely protected from meningococc they still need prophx eye ointment for ____

A

gonococcus

37
Q

Pneumonia

N. meningitidis treatment includes? -2

A
  1. ceftriaxone/cefixime
  2. rifampin (prophx)

DO NOT USE STEROIDS!!!!

hint: prevention = meningcocc vax + gonococc condoms

38
Q

Pneumonia

meningococcemia with higher fever, shock, widespread purpura, and DIC

A

Waterhouse-Friderichen Syndrome

39
Q

Pneumonia

G+, catalase⊖, diplococci that form chains in culture

A

Pneumococcus (Step pneumoniae)

40
Q

Pneumonia

How would you treat?

Strep pneumonia that sinusitis, otitis media, mild pneumonia

A

outpt amoxicillin

41
Q

Pneumonia

how would you tx severe strep pneum w. rusty sputum, lobar consoldn, ↑procalcitonin (labs: xray and urine Ag⊕)? - 3

A

admit for

  1. amoxicillin,
  2. flouroquins,
  3. a/o vanco

(after sensitivity testing)

42
Q

Pneumonia

risk factors fr invaseive pneumococc dz? - 2

A
  1. ø vax coverage
  2. ↓/ø spleen fx
43
Q

Pneumonia

Gram stain + culture would be positive in spinal tap unless?

A

abx tx began >4 hrs prior

44
Q

Pneumonia

If pneumococc came back resisant (toxic MIC), and you couldnt tx with vanco + ceftriaoxne/cefotaxime, what would you use? - 3

A
  1. rifampin
  2. meropenem
  3. chloramphenicol

hint: use steroids sparingly

45
Q

what vax prevents pneumococc invasive disease? Why did they step it up? - 2

A
  1. Prevnar13 (formally7)
  2. dt replacement dz after herd immunity established

ms2 unit4 cardioresp (4 decks)

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