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EENT/ID > Bacteria > Flashcards

Bacteria Flashcards

1
Q

define pathogen

A

micoorganism capable of causing disease

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2
Q

define opportunistic

A

rarely causes disease in immunocompetent individuals but can cause severe disease in those with weakened immune response

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3
Q

define bacteremia

A

bacteria in the bloodstream

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4
Q

define sepsis

A

systemic immune response to the infection

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5
Q

define septic shock

A

hypotension, organ dysfunction
- common deadly response to gram positive & negative infections
- high mortality rate

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6
Q

Define gram results

A

purple/blue = gram positive
- thick 2 layer cell wall
- no porin channel or endotoxin
- vulnerable to lysozyme & PCN

pink/red = gram negative
- thin 3 layer cell wall envelope with porin channel
- endotoxin-Lipid A
- resistant to lysozyme & PCN

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7
Q

Describe the coverage & MOA of Beta-Lactams

A

PCN, cephalosporins (3-5 gen), carbapenems
- inhibit cell wall synthesis
- cover gram negative bacteria

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8
Q

What are the 4 major morphologies of bacteria

A
  • cocci: spherical
  • bacilli: rod shaped
  • spiral
  • pleomorphic: lack distinct shape

can organize together to form pairs, clusters, chains, single bacteria with flagella

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9
Q

Describe some bench tests

A

used to further differentiate species
- coagulase test: differentiates staph species
- catalase tests: distinguishes staph v strep v enterococci
- oxidase: differentiates gram negative bacilli
- lancefield grouping: used for strep species

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10
Q

Describe some gram positive bacteria

A
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11
Q

Describe some gram negative bacteria

A

cocci
- neiserria
- moraxella diplococcus

spirochetes
- treponema pallidum
- borrelia
- leptospira

pleomorphic
- chlamydia
- rickettsia

bacilli/rods
- pretty much everything else (enterics & others)

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12
Q

Which bacteria is neither gram positive or negative?

A

Mycoplasma, no cell wall

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13
Q

What is referred to as walking pneumonia

A

mycoplasma pneumonia
- MC cause of atypical pneumonia
- low grade F, dry non-productive cough
- Tx with Azithromycin, doxy, or fluoroquinolone

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14
Q

What are some AEs of fluoroquinolones

A

QT prolongation, cartilage issues

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15
Q

Describe the difference between aerobic vs anaerobic bacteria

A

Obligate Aerobes
- uses oxygen
- breaks down oxygen with enzymes

Obligate anaerobes
- hates oxygen
- no enzymes to defend against oxygen

Facultative anaerobes
- aerobics
- ability to be anaerobic but don’t prefer it

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16
Q

Describe endotoxins

A

proteins released by some Gm+ and Gm- bacteria

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17
Q

describe neurotoxins

A

acts on nerves (paralysis
- tetanus, botulinum

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18
Q

describe enterotoxins

A

acts on GI tract (diarrhea)
- vibrio, e coli, campylobacter, shigella

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19
Q

describe pyrogenic endotoxins

A

lead to rash, fever, toxic shock
- staph aureus, GABHS

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20
Q

Describe tissue evasive endotoxins

A

allow bacteria to destroy tissues (GABHS)

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21
Q

Which abx lower seizure thresholds

A

cephalosporins

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22
Q

Describe a sterile site vs non-sterile site for cultures

A

differentiates if this is a true pathogen or part of the normal flora
- sterile: CSF, pleural fluid, pericardial fluid, synovial fluid, peritoneal fluid (where bacteria is not present usually)
- non-sterile: skin, oropharynx, nose, ears, eyes, throat, perineum

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23
Q

What to consider when interpreting a culture result

A
  • coag negative staph (usually just staph epidermidis - skin contaminant from procedure)
  • assess for WBCs, nitrites, leukocyte esterase in UA along with culture
  • sputum culture with poor sensitivity & specificity
  • squam epithelial cells present reduces likelihood that bacteria is pathogenic
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24
Q

What is the most common organism that causes UTIs

A

e coli

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25
Q

What are the 3 types of gram+ cocci

A

streptococcus chains, enterococcus chains, staphylococcus clusters

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26
Q

Describe the types of hemolysis in streptococci (classifications)

A
  • Alpha-hemolytic: incomplete destruction of RBC (strep pneum, strep viridans)
  • Beta-hemolytic: complete destruction of RBC (strep pyogenes, GABHS, GBBHS, GDBHS)
  • gramma-hemolytic: no destruction of RBC
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27
Q

Which strep viridans species causes dental caries

A

strep mutans

28
Q

What pathologies does strep pneumoniae cause

A

pneumonia, meningitis, otitis media

29
Q

What pathologies does strep viridians cause

A

subacute bacterial endocarditis, dental caries, brain or liver abscess

30
Q

What pathologies does GABHS (strep pyogenes) cause

A

pharyngitis, scarlet fever, skin infections, toxic shock syndrome, non-suppurative complications

31
Q

What are the Jones criteria for acute rheumatic fever diagnosis

A

need 2 major OR one major & two minor sxs

Major: carditis, arthritis, sydenham chorea, erythema marginatum, subQ nodules

Minor: fever, arthralgia, previous RF or rheumatic heart disease, acute phase reactions, prolonged PR interval

32
Q

What do you treat rheumatic fever with

A

PCN or cephalosporin

Macrolides if PCN allergy

(early tx of strep is key to prevention, recurrence is common)

33
Q

What pathologies does GBBHS cause

A

think B for baby - newborn/neonates

Neonatal meningitis, pneumonia, sepsis

34
Q

What pathologies does GDBHS cause

A

subacute bacterial endocarditis, biliary tract infections, UTIs

35
Q

What do you treat GDBHS with

A

ampicillin + aminoglycoside (severe)

Ampicillin, amoxicilli for E Faecalis UTI

Treat with Vanco if resistent

36
Q

Describe the MOA, coverage, and AEs for vancomycin

A

MOA: inhibits cell wall synthesis (not a beta lactam)

Coverage: gram+, MRSA, c. diff

AEs: nephrotoxic, red man syndrome (slow infusion can avoid)

37
Q

What do you treat VRE with

A

vancomycin resistant enterococcus

daptomycin or linezolid

38
Q

Which gram+ staphylococci are coagulase positive v negative

A

Coag positive: staph aureus
Coag negative: staph epidermidis, staph saprophyticus

39
Q

Which pathologies does staph aureus cause

A
  • acute bacterial endocarditis
  • osteomyelitis
  • pneumonia
  • septic arthritis
  • skin infections
  • blood & catheter infections
  • Toxic shock syndrome
40
Q

What pathologies does staph epidermidis cause

A

UTI in sexually active, pathogenic in prosthetic joints & heart valves

41
Q

What are the 2 classes of MRSA and how do you treat skin/soft tissue infections

A

HA-MRSA & CA-MRSA (hospital vs community acuired)

Tx with oral abx: SMX-TMP, tetracycline, clindamycin

Tx with parenteral abx: vanco, dapto

42
Q

What is an example of an acid0fast gram+ bacilli

A

mycobacterium

43
Q

Describe the etiology & treatment of bacillus antracis

A

anthrax
- only bacteria with a capsule made of protein, aerobe, forms endospores, makes exotoxins

Treat with cipro or another FQ, antitoxin (prognosis excellent for cutaneous, poor for inhaled/GI anthrax)

44
Q

Describe the etiology of clostridium botulinum

A

botulism
- produces extremely lethal neurotoxins that block Ach release
- foodborne, infant spores in honey, wound injection site

45
Q

Describe the clinical presentation & treatment of botulism

A
  • symmetric descending weakness
  • CN dysfunction: diplopia, nystagmus, ptosis, dysphagia, dysarthria, facial weakness
  • respiratory paralysis
  • no mental status change
  • floppy baby syndrome

Treat with antitoxin from the CDC, intubation, supportive care

46
Q

Describe the etiology of tetanus

A

Clostridium tetani

Classically follows a puncture wound by rusty nail

Spores deposited in the wound & endotoxin released

47
Q

Describe the clinical presentation of tetanus

A

Pain & tingling at site of inoculation, sustained contraction of skeletal muscles, severe muscle spasm, trismus, grinning expression, death

48
Q

Describe the treatment for tetanus

A

IM tetanus immunoglobulin, supportive care, mechanical ventilation

PCN

49
Q

Describe the etiology of clostridioides difficile

A

Aka c diff

Common nosocomial infection, typically follows use of broad spectrum abx (ampicillin, clindamycin, FQs, cephalosporins)

Releases exotoxins

50
Q

Describe the diagnostic testing for C. diff

A

CBC - leukocytosis

Toxin testing in stool

Colonoscopy may reveal red inflamed mucosa & areas of white exudate (pseudomembranes)

51
Q

Describe the treatment for c. diff

A

D/c original antibiotic, infection control

Oral vancomycin or fidaxomicin

+/- fecal microbiota transplantation

52
Q

Describe the etiology of diphtheria

A

Cornybacterium diphtheria

Transmitted by respiratory secretions & colonizes pharynx, releases exotoxins

53
Q

Describe the clinical presentation of diphtheria

A

Gray pseudomembrane that bleeds when picked, myocarditis & neuropathy d/t exotoxins in bloodstream

54
Q

Describe the treatment for diphtheria

A

Horse serum antitoxin

PCN or azithromycin/ erythromycin, DPT vax

55
Q

Describe the clinical presentation of syphilis

A

Primary: painless chancre on genitals

Secondary: rash on palms & soles, condyloma latum (wart), Systemic sxs: fever & LAD, may affect CNS, eyes, bones, kidneys, joints

Tertiary: develops over 6-40 years, gummas of skin & bond, CV (aortic aneurysm), neurosyphilis

Latent: sxs resolved, serologic testing still positive

56
Q

What is the treatment for syphilis

A

PCN G (Benzathine) IM x1

57
Q

Describe the clinical presentation of lyme

A

Stage 1: localized
- erythema migrans rash

Stage 2: disseminated
- smaller rashes
- neuro: meningitis, CN palsies, peripheral neuropathy
- cardiac: myocarditis
- arthritis: brief, large joints

Stage 3: late stage
- chronic arthritis
- encephalopathy

58
Q

What is the treatment for lime

A

doxycycline

59
Q

Describe the etiology of rocky mountain fever

A

Rickettsia rickettsii

Obligate intracellular parasite

More common in SE US

60
Q

Describe the clinical presentation of rocky mountain spotted fever

A

Presents 1 week after bite from wood tick or dog tick

Fever, conjunctival redness, severe HA, rash on palms, soles & wrists moving to ankles & trunk

61
Q

What is the treatment for rocky mountain spotted fever

A

prompt doxycycline

62
Q

Describe the etiology of pertussis/Whooping Cough

A

Bordatella pertussis

highly contagious

63
Q

Describe the clinical presentation of pertussis

A

Stage 1: Catarrhal, gradual onset of cough mostly at night, cold sxs, most infectious stage

Stage 2: paroxysmal, classic whoop

Stage 3: convalescent, decrease in frequency & severity of sxs, usually 4 weeks after onset

64
Q

Describe the diagnostic testing of pertussis

A

nasopharyngeal swab & culture

65
Q

describe the treatment for pertussis

A

Macrolide - Azithromycin, treat household contacts

66
Q

What is the treatment for legionnaire’s disease

A

Azithromycin

EENT/ID (15 decks)

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