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DIT G neg, Diarrhea, UTI Flashcards

1
Q

What are lactose fermenting enteric bacteria?

A

mcConKEE’S agar

Citrobacter
Klebsialla
E coli
Enterobacter
Serratia
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2
Q

What makes IgA protease?

A

SHiN

Strep pneumo
H influ
Neisseria!

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3
Q

Neisseria gon tx?

A

first line Ceft

Second azithromycin or doxy

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4
Q

What can cause adrenal hemorrhage after infection?

A

Neisseria menignitids.

Qaterhouse friedrichsen syndrome

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5
Q

Overt N mening tx?

Prophylaxis tx?

A

Ceftriaxone (and if you culture it and sensitive to pen G, switch to that)

Proph: rifampin, cipro, ceftriax (note type B has no vaccination, the rest are, so vaccinate and give meds)

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6
Q

Haemophilus influenza causes what?

Tx?

A

haEMOPhilus. Capsular type B

Epiglottitis: Thumb sign on X-ray. Protect airway by making kids comfortable
Meningitis
Otitis media
Pneumo

Ceftriaxone (seems like go to for meningitis causing bug)

Prophylactic is rifampin

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7
Q

How do you culture H influ? What is some characteristics?

A

Chocolate agar with V (nad+) and X (hemantin)

has capsule
has IgA protease

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8
Q

Painful chancroid genital ulcer caused by what?

A

Haemophilus decreyi (ducreyi makes YOU CRY (rhymes)

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9
Q

Who gets legionella?

How do you recognize it?

How do you treat it?

A

Severe pneumo, Fever, GI/CNS and HYPONATREMIA, or pontiac fever is mild flu like symptom

Aerosol transmission, no person to person transmission (think cruise ship)
Legionnaire (Quincy MacRolide) with Silver helmet around charcoal fire with Iron dagger and he is no Sissy (cysteine)

His name is Quincy MacRolide

Tx is qquinolones or macrolides

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10
Q

What does psuedomonas cause? I loves air and water

A

PSEUDO pneumonia cystic fibrosis

Pneumo in CF
Sepsis
External otitis
UTI
Drug and Diabetic
Osteomyelitis

Hot tub folliculitis

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11
Q

What is the psuedomonas toxin?

A

Exotoxin A inactivates EF-2 (cell necrosis)

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12
Q

How do you treat pseudomonas?

A

Very dangerous: use 2 drugs

aminoglycosides and extended spectrum penicillin

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13
Q

H pylori is risk of what?

Tx?

A

gastric ulcers
90% of duodenal ulcers
adenocarcionma and lymphoma

Triple therapy
PPI
Clarithromycin
Amox or metronidazole

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14
Q

ETEC toxin mechanisms? How does one of them compare to cholera?

Tx?

A

Labile: more adenylyl cyclase so more Cl kicked out

Stabile is more guanylyl cyclase so less Na taken up

Labile kind of similar to cholera which activates Gs to activate adenylyl cylase

Floroquinolones
Azythromycin if a kid

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15
Q

EHEC is from what food? Symptom?

Toxin?

Serious complication?

Tx?

A

infected meat
Bloody diarrhea
shigA like toxin inactivate 60s ribosomes

HUS: anemia, thrombocytopenia, acute renal failure b/c

Tx is supportive. Surprisingly!

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16
Q

What does EPEC do to cause diarrhea?

A

ePec and P is for Pediatrics

Watery diarrhea b/c binds to epithelium to flatten villi, but not serious

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17
Q

EIEC causes what and? What is it similar to?

Tx?

A

eIec (that is an “i”) is Invasive
Bloody diarrhea b/c INTESTINAL WALL INVASION and dysentery. Invasion causes cell death so fever and bloody diarrhea

Fluoroquinolones, TMP-SMX, azithromycin in kids

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18
Q

Shigella causes diarrhea how?

A

Shiga toxin blocks 60s subunit

Invasive into cells like EIEC

Super virulent

Watery diarrhea to bloody eventually.

Stool culture positive: use fluoroquinolones or TMP-SMX/azithromycin are second line

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19
Q

Salmonella comes from what?

Symptom?

does it ferment lactose?

A

Turtles, Egg salad or chicken salad b/c poulty/eggs at picnic and diarrhea 1-3 days later.

Bloody diarrhea/fever. No lactose fermenting

SUPPORTIVE care! if healthy.
If severely ill, fluoroquinolones.

20
Q

Salmonella vs shigella? Which can spread hematogenously?

A

Salmonella has flagella (SALMON SWIM) so spreads in blood

Osteomyelitis b/c swims and has capsule so attacks after autosplenectomy

21
Q

What is rose spots on abdomen, headache and potential diarrhea?

A

Typhoid fever. Salmonella typhi accuses it.

22
Q

What kind of diarrhea does campylobacter cause?

How do you recognize it?

What sequelae are there?

A

Bloody diarrhea

G-, z shape, oxidase positive, bloody diarrhea (children), fecal oral

Guillain barre
Reactive arthritis

Supportive or fluoroquinolones if severe

23
Q

How does heat labile toxin work for cholera?

What kind of media does it grow in?

A

activates Gs so more cAMP

Alkaline media

ORAL REHYDRATE!!!!

24
Q

What kind of diarrhea is from yersinia enterocolitica?

A

Puppy shit gave you bloody diarrhea (or pork)

Looks like salmonella

Can cause MESENTERIC adenitis (mimics appendicitis)

25
Q

What does klebsiella affect? What do you see as give away on boards?

A

red Currant jelly sputum b/c polysaccharide capsules in klebsiella (SHiNE SKiPS)

Lobar pneumonia in weak immune system

Abscess in lung
Alcoholics
Aspiration
diAbetics

also UTI

26
Q

Red currant jelly sputum?

A

red Currant jelly sputum b/c polysaccharide capsules in klebsiella (SHiNE SKiPS) and necrosis of lungs and bloody sputum

27
Q

C diff has what toxins? How do you test it?

A

Toxin A binds brush border so fluid secretion

Toxin B causes cytotoxin and kills enterocytes so PSEUDOMEMBRANOUS colitis

Test for toxins in stool

28
Q

Antibiotics of most diarrheas?

A

Fluoroquinolones or ceftriaxone/azithro

C diff: metronidazoleoral vanco (only time oral)

29
Q

Food for vibrio parahaemolyticus or vulnificus?

A

Contaminated seafod

30
Q

Food for salmonella?

A

Picnic poultry, meat, eggs or turtles a few days later

31
Q

What food has clostridium per fringes?

A

Reheated meat dish

32
Q

Pyelonephritis is different than cystitis how?

A

Has fever, WBC casts (WBCs in renal tubules get packed together and make clumps/casts), costovertebral tenderness, more hematuria.

33
Q

1, 2, 3 and 4 causes of UTI?

A

E coli
Staph S
Klebsiella
Proteus

down the list is pseudomonas, but tough to treat

34
Q

Ammonium phosphate stones formed when?

A

Proteus makes urease which ammonia magnesium stag horn stone

35
Q

Tx of UTI’s?

A

Most are gram negative.

TMP/SMX, aminopenicillins, fluoroquinolones

36
Q

Sulfonamides mechanism?

A

Folic acid inhibitors (bacteria must produce folic acid b/c can’t absorb it) so it can’t divide

Dihydropteroate synthase is blocked.

37
Q

Toxicity of sulfonamides?

A

Hypersensitivity
Hemolysis if G6PD
Nephrotoxic (tubulointerstitial nephritis)
Knocks drugs off of albumin (warfarin)
Photosensitivity (SAT: Sulfa, amiodarone and tetracycline)

38
Q

What drugs are sulfa allergies?

A

P FACTSSS

Probenecid (block reuptake of uric acid)

Furosemide
Acetazolamide
Celecoxib
Thiazies
Sulfonamides
Sulfasalazine
Sulfonylureas
39
Q

What drugs cause stephen johnson?

A

3 kinds and one extra one!

Seizure drugs
Penicillin drugs
Sulfa drugs
and allopurinol

40
Q

TMP action?

A

Dihydrofolate reductase (further down than sulfate step).

methotrexate is same mechanism

41
Q

Use for TMP/SMX?

A 
UTI
Shigella
Salmonella
MRSA
Recurring UTIs (maybe chronic)
PCP proph in AIDs
42
Q

Nitrofurantoin mechanism?

Whats it used for?

A

bacteriocidal

Reduced by bacteria proteins to inactivate ribosomes

UTI (mild, not pyelonephritis)
E coli, staph sapro (but not proteus!)

SAFE IN PREGGERS b/c not absorbed

43
Q

Fluoroquinolones mechanism? Dietary restriction?

Use?

A

Inhibits topo II (gyrase)

No antacids or metal supplements b/c chelate

G- infections G- rods, UTIs and GI infections (remember how it came up a lot for diarrhea)

44
Q

Why can’t fluroquinolones be used in children or preggers? risk in adults?

A

Damage to cardilage

Tendonitis or rupture

45
Q

Fluoroquinolones is used in kids when?

A

Cystic fibrosis for psuedomonas as long term prevention

46
Q

Metronidazole mechanism is what? What is it used for?

A

GET GAP on the Metro

Giardia
Entamoeba
Trichomaonas
Gardnerella vaginalis
Anearobic bacteria
H pylori

Toxic free radicals made destroy DNA

Boards DIT (43 decks)

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