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Micro > Micro Key Associations > Flashcards

Micro Key Associations Flashcards

1
Q

Staphylococci

A

gram positive round clusters

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2
Q

Preferentially colonizes the vagina

A

Streptococcus agalactiae

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3
Q

Anaerobic

Gram positive spore forming rod

endospores introduced through wounds

A

Clostridium tetani

Tetanus

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4
Q

Best prevention for staph

A

WASH YOUR HANDS

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5
Q

Think bunnies, Rabbits, and hares oh my…. or Peter Rabbit in a Tulle Skirt

A

Francisella tularensis

Tuleremia

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6
Q

Gastroenteritis - fever, diarrhea, cramps 24-48h

A

Listeria

spp. (L. monocytogenes)

Ampicillin & PCN or Bactrim

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7
Q

gram-negative bacilli, aerobic growh requires X factor (hemin) and V factor (NAD)

humans are only natural host, secretions or airborne droplets

A

Haemophilis influenzae

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8
Q

Strep Throat-Presence of erythema, uvulitis, and tonsillar exudates

A

Streptococcus pyogenes

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9
Q

most common cause of UTIs and Gram-negative sepsis, most frequent cause of Traveller’s diarrhea, important cause of neonatal meningitis

A

Escherichia coli

  1. cephalosporins, 2. aminoglycosides, 3. TMP/SMX (bactrim) 4. fluoroquinones
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10
Q

index organism for fecal contamination of water

A

Escherichia coli

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11
Q

Multi-system disease following a “cytokine storm” induced by a toxin, TSST-1 (a superantigen)

A

Staphylococcus aureus-toxic shock syndrome

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12
Q

UTI, bacteremia; systemic infections introduced via invasive intervention

A

Staphylococus Coagulase negative (S. saprophyitcus)

penicillin; for invasive infections: vancomycin

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13
Q

Classic Triad: fever, headache, rash, hx of bite in <50%, early: HA, intense myalgia, anorexia, fever. Rash: begins on ankles/wrist and spreads centrally. maculopapular, evolves into petechial rash, palms/soles 40-80%, severe case: hemorrhage, necorsis, gangrene of digits, usually no eschar

higher risk: G6PD deficiency, elderly, alcoholism

A

Rickettsia rickettsii

Rocky Mountain Spotted Fever (RMSF)

tropism for vascular endothelial cells

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14
Q

PCR, ELISA for toxin A and B, NOT Culture, Cdiff antigen, cytotoxicity assay, fecal leukocytes in 50%, pseudomembranes on endoscopy in 30-50%

A

Clostridium difficileC.diff, C,diff infection (CDI)

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15
Q

(G+) Clustered cocci, facultative anaerobes

A

Staphylococus

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16
Q

Placenta - in utero infection → immediate abortion/neonatal death → infection at parturition (meningitis 2wk post-birth or immediate sepsis after delivery)

A

Listeria

spp. (L. monocytogenes)

Ampicillin & PCN or Bactrim

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17
Q

No cell walls- don’t stain. Pleimorphic.

A

Mycoplasmataceae

Mycoplasma spp. Ureaplasma spp.

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18
Q

Inducible clindamycin resistance

A

beta-hymolytic streptococci

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19
Q

mouth pain, drooling, dysphagia, respiratory distress “hot potato voice”, edema of the floor of mouth with swelling and displacement of tongue superiorly and posteriorly. woody, tender SWelling of suprahyoid region of neck

^^not to be confused with diphtheria, which can cause bull neck

predisposing factors: odontogenic infection (70-85%), trauma, mandibular fracture, foreign bodies, neoplasm

A

(NOT A SPECIFIC BUG) Ludwig’s Angina

mixed oral aerobes, anaerobes, occasionally S. aureus

infection of submandibular space: sublingual, submlyohyoid spaces

Antibiotics should be initiated as soon as possible, should initially be broad-spectrum and cover gram-positive, gram-negative, and anaerobic organisms. Combinations of penicillin, clindamycin, and metronidazole are typically used. Respiratoy distress - intubation

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20
Q

endocarditis, dental caries

A

Streptococcus viridans

For all Strep: beta‐lactam; cephalosporin; macrolide;
respiratory fluorquinolone

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21
Q

“Bull Neck” appearance is Airway Obstruction

^^not to be confused with Ludwig’s Angina (hot potato voice, woody, tender swelling of suprahyoid. from mixed aerobes and anaerobes)

A

Corynebacteria diptheriae

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22
Q

veneral syphilis, yaws, endemic syphilis, pinta

A

Treponema pallidum

syphilis

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23
Q
  1. gram stain: reveals gram+ cocci in clusters.
  2. Culture: beta-hemolytic, produces a golden yellow pigment,
  3. metabolic - catalase positive, coagulase positive,
  4. PCR of rRNA
A

Staphylococus aureus

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24
Q

Infections of valves, catheters, shunts, prothetic devices, etc…

A

Coagulase negative Staphylococcus infection

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25
Q

louse-borne relapsing fever

A

Borrelia recurrentis

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26
Q

Food-borne botulism - cranial nerve palsies, muscle weakness, respiratory paralysis, (also infant botulism and wound botulism)

A

Clostridium botulinum-Botulism

Remove toxin - gastric lavage, wound debridement; respiratory support, polyvalent equine antitoxin

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27
Q

3 laboratory diagnostic techniques for Staphylococcus infections

A
  1. Gram stain
  2. PCR
  3. Culture
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28
Q

localized with systemic toxin-effect (scalded-skin syndrome, toxic-shock syndrome)

clindamycin, cephalosporins, erythromycin

For MRSA – vancomycin, TMP/SMX,
doxycycline, linazolid

A

Staphylococus aureus

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29
Q

RABIES:1. incubation can be from 2wks to year. 2. prodrome: fever, HA, sorethroat, parasthesias at inoculation site (50%) GI, behavioral and emotional symptoms, priapism, agitation, depression 3. Acute encephalitis: Furious (80%) painful contraction of pharyngeal muscles with swallowing liquids –> hydrophobia and foaming at mouth, hyperactivity and agitation leading to confusion and seizures, Paralytic (20%) Brain stem encephalitis: cranial nerve dysfunction, 4: coma and death: due to respiratory center dysfunction

A

Lyssavirus

Rabies

negative sense, enveloped ssRNA

one of the only disease where you can get vaccinated after exposure

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30
Q

after 4-6 weeks, 90% with IgG elevation, after Abx, titers fall slowly, PCR for serum, CSF, and synovial fluid. C6 antibody (ELISA)

A

Borrelia burgdorferi

Lyme disease

spirochetes

oral Abx unless patient has neurologic or cardiac symptoms, oral doxycycline, amoxiciliin, IV ceftriaxone, 15% develop Jarsich-Herxheimer reaction

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31
Q

oxacillin resistance

A

MRSA

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32
Q

pre-existing anti-dengue Ab: previous infections, maternal Ab, higher risk in secondary infections, higher risk in locations with >= 2 serotypes circulating Primary: develop Ab that can neutralize virus of homologous serotype. subsequent infections: pre-existing heterologous Ab forms complex with new infecting serotype - DO NOT neutralise new virus, can get greater proportion of monoctes increasing viral replication. infected monocytes release vasoactive mediators - increased vascular permeability and hemorrhagic manifestations

A

Dengue

Arbovirus, 4 serotypes

humans are main reservoir hosts, urban settings: Aedes aegypti and albopictus, slyvatic: non-human primates and tree-dwelling Aedes stegomyia

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33
Q

major shifts in HA and NA

A

antigenic shift:

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34
Q

culture - greenish metallic colonies on blood agar. can have fruity (grape) smell

A

Pseudomonas aeurginosa

Whirlpool folliculitis

multi-drug reistant; highest mortality rate of all noscomial pathogens. It’s the HOST not the bug.

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35
Q
  1. Gram stain, 2. Culture, 3. serology, 4. PCR of nasal swab, widening mediastinum on CXR
A

Bacillus Anthracis

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36
Q

Dental caries

A

Viridans Streptococci

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37
Q

infection occurs when bacteria enters peritoneal cavity

abcesses in GI tract, pelvis and lungs

A

Bacteroides fragilis-bacteroides

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38
Q

sore throat, fever, lymphadenopathy, tonsillar enlargement with exudate; paltal petechiae (25-60%), cervical lymphadenopathy (80-90%), splenomegaly (50%), hepatomegaly (10-15%); can be asymptomatic

A

Epstein-Barr Virus (EBV)

mononucleiosis

gamma-herpesvirus

distinguish from strep using monospot

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39
Q

“Honey crusted rash”

A

Impetigo (Streptococcus pyogenes)

Impetigo (Stayphylococcus aureus)

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40
Q

endocarditis, sepsis, UTI, opportunistic pathogen

A

Streptococcus enterococcus

Nitrofurantoin, may be PCN
sensitive (amoxicillin); For deep infections vancomycin; linezolid if
resistent

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41
Q
  • Food-borne
  • Rare, occurs in source-specific outbreaks
  • At risk: really young and really old, immunosuppressed individuals (pregnancy, steroids, transplant Pts, HIV)
A

Listeria

spp. (L. monocytogenes)

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42
Q

selective media for Staphylococcus aureus

A

mannitol salt agar

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43
Q

Latex particle agglutination for…

A

Streptococcus pneumoniae

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44
Q

incubation 2-21 days: starts with fever, severe HA, muscle pain, weakness, fatigue, GI distress - vomiting, diarrhea, abd pain. unexplaiend hemorrhage

A

Ebola virus

Filovirus

(-)ssRNA, enveloped, helical, nonsegmented, zoonotic

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45
Q

septic arthritis

A

Stayphylococcus aureus

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46
Q

gram-negative coccobacilli

through skin abrasions, unpasteurized dairy products, livestock (zoonosis)

A

Brucella Brucellosis

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47
Q

ulcers with black base at site of bite, high fever, lymphadenopathy, pneumonia (if bacteria was inhaled)

A

Francisella tularensis

Tuleremia

  1. gentamycin or streptomycin, 2. doxycycline, 2. attenuated vax (only for high risk)
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48
Q
  1. gram stain - gram + rods,
  2. culture- can grow on temps as low as 0 deg C, use cold enrichment to isolate from mixed flora
A

Listeria

spp. (L. monocytogenes)

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49
Q

gram-negative enterobacteriaceae, mucoid

A

Klebsiella pneumoniae

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50
Q

fried rice sickies

Food-poisoning (enterotoxin), traumatic ocular infection

A

Bacillus cereus

no treatment for food poisoning

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51
Q

UTI, staghorn calculi (kidney stones that take shape of tubules), sepsis

A

Proteus mirabilis; Proteus vulgaris

ampicillin

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52
Q

chancroids - begins as tender papule on genital or perianal area; lesion can ulcerate, with suppurative lymphadenopathy

A

Haemophilis ducreyi

Chancroid

  1. azithromycin, 2. ceftriaxone (IM) 3. ciprofloxacin
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53
Q

Invasive (endocarditis, pneumonia, osteomyelitis)

A

Staphylococus aureus

clindamycin, cephalosporins, erythromycin

For MRSA – vancomycin, TMP/SMX,
doxycycline, linazolid

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54
Q

Pneumococcal vaccine

A
  1. PCV13 (conjugate): all infants, young children, and adults >65
  2. PCV13 followed by PPSV23 (polysaccharide) at 6-12 mo
  3. Also high risk individuals: sickle cell, HIV, other immune dysfunction
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55
Q
  1. ciprofloxacin, 2. doxycycline, 3. raxibacumab (monoclonal Ab for inhalation anthrax) 4. vaccine for high-risk individuals
A

Bacillus Anthracis

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56
Q

infects human embryonic cortical neural progenitor cells (hNPCs) which produce infectious progeny virus, increase cell death of hNPCs

birth defects: microcephaly

A

Zika virus

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57
Q

gram stain and culture on blood or chocolate agar

A

Moraxella catarrhalis

All strains produce beta-lactamases, macrolides, fluoroquinolones, amoxicillin-clavulanate

colonization is dependent on age, COPD adults have higher rate, resistant to penicillin

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58
Q

food poisoning from enterotoxin, skin and soft tissue infection -gas gangrene or clostridial myonecrosis

A

Clostridium perfringens

gaseous gangrene

radical surgery (may require amputation) 2. penicillin, 3. hyperbaric O2

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59
Q

Non-selective media for Streptococcus

A

Sheep blood agar, chocolate agar

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60
Q

gram-negative rodbody lice feces

A

Bartonella quintana

Trench Fever

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61
Q

Acid fast stain, fluorescent stain, MTB rapid diagnostics, Gambian pouch rat expert,

.1ml PPD 5TU injected intracutaneously and induration measured 48-72 hrs. + is 5,10,15 determined by sensitivity, specificity ,and prevalence for diff groups. –> indicated presences of viable mycobacteria

A

Mycobacterium tuberculosis

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62
Q

gram-negtative non-sporulating bacillus, obligate aerobe except with nitrate, oxidase positive

typically nosocomial, colonizes damage tissues, ubiquitious

A

Pseudomonas aeurginosa

Whirlpool folliculitis

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63
Q
  1. if bitten by a possible rabid animal: A. capture the animal and observe for 10 days. 3. destroy animal and examine for Negri bodies, C. treat immediately if you cannot capture the animal or it has rabies
A

Lyssavirus

Rabies

negative sense, enveloped ssRNA

one of the only disease where you can get vaccinated after exposure

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64
Q

Sporiform, facultative anaerobes

A

Bacillus Anthracis

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65
Q

Kaposi’s sarcoma: vascular tumor associated with HIV, Castleman’s disease: focal or multicentric lymphoma (not associated w/ HIV)

A

HHV8

Kaposi’s sarcoma-associated herpes virus, castleman’s disease

Gamma- herpesvirus ds linear DNA, enveloped, icosahedral

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66
Q
  1. flea bite, 2. contact with infected animal tissue. 3. inhaled aerosolized organisms - human to human during epidemics
  2. wild rodents, city rats, squirrels and prairie dogs in southwest US
A

Yersinia pestis

bubonic plague

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67
Q

Asymptomatic: 20-50% Dengue fever (DNF): 2-7 days of high ever “break bone fever” 1. painful fever with HA, muscle aches, joint aches, backache. retro-orbital pain, diffuse erythematous maculopapular rash, no plasma leak or severe hemorrhage. N/V abdominal pain may occur. 2. critical (plasma leak): last 24-36hr, usually alert and lucid. 3. convalescent phase: stabilization of vital signs, HCR, increase urine output, rash: confluent pruritic rash with small island of unaffected skin, fluid overload if don’t decrease fluid resuscitation.

___

  1. dengue hemorrhagic fever: positive tourniquet test, skin hemorrhage: petechiae, purpura, ecchymoses, thrombocytopenia (=< 100.000/mm3), plasma leakage: hemoconcentration, pleural effusion, ascites, hypoproteinemia 3.Dengue shock syndrome: DHF + circulatory failure, narrow pulse pressure, hypotension + cold/clammy skin. >20% mortality w/o prompt tx. <1% if early intensive support therapy
A

Dengue

Arbovirus, 4 serotypes

humans are main reservoir hosts, urban settings: Aedes aegypti and albopictus, slyvatic: non-human primates and tree-dwelling Aedes stegomyia

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68
Q

sandfly

A

Bartonella bacilliformis

Oroya Fever (Carrion’s Disease)

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69
Q

penicillin; for invasive infections: vancomycin

A

Staphylococus Coagulase negative (S. saprophyitcus)

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70
Q

Bacillus

A

Gram positive rods

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71
Q

recombination of genomic material in cell co-infected with 2 diff viruses

A

reassortment

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72
Q

Catheter related sepsis– gram positive

A

enterococcus spp

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73
Q

Nitrofurantoin, may be PCN
sensitive (amoxicillin); For deep infections vancomycin; linezolid if
resistent

A

Streptococcus enterococcus

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74
Q

if given ampicillin (because you think it’s strep), will present with rash

A

Epstein-Barr Virus (EBV)

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75
Q

pneumonia with significant lung necrosis and bloody sputum common in alcoholics or those with underlying lung disease, hospital acquired UTI and sepsis

A

Klebsiella pneumoniae

  1. 3rd gen cephalosporin, 2. cipro
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76
Q

pertussis toxin, part of the TDaP vax.

A

Bordatella pertussis

whooping cough

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77
Q
  1. gram stain, 2. culture (urine, CSF, sputum, blood) 3. pathogenic strains from stool. 4. EMB agar
A

Escherichia coli

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78
Q

non-sporiforming, small cocci/diplo, motile

A

Listeria

spp. (L. monocytogenes)

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79
Q

no treatment for food poisoning

self-limiting, no treatment

A

Bacillus cereus

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80
Q

meningitis - bacteremic spread and may be associated with trauma, neurosurgery CSF leak or paranasal sinusitis, epiglottitis- emergency with celluitis and swelling pharyngitis fever drooling difficulty swallowing breahing and thumbprint sign, otitis media & sinusitis (URTI), pneumonia (LRTI), septic arthritis, sepsis

Risk: HIV/AIDS
• Sickle cell disease
• Splenectomy
• Chronic lung disease
• Also smoking, malignancy, pregnancy and alcoholism

A

Haemophilis influenzae

  1. 2nd or 3rd gen cephalosporins, Hib vax, passive immunization from mother
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81
Q
  1. acute: fever, HA, back pain, mylagia, intense arthralgia, rash in 50%: maculopapular, diffuse hyperemia, edema of face and extremities

__

  1. chronic: debilitating polyarthraglias. can last months to >1 year. less common in children, peripheral joints, spinal pain, associated with tenosynovitis and Raynaud’s syndrom
A

Chikungunya

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82
Q

15% develop Jarsich-Herxheimer reaction

A

Borrelia burgdorferi

Lyme disease

spirochetes

oral Abx unless patient has neurologic or cardiac symptoms, oral doxycycline, amoxiciliin, IV ceftriaxone, 15% develop Jarsich-Herxheimer reaction

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83
Q

radical surgery (may require amputation) 2. penicillin, 3. hyperbaric O2

A

Clostridium perfringens

gaseous gangrene

radical surgery (may require amputation) 2. penicillin, 3. hyperbaric O2

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84
Q

alpha-hemolytic strep

A

Streptococcus pneumoniae

Streptococcus viridans

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85
Q

Streptococcus

A

gram positive dipolococci

86
Q

Group B, beta-hemolytic

A

Streptococcus agalactiae

87
Q

one of the causes of “atypical” pneumonia: mostly mild or asymptomatic infections. upper (bronchitis, pharyngitis) lower (pneumonia)

A

Chlamydia pnuemoniae

88
Q

gram-negative diplococci

transmitted by sexual contact, major reservoir in women carriers

A

Neisseria gonorrhea

89
Q

Shingles: usually unilateral and contained in 1-3 dermatomes latency in dorsal root ganglia, prodromal pain 50% thoracic

__

postherpetic neuralgia - persistent pain >1 month, incidience increases with advancing age. Herpes zoster ophthalmicus - vesicles on one side of forehead and on tip of nose may be associated with severe corneal involvement, can lead to blindness

A

herpes zoster

shingles

90
Q

Antitioxin (Europe only), Antibiotics (PCN, erythromycin, rifampin, tetracycline), respiratory isolation, supportive therapy

A

Corynebacteria diptheriae

91
Q

regional lymphadenitis, enlarged and tender lymph nodes, fever, headache, rash, splenomegaly, culture-negative endocarditis, bacillary angiomatosis. Granuloma with central necrosis + giant cells.

A

Bartonella henselae

Cat scratch disease

  1. azithromycin, 2. doxycycline
92
Q
  1. gram stain: reveals gram+ cocci in clusters.
  2. Culture: gamma-hemolytict,
  3. metabolic - catalase positive, coagulase positive
A

Staphylococus Coagulase negative (S. saprophyitcus)

93
Q

gram stain, anaerobic culture (produces a black pigment when grown on blood agar)

A

Bacteroides melaninogenicus-bacteroides

94
Q

Localized infections with toxin mediated effects (scalded skin syndrome/toxic shock syndrome/food poisoning)

A

Stayphylococcus aureus

95
Q

inducible clindamycin resistance

A

Staphylococcus resistance

96
Q

CNS - brain & brainstem & CSF - Top 5 causes of meningitis, 20% mortality

A

Listeria

spp. (L. monocytogenes)

Ampicillin & PCN or Bactrim

97
Q

pyomyocysitis

A

Stayphylococcus aureus

98
Q

Anaerobic

Gram positive spore forming bacilli

  1. soil 2. canned food 3. smoked fish 4. honey (infant botulism) 5. IV drug use
A

Clostridium botulinum-Botulism

99
Q
  1. culture (easily transmited so careful 2. skin test. 3. measure rise in IgG
A

Francisella tularensis

Tuleremia

  1. gentamycin or streptomycin, 2. doxycycline, 2. attenuated vax (only for high risk)
100
Q

Detect of unique DNA sequences that are able to distinguish MRSA and MSSA

A

Staphylococcus aureus PCR

101
Q

gram-negative enterobacteriaceae

A

Yersinia pestis

bubonic plague

102
Q
  1. neonates are susceptible from 6-24 mnths with IgG is low. 2. Army recruits, college dorms
A

Neisseria meningitidis

bacterial meningitis

103
Q

immunosuppression - CF, prolonged hospitalization, burn wound patients

OTITIS EXTERNA, WHIRLPOOL FOLLICULITS. Cutaneous infections: paronychia, toe web infections, cellulitis, pyoderma (skin infection w/ pus); GI infections: typhilitis, Shanghai fever, diarrhea; bacteremia, bone + joint infections

A

Pseudomonas aeurginosa

Whirlpool folliculitis

multi-drug reistant; highest mortality rate of all noscomial pathogens. It’s the HOST not the bug.

104
Q

Men: genital infection restricted to urethra, complications: epididymitis, prostatitis, anorectal GC

Women: vaginal discharge, dysuria, abdominal pain, 10-20% ascending genital infection with tubo-ovarian abscess, PID - increased risk of infertility or ectopic/tubal preganancy, bartholinitis. Neonates: ophthalamia neonatorum

A

Neisseria gonorrhea

ceftriaxone plus azithromycin, penicillin resistance common

105
Q

human to human, respiratory route, may be 3-5 days before rash

A

varicella zoster virus (VSV)

alpha-herpesvirus, latency in neurons, has nucleocapsid, enveloped

106
Q

TETANUS - muscle spasms, persistent back spasm (opisthotonos), lowjaw (trismus), respiratory muscle paralysis, neonatal tetanus (umbilical stump -90% mortality)

A

Clostridium tetani

Tetanus

wound debridement, antibiotics, passive immunization: tetanus immune globulin, active immunization: tetanus toxoid

107
Q

Respiratory: tracheobronchitis, atypical or walking pneumonia

Genital: PID, pyelonephritis, Urethritis

A

Mycoplasmataceae

Mycoplasma spp. Ureaplasma spp.

108
Q

skin infection; localized (cellulitis, impetigo, folliculitis, furnuncles, carbuncles)

A

Staphylococus aureus

clindamycin, cephalosporins, erythromycin

For MRSA – vancomycin, TMP/SMX,
doxycycline, linazolid

109
Q

responsible for blindness, infertility

A

Chlamydia trachomatis

110
Q

Detection of _____ streptolysin O and DNAase B antibodies

A

Streptococcus pyogenes

111
Q

Whooping Cough: 1. catarrhal phase: patient is highly contagious (1-2wk) - low grade fever, rhinorrhea, mild cough, abx effective 2. paroxysmal phase: (2-10wk) whooping (burse of non-productive coughs), increase # of lymphocytes in blood smear, Abx ineffective 3. convalescent phase

A

Bordatella pertussis

whooping cough

erythromycin, vaccine, treat household contacts with erythromycin

112
Q
  1. culture of blood, bone marrow. liver, lymph nodes 2. serologic test. 3 skin test (indicates exposure only)
A

Brucella Brucellosis

6 weeks of antibiotics; pasteurization of milk

113
Q

ss RNA viruses, orthomyxovirus, enveloped, types A, B, C

A

Influenza

114
Q

ELISA, PCR, Bordet-Gengou media, fluorescein-labeled Abs

A

Bordatella pertussis

whooping cough

erythromycin, vaccine, treat household contacts with erythromycin

115
Q

biphasic: acute bacteremic phase = flu-like symptoms (fever, myalgia, arthalgia, headache, Oroya fever); chronic phase = cutaneous nodules develop 1-2 months after and persist for years

A

Bartonella bacilliformis

Oroya Fever (Carrion’s Disease)

116
Q

Worrisome AB-Resistance: Vancomyocin, Oxacillin, Clindamycin

A

Staphylococus aureus

117
Q

gram-negative, enterobacteriaceae, facultative anaerobe

A

Escherichia coli

118
Q

Gram stain, PCR, Rapid Strep

A

Streptococcus pyogenes

119
Q

Sporiform, aerobic

A

Bacillus cereus

120
Q
  1. cephalosporins, 2. aminoglycosides, 3. TMP/SMX (bactrim) 4. fluoroquinones
A

Escherichia coli

121
Q

Gram stain and culture of ulcer exudate and pus from lymph nodes

cultures are ineffective, often have no growth

A

Haemophilis ducreyi

Chancroid

122
Q

gram-negative diplococci

normal flora in vagina and orophaynx

A

Moraxella catarrhalis

123
Q

culture specimen from suspected food source

A

Bacillus cereus

124
Q

first infection = usu. more severe symptoms; recurrent infections = usu. less severe

primary genital infection: fever, anorexia, malaise, headache, regional lymphadenopathy, genital lesions

primary oral infection: gingivostomatitis (vesicles with ulceration), cervical lymphadenopathy

____

keratitis, herpetic whitlow (vesicular infection + inflammation of the nail bed); IN IMMUNOCOMPROMISED HOSTS: chronic skin lesions (primary manifestation), esophagitis, pneumonia (rare), dissemination (rare)

aseptic meningitis (from inflammation of sacral nerve roots)

A

HSV (HSV-1, HSV-2)

alpha-herpesvirus, latency in neurons, has nucleocapsid, enveloped

125
Q

Anaerobes

Gram positive spore forming bacilli

soil, water, sewage, part of normal flora

A

Clostridium perfringens

gaseous gangrene

126
Q

fever, rash, superficial fluied-filled vesicles, pustules, crusts/scabs

Complications: Hepatitis, pneumonitis, encephalitis; infection of cutaneous lesions; Reye’s syndrome (encephalopathy, liver disease) is assoc. w/ aspirin consumption; Guillain-Barre syndrome

A

varicella zoster virus (VSV)

alpha-herpesvirus, latency in neurons, has nucleocapsid, enveloped

127
Q

non-sporiform, aerobic, club-shaped

A

Corynebacteria diptheriae

128
Q

gram-negative rod

cat bite or scratch

A

Bartonella henselae

Cat scratch disease

129
Q

gram-negative diplococci (Serogroup B)

humans = only reservoir

A

Neisseria meningitidis

bacterial meningitis

130
Q

obligate aerobe, requires cysteine

rabbits, rodents, tics, fleas

A

Francisella tularensis

Tuleremia

131
Q

Antibiotic associated colitis (diarrhea), dehydration, electrolyte disturbances, shock, toxic megacolon, reactive arthritis

A

Clostridium difficile

C.diff, C,diff infection (CDI)

discontinue causative Abx, initiate Abx effective against Cdiff: metronidazole, oral vancomyocin, fidaxomicin, toxin-binding resins

132
Q

lepromatous: high bacillary lode, diffuse, extensive skin involvement, plaques, nodules, deformity of facial structures, anergy, tuberculoid: few bacilli present, <5 skin lesions, anasethesia present, react to M.leprae skin test, nerve involvement common, mixed

A

Mycobacterium leprae

Leprosy (Hansen’s disease)

133
Q

5 lab diagnostic techniques for streptococcal infections

A
  1. Gram stain
  2. antigen detection
  3. molecular diagnostics
  4. aerobic and anaerboci culture
  5. antibody detection
134
Q

Flu like sxs, leukopenia + thrombocytopenia + elevated transaminases, Complications: spetic shock, ARDS, neuro (peripheral , facial palsy, demyelinating polyneuropathy, brachial plexopathy); morulae in granulocytes

A

Anaplasma phagocytophilium

Anaplasmosis

tropism for neutrophils, intracellular bacteria

135
Q

Endocarditis

A

Viridans Streptococci

Enterococcus spp

136
Q

Gram negative rods, non spore forming, polysaccharide capsulepart of the normal flora of intestine

Anaerobes

A

Bacteroides fragilis-bacteroides

Bacteroides melaninogenicus-bacteroides

137
Q

roseola infantum in 20-30% of cases, usually self-limited, mild, febrile seizures 3-13%, rare encephalitis

___

acute onset high fever with well-appearance subocciptal adenopathy, red throat, abrupt disappearance of fever with onset of macular rash, drop in WBC prior to rash, may have atypical lymphocytes, 6 days duration, mono like illness in adults

A

HHV6

spring/fall, spread by saliva, 6th disease,

beta- herpesvirus ds linear DNA, enveloped, icosahedral

138
Q

Fluoroquinolone resistance

A

Streptococcus pneumoniae

139
Q

Neonatal sepsis/megingitis

Postpartum sepsis

A

Streptococcus agalactiae

140
Q

gram -, obligate intracellular bacteria

A

Chlamydia trachomatis

Chlamydia psittaci

Chlamydia pnuemoniae

141
Q

70 antigenic variations, resistant to beta lactamses and carbapenemase

A

Klebsiella pneumoniae

142
Q

West Nile fever (WNF) 20-30% or West nile neuroinvasive disease (WNND) <1%: meningitis, encephalitis or myelitis, that produces flaccid paralysis

_____

  1. West nile meningitis: symptoms of WN fever + meningitis. 20% have cranial nerve palsies, CSF: ~200 WBC/mm3( often neutrophils, elevated protein, normal glucose), usually recover without permanent neurological sequelae, 2. WN Encephalitis: more common in older and immunocompromised individuals, fatality rate 20% - cardiac arrythmia or respiratory failure. chronic neurologic sequelae: tremors, parkinsonism, ataxia, can last months.years, high rate of institutionalization. 3.flaccid paralysis: typically asymmetric in >1 limb, ~50% with encephalitis, rarely occurs w/o fever or other symptoms. permanent weakness and prolonged recovery
A

West Nile Virus

enveloped flavivirus

143
Q

Penicillin/cephalosporin resistance

A
  1. Streptococcus pneumoniae
  2. viridans streptococci
144
Q

Resp. Tract –> Exudate in Pharynx/trachea –> Airway Obstruction. Tonsillitis/pharyngitis; Neck Adenopathy. Other Presentations: MYOCARDITIS and Cranial neuropathies

A

Corynebacteria diptheriae

Antitioxin (Europe only), Antibiotics (PCN, erythromycin, rifampin, tetracycline), respiratory isolation, supportive therapy

145
Q

Sputum gram stain with gram positive diplococci

A

Streptococcus pneumoniae

146
Q

_Meningitis*, Pneumonia*,_ bacteremia, otitis media, sinusitis

A

Streptococcus pneumoniae

For all Strep: beta‐lactam; cephalosporin; macrolide;
respiratory fluorquinolone

147
Q

Gram positive opportunitistic infection, such as a UTI

A

enteroccocus spp

148
Q
  1. clinical : tourniquet test (positive: >20 petechiae/in2) 2. acute: virus detection, blood CSF, tissue, RT-PCR, antigent detection (NS1 protein), 0-5 days post-onset of symptoms. 3. Serology: IgM >5 days post onset. IgG: paired acute.convalescent - 4-fold rise in titers
A

Dengue

Arbovirus, 4 serotypes

humans are main reservoir hosts, urban settings: Aedes aegypti and albopictus, slyvatic: non-human primates and tree-dwelling Aedes stegomyia

149
Q

Immunochromatography for….

A
  1. Streptococcus pyogenes
  2. Streptococcus agalactiae
150
Q

subcutaneous hemorrhage results in blackish skin discoloration giving name “Black Death”

A

Yersinia pestis

bubonic plague

  1. streptomycin or gentamycin 2. doxycycline
151
Q

A woman is pregnant and expecting, with regard to Streptococcus infections, what should you test her for?

A

GBS

152
Q

spirochetes, corkscrew shaped

A

Treponema pallidum

syphilis

153
Q

Gram Stain, immunochromatography, latex, molecular diagnosis, aerobic and anaerobic, antibody detection

A

Streptococcus pneumoniae

154
Q

Intracellular pathogenesis - binds epithelial cells, escapes intracellular killing via filopods (bacteria push against membrane and through to adjacent cells, escaping immunosurveillance), cell to cell spread

A

Listeria

spp. (L. monocytogenes)

155
Q

Trench fever: fever, headache. back pain, lasts for 5 days and occurs at 5 day intervals. 2. bacteremia, endocarditis, bacillary angiomatosis

A

Bartonella quintana

Trench Fever

  1. doxycycline 2. chloramphenicol 3. azithromycin
156
Q

transmission secondary to contact with infected body fluids: contaminated medical instrumetns and close contact with sick or dead patients and their bodies. likely mechanism is skin or mucous membrane contact with virus infected fluids - blood, semen, diarrhea, vomit

A

Ebola virus

Filovirus

(-)ssRNA, enveloped, helical, nonsegmented, zoonotic

157
Q

vancomycin resistance

A

VRSA

158
Q

10-15% of otitis media, 3rd most common for bacterial sinusitis, lower RTI especially in COPD and bronchitis patients, pneumonia in elderly

A

Moraxella catarrhalis

All strains produce beta-lactamases, macrolides, fluoroquinolones, amoxicillin-clavulanate

colonization is dependent on age, COPD adults have higher rate, resistant to penicillin

159
Q

osteomyelitis

A

Stayphylococcus aureus

160
Q

For all : beta‐lactam; cephalosporin; macrolide;
respiratory fluorquinolone

A

Streptococcus

161
Q

minor shift in HA or NA with only minor changes in antigenicity.

A

antigenic drift

162
Q

Types: 1) Bubonic, 2) Septicemia, 3) Pneumonic. Presentation: Fever, headache, chills, fatigue, leucocytosis, sepsis, pneumonic plague (epidemics).

A

Yersinia pestis

bubonic plague

  1. streptomycin or gentamycin 2. doxycycline
163
Q

Scalded skin syndrome: exfoliatin-mediated detachment of the granulosum and spinosum layers within the epidermis

A

Staphylococcus aureus

164
Q

Yellow Fever: 3-6 day incubation conjunctival suffusion1. hepatitis with jaundice, 2. fever. 3. backache

A

Yellow Fever

165
Q

meningococcal meningitis with petechial rash, meningococcemia w/o meningitis, meningitis w/o meningococcemia, mild transient bacteremia, pneumonia

A

Neisseria meningitidis

bacterial meningitis

3rd gen cephalosporins (ceftriaxone, cefepime); chloramphenicol - used in developing countries

Chemoprophlyaxis should be given to close contacts only after exposure to invasive disease. Meningitis Belt = Sub-Saharan Africa

166
Q

Gram stain, blood culture for possible disseminated GC, chocolate agar, commercial antigen probes, urine NAAT

A

Neisseria gonorrhea

167
Q

Vancomycin resistance

A

enterococci

168
Q

mixed oral aerobes, anaerobes, occasionally S. aureus

infection of submandibular space: sublingual, submlyohyoid spaces

A

(NOT A SPECIFIC BUG) Ludwig’s Angina

Antibiotics should be initiated as soon as possible, should initially be broad-spectrum and cover gram-positive, gram-negative, and anaerobic organisms. Combinations of penicillin, clindamycin, and metronidazole are typically used. Respiratoy distress - intubation

169
Q

non selective media for Staphylococcus

A
  • sheep blood agar
  • chocolate agar
170
Q

gram-negative enterobacteriaceae, motile

A

Proteus mirabilis; Proteus vulgaris

171
Q

neonatal and postpartum sepsis, meningitis

A

Streptococcus agalactiae

For all Strep: beta‐lactam; cephalosporin; macrolide;
respiratory fluorquinolone

172
Q

Wide zone beta-hemolysis: Strep

A

streptococcus pyogenes

173
Q

eschars, necrosis in RT, oropharyngeal and abd infection

  1. cutaneous (95%): painless black vesicles, can be fatal if untreated. 2. pulmonary (woolsorter’s disease). 3. abd pain, vomiting, bloody diarrhea
A

Bacillus Anthracis

  1. ciprofloxacin, 2. doxycycline, 3. raxibacumab (monoclonal Ab for inhalation anthrax) 4. vaccine for high-risk individuals
174
Q

Lateral neck radiograph; Look for THUMBPRINT sign

A

Haemophilis influenzae

  1. 2nd or 3rd gen cephalosporins, Hib vax, passive immunization from mother
175
Q

Group D

A

Streptococcus enterococcus

176
Q

aerobic, non-spore forming, nonmotile bacillus

A

Mycobacterium

tuberculosis

avium and intracellulare

leprae

177
Q

CNS (Meningitis) and placenta, bacteremia in immunocompromised

A

Listeria

spp. (L. monocytogenes)

Ampicillin & PCN or Bactrim

178
Q

Endemic: Latin America, Sub-saharan Africa, East Asia

A

Bacillus Anthracis

179
Q
  1. gram stain for gram- rods, 2. blood cultures. culture of bubo aspirate 4. serology. 5. rapid diagnostic - antibody against F1
A

Yersinia pestis

bubonic plague

  1. streptomycin or gentamycin 2. doxycycline
180
Q

high fever, sweats malaise, anorexia, abdominal pain, diarrhea, back pain, lymphadenopathy (10%), hepatosplenomegaly (40%); granulomas. Can progress into undulant/Malta fever; COMPLICATIONS: arthritis, osteomyelitis, meningitis

A

Brucella Brucellosis

6 weeks of antibiotics; pasteurization of milk

181
Q
  1. culture, 2. examination of urine with high pH
A

Proteus mirabilis; Proteus vulgaris

182
Q

Gram stain and culture of CSF, CSF on chocolate agar, blood cultures

A

Neisseria meningitidis

bacterial meningitis

3rd gen cephalosporins (ceftriaxone, cefepime); chloramphenicol - used in developing countries

Chemoprophlyaxis should be given to close contacts only after exposure to invasive disease. Meningitis Belt = Sub-Saharan Africa

183
Q

down-regulates cytotoxic CD8 response Immunocompetent: asymptomatic, mono, congenital CMV, immunocompromised: retinitis (50% bilateral), pneumonitis, GI- colitis, esophagitis, CNS-encephalitis, myelitis

A

cytomegalovirus (CMV)

Also mono

Beta-herpesvirus DNA virus, icosahedral, lipid envelope

negative monospot

184
Q

Alpha hemolysis: strep

A

streptococcus pneumoniae

185
Q

diagnosis is made clinically - NEVER a microbiologic diagnosis, feel impending doom, usually with antecedent trauma

A

Clostridium perfringens

gaseous gangrene

radical surgery (may require amputation) 2. penicillin, 3. hyperbaric O2

186
Q

ampicillin resistance

A

E. faecium

187
Q

high risk: infants <1 year old, adults (as immunity wears off)

A

Bordatella pertussis

whooping cough

erythromycin, vaccine, treat household contacts with erythromycin

188
Q

Respiratory Tract [URI, pharyngitis, Scarlet fever, suppurative sequelae (tonsillar or retropharyngeal abscess), nonsuppurative sequelae (rheumatic fever, glomerularnephritis)],

Skin [Impetigo, ecthyma (punched out ulcers into dermis, green-yellow crust), cellulitis (acute skin infection, SubQ), erysipelas (superficial cellulitis), necrotizing fasciitis (incl. deep fascia), toxic shock (systemic infection, fever, hypotension, tachycardia/pnea, desquamation)]

A

Streptococcus pyogenes

For all Strep: beta‐lactam; cephalosporin; macrolide;
respiratory fluorquinolone

189
Q

toxin-mediated (food poisoning)

A

Staphylococus aureus

clindamycin, cephalosporins, erythromycin

For MRSA – vancomycin, TMP/SMX,
doxycycline, linazolid

190
Q

flu like sxs + maculopapular rash, leukopenia + thrombocytopenia + elevated transaminases, Complications: spetic shock, ARDS, coagulaopathies, neuro (meningoencephalitis, seizures, coma, peripheral, primary cranial neuritis) - more complications and fatalities; morulae in MONOCYTES

A

Ehrlichiaspp. Ehrlichiosis

191
Q

cutaneous manifestations: erythema chronicum migrans -occurs at tick bite site, 3-30 days post bite, usually red outer with central clearing, fatigue, F/C, adenopathy, meningeal signs, hepatitis, splenomegaly

MSK manifestations: 80% untreated patients affected, occur within 2wks-2years. from joint pain to intermittent arthritis to chronic erosive synovitis. Early disease: migratory pain in joints, tendonitis, bursae potenitally affected, frank arhtritis with marked swelling can occur in large joints with remission inbetween attacks, small % with chronic arthritis

Cardiac: occurs within several weeks, 5% untreated patients, usual presentation: AV block (1st degree, Wenkebach, complete heart block) may present with EKG changes, myopericarditis, LV dysfunction, brief: 3days to 6 weeks

Neuro manifestations: early- symptoms of meningeal irritation concomitant with ECM, not associated with CSF pleoctyosis or neuro defecits, late: 15% cases affected, several weeks to months after onset of diseasae, includes meningitis, encephalitis, chorea, cranial neuritis, motor/sensor radiculitis, myelitis. usual pattern: fluctuating meningitis with superimposed cranial nerve palsy or peripheral neuropathy

A

Borrelia burgdorferi

Lyme disease

spirochetes

oral Abx unless patient has neurologic or cardiac symptoms, oral doxycycline, amoxiciliin, IV ceftriaxone, 15% develop Jarsich-Herxheimer reaction

192
Q

pulmonary disease in elderly men with COPD, elderly non-smoking women, CF, hypersensitivity pneumonitis (hot tub lung), disseminated disease in AIDS patients, lymphadenitis in children

A

Mycobacterium avium and intracellulare

M. avium complex (MAC)

surgey may be required despite “modern therapy”

Lady Windermere’s Syndrome

193
Q

fever, rigors, myalgia, headache; sore throat, dry cough, nasal obstruction, viral pneumonia

CAN BE FOLLOWED BY: bacterial pneumonia, infection Guillain-Barre syndrome

A

Influenza

194
Q

0.5-3% develop disseminated infection: fever, migratory arthalgias, suppurative arthritis, pustular rash on extremities, purulent conjunctivitis in newborns (ophthalmia neonatorum); pharyngitis

A

Neisseria gonorrhea

ceftriaxone plus azithromycin, penicillin resistance common

195
Q

birdsbird owners, veternarians, zoo/per shop workers, poultry industry

Parrot fever, ornithosis

A

Chlamydia psittaci

196
Q

HPS: F/C, HA, myalgia, GI distress, dizziness, x4-10days. leads to cough, severe SOB, mortality 38%

A

Hantavirus

bunyavirus

rodents via urine or feces

197
Q
  1. neonatal conjunctivitis, 2. infant pneumonitis, 3. genital infections in adults 4. trachoma
A

Chlamydia trachomatis

198
Q

Anaerobic

Gram positive spore forming bacilli

spores may be in environment for monts, asymptomatically in colonic flora up to 5% of normal population

A

Clostridium difficile

C.diff, C,diff infection (CDI)

199
Q

Scarlet Fever- scarlatiniform sandpaper rash, strawberry tongue

A

Streptococcus pyogenes

200
Q
  1. encapsulated, beta-lactamase. filamentous hemagglutininhuman - highly contagious, transmitted via respiratory route
A

Bordatella pertussis

whooping cough

201
Q

Real-time PCR for detection of _____ amplified DNA

A

Streptococcus agalactiae

202
Q

slowly replicatng mycobacteria, incubation is 5-20 yearsvia droplets from close and frequent contact to nose and mouth, armadillos in southern US

A

Mycobacterium leprae

Leprosy (Hansen’s disease)

203
Q

Direct detection of ______ ribosomal RNA

A

Streptococcus pyogenes

204
Q
  1. serology 2. PCR
A

Bartonella henselae

Cat scratch disease

  1. azithromycin, 2. doxycycline

Bartonella quintanaTrench Fever

  1. doxycycline 2. chloramphenicol 3. azithromycin
205
Q

if it’s a nasty, leaky skin infection, it’s probably ____. Honeycomb appearance think impetigo from _____

A

Staphylococus aureus

206
Q

Vaccines: PCV13 (conjugate) + PPSV23 (polysaccharide)

A

Streptococcus pneumoniae

207
Q

Otitis media

A

streptococcus pneumoniae

208
Q
  1. necrotizing anaerobic pneumonia (LUNG ABSCESSES), brain abscesses. peridontal disease
A

Bacteroides melaninogenicus-bacteroides

  1. Metronidazole 2. Clindamycin
209
Q

GRAM POSITIVE UTI

A

Enterococcus spp

210
Q

(G+) Group A , cocci in chains, beta-hemolytic

A

Streptococcus pyogenes

211
Q

Primary TB: hematogenous dissemination including apical posterior arias of lung, development of delayed type hypersensitivity and skin test conversion or IGRA (quantiferon) Granuloma - containment of TB

Latent TB

A

Mycobacterium tuberculosis

Micro (2 decks)

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