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Clinical Science > Eval of bacterial, viral, fungal and parasitic organisms > Flashcards

Eval of bacterial, viral, fungal and parasitic organisms Flashcards

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Biology 101 flashcards
1
Q

Suspected bacterial infection, CBC can tell you

A

Leukocytosis- may or may not be present. Neutrophilia. “Left Shift”

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2
Q

Suspected bacterial infection, CMP can tell you

A

Really only useful if you suspect GI or GU infection, does not yield much information about respiratory or skin infections

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3
Q

Suspected bacterial infection, UA can tell you

A

urinary or GI bacteria

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4
Q

Suspected bacterial infection Radiology can tell you

A

CXR in pneumonia. Bony x-ray in osteomyelitis. Imaging (X-ray or CT for chronic sinusitis cases).

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5
Q

Suspected viral infection, rapid tests?

A

Rapid influenza test- treat within 2 days of symptoms. Rapid mono test. Rapid RSV test.

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6
Q

Suspected viral infection, CBC can tell you

A

Sometimes leukopenia/neutropenia. Lymphocytosis. Monocytosis.

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7
Q

Suspected viral infection, CMP can tell you

A

Again mostly used when GI origin of infection, not respiratory infections

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8
Q

Suspected viral infection, UA can tell you

A

Viruses do not causes urinary tract infections, only bacteria

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9
Q

Suspected viral infection, Radiology can tell you

A

CXR may be useful for pneumonia (frequently viral cause)

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10
Q

What Would Cheryl Do?

A
  1. Rapid testing 2. CBC 3. CMP 4. UA 5. Radiology *What specific test applies to the disease I am investigating?
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11
Q

Fungal infections

A

seen less commonly than bacterial or viral infections. Most commonly, the HCP will see fungal infections of the skin and vagina. Frequently, they are implicated due to their roles in infections in immunocompromised patients

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12
Q

Types of microscopic fungi

A

Yeasts and molds

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13
Q

Candida

A

predominant yeast found in and on the body. Can cause infection of the mouth, GI and vagina. immunosuppreseed and pts recently on abx are at risk. Can be found on blood cultures- pathogenic.

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14
Q

Dermatophytes

A

usually a skin fungus. “Tinea” Minimal lab work up or evaluation, very characteristic. If there is concern, can do skin/hair scraping for diagnosis.

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15
Q

Tinea corporis

A

caused by dermatophyte fungi

ringworm

treated with topical antifungal

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16
Q

If fungal skin infection doesnt improve with topical tx, do a blood test

A

FALSE! You need to examine the specimen- do skin scraping and KOH exam.

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17
Q

KOH test

A

Done to determine if skin infection is fungal or not. Say your diff diag is psoriasis vs. tinea, you woul do an in office KOH test. If it is fungal, you will see hyphae, psuedohyphae or budding yeast under the microscope.

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18
Q

If you suspect a subcutaneous systemic fungal infection..

A

perform a biopsy

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19
Q

If you susepect a fungal pneumonia

A

Get a sputum culture, do a bracnhioalveolar lavage or get a direct biopsy.

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20
Q

If you suspect a systemic GI fungal infection,

A

get a biopsy

21
Q

If you suspect a systemic endocarditis

A

get a blood culture for fungal inspection

22
Q

If you suspect meningitis

A

get a CSF sample for inspection of fungi

23
Q

If you susepct encephalitis

A

get a brain biopsy for fungal inspection

24
Q

If you suspect osteomyelitis

A

get a bone biopsy for fungal inspection

25
Q

If you suspect OM

A

get a direct swab/culture for fungal inspection of the ear

26
Q

If you suspect fungal sinusitis

A

get a sinus biopsy or direct culture for fungal infection

27
Q

If you suspect fungal vaginitis

A

take a wet mount

28
Q

If you suspect systemic fungal infection, order a CBC/CMP

A

FALSE. Aspergillus can sometimes cause eosinophilia, but overall, bloodwork wont tell you much about a fungal infection.

29
Q

If you suspect systemic fungal infection, order a blood culure

A

yes, you can.

30
Q

Parastitic infections are more common in the US than anywhere else

A

False. Less common in the US, but you will still see them.

31
Q

Parasitic infections dont affect many people

A

False, millions are affected every year

32
Q

examples of parasitic infections

A

§Malaria
§Rocky Mountain Spotted Fever
§Lyme Disease
§Hookworm
§Giardiasis
§Leishmaniasis

33
Q

infected with malaria annually

A
34
Q

estimated annual deaths from malaria

A

2-2.5M

35
Q

malaria primarily caused by

A
  • Anopheles mosquitos carrying one of following:
  • Plasmodium falciparum
  • Plasmodium vivax
  • Plasmodium ovale
  • Plamodium malariae
  • Plasmodium knowlesi
36
Q

Clinical presentation of malaria

A

§Occurs after exposure in infected region

§Tachycardia and tachypnea
§Fever, Myalgias, Arthralgias
§Headache
§Chills
§Cough
§N/V/D and abdominal pain
§Jaundice, splenomegaly, hepatomegaly

37
Q

Thick smear

A

Blood smear done to determine if a parasite is present in suspected malaria

38
Q

Thin smear

A

blood smear used to confirm the plasmodium species is present in suspected malaria.

39
Q

Blood smears for malaria

A

Need a skilled pathologist- this is a sensitive test even in trained hands.

Stained with Giemsa stain.

Not done in office

Smears repeated ever 12-24 hours x3 before you can rule out malaria.

40
Q

Rapid malaria tests

A

available in the US. Detects antigents to plasmodium. Drawback- the ab has to keep a positive control of blood for plasmodium falciparum

41
Q

Lyme disease early presentation

A

erythema migrans

42
Q

As Lyme disese progresses

A

get lesions of the EM and migratory arthralgias.

43
Q

Diagnosis of lyme disease

A

based off of EM rash alone. Rash appears 7-14 days post bite. Can test for IgM and IgG abs. IgM peaks within 4-6 weeks and then declines.

IgG can persist for years.

44
Q

Lyme disease caused by

A

•spirochete Borrelia burgdorferi in U.S. and transmitted by Ixodes scapularis (a.k.a dammini) or pacificus (deer ticks)

Most common tick related disease in the US and Europe

45
Q

Rocky mountain spotted fever caused by

A

•by gram-negative bacteria Rickettsia ricketsii

  • Transmitted through vector Dermacentor variabilis (east and southcentral US) and Dermacentor andersonii (west of Mississippi)
  • Like Lyme Disease, transmitted through tick bites
46
Q

Rocky mountain spotted fever clinical manifestations

A

2-4 days post tick bite you get fever, headache, malaise, myalgias, arthralgias, N/V, abdominal pain.

90% of pts get a rash, its a blanching macular rash on palms of hands and soles of feet.

Death can happen in 5 days.

47
Q

Diagnosis of Rocky mountain spotted fever

A

based primarily on presentation, but you cannot rule it out based off physical presentation alone.

Thrombocytopenia is a clue, occurs later in disease.

IgG and IgM can be done, but that takes about 7-10 days.

Can do a skin biopsy to confirm bacteria

48
Q

Ova and parasites found in your poop

A

§Giardia
§Entamoeba histolytica
§Cyclospora
§Helminth infection (roundworm, tapeworms and flukes)

49
Q

Parasitic infections that cause anemia

A

hookworm, whipworm

Clinical Science (15 decks)

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