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Systems Flashcards

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1
Q

Normal flora: nose

A

Staph epidermidis, colonized by staph aureus

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2
Q

Normal flora: oropharynx

A

Strep viridans spp

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3
Q

Normal flora: Dental plaque

A

Strep mutans

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4
Q

Normal flora: Colon

A

B.fragilis>E.coli

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5
Q

Normal flora: vagina

A

Lactobacillus, colonized by E.coli and group B strep

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6
Q

Food poisoning: reheated rice

A

B.cereus

Starts and ends quickly

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7
Q

Food poisoning: canned foods or honey

A

C.botulinum

Improperly canned foods (toxins - adults), raw honey (spores - infants)

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8
Q

Food poisoning: reheated meats

A

C.perfringens

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9
Q

Food poisoning: undercooked meat

A

E.coli O157:H7

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10
Q

Food poisoning: Poultry, meat, eggs

A

Salmonella

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11
Q

Food poisoning: Meats, mayonnaise, custard

A 
S.aureus 
Preformed toxin (start quickly and ends quickly)
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12
Q

Food poisoning: Contaminated seafood

A

V.parahaemolyticus & V.vulnificus

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13
Q

Bloody diarrhea

A

Campylobacter - comma or S-shaped organisms; growth at 42C
E.histolytica - protozoan, amebic dysentery, liver absces
enterohemorrhagic E.coli - O157:H7; can cause HUC, shiga-like toxin
Enteroinvasive E.coli - invades colonic mucosa
Salmonella - lactose -, flagella the motility; has animal reservoir; esp. Poultry & eggs
Shigella - lactose -, very low ID, produces shiga-toxin (human reservoir); bacillary dysentery
Y.enterocolitica - day care outbreaks, pseudoappendicitis

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14
Q

Watery diarrhea

A

C.difficile - pseudomembranous colitis; caused by antibiotics, occasionally bloody diarrhea
C.perfringens - also causes gas gangrene
Enterotoxigenic E.coli - travelers diarrhea; produces heat-labile (LT and heat-stable (ST) toxins
Protozoa - giardia, cryptosporidium
V.cholerae - comma-shaped organisms; rice water diarrhea; often from infected seafood
Viruses - rotavirus, Norovirus, adenovirus

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15
Q

Common causes of pneumonia: Neonates (

A

Group B strep

E.coli

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16
Q

Common causes of pneumonia: Children (4wk-18yr)

A 
Viruses (RSV)
Mycoplasma
C.trachomatis (infants-3yr)
C.pneumoniae (school age children)
S.pneumoniae
*Runts May Cough Chunky Sputum*
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17
Q

Common causes of pneumonia: Adults (18-40yr)

A

Mycoplasma
C.pneumoniae
S.pneumoniae
Viruses (influenza)

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18
Q

Common causes of pneumonia: Adults (40-65yr)

A 
S.pneumoniae
H.influenzae
Anaerobes
Viruses
Mycoplasma
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19
Q

Common causes of pneumonia: Elderly (>65yr)

A 
S.pneumoniae
Influenza virus
Anaerobes
H.influenzae
Gram - rods
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20
Q

Special causes of pneumonia: Alcoholics

A

Klebsiella

Anaerobes (peptostreptococcus, fusobacterium, prevotella, bacteroides)

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21
Q

Special causes of pneumonia: IV drug users

A

S.pneumoniae

S.aureus

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22
Q

Special causes of pneumonia: Aspiration

A

Anaerobes

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23
Q

Special causes of pneumonia: atypical

A

Mycoplasma
Legionella
Chlamydia

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24
Q

Special causes of pneumonia: Cystic Fibrosis

A

Pseudomonas
S.aureus
S.pneumoniae
Burkholderia cepacia

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25
Special causes of pneumonia: Immunocompromised
``` S.aureus enteric gram - rods Fungi Viruses P.jirovecii (with HIV) ```
26
Special causes of pneumonia: Nosocomial (hospital acquired)
S.aureus Pseudomonas Other enteric gram - rods
27
Special causes of pneumonia: Postviral
S.pneumoniae S.aureus H.influenzae
28
Common causes of meningitis: Newborn (0-6mo)
Group B strep E.coli Listeria
29
Common causes of meningitis: Children (6mo-6yr)
S.pneumoniae N.meningitidis H.influenza type B Enteroviruses
30
Common causes of meningitis: 6-60yr
S.pneumoniae N.miningitidis (#1 cause in teens) Enteroviruses HSV
31
Common causes of meningitis: 60+yr
S.pneumoniae Gram - rods Listeria
32
Viral causes of meningitis
``` Enteroviruses (Coxsackievirus) HSV-2 (HSV-1 = encephalitis) HIV West Nile virus (also causes encephalitis) VZV ```
33
Treatment of meningitis
Give ceftriaxone and vancomycin empirically Add ampicillin if Listeria is suspected Note: incidence of HiB meningitis has decreased dramatically due to the conjugate HiB vaccine (usually seen in non-immunized pts)
34
CSF findings in meningitis: Bacterial
Increased opening pressure Increased PMNs Increased proteins Decreased sugar
35
CSF findings in meningitis: fungal/TB
Increased opening pressure Increased lymphocytes Increased protein Decreased sugar
36
CSF findings in meningitis: viral
Normal to increased opening pressure Increased lymphocytes Normal to increased proteins Normal sugar levels
37
Infections causing brain abscess
Most commonly viridans streptococci and S.aureus. If dental infection or extraction precedes abscess, oral anaerobes commonly involved Multiple abscesses are usually from bacteremia; single lesions from contiguous sites: -otitis media and mastoiditis --> temporal lobe and cerebellum -sinusitis or dental infection --> frontal lobe Toxoplasma reactivation in AIDS
38
Osteomyelitis with no risk factors
S.aureus (most common overall)
39
Osteomyelitis: risk factor of sexual activity
``` Neisseria gonorrhoeae (rare) Septic arthritis is more common ```
40
Osteomyelitis: risk factor - sickle cell disease
Salmonella | S.aureus
41
Osteomyelitis: risk factor - prosthetic joint replacement
S.aureus | S.epidermidis
42
Osteomyelitis: risk factor - Vertebral involvement
``` S.aureus Mycobacterium tuberculosis (Pott disease) ```
43
Osteomyelitis: risk factor - cat and dog bites
Pasteurella multocida
44
Osteomyelitis: IV drug abuse
Pseudomonas Candida S.aureus
45
Osteomyelitis
Elevated CRP and ESR common but nonspecific finding MRI is best for detecting acute infection and detailing an atomic involvement Radiographs are insensitive early but can be useful in chronic osteomyelitis
46
Urinary Tract Infections
Cystitis: dysuria, frequency, urgency, suprapubic pain, & WBCs in urine Primarily caused by ascension of microbes from urethra to bladder -Males: infants with congenital defects, vesicoureteral reflux -elderly: enlarged prostate Ascending to kidney results in pyelonephritis, which presents with fever, chills, flank pain, CVA tenderness, hematuria, WBC casts in urine Ten times more common in women (shorter urethra colonized by fecal flora) -other factors: obstruction, kidney surgery, catheterization, GU malformation, diabetes, pregnancy
47
UTI bugs: E.coli
Leadin cause of UTI Colonies show green metallic sheen on EMB agar Diagnostic markers - +leukocyte ester are (evidence of WBC activity) & + nitrite test = reduction of urinary nitrates by E.coli
48
UTI bugs: Staph saprophyticus
second leading cause of UTI in sexually active women | Diagnostic markers: + leukocyte esterase (evidence of WBC activity)
49
UTI bugs: Klebsiella pneumoniae
3rd leading cause of UTI Large mucoid capsule and viscous colonies +leukocyte esterase & +urease test
50
UTI bugs: Serratia marcescens
Some strains produce a red pigment; often nosocomial and drug resistant +leukocyte esterase
51
UTI bugs: Enterococcus
Often nosocomial and drug resistance | +Leuocyte esterase
52
UTI bugs: Proteus mirabilis
Motility causes "swarming" on agar; produces urease Associated with struvite stones +leukocyte esterase and +urease test
53
UTI bugs: Pseudomonas aeruginosa
Blue-green pigment and fruity odor Usually nosocomial and drug resistant +leukocyte esterase
54
Bacterial vaginosis
S&S: No inflammation, thin white discharge with fish odor Labs: clue cells; pH>4.5 Treatment: metronidazole Gardnerella vaginalis
55
Trichomonas vaginitis
S&S: inflammation ("strawberry cervix"), frothy yellow-green, foul smelling discharge Labs: motile trichomonads (pear shaped); pH>4.5 Treatment: metronidazole (treat sexual partner as well)
56
Candida vulvovaginalis
S&S: Inflammation, thick white "cottage cheese" discharge Labs: pseudohyphae, normal pH (4.0-4.5) Treatment: -azoles
57
ToRCHeS infections
Microbes that may pass from mother to fetus Transmission is transplacental in most cases or via delivery (esp HSV-2) Nonspecific findings: hepatosplenomegaly, jaundice, thrombocytopenia, growth retardation other infectious agents: Strep agalactiae (group B), E.coli, Listeria monocytogenes - all causes of meningitis in neonates Parvovirus B19 - hydrops fetalis
58
ToRCHeS: Toxoplasmosis gondii
Transmission: cat feces or ingestion of undercooked meat Maternal symptoms: asymptomatic with rare lymphadenopathy Neonatal symptoms: chorioretinitis, hydrocephalus and intracranial calcifications +/- "blueberry muffin" rash
59
ToRCHeS: Rubella
Transmission: respiratory droplets Maternal symptoms: rash, lymphadenopathy, polyarthritis, polyarthralgia Neonatal symptoms: abnormalities of eye (cataract) and ear (deafness) and congenital heart disease (PDA) +/- blueberry muffin rash (*I heart Ruby Earrings*)
60
ToRCHeS: Cytomegalovirus
Transmission: sexual contact, organ transplants Maternal symptoms: usually asymptomatic; mononucleosis-like illness neonatal symptoms: hearing loss, seizures, petechial rash, "blueberry muffin" rash, periventricular calcifications
61
ToRCHeS: HIV
Transmission: sexual contact, needle stick Maternal symptoms: variable presentation depending on CD4+ count Neonatal symptoms: recurrent infections, chronic diarrhea
62
ToRCHeS: HSV-2
Transmission: skin or mucous membrane contact Maternal symptoms: usually asymptomatic; hermetic (vesicular) lesions Neonatal symptoms: encephalitis, herpetic (vesicular) lesions
63
ToRCHeS: Syphilis
Transmission: sexual contact Maternal symptoms: chancre (primary), disseminated rash (secondary) Neonatal symptoms: often results in still birth, hydrops fetalis; if child survives presents with facial abnormalities (notched teeth, saddle nose, short maxilla), saber shins, CN VIII deafness
64
Red Rashes of Childhood: Coxsackievirus type A
hand-foot-mouth disease Oval-shaped vesicles on palms and soles Vesicles and ulcers in oral mucosa
65
Red Rashes of Childhood: HHV-6
Roseola (exanthem subitum) Asymptomatic rose-colored macules appear on body after several days of high fever Can present with febrile seizures, usually affects infants
66
Red Rashes of Childhood: Measles virus
Measles (rubeola) Beginning at head and moving down; rash preceded by cough, coryza, conjunctivitis and blue-white (Koplik) spots on by cal mucosa
67
Red Rashes of Childhood: Parvovirus B19
Erythema infectiously (fifth disease) Slapped cheek rash of face Can cause hydrops fetalis in pregnant women
68
Red Rashes of Childhood: strep pyogenes
Scarlet fever | Erythematous, sandpaper like rash with fever and sore throat
69
Red Rashes of Childhood: VZV
Chickenpox | Vesicular rash begins on trunk; spreads to face and extremities with lesions of different stages
70
STIs: AIDS
Opportunistic infections. Kaposi sarcoma, lymphoma | Organism: HIV
71
STIs: Chancroid
Painful genital ulcer with exudate, inguinal adenopathy Organism: Haemophilus ducreyi (*it's so painful, you "do cry"*)
72
STIs: Chlamydia
Urethritis, cervical is, epididymitis, conjunctivitis, reactive arthritis, PID Organism: Chlamydia trachomatis (D-K)
73
STIs: Condylomata acuminata
Genital warts, koilocytes | Organism: HPV 6&11
74
STIs: Genital herpes
Painful penile, vulvar or cervical vesicles and ulcers; can cause systemic symptoms such as fever, HA, myalgia Organism: HSV-2 (less commonly HSV-1)
75
STIs: Gonorrhea
Urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, creamy prudent discharge Organism: Neisseria gonorrhoeae
76
STIs: Hepatitis B
Jaundice | Organism: HBV
77
STIs: Lymphogranuloma venereum
Infection of lymphatic system, painless genital ulcers but painful lymphadenopathy (burboes) Organism: C.trachomatis (L1-L3)
78
STIs: Primary syphilis
Painless chancre | Organism: treponema pallidum
79
STIs: secondary syphilis
Fever, lymphadenopathy, skin rashes, condylomata lata | Organism: treponema pallidum
80
STIs: Tertiary syphilis
Gummas, tabes dorsal is, general paresis, aortitis, Argyll Robertson pupil Organism: treponema pallidum
81
STIs: Trichomoniasis
Vaginitis, strawberry cervix, motile in wet prep | organism: trichomonas vaginalis
82
Pelvic Inflammatory Disease (PID)
Top bugs: Chlamydia trachomatis (subacute - often undiagnosed), Neisseria gonorrhoeae (acute), C.trachomatis (most common bacterial STI in US) Cervical motion tenderness (chandelier sing), purulent cervical discharge PID may include salpingitis (risk factor for ectopic pregnancy, infertility, chronic pelvic pain, adhesions) endometriosis, hydrosalpinx & tubo-ovarian abscess
83
Fitz-Hugh-Curtis syndrome
PID with salpingitis --> infection of the liver capsule and "violin string" adhesions of peritoneum to liver
84
Nosocomial infections: Antibiotic use
Clostridium difficile | Watery diarrhea, leukocytosis
85
Nosocomial infections: aspiration (secondary to altered mental status, old age)
Polymicrobial gram - bacteria, often anaerobes | Right lower lobe infiltrate or right upper middle lobe (patient recumbent); purulent malodorous sputum
86
Nosocomial infections: decubitus ulcers, surgical wounds, drains
S.aureus (including MRSA); S.epidermidis (long term), enterobacter Erythema, tenderness, induration, drain gins from surgical wound sites
87
Nosocomial infections: intravascular catheters
S.aureus (including MRSA), gram - anaerobes (bacteroides, prevotella, Fusobacterium) Erythema, induration, tenderness, dating from access sites
88
Nosocomial infections: Mechanical ventilation, endotracheal intubation
Late onset: P.aeruginosa, Klebsiella, Acinetobacter, S.aureus New infiltrate on CXR, increase sputum production, sweet odor (pseudomonas)
89
Nosocomial infections: Renal dialysis unit, needlestick
HBV
90
Nosocomial infections: urinary catheterization
E.coli, Klebsiella, Proteus spp. | Dysuria, leukocytosis, flank pain or CVA tenderness
91
Nosocomial infections: Water aerosols
Legionella | Signs of pneumonia, GI symptoms (N/V), neurological abnormalities
92
Unvaccinated Kids: Rubella virus
Dermatologic | Rash - beginning at head and moving down with postauricular lymphadenopathy
93
Unvaccinated Kids: Measles virus
Dermatologic Rash - beginning at head and moving down; rash preceded by cough, coryza, conjunctivitis and blue-white Koplik spots on buccal mucosa
94
Unvaccinated Kids: HiB
Neurologic | Meningitis - microbe colonized nasopharynx
95
Unvaccinated Kids: Poliovirus
Neurologic | Meningitis - can also lead to myalgia and paralysis
96
Unvaccinated Kids: HiB (respiratory)
Respiratory Epiglottitis - fever with dysphagia, drooling and difficulty breathing due to edematous "cherry red" epiglottis; "thumbprint" sign on XR Can also cause epiglottitis in fully immunized kids as well
97
Unvaccinated Kids: C.diptheriae
Respiratory Pharyngitis - grayish oropharyngeal exudate (pseudomembranes that may obstruct airway), painful throat -elaborates toxin that causes necrosis in pharynx, cardiac and CNS tissue
98
Normal flora: skin
Staph epidermidis

Microbiology (8 decks)

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