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8th > Chapter 154- Gram Negative Coccal And Bacillary Infections > Flashcards

Chapter 154- Gram Negative Coccal And Bacillary Infections Flashcards

1
Q

Facultative intracellular Gram negative bacilli that parasitize erythrocytes due to their inability to synthesize (2)

A

Bartonella
Heme
Protoporphyrin X

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2
Q

Matching type

  1. Cat scratch disease
  2. Trench fever
  3. Bacillary angiomatosis
  4. Carrion disease

A. Bartonella henselae
B. Bartonella quintana
C. Bartonella bacilliformis

A

A
B
A B
C

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3
Q

Matching type

  1. Pediculus humanus
  2. Ctenocephalides felis
  3. Lutzomiya verrucarum

A. Bartonella henselae
B. Bartonella quintana
C. Bartonella bacilliformis

A

B
A
C

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4
Q

Carrion disease is a biphasic infection with (2) phases

A

Oroya fever

Verruga peruana

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5
Q

Bartonella can be cultured in

A

5% rabbit/ sheep blood agar at 35- 37 C with 5-10% CO2

40% humidity

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6
Q

Bartonella lipopolysaccharide is an antagonist of TLR

A

4

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7
Q

Flagella of Bartonella bacilliformis is recognized by TLR5

True or False

A

False, not recognized

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8
Q

Mechanism to elude both humoral and cellular immunity

A

Parasitizing host RBCs

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9
Q

Most common Bartonella infection

A

Cat scratch disease

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10
Q

CSD affects immunocompetent patients with median age of

A

15 years

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11
Q

MC presenting sign of CSD

A

Lymphadenitis

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12
Q

Unilateral granulomatous conjunctivitis with ipsilateral preauricular and submandibular lymphadenopathy

A

Parinaud oculoglandular syndrome

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13
Q

5 regional lymphadenopathy sites of CSD

A 
Axillary
Cervical
Inguinal
Epitrochlear
Preauricular
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14
Q

Acute unilateral blurred vision resulting from optic nerve edema with an afferent pupullary defect

A

CSD neuroretinitis

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15
Q

Large bulky lymphadenopathy of CSD is treated with

A

Azithromycin
Doxycycline
Erythromycin

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16
Q

If hepatosplenic CSD, management is

A

Rifampicin +/- Gentamicin or TMP SMX

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17
Q

If ocular CSD, management is

A

Doxycycline + Rifampicin

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18
Q

Classic patient of trench fever

A

Homeless, immunocompetent, alcoholic man with poor hygiene

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19
Q

Treatment of trench fever

A

28 days PO doxycycline + 14 days of IV gentamicin

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20
Q

MC site of disease of bacillary angiomatosis

A

Skin (55%- 90%)

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21
Q

Primary cause of liver, spleen, lymph node lesions in bacillary angiomatosis

A

B. Henselae

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22
Q

Primary cause of lesions in subQ and bone in bacillary angiomatosis

A

B. Quintana

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23
Q

Characteristic lesion of bacillary angiomatosis

A

Reddish purple, angiomatous purple 1 cm in diameter

24
Q

Triad of peliosis hepatitis

A

Abdominal pain
Hepatomegaly
Splenomegaly

25
Q

Most commonly affected bone in BA (2)

A

Radius or tibia

26
Q

In BA, CD4 counts of AIDS patients is

A

<100 cells/mm3

27
Q

Relapses are common especially if antibiotic has been given for less than

28
Q

Treatment for uncomplicated BA

A

Erythromycin
Doxycycline
For 3 months

29
Q

In severe cases of BA, treatment should include

A

Rifamycin + doxycyline, erythromycin

30
Q

For Bartonella endocarditis

A

Doxycyline + Gentamicin for 2 weeks

Substitute rifamycin in renal insufficiency

31
Q

20/80 rule is consistent with carrion disease, malaria, lesihmaniasis meaning

A

80% of disease in 20% of households

32
Q

Highest incidence of Carrion disease is in

A

Less than 5 years old

33
Q

Incidence of carrion disease is inversely proportional to age due to acquired immunity.
True or False

34
Q

Matching type

  1. Hemolytic anemia
  2. Eruptive angiomatous, verrucous nodules on head and distal extremities
  3. Acute bacteremia
  4. Increase opportunistic infections
  5. Intense angioblastic proliferation

A. Oroya
B. Verruga peruana

35
Q

Blood cultures in Carrion disease are often collected during

A

Oroya phase

36
Q

Severe cases of Carrion disease are more likely to occur in natives.
True or False

A

False, travelers

37
Q

Managment of Oroya fever

A

14 day ciprofloxacin

+ chloramphenicol/ B lactam

38
Q

RBC should be transfused if Hct falls below

39
Q

Treatment for verruga peruana

A

Rifampicin + IM streptomycin

40
Q

Classic cutaneous manifestation of typhoid fever

A

Rose spots (30%)

41
Q

Most common complications of enteric fever (3)

A 
Intestinal bleeding (MC)
Ileal perforation (most serious)
Encephalopathy
42
Q

Salmonella species differ by

A

O (somatic)

H (flagellar)

43
Q

Asymptomatic, blanching, erythematous, pale to pink papules on abdomen, chest, or back that fade in 3-5 days

A

Rose spots

44
Q

Constipation is common in children and HIV patients.

True or False

A

False, diarrhea

45
Q

At risk for chronic carrier state (3)

A

Women
Elderly
Cholelithiasis

46
Q

Strongest predictive factors for enteric fever (5)

A 
Rose spots
Relative bradycardia
Splenomegaly
Thrombocytopenia
Increase AST
47
Q

Management for salmonella

A

Ciprofloxacin
Ofloxacin
Azithromycin
Ceftriaxone (severe)

48
Q

Vaccines acailable for eneteric fever (2)

A

Ty21a

Vi polysaccharide vaccine

49
Q

Rare granulomatous disease affecting nose and URT

A

Rhinoscleroma

50
Q

3 phases of rhinoscleroma

A

Atrophic
Proliferative
Cicatricial

51
Q

Large vacuolated histiocytes containing K. Granulomatis

A

Mikulicz cells

52
Q

Mikulicz cells are stained with

53
Q

Commonly used treatment for rhinoscleroma

A

Tetracycline
Rifampicin
Ciprofloxacin
TMP-SMX

54
Q

Haemophilus influenzae requires

A

Hemin (Factor X)

Nicotinamide adenine dinucleotide (Factor V)

55
Q

Unilateral facial swelling with violaceous hue in buccal or periorbital region in 3-24mos of age

A

HIB cellulitis

56
Q

Treatment for Hib (2)

A

Ceftriaxone

Cefotaxime

8th (28 decks)

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