Diseases Exam 4 Flashcards
1
Q
Causative Organism(s) for MARS Skin and Soft-Tissue Infection
A
Methicillin-resistant Staphylococcus aureus
2
Q
Most Common Modes of Transmission for MRSA Skin and Soft-Tissue Infection
A
Direct contact, indirect contact
3
Q
Virulence Factors for MRSA Skin and Soft-Tissue Infection
A
Coagulase, other enzymes, superantigens
4
Q
Culture/Diagnosis for MRSA Skin and Soft-Tissue Infection
A
PCR, culture and Gram stain, coagulase and catalase tests, multitest systems, MSA
5
Q
Prevention for MRSA Skin and Soft-Tissue Infection
A
Hygiene practices
6
Q
Treatment for MRSA Skin and Soft-Tissue Infection
A
Clindamycin + TMP/SMZ; in Serious Threat category in CDC Antibiotic Resistance Report
7
Q
EpidemiologyL for MRSA Skin and Soft-Tissue Infection
A
Community-associated MRSA infections most commonin children and young to middle-aged adultsIncidence increasing in communities (decreasing in hospitals)
8
Q
Causative Organism(s) for Measles (Rubeola)
A
Measles virus
9
Q
Most common modes of transmission for Measles (Rubeola)
A
Droplet contact
10
Q
Virulence factors for Measles (Rubeola)
A
Syncytium formation, ability to suppress CMI
11
Q
Culture/Diagnosis for Measles (Rubeola)
A
ELISA for IgM, acute/convalescent IgG
12
Q
Prevention for Measles (Rubeola)
A
Live attenuated vaccine (MMR or MMRV)
13
Q
Treatment Measles (Rubeola)
A
No antivirals; vitamin A, antibiotics for secondary bacterial infections
14
Q
Distinguishing Features of the Rashes Measles (Rubeola)
A
Starts on head, spreads to whole body, lasts over a week
15
Q
Epidemiological features for measles (Rubeola)
A
Incidence increasing in North America; in developing countries incidence is 30 million cases/yr and 1million deaths
16
Q
Causative Organism(s) for Rubella
A
Rubella virus
17
Q
Most common modes of transmission for Rubella
A
Droplet contact
18
Q
Virulence factors for Rubella
A
In fetuses; inhibition of mitosis, induction of apoptosis, and damage to vascular endothelium
19
Q
Culture/Diagnosis for Rubella
A
Acute IgM, acute/convalescent IgG
20
Q
Prevention for Rubella
A
Live attenuated vaccine (MME or MMRV)
21
Q
Treatment for Rubella
A
none
22
Q
Distinguishing feature of the rashes for Rubella
A
Milder red rash, lasts approximately 3 days
23
Q
Epidemiological features for Rubella
A
3 cases reported in United States in 2009; worldwide: 100,000 infants/yr born with congenital rubella syndrome
24
Q
Causative organism(s) for Fifth Disease
A
Parvovirus B19
25
Most common modes of transmission for Fifths Disease
Droplet contact, direct contact
26
Virulence Factor for Fifth Disease
none
27
Culture/Diagnosis for Fifth Disease
Usually diagnosed clinically
28
Prevention for Fifth Disease
none
29
Treatment for Fifth Disease
none
30
Distinguishing features of the rashes for Fifth Disease
"Slapped-face" rash first, spreads to limbs and trunk, tends to be confluent rather than distinct bumps
31
Epidemiological feature for Fifth Disease
60% of population seropositive by age 20
32
Causative organism(s) for Roseola
Human herpesvirus 6
33
Most common modes of transmission for Roseola
Unknown
34
Virulence factors for Roseola
Ability to remain latent
35
Culture/Diagnosis for Roseola
Usually diagnosed clinically
36
Prevention for Roseola
none
37
Treatment for Roseola
none
38
Distinguishing features of the Rashes for Roseola
High fever precedes rash stage; rash not always present
39
Epidemiological feature for Roseola
>90% seropositive, 90% of disease cases occur before age of 2
40
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Causative Organism(s) for
Impetigo- S. aureus
```
Staphylococcus aureus
41
Most Common Modes of Transmission for Impetigo- S. aureus
Direct contact, indirect contact
42
Virulence Factors for
| Impetigo- S. aureus
Exfoliative toxin A, coagulase, other enzymes
43
Culture/Diagnosis for Impetigo- S. aureus
Routinely based on clinical signs, when necessary, culture and Gram stain, coagulase and catalase tests, multitest systems, PCR
44
Prevention for Impetigo- S. aureus
Hygiene practices
45
Treatment for Impetigo- S. aureus
Topical mupirocin or retapamulin, oral dicloxacillin, cephalexin, or TMP-SMZ; (MRSA is in Serious Threat category in CDC Antibiotic Resistance Report)
46
Distinguishing Features for
| Impetigo- S. aureus
Seen more often in older children, adults
47
Epidemiological Features for
| Impetigo- S. aureus
Prevalence approximately 1% of children in North America
48
Causative Organism(s) forImpetigo- S. pyogenes
Streptococcus pyogenes
49
Most Common Modes of Transmission for Impetigo- S. pyogenes
Direct contact, indirect contact
50
Virulence Factors for Impetigo-S. pyogenes
Streptokinase, plasminogen-binding ability, hyaluronidase, M protein
51
Culture/Diagnosis for
| Impetigo- S. pyogenes
Routinely based on clinical signs, when necessary, culture and Gram stain, coagulase and catalase tests, multitest systems, PCR
52
Prevention for Impetigo- S. pyogenes
Hygiene practices
53
Treatment for Impetigo- S. pyogenes
Topical mupirocin or retapamulin
54
Distinguishing Features for Impetigo- S. pyogenes
Seen more often in newborns
55
Causative Organism(s) for Vesicular/Pustular Rash Diseases- Chickenpox
Human herpesvirus 3 (varicella-zoster virus)
56
Most Common Modes of Transmission for Vesicular/Pustular Rash Diseases- Chickenpox
Droplet contact, inhalation of aerosolized lesion fluid
57
Virulence Factors for Vesicular/Pustular Rash Diseases- Chickenpox
Ability to fuse cells, ability to remain latent in ganglia
58
Culture/Diagnosis for Vesicular/Pustular Rash Diseases- Chickenpox
Based largely on clinical appearance
59
Prevention for Vesicular/Pustular Rash Diseases- Chickenpox
Live attenuated vaccine; there is also vaccine to prevent reactivation of latent virus (shingles)
60
Treatment for Vesicular/Pustular Rash Diseases- Chickenpox
None in uncomplicated cases; acyclovir for high risk
61
Distinguishing Features for Vesicular/Pustular Rash Diseases- Chickenpox
No fever prodrome; lesions are superficial; in centripetal distribution (more in center of body)
62
Epidemiological Features for Vesicular/Pustular Rash Diseases- Chickenpox
Chickenpox: vaccine decreased hospital visits by 88%, ambulatory visits by 59%; shingles: 1 million cases annually
63
Causative Organism(s) for Vesicular/Pustular Rash Diseases- Smallpox
Variola virus
64
Most Common Modes of Transmission for Vesicular/Pustular Rash Diseases- Smallpox
Droplet contact, indirect contact
65
Virulence Factors for Vesicular/Pustular Rash Diseases- Smallpox
Ability to dampen, avoid immune response
66
Culture/Diagnosis for Vesicular/Pustular Rash Diseases- Smallpox
Based largely on clinical appearance
67
Prevention for Vesicular/Pustular Rash Diseases- Smallpox
Live virus vaccine (vaccinia virus)
68
Treatment for Vesicular/Pustular Rash Diseases- Smallpox
Cidofovir, immune globulin
69
Distinguishing Features for Vesicular/Pustular Rash Diseases- Smallpox
Fever precedes rash, lesions are deep and in centrifugal distribution (more on extremities)
70
Epidemiological Features for Vesicular/Pustular Rash Diseases- Smallpox
Last natural case worldwide was in 1977
71
Causative Organism(s) for Conjunctivitis- Neonatal Conjunctivitis
Chlamydia trachomatis or Neisseria gonorrhoeae
72
Most Common Modes of Transmission for Conjunctivitis- Neonatal Conjunctivitis
Vertical
73
Virulence Factors for Conjunctivitis- Neonatal Conjunctivitis, Bacterial Conjunctivitis, Viral Conjunctivitis
None
74
Culture/Diagnosis for Conjunctivitis- Neonatal Conjunctivitis
Gram stain and culture
75
Prevention for Conjunctivitis- Neonatal Conjunctivitis
Screen mothers, apply antibiotic or silver nitrate to newborn eyes
76
Treatment for Conjunctivitis- Neonatal Conjunctivitis
Topical and oral antibiotics; (antibiotic-resistant N. gonorrhoeae is in Urgent Threat category in CDC Antibiotic Resistance Report)
Gatifloxacin or levofloxacin ophthalmic solution
77
Distinguishing Features for Conjunctivitis- Neonatal Conjunctivitis
In babies <28 days old
78
Epidemiological Features for Conjunctivitis- Neonatal Conjunctivitis
Less than 0.5% in developed world; higher incidence in developing world
79
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Causative Organism(s) for Conjunctivitis-
Bacterial Conjunctivitis
```
Streptococcus pneumoniae, Staphylococcus epidermidis, Staphylococcus aureus, Haemophilus influenzae, Moraxella, and also Neisseria gonorrhoeae, Chlamydia trachomatis
80
Most Common Modes of Transmission for Conjunctivitis-
| Bacterial Conjunctivitis
Direct, indirect contact
81
Culture/Diagnosis for Conjunctivitis-
| Bacterial Conjunctivitis
Clinical diagnosis
82
Prevention for Conjunctivitis-
| Bacterial Conjunctivitis
Hygiene
83
Treatment for Conjunctivitis-
| Bacterial Conjunctivitis
Gatifloxacin or levofloxacin ophthalmic solution
84
Distinguishing Features for Conjunctivitis-
| Bacterial Conjunctivitis
Mucopurulent discharge
85
Epidemiological Features for Conjunctivitis-
| Bacterial Conjunctivitis
More common in children
86
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Causative Organism(s) for Conjunctivitis-
Viral Conjunctivitis
```
Adenoviruses and others
87
Most Common Modes of Transmission for Conjunctivitis-
| Viral Conjunctivitis
Direct, indirect contact
88
Culture/Diagnosis for Conjunctivitis-
| Viral Conjunctivitis
Clinical diagnosis
89
Prevention for Conjunctivitis-
| Viral Conjunctivitis
Hygiene
90
Treatment for Conjunctivitis-
| Viral Conjunctivitis
None, although antibiotics often given because type of infection not distinguished
91
Distinguishing Features for Conjunctivitis-
| Viral Conjunctivitis
Serous (clear) discharge
92
Epidemiological Features for Conjunctivitis-
| Viral Conjunctivitis
More common in adults
93
Causative Organism(s) for Meningitis
Neisseria meningitidis
Streptococcus pneumoniae
Haemophilus influenzae
94
Most Common Modes of Transmission for Meningitis-Neisseria meningitidis
Droplet contact
95
Virulence Factors for Meningitis-Neisseria meningitidis
Capsule, endotoxin, IgA protease
96
Culture/Diagnosis for Meningitis-Neisseria meningitidis
Gram stain/culture of CSF, blood, rapid antigenic tests, oxidase test
97
Prevention for Meningitis-Neisseria meningitidis
Conjugated vaccine; ciprofloxacin, rifampin, or ceftriaxone used to protect contacts
98
Treatment for Meningitis-Neisseria meningitidis
Ceftriaxone, aztreonam, chloramphenicol
99
Distinctive Features for Meningitis-Neisseria meningitidis
Petechiae, meningococcemia rapid decline
100
Epidemiological Features for Meningitis-Neisseria meningitidis
United States: 0.9–1.5 cases per 100,000 annually; meningitis belt: 1,000 cases per 100,000 annually
101
Most Common Modes of Transmission for Meningitis-Streptococcus pneumoniae
Droplet contact
102
Virulence Factors for Meningitis- Streptococcus pneumoniae
Capsule, induction of apoptosis, hemolysin and hydrogen peroxide production
103
Culture/Diagnosis for Meningitis- Streptococcus pneumoniae
Gram stain/culture of CSF
104
Prevention for Meningitis- Streptococcus pneumoniae
Two vaccines: PCV13 (children and adults), and PPSV23 (adults)
105
Distinctive Features for Meningitis- Streptococcus pneumoniae
Serious, acute, most common meningitis in adults
106
Treatment for Meningitis- Streptococcus pneumoniae
Vancomycin + ceftriaxone; in “Serious Threat” category in CDC Antibiotic Resistance Report
107
Epidemiological Features for Meningitis- Streptococcus pneumoniae
U.S. incidence before vaccine for children: 7.7 hospitalizations per 100,000. After vaccine for children: 2.6 per 100,000
108
Most Common Modes of Transmission for Meningitis-Haemophilus influenzae
Droplet contact
109
Virulence Factors for Meningitis-Haemophilus influenzae
Capsule
110
Culture/Diagnosis for Meningitis-Haemophilus influenzae
Culture on chocolate agar
111
Prevention for Meningitis-Haemophilus influenzae
Hib vaccine, ciprofloxacin, rifampin, or ceftriaxone
112
Treatment for Meningitis-Haemophilus influenzae
Ceftriaxone
113
Distinctive Features for Meningitis-Haemophilus influenzae
Serious, acute, less common since vaccine became available
114
Epidemiological Features for Meningitis-Haemophilus influenzae
Before vaccine, 300,000– 400,000 deaths worldwide per year
115
Causative Organism(s) for Meningitis #2
- Listeria monocytogenes
- Cryptococcus neoformans
- Coccidioides immitis
- Virus
116
Most Common Modes of Transmission for Meningitis-Listeria monocytogenes
Vehicle (food)
117
Virulence Factors for Meningitis-Listeria monocytogenes
Intracellular growth
118
Culture/Diagnosis for Meningitis-Listeria monocytogenes
Cold enrichment, rapid methods
119
Prevention for Meningitis-Listeria monocytogenes
Cooking food, avoiding unpasteurized dairy products
120
Treatment for Meningitis-Listeria monocytogenes
Ampicillin, trimethoprim- sulfamethoxazole
121
Distinctive Features for Meningitis-Listeria monocytogenes
Asymptomatic in healthy adults; meningitis in neonates, elderly, and immunocompromised
122
Epidemiological Features for Meningitis- Listeria monocytogenes
Mortality can be as much as 33%
123
Most Common Modes of Transmission for Meningitis--Cryptococcus neoformans
Vehicle (air, dust)
124
Virulence Factors for Meningitis--Cryptococcus neoformans
Capsule, melanin production
125
Culture/Diagnosis for Meningitis--Cryptococcus neoformans
Negative staining, biochemical tests, DNA probes, cryptococcal antigen test
126
Prevention for Meningitis--Cryptococcus neoformans
none
127
Treatment for Meningitis--Cryptococcus neoformans
Amphotericin B and fluconazole
128
Distinctive Features for Meningitis--Cryptococcus neoformans
Acute or chronic, most common in AIDS patients
129
Epidemiological Features for Meningitis--Cryptococcus neoformans
Incidence before AIDS: >1 case per million per year; 66 cases per year in pre-HAART era; worldwide: 1 million new cases per year
130
Most Common Modes of Transmission for Meningitis-Coccidioides immitis
Vehicle (air, dust, soil)
131
Virulence Factors for Meningitis- Coccidioides immitis
Granuloma (spherule) formation
132
Culture/Diagnosis for Meningitis- Coccidioides immitis
Identification of spherules, cultivation on Sabouraud’s agar
133
Prevention for Meningitis- Coccidioides immitis
Avoiding airborne endospores
134
Treatment for Meningitis- Coccidioides immitis
Amphotericin B or oral or IV itraconazole
135
Distinctive Features for Meningitis- Coccidioides immitis
Almost exclusively in endemic regions
136
Epidemiological Features for Meningitis- Coccidioides immitis
Incidence in endemic areas: 200–300 annually
137
Most Common Modes of Transmission for Meningitis-Viruses
Droplet contact
138
Virulence Factors for Meningitis-Viruses
Lytic infection of host cells
139
Culture/Diagnosis for Meningitis-Viruses
Initially, absence of bacteria/fungi/ protozoa, followed by viral culture or antigen tests
140
Prevention for Meningitis-Viruses
none
141
Treatment for Meningitis-Viruses
Usually none (unless specific virus identified and specific antiviral exists)
142
Distinctive Features for Meningitis-Viruses
Generally milder than bacterial or fungal
143
Epidemiological Features for Meningitis-Viruses
In United States, 4 of 5 meningitis cases caused by viruses: 26,000– 42,000 hospitalizations/year
