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USMLE STEP 1 > Micro Systems > Flashcards

Micro Systems Flashcards

1
Q

Normal Dominant Flora of Skin

A

Staphylococcus epidermidis

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2
Q

Normal Dominant Flora of Nose

A

Staph epidermidis. Colonies by Staph aureus

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3
Q

Normal Dominant Flora of Oropharynx

A

Viridans Group Strep

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4
Q

Normal Dominant Flora of Dental plaques

A

Streptococcus mutans

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5
Q

Normal Dominant Flora of Colon

A 
Bacteroides fragilis (more)
E. coli (less)
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6
Q

Normal Dominant Flora of Vagina

A

Lactobacillus

Colonies by E coli and GBS

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7
Q

Neonates delivered by Cesarean section re flora?

A

They have no flora but are rapidly colonized after birth

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8
Q

Staph aureus and B cereus food poisoning course

A

Starts quickly and ends quickly

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9
Q

Contaminated seafood

A

Vibrio parahaemolyticus and V vulnificus (can cause wound infection from contact with contaminated water or shellfish)

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10
Q

Reheated rice

A

“be serious”

B cereus

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11
Q

Meats, Mayonnaise, Custard

A

S aureus

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12
Q

Reheated meat dishes leading to watery diarrhea

A

Clostridium perfringens

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13
Q

Improperly canned foods (bulging cans)

A

Clostridium botulinum

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14
Q

Undercooked meat

A

E coli O157:H7

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15
Q

Poultry, meat, eggs

A

Salmonella

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16
Q

Bugs that can mimic appendicitis

A

Yersinia enterocolitica causes mesenteric adenitis
Nontyphoidal Salmonella
Campylobacter jejuni

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17
Q

Causes of Bloody Diarrhea with signs

A

Campylobacter: Comma or S shaped, grows at 42
Salmonella: Lac-, Flagella
Shigella: Lac-, low ID50
EHEC, EIEC
Yersinia enterocolitica: Daycare outbreaks, pseudoappendicitis
Entamoeba histolytica

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18
Q

Causes of Watery Diarrhea

A

Enterotoxigenic E coli: Traveler’s, ST and LT toxin
V Cholerae: comma-shaped, rice-water
C difficile: bloody w/ pseudomembranous colitis
C perfringens: also gas gangrene
Protazoa: Giardia, Cryptosporidium (in immunocompromised)
Rotavirus, Norovirus

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19
Q

Pneumonia in neonate (less than 4 weeks)

A

GBS, E coli

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20
Q

Pneumonia in children (4 weeks to 18 years)

A

“Runts May Cough Chunky Sputum”

RSV, Mycoplasma, C. pneumoniae (school age), Chlamydia trachomatis (infant to 3 years), Streptococcus pneumoniae

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21
Q

Pneumonia in adults (18 years to 40 years)

A

Mycoplasma, C pneumoniae, S pneumoniae

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22
Q

Pneumonia in adults (40 years to 65 years)

A

S pneumoniae, H influenzae, Anaerobes, Viruses, Mycoplasma

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23
Q

Pneumonia in elderly

A

S pneumoniae, Influenza, Anaerobes, H influenzae, H influenzae, Gram- rods

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24
Q

Special Nosocomial Infections

A

Staph, Enteric Gram negative Rods

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25
Q

Special Immunocompromised infections

A

Staphylococcus, Enteric Gram- rods, Fungi, Viruses, Pneumocystis jirovecii - w/ HIV

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26
Q

Special infections with aspiration

A

Anaerobes

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27
Q

Special infections w/ EtOH and IV drug users

A

S pneumoniae, Klebsiella, Staph

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28
Q

Special infections in CF

A

Pseudomonas, S aureus, S pneumoniae

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29
Q

Special infections in Post-Viral pt

A

Staph, H influenzae, S pneumoniae

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30
Q

Bugs that cause atypical pneumonia

A

Mycoplasma, Legionella, Chlamydia

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31
Q

Meningitis in a newborn (0 to 6 months)

A

GBS, E coli, Listeria

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32
Q

Meningitis in a child (6 months to 6 years)
PathoPhys
Presentation

A 
Streptococcus pneumoniae
Neisseria meningitidis 
Enteroviruses
Haemophilus influenzae type B
Polio
Last 2 in non immunized children 
Microbe colonizes nasopharynx leading to myalgias and paralysis
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33
Q

Meningitis in a adults (6 years to 60 years)

A

S pneumoniae
N meningitidis (#1 in teens)
Enteroviruses
HSV

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34
Q

Meningitis in elderly (60+)

A

S pneumoniae
Gram- rods
Listeria

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35
Q

Meningitis Treatment

A

Ceftiazone and Vancomycin empirically

Add ampicillin if Listeria is suspected

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36
Q

Viral causes of meningitis

A

Enterovirus (esp coxsackievirus), HSV2 (HSV1 = encephalitis), HIV, West Nile Virus, VZV

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37
Q

Meningitis in HIV pt

A

Cryptococcus, CMV, toxoplasmosis (brain abscess), JC virus (PML)

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38
Q

Recent changes in H influenzae meningitis

A

Decreased with introduction of conjugate H influenzae vaccine in last 10-15 years.
Todays cases are in un-immunized children

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39
Q 
CSF findings in Bacterial meningitis 
Opening pressure 
Cell type 
Protein 
Sugar
A

Opening pressure ↑
PMNs
Protein ↑
Sugar ↓

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40
Q 
CSF findings in Viral meningitis 
Opening pressure 
Cell type 
Protein 
Sugar
A

Opening pressure Normal or ↑
Lymphocytes
Protein is Normal or ↑
Sugar is Normal

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41
Q 
CSF findings in Fungal/TB meningitis 
Opening pressure 
Cell type 
Protein 
Sugar
A

Opening pressure ↑
Lymphocytes
Protein is Normal or ↑
Sugar ↓

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42
Q

Osteomyelitis w/ nothing else

A

S aureus

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43
Q

Osteomyelitis in sexually active individual

A

Neisseria gonorrhoeae (rare), septic arthritis more common

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44
Q

Osteomyelitis in diabetic or IV drug user

A

Pseudomonas aeruginosa, Serratia

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45
Q

Osteomyelitis in Sickle cell disease

A

Salmonella

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46
Q

Osteomyelitis in Prosthetic replacement

A

S aureus and S epidermidis

47
Q

Osteomyelitis in Vertebral disease

A

Mycobacterium Tuberculosis (Pott’s disease)

48
Q

Osteomyelitis in cat and dog bite/scratches

A

Pasteurella multocida

49
Q

Osteomyelitis
Mostly in…
Signs

A

Children

Elevated CRP and ESR

50
Q 
UTIs
Presentation 
Labs 
PathoPhys
Causes in males 
Causes in elderly 
Can progress to...
A

Dysuria, Frequency, Urgency, Suprapubic pain
WBCs (but not casts) in urine
Males: infants w/ congenital defects, vesicoureteral reflux
Elderly: Enlarged prostate
Pyelonephritis

51
Q

Pyelonephritis presentation

A

Fever, Chills, Flank pain, CVA tenderness, Hematuria, WBC casts

52
Q

UTIs in women
Frequency
Predisposing factors

A

10x more likely in women because of shorter urethra colonized by fecal flora
Obstruction, Kidney surgery, Catheterization, GU malformation, Diabetes, Pregnancy

53
Q

UTI Dx markers

A

+Leukocyte esterase test = bacterial UTI
+Nitrite test = Gram- bacterial UTI
+Urease test = Proteus, Klebsiella
-Urease test = E coli or Enterococcus

54
Q

UTI bugs

A

E coli: #1. Green metallic sheen on EMB
Staph saprophyticus: #2
Klebsiella: #3. Large mucoid capsule + viscous colonies
Serratia: Red pigment. Nosocomial and drug resistant
Enterobacter cloacae: Nosocomial and drug resistant
Proteus mirabilis: Swarming on agar, Urease+, Struvite stones
Pseudomonas aeruginosa: Blue-green pigment, fruity odor. Nosocomial and drug resistant

55
Q

ToRCHeS Infection
What are they?
Presentation

A

Mother –> fetus. Transplacental in most cases or via delivery (HSV2)
HSM, Jaundice, Thrombocytopenia, Growth retardation

56
Q

Names of ToRCHeS Infection

A 
Toxoplasma gondii 
Rubella 
CMV
HIV
HSV2
Syphilis
57
Q

Toxoplasma gondii
Mode of transmission
Maternal manifestation
Neonatal manifestation

A

Cat feces or ingestion of undercooked meat
Usually asymptomatic; Lymphadenopathy (rarely)
Classic Triad: Chorioretinitis, Hdyrocephalus, and Intracranial calcification

58
Q

Rubella
Mode of transmission
Maternal manifestation
Neonatal manifestation

A

Respiratory droplets
Rash, Lymphadenopathy, Arthritis
Classic triad: PDA (or pulmonary artery hypoplasia), Cataracts, and Deafness
Blueberry muffin rash

59
Q

CMV
Mode of transmission
Maternal manifestation
Neonatal manifestation

A

Sexual contact, organ transplant
Usually asymptomatic. Mononucleosis-like illness
Hearing loss, Seizures, Petechial rash, Blueberry muffin rash

60
Q

HIV
Mode of transmission
Maternal manifestation
Neonatal manifestation

A

Sexual contact, Needlestick
Variable presentation depending on CD4 count
Recurrent infections, Chronic diarrhea

61
Q

HSV2
Mode of transmission
Maternal manifestation
Neonatal manifestation

A

Skin or mucous membrane contact
Usually asymptomatic. Herpetic (vesicular lesions)
Encephalitis, Herpetic (vesicular) lesions

62
Q

Syphilis
Mode of transmission
Maternal manifestation
Neonatal manifestation

A

Sexual contact
Chancre (primary) and disseminated rash (secondary) are the 2 stages likely to result in fetal infection
Stillbirth, Hydrops Fetalis
If child survives presents with facial abnormalities [notched teeth (Hutchinson’s teeth), saddle nose, short maxilla, Dry wrinkled skin, yellow-brown hue, hemorrhagic rhinitis], saber sings, CN VIII deafness

63
Q

Childhood rash that begins at head and moves down –> fine truncal rash

A

Rubella virus

Usually associated with lymphadenopathy

64
Q

Childhood rash beginning at head and moving down preceded by cough, coryza, conjunctivitis, and blue-white spots on buccal mucus

A

Measles

65
Q

Childhood vesicular rash beginning on trunk and spreading to face and extremities with lesions of different ages

A

Chickenpox (VZV)

66
Q

Childhood (infant) macular rash over body appears after several days of high fever, febrile seizures

A

Roseola (HHV6)

67
Q

Childhood “slapped cheek” rash on face

A 
Erythema infectionsum (parvovirus B19)
Can cause hydrops fetalis in pregnant women)
68
Q

Childhood erythematous sandpaper rash with fever and sore throat

A

Scarlet fever from Strep pyogenes

69
Q

Childhood vesicular rash on palms and soles with ulcers in oral mucosa

A

Hand-Foot-Mouth Disease (Coxsackievirus A)

70
Q

Urethritis, Cervicitis, PID, Prostatitis, Epididymitis, arthritis, Creamy purulent discharge

A

Neisseria gonorrhoeae

71
Q

Painless Chancre

A

Primary syphilis (Treponema pallidum)

72
Q

Fever, lymphadenopathy, Skin rashes, Condylomata lata

A

Secondary syphilis (Treponema pallidum)

73
Q

Gummas, Tabes Dorsalis, General Paresis, Aortitis, Argyll Robertson pupil

A

Tertiary syphilis (Treponema pallidum)

74
Q

Painful genital ulcer with inguinal adenopathy

A

Chancroid caused by Haemophilus ducreyi

“It’s so painful, you DO CRY”

75
Q

Painful penile, vulvar, or cervical vesicles and ulcers

Fever, Headache, Myalgia

A

Genital herpes

HSV2. Less commonly HSV1

76
Q

Urethritis, Cervicitis, Conjunctivitis, Reiter’s Syndrome, PID

A

Chlamydia from Chlamydia trachomatis (D-K)

77
Q

Infection of lymphatics, Genital ulcers, Lymphadenopathy, Rectal strictures

A

Lymphogranuloma venereum from Chlamydia trachomatis (L1-L3)

78
Q

Vaginitis, Strawberry colored mucosa, motile in wet prep

A

Trichomonas vaginalis

79
Q

Opportunistic infections Kaposi sarcoma, Lymphoma

A

AIDS from HIV

80
Q

Genital warts, Koilocytes

A

HPV 6 and 11

81
Q

Jaundice

A

HBV

82
Q

Non-Inflammatory, Malodorous Discharge (fishy smell), Positive whiff test, Clue cells

A

Gardnerella vaginalis

83
Q

PID
Causes
Presentation
May include…

A 
Chlamydia trachomatis (subacute, often undiagnosed), Neisseria gonorrhoeae (acute)
Cervical motion tenderness (chandelier sign), Purulent cervical discharge
Salpingitis, Endometriosis, Hydrosalpinx, Tubo-Ovarian Abscess
84
Q

PID can lead to…

A

Hugh-Curtis Syndrome

Infection of the liver capsule and violin string adhesion of parietal peritoneium to liver

85
Q

Salpingitis is a risk factor for…

A

Ectopic pregnancy, Infertility, Chronic pelvic pain, Adhesions

86
Q

Nosocomial infections in a newborn nursery

A

CMV, RSV

87
Q

Nosocomial infections in urinary catheterizations

A

E coli, Proteus, Mirabilis

88
Q

Nosocomial infections in Respiratory Therapy Equipment

A

Pseudomonas aeruginosa

“Presume Pseudomas when Air or Water are involved”

89
Q

Nosocomial infections for work in renal dialysis unit

A

HBV

90
Q

Nosocomial infections in hyperalimentation

A

Candida albicans

91
Q

Nosocomial infections in water aerosols

A

Legionella

92
Q

Painful throat. Grayish oropharyngeal exudate in painful throat in an un-immunized child

A

Corynebacterium diphtheriae elaborating toxin that causes necrosis pharynx, cardiac and CNS tissue

93
Q

Fever, dyspnea, Drooling, difficulty breathing due to cherry red edematous epiglottis in un-immunized child

A

H influenzae type B

Can cause epiglottitis in fully immunized children too

94
Q

Pus, Empyema, Abscess

A

S aureus

95
Q

Pediatric infection

A

Haemophilus influenzae (including epiglottitis)

96
Q

Pneumonia in CF or burn pt

A

Pseudomonas aeruginosa

97
Q

Branching rods in oral infection w/ sulfur granules

A

Actinomyces israelii

98
Q

Traumatic open wound

A

Clostridium perfringens

99
Q

Surgical wound

A

S aures

100
Q

Dog or cat bite

A

Paseurella multocida

101
Q

Currant jelly sputum

A

Klebsiella

102
Q

+PAS stain

A

Tropheryma whippelei

103
Q

Sepsis/Meningitis in a newborn

A

GBS

104
Q

Healthcare provider

A

HBV from needlestick

105
Q

Fungal infection in diabetic or immunocompromised pt

A

Mucor or Rhizopus

106
Q

Asplenic pt

A

Encapsulated microbes
“SHiN”
S pneumoniae, H influenzae type B, N Meningitidis

107
Q

Chronic Granulomatous disease

A

Catalase+ microbes esp S aureus

108
Q

Neutropenic pt

A

Candida albicans (systemic), Aspergillus

109
Q

Facial nerve palsy

A

Borrelia burgdorferi (Lyme disease)

110
Q

Infectious cause of pericarditis

A

Coxsackie B

111
Q

Best Way to Prevent Tetanus?

A

Vaccinate Mother

112
Q

Most common causes of UTIs?

A

E coli

Staph saprophyticus

113
Q

Sepsis with black rash

A

Pseudomonas

USMLE STEP 1 (25 decks)

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