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Boards.CP.Micro > UTI,Diarrhea > Flashcards

UTI,Diarrhea Flashcards

-UTI -Diarrhea

1
Q

Asymptomatic bacteriuria:

-Exceptions to Treatment

A
  • Pregnant

- Undergoing Urologic Instrumentation

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2
Q

Diagnosis of Asymptomatic bacteriuria:

  • Women
  • Men
  • Catherterized patients
A
  • 2 consecutive Voided urines with isolation of same species, >10^5 cfu/mL
  • Men just 1 voided urine
  • Catheter (M&F) - 1 specimen with single species, >10^2
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3
Q

MCC of UTI.

A

E.coli (85% of all community acquired UTIs)

Other enterobacteriaceae:

  • Klebsiella
  • Enterobactor
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4
Q

Organism common in young sexually active women.

A

Staphylococcus saprophyticus

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5
Q

Population of patients more susceptible to Enterococcus UTIs.

A

Older males with obstruction

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6
Q

Organisms ass. w/ Culture Neg. UTI (3)

A
  • Ureaplasma urealyticum
  • Chlamydia species
  • Mycoplasma hominis
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7
Q

Fungal UTI organism and association.

A

Candida spp.

  • Indwelling catheters
  • Antibiotics
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8
Q

Hemorrhagic cystitis:

  • Pathogen
  • Population
A
  • Adenovirus (type 11)

- BM Transplant

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9
Q

T/F: Culture is the Gold Standard for UTI diagnosis.

A

True

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10
Q

Urine Dipstick - Leukocyte Esterase:

  • Sensitivity
  • Specificity
A
  • 70-95% (sensitivity)

- 70% (specificity)

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11
Q

Urine Diptick - Nitrite:

  • Positive in which organisms?
  • Negative “”
A

POSITIVE
-Coliforms – capable of reducing nitrate to nitrite

NEGATIVE

  • S. saprophyticus
  • Enterococci
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12
Q

MCC of Infectious diarrhea.

A

Viruses

  • Norovirus
  • Rotavirus
  • Norwalklike viurs
  • Enteric Adenovirus
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13
Q

Infectious Diarrhea:

- Cold Weather Outbreaks

A

-Rotavirus (“winter vomiting disease”)

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14
Q

Noninflammatory (Watery, NO fever) Diarrhea:

-Organisms (5)

A
  • Vibrio cholera
  • ETEC
  • C. perfringens
  • S. aureus
  • B. cereus
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15
Q

what does ETEC produce?

A

Choleralike toxin

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16
Q

WHat is MCC of “Traveler’s Diarrhea”?

A

ETEC

17
Q

Cholera:

  • Features
  • Serogroups
  • Culprit
A
  • Voluminous water diarrhea w/ flecks of white mucus (“rice water stool”)
  • Serogroup O1 and O139
  • Shellfish
18
Q

Inflammatory (dysenteric) Diarrhea:

-Organisms (8)

A
  • Shigella
  • Campylobacter
  • Salmonella
  • EHEC
  • C. diff
  • Aeromonas
  • Yesrinia
  • Vibrio (noncholera)
19
Q

What does EHEC produce?

A

-Shiga Toxin

20
Q

How is EHEC acquired?

A

Undercooked ground beef

Also:

  • Milk
  • Fruit
  • Vegetables
21
Q

Most common strain of EHEC?

A

O157:H7

22
Q

Complication of EHEC?

A

Hemolytic Uremic Syndrome (HUS)

23
Q

T/F: Enteroinvasive E. coli (EIEC) does not produce Shiga toxin.

A

True

24
Q

How is Salmonella contracted?

A

Animal contact (live or in food)

  • Milk
  • Chickens
  • Eggs
25
Q

Population at greatest risk for Salmonella bacteremia?

A
  • Age Extremes (young and old)

- Immunosuppressed

26
Q

What is the most common cause of bacterial enteritis in the US? How is it acquired?

A

Campylobacter jejuni

-Food (chicken) or water

27
Q

Complications ass. w/ Campylobacter jejuni? (2)

A
  • Guillain-Bare

- Reactive arthropathy (enteropathic arthritis) in persons with HLA-B27

28
Q

Organisms associated with Rapid onset vomiting/diarrhea. (2)

A
  • Clostridium perfingens
  • S. aureus
  • B. cerues
29
Q

C. diff:

  • virulent strain
  • gene affected
A
  • BI/NAP1/027 strain

- deletion of tcdC gene (regulatory gene) – Increased production of toxins A&B

30
Q

What is the reference method for C.diff diagnosis?

A

Cytotoxicity assay

toxin production, not growth is diagnostic of C.diff colitis

31
Q

C. diff Antigenic toxin assays (ELISA):

-Sensitivity

A

60-80%

32
Q

PCR for what toxin genes, has a sensitivity and specificity of 95-100%? (4)

A
  • tcdA (toxin A)
  • tcdB (toxin B)
  • tcdC (toxin C)
  • A/B regulator gene
33
Q

Organism ass. w/ Antibiotic ass. ischemic/hemorrhagic colitis.

A

Klebsiella oxytoca

34
Q

Parasites commonly causing diarrhea in developed countries. (3)

A
  • Giardia
  • Entamoeba
  • Cryptosporidium
35
Q

Prolonged diarrhea or in a recent traveler (or immigrant) who presents with blood diarrhea.

A

Entamoeba histolytica

36
Q

Best method for diagnosis of Entamoeba histolytica.

A

Stool EIA (high sens/spec)

*Stool microscopy only 50% sensitive (specificity limited by morphologically identical but nonpathogenic Entamoeba dispar)

37
Q

What assay can substitute for a microscopic search for leukocytes?

A

Stool lactoferrin (product of neutrophils)

38
Q

T/F: ELISA methods can substitute for stool ova and parasite examination in most instances in the US.

A

True

39
Q

Organisms susceptible to routine stool culture. (6)

A
  • Salmonella spp.
  • Shigella spp.
  • E. coli
  • Campylobacter spp.
  • Yersinia enterocolitica
  • Vibrio spp.

Boards.CP.Micro (28 decks)

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