Micro, D Kinder, Lec Flashcards
(118 cards)
1
Q
what type of microbe is bordetella
A
gram negative coccobacilli
2
Q
3 phases whooping cough
A
catarrhal
paroxysmal
convalescent
3
Q
Dx whooping cough
A
nasal swabs for culture or PCR
4
Q
Tx whooping cough
A
zpak
supportive
5
Q
Klebsiella pneumonia is what type micrbe
A
gram - non-motile capsulate rods, faculative anaerobes
6
Q
Currant jelly sputum is pathoneumonic for what
A
klebsiella ppneumonia
7
Q
what type of microbe is moraxella catarrhalis
A
gram - that grow on blood or chocolate agar
diplococci
catalase and oxidase +
8
Q
Neisseria meningitidis is what type microbe
A
gram - aerobic kidney shaped diplococci
oxidase +
ferments maltose and glucose
grows on thayer-martin media and chocolate agar!!
9
Q
Dx and tx neisseria
A
gram stain from CSF, or PCR
CSF culture blood culture, skin culture
penicillin or 3rd generation cephalosporin
10
Q
if left unTx neisseria m. patients have what mortality
A
70-90%
11
Q
What microbe produces pyocyanin
A
pseudomonas
12
Q
type of microbe that pseudomonas is
A
aerobic gram - rod
blue/green pigment
nosocomial pathogen
13
Q
what type of infections does pseudo cause
A
HAP, CAP
otitis externa!! most common cause of this.
puncture wounds
endopthalmitis
endocarditis
UTI
skin infections, burns, ecthyma gangrenosum
14
Q
Tx pseudomonas
A
extended spectrum penicillin and aminoglycoside combination
15
Q
Chlamydophila psittaci is what type microbe
A
gram - obligate intracell bacteria
macrophages are principle host
16
Q
Tx Chlamydophila psittaci
A
tetracyclines, macrolides, FQs
17
Q
What is a very common infection in most adults and cause atypical pneumonia in children <5
A
chlamydophila penumonia
18
Q
CXR and labs for chlamydophila pneumonia
A
pneumonitis on CXR
labs actually have normal WBC
19
Q
Dx of chlamydophila pneumonia
A
serology
20
Q
coxiella burnetii is what type microbe
A
gram - infects host monocytes
21
Q
what does coxiella burnetii cuse
A
Q fever
sometimes endocarditis
22
Q
major outbreaks of coxiella has been associated with what
A
sheep and goats
23
Q
clinical manifestation Q fever
A
60% seroconvert wihtout disease
38% self limited disease
prolonged fever, pneumonia, hepatitis, rash
meningitis, encephalitis, peripheral neuropathy
pericarditis, myocarditis
24
Q
what is risk of coxiella during pregnancy
A
chronic uterine infection leading to multiple spontaneous abortions
25
Dx coxiella burnetii
based on serology
26
Tx coxiella burnetii
doxy for 2 wks
| doxy+hydroxychloroquine for 18-36 mo for endocarditis
27
how does hydroxychloroquine work?
increases pH in phagosomes
28
francisella tularensis is what type microbe
zoonotic
small aerobic pleomorphic gram - bacillus
rabbits squirrels and muskrats
29
clinical manifestation tularemia
```
ulcerglandular
glandular
oculoglandula
typhoidal
oropharyngeal
pneumonic- most serious
```
30
Sx ulceroglandulat tularemia
fever
ulcer formation
sore throact
patchy infiltrates on CXR
31
glandular tularemia
fever, constitutional and lymphadenopathy
32
oralpharyngeal tularemia
oral mcous membranes of mouth
inadequately cooked game meat
pharyngeal ulcers
33
pneumonic tularemia
most serious
inhalation exposure
fever, dry cough, substernal chest discomfort, eribronchial infiltrates and bronchopneumonia
hilar adenopathy
34
Dx tularemia
serologic
35
typhoidal tularemia
fever only
36
Tx tularemia
genta or streptomycin
cipro
doxy
37
type microbe bacillus anthracis
spore forming gram + non motile rod that is aerobic or faculatively anaerobic
catalase +, hemolysis -
sheep agar!
38
clnical manifestation bacillus anthracis
mediastinal adenopathy
mediastinal widening****
pleural effusion
rapidly fatal if not Tx with multiple antibiotics and pleural drainage
39
Dx bacillus anthracis
blood cultures
40
tx bacillus anthracis
multi drug regimen
| pleural drainage
41
what type of microbe is yersinia pestis
gram - coccobacillus, microaerophilic, nonmotile, and non spore forming
prairie dogs
42
clinical manifestations yersinia pestis (bubonic plague)
bubonic( nodules), septicemia, penumonic
43
septicemia from yersinia present how
nausea, vomiting, diarrhea
DIC
hypotension, renal failure and obtundation
ARDS
44
pneumonic plague of yersinia presents how
highly fatal, die in 24 hrs
| respiratory distress, hemoptysis
45
Tx plague
strepto- pneumonic
tetracyclin- bubonic
chlorphenicol- speticemia
46
What type microbe is leptospirosis
spirochete with terminal hook
| use dark filed microscopy
47
where in hosts does leptospirosis live
renal tubules
48
early clinical phase leptospirosis
```
fever, myalgias, HA
nasuea vomiting ab pain, diarrhea
cough
muscle tenderness
conjunctival redness
```
49
late clinical phase leptospirosos
thrombocytopenia
jaundice
weils disease
GI bleed
50
Dx and tx lepto
Dx: agglutination test
Tx: doxy or penicillin
51
H influenza is what type microbe
encapsulated gram - pleomorphic rod
aerobic or faculative
grows on chocolate agar
Factor X (hemin) and Factor V (NAD)
52
common cause of meningitis in young children
H influenza type b
53
clincal manifestations H influenza
meningitis
epiglottitis- children <5. high fever drooling, dysphagia, resp distress with stridor
rapid course
54
Dx test for H influenza epiglottitis
lateral neck film
| thumb sign
55
pneumonia signs from H influenza
fever cough, lobar consolidation
56
Tx H influenza
3rd generation cephalosporins- meningitis
57
what is prophylactic Tx for unvaccinated person in contact with infected person with H influenze type b
rifampin
58
corynebacterium diptheria is what type microbe
gram + bacillus, club shaped
non spore forming
aerobic
59
signs resp diphteriae
```
sore throat, malaise
thick tonsillar exudate, very sticky
exudate changes into grayish membrane
"bull neck" from cervical adenopathy
stridor
myocarditis, recurrent laryngeal nerve damage
```
60
Tx diphteriae
erythromycin
| antitoxin
61
type microbe legionella pneumophila
wekaly gram - pleomorphic rod that is facultative intracellular
requires charcoal yeast extract!!
62
legionella is commonly found where
water type reservoirs like air conditioner units
63
risk factors legionella
smokers with high alcohol intake, immunosuppression
64
signs legionaires disease
mental confusion
myalgias, severe HA!!! and diarrhea!!!!
fevers, malaise, cough, chilld, dyspnea, myalgias!!!! HA chest pain and diarrhea
low pulse for how high fever is
65
what is pontiac fever?
| caused by?
fever, sore throat myalgia, HA and extreme fatigue
short duration lasting on average 3 days
caused by legionella
66
Dx legionella
Ag urine test
| DFA (direct fluorescent antibody)
67
Tx legniella
FQ, or zpak or erythromycin + rifampin for immunocompromised
68
type of microbe mycoplasma pneumonia
smalles
no cell wall
sterol containing membrane
need cholesterol in media
69
highest incidence of infection caused by mycoplasma pneumonia
5-20 yrs
| military or dorms (like meningitis)
70
resp infection from mycoplasma
```
2-3 week incubation
fever malaise, HA cough
walking pneumonia
cough is non-productive
some progress to tracheobronchitis
bullous myringitis
```
71
Dx and Tx mycoplasma atypical pneumonia
clinical Dx, positive cold agglutinins!!! (65%)
Tx: macrolides: erythromycin, zpak and clarithromycin
tetraclyines
72
what type microbe is strep pneumonia
gram + diplococci, lancet shapet
faculative anaerobe, grows on blood agar
alpha hemolytic, optochin sensitive
lysed by bile
73
risk factors for strep pneumonia
influenzae infection, COPD, CHF, alcoholism, asplenia
74
clinical manifestations pneumonia from strep
shaking chills, high fever, rigors, lobar consolidation, bloody tinged sputum (rusty)!!!
75
most common cause otitis media and sinusitis in children
strep pneumonia
76
Tx strep pneumonia
beta lactams, macrolids or FQ
77
Tx meningitis from strep pneumonia
3rd generation cephalosporings, vanco if penicillin R
78
What type of microbe is staph aureus
```
gram + clustered cocci
catalse, coagulae +
beta hemolytic
small yellow colonies on blood agar
ferments mannitol
```
79
what are the 3 toxin mediated diseases from staph aureus
staph food poisoning
staph TSS
staph scalded skin syndrome
80
clinical manifestations staph
```
impetigo, folliculitis, furuncle, abscess
bacteremia, endocarditis
pericarditis
osteomyelitis
septic arthritis
pneumonia
```
81
salmon colored sputum
staph aureus
82
signs of endocarditis
roth spots, oslers nodes, janeway lesions and petichiae
83
TSS from staph
secondary to TSST-1 super Ag
| involvement of 3+ organ systems, desquamation of palms and soles
84
what toxins are involved in scalded skin syndrome
exotoxin A and B
85
Tx for Staph aureus
nafcillin/oxacillin
| MRSA- vanco
86
pneumocystis jirovecii microbe
fungus
obligate extracell parasite
silver stain
opportunistic infection HIV patients CD4 count <200
87
pneumonia presentation from pneumocystic jirovecii
fever, nonproductive cough, SOB
CXR pathcy infiltrate with ground glass appearance, lower lobes and periphery
silver staining
88
Tx pneumocystis jiroveci
sulfamethaxole/trimethoprim or dapsone
89
Histoplasma capsulatum is what type microbe
dimorphic fungus in central US
faculative intracell parasite
soil, caves and abandoned buildings
Mississippi and Ohio River Valleys
90
acute pulmonary histoplasma
asymptomatic
| sometimes fevers, chills, anterioe chest pain myalgias
91
chronic histoplasma infection
progressive often fatal
| especially elderly and COPD patients
92
CXR histoplasma
pathcy lobar or multilobar infiltrate
chronic with upper lobe infiltrates and multiple cavities, fibrosis of lower lobes
mimics TB
93
Tx histoplasma capsulatum
antifungals
| though if not severe, don't always require Tx
94
type of microbe blastomyces dermatitidis
thermally dimorphic fungus
broa based! budding yeast!!
inhalation
95
acute pulmonary blastomyces
asymptomatic or CAP like
fever, malaise, nonproductive cough
CXR lobar and nodular infiltrates
96
chronic pulmonary blastomyces
cavitary lesions and fibrosis
97
Tx blastomyces
all patients Tx
itraconazole in mild
amphotericin B in severe
98
Coccidiodes immitis is what type microbe
dimorphic fungi
southwest deserts
spherules that undergo septation into endospores
99
clinical manifestations coccidiodes
asymptomatic usually
if more severe:
Sx 5-21 days post exposure
fever, weight loss, dry cough, pleuritic chest pain, arthralgias, erythema nodosum
CXR show pulm infiltrates with hilar adenopathy
cavitary pulmonary nodules
100
What patients are at risk for disseminated infection cocciocdes
HIV, AIDS
3rd trimester pregnangy
skin, joints and bones
101
Tx coccidiodes
amphotericin B and itraconazole
102
Strongyloides stercoli is endemic where
warm climates worldwide
103
trasmission stronglyoides
skin penetration of larvae rupture in alveoli then ascend and swallowed in GI tract and lay eggs which hatch in small intestine, larvae passed in feces
104
pulmonary manifestations stronglyoides
can be severe in immunocompromised
| resembles ARDS with acure onset dyspnea, hemoptysis accompanied by fever
105
Tx stronglyoides
ivermectin
106
aspergillosis microbe
spore like conidia that is aerosolized
| isolated in basements, crawl spaces, ventilation ducts, potted plants
107
invasive aspergillosis
immunocompromised
fever, pulm infiltrates
nodules
wedge shaped densities resembling infarcts
sinusitis
CNS abscesses, MI, GI, renal, osteomyelitis
108
Dx invasive aspergillosis
BAL, needle aspiration, thoracoscopic biopsy or open lung biopsy
109
Tx invasive aspergillois
antifungals like voriconazole or liposomal amphotericin B
reversal immunosuppression
surgical resection infected lesions
110
chronic pulmonary aspergillosis
aspergilloma
ball in cavity
debris form in cavity
111
Tx chronic pulmonary aspergilloma
limited benefit
| sometimes antifungals
112
Allergic bronchopulmonary aspergillosis
chronic asthma or CF patients
airway obstruction, eos!!, + sputum cultures, mucus plugs iwth hyphae, brown flecks in sputum
elevated IgE
upper lobe contraction, central bronchiectasis
113
Tx allergic bronchopulmonary aspergillosis
corticosteroids and itraconazole
114
cryptococcosis neoformans occurs in what patients?
| what type of microbe is it?
immunosuppressed- HIV CD4<50
meningitis is comon presentation
capsulated yeast
115
Pulmonary involvement cryptococcus?
risk factors?
Tx?
fever, cough ,dyspnea
risk factors: COPD, corticosteroid use and solid organ transplant
Tx: antifungals
116
Dx cryptococcus
yeast in CSF, blood, sputum, skin lesions or other body fluids
India Ink stain!!!! visualization of budding yeast with large capsuel
latex agglutination for crytpococcal polysaccharide Ag!!!
117
Tx CNS cryptococcosis
amphtericin B and flucytosine for 6 wks
| AIDS: both for 2 weeks then fluconazole for 8 weeks and suppressive therapy after
118
HACEK organisms that are common causes endocarditis
```
Haemophilus spp
Actinobacillus
Cardiobacterium hominis
Eikenella corrodens
Kingella spp
```
