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Flashcards in ID 5 Deck (51):
1

what is emetic type of b cereus usually caused by? characteristics?

1) rice and pasta
2) nausea and vomiting within 1-5 hours

2

what causes emetic type of food poisoning caused by b cereus?

Cereulide, a preformed toxin

3

characteristics of diarrheal type of food poisoning caused by b cereus?

watery, non bloody diarrhea + GI pain within 8-18 hours

4

rises sardonicus presentation

Raised eyebrows and open grin

5

tetanus treatment

1) antitoxin +/- vaccine booster
2) diazepam (for muscle spasm)
3) wound debridement

6

tetanus prophylaxis

tetanus vaccine

7

floppy baby syndrome?

botulism in babies

8

what are local botox injections used for?

1) focal dystonia
2) achalasia
3) muscle spasms

9

sources of botulism

juice and honey

10

stability of c perfringens toxin?

spores can survive in undercooked food

11

c perfringens toxin

heat-labile enterotoxin

12

AB structure of c diff

A = enterotoxin that binds to brush border of the gut
B = cytotoxin that causes cytoskeletal disruption via actin depolymerization

13

what else is c diff associated with?

PPI use

14

How do you diagnosis c diff?

Detection of one or both toxins in stool by PCR.

15

diphtheria toxin encoded by...

beta-prophage

16

other symptoms of diphtheria...

1) myocarditis
2) arrhythmias

17

appearance of diphtheria on culture?

Black colonies on cystine-tellurite agar

18

diphtheria diagnosis

1) metachromatic (blue and red) granules
2) elek ttest positive

19

listeria causes...

1) amnionitis
2) septicemia
3) spontaneous abortion in pregnant women
4) granulomatosis infantiseptica
5) neonatal meningitis
6) meningitis in immunocompromised
7) gastroenteritis in healthy

20

where is nocardia found?

soil

21

TB mimic?

nocardia

22

Nocardia causes

1) pulmonary infection in immunocompromised similar to TB presentation
2) cutaneous infections after trauma in immunocompetent

23

nocardia treatment

sulfonamides (TMP-SMX)

24

where is actinomyces found?

Normal oral, reproductive, and GI flora

25

what else can actinomyces cause?

PID with IUDs

26

actinomyces treatment

penicillin

27

Negative PPD means..

1) no infection
2) *sarcoidosis

28

other TB test?

Interferon-gamma release assay (IGRA)

29

characteristic findings with secondary TB?

1) caseating granulomas with central necrosis
2) Langerhans giant cells

30

ghon complex =

Hilar nodes + Ghon focus

31

what happens after primary TB?

1) over 90% heal by fibrosis and calcification. BUT can reactivate to secondary TB
2) 10% progress (usually in AIDS patients or malnourished people)

32

Presentation of secondary/reactivated TB?

Fibrocaseous cavitary lesion (usually upper lobes)

33

what can secondary TB progress to?

1) localized destructive disease with *caseation in kidneys or lungs.
2) OR bacteremia

34

Where does bacteremic TB infect?

1) meninges
2) vertebra
3) lymph nodes
4) lungs
5) liver
6) spleen
7) adrenal gland
8) joints and long bones

35

When do you need M avid prophylaxis?

CD4 less than 50

36

m scrofulaceum causes...

cervical lymphadenitis in children

37

cord factor appearance

"serpentine cord" appearance

38

cord factor MOA

Inhibits macrophage maturation + induces release of TNF-alpha

39

other virulence factor of TB

sulfatides

40

sulfatides MOA

Inhibit phagolysosomal fusion.

41

lepromatous leprosy presentation

1) diffuse over skin
2) leonine (lion-lake) facies
3) can be lethal

42

lepromatous immune response

humoral Th2

43

tuberculoid immune response

High cell-mediated immunity with a largely Th1-type response

44

what do you add for lepromatous form?

clofazimine

45

tuberculoid treatment

dapsone + rifampin

46

comma-shaped rods?

1) campylobacter
2) cholera
3) h pylori

47

coccobacilli?

1) h flu
2) pasteurella
3) brucella
4) b pertussis
5) francisella

48

maltose utilization characteristic of...

n meningitidis

49

fast lactose fermenters?

1) klebsiella
2) e coli
3) enterobacter

50

H2S production on TSI agar?

1) salmonella
2) *proteus

51

mycobacterium leprae characteristics

acid-fast bacillus that likes cool temperatures