Presentations Flashcards by Amanda Kim

Abdominal pain, diarrhea, leukocytosis, recent antibiotic use

C.difficile

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Indurated, ulcerated genital lesion

Nonpainful: chanchre (primary syphilis, T. pallidum)

Painful, with exudate: chancroid (H. ducreyi) + lymphadenopathy

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Painful blue fingers/toes, hemolytic anemia

Cold aggultinin disesase (autoimmune hemolytic anemia caused by Mycoplasma penumoniae)

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Rash on palms and soles, centripetal; ticks; no eschar

Rock Mountain Spotted Fever (R.Ricketsii)

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Rash on trunk, centrifugal; lice; no eschar

R.prowazekii (epidemic typhus)

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Rash on trunk, centrifugal; mites; eschar

Scrub typhus (orientia tsusugamushi)

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Red currant jelly sputum in alcoholic or diabetic

Klebsiella pneumoniae pneumonia

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Smooth, moist, painless, wart-like white lesions on genitals

Condylomata lata (secondary syphilis; T.Palladium)

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Skin infections (furuncules, carbuncles)
Post trauma fasciitis, osteomyelitis, cellulitis
Endocarditis, septic arthritis, sepsis

S. aureus, invasive disease

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Scalded skin syndrome (also called?)

Bullous impetigo

S. aureus, toxinoses caused by exfoliatin

Ritter’s disease

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Shock, fever, nausea, vomiting, diarrhea, skin desquamation after tampon use, wound dressings not changed

S. aureus, toxinosis, caused by TSST 1 or 2

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Food poisoning, heating doesn’t help, nausea, cramps, vomiting and diarrhea, gone in 24 hrs

S. aureus, toxinosis, caused by enterotoxins A-I (superantigens)

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Group A Strep diseases

Strep throat, pharyngitis, scarlet fever, necrotizing fasciitis, streptococcal toxi shock, skin infections, acute rheumatic fever, glomerulonephritis

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Scarlet fever symptoms

Follows pharyngitis (if release exotoxins A, B,C,)
Fever, sandpaper rash, STRAWBERRY TONGUE, desquamation of palms and soles

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Necrotizing fasciitis

Inoculation of fascia around muscles or untreated cellulitis, Exotoxin B

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Acute rheumatic fever dx

After GAS pharyngitis, caused by autoimmune cross rxn between GAS Ab and joint/heart tissue

2 major, 1 major 2 minor
Major criteria: Joints, Endocarditis or other heart problems, subcutaneous Nodules, Erythema marginatum, Sydenham’s chorea
Minor: history of GAS respiratory tract infxn, arthralgia, fever, other inflammatory markers (ASO+, elevated ESR)

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Neonatal meningitis

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Strep agalactiae (GBS) (50%), E.Coli (20%), Listeria (5-10%)

Pneumonia

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Typical:

S. pneumoniae (gram pos, diplococci, chains, lancet shaped)
Haemophilus influenzae (gram neg coccobacilli)
S. aureus (gram pos cocci in clusters

Atypical

Mycoplasma pneumoniae (no gram stain, no cell wall)
Chlamydia pneumoniae (intracellular)
Legionella pneumonia (gram negative rod)
Nocardia

Strep pneumo disease

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Meningitis, Otitis media, Pneumonia, Sinusitis

Legionella diseases

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Legionnaire’s disease (pneumonia, 5% if treated with antibiotics), Pointiac fever (flu like with no pneumonia, self-limiting in 1 week)

Mild cough/rhinorrhea followed by paroxysmal cough; leukocytosis

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Bordatella pertussis

Sore throat, fever, pseudomembrane covering oropharynx

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Corynebacterium diphtheria

Also can damage heart, nervous tissue if toxin spreads
Skin lesions

Meningitis

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N.meningititis (gram negative diplococci) + petechial rash
H. influenzae (gram negative coccobacilli)
Listeria (newborns and elderly) (gram positive bacilli)
Strep pneumo
## E.coli (kids)

Gram negative respiratory infxns

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Pseudomonas aeruginosa
Bordatella pertussis (whooping cough)
Haemophilus influenza
Klebsiella
Legionella

Short onset food poisoning

S. aureus (gram pos cocci clusters), B. cereus (gram pos rod)

8-16 hr onset food poisoning

C.perfrigens

Food poisoning (later onset)

- E.coli - Shigella - Salmonella - C. botulinum - C. jejuni

UTIs

- E.Coli - S. saprophyticus - Pseudomonas aeruginosa - Klebsiella

Paralysis, descending, floppy baby

C.botulinum

Muscle contraction, descending

C. tetani

Gas gangrene (under skin, crepitus

C.perfinges

Bloody diarrhea, seizures, hemolytic uremic syndrome

Shigella

Fever, headache, rash (vasculitis) - Test for all - Trx for all

Rickettsiae - Centripetal, no eschar: RMSF (rickettsii) (ticks) - Centripetal, eschar: scrub typhus (orientii) (mites) - Centrifugal, no eschar: epidemic typhus (prowazekki) (ticks) - Weil-Felix agglutination - Tetracycline (doxycycline)

Flu-like symptoms, cattle, sheep goats, milk - Test - Trx

Q fever (coxiella burnetti; rickettsiae) acute - Chronic can cause endocarditis, aortic aneurysm - NAAT, IFA serology; No Weil-Felix agglutination - Doxycycline

Urethral/vaginal infxn --> genital ulcers | Also:

- Chlamydia trachomatis | - Neonatal blindness

Mycobacterium tuberculosis - Dx - Transmission and virulence factors - Disease and symptoms

- Acid fast (carbolfuschin stain) because mycolic acid layer); Tuberculin skin test (delayed type hypersensitivity); QuantiFERON blood test (IFN-gamma); chest x-ray; cultures on LJ medium (slow) - Aerosol droplets; Cord factor (increases TNFa activating Mphages); sulfatides (prevent phagolysosome fusion - Caseating granulomas, granulomatous lesions in middle/low lung lobe + hilar lymphadenopathy; fever

Mycobacterium leprae - Dx - Trx

- Long incubation period - Skin biopsy and acid fast staining - Rifampicin, dapsone, clofazimine

Actinomyces israelii - Structure - Associated with - Pathophys - Trx

- Gram positive branching filamentous rods, anaerobe - Dental work, jaw trauma - Lump --> abscess --> sinus tracts with yellow sulfur granules - penicillin G, abscess drainage

Nocardia - Structure - Tests - Affects - Symptoms - Trx

- Gram positive branching filamentous rods, aerobe - Weakly acid fast, Catalase positive, Urease positive - Pulmonary nocardiosis: pneumonia, lung abscesses, cavitary lesions - Immunocompromised, men more than women - CNS: brain abscesses - Cutaneous: indurated lesions, from open wounds - Sulfonamides, TMP-SMX

Yersinia pestis (bubonic) - Transmission - Symptoms - Dx - Prognosis - Trx

- Flea bite - Swollen lymph nodes (bubos), flu-like symptoms - Lymph node aspirate Wayson staining, culture, serological - 40-60% fatal without treatment - Streptomycin or gentamycin

Yersinia pestis (pneumonic) - Transmission - Symptoms - Dx - Prog - Trx

- Aerosal droplets - Acute fulminating with sepsis, shock and lethal (1-3 days) - Blood culture (Wayson stain), serological, NAAT - 100% fatal without treatment - Streptomycin or gentamycin

B. anthracis - Structure - Diseases and symptoms - Virulence factor - Dx - Tx - Pvrx

- Gram positive rods, aerobic, spore forming - Cutaneous anthrax: black eschar where spore enters - Pulmonary anthrax = Woolsorter's disease: pneumonia, respiratory collapse - Gastro anthrax: vomit, blood, diarrhea (tainted meat) - Poly-D glutamic acid capsule protects from phago; Lethal factor cleaves MAPKK; Edema factor increases cAMP - Culture from blood, CSF, sputum; retrospective dx -- anti-PA Ab titer - AVA vaccine

Presentations Flashcards

(42 cards)