General characteristics and associations

Question 1

Patients with chronic graulomatous disease are at increase risk of infection to which type of pathogen?

Answer 1

Catalase (+) bacteria and fungi –> they can break down their own H2O2 and thus can survive since the host has impaired oxidative burst

Question 2

Which pathogens are urease (+)?

Answer 2

Cryptococcus, H. pylori, Proteus, Ureaplasa, Nocardia, Klebsiella, S. epidermidis, S. saprophyticus

Question 3

Which pathogens are catalase (+)?

Answer 3

Staph, Burkholderia cepacia, Serratia, Nocardia, E.coli, Psuedomonas, Listeria, Aspergillus

Question 4

Which pathogens are lactose-fermenting?

Answer 4

Citrobacter, Klebsiella, E. coli, Enterobacter, Serratia (weak lactose fermentor)

Question 5

What pathogens are sickle cell disease patients at high risk of infection?

Answer 5

encapsulated organisms: Salmonella, staph aureus (both can cause osteomyelitis), strep pneumoniae, H. influenzae B, Neisseria meningitidis, E. coli, Klebsiella

Question 6

What is the classic presentation for congenital Rubella?

Answer 6

infant born to immigrant with white pupils (cataracts), sensory-neural deafness, PDA

Question 7

What are the common causes of pneumonia in neonates (

Answer 7

Group B strep (agalactiae), E. coli

Question 8

What are the most common causes of penumonia in children (4wk-18yrs)

Answer 8

Viruses (RSV), Mycoplasma, C. trachomatis (infants-3yr), C. pneumoniae (school aged), S. pneumoniae

Question 9

What are the most common causes of pneumonia in adults 18-40yrs

Answer 9

Mycoplasma, C. pneumoniae, S. pneumoniae

Question 10

What are the most common causes of pneumonia in adults 40-65yrs

Answer 10

S. pneumoniae, H. influenzae, anaerobes, viruses, mycoplasma

Question 11

What are the most common causes of pneumonia in the elderly (>65yrs)

Answer 11

S. pneumoniae, Influenza virus, anaerobes, H. influenzae, gram(-) rods

Question 12

What are the signs, lab findings and treatment for bacterial vaginosis?

Answer 12

Signs and symptoms: No inflammation, thin white discharge with fishy odor

Lab findings: Clue cells, pH>4.5

Treatment: metronidazole

Question 13

What are the signs, lab findings and treatment for Trichomoniasis?

Answer 13

Signs and symptoms: Inflammation “strawberry cervix”; frothy, green-foul smelling discharge

Lab findings: motile trichomonads, pH >4.5

Treatment: Metronidazole (also treat partners)

Question 14

What are the signs, lab findings and treatment for Candida vulvovaginitis?

Answer 14

Signs and symptoms: inflammation; thick, “cottage cheese” discharge

Lab findings: pseudohyphae, pH normal (4-4.5)

Treatment: -azoles

Question 15

What are the ToRCHeS infections?

Answer 15

Microbes passed from mother to fetus via transplacenta or delivery (HSV-2)

Toxoplasma gondii
Rubella
CMV
HIV
HSV-2
Syphilis

Also: Strep agalactiae, E. coli and Listeria cause meningitis and Parvovirus B19 causes hydrops fetalis

Question 16

What causes “hand-foot-mouth” disease and what is the clinical presentation?

Answer 16

Coxsackievirus A (picornavirus ss RNA(+) virus)

Presentation: oval shaped vesicles on palms, soles and oral mucosa

Question 17

What childhood rash does HHV-6 cause and how does it present?

Answer 17

Herpes virus, enveloped ds linear DNA

Roseola (exanthem subitum)

Presentation: several days of high fever (can induce seizures) and then rose-colored macules appear on body (usually infants)

Question 18

What is the clinical presentation of measles?

Answer 18

Measles virus Paramyxovirus family, ss linear non-segmented RNA(-) w/ helical caspid

Presentation: Cough, Coryza, Conjunctivitis, Koplick spots (blue-white spots on bucca mucosa) followed by rash that starts at head and moves down

Question 19

What does Parvovirus B19 cause in children?

Answer 19

non-enveloped, ss linear DNA virus (only ss DNA virus)

Erythema infectiosum (fifth disease)

“slapped cheek” rash, can cause hydrops fetalis in pregnant women

Question 20

How does rubella virus present?

Answer 20

Rubella virus - Togavirus family, enveloped ss (+) linear RNA viurs

Clinical presentation: pink coalescing macules begin at head and move down, postauricular LAD

Question 21

What rash is associated with Strep pyogenes in children?

Answer 21

gram (+) cocci, catalase (-), beta hemolytic, PYR(+), bacitracin sensitive, encapsulated

Scarlet fever - erythematous “sandpaper-like” rash with fever and sore throat and “strawberry tongue”

Question 22

What does VZV cause in children?

Answer 22

Herpes virus, enveloped ds linear DNA

Chicken pox - vesicular rash beginning on trunk and spreading peripherally and to face. lesions of different ages

Question 23

What can cause meningitis in unimmunized children?

Answer 23

H. influenzae type B, Poliovirus