FA - Micro - Systems (2016)

Question 1

Bugs affecting unvaccinated children - Meningitis:

Answer 1

1. H.influenza type B ==> Microbe colonizes nasopharynx.

2. Poliovirus ==> Can also lead to myalgia + Paralysis.

Question 2

Bugs affecting unvaccinated children - Respiratory - Epiglottitis:

Answer 2

1. Fever with dysphagia.
2. Drooling.
3. Difficulty breathing due to edematous “cherry-red” epiglottis.
4. “THUMBPRINT SIGN” on X-RAY.

Question 3

Epiglottitis is caused by …?

Answer 3

H.influenza type B (also capable of causing epiglottitis in FULLY IMMUNIZED children).

Question 4

Bugs affecting unvaccinated children - Pharyngitis:

Answer 4

Grayish oropharyngeal exudate ==> Pseudomembranes may OBSTRUCT airway.
+ PAINFUL throat.

Question 5

Pharyngitis is caused by …?

Answer 5

C.diphtheriae ==> Elaborates toxin that causes NECROSIS in:

1. Pharynx.
2. Cardiac.
3. CNS tissue.

Question 6

Nosocomial infections - 2 MCC:

Answer 6

1. E.coli ==> UTI.

2. S.aureus ==> Wound infection.

Question 7

Nosocomial infections - Risk factor - Antibiotic use:

Answer 7

C.difficile ==> Watery diarrhea + Leukocytosis.

Question 8

Nosocomial infections - Aspiration (2o to altered mental status, old age):

Answer 8

1. Polymicrobial.
2. Gram(-).
3. Often anaerobes.

Question 9

Nosocomial infections - Aspiration - Unique signs/symptoms:

Answer 9

Right LOWER lobe OR right UPPER/MIDDLE lobe (patient recumbent).
==> PURULENT MALODOROUS SPUTUM.

Question 10

Nosocomial infections - Decubitus ulcers, surgical wounds, drains - Pathogen:

Answer 10

1. S.aureus (incl. MRSA).

2. Gram(-) ANAEROBES ==> Bacteroides + Prevotella + Fusobacterium.

Question 11

Nosocomial infections - Intravascular catheters - Pathogen:

Answer 11

1. S.aureus (incl. MRSA).
2. S.epidermidis (long term).
3. Enterobacter.

Question 12

Nosocomial infections - Intravascular catheters - Unique signs/symptoms:

Answer 12

1. Erythema.
2. Induration.
3. Tenderness.
4. Drainage from access sites.

Question 13

Nosocomial infections - Mechanical ventilation, endotracheal entubation - Pathogen:

Answer 13

LATE ONSET ==>

1. P.aeruginosa.
2. Klebsiella.
3. Acinetobacter.
4. S.aureus.

Question 14

Nosocomial infections - Mechanical ventilation, endotracheal intubation - Unique signs/symptoms:

Answer 14

1. Nea infiltrate on CXR.
2. Incr. sputum producton.
3. Sweet odor ==> Pseudomonas.

Question 15

Nosocomial infections - Renal dialysis unit:

Answer 15

HBV.

Question 16

Nosocomial infections - Urinary catheterization - Pathogen:

Answer 16

1. E.coli.
2. Klebsiella.
3. Proteus spp.

Question 17

Nosocomial infections - Water aerosols - Pathogen:

Answer 17

Legionella.

Question 18

Nosocomial infections - Water aerosols - Unique signs/symptoms:

Answer 18

1. Signs of pneumonia.
2. GI symptoms (nausea, vomiting).
3. Neurologic abnormalities.

Question 19

Infections causing brain abscess - MC:

Answer 19

1. Viridans streptococci.

2. S.aureus.

Question 20

Infections causing brain abscess - If dental infection or extraction PRECEDES abscess, …?

Answer 20

ORAL ANAEROBES COMMONLY INVOLVED.

Question 21

Infections causing brain abscess - Multiple abscesses are usually from …?

Answer 21

BACTEREMIA.

Question 22

Infections causing brain abscess - Single lesions from contiguous sites:

Answer 22

1. Otitis media + Mastoiditis ==> Temporal lobe + Cerebellum.
2. Sinusitis OR dental infection ==> Frontal lobe.

Question 23

Infections causing brain abscess - Reactivation in AIDS?

Answer 23

TOXOPLASMA.

Question 24

Bugs causing food poisoning - C.botulinum:

Answer 24

TOXINS ==> Improperly canned foods.

SPORES ==> Raw honey.

Question 25

Bugs affecting unvaccinated children - Dermatologic - Rash:

Answer 25

1. RUBELLA ==> Beginning at HEAD and moving DOWN with POST-AURICULAR lymphadenopathy. 2. MEASLES ==> Beginning at HEAD and moving down; rash PRECEDED by cough, coryza, conjunctivitis, and Koplik spots on buccal mucosa.