Micro FA Systems p178 - 186 Flashcards
(130 cards)
1
Q
T or F Neonates delivered by C section have no bacterial flora
A
T - Neonates delivered by C-section have no flora but are rapidly colonized after birth
2
Q
A
3
Q
Which bact cause fast and furious food poisoning? (starts and ends quickly)
A
B. cereus
S. aureus
4
Q
A
5
Q
A
6
Q
Pathogens causing bloody diarrhea
A
Campylobacter, E. histolytica, EHEC, EIEC, Salmonella, Shigella, Y. enterocolitica
7
Q
bact causing watery diarrhea
A
C Diff, C perfringens, ETEC, V cholerae
8
Q
Protozoa causing watery diarrhea
A
Giardia, Cryptosporidium
9
Q
Viruses causing watery diarrhea
A
Rotavirus, norovirus, enteric adenovirus
10
Q
Most common cause of pneumonia in neonates (<4wk)
A
Group B streptococci E coli
11
Q
Most common cause of pneumonia in children?
A
Viruses (RSV)
- *M**ycoplasma
- *C** trachomatis (infants–3 yr)
- *C** pneumoniae (school-aged children)
- *S p**neumoniae
Runts May Cough Chunky Sputum
12
Q
Most common cause of pneumonia in adults (18-40)
A
Mycoplasma C pneumoniae S pneumoniae Viruses (eg, influenza
13
Q
Pneumonia in adults (40-65)
A
S pneumoniae H influenzae Anaerobes Viruses Mycoplasma
14
Q
Causes on pneumonia in elderly
A
S pneumoniae Influenza virus Anaerobes H influenzae Gram ⊝ rods
15
Q
Causes of pneumonia in Alcoholics
A
Klebsiella, anaerobes usually due to aspiration (eg, Peptostreptococcus, Fusobacterium, Prevotella, Bacteroides)
16
Q
Pneumonia in IV drug users?
A
S pneumo
S aureus
17
Q
Aspiration pneumonia cause
A
anaerobes
18
Q
Causes of atypical pneumonia
A
Mycoplasma, Chlamydophila, Legionella, viruses (RSV, CMV, influenza, adenovirus)
19
Q
Pneumonia in CF pts
A
Pseudomonas, S aureus, S pneumoniae, Burkholderia cepacia
20
Q
Immunocompromised pts - causes of pneumonia
A
S aureus, enteric gram ⊝ rods, fungi, viruses, P jirovecii (with HIV)
21
Q
Nosocomial pneumonia
A
S aureus
Pseudomonas
other G- enteric rods
22
Q
Post viral pneumonia
A
S pneumo
S aureus
H influenzae
23
Q
What do we give for meningitis? What do we add if Listeria is suspected?
A
Give ceftriaxone and vancomycin empirically (add ampicillin if Listeria is suspected).
24
Q
Viral causes of meningitis?
A
- enteroviruses (Polio, Echo, Coxsackie virus),
- HSV-2 (HSV-1 = encephalitis), VZV.
- HIV,
- West Nile virus (also causes encephalitis),
25
Common causes of meningitis in newborns (0-6mo)
Group B streptococci
E coli
Listeria
26
Meningitis causes in children (6mo - 6yr)
S pneumoniae
N meningitidis
H influenzae type b
Enteroviruses
27
Meningitis causes in 6-60yrs
S pneumoniae
N meningitidis
Enteroviruses
HSV
28
Number 1 cause of meningitis in teens
Neisseria
29
Meningitis causes in elderly (60 +)
S pneumo
G- rods
Listeria
30
CSF findings in meningitis
31
Most common causes of brain abscess
viridans streptococci
S aureus
32
Where do temporal lobe & cerebellum / frontal lobe abscesses transfer from?
otitis media and mastoiditis --\> temporal lobe and cerebellum; sinusitis or dental infection --\> frontal lobe
33
Brain abscess in AIDS pt caused by?
Toxoplasma activation
34
Most common cause overall of osteomyelitis
S aureus
35
Osteomyelitis in sexual active person?
Neisseria gon (but rare)
36
Sickle cell osteomyelitis
Salmonella
S aureus
37
Prosthetic joint replacement osteomyelitis
S aureus and S epidermidis
38
Osteomyelitis in the vertebrae
S aureus
Pott disease (Myco Tb)
39
Osteomyelitis assoc w/ cat/dog bite
Pasteurella
40
Osteomyelitis assoc w/ IV drug use
S aureus
Pseudomonas
Candida
41
Testing for Osteomyelitis
1. Lab values
2. Imaging
Elevated ESR and CRP sensitive but not specific. Radiographs are insensitive early but can be useful in chronic osteomyelitis MRI is best for detecting acute infection and detailing anatomic involvement
42
Sx of UTI
Cystitis presents with dysuria, frequency, urgency, suprapubic pain, and WBCs (but not WBC casts) in urine
43
Presentation of pyelonephritis
. Ascension to kidney results in pyelonephritis, which presents with fever, chills, flank pain, costovertebral angle tenderness, hematuria, and WBC casts.
44
Risk factors for UTI`
obstruction (eg, kidney stones, enlarged prostate), kidney surgery, catheterization, congenital GU malformation (eg, vesicoureteral reflux), diabetes, pregnancy.
45
The leading cause of UTI? What growth medium is it grown on? What do the colonies look like?
Escherichia coli - Leading cause of UTI. Colonies show strong pink lactose-fermentation on MacConkey agar
46
⊕ Leukocyte esterase in UTI indicates what?
evidence of WBC activity
47
⊕ Nitrite test indicates what in UTI?
reduction of urinary nitrates by gram ⊝ bacterial species (eg, E coli).
48
Which UTI bugs produce urease
S saprophyticus, Proteus, Klebsiella
49
2nd/ 3rd leading cause of UTI ?
s. saprophyticus
K pneumoniae
50
2 nosocomial causes of UTI
Serratia marscescens
Enterococcus
Pseudomonas
51
Motility causes “swarming” on agar; associated with struvite stones.
Proteus
52
Blue-green pigment and fruity odor;
Pseudomonas
53
Thin white vaginal discharge with fishy odor and bubbles
Gardnerella vaginalis
54
What are clue cells?
vaginal epith cells covered with bacteria
55
Tx for Bact vaginosis
Metronidazole
Clindamycin
56
strawberry cervix, Frothy, yellow-green, foulsmelling discharge - Pathogen? shape of it?
Motile pear-shaped trichomonads (Trichomonas vaginalis)
57
tx for Trichomonas?
Metronidazole
58
strawberry cervix and Thick, white, “cottage cheese” discharge
Candida vulvovaginitis
59
What makes one more prone to Candida infections?
DB, Antibiotic use, douches, pregnancy
60
Diff in pH b/w Bact vaginosis, Trichomonas, and Candida
Normal pH in Candida
pH\>4.5 in the other two
61
Which of the TORCHES infections more commonly spreads via delivery \> pregnancy?
HSV2
62
Parvo B19 causes what in utero?
hydrops fetalis
63
Sx of Toxoplasma in mom/baby? Mode of maternal transmission?
Cat feces or ingestion of undercooked meat
Maternal - Usually asymptomatic; lymphadenopathy (rarely)
Neonate - Classic triad: chorioretinitis, hydrocephalus, and intracranial calcifications, +/− “blueberry muffin” rash
64
Rubella - MoT? Maternal Sx? Neonate Sx?
Respiratory droplets
Maternal - Rash, lymphadenopathy, polyarthritis, polyarthralgia
Neonate - Classic triad: abnormalities of eye (cataracts B) and ear (deafness) and congenital heart disease (PDA); ± “blueberry muffin” rash. “I (eye) ♥ ruby (rubella) earrings”
65
CMV - MoT? Maternal Sx? Neonate Sx?
Sexual contact, organ transplants
Maternal - Usually asymptomatic; mononucleosis-like illness
Neonate - Hearing loss, seizures, petechial rash, “blueberry muffin” rash, chorioretinitis, periventricular calcifications C
66
HIV - MoT? Maternal Sx? Neonate Sx?
Sexual contact, needlestick
Maternal - Variable presentation depending on CD4+ cell count
Neonate - Recurrent infections, chronic diarrhea
67
HSV2 - MoT? Maternal Sx? Neonate Sx?
Skin or mucous membrane contact
Maternal - Usually asymptomatic; herpetic (vesicular) lesions
Neonate - Meningoencephalitis, herpetic (vesicular) lesions
68
Syphilis - MoT? Maternal Sx? Neonate Sx?
Sexual contact
Maternal - Chancre (1°) and disseminated rash (2°) are the two stages likely to result in fetal infection
Neonate - Often results in stillbirth, hydrops fetalis; if child survives, presents with facial abnormalities (eg, notched teeth, saddle nose, short maxilla), saber shins, CN VIII deafness
69
Present with rashes of palms and soles
TSST of S aureus
Syphilis
Rocky Mountain Spotted Fever
Coxsackie A
70
Oval-shaped vesicles on palms and soles A; vesicles and ulcers in oral mucosa
Coxsackievirus type A Hand-foot-mouth disease
71
Asymptomatic rose-colored macules appear on body after several days of high fever; can present with febrile seizures; usually affects infants
Human herpesvirus 6
Roseola (exanthem subitum)
72
Confluent rash beginning at head and moving down; preceded by cough, coryza, conjunctivitis, and blue-white spots on buccal mucos
Measles virus
Measles (rubeola)
73
Coxsackie A - what family? DNA/RNA? What type? Envelope?
Picorna
SS+ linear RNA
Naked
Icosahedral capsid
74
HHV6 - family? envelope? DNA/RNA?
dsDNA linear, enveloped, Herpes family
75
Measles virus - Family? DNA/RNA? envelope?
Paramyxo; -SS linear enveloped, helical capsid
76
Parvovirus - enveloped? DNA/RNA?
ss linear DNA naked virus
77
Pink macules and papules begin at head and move down, remain discrete --\> fine desquamating truncal rash; postauricular lymphadenopathy
Rubella
78
Rubella - family? DNA/RNA? envelope?
Togaviridae
SS+ linear RNA enveloped, icosahedral capsid
79
Flushed cheeks and circumoral pallor on face; erythematous, sandpaper-like rash from neck to trunk and extremities; fever and sore throat
S. pyogenes
80
S pyogenes -
Catalase +/-?
what type of hemolysis?
sensitive to what?
Catalase neg
Beta hemolytic
Bacitracin sensitive
81
Vesicular rash begins on trunk; spreads to face and extremities with lesions of different stages
VZV
82
Neonatal conjuctivitis - 1-2 days. Nonpurulent watery discharge.
Chemical - Irritation from antibiotic ointment.
83
Neonate - 2-5+ days. Hyperacute conjunctivitis, marked conjunctival injection, lid swelling, profuse purulent discharge. Rapid corneal involvement may be blinding. May disseminate.
Gonorrhea
84
Neonatal conjunctivitis - 5-14 days. Most common etiology. Mild to severe hyperemia, thick mucopurulent discharge, possibly bloody.
Chlamydia
85
Neonatal conjunctivitis - Days to 6 weeks. Conjunctival injection, nonpurulent discharge; keratitis, vesicular skin lesions, disseminated infection.
HSV
86
Painful genital ulcer with exudate, inguinal adenopathy
H. ducreyi chancroid
87
Urethritis, cervicitis, epididymitis, conjunctivitis, reactive arthritis, PID
Chlamydia trachomatis (D–K)
88
Genital warts, koilocytes
Condylomata acuminata
HPV 6, 11
89
Painful penile, vulvar, or cervical vesicles and ulcers; can cause systemic symptoms such as fever, headache, myalgia
HSV2 (HSV1)
90
Urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, creamy purulent discharge
Neisseria gonorrhoeae
91
Painless, beefy red ulcer that bleeds readily on contact
Granuloma inguinale
Klebsiella (Calymmatobacterium) granulomatis
92
What are Donovan bodies?
macrophages that are large and vacuolated centrally - bipolar staining - in Klebsiella granulomatis
93
Infection of lymphatics; painless genital ulcers, painful lymphadenopathy (ie, buboes
Lymphogranuloma venereum
C trachomatis (L1–L3)
94
Vaginitis, strawberry cervix, motile in wet prep
Trichomonas vaginalis
95
most common bacterial STI in the United States
Chlamydia trachomatis
96
cervical motion tenderness, adnexal tenderness, purulent cervical discharge
C trachomatis PID
97
infection and inflammation of liver capsule and “violin string” adhesions of peritoneum to liver
Fitz-Hugh–Curtis syndrome - perihepatitis
98
Most common causes of nosocomial infections
E coli (UTI) and S aureus (wound infection) are the two most common causes.
99
Watery diarrhea, leukocytosis rel to Antibiotic use, pathogen? Tx?
C. Diff , Metronidazole
100
Right lower lobe infiltrate or right upper/ middle lobe (patient recumbent); purulent malodorous sputum - disease? cause?
Aspiration pneumonia
Polymicrobial, gram ⊝ bacteria, often anaerobes
101
Decubitus ulcers, surgical wounds, drains - puts one at risk for infections with?
S aureus (including MRSA), gram ⊝ anaerobes (Bacteroides, Prevotella, Fusobacterium
102
Intravascular catheters - pathogens?
S aureus (including MRSA), S epidermidis (long term), Enterobacter
103
New infiltrate on CXR, Inc sputum production; sweet odor in pt wtih mech ventilations
Pseudomonas
104
Pt with mech ventilators are also at risk for?
Klebsiella, Acinetobacter, S aureus
105
Urinary Cath infection - pathogens?
Proteus spp, E coli, Klebsiella (infections in your PEcKer)
106
Disease assoc with water aerosols?
Legionella
107
Two rashes that affect unvacc children?
Rubella, Measles
108
3 pathogens that can lead to neuro sx in unvacc children?
H influ
Polio
C. tenani
109
Fever with dysphagia, drooling, and difficulty breathing due to edematous “cherry red” epiglottis; “thumbprint sign” on x-ray in unvacc child
H. influ type B
110
Low-grade fevers, coryza, inspiratory stridor, post-tussive vomiting in unvacc child
Bordetella Pertussis
111
grayish membrane on throat, that bleeds when disturbed in unvacc child
C. diphteriae
112
Asplenic patients
Encapsulated microbes, especially SHiN (S pneumoniae \>\> H influenzae type b \> N meningitidis
113
Branching rods in oral infection, sulfur granules
Actinomyces israelii
114
Chronic granulomatous disease
Catalase ⊕ microbes, especially S aureus
115
“Currant jelly” sputum
Klebsiella
116
Dog or cat bite
Pasteurella multocida
117
Facial nerve palsy (typically bilateral)
Borrelia burgdorferi (Lyme disease)
118
Sinus/CNS infection in diabetics
Mucor or Rhizopus spp.
119
Neutropenic patients
Candida albicans (systemic), Aspergillus
120
Organ transplant recipient
CMV
121
PAS ⊕
Tropheryma whipplei (Whipple disease)
122
Pediatric infection
Haemophilus influenzae (including epiglottitis)
123
Pneumonia in cystic fibrosis, burn infection
Pseudomonas aeruginosa
124
Puncture wound, lockjaw
Clostridium tetani
125
Pus, empyema, abscess
S aureus
126
Rash on hands and feet
Coxsackie A virus, T pallidum, R rickettsii
127
Sepsis/meningitis in newborn
Group B strep
128
Surgical wound
S aureus
129
Traumatic open wound
Clostridium perfringens
130
