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EENT/ID > Bacteria > Flashcards

Bacteria Flashcards

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1
Q

define pathogen

A

micoorganism capable of causing disease

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2
Q

define opportunistic

A

rarely causes disease in immunocompetent individuals but can cause severe disease in those with weakened immune response

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3
Q

define bacteremia

A

bacteria in the bloodstream

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4
Q

define sepsis

A

systemic immune response to the infection

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5
Q

define septic shock

A

hypotension, organ dysfunction
- common deadly response to gram positive & negative infections
- high mortality rate

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6
Q

Define gram results

A

purple/blue = gram positive
- thick 2 layer cell wall
- no porin channel or endotoxin
- vulnerable to lysozyme & PCN

pink/red = gram negative
- thin 3 layer cell wall envelope with porin channel
- endotoxin-Lipid A
- resistant to lysozyme & PCN

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7
Q

Describe the coverage & MOA of Beta-Lactams

A

PCN, cephalosporins (3-5 gen), carbapenems
- inhibit cell wall synthesis
- cover gram negative bacteria

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8
Q

What are the 4 major morphologies of bacteria

A
  • cocci: spherical
  • bacilli: rod shaped
  • spiral
  • pleomorphic: lack distinct shape

can organize together to form pairs, clusters, chains, single bacteria with flagella

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9
Q

Describe some bench tests

A

used to further differentiate species
- coagulase test: differentiates staph species
- catalase tests: distinguishes staph v strep v enterococci
- oxidase: differentiates gram negative bacilli
- lancefield grouping: used for strep species

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10
Q

Describe some gram positive bacteria

A
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11
Q

Describe some gram negative bacteria

A

cocci
- neiserria
- moraxella diplococcus

spirochetes
- treponema pallidum
- borrelia
- leptospira

pleomorphic
- chlamydia
- rickettsia

bacilli/rods
- pretty much everything else (enterics & others)

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12
Q

Which bacteria is neither gram positive or negative?

A

Mycoplasma, no cell wall

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13
Q

What is referred to as walking pneumonia

A

mycoplasma pneumonia
- MC cause of atypical pneumonia
- low grade F, dry non-productive cough
- Tx with Azithromycin, doxy, or fluoroquinolone

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14
Q

What are some AEs of fluoroquinolones

A

QT prolongation, cartilage issues

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15
Q

Describe the difference between aerobic vs anaerobic bacteria

A

Obligate Aerobes
- uses oxygen
- breaks down oxygen with enzymes

Obligate anaerobes
- hates oxygen
- no enzymes to defend against oxygen

Facultative anaerobes
- aerobics
- ability to be anaerobic but don’t prefer it

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16
Q

Describe endotoxins

A

proteins released by some Gm+ and Gm- bacteria

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17
Q

describe neurotoxins

A

acts on nerves (paralysis
- tetanus, botulinum

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18
Q

describe enterotoxins

A

acts on GI tract (diarrhea)
- vibrio, e coli, campylobacter, shigella

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19
Q

describe pyrogenic endotoxins

A

lead to rash, fever, toxic shock
- staph aureus, GABHS

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20
Q

Describe tissue evasive endotoxins

A

allow bacteria to destroy tissues (GABHS)

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21
Q

Which abx lower seizure thresholds

A

cephalosporins

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22
Q

Describe a sterile site vs non-sterile site for cultures

A

differentiates if this is a true pathogen or part of the normal flora
- sterile: CSF, pleural fluid, pericardial fluid, synovial fluid, peritoneal fluid (where bacteria is not present usually)
- non-sterile: skin, oropharynx, nose, ears, eyes, throat, perineum

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23
Q

What to consider when interpreting a culture result

A
  • coag negative staph (usually just staph epidermidis - skin contaminant from procedure)
  • assess for WBCs, nitrites, leukocyte esterase in UA along with culture
  • sputum culture with poor sensitivity & specificity
  • squam epithelial cells present reduces likelihood that bacteria is pathogenic
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24
Q

What is the most common organism that causes UTIs

A

e coli

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25
What are the 3 types of gram+ cocci
streptococcus chains, enterococcus chains, staphylococcus clusters
26
Describe the types of hemolysis in streptococci (classifications)
- Alpha-hemolytic: incomplete destruction of RBC (strep pneum, strep viridans) - Beta-hemolytic: complete destruction of RBC (strep pyogenes, GABHS, GBBHS, GDBHS) - gramma-hemolytic: no destruction of RBC
27
Which strep viridans species causes dental caries
strep mutans
28
What pathologies does strep pneumoniae cause
pneumonia, meningitis, otitis media
29
What pathologies does strep viridians cause
subacute bacterial endocarditis, dental caries, brain or liver abscess
30
What pathologies does GABHS (strep pyogenes) cause
pharyngitis, scarlet fever, skin infections, toxic shock syndrome, non-suppurative complications
31
What are the Jones criteria for acute rheumatic fever diagnosis
**need 2 major OR one major & two minor sxs** Major: carditis, arthritis, sydenham chorea, erythema marginatum, subQ nodules Minor: fever, arthralgia, previous RF or rheumatic heart disease, acute phase reactions, prolonged PR interval
32
What do you treat rheumatic fever with
PCN or cephalosporin Macrolides if PCN allergy (early tx of strep is key to prevention, recurrence is common)
33
What pathologies does GBBHS cause
**think B for baby - newborn/neonates** Neonatal meningitis, pneumonia, sepsis
34
What pathologies does GDBHS cause
subacute bacterial endocarditis, biliary tract infections, UTIs
35
What do you treat GDBHS with
ampicillin + aminoglycoside (severe) Ampicillin, amoxicilli for E Faecalis UTI Treat with Vanco if resistent
36
Describe the MOA, coverage, and AEs for vancomycin
MOA: inhibits cell wall synthesis (not a beta lactam) Coverage: gram+, MRSA, c. diff AEs: nephrotoxic, red man syndrome (slow infusion can avoid)
37
What do you treat VRE with
vancomycin resistant enterococcus daptomycin or linezolid
38
Which gram+ staphylococci are coagulase positive v negative
Coag positive: staph aureus Coag negative: staph epidermidis, staph saprophyticus
39
Which pathologies does staph aureus cause
- acute bacterial endocarditis - osteomyelitis - pneumonia - septic arthritis - skin infections - blood & catheter infections - Toxic shock syndrome
40
What pathologies does staph epidermidis cause
UTI in sexually active, pathogenic in prosthetic joints & heart valves
41
What are the 2 classes of MRSA and how do you treat skin/soft tissue infections
HA-MRSA & CA-MRSA (hospital vs community acuired) Tx with oral abx: SMX-TMP, tetracycline, clindamycin Tx with parenteral abx: vanco, dapto
42
What is an example of an acid0fast gram+ bacilli
mycobacterium
43
Describe the etiology & treatment of bacillus antracis
**anthrax** - only bacteria with a capsule made of protein, aerobe, forms endospores, makes exotoxins Treat with cipro or another FQ, antitoxin (prognosis excellent for cutaneous, poor for inhaled/GI anthrax)
44
Describe the etiology of clostridium botulinum
**botulism** - produces extremely lethal neurotoxins that block Ach release - foodborne, infant spores in honey, wound injection site
45
Describe the clinical presentation & treatment of botulism
- symmetric descending weakness - CN dysfunction: diplopia, nystagmus, ptosis, dysphagia, dysarthria, facial weakness - respiratory paralysis - no mental status change - floppy baby syndrome Treat with antitoxin from the CDC, intubation, supportive care
46
Describe the etiology of tetanus
Clostridium tetani Classically follows a puncture wound by rusty nail Spores deposited in the wound & endotoxin released
47
Describe the clinical presentation of tetanus
Pain & tingling at site of inoculation, sustained contraction of skeletal muscles, severe muscle spasm, trismus, grinning expression, death
48
Describe the treatment for tetanus
IM tetanus immunoglobulin, supportive care, mechanical ventilation PCN
49
Describe the etiology of clostridioides difficile
Aka c diff Common nosocomial infection, typically follows use of broad spectrum abx (ampicillin, clindamycin, FQs, cephalosporins) Releases exotoxins
50
Describe the diagnostic testing for C. diff
CBC - leukocytosis Toxin testing in stool Colonoscopy may reveal red inflamed mucosa & areas of white exudate (pseudomembranes)
51
Describe the treatment for c. diff
D/c original antibiotic, infection control Oral vancomycin or fidaxomicin +/- fecal microbiota transplantation
52
Describe the etiology of diphtheria
Cornybacterium diphtheria Transmitted by respiratory secretions & colonizes pharynx, releases exotoxins
53
Describe the clinical presentation of diphtheria
Gray pseudomembrane that bleeds when picked, myocarditis & neuropathy d/t exotoxins in bloodstream
54
Describe the treatment for diphtheria
Horse serum antitoxin PCN or azithromycin/ erythromycin, DPT vax
55
Describe the clinical presentation of syphilis
Primary: painless chancre on genitals Secondary: rash on palms & soles, condyloma latum (wart), Systemic sxs: fever & LAD, may affect CNS, eyes, bones, kidneys, joints Tertiary: develops over 6-40 years, gummas of skin & bond, CV (aortic aneurysm), neurosyphilis Latent: sxs resolved, serologic testing still positive
56
What is the treatment for syphilis
PCN G (Benzathine) IM x1
57
Describe the clinical presentation of lyme
Stage 1: localized - erythema migrans rash Stage 2: disseminated - smaller rashes - neuro: meningitis, CN palsies, peripheral neuropathy - cardiac: myocarditis - arthritis: brief, large joints Stage 3: late stage - chronic arthritis - encephalopathy
58
What is the treatment for lime
doxycycline
59
Describe the etiology of rocky mountain fever
Rickettsia rickettsii Obligate intracellular parasite More common in SE US
60
Describe the clinical presentation of rocky mountain spotted fever
Presents 1 week after bite from wood tick or dog tick Fever, conjunctival redness, severe HA, rash on palms, soles & wrists moving to ankles & trunk
61
What is the treatment for rocky mountain spotted fever
prompt doxycycline
62
Describe the etiology of pertussis/Whooping Cough
Bordatella pertussis highly contagious
63
Describe the clinical presentation of pertussis
Stage 1: Catarrhal, gradual onset of cough mostly at night, cold sxs, most infectious stage Stage 2: paroxysmal, classic whoop Stage 3: convalescent, decrease in frequency & severity of sxs, usually 4 weeks after onset
64
Describe the diagnostic testing of pertussis
nasopharyngeal swab & culture
65
describe the treatment for pertussis
Macrolide - Azithromycin, treat household contacts
66
What is the treatment for legionnaire's disease
Azithromycin

EENT/ID (15 decks)

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