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FA - Micro - Systems Flashcards

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0
Q

Normal dominant flora - nose?

A

S.epi - colonized by S.aureus.

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1
Q

Normal dominant flora - Skin?

A

S.epi

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2
Q

Normal dominant flora - oropharynx?

A

Viridans group strep

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3
Q

Normal dominant flora - dental plaque?

A

S.mutans

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4
Q

Normal dominant flora - colon?

A

B.fragilis>E.coli

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5
Q

Normal dominant flora - vagina?

A

Lactobacillus - colonized by E.coli and group B strep.

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6
Q

Normal flora - neonates by C-section?

A

Have NO FLORA but are rapidly colonized after birth.

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7
Q

Food poisoning - starts quickly/ends quickly?

A
  1. S.aureus

2. B.cereus

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8
Q

Food poisoning - B.cereus source?

A

Reheated rice.

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9
Q

Food poisoning - C.perfringens source?

A

Reheated meat dishes.

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10
Q

Food poisoning - E.coli O157:H7 source?

A

Undercooked meat.

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11
Q

Food poisoning - Salmonella source?

A

Poultry, meat, and eggs.

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12
Q

Food poisoning - S.aureus source?

A
  1. Meats
  2. Mayonnaise
  3. Custard
    ==> PREFORMED TOXIN.
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13
Q

Food poisoning - V.parahemolyticus and V.vulnificus source?

A

Contaminated SEAfood.

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14
Q

V.vulnificus besides food poisoning?

A

Wound infections from contact with contaminated water or shellfish.

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15
Q

Mention altogether the most important food poisoning bugs.

A
  1. B.cereus
  2. S.aureus
  3. C.botulinum
  4. C.perfringens
  5. E.coli O157:H7
  6. Salmonella
  7. V.parahemolyticus and V.vulnificus
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16
Q

Bugs causing bloody diarrhea?

A
  1. Campylobacter
  2. E.histolytica
  3. EHEC
  4. EIEC
  5. Salmonella
  6. Shigella
  7. Y.enterocolitica
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17
Q

Bloody diarrhea - Campylobacter?

A
  1. Comma- or S-shaped organism.

2. Growths at 42C.

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18
Q

Bloody diarrhea - E.histolytica?

A
  1. Protozoan
  2. Amebic dysentery
  3. Liver abscess
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19
Q

Bloody diarrhea - EHEC?

A
  1. O157:H7.
  2. Can cause HUS.
  3. Makes Shiga-like toxin.
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20
Q

Bloody diarrhea - EIEC?

A

Invades colonic mucosa.

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21
Q

Bloody diarrhea - Salmonella?

A
  1. Lactose(-)
  2. Flagellar motility
  3. Animal reseervoir
  4. Especially POULTRY/EGGS
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22
Q

Bloody diarrhea - Shigella?

A
  1. Lactose(-)
  2. Very low ID50
  3. Shiga toxin - Human reservoir only
  4. Bacillary dysentery
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23
Q

Bloody diarrhea - Y.enterocolitica?

A
  1. Day-care outbreaks

2. Pseudoappendicitis

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24
Watery diarrhea bugs?
1. C.difficile 2. C.perfringens 3. ETEC 4. Protozoa 5. V.cholerae 6. Viruses
25
Watery diarrhea - C.difficile?
1. Pseudomembranous colitis 2. By antibiotics 3. Occasionally bloody diarrhea
26
Watery diarrhea - C.perfringens?
Also causes GAS GANGRENE.
27
Watery diarrhea - ETEC?
1. Traveler's diarrhea | 2. Heat-labile and heat-stable toxins
28
Watery diarrhea - Protozoa
1. Giardia | 2. Cryptosporidium (immunocompromised)
29
Watery diarrhea - V.cholerae?
1. Comma-shaped organisms 2. Rice-water diarrhea 3. Often from INFECTED SEAfood
30
Watery diarrhea - Viruses?
1. Rotavirus 2. Norovirus 3. Adenovirus
31
Common causes of pneumonia - neonates (<4wk)?
1. Group B strep | 2. E.coli
32
Common causes of pneumonia - children (4wk-18y)?
1. Viruses - RSV 2. Mycoplasma 3. C.trachomatis (infants-3y) 4. C.pneumoniae (school-aged children) 5. S.pneumoniae
33
Common causes of pneumonia - adults (18-40yr)?
1. Mycoplasma 2. C.pneumoniae 3. S.pneumoniae 4. Viruses ==> Influenza.
34
Common causes of pneumonia - adults (40-65y)?
1. S.pneumoniae 2. H.influenza 3. Anaerobes 4. Viruses 5. Mycoplasma
35
Common causes of pneumonia - Elderly?
1. S.pneumoniae 2. Influenza virus 3. Anaerobes 4. H.influenza 5. Gram(-) rods
36
Common causes of pneumonia - Alcoholic/IVDA?
Alcoholics ==> Klebsiella + Anaerobes (eg Peptostreptococcus, Fusobacterium, Prevotella, Bacteroides). IVDA ==> S.pneumo + S.aureus.
37
Common causes of pneumonia - Aspiration?
Anaerobes
38
Common causes of pneumonia - Atypical?
1. Mycoplasma 2. Legionella 3. Chlamydia
39
Common causes of pneumonia - CF?
1. Pseudomonas 2. S.aureus 3. S.pneumoniae 4. B.cepacia.
40
Common causes of pneumonia - Immunocompromised?
1. Staph 2. Enteric gram(-) rods 3. Fungi 4. Viruses 5. P.jiroveci (with HIV)
41
Common causes of pneumonia - Nosocomial?
1. Staph 2. Pseudomonas 3. Other enteric gram(-) rods
42
Common causes of pneumonia - Postviral?
1. S.pneumo 2. H.influenza 3. S.aureus
43
Common causes of meningitis - Newborn (0-6mo)?
1. Group B strep 2. E.coli 3. Listeria
44
Common causes of meningitis - Children (6-6yr)?
1. S.pneumoniae 2. N.meningitis 3. H.influenza type B 4. Enteroviruses
45
Common causes of meningitis - 6-60y?
1. S.pneumoniae 2. N.meningitidis (#1 in teens) 3. Enteroviruses 4. HSV
46
Common causes of meningitis - 60+y?
1. S.pneumoniae 2. Gram(-) rods 3. Listeria
47
Meningitis empirical treatment?
1. Vancomycin 2. Ceftriaxone 3. Add ampicillin if Listeria is suspected.
48
Viral causes of meningitis?
1. Enteroviruses (Coxsackie) 2. HSV-2 (HSV-1=encephalitis) 3. HIV 4. West Nile virus ==> ALSO causes encephalitis. 5. VZV
49
In HIV - causes of meningitis?
Cryptococcus spp.
50
CSF findings in meningitis - Bacterial?
1. UP pressure 2. UP PMNs 3. UP protein 4. DOWN sugar
51
CSF findings - Fungal/TB?
1. UP pressure 2. UP lymphocytes 3. UP proteins 4. DOWN sugar
52
CSF findings in meningitis - viral?
1. Normal/UP pressure 2. UP lymphocytes 3. Normal/UP protein 4. Normal sugar
53
Osteomyelitis - assume no other info is available?
S.aureus (MC overall)
54
Osteomyelitis - sexually active?
N.gonorrhoeae (rare) - septic arthritis more common.
55
Osteomyelitis - IVDA?
1. P.aeruginosa 2. Candida. 3. S.aureus.
56
Osteomyelitis - sickle cell?
1. Salmonella | 2. S.aureus
57
Osteomyelitis - prosthetic joint replacement?
1. S.aureus | 2. S.epi
58
Osteomyelitis - vertebral involvement?
1. S.aureus. | 2. Myco TB (Pott).
59
Osteomyelitis - cat and dog bites?
P.multocida
60
Osteomyelitis - target group?
Children
61
Osteomyelitis - Radiograph or MRI?
MRI ==> Acute infection + Detailing anatomic involvement. | X-RAY ==> Useful in CHRONIC osteomyelitis.
62
Cystitis presents with?
1. Dysuria 2. Frequency 3. Urgency 4. Suprapubic pain 5. WBCs (but NOT WBCs casts) in urine.
63
Cystitis - mechanism in MALES - infants, elderly?
1. Congenital defects (Infants). 2. Vesicoureteral reflux (Infants) 3. Enlarged prostate (elderly)
64
Pyelonephritis symptoms?
1. Fever 2. Chills 3. Flank pain 4. Costovertebral angle 5. Tenderness 6. Hematuria 7. WBC casts
65
UTI - how more common in women?
10X! - shorter urethras colonized by fecal flora.
66
UTI - Predisposing factors besides female?
1. Obstruction 2. Kidney surgery 3. Catheterization 4. GU malformation 5. Diabetes 6. Pregnancy
67
UTI - Diagnostic markers?
1. Leukocyte esterase test (+) ==> Evidence of WBC activity. 2. Nitrite test (+) ==> Reduction of urinary nitrates by bacterial species (eg E.coli). 3. Urease test (+) ==> Urease-producing bugs (eg Proteus, Klebsiella).
68
UTI bugs - E.coli - features?
1. Leading cause of UTI. | 2. Colonies show green metallic sheen on EMB agar.
69
UTI bugs - Staph sapro - features?
2nd leading cause of UTI in sexually active women.
70
UTI bugs - K.pneumoniae - features?
1. 3rd leading cause of UTI. | 2. Large mucoid capsule and viscous colonies.
71
UTI bugs - Serratia marcescens - features?
1. Some strains produce a red pigment. | 2. Often nosocomial and drug resistant.
72
UTI bugs - Enterococcus - features?
Often nosocomial and drug resistant.
73
UTI bugs - P.mirabilis - features?
1. Motility causes "swarming" on agar. 2. Produces urease 3. Associated with struvite stones
74
UTI bugs - P.aeruginosa - features?
1. Blue-green pigment and fruity odor | 2. Usually nosocomial and drug resistant
75
UTI - diagnostic tests - Leucocyte esterase (+)?
Bacterial UTI.
76
UTI - diagnostic tests - nitrite tests?
Gram(-) bugs.
77
UTI - Urease test (+)?
1. Klebsiella | 2. Proteus
78
UTI - urease (-)?
1. E.coli | 2. Enterococcus
79
Mention altogether the most important UTI bugs.
1. E.coli 2. S.sapro 3. K.pneumoniae 4. Serratia marcescens 5. Enterococcus 6. P.mirabilis 7. P.aeruginosa
80
3 common vaginal infections?
1. Bacterial vaginosis 2. Trichomonas vaginitis. 3. Candida vulvovaginitis
81
Bacterial vaginosis - signs/symptoms?
1. No inflammation | 2. Thin, white discharge with fishy odor
82
Bacterial vaginosis - lab findings?
1. Clue cells | 2. pH>4.5
83
Bacterial vaginosis - Treatment?
Metronidazole
84
Trichomoniasis - signs/symptoms?
1. Inflammation ==> Strawberry cervix. | 2. Frothy, grey-green, foul-smelling discharge
85
Trichomoniasis - Lab findings?
1. Motile trichomonads | 2. pH>4.5
86
Trichomoniasis - treatment?
Metronidazole - treat sexual partner.
87
Candida vulvovaginitis - signs/symptoms?
1. Inflammation | 2. Thick, white, "cottage cheese" discharge
88
Candida vulvovaginitis - lab findings?
1. Pseudohyphae | 2. pH NORMAL (4-4.5)
89
Candida vulvovaginitis - treatment?
-azoles
90
ToRCHeS infections - Transmission?
Mostly transplacentally, or via delivery (especially HSV-2).
91
Non specific signs common to many ToRCHeS infections?
1. HSM 2. Jaundice 3. Thrombocytopenia 4. Growth retardation
92
Besides ToRCHeS, other important infectious agents?
1. S.agalactiae 2. E.coli 3. Listeria 4. B19 --> Hydrops fetalis
93
T.gondii - transmission?
Cat feces or ingestion of undercooked meat.
94
T.gondii - maternal manifestations?
1. Usually asymptomatic | 2. Lymphadenopathy (rarely)
95
T.gondii - neonatal manifestations?
``` Classic triad: 1. Chorioretinitis 2. Hydrocephalus 3. Intracranial calcifications +/- "BLUEBERRY MUFFIN RASH" ```
96
Rubella - transmission?
Respiratory droplets.
97
Rubella - maternal manifestations?
1. Rash 2. Lymphadenopathy 3. POLYARTHRITIS/POLYARTHRALGIA
98
Rubella - neonatal manifestations?
``` Classic triad: 1. PDA (or pulmonary artery hypoplasia) 2. Cataracts 3. Deafness +/- "blueberry muffin" rash. ```
99
CMV - transmission?
1. Sexual contact | 2. Organ transplants
100
CMV - Maternal manifestations?
1. Usually asymptomatic | 2. Mononucleosis-like illness
101
CMV - Neonatal manifestations?
1. Hearing loss 2. Seizures 3. Petechial rash 4. "Blueberry muffin" rash 5. PERIVENTRICULAR CALCIFICATIONS
102
HIV -transmission?
1. Sexual contact | 2. Needlestick
103
HIV - maternal manifestations?
Variable presentation depending on CD4+ count.
104
HIV - neonatal manifestations?
1. Recurrent infections | 2. Chronic diarrhea
105
HSV-2 - transmission?
Skin or mucous membrane contact.
106
HSV-2 - maternal manifestations?
1. Usually asymptomatic | 2. Herpetic (vesicular) lesions
107
HSV-2 - Neonatal manifestations?
1. Encephalitis | 2. Herpetic (vesicular) lesions
108
Syphilis - transmission?
Sexual contact
109
Syphilis - maternal manifestations?
Chancre (1o) and disseminated rash (2o) are the two stages likely to result in fetal infection.
110
Syphilis - neonatal manifestations?
1. Often stillbirth 2. Hydrops fetalis ==> IF CHILD SURVIVES: 3. Notched teeth 4. Saddle nose 5. Short maxilla 6. Saber shins 7. CN VIII deafness
111
ToRCHeS?
``` Toxo Rubella CMV HSV-2 Syphilis ```
112
Red rashes of childhood?
1. Coxsackievirus type A 2. HHV-6 3. Measles virus 4. Parvo B19 5. Rubella virus 6. S.pyogenes 7. VZV
113
Red rashes of childhood (RRC) - Coxsackie A?
Hand-foot-mouth disease
114
Hand-foot-mouth disease clinical presentation?
1. Vesicular rash on palms 2. Soles 3. Vesicles and ulcers in oral mucosa
115
RRC - HHV-6?
Roseola = EXANTHEM SUBITUM
116
Roseola clinical presentation?
1. ASYMPTOMATIC rose-colored MACULES over body appears after several days of high fever. 2. Can present with febrile seizures. 3. Usually affects infants.
117
Measles (rubeola) clinical presentation?
1. A paramyxovirus 2. Beginning at head and moving down 3. Rash is PRECEDED by cough, coryza, conjunctivitis, and blue-white (Koplik) spots on buccal mucosa.
118
Erythema infectiosum (5th disease - B19) clinical presentation?
"Slapped cheek" rash on face - can cause hydrops fetalis in pregnant woman.
119
Rubella (German measles) clinical presentation?
Pink coalescing MACULES begin at head and moves down --> fine truncal rash. ==> POST-AURICULAR LYMPHADENOPATHY.
120
S.pyogenes - scarlet fever - clinical presentation?
Erythematous, sandpaper-like rash with fever and sore throat.
121
VZV - chickenpox - clinical presentation?
1. Vesicular rash begins on TRUNK. | 2. Spreads to FACE + EXTREMITIES with lesions of DIFFERENT ages.
122
Mention the major sexually transmitted diseases?
1. AIDS 2. Chancroid 3. Chlamydia 4. Condylomata acuminata 5. Genital herpes 6. Gonorrhea 7. Hep B 8. Lymphogranuloma venereum 9. Syphilis 10. Trichomoniasis
123
Chancroid - clinical features?
1. Painful genital ulcer | 2. Inguinal adenopathy
124
Chancroid - organism?
H.ducreyi
125
Chlamydia - clinical features?
1. Urethritis 2. Cervicitis 3. Conunctivitis 4. Reactive arthritis 5. PID 6. EPIDIDYMITIS.
126
Chlamydia - organisms (types)?
Chlamydia trachomatis D-K
127
Condylomata acuminata - features?
1. Genital warts | 2. Koilocytes
128
Condylomata acuminata - organism?
HPV-6 and -11.
129
Genital herpes - features?
1. Painful penile, vulvar, or cervical vesicles and ulcers. | 2. Systemic symptoms such as fever, headache, myalgia.
130
Genital herpes - organisms?
1. HSV-2 | 2. HSV-1 less commonly
131
Gonorrhea - features?
1. Urethritis 2. Cervicitis 3. PID 4. Prostatitis 5. Epididymitis 6. Arthritis 7. Creamy purulent discharge
132
Lymphogranuloma venereum - features?
1. Infection of lymphatics 2. Painless, genital ulcers 3. Painful lymphadenopathy (buboes)
133
Lymphogranuloma venereum - C.trachomatis subtypes?
L1-L3.
134
1o syphilis - features?
PainLESS chancre
135
2o syphilis - features?
1. Fever 2. Lymphadenopathy 3. Skin rashes 4. Condylomata lata
136
3o syphilis - features?
1. Gummas 2. Tabes dorsalis 3. General paresis 4. Aortitis 5. Argyll-Robertson pupil
137
Trichomoniasis - features?
1. Vaginitis 2. Strawberry cervix 3. Motile in wet prep
138
PID - Top bugs?
1. Chlamydia trachomatis ==> Subacute + Often UNDIAGNOSED. | 2. N.gonorrhoeae ==> ACUTE.
139
PID features?
1. Chandelier sign = cervical motion tenderness. | 2. Purulent cervical discharge
140
PID may include which conditions?
1. Salpingitis 2. Endometritis 3. Hydrosalpinx 4. Tubo-ovarian abscess
141
C.trachomatis + N.gonorrhoeae --> which syndrome?
Fitz-Hugh-Curtis syndrome --> Infection of the liver CAPSULE and "violin string" adhesions of PERITONEUM to liver.
142
Salpingitis - risk factor for?
1. Ectopic pregnancy 2. Infertility 3. Chronic pelvic pain 4. Adhesions
143
Major nosocomial infections?
1. C.albicans 2. CMV, RSV 3. E.coli 4. P.mirabilis 5. HBV 6. Legionella 7. P.aeruginosa
144
Nosocomial infection (NI) - C.albicans - risk factor?
Hyperalimentation
145
NI - CMV, RSV - Risk factors?
Newborn surgery
146
NI - E.coli, P.mirabilis - Risk factors?
Urinary catheterization.
147
2 MCC of NI are?
1. E.coli (UTI) | 2. S.aureus (wound infection)
148
NI - HBV - Risk factor?
Work in renal dialysis unit.
149
Bugs affecting unimmunized children - dermatologic - pathogens?
1. Rubella virus | 2. Measles virus
150
Asplenic patient
Encapsulated microbes - SHiN | S.pneumoniae >> H.influenza B > N.meningitidis
151
Branching rods in oral infection | Sulfur granules
Actinomyces israelii
152
Chronic granulomatous disease
Cat (+) microbes - esp. S.aureus
153
"Currant jelly" sputum
Klebsiella
154
Dog or cat bite
P.multocida
155
Facial nerve palsy
Borrelia burgdorferi (Lyme disease)
156
Fungal infection in diabetic or immunocompromised
Mucor or Rhizopus spp.
157
Health care provider
HBV - from needle stick.
158
Neutropenic patients
C.albicans (systemic) | Aspergillus
159
Organ transplant recipient
CMV
160
PAS (+)
Tropheryma whipplei
161
Pediatric infection
Haemophilus influenza (including epiglottitis).
162
Pneumonia in CF | Burn infection
P.aeruginosa
163
Pus Empyema Abscess
S.aureus
164
Rash on hands and feet
Coxsackie A Treponema pallidum Rickettsia rickettsii
165
Sepsis/meningitis in newborn
Group B strep
166
Surgical wound
S.aureus
167
Traumatic open wound
C.perfringens
Microbiology
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