5. Microbiology by Diseases Flashcards
1
Q
Dominant normal flora of the: Skin
A
Staphylococcus epidermis
2
Q
Dominant normal flora of the: Nose
A
S. epidermis; colonized by S. aureus
3
Q
Dominant normal flora of the: Oropharynx
A
Viridans group streptococci
4
Q
Dominant normal flora of the: Dental plaque
A
Streptococcus mutans
5
Q
Dominant normal flora of the: Colon
A
Bacteroides fragilis > E. coli
6
Q
Dominant normal flora of the: Vagina
A
Lactobacillus, colonized by E. coli and GBS
7
Q
Neonates and normal flora
A
Neonates delivered by cesarean section havve no flora, but are rapidly colonized after birth.
8
Q
Food poisoning from: Vibrio parahemolyticus and V. vulnificus
A
Food: Contaminated seafood (V. vulnificus can also cause wound infxn from contact w/ contaminated water or shellfish)
9
Q
Food poisoning from: Bacillus cereus
A
Food: reheated rice. (Food poisoning from reheated rice? Be Serious! [B. cereus])
10
Q
Food poisoning from: S. aureus
A
Food: Meats, mayonnaise, custard (pre-formed toxin)
11
Q
Food poisoning from: Clostridium perfringens
A
Food: reheated meat dishes
12
Q
Food poisoning from: Clostridium botulinum
A
Food: improperly canned foods (bulging cans)
13
Q
Food poisoning from: E. coli O157:H7
A
Food: Undercooked meat
14
Q
Food poisoning from: Salmonella
A
Food: poultry, meat, and eggs.
15
Q
What are two bacteria that cause a food poisoning that starts quickly and ends quickly?
A
S. aureus and B. cereus
16
Q
Bugs that cause diarrhea: Campylobacter Type of diarrhea? Findings?
A
Bloody diarrhea. Comma- or S-shaped organisms; growth at 42C; Oxidase (+) [bugs that cause diarrhea: type of diarrhea and findings]
17
Q
Bloody diarrhea. Comma- or S-shaped organisms; growth at 42C; Oxidase (+) [bugs that cause diarrhea: type of diarrhea and findings]
A
Bugs that cause diarrhea: Campylobacter
18
Q
Bugs that cause diarrhea: Salmonella Type of diarrhea? Findings?
A
bloody diarrhea. Lactose (-); Flagellar motility [bugs that cause diarrhea: type of diarrhea and findings]
19
Q
bloody diarrhea. Lactose (-); Flagellar motility [bugs that cause diarrhea: type of diarrhea and findings]
A
Bugs that cause diarrhea: Salmonella
20
Q
Bugs that cause diarrhea: Shigella Type of diarrhea? Findings?
A
Bloody diarrhea Lactose (-) Very low ID50 Produces Shiga toxin [bugs that cause diarrhea: type of diarrhea and findings]
21
Q
Bloody diarrhea Lactose (-) Very low ID50 Produces Shiga toxin [bugs that cause diarrhea: type of diarrhea and findings]
A
Bugs that cause diarrhea: Shigella
22
Q
Bugs that cause diarrhea: Enterohemorrhagic E. coli (EHEC) Type of diarrhea? Findings?
A
Bloody diarrhea O157:H7 Can cause HUS Makes Shiga-like toxin [bugs that cause diarrhea: type of diarrhea and findings]
23
Q
Bloody diarrhea O157:H7 Can cause HUS Makes Shiga-like toxin [bugs that cause diarrhea: type of diarrhea and findings]
A
Bugs that cause diarrhea: Enterohemorrhagic E. coli (EHEC)
24
Q
Bugs that cause diarrhea: Enteroinvasive E. coli (EIEC) Type of diarrhea? Findings?
A
Bloody diarrhea. Invades colonic mucosa. [bugs that cause diarrhea: type of diarrhea and findings]
25
Bloody diarrhea. Invades colonic mucosa. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Enteroinvasive E. coli (EIEC)
26
Bugs that cause diarrhea: Yersinia enterocolitica Type of diarrhea? Findings?
Bloody diarrhea Day-care outbreaks Pseudoappendicitis [bugs that cause diarrhea: type of diarrhea and findings]
27
Bloody diarrhea Day-care outbreaks Pseudoappendicitis [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Yersinia enterocolitica
28
Bugs that cause diarrhea: C. difficile Type of diarrhea? Findings?
Can cause both watery and bloody diarrhea. Pseudomembranous colitis. [bugs that cause diarrhea: type of diarrhea and findings]
29
Can cause both watery and bloody diarrhea. Pseudomembranous colitis. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: C. difficile
30
Bugs that cause diarrhea: Entamoeba histolytica Type of diarrhea? Findings?
Bloody diarrhea. Protozoan. [bugs that cause diarrhea: type of diarrhea and findings]
31
Bloody diarrhea. Protozoan. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Entamoeba histolytica
32
Bugs that cause diarrhea: Enterotoxigenic E. coli (ETEC) Type of diarrhea? Findings?
Watery diarrhea. Traveler's diarrhea Produces ST and LT toxins [bugs that cause diarrhea: type of diarrhea and findings]
33
Watery diarrhea. Traveler's diarrhea Produces ST and LT toxins [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Enterotoxigenic E. coli (ETEC)
34
Bugs that cause diarrhea: Vibrio cholerae Type of diarrhea? Findings?
Watery diarrhea. Comma-shaped organisms Rice-water diarrhea. [bugs that cause diarrhea: type of diarrhea and findings]
35
Watery diarrhea. Comma-shaped organisms Rice-water diarrhea. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Vibrio cholerae
36
Bugs that cause diarrhea: C. perfringens Type of diarrhea? Findings?
Watery diarrhea. Also causes gas gangrene. [bugs that cause diarrhea: type of diarrhea and findings]
37
Watery diarrhea. Also causes gas gangrene. [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: C. perfringens
38
Bugs that cause diarrhea: Protozoa Type of diarrhea? Findings?
Watery diarrhea Giardia, Cryptosporidium (in immunocompromised) [bugs that cause diarrhea: type of diarrhea and findings]
39
Watery diarrhea Giardia, Cryptosporidium (in immunocompromised) [bugs that cause diarrhea: type of diarrhea and findings]
Bugs that cause diarrhea: Protozoa
40
Bugs that cause diarrhea: Viruses Type of diarrhea? Findings?
Watery diarrhea. Rotavirus, adenovirus, Norwalk virus (norovirus). [bugs that cause diarrhea: type of diarrhea and findings]
41
Common causes of pneumonia in neonates (\< 4wks)
Group B streptococci E. coli
42
Common causes of pneumonia in children (4wks - 18yrs)
Viruses (R SV) M ycoplasma C hlamydia pneumoniae S treptococcus pneumoniae (R unts M ay C ough S putum)
43
Common causes of pneumonia in adults (18-40yrs)
Mycoplasma Chlamydia pneumoniae Streptococcus pneumoniae
44
Common causes of pneumonia in Adults (40-65yrs)
Streptococcus pneumoniae H. influenzae Anaerobes Viruses Mycoplasma
45
Common causes of pneumonia in the elderly (\>65)
Streptococcus pneumoniae Viruses Anaerobes H. influenzae Gram (-) rods
46
Common causes of nosocomial (hospital-acquired) pneumonia
Staphylococcus Enteric Gram (-) rods
47
Common causes of pneumonia in the immunocompromised
Staphylococcus Enteric Gram (-) rods Fungi Viruses Pneumocystis jiroveci (w/ HIV)
48
Common cause of pneumonia w/ aspiration
Anaerobes
49
Common cause of pneumonia in alcoholics/IV drug users
Streptococcus pneumoniae Klebsiella Staphylococcus
50
Common causes of pneumonia in CF
Pseudomonas
51
Common causes of post-viral pneumonia
Staphylococcus H. influenzae
52
Common causes of atypical pneumonia
Mycoplasma Legionella Chlamydia
53
Common causes of meningitis in newborn (0-6 months
Group B streptococci E. coli Listeria
54
Common causes of meningitis in children (6mos - 6yrs)
Streptococcus pneumoniae Neisseria meningitidis Haemophilus influenzae type B Enteroviruses
55
Common causes of meningitis (6-60yrs)
N. miningitidis Enteroviruses S. pneumoniae HSV
56
Common causes of meningitis in 60+ year-olds
Streptococcus pneumoniae Gram (-) rods Listeria
57
Viral causes of meningitis
Enteroviruses (esp. coxsackievirus) HSV HIV West Nile virus VZV
58
Common causes of meningitis in HIV
Cryptococcus CMV Toxoplasmosis (brain abscess) JC virus (PML)
59
Incidence of H. influenzae meningitis?
Has decreased greatly w/ introduction of H. influenzae vaccine in last 10-15 years.
60
CSF findings in meningitis: Bacterial [Pressure? Cell type? Protein? Sugars?]
Increased pressure Increased PMNs Increased protein Decreased sugar
61
Increased pressure Increased PMNs Increased protein Decreased sugar [CSF findings in meningitis -- what is the bug?]
Bacterial
62
CSF findings in meningitis: Fungal/TB [Pressure? Cell type? Protein? Sugars?]
Increased pressure Increased lymphocytes Increased proein Decreased sugar
63
Increased pressure Increased lymphocytes Increased proein Decreased sugar [CSF findings in meningitis -- what is the bug?]
Fungal/TB
64
CSF findings in meningitis: Viral [Pressure? Cell type? Protein? Sugars?]
Normal/increased pressure Increased lymphocytes Normal/increased protein Normal sugar
65
Normal/increased pressure Increased lymphocytes Normal/increased protein Normal sugar [CSF findings in meningitis -- what is the bug?]
Viral
66
Osteomyelitis in most ppl is due to...? Who gets most osteomyelitis?
Staph aureus in most ppl. Most osteomyelitis occurs in children.
67
Elevated CRP and ESR in osteomyelitis?
Classic findings, but nonspecific
68
Osteomyelitis in sexually active pt
Neisseria gonorrhoeae (rare) Septic arthritis more common
69
Osteomyelitis in diabetics and drug addicts
Pseudomonas aeruginosa
70
Osteomyelitis in Sickle cell
Salmonella
71
Osteomyelitis in prosthetic replacement
S. aureus and S. epidermis
72
Osteomyelitis in vertebra
Mycobacterium tuberculosis (Pott's dz)
73
Osteomyelitis with cat and dog bites/scratches
Pasteurella multocida
74
3 Most common causes of ambulatory UTI
1.) E. coli (50-80%) 2.) Staphylococcus saprophyticus (10-30%): 2nd most common cause of UTI in young, sexually active, ambulatory women 3.) Klebsiella (8-10%)
75
Common causes of UTI in a hospital setting
E. coli Proteus Klebsiella Serratia Pseudomonas
76
Gender and epidemiology of UTIs
10:1 women to men (b/c of short urethra colonized by fecal flora)
77
Predisposing factors to UTIs
Flow obstruction Kidney surgery Catheterization Gynecologic abnormalities Diabetes Pregnancy
78
Mechanisms of UTI infxn
Mostly caused by ascending infxns. In males: babies w/ congenital defects, elderly w/ enlarged prostates
79
Sx of UTI
Dysuria Frequency Urgency Suprapubic pain
80
Sx of Pyelonephritis
Fever Chills Flank pain CVA tenderness (costovertebral angle -- tender above kidneys on back)
81
UTI bugs: Serratia maracescens Features?
Some strains produce a red pigment; often nosocomial and drug-resistant.
82
Features: Some strains produce a red pigment; often nosocomial and drug-resistant. Which UTI bug is this?
Serratia maracescens
83
UTI bugs: Staphylococcus saprophyticus Features?
2nd leading cause of community-acquired UTI in sexually active women.
84
Features: 2nd leading cause of community-acquired UTI in sexually active women. Which UTI bug is this?
Staphylococcus saprophyticus
85
UTI bugs: Escherichia coli Features?
Leading cause of UTI. Colonies show metallic sheen on EMB agar.
86
Features: Leading cause of UTI. Colonies show metallic sheen on EMB agar. Which UTI bug is this?
Escherichia coli
87
UTI bugs: Enterobacter cloacae Features?
Often nosocomial and drug resistant.
88
Features: Often nosocomial and drug resistant. Which UTI bug is this?
Enterobacter cloacae
89
UTI bugs: Klebsiella pneumoniae Features?
Large mucoid capsule and viscous colonies
90
Features: Large mucoid capsule and viscous colonies Which UTI bug is this?
Klebsiella pneumoniae
91
UTI bugs: Proteus mirabilis Features?
Motility cuases swarming on agar. Produces urease; associated w/ struvite stones.
92
Features: Motility cuases swarming on agar. Produces urease; associated w/ struvite stones. Which UTI bug is this?
Proteus mirabilis
93
UTI bugs: Pseudomonas aeruginosa Features?
Blue-green pigment and fuity odor. Usually nosocomial and drug-resistant.
94
Features: Blue-green pigment and fuity odor. Usually nosocomial and drug-resistant. Which UTI bug is this?
Pseudomonas aeruginosa
95
List of UTI bugs
SSEEK PP S erratia marcescens S taphylococcus saprophyticus E scherichia coli E nterobacter cloacae K lebsiella pneumoniae P roteus mirabilis P seudomonas aeruginosa
96
Diagnostic markers of UTI
Leukocyte esterase: (+) = bacterial Nitrite test: (+) = Gram(-) organism
97
ToRCHeS infxns What are they? List?
These important infxns are transmitted in utero or during vaginal birth: T oxoplasma gondii o R ubella C MV H IV H SV-2 e S yphilis
98
Other important congenital infxns that do not fit into ToRCHeS
Listeria E. coli Group B streptococci All can be acquired placentally or from birth canal.
99
ToRCHeS infxns, organism: Toxoplasma gondii Major clinical manifestations?
Classic triad of chorionitis, intracranial calcifications, and hydrocephalus. May be asymptomatic at birth.
100
Major clinical manifestations: Classic triad of chorionitis, intracranial calcifications, and hydrocephalus. May be asymptomatic at birth. Which ToRCHeS organism is this?
Toxoplasma gondii
101
ToRCHeS infxns, organism: Rubella Major clinical manifestations?
Deafness Cataracts Heart defects (PDA, pulmonary artery stenosis) Microcephaly Mental retardation Blueberry muffin baby due to rash
102
Major clinical manifestations: Deafness Cataracts Heart defects (PDA, pulmonary artery stenosis) Microcephaly Mental retardation Blueberry muffin baby due to rash Which ToRCHeS organism is this?
Rubella
103
ToRCHeS infxns, organism: CMV Major clinical manifestations?
Petechial rash Intracranial calcifications Mental retardation Hepatosplenomegaly Microcephaly Jaundice 90% are asymptomatic at birth.
104
Major clinical manifestations: Petechial rash Intracranial calcifications Mental retardation Hepatosplenomegaly Microcephaly Jaundice 90% are asymptomatic at birth. Which ToRCHeS organism is this?
CMV
105
ToRCHeS infxns, organism: HIV Major clinical manifestations?
Hepatosplenomegaly Neurologic abnormalities Frequent infxns
106
Major clinical manifestations: Hepatosplenomegaly Neurologic abnormalities Frequent infxns Which ToRCHeS organism is this?
HIV
107
ToRCHeS infxns, organism: HSV-2 Major clinical manifestations?
Encephalitis Conjuntivitis Vesicular skin lesions Often asymptomatic at birth Most infxns are transmitted during birth thru an infected maternal genital tract.
108
Major clinical manifestations: Encephalitis Conjuntivitis Vesicular skin lesions Often asymptomatic at birth Most infxns are transmitted during birth thru an infected maternal genital tract. Which ToRCHeS organism is this?
HSV-2
109
ToRCHeS infxns, organism: Syphilis Major clinical manifestations?
Cutaneous lesions Hepatosplenomegaly Jaundice Saddle nose Saber shins Hutchinson teeth CN VIII deafness Rhinitis (snuffles)
110
Major clinical manifestations: Cutaneous lesions Hepatosplenomegaly Jaundice Saddle nose Saber shins Hutchinson teeth CN VIII deafness Rhinitis (snuffles) Which ToRCHeS organism is this?
Syphilis
111
Red rashes of childhood
Measles Rubella HHV-6 (roseola) Scarlet fever (group A streptococcus) Parvovirus B19 (slapped cheek rash, erythema infectiosum) VZV (Chickenpox), Coxackievirus type A (Hand-foot-mouth)
112
STD's: Gonorrhea Organism? Clinical features?
Neisseria gonorrhoeae Urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, creamy purulent discharge
113
Neisseria gonorrhoeae Urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, creamy purulent discharge Disease?
Gonorrhea
114
STD's: Primary syphilis Organism? Clinical features?
Treponema pallidum Painless chancre
115
Treponema pallidum Painless chancre Disease?
Primary syphilis
116
STD's: Secondary syphilis Organism? Clinical features?
Treponema pallidum Fever, lymphadenopathy, skin rashes, condylomata lata
117
Treponema pallidum Fever, lymphadenopathy, skin rashes, condylomata lata Disease?
Secondary syphilis
118
STD's: Tertiary syphilis Organism? Clinical features?
Treponema pallidum Gummas (a non-cancerous growth, a form of granuloma) Tabes dorsalis General paresis Aortitis Argyll Robertson pupil
119
Treponema pallidum Gummas (a non-cancerous growth, a form of granuloma) Tabes dorsalis General paresis Aortitis Argyll Robertson pupil Disease?
Tertiary syphilis
120
STD's: Genital herpes Organism? Clinical features?
HSV-2 Painful penile, vulvar, or cervical ulcers; can cause systemic Sx such as: fever, HA, myalgia
121
HSV-2 Painful penile, vulvar, or cervical ulcers; can cause systemic Sx such as: fever, HA, myalgia Disease?
Genital herpes
122
STD's: Chlamydia Organism? Clinical features?
Chlamydia trachomatis (D-K) Urethritis, cervicitis, conjunctivitis, Reiter's syndrome, PID
123
Chlamydia trachomatis (D-K) Urethritis, cervicitis, conjunctivitis, Reiter's syndrome, PID Disease?
Chlamydia
124
STD's: Lymphogranuloma venereum Organism? Clinical features?
Chlamydia trachomatis (L1-L3) Ulcers, lymphadenopathy, rectal strictures.
125
Chlamydia trachomatis (L1-L3) Ulcers, lymphadenopathy, rectal strictures. Disease?
Lymphogranuloma venereum
126
STD's: Trichomoniasis Organism? Clinical features?
Trichomonas vaginalis Vaginitis Strawberry-colored mucosa
127
Trichomonas vaginalis Vaginitis Strawberry-colored mucosa Disease?
Trichomoniasis
128
STD's: AIDS Organism? Clinical features?
HIV Opportunistic infxns, Kaposi's sarcoma, lymphoma
129
HIV Opportunistic infxns, Kaposi's sarcoma, lymphoma Disease?
AIDS
130
STD's: Condylomata accumulata Organism? Clinical features?
HPV 6 and 11 Genital warts, koilocytes
131
HPV 6 and 11 Genital warts, koilocytes Disease?
Condylomata accumulata
132
STD's: Hepatitis B Organism? Clinical features?
HBV Jaundice
133
HBV Jaundice Disease?
Hepatitis B
134
STD's: Chancroid Organism? Clinical features?
Haemophilus ducreyi (it's so painful, you do cry ) Painful genital ulcer, inguinal adenopathy.
135
Haemophilus ducreyi (it's so painful, you do cry ) Painful genital ulcer, inguinal adenopathy. Disease?
Chancroid
136
STD's: Bacterial vaginosis Organism? Clinical features?
Garnderella vaginalis Noninflammatory, malodorous discharge (fishy smell) Positive whiff test Clue cells
137
Garnderella vaginalis Noninflammatory, malodorous discharge (fishy smell) Positive whiff test Clue cells Disease?
Bacterial vaginosis
138
Top bugs that cause Pelvic inflammatory dz
Chlamydia trachomatis (subacute, often undiagnosed) Neisseria gonorrhoeae (acute, high fever) Chlamydia trachomatis (the most common STD in the USA: 3-4milliion cases/year)
139
Signs and Sx's of Pelvic inflammatory dz
Cervical motion tenderness (chandelier sign) Purulent cervical discharge. May include: Salpingitis, endometritis, hydrosalpinx, and tubo-ovarian abscess.
140
Pelvic inflammatory dz can lead to... ?
Fitz-Hugh-Curtis Syndrome: infxn of the liver capsule and violin string adhesions of parietal peritoneum to liver.
141
What is salpingitis a risk factor for?
Ectopic pregnancy Infertility Chronic pelvic pain Adhesions
142
Other STD's that cause PID
Garnderella (clue cells) Trichomonas (corkscrew motility on wet prep)
143
Nosocomial pathogen: CMV, RSV Risk factor?
Newborn nursery
144
Risk factor for a nosocomial pathogen: Newborn nursery
What is the pathogen? CMV, RSV
145
Nosocomial pathogen: E. coli, Proteus mirabilis Risk factor?
Urinary catheterization
146
Risk factor for a nosocomial pathogen: Urinary catheterization What is the pathogen?
E. coli, Proteus mirabilis
147
Nosocomial pathogen: Pseudomonas aeurginosa Risk factor?
Respiratory therapy equipment
148
Risk factor for a nosocomial pathogen: Respiratory therapy equipment What is the pathogen?
Pseudomonas aeurginosa
149
Nosocomial pathogen: HBV Risk factor?
Work in renal dialysis unit
150
Risk factor for a nosocomial pathogen: Work in renal dialysis unit What is the pathogen?
HBV
151
Nosocomial pathogen: Candida albicans Risk factor?
Hyperalimentation
152
Risk factor for a nosocomial pathogen: Hyperalimentation What is the pathogen?
Candida albicans
153
Nosocomial pathogen: Legionella Risk factor?
Water aerosols
154
Risk factor for a nosocomial pathogen: Water aerosols What is the pathogen?
Legionella
155
The 2 most common causes of nosocomial infxns?
E. coli (UTI) S. aureus (wound infxn)
156
Presume Pseudomonas aeruginosa as the cause of a nosocomial infxn when...?
Presume Pseudomonas AIR uginosa when AIR or burns are involved.
157
When do you suspect Legionella as a cause of nosocomial infxn?
Suspect Legionella when a water source is involved.
158
Bug hints (if all else fails):Pus, empyema (collection of pus in pre-existing anatomical cavity), abscess What is the bug?
S. aureus
159
Bug hints (if all else fails):Pediatric infxn What is the bug?
haemophilus influenzae (including epiglottitis)
160
Bug hints (if all else fails):Pneumonia in CF, burn infxn What is the bug?
Pseudomonas aeruginosa
161
Bug hints (if all else fails):Branching rods in oral infxn What is the bug?
Actinomyces israellii
162
Bug hints (if all else fails):Traumatic open wound What is the bug?
Clostridium perfringens
163
Bug hints (if all else fails):Surgical wound What is the bug?
S. aureus
164
Bug hints (if all else fails):Dog or cat bite What is the bug?
Pasteurella multocida
165
Bug hints (if all else fails):Currant jelly sputum What is the bug?
Klebsiella
166
Bug hints (if all else fails):Sepsis/meningitis in newborn What is the bug?
group B strep
