Part 2- Microbio Diagnosing - Sheet1

Question 1

UTI presentation

Answer 1

Dysuria, frequency, urgency, suprapubic pain, WBCs (but no wbc casts)

Question 2

Pyelonephritic presentation

Answer 2

WBC casts*, fever, chills, flank pain, CVA tenderness, hematuria

Question 3

Predisposing factors for UTI

Answer 3

• Women (short urethras, colonized by fecal flora)
• obstruction
• kidney surgery
• catheterization
• GU malformations (vesicoureteral reflux)
• Diabetes
• pregnancy

Question 4

Diagnosing UTI

Answer 4

• Positive leukocyte esterase test = Bacterial UTI

- Positive Nitrite test = Gram-neg bacterial UTI

Question 5

Leading cause of UTI

Answer 5

E. coli

Question 6

2nd leading cause of community-acquired UTI in sexually active women

Answer 6

Staph Saprophyticus

suck it, saprophyticus!

Question 7

3rd leading cause of UTI

Large mucoid capsule, viscous colonies, positive urease

Answer 7

Klebsiella

Question 8

Nosocomial and drug-resistant UTI

Answer 8

• Serratia Marcescens (produce cherry red pigment)
• Enterobacter cloacae
• Pseudomonas (blue-green pigment, fruit odor)

Question 9

UTI: assoc w struvite stones. Motility causes “swarming” on agar, produces urease

Answer 9

Proteus mirabilis

Question 10

Childhood rash: rash begins on face and moves down –> fine truncal rash, Postauricular lymphadenopathy

Answer 10

Rubella!

Question 11

Childhood rash: beginning at head and moving down, rash is preceded by cough, coryza, conjunctivitis and blue-white/Koplik spots on buccal mucosa

Answer 11

Measles! (a paramyxovirus)

Question 12

Childhood rash: Vesicular rash begins on trunk, spreads to face and extremities w lesions of different age**

Answer 12

Chickenpox (VZV)

Question 13

Childhood rash: Macular rash over body appears after several days of high fever. can present w febrile seizures**. Affects infants

Answer 13

Roseola (HHV-6)

Question 14

Childhood rash: “Slapped cheek” rash on face (can cause hydrops fetalis in pregnant woman)

Answer 14

Parvovirus B19

“Erythema infectiosum”

Question 15

Childhood rash: Erythematous, sandpaper-like rash w fever and sore throat

Answer 15

Scarlet fever (Step pyogenes)

Question 16

Childhood rash: Vesicular rash on palms and soles, ulcers* in oral mucosa

Answer 16

Hand-foot-mouth ds (Coxsackievirus type A)

Question 17

STD: Urethritis, cervicitis, PID, prostatitis, epididymis, arthritis*, creamy PURULENT discharge

Answer 17

Gonorrhea (N. gonorrhoeae)

Question 18

STD: Painless chancre

Answer 18

Primary syphillis (Treponema pallidum)

Question 19

STD: Fever, lymphadenopathy, skin rashes, condyloma lata

Answer 19

2ndary syphillis (Treponema pallidum)

Question 20

STD: Gummas, tabes dorsalis, general paresis, aortitis, Argyll Robertson pupil

Answer 20

Tertiary syphillis (Treponema pallidum)

Question 21

STD: Painful genital ulcer, inguinal adenopathy

Answer 21

Chancroid (Haemophilus ducreyi - “it’s so painful, you DO CRY”)

Question 22

STD: Painful penile, vulvar, or cervical vesicles and ulcers. Can cause systemic sxs such as fever, headache, myalgia

Answer 22

Genital herpes: HSV-2, less commonly HSV-1

Question 23

STD: Urethritis, cervicitis, conjunctivitis, Reiter’s syndrome, PID

Answer 23

Chlamydia (Chlamydia trachomatis D-K)

Question 24

STD: Infxn of lymphatics; genital ulcers (heal quickly, painless), lymphadenopathy, RECTAL STRICTURES**

Answer 24

Lymphogranulmoa venereum (C. trachomatis L1-L3)

Question 25

STD: Vaginitis, strawberry-colored mucosa, motile on wet prep

Answer 25

Trichomoniasis (Trichomonas vaginalis)

Question 26

STD: Opportunistic infxns, kaposi's sarcoma, lymphoma

Answer 26

AIDS/HIV

Question 27

STD: Genital warts, Koilocytes

Answer 27

Condyloma Accuminata* (HPV6 and 11)

Question 28

STD: Jaundice

Answer 28

Hepatitis B

Question 29

STD: Noninflammatory, malodorous discharge (fishy smell), positive whiff test, clue cells, not exclusively an STD

Answer 29

BV: Gardenella vaginalis

Question 30

PID top bugs:

Answer 30

``` Chlamydia tachomatis (subacute, often undiagnosed) Neisseria gonorrhoeae (acute) -Sxs: Cervical motion tenderness/Chandelier sign, purulent cervical discharge ```

Question 31

Nosocomial: Newborn nursery

Answer 31

RSV, CMV

Question 32

Nosocomial: Urinary catheterization

Answer 32

E. coli | Proteus mirabilis

Question 33

Nosocomial: wound infection

Answer 33

Staph aureus

Question 34

Nosocomial: Respiratory therapy equipment

Answer 34

Pseudomonas (assume when air or burns are involved)

Question 35

Nosocomial: work in renal dialysis unit

Answer 35

HBV (needle stick)

Question 36

Nosocomial: Hyperalimentation (over eating, too much protein/urea --> osmotic diuresis)

Answer 36

Assoc w Candida

Question 37

Nosocomial; water aerosols

Answer 37

Legionella!

Question 38

HY: pus, empyema, abscess

Answer 38

Staph aureus

Question 39

HY: Pediatric infection

Answer 39

Haemophilus influenzae (including epiglottis for those not vaccinated)

Question 40

HY: Pneumonia in CF, burn infection

Answer 40

Pseudomonas aeruginosa

Question 41

HY: Branching rods in oral infxn, sulfur granules

Answer 41

Actinomyces Israelii

Question 42

HY: Traumatic open wound

Answer 42

Clostridium perfingens

Question 43

HY: Surigcal wound

Answer 43

Staph aureus

Question 44

HY: Dog or cat bite

Answer 44

Pasteurella multocida

Question 45

HY: "currant jelly" sputum

Answer 45

Klebsiella

Question 46

HY: positive PAS stain

Answer 46

Tropheryma whipplei (Whipple's ds)

Question 47

HY: sepsis/meningitis in newborn

Answer 47

Group B strep (aglactaie)

Question 48

HY: Health care provider

Answer 48

HBV (needle stick)

Question 49

HY: Fungal infxn in diabetic or immunocompromized

Answer 49

Mucor or Rhizopus spp

Question 50

HY: Asplenic pt

Answer 50

Encapsulated, esp: Strep pneumo, H. flu type B, N. meningitidies

Question 51

HY: Chronic granulomatous ds

Answer 51

Catalase positive microbes, esp S. aureus

Question 52

HY: Neutropenic pts

Answer 52

Candida albicans (systemic), Aspergillus

Question 53

HY: Facial nerve palsy

Answer 53

Borrelia burgdorferi (Lyme ds)