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MSK, rheum, derm > microbiology > Flashcards

microbiology Flashcards

(65 cards)

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1
Q

polyarticular septic arthritis suggests which pathogen?

A

GBS

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2
Q

what location of septic arthritis suggests IVDU?

A

sternoclavicular joint

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3
Q

what bug is most responsible by far for septic arthritis? in which conditions is it seen even more?

A

staph aureus

RA and IVDU

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4
Q

what is the second most common cause of septic arthritis? what conditions are risk factors?

A

GBS

neonates, DM, malignancies

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5
Q

pseudomonas suggests what etiology of septic arthritis?

A

iatrogenic or IVDU

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6
Q

what bug is a cause of septic arthritis in young adults and those with complement deficiency, also SLE?

A

Neisseria

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7
Q

what bugs can cause septic arthritis in SLE? sickle cell?

A

salmonella: SLE and sickle cell
neisseria: SLE

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8
Q

what bug causes septic arthritis following dog or cat bite?

A

Pasteurella multocida

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9
Q

what is the etiology of septic arthritis due to brucella?

A

unpasteurized milk

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10
Q

what manifests with the clinical triad of 1. dermatitis 2. tenosynovitis 3. migratory polyarthritis

A

disseminated gonococcal infection: causes gonococcal arthritis

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11
Q

what groups does gonococcal arthritis occur in?

A

4x more in women

young and sexually active or IVDU

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12
Q

what does blood culture show in gonococcal arthritis?

A

occult bacteremia: won’t be able to culture

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13
Q

what is the most common cause of osteomyelitis? 2nd most common

A
  1. staph. aureus

2. staph. epidermidis

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14
Q

what bug causes osteomyelitis in someone who stepped on a nail?

A

pseudomonas

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15
Q

what are 2 most common and 2 other causes of vertebral osteomyelitis and spondyodiskitis?

A

staph aureus and staph epidermidis

MTB and brucella

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16
Q

what are 2 most common bugs responsible for osteomyelitis in children? what can also cause it in neonates?

A
  1. staph aureus
  2. strep pneumo
    neonates: GBS, E. coli
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17
Q

what bug, besides staph aureus, causes osteomyelitis in sickle cell? how?

A

salmonella

-gut infarcts release salmonella and auto-splenectomy so can’t clear it

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18
Q

what unusual locations of osteomyelitis suggest IVDU? what two bugs are responsible beside staph aureus?

A

sternoclavicular, sternochondral joint, pubic symphysis

pseudomonas and candida

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19
Q

what bug causes needle-licker OM?

A

eikenella corrodens

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20
Q

what are the two most common causes of pyomyositis?

A
  1. staph aureus by far (60-70%)

2. GAS (1-5%)

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21
Q

what bug causes gas gangrene? how is it cultured? appearance?

A

Clostridia perfringens
anaerobic culture with sugar fermentation and acid production
large box-car gram-positive rods

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22
Q

what is the pathogenesis of gas gangrene?

A

alpha toxin is liecithinase that damages cell membranes, causes hemolysis, produces gas in tissues

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23
Q 
describe the genome of: 
alphaherpesviruses
HPV
poxviridae
parvovirus B19
measles
mumps
rubella
coxsackievirus/enterovirus
HHV-6
A 
alphaherpesviruses: linear, dsDNA
HPV: circular dsDNA, very small
poxviridae: linear, dsDNA
parvo: -ssDNA, tiniest genome
measles/mumps: (paramxyo) -ssRNA
rubella: (toga) +ssRNA
coxsackie/entero: +ssRNA
HHV-6: dsDNA
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24
Q

what are the three stages of lytic cycle in herpes viruses?

A

immediate early: proteins contained in virus on infection lead to expression of other herpes genes by redirecting use of host RNA polymerase

early: replication of virus genome in nucleus of host cell
late: structural proteins synthesized in cytoplasm of host cell

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25
what is the neurotropism of HSV-1, HSV-2 and VZV?
HSV1: trigeminal nerve HSV2: lumbar and sacral nerves VZV: dorsal root ganglia
26
what does LAT gene do in HSV-1?
produces microRNAs in latency to prevent apoptosis, repress viral gene expression, may inhibit CD8s
27
what test can be used to diagnose alphaherpesviruses? what does it show?
Tzanck smear: shows multinucleated cells
28
how do HPV warts turn into malignant tumors?
occasionally, viral genome is integrated into host genome -if E2 is split, high level expression of E6/7 E6: causes degradation of p53 E7: inhibits Rb
29
what does the Gardasil vaccine contain?
L1 capsid protein from each carcinogenic strain of HPV
30
what is unique about the replication of pox viruses?
encode all of own proteins so replicate in cytoplasm | -unique for DNA viruses
31
how is molluscum contagiosum diagnosed in lab?
presence of cytoplasmic inclusions in keratinocytes
32
how did the smallpox vaccine work?
live vaccinia viruses (lab strain of pox virus)
33
what disease does parvovirus B19 cause in children? describe it
fifth disease of erythema infectiosum | slapped cheek and erythematous reticular rash
34
what does parvovirus B19 cause in adults?
less rash and more polyarthritis, flu-like syndrome
35
what cells do parvovirus B19 replicated in? what are two possible consequences?
precursor RBCs aplastic crisis in sickle cell chronic anemia in immunocompromised
36
what two viral exanthems can cause neonatal infection? what do they do to the fetus?
parvovirus: fatal anemia or hydrops fatalis rubella: congenital defects, blueberry rash
37
what causes the symptoms of parvovirus infection?
immune response: cell-mediated causes rash, cytokines cause fever prodrome
38
what is the clinical diagnosis definition of measles?
1. generalized rash lasting >3 days 2. high fever >38..3C (101F) 3. three C's: cough, coryza, conjunctivitis
39
what is pathognomonic for measles? what causes the rash in measles?
Koplik spots | cell-mediated immune response
40
what type of vaccine is the measles one?
live attenuated
41
what are two potentially serious complications of measles?
immune suppression for about a month | encephalitis/encephalomyelitis
42
what is the first sign of mumps?
parotid gland swelling and inflammation
43
what are two potentially serious complications of mumps?
aseptic meningitis | gonadal involvement in post-pubertal men can cause sterility if bilateral
44
which morbilliform viral rash begins on face and spreads and is accompanied by low fever, LAD, conjunctivitis, sore throat?
rubella
45
what exanthem disease do coxsackievirus and enterovirus cause?
hand, foot and mouth disease - oral ulcerative lesions on tonsils, uvula - vascular lesions on hands and feet
46
what does HHV-6 cause and who does it infect?
infants, children
47
what causes Rocky Mountain Spotted Fever? how does the rash present? How can you diagnose it?
Rickettsia rickettsii petechial rash starts on ankles/wrists and spreads Weil-Felix test: antibody cross-reacts with Proteus antigens
48
what causes Epidemic Typhus? how does the rash present? how is it transmitted?
Rickettsia prowazekii petechial rash spreads from trunk to extremities (inverse of RMSF) fleas/lice: virus in feces infects the bites
49
what causes Endemic Typhus? How does it present? reservoir and transmission?
Rickettsia typhus milder version of epidemic typhus small mammals, fleas
50
what can be diagnosed by morulae in monocytes/granuloctyes? what type of disease does it cause?
Ehrlichia chaffeensis and Anaplasma phagocytophilia | southern tick-borne diseases
51
what is Anaplasmosis sometimes called? what are possible presentations?
Rocky Mountain Spotless Fever - CNS involvement - difficulty breathing, renal failure, hemorrhage
52
Coxiella: most common location in US, reservoir, modes of transmission, possible complications
- western agricultural states - sheep, cattle, goats - contaminated dairy of animal viscera, ticks, aerosolized spore-like form - pneumonic disease, liver or heart involvement causes chronic infection
53
which spirochete may be visualized on blood smear?
Borrelia of relapsing fever: hermsii and recurrentis
54
what causes Lyme disease? how can it be visualized? how is it diagnosed?
Borrelia burgdorferi darkfield microscopy, Giemsa or silver stain ELISA confirmed with Western Blot
55
describe the 3 stages of Lyme disease
1. erythema migrans, maybe flu/arthralgias 2. heart block/myocarditis, meningitis, facial/Bell's palsies 3. progressive CNS disease, arthritis
56
what species cause relapsing fever? where is it endemic to? reservoir and transmission? describe the rash
Borrelia hermsii and recurrentis western US rodents/small animals; ticks and body lice rash is usually not present
57
how can relapsing fever be diagnosed?
visualization on blood smear of spirochetes | convalescent serum during active symptoms
58
what sort of bacteria is Leptospira interrogans? primary reservoir and transmission?
spirochete dogs (also rodents, livestock) water or soil contaminated from animal urine
59
what is the clinical presentation of Leptospira infection? what is a characteristic finding?
two stages separated by quiescence: 1. flu-like, conjunctivitis 2. organ damage: liver, kidney, lung hemorrhage, meningitis - very high bilirubin is characteristic
60
what causes Cat Scratch Fever? how does it present? in immunocompromised? how can it be diagnosed?
Batonella heneslae fever with LAD, papule at site of infection, long course immunocompromised: bacillary angiomas Warthin-Starry silver stain
61
what is the reservoir for anthrax? how does cutaneous infection present?
cattle, sheep painless lesion that becomes blistered with necrotic center -can have dizziness, palpitations, sepsis
62
what is the reservoir for Burkholderia? what strange way may it be diagnosed?
soil, water and livestock | resistant to gentamicin and colistin
63
where is francisella found? how is it transmitted? what does the cutaneous infection look like? what is the virulence factor? how can it be diagnosed?
Arkansas, Missouri, Martha's Vineyard fleas, lice, ticks; contaminated animals, blood or water ulceroglandular with bubo-like LAD and flu symptoms agglutination testing
64
where does plague occur in US and why? what causes "black death"? how can the safety pin be visualized?
west: reservoir is prairie dogs endotoxin-related effects cause DIC and cutaneous hemorrhages Giemsa or Wayson stains
65
what are three virulence factors of plague?
1. anti-phagocytic capsule 2. LPS endotoxin 3. Yops: injected into host cells, inhibit phagocytosis and cytokine production

MSK, rheum, derm (6 decks)

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