Cases 1 Flashcards

1
Q

What is the leading cause of acute OM?

A

Viral (70% of the time)

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2
Q

Gram positive cocci in chains = ?

A

Streptococcus

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3
Q

What is the test that differentiates between staph and strep? What is the result for each?

A

Catalase test

Strep is catalase negative
Staph is positive

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4
Q

How do differentiate staph aureus from other staph species?

A

Staph aureus is coagulase positive

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5
Q

What are the four gram positive rods?

A

Clostridium
Corynebacterium
Listeria
bacillus

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6
Q

alpha hemolytic strep = ?

A

S. pneumoniae or strep viridans

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7
Q

Beta hemolytic strep = ?

A

Staph pyogenes

Staph agalactiae

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8
Q

Gamma hemolytic strep = ?

A

Peptostreptococcus

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9
Q

How do you differentiate between S pneumoniae and viridans strep, since both are alpha hemolytic?

A

S pnueumoniae is optochin sensitive and bile souble

viridans is not afraid of da chin

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10
Q

How do you differentiate between group A strep (pyogenes) and group B strep (agalactiae)?

A

Group A is bacitracin sensitive

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11
Q

What does alpha hemolysis result in?

A

Partial,, green clearing of the blood agar

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12
Q

What does beta hemolysis result in?

A

Clear hemolysis

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13
Q

What is the abx of choice for acute OM? What if this is contraindicated?

A

Amoxicillin

TMP-SMX

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14
Q

What is the bacterial class that amoxicillin targets?

A

Gram positive

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15
Q

What does insufflation test?

A

Eustachian tube, not the TM

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16
Q

What is the abx treatment for recurrent OM?

A

Augmentin

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17
Q

What are the complications of OM?

A
  • TM perforation
  • Tympanosclerosis
  • mastoiditis
  • Meningitis
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18
Q

Clear fluid behind the TM indicates what?

A

Eustachian tube dysfunction

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19
Q

If the insufflation test produces movement of the TM, what does this indicate?

A

That there is not eustachian tube pathology

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20
Q

What is the pathophysiology behind acute OM?

A

Blocked drainage and transudation of fluid. Bacteria grow in the transudate.

21
Q

What is the pathophysiology of OME/SOM?

A

Same as OM but no bacterial growth

22
Q

What is the treatment for OME/SOM?

A

Watchful waiting unless hearing loss

23
Q

What are the organisms that usually cause otitis externa? (2)

A

Pseudomonas

Staph aureus

24
Q

What are the organisms that usually cause otitis media? (4)

A

Strep pneumoniae
Moraxella catarrhalis
Staph Aureus
HiB

25
Q

Does candida have septated hyphae? Does aspergilus?

A

Candida no (no hyphae)

Aspergillus yes

26
Q

In whom does mucor cause sinusitis?

A

DM pts

27
Q

What is the treatment for a fungal cause of otitis externa?

A

Azole

28
Q

Tinea versicolor is usually caused by what?

A

Malassezia furfur

29
Q

What are the three dermatophytes that cause onychomycosis?

A

Microsporum
Trichophyton
Epidermophyton

30
Q

What is the cause of rose thorn cellulitis?

A

Sporothrix schenckii

31
Q

What are the three major opportunistic fungal infections?

A

Candidiasis
Aspergillosis
Mucormycosis

32
Q

Where is coccidioidomycosis common? What symptoms does it cause?

A

Southwest

pneumonia or vally fever

33
Q

Where is blastomycosis common? What symptoms does it cause?

A

Northeast
Wooded areas
skin/pulmonary infections

34
Q

Where is histoplasmosis common? What symptoms does it cause?

A

Bird droppings
Midwest

Pulmonary and erythema nodosum

35
Q

What are the usual pathogens that cause sinusitis? (3 bacteria, 2 viruses)

A
Strep pneumo
Moraxella catarrhalis
HiB
Rhinovirus
Coronavirus
36
Q

What is the treatment for bacterial sinusitis?

A
  • amoxicillin
  • None antihistamine decongestants
  • Mucolytics
37
Q

How common is bacterial sinusitis?

A

2% ish

38
Q

What is the triad that is suspicious for atopy?

A

ASA asthma
Sinusitis
Nasal polyps

39
Q

Why are antihistamine decongestants contraindicated for sinusitis?

A

Will decreased flow of mucus, make it worse

40
Q

Gram negative rods + blue-green culture = ?

A

Pseudomonas aruginosa

41
Q

What is the treatment for pseudomonas sinusitis?

A

Fluoroquinolone

42
Q

What are the complications from sinusitis?

A

Meningitis

boney invasion of the orbit

43
Q

Tonsil exudates = what two organisms?

A

EBV or strep pyogenes

44
Q

strep pyogenes has what type of hemolysis?

A

beta

45
Q

GBS is also known as what?

A

Strep agalactiae

46
Q

Is strep pyogenes bacitracin sensitive or resistant?

A

Sensitive

47
Q

What is the sensitivity of the rapid strep test?

A

95%

48
Q

Why treat strep throat?

A

Prevent rheumatic fever

symptomatic relief