Microbiology - systems Flashcards
(118 cards)
1
Q
normal flora dominant - skin / nose / oropharynx / dental plaque, colon, vagina
A
skin –> S. epidermidis
nose –> S. epidermidis, colonized by S. aureus
oropharynx: viridans
dental plaque: S. mutans
colon: Bacteroid fragilis > E. coli
vagina: lactobacillus, colonized by E. coli and group B strep
2
Q
Foods poisoning - bugs (and source)
A
- B. cereus (reheated rice)
- C. botulinum (inproperly canned foods, raw honey)
- C. perfingerns (reheated meat)
- E. coli O157:H7 (undercooked meat)
- Salmonealla (poultry, meat eggs)
- S aureus (meats, mayonnaise, custard) –> preformed toxin
- V. parahaemolyticus and V. vulnificus (contaminated food)
3
Q
Beside food poisoning, V. vulnificus can cause
A
wound infection from contact with contaminated water or shellfish
4
Q
Bags that cause bloody diarrhea
A
- campylobacter jejuni
- E. histolytica
- EHEC
- EIEC
- Salmonella
- Shigella
- Y. enterocolitica
- C difficile
5
Q
salmonella source
A
eggs, pets, turtles,
6
Q
Y. enterocolitica - situations
A
day care oubreaks
7
Q
Y. enterocolitica causes
A
- bloody diarrhea
2. pseudoappendicitis
8
Q
bacillary dysentery is caused by
A
shigella
9
Q
Watery diarrhea - bacs
A
- C difficile
- C. pefringens
- ETEC
- Protoza (giardia, Cryptosporidium)
- V cholerae
- Viruses (Rotavirus, norovirus, adenovirus)
10
Q
Viruses that causes watery diarrhea
A
Rotavirus, norovirus, adenovirus
11
Q
common cuase of pneumonia in neonates (less than 4 weeks)
A
- S. agalactiae
2. E. coli
12
Q
common cuase of pneumonia in children (4wks - 18yr) (in order)
A
- viruses (RSV)
- mycoplasma
- C. trachomatis (infants - 3 years)
- C. pneumoniae (school-aged children)
S. pneumoniae
13
Q
common cuase of pneumonia in adults (18-40yr) (in order)
A
- mycoplasma
- C. pneumoniae
- S. pneumoniae
- viruses (eg. influenza)
14
Q
common cuase of pneumonia in adults (40-65yr) (in order)
A
- S. pneumoniae
- H. infuenzae
- Anaerobes
- viruses
5, Mycoplasma
15
Q
common cuase of pneumonia in elderly (in order)
A
- S. pneumoniae
- Influenza virus
- Anaerobes
- H Influenzae
- Gram (-) robs
16
Q
pneumonia in alcoholics/iv drug users - bugs
A
S. pneumoniae, klebsiella, S. aureus, anaerobes
17
Q
pneumonia with aspiration - bugs
A
anaerobes
18
Q
atypical pneumonia - bugs
A
mycoplasma, legionella, chlamydia
19
Q
pneumonia with cystic fibrosis
A
pseudomonas (adolscent), s. aureus (infants),
s. pneumoniae
+ Burkholderia cepacia
20
Q
postviral pneumonia - bugs
A
s. aureus, H. infuenzae, S pneumoniae
21
Q
Nosocomial (hostpital acquired) pneumonia - bugs
A
s. aureus, Pseudomonas, other enteric gram (-) negative robs
22
Q
pneumonia in immunocompromised
A
s. aureus, enteric gram-negative robs, fungi, viruses, P. jirovecii (with HIV)
23
Q
common cause of meningitis in newborn (0-6months) (in order)
A
- Group B streptococci
- E. coli
- Listeria
24
Q
common cause of meningitis in children (6months-6yr) (in order)
A
- S. pneumoniae
- N. meningitis
- H. influenzae type B
- Enteroviruses
25
common cause of meningitis in 6-60 years (in order)
1. S. pneumoniae
2. N. meningitis (1st in teens)
3. Enteroviruses
4. HSV
26
common cause of meningitis in 60+ (in order)
1. S. pneumoniae
2. Gram - robs
3. Listeria
27
meningitis - how to treat
give ceftriaxone + vancomycin (empirically)
| add ampicillin if Listeria is suspected
28
viral causes of meningitis
1. enteroviruses (esp coxsackievirus)
2. HSV-2
3. HIV
4. West Nile virus (also causes encephalitis)
5. VZV
29
West Nile virus causes
encephalitis and meningitis
30
HSV causes (on CNS)
HSV-1 --> encephalitis
| HSV-2 --> meningitis
31
H. influenzae - meningitis?
incidence has decreased greatly with indroduction of the conjugate. H. influenzae vaccine in last 10-15 yrs. Today, cases are usually seen in unimmunized children
32
CSF findings in bacterial meningitis
1. Increased opening pressure
2. increased PMNs
3. increased protein
4. decreased sugar
33
CSF findings in fungal meningitis
1. Increased opening pressure
2. increased lymphocytes
3. increased protein
4. decreased sugar
34
CSF findings in viral meningitis
1. normal/Increased opening pressure
2. increased lymphocytes
3. normal/increased protein
4. normal sugar
35
CSF findings in TB meningitis
1. Increased opening pressure
2. increased lymphocytes
3. increased protein
4. decreased sugar
36
infections causing brain abscess - most commonly by
Viridans streptococci and S. aureus
37
infections causing brain abscess - if dental infection - bugs?
oral anaerobes
38
infections causing brain abscess - if extraction precedes abscess
oral anaerobes
39
infections causing brain abscess - Multiple abscess are usually from
bacteremia
40
infections causing brain abscess - single lesion from contiguous sites - sites (and area of the brail lesion)
1. otitis media --> temporal lobe and cerebellum
2. mastoiditis --> temporal lobe and cerebellum
3. sinusitis --> frontal lobe
4. dental infection --> frontal lobe
41
MCC of osteomyelitis
S. aureus
42
osteomyelitis associated with IV drug use - bugs
1. pseudomonas
2. Candida
3. S. aureus
43
osteomyelitis associated with sickle cell anemia - bugs
| osteomyelitis associated with cat and dog bites - bugs
SC anemia: salmonella and S. aureus
| dog: pasteruella multocida
44
osteomyelitis associated with sexually active - bugs
```
Neisseria gonorrhoeae (RARE)
septic arthritis more common
```
45
osteomyelitis associated with prosthetic joint replacement - bugs
S. aureus and S. epidermidis
46
osteomyelitis with vertebral involvement - bugs
S. aureus
| M. tuberculosis (Pott disease)
47
osteomyelitis - test for diagnosis (and characteristics)
1. elevated CRP (nonspecific)
2. elevated sedimentation rate (nonspecific)
3. MRI --> best for detecting acute infection and detailing anatomic involvement
4. Radiographs --> insensitive early but can be useful in chronic osteomyelitis
48
Sexual transmitted infections - bugs and diseases
1. HIV --> aids
2. Haemophilus ducreyi --> Chancroid
3. Chlamydia trachomatis (D-K)
4. HPV --> Condylomata acuminata (6 + 11)
5. HSV-2 (less commonly HSV-1) --> Genital herpes
6. Neisseria gonorrhoeae --> Gonorrhea
7. HBV --> Hepatitis B
8. Clamydia trachomatis (L1-L3) --> Lymphogranuloma venereum
9. Treponema pallidum --> syphilis
10. Trichomonas vaginalis --> Trichomoniasis
11. HHV-8 --> kaposi sarcoma
49
Condylomata acuminata are caused by / special feature in biopsy
HPV-6 and HPV-11
| koilocytes
50
Chancroid is caused by ....
| clinical features
Haemophilus ducreyi
| Painful genital ulcer with exudate, inguinal adenopathy
51
genital herpes are caused by? clinical features
- HSV-2 (Less commonly HSV-1)
- Painful penile, vulvar or cervical vesicles, and ulcers
- can also cause systemic symptoms (fever, headache, myalgia)
52
Rashes in childhood - bugs and disease
1. Coxsackievirus type A --> Hand-foot-mounth disease
2. HHV-6 (Less commonly HHV-7)--> Roseola (exannthem subitum or 6th disease)
3. Measles virus --> Measles (rubeola)
4. B19 --> Erythema infectiosum (Slapped cheek, 5th disease)
5. Rubella virus --> Rubella (German measles)
6. S. pyogenes --> Scarlet fever
7. VZV --> chickenpox
53
Hand-foot-month disease is caused by? clinical presentation
Coxsackievirus type A
OVAL-haped vesicles on palms and soles
vesicles and ulcers in oral mucosa
54
Rubeola is caused by? clinical presentation
Beginning at head and moving down (maculopapular). Rash is preceded by cough, coryza, conjuctivitis, and blue white (Koplik) sptos on buccal mucosa
55
Scarlet fever is caused by? clinical presentation
Streptococcus pyogenes
| Erythematus sandpaper-like rash with fever and sore throat
56
Chickenpox is caused by? clinical presentation
VZV
| vesicular rash begins on trunk --> spreads to face and extremities with lesions of DIFFERENT STAGES
57
Bugs affecting unimmunized children (group with symptoms)
```
RASH
1. Rubella
2. Measles
Meningitis
1. H. influenzae type B
2. Polioviris
Epiglottitis
H. influenzae type B
Pharyngitis
1. C. diptheriae)
```
58
Epiglotitis is caused by/clinical presentation/findings etc
H. influenzae type B
Fever with dysphagia, drooling and difficulty breathing due to edematous "cherry red" epiglottis
Thumbprint sign on X-ray
59
H. influenzae type B mediated Epiglotitis - immunization
it usually protects
but
H. influenzae type B is also capable to of causing epiglottitis in fully immunized children
60
pelvic inflammatory disease is caused by - bugs (and onset)
```
Chlamydia trachimatis (sabacute --> OFTEN UNDIAGNOSED)
Neisseria gonorrhoeae (acute)
```
61
MCC bacterial sexuall trasnmited infection in US
Chlamydia trachimatis
62
pelvic inflammatory disease - clinical findings
1. purulent cervical discharge
| 2. Cervical motion tenderness (Chadnderier sign)
63
pelvic inflammatory disease may include
1. saplingitis
2. endometritis
3. hydrosalpinx
4. tubo-ovarian abscess
64
salpingitis is a risk factor for
1. ectopic pregnancy
2. infertility
3. chronic pelvic pain
4. adhension
65
pelvic inflammatory disease can lead to (explain)
FItz-Hugh-Curtis syndrome: infection of the liver capsule and "violin string" adhesion of peritoneum to liver
66
Common vaginal infections - types and bugs
1. Bacterial vaginosis (Gardnerella vaginalis)
2. Thrichomoniasis (trichomonas vaginalis)
3. Candida vulvovaginitis (Candida)
67
Common vaginal infections - treatment
1. Bacterial vaginosis --> metronidazole/clinddamycin
2. Thrichomoniasis --> metronidazole (also treat sexual partner)
3. Candida vulvovaginitis --> -azoles
68
Common vaginal infections - labs
1. Bacterial vaginosis --> clue cells, ph>4.5, amine whiff test (mixing discharge with 10% KOH enhance, fishy odor
2. Thrichomoniasis --> motile trichomonas, ph>4.5
3. Candida vulvovaginitis --> pseudohyphae, ph normal (4-4.5)
69
Common vaginal infections - signs and symptoms
1. Bacterial vaginosis --> no inflammation, thin white discharge with fishy odor
2. Thrichomoniasis --> inflammation (strawberry cervix), frothy, grey geen, foul smeeling discharge
3. Candida vulvovaginitis --> inflammation, thick white cottage cheese discharge
70
Common vaginal infections - discharge
1. Bacterial vaginosis --> thin, white with fishy odor
2. Thrichomoniasis --> frothy, grey green, foul smelling dishcarge
3. Candida vulvovaginitis - thick, white cottage cheese discharge
71
Candida vulvovaginitis - predisposition
1. diabetes
| 2. antibiotics
72
Cystitis - symptoms
1. dysuria
2. Frequenct
3. Urgency
4. Suprapubic pain
5. WBCs (not casts) in urine)
73
Cystitis is primarily caused by (not bugs, mechanism)
ascension of microbes from urethra to bladder
74
Cystitis in males (mechanism)
infacts --> congenital defects, vesicoulateral refulx
| elderly --> enlarged prostate
75
pyelonephritis - symptoms
1. fever
2. chills
3. Flank pain
4. Costovertebral angle tenderness
5. Hematuria
6. WBC casts in urine
76
UTI - men vs women (why)
ten times more common in women: shorter urethras colonized by fecal flora
77
UTI - predisposing factors
1. women
2. obstruction
3. kidney surgery
4. catheterization
5. GU malformation
6. diabetes
7. pregnancy
78
UTI - diagnostic markers
1. + leukocyte esterase --> WBC activity
2. + Nitrate test --> reduction of urinary nitrates by bacterial species (eg. E. coli)
3. + Urease test --> urease-producing bags (eg. Proteus, klebsiella)
79
UTI - --> + Nitrate test -->
reduction of urinary nitrates by bacterial species (eg. E. coli)
80
UTI - bags
1. E. Coli
2. S. saprophyticus
3. Klebsiella pneumoniae
4. Serratia marcescens
5. Enterococcus
6. Proteus mirabilis
7. Pseudomonas aeruginosa
81
3 MCC of UTI (in order)
1. E. Coli
2. S. saprophyticus
3. Klebsiella pneumoniae
82
Proteus mirabilis - appearance
| Klebsiella pneumoniae - appearance
proteus: Motility causes swarming on agar
klebsiella: large mucoid capsule and viscous colonies
83
Serratia marcescens - special features (2)
1. red pigment (some stains)
| 2. often nosocomial and drug resistance
84
enteroccocus - special features
often nosocomial and drug resistance
85
Proteus mirabilis - beside UTI is also associated with
struvite stones
86
Pseudomonas aeruginosa - - special features (2)
1. Bleu-green pigment and fruity odor
| 2. often nosocomial and drug resistance
87
Congenital infections - definition / transmission
microbes that may pass from mother to fetus:
| 1. transplacental (MC) 2. delivery
88
Non-specific signs of congenital infection
1. hepatosplenomegaly
2. jaundice
3. thrombocytopenia
4. growth retardation
89
Congenital infections - bugs
ToRCHeS infections: (+ other)
1. Toxoplasma gondi
2. Rubella
3. CMV
4. HIV
5. HSV-2
6. Syphilis
7. S. agalactiae 8. E.coli 9. Listeria, 10. B19
90
Toxoplasma gondi - maternal manifestation
asymptomatic
| lympadenopathy (rarely)
91
Toxoplasma gondi - neonatal manifestation
classic triad: 1. chorioretinitis 2. hydrocephalus 3. intracranial calcifications
+/- blueberry muffin rash
92
Rubella - neonatal manifestation
classic triad: 1. PDA (or pulmonary artery stenosis, or septal defects)
2. Hearing loss 3. Deafness
+/- blueberry muffin rash
93
CMV - neonatal manifestation
1. hearing loss
2. seizures
3. petechial rash
4. blueberry muffin rash
5. periventricular calcifications
94
HIV - neonatal calcification
1. Reccurent diarrhea
| 2. chronic diarrhea
95
HSV -2 neonatal manifestation
1. encephalitis
| 2. herpetic (vesicular) lesions
96
syphilis - neonatal manifestation
OFTEN RESILTS IN STILLBIRTH, HYDROPS FETALIS
1. facial abnormalities
2. snuffles (nasal discharge)
3. saddle nose
4. notched (Hutchinson) teeth
5. mulberry molars
6. short maxilla
7. saber shins
8. CN VIII deafness
97
infection in asplenic patients
```
encapsuled microbes (S. pneum>H. inf type b> N. meningitis)
babesia
```
98
Chronic granoulomatous disease - infection?
Catalase + (esp S. aureus)
99
infection in neutropenic patients
1. Candida (systemic)
2. Aspergilus
3. Mucor
4. Rhizopus
100
nosocomial infection - water aerosols - pathogen
nosocomial infection - renal dialysis unit
nosocomial infection - needle-stick
water: legionella
| renal dialyisis + needle-stick: HBV
101
nosocomial infection - urinary catheterization - pathogens
E. coli
klebsiella
Proteus
102
nosocomial infection - intravascular catheters - pathogens
s. aureus (including MRSA), s. epidermides (Long term), Enterobacter
103
nosocomial infection - Decubitus ulcers, surgical wound drains
S. aureus (including MRSA), gram (-) anaerobes
104
nosocomial infection - mechanical ventilation, endotracheal intubation - pathogens
P. aeruginosa, Klebsiella, Acinetobacter, S.aureus
105
nosocomial infection - altered mental status - old age, aspiration - pathogens and findings
gram (-) often anaerobes, polymicrobal
| right lower lobe infiltrate or right upper/middle lobe (patient recumbent), purulent malodorous sputum
106
traumatic open wound - bug
Clostiriduim pefringens
107
Infection control techniques - goals
reduction of pathogenic organism counts to safe levels (disinfection) and the inactivation of self-propagating biological entities (sterilization)
108
disinfection?
reduction of pathogenic organism counts to safe levels
109
sterilization
inactivation of self-propagating biological entities
110
Infection control techniques - types and definitions
1. Autoclave: pressurized steam at >120c. May be sporicidal
2. Alcohols: denature proteins and disrupt cell membranes. Not sporocidal
3. Chlorhexidine: denature proteins and disrupt cell membranes. Not sporocidal
4. Hydrogen peroxide: Free radical radiation. Sporocidal
5. Iodine and iodophors: Halogenation of DNA, RNA and proteins. May be sporicidal
111
Infection control techniques - sporocidal
1. autoclave (may be)
2 Free radical radiation
3. Iodine and iodophors (May be)
112
Ectoparasites - bugs / treatment
1. Scabies (sarcoptes scabiei) --> pemethrin cream, washing/drying all cothing, bedding, treat close contacts
2. Lice (Pediculus humanus/Phthirus pubis) --> Pyrethroids, malathion or ivermectin lotion, and nit combing
113
Anti-mite/louse therapy - drugs and mechanism of action
1. Pemethrin --> blocks Na+ ch --> neurotoxicity
2. Malathion --> acetylcholinesterase inhibitor
3. Lindane --> blocks GABA ch --> neurotoxicity
114
Scabies (sarcoptes scabiei) - epidimiology / transmission
common in children, crowded populations (jails, nuesing homes)
trasmission through fomites
115
Lice (Pediculus humanus/Phthirus pubis) can transmit
1. Ricketsia prowazekii (epidemic typhus)
2. Borreia recurrentis (relpapsing fever)
3. Bartonella quintana (trench fever)
116
Ectoparasites - bugs / mechanism
1. Scabies (sarcoptes scabiei) --> Mites that burrow into the stratum corneum and cause pruritus and cause pruritus
2. Lice (Pediculus humanus/Phthirus pubis) --> blood-sucking insects that prefer to live on clothing
117
Scabies (sarcoptes scabiei) - epidimiology / transmission
common in children, crowded populations (jails, nuesing homes)
trasmission through fomites
118
Ectoparasites - bugs / manifestation
1. Scabies (sarcoptes scabiei) --> causes serpiginous burrows (lines) in wedscape of hands and feet
2. Lice (Pediculus humanus/Phthirus pubis) --> intense pruritus, pink macules and papules commonly in intertiginous regions
