MEGAQUIZ Flashcards
(34 cards)
common “colonizers”
-skin- staph, strep, corynebacterium, candida
-mouth- strep (aerobes and anaerobes), candida
-colon- bacteroides, enterobacter, enterococcus, candida
-vagina- lactobacillus, costridium, enterobacter
tuberculosis
-aerobic, nonmotile, acid-fast bacillus
-incubation- 2-12 weeks
-mycobacterium tuberculosis
-M. tuberculosis complex - M. bovis
-primary progressive TB
-latent -> reactivation TB or progressive secondary TB
-extrapulmonary TB -> children and immunocompromised (pleura, meninges, lymphatic system, genitourinary (GU), bones)
-gold standard- sputum for acid-fast bacilli (AFB) staining using Ziehl-Neelsen (ZN) stain -> PCR
macule vs papule
-macule is flat
-vesicle has pus/liquid
-papule has texture
tuberculosis treatment
-latent- isoniazid w/ or w/o pyridoxine for 9 months
-daily rifampin for 4 months- alternative
-active and/or extrapulmonary TB- isoniazid, rifampin, ethambutol, streptomycin, pyrazinamide
-hard to treat- bacterias slow reproductive rate
lyme disease
-incubation- 3-30 days
-early localized- EM, flu
-early disseminated- multiple ME
-late disseminated- neurological, heart
-EM bx culture in Barbour Stoenner Kelly medium -> IgM and IgG serologica antibody testing
-24-36 hour- increased transmission
-single dose doxycycline within 72 hours
syphilis
-presents differently
-10-90 days
-gram neg spirochete
-can be congenital
-condyloma latum- mucous membranes -> resolve 3-6 weeks without treatment -> enters latency
-secondary- 4-10 weeks
-chancres, macules, and papules
syphilis testing
-darkfield microscopy or direct fluorescent antibody testing on fluid or smears from lesions
-serological tests:
-nontreponemal (screening)
-treponemal specific (confirmatory)
-RPR, VDRL, TRUST
-+ results followed up with confirmatory treponemal-specific testing -> T. pallidum enzyme immunoassay (TP-EIA) or fluorescent treponemal antibody absorption (FTA-ABS)
syphilis treatment
-benzathine penicillin G x 1 for primary, secondary, or latent infections less than 1 years duration
-latent > 1 year or indeterminate age and tertiary infections other than neurosyphilis -> benzathine penicillin G weekly x 3
-neurosyphilis -> continuous IV for 10-14 days
RMSF
-rickettsia rickettsii
-transovarial transmission- tick to eggs
-incubation- 2-14 days
-gram negative obligate intracellular bacteria
-6-10 hours transmission
-macular
-labs- hyponatremia, thrombocytopenia, high LFTs, increased bilirubin, and increased BUN
-western blot- detection of rickettsial nucleic acids by PCR in blood/skin biopsy
-fever w/o rash- Eldery and African American
-More severe- males, alcoholic, AA, pts with G6PD, immunocompromised
-severe case- necrosis, gangrene, acute respiratory distress syndrome, pulmonary edema, nausea/vomiting, abdominal pain, diarrhea, confusion, acute renal failure, meningoencephalitis, ataxia, blindness
chlamydia
-incubation- 1-3 weeks
-gold standard- nucleic acid amplification testing (NAAT)
-rapid version -> 90 mins
-uncomplicated- single dose of azithromycin OR doxycyclin 100 mg orally twice a day for 7 days
pelvic inflammatory disease
-treated w/ ceftriaxone and doxycycline +/- metronidazole, IV
-systemic symptoms - fever, chills, nausea, vomiting
-cervical motion tenderness, adnexal tenderness, peritonitis
-tubo-ovarian abscess
-infertility
-increased risk for ectopic
-Fitz-Hugh-Curtis syndrome*- perihepatic adhesions late symptom
gonorrhea
-incubation- 1-14 days
-purulent urethral discharge in men
-extragenital infection- rectum, pharynx, conjunctiva
-disseminated gonococcal infection (DGI) -> triad of polyarthritis, tenosynovitis, dermatitis OR septic arthritis (knees)
-DG meningitis and endocarditis -> rare
gonorrhea treatment
-uncomplicated- ceftriazone IM and oral azithromycin
-azithromycin may reduce gonococcal resistance to cephalosporins
-IM ceftriaxone and 10 days of doxycycline -treat epididymo-orchitis, prostatitis, and proctitis
-conjunctivitis- ceftriaxone IM and azithromycin
leprosy
-Hansen disease
-Myobacterium leprae
-incubation- 9 months- 20 years
-slow growing gram positive intracellular bacteria
-macular w/ raised granular margin
-anhidrosis
-muscle weakness
-auto-amputation
-skin bx and PCR to confirm
-dapsone was used until resistance emerged
-MULTIDRUG therapy is required now for 6-12 months longer
-2 protocols:
-paucibacillary- dapsone + rifampicin for 6 months
-multibacillary- dapsone, rifampicin, + clofazimine for 12 months
cholera
-incubation- 1-5 day
-vibrio cholerae
-afebrile, painless
-renal failure, acidosis, circulatory collapse, death
-sudden onset
-nonmalodorous- does not smell
-vomiting in beginning bc less gastric motility
-cholera gravis -> severe, fatal dehydration if untreated
-doxycyclin may reduce length/severity -> does not cure
shigella
-tenesmus
-small frequent stools
-initially water and becomes mucoid and blood
-complications: hemolytic uremic syndrome (HUS), seizures in children, and reactive arthritis
-stool culture- PCR
-azithromycin or ciprofloxacin
salmonella
-nontyphoidal salmonella
-tenesmus
-bloody diarrhea more common in children
-Complications: bacteremia, meningitis, septic arthritis, osteomyelitis (sickle cell pts are at increased risk), postinfectious IBS, reactive arthritis
-stool culture
-fluoroquinolones (ciprofloxacin or levofloxacin), macrolides (azithromycin), or cephalosporins (ceftriaxone or cefotazmine)
diphtheria
-can be asymptomatic carrier
-progressive symptoms
-gray psudomembrane
-tonsillopharyngeal diphtheria- lymphadenopathy, odynophagia (painful swallowing)
-laryngeal diphtheria- barking, bull, hoarse
-spreads hematogenously -> damage to cardiac, renal, and/or nervous system
-nasopharyngeal and oropharyngeal- cultures on Loffler or Tindale media -> chinese characters -> PCR and ELISA
-horse serum, erythromycin or penicillin
tetanus
-3-21 day incubation (10)
-generalized- trismus, risus sardonicus, descending muscle spasms, opisthotonus, laryngospasm
-localized
-neonatal- contamination of umbilical stump
-cephalic- 1-2 day incubation, unilateral facial paralysis
-tetanus immune globulin, wound care, benzodiazepines, intubation
boltulism
-no fever
-6 hour-10 day incubation
-wound infection- no GI, fever secondary to wound infection
-bilateral facial paralysis
-descending weakness
-bradycardia
-EMG, stool, serum, vomitus, food specimen
-wound must be by serum
-intubation
->1 year- horse serum
-<1 year- human derived immune globulin
campylobacter jejuni
-GI of animals
-fever and pseudo appendicitis prodromes
-tenesmus
-Guillain-Barre syndrome and reactive arthritis
-becomes bloody
-stool culture- PCR
-azithromycin 3 days or erythromycin 5 days 4x daily
group A streptococcus
-peaks late winter and early spring
-bacterial pharyngitis
-complications- poststreptococcal glomerulonephritis, and peritonsillar abscess
-RADT- rapid antigen detection test and throat culture
-oral petechiae, lymphadenopathy
-fever, anorexia, malaise, sore throat, headache, abdominal pain, nausea, and vomiting
-scarlatiniform rash
-no cough
-modified centor criteria
-penicillin, amoxicillin, cephalosporin
-erythromycin, clindamycin, or macrolides for penicillin allergy
infective endocarditis
-caused by staphylococci, streptococci, HACEK (Haemophilus, Aggregatibacter, Cardiobacterium, Eikenell a, Kingella)
-short incubation
-risk factors- IV drug abuse, poor dentition, valvular heart disease, congenital heart disease, prosthetic heart valves, indwelling lines, pacemakers, past hx of infective endocarditis, and chronic hemodialysis
-fever, murmur, myalgia, arthralgia, splinter hemorrhages, septic emboli, petechiae, splenomegaly, cough, weight loss, and/or glomuleronephritis
-Janeway lesions, Osler nodes, and Roth spots
infective endocarditis treatment and diagnosis
-blood cultures from 3 different sites, if neg repeat before empiric treatment
-echocardiagram
-C-reactive protein, ESR and rheumatoid factor labs
-empiric treatment
-vancomycin and ceftriaxone or gentamycin
