DIT G neg, Diarrhea, UTI Flashcards
What are lactose fermenting enteric bacteria?
mcConKEE’S agar
Citrobacter Klebsialla E coli Enterobacter Serratia
What makes IgA protease?
SHiN
Strep pneumo
H influ
Neisseria!
Neisseria gon tx?
first line Ceft
Second azithromycin or doxy
What can cause adrenal hemorrhage after infection?
Neisseria menignitids.
Qaterhouse friedrichsen syndrome
Overt N mening tx?
Prophylaxis tx?
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)
Haemophilus influenza causes what?
Tx?
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
How do you culture H influ? What is some characteristics?
Chocolate agar with V (nad+) and X (hemantin)
has capsule
has IgA protease
Painful chancroid genital ulcer caused by what?
Haemophilus decreyi (ducreyi makes YOU CRY (rhymes)
Who gets legionella?
How do you recognize it?
How do you treat it?
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
What does psuedomonas cause? I loves air and water
PSEUDO pneumonia cystic fibrosis
Pneumo in CF Sepsis External otitis UTI Drug and Diabetic Osteomyelitis
Hot tub folliculitis
What is the psuedomonas toxin?
Exotoxin A inactivates EF-2 (cell necrosis)
How do you treat pseudomonas?
Very dangerous: use 2 drugs
aminoglycosides and extended spectrum penicillin
H pylori is risk of what?
Tx?
gastric ulcers
90% of duodenal ulcers
adenocarcionma and lymphoma
Triple therapy
PPI
Clarithromycin
Amox or metronidazole
ETEC toxin mechanisms? How does one of them compare to cholera?
Tx?
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
EHEC is from what food? Symptom?
Toxin?
Serious complication?
Tx?
infected meat
Bloody diarrhea
shigA like toxin inactivate 60s ribosomes
HUS: anemia, thrombocytopenia, acute renal failure b/c
Tx is supportive. Surprisingly!
What does EPEC do to cause diarrhea?
ePec and P is for Pediatrics
Watery diarrhea b/c binds to epithelium to flatten villi, but not serious
EIEC causes what and? What is it similar to?
Tx?
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
Shigella causes diarrhea how?
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
Salmonella comes from what?
Symptom?
does it ferment lactose?
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.
Salmonella vs shigella? Which can spread hematogenously?
Salmonella has flagella (SALMON SWIM) so spreads in blood
Osteomyelitis b/c swims and has capsule so attacks after autosplenectomy
What is rose spots on abdomen, headache and potential diarrhea?
Typhoid fever. Salmonella typhi accuses it.
What kind of diarrhea does campylobacter cause?
How do you recognize it?
What sequelae are there?
Bloody diarrhea
G-, z shape, oxidase positive, bloody diarrhea (children), fecal oral
Guillain barre
Reactive arthritis
Supportive or fluoroquinolones if severe
How does heat labile toxin work for cholera?
What kind of media does it grow in?
activates Gs so more cAMP
Alkaline media
ORAL REHYDRATE!!!!
What kind of diarrhea is from yersinia enterocolitica?
Puppy shit gave you bloody diarrhea (or pork)
Looks like salmonella
Can cause MESENTERIC adenitis (mimics appendicitis)
What does klebsiella affect? What do you see as give away on boards?
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
Red currant jelly sputum?
red Currant jelly sputum b/c polysaccharide capsules in klebsiella (SHiNE SKiPS) and necrosis of lungs and bloody sputum
C diff has what toxins? How do you test it?
Toxin A binds brush border so fluid secretion
Toxin B causes cytotoxin and kills enterocytes so PSEUDOMEMBRANOUS colitis
Test for toxins in stool
Antibiotics of most diarrheas?
Fluoroquinolones or ceftriaxone/azithro
C diff: metronidazoleoral vanco (only time oral)
Food for vibrio parahaemolyticus or vulnificus?
Contaminated seafod
Food for salmonella?
Picnic poultry, meat, eggs or turtles a few days later
What food has clostridium per fringes?
Reheated meat dish
Pyelonephritis is different than cystitis how?
Has fever, WBC casts (WBCs in renal tubules get packed together and make clumps/casts), costovertebral tenderness, more hematuria.
1, 2, 3 and 4 causes of UTI?
E coli
Staph S
Klebsiella
Proteus
down the list is pseudomonas, but tough to treat
Ammonium phosphate stones formed when?
Proteus makes urease which ammonia magnesium stag horn stone
Tx of UTI’s?
Most are gram negative.
TMP/SMX, aminopenicillins, fluoroquinolones
Sulfonamides mechanism?
Folic acid inhibitors (bacteria must produce folic acid b/c can’t absorb it) so it can’t divide
Dihydropteroate synthase is blocked.
Toxicity of sulfonamides?
Hypersensitivity
Hemolysis if G6PD
Nephrotoxic (tubulointerstitial nephritis)
Knocks drugs off of albumin (warfarin)
Photosensitivity (SAT: Sulfa, amiodarone and tetracycline)
What drugs are sulfa allergies?
P FACTSSS
Probenecid (block reuptake of uric acid)
Furosemide Acetazolamide Celecoxib Thiazies Sulfonamides Sulfasalazine Sulfonylureas
What drugs cause stephen johnson?
3 kinds and one extra one!
Seizure drugs
Penicillin drugs
Sulfa drugs
and allopurinol
TMP action?
Dihydrofolate reductase (further down than sulfate step).
methotrexate is same mechanism
Use for TMP/SMX?
UTI Shigella Salmonella MRSA Recurring UTIs (maybe chronic) PCP proph in AIDs
Nitrofurantoin mechanism?
Whats it used for?
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
Fluoroquinolones mechanism? Dietary restriction?
Use?
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)
Why can’t fluroquinolones be used in children or preggers? risk in adults?
Damage to cardilage
Tendonitis or rupture
Fluoroquinolones is used in kids when?
Cystic fibrosis for psuedomonas as long term prevention
Metronidazole mechanism is what? What is it used for?
GET GAP on the Metro
Giardia Entamoeba Trichomaonas Gardnerella vaginalis Anearobic bacteria H pylori
Toxic free radicals made destroy DNA
