Infectious II Exam Flashcards
(170 cards)
1
Q
Most Common TB treatment
A
isoniazid (INH)
rifampin (RIF)
ethambutol (EMB)
pyrazinamide (PZA)
2
Q
What drugs not to use with Multi-Drug Resistant TB
A
don’t use isoniazid (INH) and Rifampin
3
Q
Leprosy Tx
A
Dapsone, rifampin, clofazimine
4
Q
Two types of Leprosy
A
Tuberculoid: more nerve involvement, less skin lesions
Lepromatous: more skin, less nerve involvement
5
Q
What disease is a AIDS defining disease
A
MAC (Mycobacterium avium complex )
6
Q
What bacteria are the atypical cause of pneumonia?
A
Mycoplasma pneumonia
Legionairres’ disease
Chlamydia pneumoniae
7
Q
How is mycoplasma pneumonia transmitted?
A
person-to-person via respiratory droplets
8
Q
What is an appropriate antibiotic choice for empiric treatment in an assumed Mycoplasma pneumonia?
A
Azithromycin 500 mg on day 1, 250mg once daily on days 2-5
9
Q
What is the drug of choice for Chlamydia pneumonia?
A
Doxycycline
10
Q
How is Legionnaires’ Disease spread?
A
contaminated water
11
Q
What test do you order to diagnose Legionella?
A
Urinary antigen test and sputum culture
12
Q
What is the drug of choice for Legionnaire’s disease
A
Ciprofloxacin (Fluoroquinolone)
13
Q
What step/chemical is the “mordant” in the gram stain?
A
iodine; fixes crystal violet
14
Q
What does the result of a Catalase test tell you?
A
Pos: Staph
Neg: Strep
15
Q
What does a Coagulase test tell you?
A
Pos: confirm Staph. aureus
Neg: Staph. epidermidis
16
Q
What does a blood agar characteristic tell you?
A
Hemolysis;
Alpha-hemolytic: Strep. mitis
Beta: Strep. pyogenes
Gamma: Strep faecalis
17
Q
What are the toxins produced by S. aureus?
A
enterotoxins, Exfoliatin, toxic shock syndrome toxin, alpha-toxin
18
Q
How can you get Toxic Shock Syndrome?
A
extended tampon use; NOT BACTEREMIA
19
Q
What can exfoliatin cause?
A
Staph Scalded Skin Syndrome (“Ritter’s disease”) –> usually pediatric
20
Q
Toxic Shock Syndrome characteristics
A
- Temp ≥ 101 F BP<90
- Rash with desquamation (peeling skin)
- Involvement of three or more of the following organ systems: GI, Muscular, Renal, CNS, Liver
21
Q
What antibiotics to treat S. aureus (non-resistant)?
A
PCN (Nafcillin, Oxacillin), Cephalosporins (1st, 2nd gen: Cephalexin, Cefazolin, Cefuroxime), Erythromycin
22
Q
How to treat MRSA?
A
Bactrim, Clindamycin, Doxycycline x7-10 days
Vancomycin for inpatient (7-14 days)
23
Q
What does Staph. saprophyticus cause?
A
UTI, esp young women
24
Q
What is S. epidermidis associated with?
A
intravascular devices, osteomyelitis
break in skin from procedures, IV
25
What species of Strep is Group A, B-hemolytic and what infection does it cause?
Strep. pyogenes --> strep throat
26
What genus causes gamma hemolysis?
Enterococcus
27
What species causes alpha hemolysis?
S. pneumonia
28
What species of Strep is Group B, B-hemolytic?
Strep. agalactiae
29
What kind of membrane does Streptococcus live on?
mucous membrane
30
Where in the respiratory system does Streptococcus live on?
upper respiratory tract
31
What is the morphology of S. pneumoniae
encapsulated diplococci
32
What sequelae can accompany strep pharyngitis?
Scarlet fever
33
Patient presents with "strawberry tongue" and strep throat, what is the diagnosis
Scarlet fever
34
What organisms can cause toxic shock syndrome?
Staph. aureus
| Strep. pyogenes
35
"Honey-color crust"
Impetigo
36
What is the leading cause of bacterial disease and death in newborns and in maternal infections?
Strep. agalactiae
37
Where does Strep. agalactiae reside?
vagina
| also upper resp tract
38
What part of the body does Strep. pyogenes primarily affect?
Larynx
39
What part of the body does Strep. pneumoniae primarily affect?
Lungs (respiratory)
40
What enzyme does Strep. pneumoniae produce?
IgA protease
41
Who should be vaccinated for Strep. pneumoniae?
>65, <5
42
What respiratory infections does Strep. pneumoniae cause?
Pneumonia
Otitis Media
Sinusitis
43
What bacteria can cause endocarditis?
Strep. Viridans, Strep. Bovis, Enterococcus
44
What does ASO titers test?
Antibody to Group A Strep --> tests for HISTORY of strep
45
What antibiotic to treat Streptococcal infection in PCN allergic patient?
Erythromycin
46
Enterococcus treatment
Ampicillin
47
Vancomycin-resistant Enterococci treatment
Linezolid
48
S. pyogenes and S. pneumoniae treatment
PCN
| pneumonia: increased resistance
49
Gram positive bacilli bacteria
Clostridium tetani and botulinum
Corynebacterium diphtheriae (Diphtheria)
Listeria monocytogenes
Bacillus anthracis
50
What bacteria produces "Lockjaw"
Clostridium tetani (tetanus)
51
What are the characteristics of "Lockjaw"
spasms and rigidity of voluntary muscles
52
What infection does C. diff cause?
pseudomembranous colitis
53
Gas Gangrene
Clostridium perfringens
54
Pseudomembrane on tonsils is characteristic of what disease?
Diphtheria
55
What gram positive bacillus bacteria grows intracellularly?
Listeria monocytogenes (Listeriosis)
56
Listeriosis
food-borne illness
57
What gram positive bacillus bacteria is primarily a disease of domesticated and wild animals, cows, sheep
Anthrax
58
What cell structures are unique to gram negative bacteria
periplasmic space and lipopolysaccharide (LPS)
59
What is the most severe strain of E. coli?
Enterohemorrhagic E. coli
60
What severe pathology can Enterohemorrhagic E. coli cause?*
hemorrhagic colitis and hemolytic uremia syndrome
61
Which strain of E. coli causes Traveler's Diarrhea
Enterotoxigenic E. coli
62
How to treat E. coli
nothing; usually self-limiting and goes away in a few days
| only treat bloody, invasive infections
63
What's the leading cause of bacterial gastroenteritis worldwide?
Campylobacter
64
What gram negative bacteria can survive at low temperatures?
Yersenia enterocolitica
65
What gram negative bacteria caused the plague?
Yersenia pestis
66
Which manifestation of Y. pestis has the highest mortality rate?
```
Pneumonic plague (90%)
fast spread, respiratory failure
```
67
What gram negative bacteria live in coastal waters and can be transmitted through seafood?
Vibrio cholera
68
What gram negative bacteria causes Typhoid Fever?
Salmonella typhi
69
What bacteria causes "currant jelly" sputum
Klebsiella pneumonia
70
What bacteria associated with staghorn calculi (very large kidney stones)? (also UTI and indwelling catheters)
Proteus mirabilis
71
If you smell fruity grape scent from a wound or breath of a patient, what bacteria caused the infection?
Pseudomonas aeruginosa
72
What is the model organism for resistance?
Pseudomonas
73
What causes "Rabbit Fever"
Tularemia
74
Most common STD
Chlamydia
75
2nd most common STD
Neisseria gonorrhoeae
76
Most common MRSA colonization site
anterior nares
77
Most common nasal MRSA treatment
Mupirocin (topical ointment) in the nose
| aka Bactroban
78
Hear "spider bite", what do you consider
CA-MRSA
79
What is Ascaris lumbricoides known as
roundworm
80
What is Necator americanus known as
hookworm
81
What parasite can be transmitted from undercooked pork?
Trichinella spiralis
82
What is Enterobius vermicularis known as
pinworm
83
Which helminth does not cause eosinophilia?
pinworm (Enterobius vermicularis)
84
Katayama fever, Swimmer's itch, flukes
Schistosomiasis
85
look like "old man with glasses"; flagellated protozoa; traveler's diarrhea; "Beaver Fever"
Giardia
86
"Walking pneumonia"
Mycoplasma pneumoniae
87
Stevens Johnson Syndrome
skin sloughing off/lesions, affects mucosal membranes
88
What organism causes "Parrot Disease"?
Chlamydia psittaci
89
Ziehl-Neelsen Stain
stains Acid Fast bacteria
| primary stain: carbolfuschin
90
What are the 3 phases of TB
Primary
Latent
Reactivated
91
What are the characteristics of the Latent phase of TB
No symptoms
Non-infectious
(+) PPD
92
Give 2 examples of Non-Tuberculosis Mycobacterium
M. avium (complex)
| M. scrofula
93
What is a characteristic of acid fast bacteria cell structure that prevents easy staining
high cell wall lipid content (wax-like)
94
Ghon lesion
granuloma of macrophages and mycobacterium
95
Miliary TB
disseminated TB
| CXR: snow storm
96
Pott's disease
Spinal TB (curved spine)
97
What's the initial symptom of TB
fever
98
What is a positive PPD result for immunocompromised, higher risk people, and immunocompetent (very rarely tested)?
≥ 5mm induration
≥ 10mm
≥ 15mm
,respectively
99
What are the diagnostic tests for TB?
```
PPD
Quantiferon
CXR
AFB Smears
Culture: gold standard
NAA
```
100
What are diseases caused by acid fast bacteria
Tuberculosis
Leprosy
MAC
101
Tx for MAC
Macrolides (e.g. erythromycin, azithromycin)
102
What type of fungus causes Tinea and onycholysis
Dermatophytes
103
Tx for Candida
Polyene (amphotericin B, nystatin)
| Azoles
104
Diagnose dermatophytes
KOH skin scrapings
| wood light
105
Aspergillomas
"fungus balls" in healed lung scars from previous disease
106
Tx for aspergillosis
amphotericin B
107
What fungal/yeast infections are caused by bird feces?
Histoplasmosis and Cryptococcosis
108
Biggest nutritional deficiency in the world
iron
109
What is the primary cause of immunodeficiency worldwide?
Protein-energy malnutrition
110
Sources of iron
red meat, poultry, fish, egg yolks, dark green vegetables, legumes, dried fruit
111
Kwashiokor
protein malnutrition
112
Marasmus
protein and calorie deficiency
113
Which antibody does not cross placenta?
IgM
114
Which antibody is best for diagnosing acute Hep A?
HAV-IgM
115
Which antibody is best for detecting vaccinated Hep A?
HAV-IgG
116
Which antibody is best for detecting past Hep A infection?
HAV-total
117
prion
infectious protein
118
Which viruses have DNA
Adenovirus (ds)
HSV (ds)
Varicella Zoster Virus (ds)
CMV (ds)
119
What is croup caused by
Parainfluenza Type I
120
What is the most frequent cause of pediatric bronchiolitis and pneumonia?
RSV
121
What is Fifth Disease, what virus is it caused by, and what is the classic presentation?
Erythema Infectiosum
Parvovirus B19
reticular (lacey) rash
122
What virus causes Mono?
Epstein Barr Virus (EBV)
123
What disease is EBV also associated with?
cancer
124
CMV IV treatment for immunocompromised patients
ganciclover
125
What is the common cause of blindness in HIV patients?
CMV retinitis
126
What infection is associated with warts?
HPV (Human Papilloma Virus)
127
How are viruses with lipid envelopes transmitted?
respiratory, parenteral, sexual routes (easier to sterilize)
128
How are non-enveloped viruses transmitted?
fecal-oral (stable to harsh conditions)
129
Horizontal transmission
one host to another in the same generation
130
Vertical transmission
host to offspring
131
Direct horizontal transmission
contact, aerosolized droplets
132
Indirect horizontal transmission
vector mediated
133
Who do you not give aspirin to?
people under 18 years old
134
What virus causes the common cold and SARS?
Coronavirus
135
What is the most common cause of the common cold?
Rhinovirus
136
What virus can survive outside the body for up to 2 weeks?
Adenovirus
137
What virus causes "dew drops on rose petal" rash?
Varicella (chicken pox)
138
What virus causes parotitis (hallmark)
Mumps
139
What virus is the leading cause of gastroenteritis in children?
Rotavirus
140
What is the hand-foot-and-mouth disease? (visible vesicles)
Coxsackievirus A (Enterovirus)
141
What virus presents with Koplik spots on oral mucosa and a non-pruritic macolopapular rash?
Measles (Rubeola)
142
What virus causes cold sores?
Herpes labialis
143
Ramsay Hunt Syndrome
Herpes Zoster Oticus (ear)
144
Which virus is resistant to most disinfectants and highly contagious?
Norovirus
145
Which class of viruses can cause viral meningitis, encephalitis, percaditis, and myocarditis?
Enteroviruses
146
What viruses are enteroviruses?
Poliovirus
Coxsackievirus
Echovirus
Enterovirus
147
What are the 3 C's of the Prodromal phase of Measles
cough, coryza (nose), conjunctivitis
148
Classic signs of Measles
Koplik spots on oral mucosa
| Rash
149
Which Herpes Simplex Virus causes genital herpes? (majority)
HSV-2
150
What are the CNS involvement in HSV-1 and HSV-2?
HSV-1: common for infectious Encephalitis
| HSV-2: Viral Meningitis
151
What is neonatal HSV encephalitis caused by?
HSV-2 during vaginal delivery
152
What bacteria causes the hemolytic uremic syndrome?
Enterohemorrhagic E. coli
153
What are the 3 symptoms of hemolytic uremic syndrome?
hemolysis, thrombocytopenia, renal failure
154
What does enteroinvasive E. coli cause?
fever, severe abdominal pain
155
Which virus should you avoid aspirin?
Varicella Zoster Virus
156
What virus is associated with the "Slapped Cheek Appearance"?
Fifth Disease of Parovirus B19
157
Tx for Parovirus B19
supportive unless complications (then IV Ig)
158
Which virus should you not treat with amoxicillin/ampicillin bc can develop non-allergic maculopapular rash?
EBV
159
Which virus can you develop splenomegaly in up to 50% of patients?
EBV
160
Which virus is particularly harmful during pregnancy, leading to congenital infection/defects/hearing loss?
CMV
161
What virus occurs in over 40% solid organ transplant patients (immunocompromised)?
CMV
162
What is the most common sexually transmitted virus?
HPV
163
Give an example of a prion virus
Creutzfelt-Jakob Disease
164
Tropical disease that causes conjunctivitis
Zika
165
What virus can cause congenital microcephaly?
Zika
166
What virus causes severe joint pain with primary Tx of pain management? (spread through mosquitoes)
Chikungunya
167
Most common mosquito viral illness in humans
Dengue Fever
168
Which virus should you NOT treat with NSAIDs due to risk of hemorrhage?
Dengue Fever
169
What is can example of acid fast bacteria?
Mycobacterium:
M. tuberculosis
M. Leprae
M. avium complex
170
Erythromycin is D.O.C. for which diseases?
Pertusis
Diphtheria
Mycoplasma pneumoniae
Chlamydia
