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Microbiology Exam 5 > Etiologic Agents & Predisposing Factors > Flashcards

Etiologic Agents & Predisposing Factors Flashcards

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1
Q

GPC

A

s. pneumo, s. aureus

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2
Q

GPR

A

l. monocytogenes (coccobacilli)

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3
Q

GNR

A

Hib, E. coli, K. pneumo

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4
Q

GNC

A

n. meningitidis (diplococci)

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5
Q

LPS-containg agents

A

E. coli and K. pneumo

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6
Q

LOS-containing agents

A

Hib, N. meningitidis

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7
Q

Catalase (+) agents

A

Hib, N. meningitidis, E. coli, K. pneumo, L. monocytogenes

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8
Q

Catalase (-) agents

A

S. pneumo, S. agalactiae

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9
Q

Encapsulated agents

A

S. pneumo, S. agalactiae, Hib, N. meningitidis, E. coli, K pneumo

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10
Q

Non-immunogenic capsules composed of salic acid

A

E. coli K1 and N. meningitidis type B

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11
Q

Multiple capsular serotypes (capable of multiple infections w/ little cross-reactivity)

A

S. pnuemo, S. agalactiae, K. pneumo, N. meningitidis

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12
Q

Single antigenic capsular serotype

A

Hib, E. coli K1

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13
Q

Oxidase negative

A

E. coli, K. pneumo

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14
Q

Oxidase positive

A

Hib, N. meningitidis

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15
Q

All bacterial capable of meningitis are extracellular except

A

L. monocytogenes (facultative intracellular)

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16
Q

2 bacterial agents that produce toxins in meningitis

A

S. pneumo and L. monocytogenes

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17
Q

S. pneumo’s 1 exotoxin

A

pneumolysin

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18
Q

Listeria’s main exotoxin

A

Listeriolysin O (escape phagosome for replication in cytoplasm)

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19
Q

Agents causing petechial/purpuric rash

A

Hib, N. meningitidis, S. pneumo

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20
Q

Agents grown on blood agar

A

E. coli, K. pneumo, S. agalactiae, S. pneumo

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21
Q

Fastidious agents

A

Hib, N. meningitidis

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22
Q

Culture Hib on

A

Chocolate agar

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23
Q

Listeria monocytogenes requires

A

enrichment due to low numbers

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24
Q

MDR is common for

A

K. pneumo

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25
Q

MDR is on the rise for

A

S. pneumo

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26
Q

S. pneumo drug-resistance marker is

A

penicillin

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27
Q

Bacterial meningitis is vaccine preventable for

A

Hib, N. meningitidis (except B), and S. pneumo

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28
Q

Human Nasopharynx carriage

A

Hib, N. meningitidis, S. pneumo, Mycoplasma pneumo

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29
Q

Human colon carriage

A

S. agalactiae, E. coli K1, K. pneumo, L. monocytogenes

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30
Q

Animal and/or human reservoir

A

E. coli K1, K. pneumo, L. monocytogenes, M. leprae, S. agalactiae

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31
Q

C. tetani reservoir

A

soil

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32
Q

C. botulinum reservoir

A

soil, water, animal reservoir

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33
Q

L. monocytogenes reservoir

A

ubiquitous

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34
Q

Neonate bacterial meningitis agents

A

S. agalactiae, K. pneumo (K1, K2), E. coli K1, Listeria monocytogenes

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35
Q

Infant to adult bacterial meningitis agents

A

N. meningitidis, S. pneumo

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36
Q

Elderly bacterial meningitis agents

A

N. meningitidis, S. pneumo, L. monocytogenes (> 50)

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37
Q

Leading cause of bacteremia w/in first 3mo of life

A

S. agalactiae

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38
Q

1/3 of GBS invasive disease occurs in

A

pregnant female (UTI before/after birth)

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39
Q

Recurrent meningitis

A

S. pneumo

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40
Q

Highest fatality w/ bacterial meningitis agent

A

S. pneumo

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41
Q

Risk factors for S. pneumo

A

antecedent RTI (pulmonary > bacteremia > meningitis)

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42
Q

Head trauma, congenital defects, etc w/ CSF leaks, most likely agent for meningitis

A

S. pneumo

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43
Q

CSF is distinguishable from Nasal discharge by

A

presence of beta-2-transferrin

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44
Q

ExPEC

A

all strains of E. coli isolated from extraintestinal infection sites

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45
Q

Major agent of UTIs in humans

A

ExPEC

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46
Q

E. coli K1 diseases

A

severe + high incidence of sequelae; invasive neonatal disease (neonatal sepsis, meningitis, enterocolitis)

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47
Q

Transmission of L. monocytogenes

A

food-borne, human-to-human via vertical transmission, animal-to-human

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48
Q

Risk Factors for L. monocytogenes

A

T-cell suppression

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49
Q

8d-3mo old, fever + focal infection (meningitis, cellulitis, osteomyelitis, septic arthritis)

A

S. agalactiae Late Onset Sepsis

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50
Q

0-6d old infant, low-birth weight, fever, lethargy, poor feeding, abdominal distention, dyspnea, cyanosis, tachycardia, bulging fontanelle; GPC

A

S. agalactiae Early Onset Sepsis

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51
Q

0-6d old infant, low-birth weight, fever, lethargy, poor feeding, abdominal distention, dyspnea, cyanosis, tachycardia, bulging fontanelle; GNR

A

E. coli K1

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52
Q

0-6d old infant, low-birth weight, fever, lethargy, poor feeding, abdominal distention, dyspnea, cyanosis, tachycardia, bulging fontanelle; GPR

A

L. monocytogenes

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53
Q

Gravid female w/ flu Sx in 3rd trimester, child is born ill or becomes ill weeks later; Meningitis and focal Sx in child

A

L. monocytogenes

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54
Q

Gravid female suffers form a spontaneous abortion (5m+ gestation) or stillborn

A

L. monocytogenes

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55
Q

Weak-ill infant at birth or w/in 5d of birth, child has fever and disseminated infection involving multiple organs

A

L. monocytogenes - Early Onset Sepsis

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56
Q

At birth, infant has fever, lethargy, poor feeding, abdominal distention, dyspnea, cyanosis, tachycardia, papules in throat, skin, bulging fontanelle; GPR

A

L. monocytogenes - Granulomatosis infantisepticum

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57
Q

Foul-smelling greenish-brown color amniotic fluid is associated with

A

L. monocytogenes - Granulomatosis infantisepticum

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58
Q

7-14d old neonate, fever + meningoencephalitis (focal - seizures)

A

L. monocytogenes - Late Onset Meningoencephalitis

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59
Q

Adult w/ fever, HA, abd cramps, n/v, arthopathy, myalgia, non-bloody diarrhea, gastroenteritis

A

L. monocytogenes

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60
Q

Adult w/ fever + focal infection (meningitis, meningoencephalitis, encephalitis, mass lesion (abscess), or meningitis (seizures))

A

L. monocytogenes

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61
Q

Otherwise healthy 5mo - 6y/o manifests w/ S/S of meningitis, Hx of “cold for several days”

A

Hib (GNR or pleomorphic)

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62
Q

< 16 y/o manifests w/ acute signs of meningitis, Hx of leg pains, cold hands and feet, abnormal skin color 8 hrs before current Sx

A

N. meningitidis

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63
Q

College dorm or military recruits w/ acute meningitis S/S + non-blanching rash on wrists/ankles

A

N. meningitidis

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64
Q

College dorm or military recruits w/ acute meningitis S/S + non-blanching rash on wrists/ankles + GNC in skin lesions

A

N. meningitidis

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65
Q

Cold sores

A

HSV-1 recrudescence

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66
Q

College dorm or military recruits w/ acute meningitis S/S + non-blanching rash on wrists/ankles + NO organisms in skin lesion

A

S. pneumo

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67
Q

Meningitis w/ S. pneumo is treated w/ vancomycin adn a fluoroquinolone, infection returns several times despite appropriate therapy

A

Tolerance! S. pneumo may cause recurrent infections and build tolerance against drugs

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68
Q

T-cell immunosuppressed pt w/ fever, cough, exertional dyspnea, anorexia, weight loss, HA, lethargy, n/v, minimal nuchal rigidity for 2 weeks; CXR + for diffuse bilateral interstitial infiltrates

A

Cryptococus neoformans

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69
Q

Yeast w/ large capsules

A

Cryptococus neoformans

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70
Q

Cryptococus neoformans definitive diagnosis

A

Specific antigen in body fluids

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71
Q

Aseptic meningitis if late summer and early fall

A

ECHO, Coxsackie, Polio, Arbovirus

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72
Q

Aseptic meningitis + genital infection

A

HSV-2

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73
Q

Aseptic meningitis if winter or Hx of rodent exposure

A

LCMV

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74
Q

CSF of bacterial meningitis

A

PMNs predominate, low glucose, high protein

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75
Q

CSF of viral meningitis

A

Monocytes + Lymphocytes predominate, normal-high protein, normal-low glucose

76
Q

1 cause of meningitis prior to vaccination

A

Mumps and polio

77
Q

Benign w/ little/no sequelae describes

A

viral meningitis

78
Q

Aseptic meningitis in 6mo-2y/o infants is likely due to

A

HHV-6 and HHV-7

79
Q

Aseptic meningitis in > 2y/o is likely due to

A

Non-polio enterovirus

80
Q

Which viruses may cause systemic disease and/or death in immunocompromised pts

A

HHV-6/7, Non-polio enteroviruses, LCMV

81
Q

Humans are the sole host of which viruses

A

enteroviruses, Herpes, HIV, mumps

82
Q

Viral Zoonosis - mammals, birds, arthropods (mosquitos and ticks)

A

Arbovirus

83
Q

Viral Zoonosis - mammals, bats, raccoon, skunk, dog

A

Rabies

84
Q

Viral Zoonosis - rodents

A

LCMV

85
Q

Viral fecal-oral route transmission

A

Polio, Non-polio, enteroviruses 68-71 and LCMV (rodent feces)

86
Q

Viral Vertical transmission - In utero

A

LCMV, HHV-1,-2, ECHO, Coxsackie, Enteroviruses 68-71

87
Q

Viral Inhalation of Infectious dust

A

LCMV

88
Q

Viral vertical transmission - during parturition

A

LCMV

89
Q

Viral CNS agents associated w/ familial outbreaks

A

Non-polio enteroviruses, Mumps, Polio

90
Q

Mosquito or Tick

A

arbovirus

91
Q

LCMV

A

Rodents

92
Q

Human Feces

A

polio and non-polio viruses (enteroviruses)

93
Q

Bat, dog, animal exposure

A

Rabies virus

94
Q

HHV causes infection in young children and leads to

A

asymptomatic or Roseola infection +/- aseptic meningitis S/S; latent persistent infection in T-cells, lymphocytes, monocytes, and CNS and chronic infection in salivary glands

95
Q

Most common cause of aseptic meningitis

A

Non-polio enteroviruses

96
Q

Responsible for 50% of ALL febrile illness in infants and young children (nonspecific w/ or w/o rash)

A

Non-polio enteroviruses

97
Q

Transmission of Non-polio enteroviruses occurs via

A

Fecal-oral (water, diaper changing), Inhalation of aerosols, direct contact w/ secretions, in-utero (for some strains)

98
Q

Non-polio enteroviruses Reservoir

A

Humans and environment

99
Q

Incidence and Severity of Non-polio enteroviruses

A

Incidence is highest in infants, but severity is worse with older adults

100
Q

Seasonality of Non-polio enteroviruses

A

Summer, fall

101
Q

< 2y/o, acute fever, irritability, poor feeding for 1-2 days or high fever + nuchal rigidity, after fever broke a maculopapular rash appeared

A

HHV-6 or -7

102
Q

Late summer/early fall, child w/ moderate fever + lethargy of several days +/- maculopapular rash and/or diarrhea

A

Non-polio enteroviruses

103
Q

Late summer/early fall, child w/ aseptic meningitis findings (severe HA, diarrhea, rash), 2 weeks prior another family member had same Sx

A

Non-polio enteroviruses

104
Q

Winter, Hx of rodent exposure, flu-like Sx for weeks/months, fever breaks but w/in days mild meningitis Sx begin and persists for months

A

LCMV

105
Q

Genital rash followed by meningitis Sx

A

HSV-2

106
Q

bacteremia 1-6d post-birth

A

early acute onset sepsis w/ S. agalactiae

107
Q

Bacterial Meningitis in infant 7d -3mo

A

Late Onset Sepsis w/ S. agalactiae

108
Q

Diagnosis of S. agalactiae

A

Rapid Slide Agglutination or PCR

109
Q

Treatment of S. agalactiae

A

Penicillin G

110
Q

Prevention of S. agalactiae

A

Screening approach (35-37 wks, vaginal and GIT swabs, carriers or those who deliver before screening receive IV intrapartum penicillin G)

111
Q

Non-Screening approach to preventing S. agalactiae

A

Elevated intrapartum temperature, membrane rupture >18h, premature onset of labor, premature rupture of membranes at < 37wks

112
Q

Cold enrichment

A

L. monocytogenes

113
Q

Only facultative intracellular bacterial agent of meningitis

A

L. monocytogenes

114
Q

Gastroenteritis

A

L. monocytogenes (rare, but severe disease)

115
Q

Listeriolysin O

A

L. monocytogenes (helps agent escape phagosome to replicate in cytosol)

116
Q

Staining of L. monocytogenes

A

easily destains to appear GNR, coyneform-shape, low in numbers

117
Q

Immunity to L. monocytogenes is

A

CMI

118
Q

LPS-like containing agents

A

Lipoteichoic acid, like LPS, of L. monocytogenes

119
Q

ActA

A

L. monocytogenes uses actin polymerization to spread from cell-to-cell

120
Q

Treatment for L. monocytogenes

A

Ampicillin + Gentamycin; or TMP-SMX

121
Q

Treatment for Hib

A

Dexamethasone + Ceftriaxone

122
Q

Virulence factors of S. agalactiae

A

capsular polysaccharide, bacitracin-resistantance

123
Q

Virulence factors of L. monocytogenes

A

Listeriolysin O, Lipoteichoic acid (LPS-like), surface proteins for directed-phagocytosis

124
Q

Virulence factors of E. coli K1

A

Sialic acid (poorly immunogenic), capsule

125
Q

What 2 bacterial agents have sialic capsules

A

N. meningitidis and E. coli K1

126
Q

Virulence factors of Hib

A

LOS, exopolysaccharide capsule, peptidoglycan

127
Q

Dexamethasone is advised for

A

Hib meningitis for all ages and S. pneumo meninigitis for < 17 y/o

128
Q

Recurrent meningitis, worsening each time

A

S. pneumo

129
Q

Treatment for S. pneumo

A

IV Cefotaxime + Vancomycin + Dexamethasone until strain is proven sensitive to penicillin

130
Q

Tolerance of S. pneumo

A

Vancomycin tolerance indicated by recurrent worsening meningitis

131
Q

PNSP

A

intermediate or full resistance to penicillin (often followed by TMP-SMX, Macrolides, Fluoroquinolones0

132
Q

DRSP

A

Penicillin and 1 other ABX resistance, Cephalosporin

133
Q

MDRSP

A

Penicillin and resistance to >/= 3 other classes of ABX

134
Q

Vancomycin tolerance of S. pneumo

A

Static, no longer cidal to vancomycin (relapses in pediatric cases)

135
Q

Virulence factors of N. meningitidis

A

LOS, sialic acid capsule, Lipid A

136
Q

N. meningitidis most commonly found in

A

closely-housed individuals (dorm, military recruits), Africa, Infants < 1, children - young adults

137
Q

Insidious onset w/ Hx of RTI or ear infection

A

Hib

138
Q

Seasonality of N. meningitidis

A

Late fall, winter, early spring

139
Q

Immunity deficiency associated w/ N. meningitidis

A

complement deficiency (C3-C9) or Ig deficiency

140
Q

Protective against DIC

A

activated protein C

141
Q

Waterhouse-Friderishsen Syndrome

A

Circulatory shock -> septic shock, bilateral necrosis of adrenals -> HYPOTENSION, DIC (common w/ N. meningitidis)

142
Q

N. meningitidis Sx in < 16 y/o

A

early Sx: leg pain, cold hands/feet, abnormal skin color; late Sx: meningitis

143
Q

N. meningitidis Sx in adults

A

early Sx: pharyngitis, fever, HA, flu-like; late Sx: classic meningitis Sx purpuric rash

144
Q

Purpura lesion that reveals agent __________; skin lesions that would not reveal agent

A

N. meningitidis; S. pneumo

145
Q

Treatment for N. meningitides meningitis

A

Ceftriaxone, cefoxtamine, or penicillin G

146
Q

Carriers of N. meningitides are treated w/

A

Rifampin

147
Q

MPSV4/Menomune

A

type II, T-independent vaccine for N. meningitides; no used for infants < 2, short-lived immunity (3-5yrs), doesn’t eliminate carriers, not for Group B; administered SubQ

148
Q

MCV4/Menactra

A

T-dependent vaccine for N. meningitides; Given to children, adults, college kids, military, complement def, asplenic, travel to Africa, etc; not for Group B; administered IM for long-term coverage (8+ yrs), eliminates carriage

149
Q

Petechial rash on ankles/wrists

A

N. meningitidis infection

150
Q

Small outbreaks of N. meningitides

A

give everyone Rifampin abx-prophylaxis

151
Q

Large outbreaks of N. meningitides

A

give close contacts Rifampin w/in 14d and everyone else should be vaccinated

152
Q

3 most common causes of CNS infection in advanced HIV/AIDS patients

A

1 HIV, #2 Toxoplasmosis, #3 Cryptococcus neoformans

153
Q

4 most common causes of opportunistic infections in advanced HIV/AIDS patients

A

1 P. jiroveci, #2 CMV, #3 M. avium complex, #4 Cryptococcus neoformans

154
Q

Sx of Cryptococcus neoformans

A

insidious onset 2-4 weeks of HA, fever, focal changes, little nuchal rigidity, pulmonary infiltrates

155
Q

Antigenemia of Cryptococcus neoformans

A

+ serum antigen w/o agent finding, must Treat

156
Q

Treatment for Cryptococcus neoformans

A

Amphotericin B + 5-Fluorocytosine for 2 weeks; Fluconazole for 8 weeks and life-long

157
Q

Treat elevated ICP w/

A

Mannitol

158
Q

Stain for Cryptococcus neoformans

A

India Ink prep

159
Q

Sx of Naegleria fowleri

A

Hyperacute, unrelenting bacterial meningitis symptoms, Hx of fresh water exposure

160
Q

Time course of Naegleria fowleri

A

Hyperacute; 2-4days w/ bacterial meningitis Sx, w/in 1-2days diffuse encephalitis and 2-7days death

161
Q

Treatment for Naegleria fowleri

A

Amphotericin B, Miltefosine (antineoplastic drug that targets Akt/PKB for inhibition of infected macrophages)

162
Q

< 2 y/o w/ aseptic meningitis

A

HHV-6, -7

163
Q

Viruses common in late summer/fall

A

Non-polio enteroviruses, polio, arbovirus

164
Q

Viruses common in winter

A

LCMV

165
Q

> 2y/o w/ aseptic meningitis

A

Non-polio enteroviruses

166
Q

Latent or chronic HHV-6/7 infection in

A

T-cells; chronic in salivary glands

167
Q

Sx of HHV-6/7 infection

A

Very high fever, lethargy, irritability, rash ONLY appears after fever breaks

168
Q

Treatment for HHV-6/7 infection

A

Supportive

169
Q

Roseola rash is due to

A

HHV-6/7

170
Q

Most common result of HHV-6/7 infection

A

asymptomatic

171
Q

HSV-2 infection

A

genital herpes + nuchal rigidity; no Tx

172
Q

LCMV viruses are

A

arenavirus, resistant to drying, carried by rodents

173
Q

Teratogenic virus

A

LCMV

174
Q

In-uero infection w/ LCMV in 1st or 2nd trimester results in

A

abortion, chorioretinitis, micro/macro/hydrocephalus

175
Q

Sx of LCMV infection

A

BIPHASIC: long incubation period followed by extended flu-like Sx for months “Grippe”, once fever breaks -> meningitis Sx follow

176
Q

Treatment for LCMV infection

A

Supportive; ~3months

177
Q

Late summer/early fall + febrile child

A

Non-polio enterovirus

178
Q

Encephalitis is primarily due to which non-polio EV?

A

EV71 -> acute flaccid paralysis

179
Q

Risk factors for non-polio EV infection

A

neonates and immunocompromised

180
Q

Adult w/ non-polio EV meningitis would have Sx of

A

Severe HA, fever, irritability, nuchal rigidity

181
Q

Treatment for non-polio EV

A

Supportive (pleconaril if requested)

182
Q

Primary cause of epidemic encephalitis

A

Arbovirus

183
Q

Diseases spread by ticks

A

Colorado tick fever and Powassan fever

184
Q

Life cycle of Arboviruses

A

Alternation b/w reservoir (birds, small mammals) and vector/arthropod host

185
Q

Arboviruses specifically target

A

Reticuloendothelial system: Endothelial cells of capillaries, Macrophages/monocytes, Erythrocytes

186
Q

Arboviruses replicate in the Reticuloendothelial system, once enough virus is made they infect

A

brain, liver, skin, vasculature, kidney, etc

187
Q

4/5 pts infected w/ arbovirus are

A

asymptomatic

Microbiology Exam 5 (3 decks)

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