Bacterial Flashcards

1
Q

2 countries with highest Leprosy

A

Brazil, India

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2
Q

2 rickettsia with higher mortality (40% UnTx)

A

RMSF

epidemic typhus

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3
Q

3 spirochetes

A

lepstospirosis, treponema, Borrelia

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4
Q

3 typhus types: disease, agent, vector

A

Epidemic- R. prowazekii- Louse

Scrub- O. tsutsu- Mites/chiggers

Murine- R. typhi- flea

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5
Q

acute watery diarrhea causes CCERN

A

rotovirus, norovirus, cholera, cryptosporidium, ETEC

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6
Q

African Tick Borne Fever- agent, vector, skin

A

R. africae

tick

eschar, often vesicular rash

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7
Q

Anthrax- agent, micro, bioterror, transmission, incubation max, Sx, Tx, special

A

Bacilius anthracis

gram pos rod

1

arerosol, contect, ingest

typical 1-7 d but pulmonary up to 43 day

95% cutaneous- painless eschar with edema and satellite vesicles, Do NOT debride

Inhalation- mortality up to 90%; Hemorrhagic mediastinal lymphadenitis (wide mediastinum)

GI- dysentery, ascites, sepsis (mortality > 50%)

Cipro (doxy, amp)- use 2 agents

Resistant to EtOH

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8
Q

Bacillary angiomatosis- agent, pt, Sx, Tx

A

B. henselae and B. Quintana

immunocompromised

vascular lesions, may ulcerate

doxy/macrolide

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9
Q

Bacillus anthracis- micro, portal (3), 2 findings, Dx (3), Tx, proph, mortality

A

gram pos rod

cutaneous (most), GI, inhalation

painless ulcer with lots edema and vesicles; widened mediastinum

culture, biopsy, serology

quinolone (multidrug)

doxy exposure prophylaxis for 60 days; PEP

20% UnTx cutaneous, 90% pulmonary

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10
Q

Bacterial diarrhea needing ABx

A

ETEC, EAEC, Shigella

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11
Q

Bartonella vectors

A

bacilliformis- sandfly

hensaleae- flea

quintana- louse

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12
Q

Bartonella- micro, 3 types, vectors and Sx

A

gram neg rod flagella intracellular

B. bacilloformis – bartonellosis (Oroyo, Verruga peruana- Carrion dz) in Andes, sand-fly; Tx chloramp + PCN

B. henselae- flea, cat scratch (zithro), bacillary angiomatosis (HIV), endocarditis (culture negative)

B. quintana- trench fever due louse (doxy), endocarditis, bacillary angiomatosis

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13
Q

Bartonellosis- agent, vector, 2 forms dz, Tx

A

B. Bacilliformis

sand fly

Oromo and Verruga peruana

Chloramphenicol and PCN

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14
Q

BCG partial protection against 3

A

TB, Bureli ulcer, leprosy

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15
Q

bejel- cause, Sx

A

endemic syphilis

ulcers of lips and oropharynx

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16
Q

Best culture source for S. typhi

A

bone marrow

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17
Q

Bioterror categories

A

A- airborne, sturdy, easily grown; e.g. anthrax, small pox, plague, tularemia, ebola, botulism (P. BATES)

B- moderately easy to produce, moderate Sx; e.g. Q-fever, brucellosis, ricin, glanders, meliodosis, typhus, staph, salmonella, shigella, E. coli O157:H7, cholera

C- more difficult to produce and distribute

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18
Q

Botulism- agent, micro, transmission, incubation max, Sx, Tx

A

Clostridium botulinum toxin

gram pos rod

aerosol, ingest

10 days max

Neuro- CN, descending paralysis, pupils fixed/dilated, autonomic dysfxn

Supportive, equine antitoxin

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19
Q

Brucellosis- micro, source, Dx, Tx

A

gram neg intracellular coccobacilli

dairy, meat, hunting/skin, inhalation

Cx- esp marrow or tissue

doxy, rifampin, bactrim

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20
Q

Brucellosis- source, Sx, Tx

A

animal milk, urine, afterbirth; labs (many farm animals)

Arthritic, Miscarriage. Orchitis. Heptatis, Peritonitis,

Meningitis, Endocarditis (most mortality)

PO doxy + rifampicin AND 2 wks streptomycin or gent

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21
Q

Bubonic plague- agent, frequency, Sx, Tx, prophylaxis

A

Yersinia pestis

90%

Bubos, LAD, fever, sepsis UnTx

streptomycin

doxy and cipro

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22
Q

bubos can be caused by (3)

A

Bubonic plague

Lymphgramuloma venereum

Chancroid

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23
Q

Campylobacter- kids in developing vs developed

A

developing may have multiple

developed more inflammatory

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24
Q

Campylobacter- 2 main strains, micro, source, season, classic Sx, complication, Tx

A

C. jejuni (more industrialized) and C. coli

spiral neg rod with flagella

food (chicken), animal (no P2P)

more dry season

bloody stool, mimic appy

Guillian-Barre

ABx only IF high risk

highest identified travel diarrhea

fewer outbreaks in developing due to some immunity

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25
can present as either watery or bloody diarrhea
shigella and campylobacter
26
Cat scratch disease- agent, Sx, Tx
B. henselae papule, LAD may suppurate zithro (doxy and gent if neuro or retino)
27
Cat scratch- agent, vector, Tx
B. henselae flea zithro
28
Cats assoc with- saliva (4), fecal (8), aerosol (1), direct (2)
saliva- bartonella, pasturella, rabies, tularemia fecal- salmonella, campy, giardia, toxocara, echinococcus, toxoplasma, ancylostoma, dipylidium aerosol- coxiella (Q) direct- sporothrix, microsporum canis
29
Most common cause of necrotizing fasciitis
Group A BHS
30
Chancroid- agent, micro, Sx, Tx
H. ducreyi gram neg rod painful ulcer and bubos zithro, roceph, cipro, erythro
31
Chancroid- agent, Sx, Tx (3)
Haemophilus ducreyi, gram neg rod genital ulcer, bubos zithro, EES, Cipro
32
Chlamydia- micro, tx, serovars
gram neg intracellular zithro, doxy A-C -\> blindness D-K -\> STD L -\> lymphogranuloma venereum
33
Cholera- agent, host, gram, source, Sx, Tx, Cx, prevention
Vibrio cholera, El Tor strain man gram neg bacilli with flagella water, fish, shellfish, produce Sx rice water diarrhea; rare fever or pain Tx: hydration, optional ABx (doxy, TTC) Cary-Blair, tellurite or bile salts 2 oral vaccines outside US
34
clofazine for leprosy- effect, SE
bacteriostatic SE: transient blue skin, itch, constipation
35
Clostridia perfringens spores- diagnostic amt in stool, killed by
feces \>106 spores per gram of stool cooking
36
Clostridum tetani micro
Gram positive rod, drumstick appearance
37
Coxiella burnetii- micro, bio terror category, source, complications (3), Tx
Intracellular rod Cat B Animals- inhale, contact Endocarditis, OB complications, persistent localized Doxy, bactrim for preg, kids
38
Cryptosporidium- person
infants, immunocompromised
39
Cryptospridium- size, pt type, source, resistant, incubation, Sx, Dx, Tx
5 microns Infants, immunocompromised Fecal-oral: soil, food, water; autoinfective RESISTANT chlorine Both sexual and asexual reporduction Incubation 1 wk Sx: watery diarrhea, weight loss, abdominal pain, fever, N+V Stool AFB/modified ZN stain, DFA, Ag test Most Sx resolve in 10-14 d Nitrazoxanide - reduces oocyst shedding No swimming for 2 weeks after Sx resolved
40
Culture media for Francisella tularensis
Buffered Charcoal Yeast Extract (BCYE)
41
dapsone for leprosy- effect, SE (3)
bacteriostatic check G6PD SE: methemoglobinemia, neutropenia, neuropathy
42
dapsone special
check G6PD
43
diarrheal infections causing HUS
shigella (give ABx), EHEC (avoid ABx)
44
diarrheal infections NOT requiring ABx
salmonella, EHEC, yersinia
45
diphtheria transmission
P2P, droplet, rare fomite
46
Dogs assoc with saliva (3), fecal (7), aerosol (2)
saliva- rabies, pasturella, brucella fecal- salmonella, campy, giardia, toxocara, ancylostoma, echinococcus, dipylidium caninum Aerosol- bordetella, Coxiella (Q)
47
Donovanosis (granuloma inguinale)/ agent, micro, Tx
calymmatobacterium (Klebsiella) granulomatis gram neg rod, intracellular, bipolar stain beefy destructive ulcers (no LAD) doxy
48
E. coli micro
gram neg rod fermenting lactose
49
EAEC Sx, Tx, more from..
persistent diarrhea in kids and HIV ABx Latin America
50
EHEC- agent, reservoir, pathogenesis, sx, tx
enterohemorrhagic E. coli (e.g. O157:H7) reservoir is primarily cattle (Shiga-producing E. coli) 1-2 days of watery, then cramping and bloody diarrhea Treatment: antimicrobials are NOT recommended, (increased risk of HUS)
51
EHEC- pathology, Sx, complication, Tx
shiga toxin 50% bloody, significant abd pain HUS supportive; NO ABx (increased risk HUS)
52
Ehrlichia- agents, vectors, target cells, Sx, Tx
E. chaffeensis and E. ewingii- deer and dog ticks Anaplasma phagocytophilum- Ixodes leukocytes Flu, Rash, vomit, meningitis doxy
53
EIEC- sx
bloody dysentery similar shigellosis
54
Entamoeba histolytica- agent, complication
protozoa hepatic abscess
55
enteric fever is due to
salmonella typhi and paratyphi
56
Enteritis necroticans- agent, pt profile
Clostridium perfringens malnutrition, diabetic, neutropenia also known as pigbel
57
EPEC Sx
infant diarrhea
58
Epidemic typhus- agent, vector, skin, special
R. prowazekii louse No eschar Brill-Zinsser recrudescence
59
Erythema nodosum leprosum (ENL)(type 2)- type, cause, Sx, timing, Tx
BL, LL (lepromatous types) Immune complex with vasculitis (type III hypersensitvity), Elevated TNF-alpha New papules/plaques/pustules and tender subq nodules neuritis, orchitis, iriditis, GN, HSM, LAD fever, flu-like before diagnosis or even years after Tx Tx: severe need thalidomide (or clofazimine per WHO) and prednisone
60
eschars can be caused by (5)
Anthrax Staph Tularemia Scrub typhus Rikettsial spotted
61
ETEC Sx, person, Tx
acute watery diarrhea leading cause diarrhea in older kids and adults ABx
62
ethambutol- effect, SE
disrupts cell wall vision vision, hepatotoxic
63
feacal lactoferrin
more sensitive than leokocyte smear for inflammatory diarrhea
64
Flagellated bacteria (5) BCCCS
Bartonella, Clostridium, Campylobacter, Cholera, Salmonella
65
Flea borne rickettsia (3), other bacteria (2), parasite (2)
R. felis R. typhi (murine) Wolbachia piientis B. henslae Y. pestis Parasite: Dipylidium caninum, tungiasis
66
Flea Rickettsiosis- agent, vector
R. felis flea
67
Flinders Island fever- agent, vector
R. honei tick
68
Gram beg coccobacilli
Yersina, Brucella
69
Gram neg cocci (1)
Neisseria
70
Gram negative coco bacilli resembling safety pin
Yersinia
71
Gram pos rod (CALC)
Clostridia, Anthrax, Listeria, Corynebacteria
72
helminth borne rickettsia (2)
Wolbachia Neorickettsia
73
How long is anthrax proph needed?
60 d
74
HUS- Sx (3), causes (3)
triad- thromobytopenia, micro hemolytic anemia, ARF assoc shigella, EHEC, campy
75
HUS related to which infections
Shigella, EHEC, streptococcus in US
76
Incubation on bioterror A- highest, lowest
Anthrax 43 days Tularemia 5 d
77
Infections mimicking appendicitis- 3 bacteria, 4 worms
Yersinia, TB, campylobacter Pinworm, Ascaris, Angiostrongylus, Oesophagostomum
78
infections presenting as eschar
aspergillosis, anthrax, ecthyma gangrenosum, rickettsial, plague, Staph, Tularemia, Scrub typhus
79
intracellular bacteria (BBCCEFMORS)
Brucella, Burkholderia, Coxiella, Chlamydia, Ehrlichia, Francissella, MAC, Orientia, Rickettsia, Salmonella
80
invasive diarrhea causes (7) CEEESSTY
non-typhoidal salmonella, shigella, yersinia, campylobacter, EIEC, EHEC, entamoeba
81
Ioxides tick transmits (3) BELA
Anaplasma/ehrlichiosis, babesiosis and Lyme
82
Isoniazid- effect, SE
inhibit cell wall synthesis hepatitis, neuropathy (take B6)
83
Japanese Spotted Fever- agent, vector
R. japonica tick
84
Leprosy BB type- number, appearance, AFB, special
BB- Borderline Multiple mac, pap, plaque, dome, punched out Satellite lesions Less distinct borders asymmetric AFB readily seen common periph nerves
85
Leprosy BL type- number, appearance, AFB, special
BL- Borderline-lepromatous Multiple macules, papules, nodules Often symmetrical Smooth, shiny Borders may be ill defined Sensation diminished or lost Smear with many bacilli Enlarged periph nerves
86
Leprosy BT type- number, appearance, anesthesia, AFB, special
BT- Borderline tuberculoid Few to multiple patches Vary size Mod-marked anesthesia Some AFB Early neuropathy- may not resolve with Tx Reversal reactions
87
Leprosy indeterminate type- number, appearance, anesthesia, AFB
one or few hypopigmented, undefined edges +/- anesthesia rare AFB
88
Leprosy lesion number
Paucibacillary 1-5 (TT, BT) Multibacillary \> 5 (BB, BL, LL)
89
Leprosy LL type- number, appearance, AFB, special
LL- Lepromatous leprosy Many lesions macule, papule, nodule, infiltration, erythema, hyperpigment Symmetric Anesthesia appears late Neuropathy late erythema nodosum 50%, rare Lucio phenomena Ocular, nasal, testicular Smears very positive
90
leprosy reaction 1 +2- name, hypersensitivity type, leprosy type, fever ?
1 vs 2 reversal vs erythema nodosum type 4 vs type 3 borderline vs lepromatous fever rare vs common
91
Leprosy TT type- number, appearance, anesthesia, AFB, special
tuberculoid- few lesions large, flat, irreg, scaly, hypopig asymmetric anesthesia (5% diag early before rash) AFB rare corneal denervation/lagopthalmos in 10% (unable close eyes)
92
Leprosy type having corneal denervation/lagopthalmos
tuberculoid
93
Leprosy type having erythema nodosum
lepromatous
94
Leprosy types- source, incubation, susceptibility, Sx, Dx
Human reservoir, 9 banded armadillo Incubation up to 20 yrs Only 3-5% of population susceptible Rash with anesthesia 75% sensitive. Also congestion, leonine, Madurosis, ocular, erythema nodosum, nerve hypertrophy skin fluid smear, nasal, skin Bx, nerve Bx -\> AFB bunching into globi
95
leprosy: tuberculoid vs lepromatous
few vs many lesions few vs many AFB early vs late anesthesia asymmetric vs symmetric
96
Leptospirosis- reservoir, entrance, micro, Sx, Tx
rodent reservior, affects mammals (human dead end ) urine, water/soil enter thru skin cute conjunctiva (rare ingest) gram neg spirochete ? fever, HA, conjuntivitis, GI to Weil's disease- liver and renal failure Tx: doxy, zithro, PCN, ceftriaxone
97
Louse borne relapsing fever- agent, geo, Sx, special
Borrellia recurentis- sprochete NE Africa Fever, Bleed, Miscarriage, Myocarditis. Liver failure, Spleen rupture Jarisch-Herxheimer (Acute worsening with Tx)
98
Louse borne rickettsia (1)
R. prowazekii (epidemic)
99
Lucio Phenomenon- type, cause, Sx, Tx
LL Necrotizing vasculitis due to massive load bacteria Diffuse shiny skin infiltration with Madurosis, Looks like burns, loss body hair, anemia, myxedema, bacterial sepsis -\> toxic -\> death Tx- supportive, steroids, treat AFB
100
Lymphogranuloma venereum- agent, micro, Sx, Tx
C. trachomatis gram neg intracellular painless ulcer, bubos doxy, zithro, TTC
101
MAC in HIV, Sx, CXR, Dx
fever, wt loss, LAD, HSM, cytopenias, LFTabnormalities. lack of pulmonary symptoms and normal chest isolation of the organism, most often from blood or bone marrow (granulomas)
102
main dource of leprosy
UnTx multibacillary
103
main source for new leprosy infections
untreated multibacillary in human
104
Mediterranean spotted fever- agent, vector, skin
R. coronii tick eschar
105
Melioidosis- agent, micro, bioterror, source, Sx, Tx, special
Burkholderia pseudomallei gram neg intracellular, bipolar safety pin 3 saprophytic soil, water abcess esp parotid, sepsis, pneumonia IV ceftaz -\> bactrim PO; may be 10 days before defervesce may relapse up to 10 yrs
106
Mite borne rickettsia (2)
R. akari (rickettsial pox) O. tsutsugamushi (scrub)
107
most common bacterial diarrhea in US
Campylobacter
108
most common causes of dysentery- 6 bacteria, 3 parasites
Shigella, Campy, EHEC, salmonella, C. dif, Yersinia E. histolytica, Balantidium coli, schisto
109
most common infectious diarrhea in US? world?
norovirus, rotovirus
110
Murine typhus- agent, vector, skin, special
R. typhi flea NO ESCHAR 25% renal
111
Mycobacterium Avian Complex prophylaxis indication for HIV
CD4 count \<50
112
Mycoplasma genitalium- micro, Tx
gram neg zithro
113
Mycoplasma genitalium- micro, Tx
gram neg zithro
114
Neisseria gonorrhea- agent, Tx
gram neg diplococcus rocephin
115
neonatal tetanus Tx
diazepam IG TT if \> 6 wks Flagyl (alt pen, erythro) quiet, dark
116
non-typhoidal salmonella enterica- source, micro, Sx, Tx
food- FO, P2P gram neg rod with flagella- O somatic and H flagella antigens GI, disseminated in kids, old, immunocompromised NO Abx -\> prolongs shedding
117
O. tsutsugamushi causes
scrub typhus
118
Oroya fever- agent, Sx, Tx
B. bacilliformis fever, anemia, HSM, LAD, possible secondary infection Cipro
119
Painless skin ulcer with surrounding edema
Anthrax
120
Pinta- cause, Sx
treponema papules, plaques, depigmentation
121
Plague- micro, source/transmission, incubation max, Sx, Tx, prevention, high risk
Yersinia pestis, gram neg coccobacilli, bipolar stain aerosol, contact, P2P 19 d max pulmonary- V, D (30% bloody), abd pain, SOB, hemoptysis, shock, 100% fatal UnTx Bubonic- more common, 50% fatal UnTx streptomycin 1st, gent, Cipro, chloramphenicol vaccine available, Cipro proph high iron levels, e.g chronic hemolysis, sickle cell disease, or Beta thalassemia
122
Pneumonia with cavitary lesions- 4 bacteria, 1 worm
TB, S. aureus, Klebsiella, meliodosis, paragonimiasis
123
pyrazinamide- effect, SE
acidify -\> disrupt cell mem; bacteriostatic for TB hepatitis (esp with RIF), avoid in pregnant
124
Q fever- agent, sx, Tx
Coxiella burnetti (intracellular) Flu, hepatitis, Pneumonia, Meningitis, Miscarriage, Chronic fatigue doxy (add hydroxychloroquine for endocarditis)
125
Queensland TBF- agent, vector, skin
R. australis tick eschar, vesicular
126
R. africa causes... eschar?, complication
AfricanTBF eshar may be tiny and hard to find reactive arthritis
127
R. akari causes
Richettsial pox
128
R. australis
QuuenslandTBF
129
R. coronii causes
Mediteranean SF
130
R. felis causes
Flea rickettsiosis
131
R. honei causes
Flinders Island
132
R. japonica causes
Japanese Spotted Fever
133
R. prowazekii causes
epidemic typhus
134
R. rickettsia causes
RMSF
135
R. siberica causes
Siberian Tick Typhus
136
R. slovaca causes
Tick borne LAD
137
R. typhus causes
murine typhus
138
relationship between salmonella and schistosomiasis
salmonella can hide in schisto
139
Reversal reaction (type I)- types, Sx, Tx
BT, BB, BL (borderlines) type IV hypersensitity, CMI acute neuritis Inflammation in old lesions- red, pain, swelling new lesions Tx: prednisone 3-6 mos
140
Ricin- transmission, category, source, Sx
inhaled Category B Toxin castor bean seed fever, cough, pulm edema, resp failure
141
Ricketsial infections with high mortality (2)
RMSF, epidemic typhus
142
Rickettsial diseases without eschar (4)
RMSF, murine typhus, epidemic typhus, tick borne LAD
143
Rickettsial pox- agent, vector, geo
R.akari mite S. Africa, Ukraine
144
rifampin for leprosy- effect, prednisone interaction, SE
bactericidal reduce if prednisone needed (induces hypermetabolism) SE: bone marrow suppression, red fluids, elevated LFT, interstitial nephritis
145
rifampin- effect, SE
block RNA pol rash, multiple drug interactions
146
Rifaximin- treats _____ but not _____ because \_\_\_\_\_\_\_
watery diarrhea but not invasive because not absorbed
147
RMSF- agent, vector, skin
R. rickettsia tick no eschar, rash often purpuric (centripital- ext 1st) and after viral syndrome
148
Rose spot
shigella; invasive salmonella blanching 2-4 mm papules on torso
149
rose spots
typhoid
150
Rotovirus claim to fame
leading cause diarrhea
151
Salmonella in HIV
high risk of invasive disease, 50% mortality rate, 40% rate of recurrent infection.
152
Salmonella typhi/paratyphi vs non-typhoidal salmonella
Salmonella typhi- prodrome weeks before GI non-typhoidal- acute GI
153
Scrofula
TB in node, seen in 43%
154
Scrub typhus- agent, geo, vector, special Sx, Tx
O. tsutsugamushi Asia, AUS Chigger (immature mite) 50% eschar, ocular ingection, deafness doxy, chloramphenicaol, macrolide
155
Shigella complications- 4 systems
GI: toxic megacolon, perforation renal: HUS Neuro: Sz Rheum: Reiter's syndrome (urethritis, conjunctivitis, arthritis)
156
Shigella 4 strains and their geo/situation
S. dysenteriae- developing, epidemics S. flexneri- more in developing S. boydii- Indian subcontinent S. sonnei- more in developed, milder Sx
157
Shigella- fame, micro, pathology, source, Sx (GI, neuro), Tx
leading cause invasive diarrhea anaerobic neg rod serotype 1 has shiga toxin -\> epidemics human (FO, P2P) toxic megacolon, rectal prolapse, perforation, Sz, sepsis, encephalopathy, HUS (due to toxin) Tx: antibiotics if severe only
158
Siberian typhus- agent, vector
R. siberica tick
159
Smallpox- agent, transmission, incubation max, Sx, Tx, prevention
variola virus aerosol, contact, P2P 19 days max mucosal lesion followed next day by papular face rash- spreads centrifugal Mortality due to response to infection supportive vaccine available
160
Streptomycin SE
Ototoxic, nephrotoxic, drug interactions, no pregnant
161
Syphilis- agent, micro, Tx
Treponema pallidum gram neg spirochete PCN
162
TB % pulmonary
85%
163
TB meds that are most bactericidal (2)
rifampin and INH
164
tetanus presentations (3)
Classic rigidity: jaw -\> generalized Local tetanus- muscle contraction around wound Cephalic tetanus is rare, related to OM, involves paralysis of cranial nerves, especially facial area
165
third leading cause of infectious death
diarrhea
166
Typhoid- agent, host, HIV, incubation, Sx by week, Dx, Tx (2), vaccine effectiveness
Salmonella typhi human carriers HIV protective incubation 10-20 d Sx by week: 1: fever, abd pain, constipation, HA, cough 2: high fever with bradycardia, rose spots 3: weak, diarrhea 4: improve Dx- blood Cx Tx Cipro, azithro in Asia 75% vaccine effective
167
Tick borne LAD- agent, vector, skin, geo
R. slovaca tick NO rash, just LAD Gulf Coast, Brazil, Uraguay
168
Tick borne relapsing fever- agent, geo, Sx
Borrelia widespread, esp Africa Epistaxis, Abdpain, Diarrhea, Cough, Splenomegaly, Neuro, Rash including petechiae
169
top 2 causes of infectious blindness in world
Oncho, chlamydia (toxocaria)
170
Treatment and proph for Yersinia pestis
Streptomycin, Doxy, cipro
171
Treatment for active pulmonary TB
INH + RIF x 6 mo WITH ETH and PZA for 1st 2 mo
172
treatment for chronic Bartonella quintana (trench fever)
Doxycycline for 4 weeks plus gentamicin for the first 2 weeks
173
Treatment of Brucella
Rifampin and doxycycline for 6 weeks
174
treatment of Q fever
doxycline
175
Treatment severe erythema nodosum leprosum
Prednisone + thalidomide or clofazine
176
Trench fever- agent, vector, Tx
B. quintana louse doxy
177
trench fever agent, Sx, Tx
B. quintana fever, myalgia, HA, conjunctivitis (95%), splenomegaly, **shin bone pain** may be single or recurent episodes over 6 week gent 2 weeks, doxy 4 wks overlap
178
Tropical Pyomyositis- cause, Sx, Tx
usually Staph aureus muscle abscess drainage and ABx
179
Tularemia bioterror- agent, micro, transmission, incubation max, Sx, mortality, Tx, Cx
Francisella tularensis (Gram neg intracellular) aerosolized 5 days max pneumonia mortality 60% untreated gent, cipro, doxy, chloramphenicol yeast charcoal
180
Tx bloody diarrhea
Cipro if no improve 48 h change to zithro if Giardia change to tindazole
181
Tx MAC in HIV (3)
Clarithromycin, ethambutol, rifabutin
182
Tx multibacillary leprosy- daily/monthly, duration
daily dapsone + clofazine (self) OR monthly rifampin + clofazine (supervised) x 12 months or more
183
Tx paucibacillary leprosy, duration
daily dapsone + monthly rifampin (supervised) 6 months
184
typhoid vs non-typhoid salmonella- Sx, timing
non-typhoidal- acute enterocolitis, N+V, in days Salmonella typhi- rare diarrhea (fever, Ha, pain), 2-3 weeks after infection
185
Verruga peruana- agent, Sx, Tx
B. bacilliformis angioma-like nodules and ulcers -\> resolve no scarring rifampin or streptomycin can clear faster
186
Vibrio cholera- micro, pathology, source, Sx, Tx
curved neg rod with flagella phage toxin affecting chloride secretion water, fish, P2P vomit, rice water stool (no fever) rehydration Abx may reduce duration and shedding
187
Weils disease
Renal and liver failure seen with leptospirosis
188
Where MDR TB most prevalent
USSR
189
Where TB most prevalent
Africa (esp horn)\> Asia
190
Which form of plague has P2P
pneumonic
191
Yaws- agent, sx, tx
treponema (not T. pallidum) papule, ulcers, scabs, hyerkeratosis, late gummas “mother yaw” painless and heals in months without scarring -\> more wks to yrs later Untreated can cause destructive lesions of the skin and bone (gummas) Tx: penG x 1
192
Yersinosis- micro, source, Tx, complications
neg coccobacilli, safety pin bipolar stain, fermenting glucose pork, surface water supportive, ABx if septic (rocephin) erythema nodosum, reactive arthritis
193
Yersinosis- agent, Sx (3)
Y. enterolittica GI (DDx appy) few rash and joint pain