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Infectious Disease > Bacterial Infections II: Atypical > Flashcards

Bacterial Infections II: Atypical Flashcards

1
Q

Mycoplasma, Legionella, Chlamydia are all ????

A

atypical causes of pneumonia

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2
Q

Small bacteria lacking a cell wall are _____

A

mycoplasma

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3
Q

Where are mycoplasma commonly found?

A

Commonly found lining mucous membrane of genitourinary tract and respiratory tract

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4
Q

_____ most associated with acute infection - pneumonia

A

M. pneumoniae

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5
Q

Filamentous organism
Attaches to epithelial membranes - especially the respiratory tract
Causes epithelial injury and activates immune response

What am I?

A

mycoplasma

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6
Q

Transmitted via respiratory droplets
Incubation period - 2-3 weeks
Most common during fall and summer
Most common in young adults; high school students, college students, military, etc.
Community-acquired rates increasing

What am I?

A

mycoplasma

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7
Q

What kind of infection is characterized by Gradual onset
Milder form of “pneumonia”
Scant sputum production
Often associated with pharyngitis and/or AOM
“Bullous myringitis”
Cough
Extrapulmonary manifestations
Also referred to as “Walking Pneumonia”

A

mycoplasma

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8
Q

How is mycoplasma pneumoniae diagnosed?

A

Labs - often normal or nonspecific
Typically, a “clinical” diagnosis
Diagnosed by NP swab

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9
Q

What does the chest xray look like on a pt with mycoplasma pneumoniae?

A

Chest X-ray - often nondiagnostic patchy infiltrates (no lobar consolidation)

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10
Q

What is the empiric antimicrobial treatment of choice for possible M. pneumoniae community acquired pneumonia?

A

macrolides

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11
Q

Infections of genital/reproductive tract, eye, and respiratory tract in infants are ____

A

Chlamydia trachomatis

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12
Q

Obligate intracellular bacteria
Do not contain a peptidoglycan cell wall

What am I?

A

Chlamydia

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13
Q

_____ is the Second most common cause of “atypical” pneumonia

A

Chlamydia Pneumoniae

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14
Q

Must you distinguish between C. pneumoniae and M. pneumoniae before treatment?

A

No, they are treated the same

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15
Q

What treatment would you prescribe for chlamydia pneumoniae?

A

macrolides

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16
Q

What does Chlamydia Psittaci present as?

A

“Atypical” pneumonia
Fever, chills, cough, HA

Contact with birds (usually pet birds)

7–15-day incubation period

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17
Q

Pneumonia s/s and the have a pet bird at home.

What am I?

A

Chlamydia Psittaci

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18
Q

What is the treatment for Chlamydia Psittaci?

A

tetracycline
erythromycin

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19
Q

What is the most common STD?

A

Chlamydia Trachomatis

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20
Q

What is the incubation period for Chlamydia Trachomatis?

A

7-14 days, often asymptomatic

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21
Q

Female - cervicitis, urethritis, PID
Male - urethritis, epididymitis, prostatitis
Both sexes - conjunctivitis, lymphogranuloma venereum

What am I?

A

Chlamydia Trachomatis

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22
Q

Mucopurulent discharge
Red, inflamed, friable cervix
PID - pelvic pain, dyspareunia, cervical motion tenderness

What am I?

A

Chlamydia
Trachomatis

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23
Q

Mucoid/watery urethral discharge
Dysuria
Epididymitis - testicular pain; palpable, swollen epididymis

What am I?

A

Chlamydia
Trachomatis

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24
Q

What is the diagnostic test for Chlamydia Trachomatis?

A

culture

gram stain is not helpful

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25
Q

What is the Ddx for cervicitis?

A
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26
Q

What is the treatment of choice for urogenital chlamydia?

A

Z- Max or doxy BID for 7 days

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27
Q

What are the complications of Chlamydia Trachomatis

A

Pregnancy complications - PROM (premature rupture of the membranes)
Infertility (from PID)
Transmission to newborn
Perihepatitis (Fitz Hugh-Curtis syndrome)

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28
Q

What is Fitz Hugh-Curtis syndrome?

A

a rare chronic condition that causes inflammation of the liver capsule and adhesions, leading to pain in the upper right quadrant of the abdomen. It’s a complication of pelvic inflammatory disease (PID) that can be caused by infections with Neisseria gonorrhoeae or Chlamydia trachomatis.

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29
Q

What are three diseases commonly associated with spirochetes?

A

Syphilis
Lyme Disease
Leptospirosis

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30
Q

Syphilis is caused by what bacteria?

A

Treponema pallidum

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31
Q

______ transmitted by direct contact with infectious lesion during sexual activity

A

Syphilis

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32
Q

What is the incubation period for syphilis?

A

21 days before symptoms

33
Q

What are the clinical stages of syphilis?

A

Primary Syphilis
Secondary Syphilis
Tertiary Syphilis (Late Syphilis)
Neurosyphilis
Latent Syphilis

34
Q

Early syphilis occurs ???

A

Within the first year

very infectious

35
Q

What is the symptom free period between early and late syphilis?

A

Latent syphilis = Infectious w/in 1st year of primary infection

36
Q

Is Tertiary/late syphilis contagious?

A

NOT contagious

37
Q

When do sx appear in a syphilis pt? Name a definite sign?

A

Symptoms appear 3-4 weeks after contact

chancre: painless ulcer

38
Q

How is syphilis diagnosed?

A

Culture of ulcer

Serologic tests: Non-treponemal antibody test

If positive then Treponemal antibody test: TPPA and FTA used to confirm diagnosis

39
Q

When will a RPR test be positive on a pt who has syphilis?

A

Positive 4-6 weeks after infection; 1-2 weeks after presence of chancre

40
Q

What is the treatment for syphilis?

A

benzathine penicillin G 2.4 million units IM in a single dose (Bicillin L-A)

pencillin VK

amoxicillian

41
Q

Do you need to report syphilis to the local health department?

A

YES!!

42
Q

When does secondary syphilis begin? Are you still infectious?

A

Begins several weeks to 6 months after chancre
***Still Infectious

43
Q

In secondary syphilis, you will see dissemination of ______ throughout body produces systemic symptoms

A

T. pallidum

44
Q

What is condyloma lata?

A

genital warts

45
Q

Are all clinical manifestations of ______

A

secondary syphilis

46
Q

early latent syphilis is ???? after the primary infection. Is it still infectious?

A

within the first year

Yes

47
Q

late latent syphilis is ???? after the primary infection. Is it still infectious?

A

after the first year

NOT infectious

48
Q

What is the presence of gummas indicate?

A

tertiary syphilis

infiltrative tumors
Skin, bones, internal organs (liver)

49
Q

Skin & mucous membrane lesions - gumma
Bone lesions - marked bone pain
Respiratory distress - gumma deposits in lungs
Liver disease/cirrhosis
Cardiovascular lesions
Aneurysms
Neurosyphilis

What am I?

A

Tertiary syphilis

50
Q

Neurosyphilis is most common during what stage?

A

late syphilis

51
Q

What is Asymptomatic neuroinvasion?

A

T. pallidum infects CSF; no symptoms yet

52
Q

Impairment of proprioception and vibration sense
Wide based gait; inability to walk in the dark
Muscle hypotonia and hyporeflexia
Paresthesia; sharp, recurring pains; pain “crises”
Inability to control bladder

What am I?

A

Tabes dorsalis

53
Q

What is tabes dorsalis? What disease is it associated with?

A

Chronic progressive degeneration of posterior columns of spinal cord

neurosyphilis

54
Q

How do you dx neurosyphilis?

A

same as syphilis plus lumbar puncture

55
Q

What is the treatment for neurosyphilis?

A

PCN

56
Q

What are some risk factors for neurosyphilis?

A

HIV
Non-HIV
Male gender
Age 45 years and older

57
Q

What bacteria is associated with Lyme disease?

A

Borrelia burgdorferi

58
Q

Where is lyme disease more common?

A

More common in northeastern and north central US

59
Q

Erythema migrans - flat “bulls’ eye” lesion with central clearing, HA, myalgias, fatigue.

What am I?

A

Lyme disease

60
Q

When does the bulls eye lesion tend to appear? What % of patients do NOT show this symptom?

A

occurs 1 week after tick bite

10-20% of patients do not present with lesion

61
Q

What does stage 2 of lyme disease present like?

A

Bacteremia
Secondary skin lesions and rash
Worsening of flu-like symptoms
Cardiac involvement (4-10% of patients)
Neurologic manifestations (10-15% of patients)

62
Q

What does stage 3 lyme disease present like?

A

Musculoskeletal (60%)
Joint pain: arthritis (knee)
Neurologic
Skin

63
Q

What criteria do you need to establish lyme disease as the cause?

A

A person exposed to a tick bite who:

*Developed erythema migrans

or

*Had at least one late manifestation

and

*Laboratory confirmation

64
Q

What lab test do you order to check for lyme disease?

A

ELISA (Enzyme linked immunosorbent assay) - detects antibodies to B. burgdorferi

Confirm with Western Blot

65
Q

What is the treatment of choice for Lyme Disease? Pregnant pt?

A

doxy

amoxicilin

66
Q

How long should you continue treatment for lyme disease?

A

10-21 days

67
Q

Who do you treat prophalaxis for lyme disease?

A
68
Q

_____ is transmitted to humans by ingestion of food or drink contaminated by urine of the infected animal (rat)

A

Leptospirosis

69
Q

_____ manifestations can range from minor to fatal liver and kidney disease

A

Leptospirosis

70
Q

How is Leptospirosis dx?

A

serologic testing

71
Q

What is the treatment for Leptospirosis?

A

doxy

72
Q

_____ is the most serious rickettsial disease

A

Rocky mountain spotted fever

73
Q

Dermacentor (wood tick, dog tick) is the cause of _____

A

Rocky Mountain Spotted Fever

74
Q

What states are Rocky Mountain Spotted Fever commonly found in?

A

N. Carolina, Tennessee, Oklahoma, Arkansas, Missouri

75
Q

How long does it take for Rocky Mountain Spotted fever s/s to appear?

A

2-14 days after tick bite

76
Q

fever, chills, HA, N/V, myalgias, insomnia, and characteristic rash
Rash - faint macules progressing to papules, then to petechiae
Rash appears on first on wrists and ankles and spreads centrally
Can progress to delirium, lethargy, seizures, and coma

What am I?

A

Rocky Mountain Spotted Fever

77
Q

What is the treatment of choice for RMSF?

A

Doxy BID

78
Q

Typhus, Ehrlichiosis and Anaplasma all produce symptoms of ____, _____ and ______.

What is the treatment?

A

Fever, rash, myalgia

Doxy

Infectious Disease (16 decks)

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