Flashcards in Micro Systems - First Aid Deck (98):
Dominant flora of the skin
Dominant flora of the nose
S. epidermidis; colonized by S. aureus
Dominant flora of the oropharynx
viridans group strep
Dominant flora of the dental plaque
Dominant flora of the colon
B. fragilis > E. coli
Dominant flora of the vagina
Lactobacillus; colonized by E. coli and group B strep
Food poisoning that starts and ends quickly is from...
S. aureus or B. cereus.
B. cereus source
C. botulinum source
improperly canned foods
C. perfringens source
reheated meat dishes
E. coli O157:H7 source
poultry, meat, eggs
S. aureus source
meats, mayonnaise, custard; preformed toxin
V. parahaemolyticus and V. vulnificus source
Bugs that cause bloody diarrhea (7)
2. E. histolytica
7. Yersinia enterocolitica
Bugs that cause watery diarrhea (6)
1. C. difficile
2. C. perfringens
4. Protozoa (Giardia, Cryptosporidium)
5. V. cholerae
Common causes of pneumonia in neonates (< 4 wks)
1. Group B strep
2. E. coli
Common causes of pneumonia in children 1 mo - 18 yrs
C. trachomatis (infants - 3 yrs)
C. pneumnoniae (school-aged)
Common causes of pneumonia in 18-40 yr olds
Common causes of pneumonia in the elderly
Common causes of pneumoniae in alcoholics/IVDUs
Common causes of pneumonia (aspiration)
Commona atypical pneumonias
Common causes of pneumonia in Cystic Fibrosis
Common causes of pneumonia in the immunocompromised
enteric gram-negative rods
common nosocomial causes of pneumonia
Common causes of postviral pneumonia
Common causes of meningitis in newborns (0-6 mo)
Group B strep
common causes of meningitis inchildren 6 mo - 6 yrs
Common causes of meningitis in those 6-60 yrs
common causes of meningitis in those over 60
To treat pneumonia, empirically give...
ceftriaxone and vancomycin. Add ampicillin if listeria is suspected.
Viral causes of meningitis include...
enterovirus (esp coxsackie), HSV-2, HIV, west nile and VZV
In HIV, likely causes of meningitis are...
Cryptococcus, CMV, toxoplasmosis (brain abscess) and JC virus.
CSF findings in bacterial meningitis
Opening pressure: increased
Cell type: increased PMNs
CSF findings in fungal/TB meningitis
Opening pressure: increased
Cell type: increased lymphocytes
CSF findings in viral meningitis
Opening pressure: normal/increased
Cell type: increased lymphocytes
Most common cause of Osteomyelitis is...
If a pt is sexually active and has osteomyelitis, think...
N. gonorrhoeae or septic arthitis.
If a pt has osteomyelitis and diabetes/or IVDU, suspect...
P. aeruginosa or serratia.
If a pt has osteomyelitis and sickle cell, suspect...
If a pt has prosthetic joint replacement and osteomyelitis, suspect...
S. aureus and S. epidermidis.
If a pt has osteomyelitis with vertebral involvement, suspect...
Mycobacterium tubercuosis (pott disease).
If a pt has cat and dog bites and osteomyelitis, suspect...
Osteomyelitis may be subtle on...
radiographs and is more easily seen on MRI.
Cystitis presents with...
dysuria, frequency, urgency, suprapubic pain and WBCs in the urine.
Bladder infxn that ascends to the kidney presents with...
pyelonephritis (fever, chills, flank pain, CVA tenderness, hematuria, WBC casts.
Diagnostic markers for UTI are:
1. positive leukocyte esterase test = bacterial UTI
2. Nitrite test positive = gram-negative bacterial UTI
3 most common causes of UTI are:
1. E. coli
2. Staph saprophyticus
Bacterial vaginosis signs
-thin, white discharge with fishy odor
Bacterial vaginosis lab findings
-pH > 4.5
Bacterial vaginosis treatment
-frothy, grey-green, foul-smelling discharge
Trichomoniasis lab findings
-pH > 4.5
Candida vulvovaginitis signs
-thick, white "cottage cheese" discharge
Candida vulvovaginitis lab findings
-pH normal (4-4.5)
Treatment for Trichomoniasis
Metronidazole; also treat sexual partner
Treatment for Candida vulvovaginitis
Nonspecific signs common to many TORCHES infections are...
hepatosplenomegaly, jaundice, thrombocytopenia and growth retardation.
In neonates, Parvovirus B19 causes...
Toxoplasma gondii transmission
cat feces or ingestion of undercooked meat
Toxoplasma maternal manifestations
asymptomatic; rare lymphadenopathy
Neotnatal manifestations of toxoplasma
Classic triad: chorioretinitis, hydrocephalus, intracranial calcifications
Transmission of rubella
Rubella maternal manifestations
rash, lymphadenopathy, arthritis
Rubella neonate manifestations
Class triad: PDA, cataracts and deafness
+/- "blueberry muffin" rash
CMV maternal manifestations
rare mono-like illness
CMV neonatal manifestations
hearing loss, seizures, petechial rash, "blueberry muffin" rash
HIV neonatal manifestations
recurrent infections and chronic diarrhea
skin or mucous membrane contact (during delivery)
HSV-2 neonatal manifestations
encephalitis, herpetic lesions
Syphilis maternal manifestations
Primary chancre and disseminated rash
Syphilis neonatal manifestations
-often results in stillbirth, hydrops fetalis
-if child survives, present with facial abnormalities (notched teeth (Hutchinson), saddle nose, short maxilla), saber shins and deafness
Coxsackie virus presentation/hand-foot-mouth disease
vesicular rash on palms and soles; vesicles/ulcers in oral mucosa
macular rash over body appears several days after high fever; can present with febrile seizure
begininning at head and moving down; rash is preceded by cough, coryza, conjunctivitis and blue-white spots on buccal mucosa
Parvovirus B19/Erythema infectiosum/fifth disease presentation
"slapped cheek" rash on face
Rubella virus presentation
rash begins at head and moves down leading to a fine truncal rash; postauricular lymphadenopathy
Strep pyogenes/scarlet fever presentation
erythematous, sandpaper-like rash with fever and sore throat
vesicular rash begins on trunk; spreads to face and extremities with lesions of different ages
-painful genital ulcer, inguinal adenopathy
-urethritis, cervicitis, conjunctivitis, reactive arthritis, PID
-HPV-6 and 11
-painful penile, vulvar or cervical vesicles and ulcers; can cause systemic symptoms such as fever, HA , myalgia
-creamy purulent discharge
-infxn of lymphatics; painless genital ulcers
-painful lymphadenopathy (buboes)
-motile in wet prep
Common causes of PID are...
Chlamydia trachomatis, N. gonorrhoeae.
PID presents with...
cervical motion tenderness (chandelier sign), purulent discharge. May include salpingitis, endometritis, hydrosalpinx and tubo-ovarian abscess.
PID can lead to...
Fitz-High-Curtis syndrome = infxn of the liver capsule and "violin string" adhesions of peritoneum to liver.
Salpingitis is a risk factor for...
ectopic pregnancy, infertility, chronic pelvic pain and adhesions.
Meningitis in unimmunized children is often caused by...
H. ib or poliovirus.
Epiglottitis is often caused by...
H.ib (esp in unimmunized children).
Epiglottitis presents with...
fever, dysphagia, drooling, dificulty breathing due to edematous "cherry red" epiglottis; shows thumbprint sign on X-ray.
Pharyngitis in unimmunized is usually caused by...