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Medicine > Bugs and Drugs > Flashcards

Bugs and Drugs Flashcards

1
Q

Bacillus anthracis

A

Gram positive rod, aerobic

Dx: eschar, hemorrhagic mediastinitis, bloody diarrhea

Tx: ciprofloxacin (alt: doxycycline)

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2
Q

Bacillus cereus

A

Gram positive rod, aerobic

Dx: vomiting (heat-stable toxin), diarrhea (heat-labile toxin)

Tx: supportive

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3
Q

Clostridium tetani

A

Gram positive rod, anaerobic

Dx: localized/generalized muscle spasm/rigidity with sweating, arrhythmias, and respiratory failure

Tx: tetanus antitoxin globulin, tetanus toxoid, metronidazole or penicillin

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4
Q

Clostridium perfringens

A

Gram positive rod, anaerobic

Dx: gas gangrene, food poisoning (cramps and watery diarrhea), necrotizing enteritis

Tx: penicillin and clindamycin, wound debridement if applicable

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5
Q

Clostridium botulinum

A

Gram positive rod, anaerobic

Dx: bilateral descending flaccid paralysis from home canned foods and honey

Tx: 3 valent botulinum antitoxin, metronidazole or penicillin

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6
Q

Clostridium difficile

A

Gram positive rod, anaerobe

Dx: pseudomembranous colitis (fever, abdominal pain, non-bloody diarrhea with abx use)

Tx: metronidazole (alt: vancomycin)

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7
Q

Corynebacterium diphtheriae

A

Gram positive rod, aerobe

Dx: fever, sore throat, gray pseudomembrane on tonsils/pharynx causing airway obstruction, arrhythmias, or nerve palsy

Tx: diphtheria antitoxin, penicillin or erythromycin (preventable with vaccine)

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8
Q

Listeria monocytogenes

A

Gram positive rod, facultative

Dx: gastroenteritis (watery diarrhea), meningitis (neonates/elderly/AIDS) with sepsis

Tx: ampicillin and gentamicin (alt: TMP-SMX)

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9
Q

Nocardia asteroides

A

Gram positive rod, aerobe

Dx: weakly acid fast filament-like rods, causes nocariosis, pneumonia, cellulitis, and abscesses in immunocompromised

Tx: TMP-SMX

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10
Q

Propionibacterium acnes

A

Gram positive rod, anaerobe

Dx: acne

Tx: benzoyl peroxide (topical) –> erythromycin/clindamycin (topical) –> minocycline (oral)

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11
Q

Staphylococcus aureus

A

Gram positive cocci, catalase + coagulase +

Dz:

  • Acute osteomyelitis
  • Skin infections: impetigo, cellulitis, post-surgical wounds
  • Tricuspid valve endocarditis (IVDU) or acute endocarditis (mitral)
  • Post influenzal pneumonia with empyema (HAP and VAP)
  • Postpartum mastitis
  • Sepsis and bacteremia
  • Toxigenic: TSS, gastroenteriti, scalded skin syndrome

Tx: methicillin (MSSA), vancomycin (MRSA), linezolid (VISA/VRSA), cefazolin (prophylaxis)

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12
Q

Staphylococcus epidermidis

A

Gram positive cocci, catalase + coagulase -

Dz: implant related infections (heart valves, joints, catheters, shunts)

Tx: vancomycin

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13
Q

Staphylococcus saprophyticus

A

Gram positive cocci, catalase + coagulase -

Dz: UTI in sexually active women (2nd to E. coli)

Tx: fluoroquinolone (ciprofloxacin)

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14
Q

Streptococcus pyogenes

A

Gram positive cocci, catalase - beta-hemolytic bacitracin-sensitive

Dz:

  • Skin infections: impetigo, cellulitis, necrotizing fasciitis, lymphangitis
  • Pharyngitis
  • Acute rheumatic fever
  • Acute glomerulonephritis
  • Toxigenic: toxic shock syndrome, scarlet fever

Tx: penicillin G

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15
Q

Streptococcus agalactiae (GBS)

A

Gram positive cocci, catalase - beta-hemolytic bacitracin resistant

Dz: neonatal pneumonia, meningitis, and sepsis

Tx: Penicillin G and gentamycin if severe

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16
Q

Enterococcus (E. faecalis, E. faecium)

A

Gram positive cocci, Group D, + growth in 6.5% NaCl

Dz: subacute bacterial endocarditis, UTIs, intraabdominal infections

Tx: penicillin G and gentamycin (B-lactam resistant: vancomycin and gentamycin; Vancomycin resistant: linezolid)

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17
Q

Streptococcus bovis

A

Gram positive cocci, Group D, - growth in 6.5% NaCl

Dz: subacute bacterial endocarditis associated with colon cancer

Tx: penicillin G (alt: vancomycin)

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18
Q

Streptococcus pneumoniae

A

Gram positive cocci, alpha-hemolytic, optochin sensitive

Dz: pneumonia, meningitis, otitis media, sinusitis, sepsis in asplenic patients

Tx: penicillin G (severe infection: ceftriaxone + vacomycin or newer fluoroquinolone)

Vaccine: 7 valent-conjugated polysaccharide (< 2 yrs), 23 valent-capsular polysaccharide (> 2 yrs)

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19
Q

Viridans streptococci

(S. mutans, S. mitis, S. sanguis, S. salivarius)

A

Gram positive cocci, catalase - alpha-hemolytic optochin resistant

Dz: dental plaque (S. mutans), subacute bacterial endocarditis (S. sanguis)

Tx: penicillin + gentamycin (alt: cephalosporin or vancomycin if severe), penicillin prophylaxis for dental procedures in valve disease

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20
Q

Neisseria meningitidis

A

Gram negative cocci, oxidase +, maltose fermentation +

Dz:

  • Meningitis (CSF: icnreased PMN and protein, decreased glucose)
  • Meningococcemia (Waterhouse-Friderichsen syndrome: fever, purpura, shock, DIC, bilateral adrenal hemorrhage)
  • Pneumonia

Tx: penicillin G or ceftriaxone (alt: chloramphenicol)

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21
Q

Neisseria gonorrhoeae

A

Gram negative cocci, oxidase +, maltose fermentation -

Dz: purulent arthritis (wrist/ankle/knees), conjunctivitis, cervicitis, urethritis, pharyngitis, pustules on erythematous base

Tx: ceftriaxone and azithromycin for chlamydia

Alt: ciprofloxacin in penicillin allergy or specinomycin in pregnancy

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22
Q

Moraxella catarrhalis

A

Gram negative cocci, oxidase +

Dz: bronchitis and bronchopneumonia, otitis, sinusitis

Tx: **amoxicillin-clavulanate, cefuroxime axetil, TMP-SMX, azithromycin **

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23
Q

Escherichia coli

A

Gram negative rod, facultative, lactose fermenter

Dz:

  • Gastroenteritis (Traveler’s diarrhea):
    • EPEC/ETEC: watery diarrhea
    • EHEC: shiga toxins → bloody diarrhea, HUS
    • EIEC: dysenteric darrhea
  • UTIs
  • Neonatal meningitis, sepsis

Tx: supportive +/- rifaximin or fluoroquinolone for diarrhea, fluoroquinolone or TMP-SMX for UTIs, ceftriaxone for meningitis/sepsis

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24
Q

Klebsiella pneumoniae

A

Gram negative rod, lactose fermenter

Dz: nosocomial and community acquired infections in alcoholics, diabetics, and elderly including lobar pneumonia and UTIs

Tx: carbapenem (MDR: based on susceptibilities)

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25
Q

Enterobacter cloacae

A

Gram negative rod, lactose fermenter

Dz: nosocomial infections including pneumonia and UTI

Tx: carbapenem (MDR: based on susceptibilities)

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26
Q

Serratia marcescens

A

Gram negative rods, lactose fermenter

Dz: nosocomial infections in immunocompromised including pneumonia and UTI

Tx: G3 cephalosporin + gentamicin (MDR: based on susceptibilities)

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27
Q

Shigella dysenteriae

A

Gram negative rod, non-lactose fermenter, oxidase -, H2S -

Dz: bacillary dysentery (fever, cramps, tenesmus, blood stools with neutrophils and mucus)

Tx: supportive care +/- fluoroquinolone or TMP-SMX

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28
Q

Salmonella typhi

A

Gram negative rod, non-lactose fermenter, oxidase -, H2S +

Dz: enteric (typhoid) fever (bradycardia, abdominal pain, diarrhea and constipation, rose spots on trunk, hepatosplenomegaly, delirium, GI bleeding (*developing countries)

Tx: ciprofloxacin or ceftriaxone (alt: chloramphenicol), cholecystectomy if chronic carrier in gallbladder

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29
Q

Salmonella enteritidis

A

Gram negative rod, non-lactose fermenter, oxidase -, H2S +

Dz: enteritis (fever, nausea, vomiting, abdominal pain, bloody or nonbloody diarrhea)

Tx: self-limited, supportive only, no abx

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30
Q

Proteus mirabilis

A

Gram negative rod, non-lactose fermenter, oxidase -, H2S +, urease +

Dz: nosocomial UTI with struvite stones (catether associated)

Tx: ampicillin or SMX-TMP

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31
Q

Yersinia enterocolitica

A

Gram negative rod, non-fermenter, oxidase -, H2S -

Dz: enterocolitis, autoimmune complications (Reiter’s syndrome, reactive polyarthritis, erythema nodosum)

Tx: fluoroquinolone or TMP-SMX

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32
Q

Yersinia pestis

A

Gram negative rod, non-lactose fermenter, oxidase -, H2S-

Dz: bubonic plague, pneumonic plague, septicemic plague

Tx: streptomycin, doxycycline

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33
Q

Campylobacter jejuni

A

Gram negative rod (comma shaped)

Dz: acute enteritis (bloody diarrhea), autoimmune (Guillain-Barre, Reiter’s syndrome, reactive arthritis)

Tx: supportive if mild, erythromycin if severe

34
Q

Helicobacter pylori

A

Gram negative rod (comma shaped), urease breath test +

Dz: gastritis, peptic ulcers, gastric carcinoma

Tx: **omeprazole + amoxicillin + clarithromycin **

35
Q

Vibrio cholerae

A

Gram negative rod (comma shaped)

Dz: cholera (severe watery diarrhea with electrolyte loss)

Tx: fluid and electrolyte replacement, doxycycline or TMP-SMX

36
Q

Vibrio parahaemolyticus

A

Gram negative rod (comma shaped)

Dz: explosive watery diarrhea from undercooked seafood

Tx: rehydration, self-limited, no abx

37
Q

Pseudomonas aeruginosa

A

Gram negative rod, non-lactose fermenter, strict aerobe, oxidase +, catalase +

Dz:

  • Pneumonia in CF
  • Eyes/Ears: corneal infections, external otitis (malignant), hot tub folliculitis
  • Osteomyelitis and endocarditis in IVDU
  • Burn wound infections
  • UTIs with catheters
  • Sepsis

Tx: ticarcillin + tobramycin (aminoglycoside) or cefepime or **imipenem + ciprofloxacin **

38
Q

Bordetella pertussis

A

Gram negative rod (coccobacillus)

Dz: whooping cough

Tx: erythromycin

Vaccine: killed vaccine in infants, acellular vaccine in children > 15 months

39
Q

Legionella pneumophila

A

Gram negative rod, faint gram stain, silver stain +, urine antigen +

Dz: Legionnaires’ disease (atypical pneumonia) in elderly and immunocompromised, Pontiac fever (flu-like)

Tx: azithromycin (macrolides) or fluoroquinolones

40
Q

Coxiella burnetii

A

Gram negative rod, intracellular, Giemsa stain +

Dz: Q fever (fever, pneumonia, hepatitis, meningoencephalitis, and endocarditis)

Tx: doxycycline

41
Q

Haemophilus influenzae

A

Gram negative rod (coccobacillus), grows on heme enriched chocolate agar, PRP +

Dz: pneumonia, otitis media, sinusitis, epiglottitis, meningitis

Tx: ceftriaxone for meningitis or epiglottitis, amoxicillin clavulanate or cefuroxime axetil or TMP-SMX or azithromycin for otitis media/sinusitis

42
Q

Haemophilus aegyptius

A

Gram negative rod (coccobacillus)

Dz: conjunctivitis (pink eye)

Tx: azithromycin (topical)

43
Q

Haemophilus ducreyi

A

Gram negative rod (coccobacillus)

Dz: chancroid

Tx: azithromycin (macrolide) or ceftriaxone

44
Q

Pasturella multocida

A

Gram negative rod (coccobacillus)

Dz: cellulitis and lymphadenitis from cat or dog bites

Tx: penicillin G

45
Q

Brucella abortus/melitensis/suis

A

Gram negative rods (coccobacillus), zoonotic

Dz: brucellosis (udulant fever, adenopathy, hepatosplenomegaly, septic arthritis, vertebral osteomyelitis)

Tx: streptomycin + doxycycline (alt: TMP-SMX in pregnancy and children)

46
Q

Bacteroides fragilis

A

Gram negative rod, anaerobe

Dz: bacteremia/sepsis, abdominal and pelvic abscesses, peritonitis, cutaneous and soft tissue infections

Tx: metronidazole

Prophylaxis: cefoxitin before abdominal or pelvic surgery

47
Q

Fusobacterium nucleatum

A

Gram negative rod, anaerobe

Dz: abscesses (brain, lung, abdominal, pelvic)

Tx: metronidazole

48
Q

Prevotella melaninogenica

A

Gram negative rod, anaerobe

Dz: abscesses (brain, lung)

Tx: metronidazole

49
Q

Bartonella henselae

A

Gram-variant rod, silver stain +

Dz: cat-scratch fever (fever and purulent lymphadenitis), bacillary angiomatosis (wide spread vascular lesions and nodules) and bacillary peliosis (vascular lesions in liver/spleen) in immunocompromised

Tx: azithromycin

50
Q

Gardnerella vaginalis

A

Gram-variant rod

Dz: bacterial vaginosis (foul smelling discharge with clue cells)

Tx: metronidazole

51
Q

Mycobacterium tuberculosis

A

Mycobacteria, aerobic, acid fast stain +

Dz:

  • Pulmonary TB: fever, sweats, weight loss, hemoptysis
    • Primary: Ghon complex
    • Secondary: fibrocaseous cavitary lesions in apices
  • Extrapulmonary TB: spread to LN, pleura, CNS, GU, GI, and vertebral bodies
  • Miliary TB: hematogenous dissemination in immunocompromised

Tx: isoniazid + rifampin + pyrazinamide + ethambutol

52
Q

Mycobacterium leprae

A

Mycobacterium, aerobe, acid fast stain +

Dz:

  • Tuberculoid leprosy: hypopigmented and anesthetic skin plaques associated with enlarged peripheral nerves (few bacilli in granulomas)
  • Lepromatous leprosy: symmetrical widespread skin nodules/plaques (many bacilli in foamy macrophages of granulomas)

Tx: dapsone + rifampin for tuberculoid, dapsone + rifampin + clofazimine in lepromatous

53
Q

Chlamydia trachomatis

A

Obligate intracellular bacteria

Dz: trachoma (blindness), neonatal conjunctivitis/pneumonia, STD (urethritis, cervicitis, epididymitis, PID), lymphogranuloma venereum, Reiter’s syndrome

Tx: azithromycin (tetracycline for LGV)

54
Q

Chlamydia psittaci

A

Obligate intracellular bacteria, Giemsa stain +, infection from aerosolized bird feces

Dz: psittacosis (atypical pneumonia)

Tx: doxycycline

55
Q

Rickettsia rickettsii

A

Obligate intracellular rod, Giemsa stain +

Dz: Rocky Mountain Spotted Fever (maculopapular to petechial rashes spreading from wrists and ankles to trunk, involves palms and soles), encephalitis

Tx: doxycycline (alt: chloramphenicol or ciprofloxacin)

56
Q

Mycoplasma pneumoniae

A

Extracellular atypical bacteria

Dz: Atpical pneumonia (patchy interstitial infiltrates with fever and nonproductive cough) which can be complicated by erathema multiforme, Raynaud’s, arthalgias, hemolytic anema, and Guillain Barre

Tx: macrolides (azithromycin) or tetracycline

57
Q

Borrelia burgdorferi

A

Spirochete, Giemsa stain +, silver stain +

Dz: Lyme disease

  • Stage 1: erythema chronicum migrans (bull’s eye rash)
  • Stage 2: neuropathy (meningitis, polyneuritis) and cardiopathy (AV block)
  • Stage 3: arthritis

Tx: doxycycline in early stages (amoxicillin for kids), ceftriaxone in late stages

58
Q

Treponema pallidum

A

Spirochete, viewed in darkfield microscopy

Dz: syphilis

  • Primary: chancre
  • Secondary: widespread maculopapular rash involving palms and soles, condylomata lata, non-tender lymphadenopathy, meningitis, mucous patches
  • Tertiary: granulomas, aortitis, neurosyphilis (paresis, tabes dorsalis, Argyll Robertson pupil)

Treatment: penicillin G or doxycycline

59
Q

Malassezia furfur

A

Dimorphic spherical budding yeasts with short chain-like hyphae

Dz: tinea versicolor (hypo/hyperpigmentations with scales and itching)

Tx: miconazole or selenium sulfide (topical), itraconazole (oral)

60
Q

Trichophyton rubrum/tonsurans/schoenlenii

A

Mold with filamentous septate hyphae

Dz: dermatophytoses (tinea capitis, tinea pedis, tinea corporis, tinea cruris, favus, onychomycosis)

Tx: miconazole (topical for pedis, corporis, cruris), griseofulvin (oral for capitis and onychomycosis)

61
Q

Coccidioides immitis

A

Fungus, endemic to southwest US and Latin America

Dz: Valley fever (pneumonitis and erythema nodosum)

Tx: itraconazole or amphotericin B for disseminated infections

62
Q

Histoplasma capsulatum

A

Fungus, from bird and bat droppings in the Mississippi and Ohio River Valleys

Dz: histoplasmosis (atypical pneumonia or disseminated infections in immunocompromised)

Tx: itraconazole or amphotericin B for disseminated infections

63
Q

Blastomyces dermatitidis

A

Fungus, endemic to northeast US

Dz: blastomycosis (pulmonary infection that can spread to skin or bone forming ulcerated granulomas)

Tx: itraconazole or amphotericin B for disseminated infections

64
Q

Candida albicans

A

Opportunistic fungus (yeast only)

Dz: candidiasis (thrush, vulvovagintitis, skin/nail infections (diaper rash), right sided endocarditis in IVDU, UTI in catheters)

Tx: nystatin (topical), fluconazole (vulvovaginitis), amphotericin B (systemic infections)

65
Q

Cryptococcus neoformans

A

Opportunistic fungus (yeast only) from bird droppings, thick walled capsule on India Ink stain

Dz: meningitis (AIDS), pulmonary infections

Tx: amphotericin B + flucytosine for induction and fulconazole for maintenance

66
Q

Aspergillus fumigatus

A

Opportunistic fungus (mold only with septate hyphae)

Dz: aspergillosis

  • Allergic bronchopulmonary aspergillosis
  • Fungus ball in preexisting TB cavities

Tx: amphotericin B, caspofungin, surgical removal of fungus ball

67
Q

Mucor and Rhizopus

A

Opportunistic fungus (mold only) with irregular broad aseptate hyphae

Dz: mucormycosis (invasion leads to ischemic necrosis in sinuses and brain, as well as lungs and GI tract)

Tx: amphotericin B and surgical removal of necrotic tissue

68
Q

Pneumocystis jiroveci

A

Opportunistic fungus, methenamine-silver stain +

Dz: pneumonia (diffuse bilateral interstitial infilatrates with ground-glass appearance)

Tx: TMP-SMX (also used for prophylaxis in CD4 < 200)

69
Q

Plasmodium vivax/ovale/malariae/falciparum

A

Protozoa transmitted by mosquito bite

Dz: malaria (fever chills, sweats, hemolytic anemia, and hepatosplenomegaly), black water disease (P. falciparum - above plus cerebral malaria, lung edema, renal failure from hemoglobinuria, and death)

  • P. malariae: endemic to Asia, Africa, and Latin America and targets mature RBC
    • Tx: chloroquine
  • P. vivax/ovale: endemic to Asia, Africa, and Latin America and targets reticulocytes and remains latent in hepatocytes
    • Tx: chloroquine and primaquine (for dormant form)
  • P. falciparum: endemic to SE Asia, E Africa, and South America and targets all age RBC
    • Tx: mefloquine or quinine + doxycycline
70
Q

Babesia microti

A

Protozoa (sporozoites, trophozoites, merozoites) trasmitted by Ixodes tick in NE US

Dz: babesiosis (fever, chills, hemolytic anemia, hepatosplenomegaly) - blood smear shows ring-like trophozoites or Maltese cross-like merozoites

Tx: **quinine + clindamycin **

71
Q

Naegleria fowleri

A

Amoeba that invades nasal mucosa and eats brain in southwest US

Dz: primary amebic meningoencephalitis

Tx: amphotericin B + miconazole + rifampin or don’t put head underwater

72
Q

Toxoplasma gondii

A

Protozoa from ingestion of undercooked meat or contact with cat feces

Dz:

  • Congential toxoplasmosis: abortion, stillbirth, hepatosplenomegaly, or triad of intracranial calcification, hydrocephalus, and chorioretinitis
  • Mononucleosis in immunocompetent
  • Encephalitis, brain abscess, pneumonia, myocarditis in immunocompromised

Tx: sulfadiazine + pyrimetamine and avoid cats/raw meat if pregnant

73
Q

Leishmania donovani (tropica/mexiana/braziliensis)

A

Intracellular parasite that infects bone marrow and spleen (transmitted by sandfly bite)

Dz:

  • L. donovani: visceral leishmaniasis (fever, hepatosplenomegaly, skin hyperpigementation, and bone marrow suppression causing pancytopenia, infections, and bleeding)
  • L. tropica/mexicana: cutaneous leishmaniasis (nodules and ulcers)
  • L. braziliensis: mucocutaneous leishmaniasis (granulomatous ulcerating lesions)

Tx: sodium stibogluconate or amphotericin B

74
Q
A
75
Q

Trypanosoma cruzi

A

Flagellated trypomastigotes and nonflagellated amastigotes (reduviid bug bite)

Dz: Chagas’ disease (facial edema and nodules, chronic dilated cardiomyopathy, arrhythmias, megacolon, megaesophagus)

Tx: nifurtimox or benznidazole

76
Q

Trypanosoma gambiense/rhodesiense

A

Flagellated trypomastigotes in blood/CSF without nonflagellated amastigotes in tissue

Dz: sleeping sickness (recurring fever, lymphadenopathy, encephalitis leading to coma and death)

Tx: suramin and melarsoprol for encephalitis

77
Q

Entamoeba histolytica

A

Trophozoites and cysts

Dz:

  • Amoebic dysentery: bloody diarrhea and abdominal pain
  • Hepatic abscesses (anchovy sauce-like pus)

Tx: metronidazole

78
Q

Giardia lamblia

A

Trophozoites and cysts

Dz: giardiasis (watery, fatty, foul-smelling diarrhea)

Tx: metronidazole and supportive care

79
Q

Cryptosporidium parvum

A

Ingestion of oocysts (acid fast) which form sporozoites then trophozoites

Dz: cryptosporidiosis (watery diarrhea, worse in immunocompromised)

Tx: self-limited with normal immunity, paromomycin for immunocompromised

80
Q

Trichomonas vaginalis

A

Trophozoites with no cysts transmitted by sexual contact

Dz: trichomoniasis (foul smelling, greenish vaginal discharge)

Tx: metronidazole

Medicine (4 decks)

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