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AAW - CRAAB 1 > Diebels shit > Flashcards

Diebels shit Flashcards

1
Q

when do you see septic emboli

A

ACUTE infectious endocarditis

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2
Q

osler node

A

painful red lesion found on hand. deposition of immune complexes (hypersensitivity type III) phenomenon seen in IE

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3
Q

Janeway lesion

A

septic emboli in extremities seen in IE

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4
Q

Nafcillin in IE

A

penecillin that is resistant to beta-lactamase activity (which is common in staph)

give it for acute infectious endocarditis

can give with genta/tobramycin too

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5
Q

What do you give for subacute endocarditis usually

A
  1. Ampicillin/sulbactam

2. Vanco

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6
Q

What do you give for IE if the patient has a penecillin allergy

A

3rd or 5th gen cephalosporins

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7
Q

Things about staph aureus: catalase? coagulase? Virulence factors? When do you see it?

A

catalase + (decomposes peroxide to hydrogen and water)
coagulase + (forms fibrin coat around the organism)
Protein A (binds Fc portion of IgG)
Hemolysins and leukocidins (destroys RBCs and WBCs)
Hyaluronidase (breaks down connective tissue)
Staphylokinase (lyses formed clots)
Lipase (breaks down fat)
beta hemolytic

Cells, conective tissue, clots, IgG, and fat are all no match

see it in surgical wounds, IV drug users. Localized skin infections: impetigo, cellulitis, folliculitis, furuncles, carbuncles

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8
Q

Protein A

A

Binds Fc portion of IgG

found in : S. Aureus

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9
Q

Strep viridans: catalase?

A

Catalase -

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10
Q

strep viridans: bacitracin?

A

bacitracin resistant

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11
Q

general things about strep viridans

A

Catalase -
alpha hemolytic
bacitracin resistant
produces dextran for glycocalyx formation and surface adhesion proteins

needs underlying valve damage to become IE
found normally in mouths

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12
Q

when do you usually see enterococcus species of bacteria causing endocarditis

A

following genitourinary procedures in older men and obstetric procedures in women

usually preceded by bacteremia

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13
Q

3rd major cause of IE

A

enterococcus

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14
Q

virulence factors of enterococcus

A

pili
surface proteins
proteases and hyaluronidases

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15
Q

Tx for enterococcus

A

penicillins and carbepenems

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16
Q

strep pyogenes: catalase? hemolytic? bacitracin?

A

catalase -
beta hemolytic
bacitracin sensitive

17
Q

virulence factors in S. pyo.

A

streptokinase (converts plasminogen to plasmin)
M protein (resists phagocytosis)
Hyaluronidase (breaks down connective tissue)
DNase (digests DNA)
Streptolysin O (destroys RBCs)
Streptolysin S (destroys WBCs)

18
Q

what key bacteria have hyaluronidase

A

S. Aureus AND S. Pyo

19
Q

What key bacteria have DNase?

A

S. Pyo

20
Q

What bacteria has exotoxin A? what does it do?

A

Strep Pyo. Exotoxin A (superantigen) causes polyclonal activation of T cells.

21
Q

What bacteria has exotoxin B? what does it do?

A

Strep pyo. Necrotizing fasciitis

22
Q

Things that usually cause myocarditis

A

coxsackie a, b and adenovirus

23
Q

Characteristics of Coxsackie B virus

A 
Group IV (ssRNA +)
nonsegmented
Icosahedral
non enveloped
picornaviridae (polio family)
enterovirus
coxsackie
24
Q

things that usually cause pericarditis

A

cocksackie a, b, echo virus (the enteroviruses)

influenza

25
Q

name of the tick that transmists Rickettsia

A

Dermacentor

26
Q

How rash forms in Rickettsia

A

Organism infects endothelial cells -> inflamattion of small blood vessels -> maculopapular rash spreading from extremities to trunk

27
Q

Things that cause palm and sole rash

A

RMSF
Syphilus
Coxsackievirus

28
Q

Tweo obligate intracellular parasites that need host ATP that we learned

A

Chlamydiae

Rickettsia

29
Q

what usually exacerbates pericarditis symptoms

A

swallowing or laying supine

30
Q

What do all patients with pericarditis have upon examination of the heart

A

tachycardia and 3 component friction rub

31
Q

infectious agents timeline for prosthetic heart valves

A

Staph. Epi. most common for initial year (50%)

after 1 year strep viridans

32
Q

infectious agent timeline for pacemakers and defibrillators

A

within 2 weeks: S. aureus
2weeks - 1 year: coagulase negative staph i.e. staph epi

after 1 year viridans

33
Q

virulence factors of Rickettsia

auto immune hypersensitivity? What Sx does it cause?

A

OmpA and OmpB

Type 4 secretion system

Type III hypersensitivity - pain, swelling, myalgias

34
Q

How to image rickettsia

A

IgG Direct immunofluorescence assay

Do one assay right away and another in 2-4 weeks. if IgG rises 4 fold, it is positive

AAW - CRAAB 1 (8 decks)

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