Cases 1 Flashcards
What is the leading cause of acute OM?
Viral (70% of the time)
Gram positive cocci in chains = ?
Streptococcus
What is the test that differentiates between staph and strep? What is the result for each?
Catalase test
Strep is catalase negative
Staph is positive
How do differentiate staph aureus from other staph species?
Staph aureus is coagulase positive
What are the four gram positive rods?
Clostridium
Corynebacterium
Listeria
bacillus
alpha hemolytic strep = ?
S. pneumoniae or strep viridans
Beta hemolytic strep = ?
Staph pyogenes
Staph agalactiae
Gamma hemolytic strep = ?
Peptostreptococcus
How do you differentiate between S pneumoniae and viridans strep, since both are alpha hemolytic?
S pnueumoniae is optochin sensitive and bile souble
viridans is not afraid of da chin
How do you differentiate between group A strep (pyogenes) and group B strep (agalactiae)?
Group A is bacitracin sensitive
What does alpha hemolysis result in?
Partial,, green clearing of the blood agar
What does beta hemolysis result in?
Clear hemolysis
What is the abx of choice for acute OM? What if this is contraindicated?
Amoxicillin
TMP-SMX
What is the bacterial class that amoxicillin targets?
Gram positive
What does insufflation test?
Eustachian tube, not the TM
What is the abx treatment for recurrent OM?
Augmentin
What are the complications of OM?
- TM perforation
- Tympanosclerosis
- mastoiditis
- Meningitis
Clear fluid behind the TM indicates what?
Eustachian tube dysfunction
If the insufflation test produces movement of the TM, what does this indicate?
That there is not eustachian tube pathology
What is the pathophysiology behind acute OM?
Blocked drainage and transudation of fluid. Bacteria grow in the transudate.
What is the pathophysiology of OME/SOM?
Same as OM but no bacterial growth
What is the treatment for OME/SOM?
Watchful waiting unless hearing loss
What are the organisms that usually cause otitis externa? (2)
Pseudomonas
Staph aureus
What are the organisms that usually cause otitis media? (4)
Strep pneumoniae
Moraxella catarrhalis
Staph Aureus
HiB
Does candida have septated hyphae? Does aspergilus?
Candida no (no hyphae)
Aspergillus yes
In whom does mucor cause sinusitis?
DM pts
What is the treatment for a fungal cause of otitis externa?
Azole
Tinea versicolor is usually caused by what?
Malassezia furfur
What are the three dermatophytes that cause onychomycosis?
Microsporum
Trichophyton
Epidermophyton
What is the cause of rose thorn cellulitis?
Sporothrix schenckii
What are the three major opportunistic fungal infections?
Candidiasis
Aspergillosis
Mucormycosis
Where is coccidioidomycosis common? What symptoms does it cause?
Southwest
pneumonia or vally fever
Where is blastomycosis common? What symptoms does it cause?
Northeast
Wooded areas
skin/pulmonary infections
Where is histoplasmosis common? What symptoms does it cause?
Bird droppings
Midwest
Pulmonary and erythema nodosum
What are the usual pathogens that cause sinusitis? (3 bacteria, 2 viruses)
Strep pneumo Moraxella catarrhalis HiB Rhinovirus Coronavirus
What is the treatment for bacterial sinusitis?
- amoxicillin
- None antihistamine decongestants
- Mucolytics
How common is bacterial sinusitis?
2% ish
What is the triad that is suspicious for atopy?
ASA asthma
Sinusitis
Nasal polyps
Why are antihistamine decongestants contraindicated for sinusitis?
Will decreased flow of mucus, make it worse
Gram negative rods + blue-green culture = ?
Pseudomonas aruginosa
What is the treatment for pseudomonas sinusitis?
Fluoroquinolone
What are the complications from sinusitis?
Meningitis
boney invasion of the orbit
Tonsil exudates = what two organisms?
EBV or strep pyogenes
strep pyogenes has what type of hemolysis?
beta
GBS is also known as what?
Strep agalactiae
Is strep pyogenes bacitracin sensitive or resistant?
Sensitive
What is the sensitivity of the rapid strep test?
95%
Why treat strep throat?
Prevent rheumatic fever
symptomatic relief
