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test II lect. 1 Flashcards

(47 cards)

1
Q

What is Otitis externa

A

inflammation of external auditory canal

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2
Q

What are the signs/symptoms of otitis externa?

A

otalgia, otorrhea (ear pain, ear discharge)

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3
Q

What is the most common precipitating factor in getting otitis externa?

A

moisture

can also be due to trauma, foregin objects, and skin conditions

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4
Q

What are the two most common bugs that cause otitis externa?

A

Pesudomonas aeruginosa

and staphy auerus

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5
Q

What is the gram stain of Pseudomonas aeruginosa?

A

Gram Negative

encapsulated bacillus

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6
Q

What is the gram stain of Staph arueus? morphology?

A

Gram Positive, encapsulated,

coagulase positive, B-hemolytic

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7
Q

What gives the diagnosis for otitis externa?

A

examination of the ear.

can use a UV light to see pyoverdin pigment (from pseudomonas aeruginosa)

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8
Q

What is the treatment for otitis externa?

A

topical antibacterial agents (if local)
oral antibiotics if febrile
analgesics PRN

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9
Q

What is the fluorescent, and what is the non fluorescent pigment from pseudomonas aeruginosa?

A

Pyocyanin- NONfluorescent

Pyoverdin (glows green)

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10
Q

What is otitis media?

A

this is inflammation of the middle ear- including the tympanic membrane- often associated with fluid build up

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11
Q

Who usually gets otitis media?

A

children

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12
Q

What is the gram stain and morphology of Strep Penuomiae?

A

Gram Positive, encapsulated.
Diplococcus
Alpha-hemolysis

(otitis media)

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13
Q

What is the gram stain and morphology of H. influenzae?

A

Gram Neative coccobacillus
nontypeable strains

(otitis media)

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14
Q

What is the gram stain and morphology of Moraxella catarhalis?

A

gram negative diplococcus
oxidase positive

(causes otiis media)

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15
Q

How do you diagnose otitis media?

A

clinical presentation is the most common

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16
Q

What is the DOC for otitis media?

A

Amoxicillin

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17
Q

What is the treatment for long term otitis media?

A

tympanostomy tubes

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18
Q

What is sinusitis?

A

inflammation within the paranasal sinuses- which may or may not be purulent

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19
Q

What bugs cause sinusitis?

A

the same that cause otitis media

strep pneumonia, H influenzae, and Moraxell catarrhalis

20
Q

What is the diagnosis of sinusitis made on?

A

clinical presentation and history

21
Q

What is the gram stain and morphology of Corynebacterium Diptheriae

A

this is gram positive, pleomorphic bacillus

chinese letter” appearance

22
Q

What is the Diptheria toxin like?

A

this is an A-B toxin

23
Q

What does the diptheria toxin affect?

A

This inactivates EF-2, resulting in inhibition of eukaryotic protein synthesis

24
Q

How do you get infected with Corynebacterium Diptheriae?

A

Respiratory droplets or direct contact.

25
What does diptheria toxin do in the respiratory tract?
this toxin is absorbed into mucous membranes, and kills them- causing destruction of the epithelium. This superficial inflammatory response creates a pseudomembrane- that is gray.
26
What is an external sign of serious respiratory diptheria infection?
A very edematious Bull Neck""
27
Where is diptheria found most often? and how is it transmitted?
Usually in poor urban areas, transmitted person to person
28
How is the diagnosis of diptheria usually made?
by clinical examination | Also- bacterial isolation- of club shaped" metachromatic granules"
29
What culture is done to test for diptheria?
Culture on blood agar Cysteine-tellurite agar and Loefflers medium
30
What lab test are done to identify Diptheria?
Elek immunodiffusion test PCR (tox gene) ELISA (diphteria exotoxin) Immunochromatographic strip assay
31
What is the 3 step treatment plan for strongly suggestive diphtheria?
1) antitoxin 2) DOC erythromycin/penicillin 3) vaccinate against further disease once recovered!
32
What is the gram stain and morphology of Bordetella pertussis?
Gram Negative- coccobacillus
33
What are the 6 types of virulence factors that Pertussis has?
``` Adhesins Exotoxins Pertussis Toxin Adenylate cyclase toxin tracheal cytotoxin dermonectoric toxin ```
34
What are the two main pertussis adhesins? what do they do?
``` Pertactin (P69) Filamentous Hemagglutinin (FHA) ``` These contain RGD sequences that mediate attachment to integrins
35
What does pertussis toxin do?
this is an A-B exotoxin, which increases respiratory secretions (via increased cAMP) AND lymphocytosis
36
What does adenylate cyclase toxin do?
this increase cAMP levels and function to reduce phagocytic activity
37
What does tracheal cytotoxin do?
causes ciliostasis, and stimulates IL-1 secretion (makes ya feel crappy)
38
What does dermonecrotic toxin do?
this is cause localized tissue destruction and vasoconstriction in critters
39
Where does pertussis attach initially?
in the ciliated respiratory epithelial cells, via adhesins and pertussis toxin
40
After attachment, how does pertussis affect the cells it binds?
this inhibits intraceullar killing mechanisms, and replicates intracellularly
41
how exactly does pertussis toxin affect WBCs?
this inhibits their extravasation- called lymphocytic leukocytosis
42
What is the Catarhhal stage of pertussis infection?
presents as a non-specific URT infection with insidious onset not ill, but highly contagious
43
What is the Paroxsmal stage of pertussis infection?
Paroxsmal coughing (Whooping cough)- followed by vomiting. can have up to 50 attacks a day Epitherial cells are extruded, impeding mucus clearing
44
What are the complications of pertussis?
all due to vomiting/ increased pressure from paroxsysms. dehydration, weight loss, insomnia, petechiae, hernia, rectal prolapse, rib facture.
45
what happens in the convalescent stage of pertussis?
paroxysms decrease in number and severity
46
What is the diagnosis of pertussis?
culture on enriched medium, or PCR
47
What is the DOC for pertussis?
Macrolides (mycins) Immunization is also good