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IBI Test 2 > B3-054 Ear Infection Pathogens > Flashcards

B3-054 Ear Infection Pathogens Flashcards

1
Q

primary otalgia

A

abnormal ear exam

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2
Q

do the inner ear structures cause pain in primary otalgia?

A

no

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3
Q

secondary otalgia

A

normal ear exam

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4
Q

do the inner ear structures cause pain in secondary otalgia?

A

yes, referred pain

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5
Q

causes of otitis media

A

recent UTRI-winter
red/cloudy and immobile tympanic membrane

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6
Q

causes of otitis externa

A

swimmer’s ear-summer
ear bud use
white discharge

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7
Q

common causes of secondary otalgia

A

dental caries, periodontal abscessess
pharyngitis, tonsilits

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8
Q

what characterizes malignant (necrotizing) otitis externa?

A

painful, granulation tissue

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9
Q

what characterizes malignant (necrotizing) otitis externa?

A

painful, granulation tissue

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9
Q

what characterizes malignant (necrotizing) otitis externa?

A

painful, granulation tissue

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10
Q

what population is concerning for malignant (necrotizing) otitis externa?

A

diabetes, elderly, immunocompromised

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11
Q

ramsay hunt is caused by

A

herpes zoster oticus

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12
Q

vesicular rash
vertigo, hearing loss, tinnitus

A

ramsay hunt

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13
Q

similar to otitis media, but no tympanic membrane bulging

A

viral myringitis

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14
Q

common pathogens causing otitis media

A

S. pneumoniae
H. influenzae
M. catarrhalis
S. pyogenes

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15
Q

common pathogens causing otitis externa

A

S. epidermis
P. aeruginosa
S. aureus

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16
Q

H. influenzae is gram _______

A

negative

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17
Q

shape of H. influenzae

A

coccobacilli

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18
Q

What strain of H. flu is the most virulent?

A

type B (HiB)

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19
Q

NTHi _______ cause invasive disease

A

rarely

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20
Q

Hib colonizes the

A

oropharynx

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21
Q

Virulence factors Hib

A

fimbriae
IgA protease
LPS

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22
Q

Hib capsule is made of

A

polyribosylribitol phosphate (PRP)

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23
Q

Hib vaccine is a conjugate vaccine consisting of _______

A

PRP

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24
Q

PRP allows H flu to spread to

A

joints
meninges, CNS

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25
Q

LPS from Hib causes

A

disseminated disease (meningitis)

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26
Q

Hib vaccine is purified PRP conjugated to

A

carrier proteins

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26
Q

Hib vaccine is purified PRP conjugated to

A

carrier proteins

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27
Q

combination vaccines for Hib

A

DTap-Hib and Hepatitis B-Hib

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28
Q

the Hib vaccine contain _______ antigens

A

t cell dependent

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29
Q

the Hib vaccines is given at what ages?

A

2-18 months

**prior to two months, maternal antibodies are protective

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30
Q

the Hib vaccine is not recommended >5 years of age. What are the exceptions?

A

sickle cell, aspenia, immunodeficiency, HIV infections

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31
Q

Hib can be diagnosed via a gram stain of ______

A

CSF or synovial fluid

32
Q

Hib can be diagnosed via antigen detection for

A

PRP

33
Q

Hib is grown on _____ agar

A

chocolate

34
Q

Hib requires media containing

A

NAD (factor V)
Hemattin (factor X)

35
Q

Hib can be grown on blood agar with ________ due to its ____ hemolytic properties

A

S. aureus; beta

36
Q

NTHi lacks

A

a capsule

37
Q

NTHi is a common cause of [3 diseases]

A

otitis media
sinusitis
pneumonia

38
Q

NTHi causes a _______ spread

A

localized

39
Q

is penicillin a good treatment for H. Flu?

A

no, growing resistance

40
Q

treatment for invasive H. flu (menigitis)

A

ceftriaxone

41
Q

pseudomonas is gram

A

negative

42
Q

is pseudomonas motile?

A

yes

43
Q

what is the oxygen dependency of pseudomonas?

A

obligate aerobes

44
Q

where is pseudomonas found?

A

everywhere; ubiquitous

45
Q

common nosocomial pathogen

A

psuedomonas

46
Q

pseudomonas commonly infects [4]

A

skin, pulmonary, outer ear, eye

47
Q

capsule of pseudomonas aeruginosa is called

A

alginate

48
Q

what contributes to the antibiotic resistance of . aeruginosa?

A

alginate capsule

antiphagocytic and adhesive

49
Q

alginate is made of

A

polymer of mannuronic and glucuronic acid

50
Q

in virtro p. aeruginosa is

A

smooth and pigmented

Flagella +, pilli +, alginate negative

51
Q

in a CF lung, P. aeruginosa is

A

mucoid colonies of highly encapsulated bacteria

Flagella-, Pili-, Alginate+

52
Q

production of alginate is

A

highly regulated, environmental

53
Q

alginate is produced at high levels

A

in CF lungs

54
Q

P. aeruginosa: Exotoxin A

A

ADP ribosylates EF-2 affecting protein synthesis

AB toxin

55
Q

P. aeruginosa: Exotoxin S

A

T3SS, blocks phagocytosis

56
Q

P. aeruginosa: Exotoxin U

A

cytotoxic to macrophages

57
Q

P. aeruginosa elastase

A

degrades elastin

regulated by quorum sensing

58
Q

P. aeruginosa: infections in otherwise healthy

A

hot tub folliculitis
otitis externa “swimmer’s ear”
eye infection related trauma

59
Q

default treatment of P. aeruginosa

A

ear drops

60
Q

if the TM is ruptured

A

no neomycin eardrops

61
Q

P. aeruginosa otitis externa prevention

A

alcohol ear drops

62
Q

in diabetic, P. aeruginosa can cause _________ which spreads to surrounding tissues

A

malignant otitis externa

63
Q

when would you expect to see pseudomonas colonize a wound in a burn patient?

A

> 2 weeks later

64
Q

P. aeruginosa is extremely prevalent in what patient population?

A

Cystic fibrosis

65
Q

P. aeruginosa can form a ________

A

biofilm

66
Q

CF antibiotic therapies select for

A

highly resistant organisms

67
Q

80-90% of CF patients are colonized with P.A by age

A

3

68
Q

symptoms of P.A. pneumonia

A

fever, chills, dyspnea, cyanosis, productive cough

69
Q

What patient populations are most as risk for P.A. pneumonia?

A

ICU patients and nursing home residents

70
Q

P.A. is catalase

A

positive

71
Q

P.A is oxidase

A

positive

72
Q

what color colonies are associated with P.A?

A

blue-gree

73
Q

what is the blue antibiotic pigment in P.A.

A

pyocyanin

**cytotoxic, causes oxidative stress

74
Q

P.A.: Fluroscein is what color

A

yellow

75
Q

fruity smell (grapes, tortillas)

A

P.A.

76
Q

Pyocyanin causes

A

low ATP
low NADPH

77
Q

because pyocyanin causes oxidative stress, it greatly affects what cell type

A

neutrophils

78
Q

initial empiric combination treatment for P.A

A

antipseudomonal B-lactam + B-lactamase inhibitor + aminoglycoside

(ex. piperacillin, tazobactam, and tobramycin)

79
Q

P.A. monotherapy is based on

A

local susceptibility patterns

80
Q

last resort for P.A.

A

colistin (solubilizes bacterial membrane)

IBI Test 2 (14 decks)

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