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Flashcards in FA - Micro - Systems Deck (168):
0

Normal dominant flora - Skin?

S.epi

1

Normal dominant flora - nose?

S.epi - colonized by S.aureus.

2

Normal dominant flora - oropharynx?

Viridans group strep

3

Normal dominant flora - dental plaque?

S.mutans

4

Normal dominant flora - colon?

B.fragilis>E.coli

5

Normal dominant flora - vagina?

Lactobacillus - colonized by E.coli and group B strep.

6

Normal flora - neonates by C-section?

Have NO FLORA but are rapidly colonized after birth.

7

Food poisoning - starts quickly/ends quickly?

1. S.aureus
2. B.cereus

8

Food poisoning - B.cereus source?

Reheated rice.

9

Food poisoning - C.perfringens source?

Reheated meat dishes.

10

Food poisoning - E.coli O157:H7 source?

Undercooked meat.

11

Food poisoning - Salmonella source?

Poultry, meat, and eggs.

12

Food poisoning - S.aureus source?

1. Meats
2. Mayonnaise
3. Custard
==> PREFORMED TOXIN.

13

Food poisoning - V.parahemolyticus and V.vulnificus source?

Contaminated SEAfood.

14

V.vulnificus besides food poisoning?

Wound infections from contact with contaminated water or shellfish.

15

Mention altogether the most important food poisoning bugs.

1. B.cereus
2. S.aureus
3. C.botulinum
4. C.perfringens
5. E.coli O157:H7
6. Salmonella
7. V.parahemolyticus and V.vulnificus

16

Bugs causing bloody diarrhea?

1. Campylobacter
2. E.histolytica
3. EHEC
4. EIEC
5. Salmonella
6. Shigella
7. Y.enterocolitica

17

Bloody diarrhea - Campylobacter?

1. Comma- or S-shaped organism.
2. Growths at 42C.

18

Bloody diarrhea - E.histolytica?

1. Protozoan
2. Amebic dysentery
3. Liver abscess

19

Bloody diarrhea - EHEC?

1. O157:H7.
2. Can cause HUS.
3. Makes Shiga-like toxin.

20

Bloody diarrhea - EIEC?

Invades colonic mucosa.

21

Bloody diarrhea - Salmonella?

1. Lactose(-)
2. Flagellar motility
3. Animal reseervoir
4. Especially POULTRY/EGGS

22

Bloody diarrhea - Shigella?

1. Lactose(-)
2. Very low ID50
3. Shiga toxin - Human reservoir only
4. Bacillary dysentery

23

Bloody diarrhea - Y.enterocolitica?

1. Day-care outbreaks
2. Pseudoappendicitis

24

Watery diarrhea bugs?

1. C.difficile
2. C.perfringens
3. ETEC
4. Protozoa
5. V.cholerae
6. Viruses

25

Watery diarrhea - C.difficile?

1. Pseudomembranous colitis
2. By antibiotics
3. Occasionally bloody diarrhea

26

Watery diarrhea - C.perfringens?

Also causes GAS GANGRENE.

27

Watery diarrhea - ETEC?

1. Traveler's diarrhea
2. Heat-labile and heat-stable toxins

28

Watery diarrhea - Protozoa

1. Giardia
2. Cryptosporidium (immunocompromised)

29

Watery diarrhea - V.cholerae?

1. Comma-shaped organisms
2. Rice-water diarrhea
3. Often from INFECTED SEAfood

30

Watery diarrhea - Viruses?

1. Rotavirus
2. Norovirus
3. Adenovirus

31

Common causes of pneumonia - neonates (<4wk)?

1. Group B strep
2. E.coli

32

Common causes of pneumonia - children (4wk-18y)?

1. Viruses - RSV
2. Mycoplasma
3. C.trachomatis (infants-3y)
4. C.pneumoniae (school-aged children)
5. S.pneumoniae

33

Common causes of pneumonia - adults (18-40yr)?

1. Mycoplasma
2. C.pneumoniae
3. S.pneumoniae
4. Viruses ==> Influenza.

34

Common causes of pneumonia - adults (40-65y)?

1. S.pneumoniae
2. H.influenza
3. Anaerobes
4. Viruses
5. Mycoplasma

35

Common causes of pneumonia - Elderly?

1. S.pneumoniae
2. Influenza virus
3. Anaerobes
4. H.influenza
5. Gram(-) rods

36

Common causes of pneumonia - Alcoholic/IVDA?

Alcoholics ==> Klebsiella + Anaerobes (eg Peptostreptococcus, Fusobacterium, Prevotella, Bacteroides).
IVDA ==> S.pneumo + S.aureus.

37

Common causes of pneumonia - Aspiration?

Anaerobes

38

Common causes of pneumonia - Atypical?

1. Mycoplasma
2. Legionella
3. Chlamydia

39

Common causes of pneumonia - CF?

1. Pseudomonas
2. S.aureus
3. S.pneumoniae
4. B.cepacia.

40

Common causes of pneumonia - Immunocompromised?

1. Staph
2. Enteric gram(-) rods
3. Fungi
4. Viruses
5. P.jiroveci (with HIV)

41

Common causes of pneumonia - Nosocomial?

1. Staph
2. Pseudomonas
3. Other enteric gram(-) rods

42

Common causes of pneumonia - Postviral?

1. S.pneumo
2. H.influenza
3. S.aureus

43

Common causes of meningitis - Newborn (0-6mo)?

1. Group B strep
2. E.coli
3. Listeria

44

Common causes of meningitis - Children (6-6yr)?

1. S.pneumoniae
2. N.meningitis
3. H.influenza type B
4. Enteroviruses

45

Common causes of meningitis - 6-60y?

1. S.pneumoniae
2. N.meningitidis (#1 in teens)
3. Enteroviruses
4. HSV

46

Common causes of meningitis - 60+y?

1. S.pneumoniae
2. Gram(-) rods
3. Listeria

47

Meningitis empirical treatment?

1. Vancomycin
2. Ceftriaxone
3. Add ampicillin if Listeria is suspected.

48

Viral causes of meningitis?

1. Enteroviruses (Coxsackie)
2. HSV-2 (HSV-1=encephalitis)
3. HIV
4. West Nile virus ==> ALSO causes encephalitis.
5. VZV

49

In HIV - causes of meningitis?

Cryptococcus spp.

50

CSF findings in meningitis - Bacterial?

1. UP pressure
2. UP PMNs
3. UP protein
4. DOWN sugar

51

CSF findings - Fungal/TB?

1. UP pressure
2. UP lymphocytes
3. UP proteins
4. DOWN sugar

52

CSF findings in meningitis - viral?

1. Normal/UP pressure
2. UP lymphocytes
3. Normal/UP protein
4. Normal sugar

53

Osteomyelitis - assume no other info is available?

S.aureus (MC overall)

54

Osteomyelitis - sexually active?

N.gonorrhoeae (rare) - septic arthritis more common.

55

Osteomyelitis - IVDA?

1. P.aeruginosa
2. Candida.
3. S.aureus.

56

Osteomyelitis - sickle cell?

1. Salmonella
2. S.aureus

57

Osteomyelitis - prosthetic joint replacement?

1. S.aureus
2. S.epi

58

Osteomyelitis - vertebral involvement?

1. S.aureus.
2. Myco TB (Pott).

59

Osteomyelitis - cat and dog bites?

P.multocida

60

Osteomyelitis - target group?

Children

61

Osteomyelitis - Radiograph or MRI?

MRI ==> Acute infection + Detailing anatomic involvement.
X-RAY ==> Useful in CHRONIC osteomyelitis.

62

Cystitis presents with?

1. Dysuria
2. Frequency
3. Urgency
4. Suprapubic pain
5. WBCs (but NOT WBCs casts) in urine.

63

Cystitis - mechanism in MALES - infants, elderly?

1. Congenital defects (Infants).
2. Vesicoureteral reflux (Infants)
3. Enlarged prostate (elderly)

64

Pyelonephritis symptoms?

1. Fever
2. Chills
3. Flank pain
4. Costovertebral angle
5. Tenderness
6. Hematuria
7. WBC casts

65

UTI - how more common in women?

10X! - shorter urethras colonized by fecal flora.

66

UTI - Predisposing factors besides female?

1. Obstruction
2. Kidney surgery
3. Catheterization
4. GU malformation
5. Diabetes
6. Pregnancy

67

UTI - Diagnostic markers?

1. Leukocyte esterase test (+) ==> Evidence of WBC activity.
2. Nitrite test (+) ==> Reduction of urinary nitrates by bacterial species (eg E.coli).
3. Urease test (+) ==> Urease-producing bugs (eg Proteus, Klebsiella).

68

UTI bugs - E.coli - features?

1. Leading cause of UTI.
2. Colonies show green metallic sheen on EMB agar.

69

UTI bugs - Staph sapro - features?

2nd leading cause of UTI in sexually active women.

70

UTI bugs - K.pneumoniae - features?

1. 3rd leading cause of UTI.
2. Large mucoid capsule and viscous colonies.

71

UTI bugs - Serratia marcescens - features?

1. Some strains produce a red pigment.
2. Often nosocomial and drug resistant.

72

UTI bugs - Enterococcus - features?

Often nosocomial and drug resistant.

73

UTI bugs - P.mirabilis - features?

1. Motility causes "swarming" on agar.
2. Produces urease
3. Associated with struvite stones

74

UTI bugs - P.aeruginosa - features?

1. Blue-green pigment and fruity odor
2. Usually nosocomial and drug resistant

75

UTI - diagnostic tests - Leucocyte esterase (+)?

Bacterial UTI.

76

UTI - diagnostic tests - nitrite tests?

Gram(-) bugs.

77

UTI - Urease test (+)?

1. Klebsiella
2. Proteus

78

UTI - urease (-)?

1. E.coli
2. Enterococcus

79

Mention altogether the most important UTI bugs.

1. E.coli
2. S.sapro
3. K.pneumoniae
4. Serratia marcescens
5. Enterococcus
6. P.mirabilis
7. P.aeruginosa

80

3 common vaginal infections?

1. Bacterial vaginosis
2. Trichomonas vaginitis.
3. Candida vulvovaginitis

81

Bacterial vaginosis - signs/symptoms?

1. No inflammation
2. Thin, white discharge with fishy odor

82

Bacterial vaginosis - lab findings?

1. Clue cells
2. pH>4.5

83

Bacterial vaginosis - Treatment?

Metronidazole

84

Trichomoniasis - signs/symptoms?

1. Inflammation ==> Strawberry cervix.
2. Frothy, grey-green, foul-smelling discharge

85

Trichomoniasis - Lab findings?

1. Motile trichomonads
2. pH>4.5

86

Trichomoniasis - treatment?

Metronidazole - treat sexual partner.

87

Candida vulvovaginitis - signs/symptoms?

1. Inflammation
2. Thick, white, "cottage cheese" discharge

88

Candida vulvovaginitis - lab findings?

1. Pseudohyphae
2. pH NORMAL (4-4.5)

89

Candida vulvovaginitis - treatment?

-azoles

90

ToRCHeS infections - Transmission?

Mostly transplacentally, or via delivery (especially HSV-2).

91

Non specific signs common to many ToRCHeS infections?

1. HSM
2. Jaundice
3. Thrombocytopenia
4. Growth retardation

92

Besides ToRCHeS, other important infectious agents?

1. S.agalactiae
2. E.coli
3. Listeria
4. B19 --> Hydrops fetalis

93

T.gondii - transmission?

Cat feces or ingestion of undercooked meat.

94

T.gondii - maternal manifestations?

1. Usually asymptomatic
2. Lymphadenopathy (rarely)

95

T.gondii - neonatal manifestations?

Classic triad:
1. Chorioretinitis
2. Hydrocephalus
3. Intracranial calcifications
+/- "BLUEBERRY MUFFIN RASH"

96

Rubella - transmission?

Respiratory droplets.

97

Rubella - maternal manifestations?

1. Rash
2. Lymphadenopathy
3. POLYARTHRITIS/POLYARTHRALGIA

98

Rubella - neonatal manifestations?

Classic triad:
1. PDA (or pulmonary artery hypoplasia)
2. Cataracts
3. Deafness
+/- "blueberry muffin" rash.

99

CMV - transmission?

1. Sexual contact
2. Organ transplants

100

CMV - Maternal manifestations?

1. Usually asymptomatic
2. Mononucleosis-like illness

101

CMV - Neonatal manifestations?

1. Hearing loss
2. Seizures
3. Petechial rash
4. "Blueberry muffin" rash
5. PERIVENTRICULAR CALCIFICATIONS

102

HIV -transmission?

1. Sexual contact
2. Needlestick

103

HIV - maternal manifestations?

Variable presentation depending on CD4+ count.

104

HIV - neonatal manifestations?

1. Recurrent infections
2. Chronic diarrhea

105

HSV-2 - transmission?

Skin or mucous membrane contact.

106

HSV-2 - maternal manifestations?

1. Usually asymptomatic
2. Herpetic (vesicular) lesions

107

HSV-2 - Neonatal manifestations?

1. Encephalitis
2. Herpetic (vesicular) lesions

108

Syphilis - transmission?

Sexual contact

109

Syphilis - maternal manifestations?

Chancre (1o) and disseminated rash (2o) are the two stages likely to result in fetal infection.

110

Syphilis - neonatal manifestations?

1. Often stillbirth
2. Hydrops fetalis
==> IF CHILD SURVIVES:
3. Notched teeth
4. Saddle nose
5. Short maxilla
6. Saber shins
7. CN VIII deafness

111

ToRCHeS?

Toxo
Rubella
CMV
HSV-2
Syphilis

112

Red rashes of childhood?

1. Coxsackievirus type A
2. HHV-6
3. Measles virus
4. Parvo B19
5. Rubella virus
6. S.pyogenes
7. VZV

113

Red rashes of childhood (RRC) - Coxsackie A?

Hand-foot-mouth disease

114

Hand-foot-mouth disease clinical presentation?

1. Vesicular rash on palms
2. Soles
3. Vesicles and ulcers in oral mucosa

115

RRC - HHV-6?

Roseola = EXANTHEM SUBITUM

116

Roseola clinical presentation?

1. ASYMPTOMATIC rose-colored MACULES over body appears after several days of high fever.
2. Can present with febrile seizures.
3. Usually affects infants.

117

Measles (rubeola) clinical presentation?

1. A paramyxovirus
2. Beginning at head and moving down
3. Rash is PRECEDED by cough, coryza, conjunctivitis, and blue-white (Koplik) spots on buccal mucosa.

118

Erythema infectiosum (5th disease - B19) clinical presentation?

"Slapped cheek" rash on face - can cause hydrops fetalis in pregnant woman.

119

Rubella (German measles) clinical presentation?

Pink coalescing MACULES begin at head and moves down --> fine truncal rash.
==> POST-AURICULAR LYMPHADENOPATHY.

120

S.pyogenes - scarlet fever - clinical presentation?

Erythematous, sandpaper-like rash with fever and sore throat.

121

VZV - chickenpox - clinical presentation?

1. Vesicular rash begins on TRUNK.
2. Spreads to FACE + EXTREMITIES with lesions of DIFFERENT ages.

122

Mention the major sexually transmitted diseases?

1. AIDS
2. Chancroid
3. Chlamydia
4. Condylomata acuminata
5. Genital herpes
6. Gonorrhea
7. Hep B
8. Lymphogranuloma venereum
9. Syphilis
10. Trichomoniasis

123

Chancroid - clinical features?

1. Painful genital ulcer
2. Inguinal adenopathy

124

Chancroid - organism?

H.ducreyi

125

Chlamydia - clinical features?

1. Urethritis
2. Cervicitis
3. Conunctivitis
4. Reactive arthritis
5. PID
6. EPIDIDYMITIS.

126

Chlamydia - organisms (types)?

Chlamydia trachomatis D-K

127

Condylomata acuminata - features?

1. Genital warts
2. Koilocytes

128

Condylomata acuminata - organism?

HPV-6 and -11.

129

Genital herpes - features?

1. Painful penile, vulvar, or cervical vesicles and ulcers.
2. Systemic symptoms such as fever, headache, myalgia.

130

Genital herpes - organisms?

1. HSV-2
2. HSV-1 less commonly

131

Gonorrhea - features?

1. Urethritis
2. Cervicitis
3. PID
4. Prostatitis
5. Epididymitis
6. Arthritis
7. Creamy purulent discharge

132

Lymphogranuloma venereum - features?

1. Infection of lymphatics
2. Painless, genital ulcers
3. Painful lymphadenopathy (buboes)

133

Lymphogranuloma venereum - C.trachomatis subtypes?

L1-L3.

134

1o syphilis - features?

PainLESS chancre

135

2o syphilis - features?

1. Fever
2. Lymphadenopathy
3. Skin rashes
4. Condylomata lata

136

3o syphilis - features?

1. Gummas
2. Tabes dorsalis
3. General paresis
4. Aortitis
5. Argyll-Robertson pupil

137

Trichomoniasis - features?

1. Vaginitis
2. Strawberry cervix
3. Motile in wet prep

138

PID - Top bugs?

1. Chlamydia trachomatis ==> Subacute + Often UNDIAGNOSED.
2. N.gonorrhoeae ==> ACUTE.

139

PID features?

1. Chandelier sign = cervical motion tenderness.
2. Purulent cervical discharge

140

PID may include which conditions?

1. Salpingitis
2. Endometritis
3. Hydrosalpinx
4. Tubo-ovarian abscess

141

C.trachomatis + N.gonorrhoeae --> which syndrome?

Fitz-Hugh-Curtis syndrome --> Infection of the liver CAPSULE and "violin string" adhesions of PERITONEUM to liver.

142

Salpingitis - risk factor for?

1. Ectopic pregnancy
2. Infertility
3. Chronic pelvic pain
4. Adhesions

143

Major nosocomial infections?

1. C.albicans
2. CMV, RSV
3. E.coli
4. P.mirabilis
5. HBV
6. Legionella
7. P.aeruginosa

144

Nosocomial infection (NI) - C.albicans - risk factor?

Hyperalimentation

145

NI - CMV, RSV - Risk factors?

Newborn surgery

146

NI - E.coli, P.mirabilis - Risk factors?

Urinary catheterization.

147

2 MCC of NI are?

1. E.coli (UTI)
2. S.aureus (wound infection)

148

NI - HBV - Risk factor?

Work in renal dialysis unit.

149

Bugs affecting unimmunized children - dermatologic - pathogens?

1. Rubella virus
2. Measles virus

150

Asplenic patient

Encapsulated microbes - SHiN
S.pneumoniae >> H.influenza B > N.meningitidis

151

Branching rods in oral infection
Sulfur granules

Actinomyces israelii

152

Chronic granulomatous disease

Cat (+) microbes - esp. S.aureus

153

"Currant jelly" sputum

Klebsiella

154

Dog or cat bite

P.multocida

155

Facial nerve palsy

Borrelia burgdorferi (Lyme disease)

156

Fungal infection in diabetic or immunocompromised

Mucor or Rhizopus spp.

157

Health care provider

HBV - from needle stick.

158

Neutropenic patients

C.albicans (systemic)
Aspergillus

159

Organ transplant recipient

CMV

160

PAS (+)

Tropheryma whipplei

161

Pediatric infection

Haemophilus influenza (including epiglottitis).

162

Pneumonia in CF
Burn infection

P.aeruginosa

163

Pus
Empyema
Abscess

S.aureus

164

Rash on hands and feet

Coxsackie A
Treponema pallidum
Rickettsia rickettsii

165

Sepsis/meningitis in newborn

Group B strep

166

Surgical wound

S.aureus

167

Traumatic open wound

C.perfringens