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Andrews > Bacterial I Lecture Review > Flashcards

Bacterial I Lecture Review Flashcards

1
Q

Gram positive stain? why?

A

blue (crystal violet)

peptidoglycan in cell wall (no outer membrane)

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2
Q

gram negative stain? why?

A

pink (safranin counterstain)

outer membrane with LPS

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3
Q

beta hemolytic? alpha hemolytic?

A

beta: strep pyogenes (GAS)
alpha: strep pneumo

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4
Q

catalase positive?

coagulase positive?

A

catalase: staph
coagulase: aureus

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5
Q

CA-MRSA virulence factor

A

Panton-Valentine leukocidin

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6
Q

CA-MRSA txt

A

clindamycin, bactrim +/- rifampin, minocycline, linezolid, vanco
mupirocin to nares
I&D abscesses <5cm, bleach, tea tree, BPO

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7
Q

name for superficial folliculitis? name for deep folliculitis & folliculitis of beard?
mcc?

A

Bockhart’s impetigo
Sycosis, sycosis barbae
staph aureus

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8
Q

risk of chlorhexidine

A

ototoxicity

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9
Q

difference between furuncle and cabuncle

A 
furuncle = acute, hair follicle only
carbuncle = collections of furuncles extending into subq, sinus tracts, possibly systemic sxs
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10
Q

types of paronychia and characteristics?

cause?

A

acute abscess: s. aureus
acute erythema & swelling: strep pyogenes
chronic swelling: candida
cause: separation eponychium from plate from trauma

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11
Q

botryomycosis mcc? presentation?

A

aka granular bacteriosis, bacterial pseudomycosi
staph aureus
nodular purulent lesions draining sulfure granules

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12
Q

splendore-hoeppli phenomenon? DDx?

A 
granule of non-filamentous bacteria in hyaline matrix with IgG and C3 = eosinophilic periphery wiht basophilic center = bunch of grapes
actinomycosis
mycetoma
sarcoid
botryomycosis
sporotrichosis
nocardia
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13
Q

pyomyositis cause? presentation? test?

A

s. aureus
abscess in deep muscles. tropics in children: thigh, immunocompromised in temperate: deltoid
test: MRI w/gadolinium

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14
Q

MC bacterial infection in kids? cause?

A

impetigo contagiosa
staph aureus, then GAS (newborns - GBS)
strep w/ LAD

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15
Q

acute glomerulonephritis cause? preceding infection? prognosis affected by abx?

A

group A beta-hemolytic strep M type 2
impetigo contagiosa, bullous impetigo, scarlet fever, perianal dermatitis (GAS)
prognosis not affected by abx

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16
Q

bullous impetigo cause? pathology? culture from lesion?

A

staph aureus group 2 phage type 71 or 55 –> exfoliative toxins A & B –> binds desmoglein 1
positive culture from blister

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17
Q

Staph Scalded Skin Syndrome other names? cause? culture? presentation?

A

Ritter’s ds, pemphigus neonatorum
children and renal failure pts: staph aureus group 2 phage type 55 & 71 exfoliative toxins A&B not cleared by kidneys + no immunity. binds dsg1

culture nasopharynx/conjunctiva. sterile bullae

erythema head to generalized, then flaccid bullae, facial edema. spares palms, soles, mucous membranes

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18
Q

Toxic Shock Syndrome cause? presentation? culture?

A

staph aureus exotoxin TSST-1 binds MHC class II –> cytokine release

acute febrile illness with scarlatiniform exanthem starts on trunk, strawberry tongue, erythema of palms and soles, desquamation 1-3 wks after onset. rapid progression to shock, organ involvement

negative cultures

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19
Q

Strep Toxic Shock Syndrome cause? presentation?

A

GAS M types 1 and 3 –> exotoxin A
adults 20-50 yo, portal of entry into skin –> superantigens bind to MHC II –> T cell cytokine release –> severe local pain +/- violaceous bullae –> shock, multi-organ failure, generalized erythema –> 30-60% mortality

20
Q

ecthyma cause? presentation?

A

staph or strep pyoderma
shin or feet: vesiculopustule –> crust –> ulcer
urban, IVDA, HIV

21
Q

pupura fulminans three forms

A

intravascular thrombosis and hemorrhagic infarction –> DIC

  1. neonatal: hereditary def protein C, protein S, antithrombin III
  2. idiopathic: follows febrile illness, def of protein S
  3. acute infectious: MCC. children after strep infection
22
Q

scarlet fever cause? presentation? test?

A

GAS types A, B, C exotoxin –> delayed hypersensitivity rxn
1-10 yo’s
strep pharyngitis –> blanchable erythema at neck –> trunk & extremities –> sandpaper papules with skin fold accentuation
circumoral pallor, palatal petechiae, cervical LAD
palm&sole desquamation
ASO titer

23
Q

schultz-carlton phenomenon

A

blanching erythema secondary to exotoxin in scarlet fever

24
Q

erysipelas cause? location of infection?presentation?

A

mcc: GAS (gbs in newborns)
infection of dermis and superficial dermal lymphatics
erythema, induration, constitutional symptoms, leukocytosis >20

25
Q

cellulitis mcc? location? presentation?

A

s. aureus & s. pyogenes, mixed in diabetics
deep dermal & SQ
portal of entry t. pedis
rubor, dolor, calor, tumor. no wbc. can have fever with prodrome

26
Q

result of chronic cellulitis/erysipelas?

A

elephantiasis verrucosa nostras

recurrent lymphangitis and hypertrophic fibrosis

27
Q

meleney’s gangrene

A

polymicrobial necrotizing fasciitis secondary to surgical trauma

28
Q

three types of necrotizing fasciitis

A

type I: polymicrobial
type II: GAS
type III: gas gangrene/clostridial myonecrosis

29
Q

GAS tense superficial blisters on volar fat pads

A

blistering distal dactylitis

30
Q

strep intertrigo presentation? differentiation from candida?

A

well-demarcated fiery-red erythematous patches with pain and foul odor.
no satellite lesions

31
Q

rheumatic fever diagnostic skin signs/major criteria? cause?

A

erythema marginatum (early) = patchy, polycyclic, evanescent erythema spreads peripherally
subcutaneous nodules (late)
also carditis, chorea, polyarthritis
strep

32
Q

strep iniae

A

fish pathogen –> cellulitis of hands (tilapia, hawaiian sunfish)
fever, lymphangitis, cellulitis. PCN

33
Q

erysipeloid of rosenbach cause? two types? presentation?

A

erysipelothrix rhusiopathiae (gram + rods)
fisherman, meat handlers (swine)
1. MC: localized purplish swelling of finger webs, spares phalanges
2. Generalized: fever, arthralgias, perifollicular papules –> violaceous plaques, endocarditis, septic arthritis

34
Q

pneumococcal cellulitis presentation

A

strep pneumo
children w/ facial or periorbital edema & cellulitis with blue violaceous hue
fever, leukocytosis, septicemia
IVDA: extremity

35
Q

anthrax cause? capsule? toxins? presentation? treatment?

A

woolsorter’s disease

bacillus anthracis (aerobic gram + spore forming rod)

polyglutamic acid capsule (inhibits phagocytosis)
edema toxin –> increased cAMP
lethal toxin –> TNF alpha and IL-1beta release

abx does not alter progression of cutaneous ds
vesicle –> ulcer –> eschar. nontender but suppurative adenitis

doxy or cipro. do not I&D

36
Q

listeriosis presentation?

A

listeria monocytogenes (gram + bacillus)
eating cheese/dairy
skin: erythematous papules & pustules, LAD, fever
encephalitis/meningitis. neonates, pregnancy, alcoholics

37
Q

cutaneous diphtheria organism? presentation? complications? what to do before treatment?

A

corynebacterium diphtheria (Klebs-Loeffler bacillus) gram + bacillus
punched out ulcer with rolled edges, pseudomembranous eschar on acral sites in tropics
complications: paralysis, cardiac ds
rule out hypersensitivity to horse serum via conjunctival test before txt

38
Q

erythrasma cause? presentation? cause of coral red fluorescence?

A

corynebacterium minutissimum (gram + spore forming rod)

excessive growth in SC in humid environment –> pink brown scaling patches in intertriginous areas

coproporphyrin III causes coral-red w/ woods lamp

39
Q

pitted keratolysis cause? pathophys? presentation? txt?

A

kytococcus sedentarius –> serine proteases K1 and K2 and sulfur compounds –> pits & odor

1-7 mm crater-like depressions in SC on weight bearing surfaces

BPO gel, erythromycin/clinda, antifungles, aluminum chloride

40
Q

trichomycosis axillaris cause? presentation? txt?

A

corynebacterium tenuis
superficial bacterial infection of axillary/pubic hair w/ adherent yellow, red, black nodules on woods lamp
txt: shave, abx soap

41
Q

gas gangrene cause? pathology? presentation?

A

clostridium perfringens (anaerobe)

membrane active toxins: alpha toxin & perfingolysin

infection of muscle with sudden onset shock, hemolytic anemia, leukocytosis, gas bubbles on palpation from hydrogen sulfide and CO2

42
Q

tropical ulcer cause?

A

bacteriodes vincentii

43
Q

desert sore cause?

A

corynebacterium diptheriae, staph, strep

grouped vesicles rupture –> ulcers covered by pseudomembrane

44
Q

actinomyces israelii infection? txt?

A

anaerobic gram +, non-acid fast
dental procedures
lumpy jaw: nodules draining sulfure granules, may have underlying osteo
pcn

45
Q

nocardia asteroides and norcadia brasilliensis presentations? 4 types? txt?

A

acid fast gram +
asteroides: MC disseminated in immunocomp
brasiliensis: MC primary cutaneous due to penetrating injury
4 forms: mycetoma, lymphocutaneous, superficial cutaneous, pulm/systemic
sulfa (bactrim)

Andrews (15 decks)

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