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FA - Micro - Systems Flashcards

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0
Q

Normal dominant flora - nose?

A

S.epi - colonized by S.aureus.

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1
Q

Normal dominant flora - Skin?

A

S.epi

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2
Q

Normal dominant flora - oropharynx?

A

Viridans group strep

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3
Q

Normal dominant flora - dental plaque?

A

S.mutans

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4
Q

Normal dominant flora - colon?

A

B.fragilis>E.coli

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5
Q

Normal dominant flora - vagina?

A

Lactobacillus - colonized by E.coli and group B strep.

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6
Q

Normal flora - neonates by C-section?

A

Have NO FLORA but are rapidly colonized after birth.

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7
Q

Food poisoning - starts quickly/ends quickly?

A
  1. S.aureus

2. B.cereus

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8
Q

Food poisoning - B.cereus source?

A

Reheated rice.

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9
Q

Food poisoning - C.perfringens source?

A

Reheated meat dishes.

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10
Q

Food poisoning - E.coli O157:H7 source?

A

Undercooked meat.

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11
Q

Food poisoning - Salmonella source?

A

Poultry, meat, and eggs.

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12
Q

Food poisoning - S.aureus source?

A
  1. Meats
  2. Mayonnaise
  3. Custard
    ==> PREFORMED TOXIN.
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13
Q

Food poisoning - V.parahemolyticus and V.vulnificus source?

A

Contaminated SEAfood.

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14
Q

V.vulnificus besides food poisoning?

A

Wound infections from contact with contaminated water or shellfish.

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15
Q

Mention altogether the most important food poisoning bugs.

A
  1. B.cereus
  2. S.aureus
  3. C.botulinum
  4. C.perfringens
  5. E.coli O157:H7
  6. Salmonella
  7. V.parahemolyticus and V.vulnificus
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16
Q

Bugs causing bloody diarrhea?

A
  1. Campylobacter
  2. E.histolytica
  3. EHEC
  4. EIEC
  5. Salmonella
  6. Shigella
  7. Y.enterocolitica
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17
Q

Bloody diarrhea - Campylobacter?

A
  1. Comma- or S-shaped organism.

2. Growths at 42C.

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18
Q

Bloody diarrhea - E.histolytica?

A
  1. Protozoan
  2. Amebic dysentery
  3. Liver abscess
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19
Q

Bloody diarrhea - EHEC?

A
  1. O157:H7.
  2. Can cause HUS.
  3. Makes Shiga-like toxin.
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20
Q

Bloody diarrhea - EIEC?

A

Invades colonic mucosa.

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21
Q

Bloody diarrhea - Salmonella?

A
  1. Lactose(-)
  2. Flagellar motility
  3. Animal reseervoir
  4. Especially POULTRY/EGGS
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22
Q

Bloody diarrhea - Shigella?

A
  1. Lactose(-)
  2. Very low ID50
  3. Shiga toxin - Human reservoir only
  4. Bacillary dysentery
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23
Q

Bloody diarrhea - Y.enterocolitica?

A
  1. Day-care outbreaks

2. Pseudoappendicitis

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24
Q

Watery diarrhea bugs?

A
  1. C.difficile
  2. C.perfringens
  3. ETEC
  4. Protozoa
  5. V.cholerae
  6. Viruses
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25
Q

Watery diarrhea - C.difficile?

A
  1. Pseudomembranous colitis
  2. By antibiotics
  3. Occasionally bloody diarrhea
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26
Q

Watery diarrhea - C.perfringens?

A

Also causes GAS GANGRENE.

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27
Q

Watery diarrhea - ETEC?

A
  1. Traveler’s diarrhea

2. Heat-labile and heat-stable toxins

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28
Q

Watery diarrhea - Protozoa

A
  1. Giardia

2. Cryptosporidium (immunocompromised)

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29
Q

Watery diarrhea - V.cholerae?

A
  1. Comma-shaped organisms
  2. Rice-water diarrhea
  3. Often from INFECTED SEAfood
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30
Q

Watery diarrhea - Viruses?

A
  1. Rotavirus
  2. Norovirus
  3. Adenovirus
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31
Q

Common causes of pneumonia - neonates (<4wk)?

A
  1. Group B strep

2. E.coli

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32
Q

Common causes of pneumonia - children (4wk-18y)?

A
  1. Viruses - RSV
  2. Mycoplasma
  3. C.trachomatis (infants-3y)
  4. C.pneumoniae (school-aged children)
  5. S.pneumoniae
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33
Q

Common causes of pneumonia - adults (18-40yr)?

A
  1. Mycoplasma
  2. C.pneumoniae
  3. S.pneumoniae
  4. Viruses ==> Influenza.
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34
Q

Common causes of pneumonia - adults (40-65y)?

A
  1. S.pneumoniae
  2. H.influenza
  3. Anaerobes
  4. Viruses
  5. Mycoplasma
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35
Q

Common causes of pneumonia - Elderly?

A
  1. S.pneumoniae
  2. Influenza virus
  3. Anaerobes
  4. H.influenza
  5. Gram(-) rods
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36
Q

Common causes of pneumonia - Alcoholic/IVDA?

A

Alcoholics ==> Klebsiella + Anaerobes (eg Peptostreptococcus, Fusobacterium, Prevotella, Bacteroides).
IVDA ==> S.pneumo + S.aureus.

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37
Q

Common causes of pneumonia - Aspiration?

A

Anaerobes

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38
Q

Common causes of pneumonia - Atypical?

A
  1. Mycoplasma
  2. Legionella
  3. Chlamydia
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39
Q

Common causes of pneumonia - CF?

A
  1. Pseudomonas
  2. S.aureus
  3. S.pneumoniae
  4. B.cepacia.
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40
Q

Common causes of pneumonia - Immunocompromised?

A
  1. Staph
  2. Enteric gram(-) rods
  3. Fungi
  4. Viruses
  5. P.jiroveci (with HIV)
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41
Q

Common causes of pneumonia - Nosocomial?

A
  1. Staph
  2. Pseudomonas
  3. Other enteric gram(-) rods
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42
Q

Common causes of pneumonia - Postviral?

A
  1. S.pneumo
  2. H.influenza
  3. S.aureus
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43
Q

Common causes of meningitis - Newborn (0-6mo)?

A
  1. Group B strep
  2. E.coli
  3. Listeria
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44
Q

Common causes of meningitis - Children (6-6yr)?

A
  1. S.pneumoniae
  2. N.meningitis
  3. H.influenza type B
  4. Enteroviruses
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45
Q

Common causes of meningitis - 6-60y?

A
  1. S.pneumoniae
  2. N.meningitidis (#1 in teens)
  3. Enteroviruses
  4. HSV
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46
Q

Common causes of meningitis - 60+y?

A
  1. S.pneumoniae
  2. Gram(-) rods
  3. Listeria
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47
Q

Meningitis empirical treatment?

A
  1. Vancomycin
  2. Ceftriaxone
  3. Add ampicillin if Listeria is suspected.
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48
Q

Viral causes of meningitis?

A
  1. Enteroviruses (Coxsackie)
  2. HSV-2 (HSV-1=encephalitis)
  3. HIV
  4. West Nile virus ==> ALSO causes encephalitis.
  5. VZV
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49
Q

In HIV - causes of meningitis?

A

Cryptococcus spp.

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50
Q

CSF findings in meningitis - Bacterial?

A
  1. UP pressure
  2. UP PMNs
  3. UP protein
  4. DOWN sugar
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51
Q

CSF findings - Fungal/TB?

A
  1. UP pressure
  2. UP lymphocytes
  3. UP proteins
  4. DOWN sugar
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52
Q

CSF findings in meningitis - viral?

A
  1. Normal/UP pressure
  2. UP lymphocytes
  3. Normal/UP protein
  4. Normal sugar
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53
Q

Osteomyelitis - assume no other info is available?

A

S.aureus (MC overall)

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54
Q

Osteomyelitis - sexually active?

A

N.gonorrhoeae (rare) - septic arthritis more common.

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55
Q

Osteomyelitis - IVDA?

A
  1. P.aeruginosa
  2. Candida.
  3. S.aureus.
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56
Q

Osteomyelitis - sickle cell?

A
  1. Salmonella

2. S.aureus

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57
Q

Osteomyelitis - prosthetic joint replacement?

A
  1. S.aureus

2. S.epi

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58
Q

Osteomyelitis - vertebral involvement?

A
  1. S.aureus.

2. Myco TB (Pott).

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59
Q

Osteomyelitis - cat and dog bites?

A

P.multocida

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60
Q

Osteomyelitis - target group?

A

Children

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61
Q

Osteomyelitis - Radiograph or MRI?

A

MRI ==> Acute infection + Detailing anatomic involvement.

X-RAY ==> Useful in CHRONIC osteomyelitis.

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62
Q

Cystitis presents with?

A
  1. Dysuria
  2. Frequency
  3. Urgency
  4. Suprapubic pain
  5. WBCs (but NOT WBCs casts) in urine.
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63
Q

Cystitis - mechanism in MALES - infants, elderly?

A
  1. Congenital defects (Infants).
  2. Vesicoureteral reflux (Infants)
  3. Enlarged prostate (elderly)
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64
Q

Pyelonephritis symptoms?

A
  1. Fever
  2. Chills
  3. Flank pain
  4. Costovertebral angle
  5. Tenderness
  6. Hematuria
  7. WBC casts
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65
Q

UTI - how more common in women?

A

10X! - shorter urethras colonized by fecal flora.

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66
Q

UTI - Predisposing factors besides female?

A
  1. Obstruction
  2. Kidney surgery
  3. Catheterization
  4. GU malformation
  5. Diabetes
  6. Pregnancy
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67
Q

UTI - Diagnostic markers?

A
  1. Leukocyte esterase test (+) ==> Evidence of WBC activity.
  2. Nitrite test (+) ==> Reduction of urinary nitrates by bacterial species (eg E.coli).
  3. Urease test (+) ==> Urease-producing bugs (eg Proteus, Klebsiella).
68
Q

UTI bugs - E.coli - features?

A
  1. Leading cause of UTI.

2. Colonies show green metallic sheen on EMB agar.

69
Q

UTI bugs - Staph sapro - features?

A

2nd leading cause of UTI in sexually active women.

70
Q

UTI bugs - K.pneumoniae - features?

A
  1. 3rd leading cause of UTI.

2. Large mucoid capsule and viscous colonies.

71
Q

UTI bugs - Serratia marcescens - features?

A
  1. Some strains produce a red pigment.

2. Often nosocomial and drug resistant.

72
Q

UTI bugs - Enterococcus - features?

A

Often nosocomial and drug resistant.

73
Q

UTI bugs - P.mirabilis - features?

A
  1. Motility causes “swarming” on agar.
  2. Produces urease
  3. Associated with struvite stones
74
Q

UTI bugs - P.aeruginosa - features?

A
  1. Blue-green pigment and fruity odor

2. Usually nosocomial and drug resistant

75
Q

UTI - diagnostic tests - Leucocyte esterase (+)?

A

Bacterial UTI.

76
Q

UTI - diagnostic tests - nitrite tests?

A

Gram(-) bugs.

77
Q

UTI - Urease test (+)?

A
  1. Klebsiella

2. Proteus

78
Q

UTI - urease (-)?

A
  1. E.coli

2. Enterococcus

79
Q

Mention altogether the most important UTI bugs.

A
  1. E.coli
  2. S.sapro
  3. K.pneumoniae
  4. Serratia marcescens
  5. Enterococcus
  6. P.mirabilis
  7. P.aeruginosa
80
Q

3 common vaginal infections?

A
  1. Bacterial vaginosis
  2. Trichomonas vaginitis.
  3. Candida vulvovaginitis
81
Q

Bacterial vaginosis - signs/symptoms?

A
  1. No inflammation

2. Thin, white discharge with fishy odor

82
Q

Bacterial vaginosis - lab findings?

A
  1. Clue cells

2. pH>4.5

83
Q

Bacterial vaginosis - Treatment?

A

Metronidazole

84
Q

Trichomoniasis - signs/symptoms?

A
  1. Inflammation ==> Strawberry cervix.

2. Frothy, grey-green, foul-smelling discharge

85
Q

Trichomoniasis - Lab findings?

A
  1. Motile trichomonads

2. pH>4.5

86
Q

Trichomoniasis - treatment?

A

Metronidazole - treat sexual partner.

87
Q

Candida vulvovaginitis - signs/symptoms?

A
  1. Inflammation

2. Thick, white, “cottage cheese” discharge

88
Q

Candida vulvovaginitis - lab findings?

A
  1. Pseudohyphae

2. pH NORMAL (4-4.5)

89
Q

Candida vulvovaginitis - treatment?

A

-azoles

90
Q

ToRCHeS infections - Transmission?

A

Mostly transplacentally, or via delivery (especially HSV-2).

91
Q

Non specific signs common to many ToRCHeS infections?

A
  1. HSM
  2. Jaundice
  3. Thrombocytopenia
  4. Growth retardation
92
Q

Besides ToRCHeS, other important infectious agents?

A
  1. S.agalactiae
  2. E.coli
  3. Listeria
  4. B19 –> Hydrops fetalis
93
Q

T.gondii - transmission?

A

Cat feces or ingestion of undercooked meat.

94
Q

T.gondii - maternal manifestations?

A
  1. Usually asymptomatic

2. Lymphadenopathy (rarely)

95
Q

T.gondii - neonatal manifestations?

A 
Classic triad:
1. Chorioretinitis
2. Hydrocephalus
3. Intracranial calcifications 
\+/- "BLUEBERRY MUFFIN RASH"
96
Q

Rubella - transmission?

A

Respiratory droplets.

97
Q

Rubella - maternal manifestations?

A
  1. Rash
  2. Lymphadenopathy
  3. POLYARTHRITIS/POLYARTHRALGIA
98
Q

Rubella - neonatal manifestations?

A 
Classic triad:
1. PDA (or pulmonary artery hypoplasia)
2. Cataracts
3. Deafness
\+/- "blueberry muffin" rash.
99
Q

CMV - transmission?

A
  1. Sexual contact

2. Organ transplants

100
Q

CMV - Maternal manifestations?

A
  1. Usually asymptomatic

2. Mononucleosis-like illness

101
Q

CMV - Neonatal manifestations?

A
  1. Hearing loss
  2. Seizures
  3. Petechial rash
  4. “Blueberry muffin” rash
  5. PERIVENTRICULAR CALCIFICATIONS
102
Q

HIV -transmission?

A
  1. Sexual contact

2. Needlestick

103
Q

HIV - maternal manifestations?

A

Variable presentation depending on CD4+ count.

104
Q

HIV - neonatal manifestations?

A
  1. Recurrent infections

2. Chronic diarrhea

105
Q

HSV-2 - transmission?

A

Skin or mucous membrane contact.

106
Q

HSV-2 - maternal manifestations?

A
  1. Usually asymptomatic

2. Herpetic (vesicular) lesions

107
Q

HSV-2 - Neonatal manifestations?

A
  1. Encephalitis

2. Herpetic (vesicular) lesions

108
Q

Syphilis - transmission?

A

Sexual contact

109
Q

Syphilis - maternal manifestations?

A

Chancre (1o) and disseminated rash (2o) are the two stages likely to result in fetal infection.

110
Q

Syphilis - neonatal manifestations?

A
  1. Often stillbirth
  2. Hydrops fetalis
    ==> IF CHILD SURVIVES:
  3. Notched teeth
  4. Saddle nose
  5. Short maxilla
  6. Saber shins
  7. CN VIII deafness
111
Q

ToRCHeS?

A 
Toxo
Rubella
CMV
HSV-2
Syphilis
112
Q

Red rashes of childhood?

A
  1. Coxsackievirus type A
  2. HHV-6
  3. Measles virus
  4. Parvo B19
  5. Rubella virus
  6. S.pyogenes
  7. VZV
113
Q

Red rashes of childhood (RRC) - Coxsackie A?

A

Hand-foot-mouth disease

114
Q

Hand-foot-mouth disease clinical presentation?

A
  1. Vesicular rash on palms
  2. Soles
  3. Vesicles and ulcers in oral mucosa
115
Q

RRC - HHV-6?

A

Roseola = EXANTHEM SUBITUM

116
Q

Roseola clinical presentation?

A
  1. ASYMPTOMATIC rose-colored MACULES over body appears after several days of high fever.
  2. Can present with febrile seizures.
  3. Usually affects infants.
117
Q

Measles (rubeola) clinical presentation?

A
  1. A paramyxovirus
  2. Beginning at head and moving down
  3. Rash is PRECEDED by cough, coryza, conjunctivitis, and blue-white (Koplik) spots on buccal mucosa.
118
Q

Erythema infectiosum (5th disease - B19) clinical presentation?

A

“Slapped cheek” rash on face - can cause hydrops fetalis in pregnant woman.

119
Q

Rubella (German measles) clinical presentation?

A

Pink coalescing MACULES begin at head and moves down –> fine truncal rash.
==> POST-AURICULAR LYMPHADENOPATHY.

120
Q

S.pyogenes - scarlet fever - clinical presentation?

A

Erythematous, sandpaper-like rash with fever and sore throat.

121
Q

VZV - chickenpox - clinical presentation?

A
  1. Vesicular rash begins on TRUNK.

2. Spreads to FACE + EXTREMITIES with lesions of DIFFERENT ages.

122
Q

Mention the major sexually transmitted diseases?

A
  1. AIDS
  2. Chancroid
  3. Chlamydia
  4. Condylomata acuminata
  5. Genital herpes
  6. Gonorrhea
  7. Hep B
  8. Lymphogranuloma venereum
  9. Syphilis
  10. Trichomoniasis
123
Q

Chancroid - clinical features?

A
  1. Painful genital ulcer

2. Inguinal adenopathy

124
Q

Chancroid - organism?

A

H.ducreyi

125
Q

Chlamydia - clinical features?

A
  1. Urethritis
  2. Cervicitis
  3. Conunctivitis
  4. Reactive arthritis
  5. PID
  6. EPIDIDYMITIS.
126
Q

Chlamydia - organisms (types)?

A

Chlamydia trachomatis D-K

127
Q

Condylomata acuminata - features?

A
  1. Genital warts

2. Koilocytes

128
Q

Condylomata acuminata - organism?

A

HPV-6 and -11.

129
Q

Genital herpes - features?

A
  1. Painful penile, vulvar, or cervical vesicles and ulcers.

2. Systemic symptoms such as fever, headache, myalgia.

130
Q

Genital herpes - organisms?

A
  1. HSV-2

2. HSV-1 less commonly

131
Q

Gonorrhea - features?

A
  1. Urethritis
  2. Cervicitis
  3. PID
  4. Prostatitis
  5. Epididymitis
  6. Arthritis
  7. Creamy purulent discharge
132
Q

Lymphogranuloma venereum - features?

A
  1. Infection of lymphatics
  2. Painless, genital ulcers
  3. Painful lymphadenopathy (buboes)
133
Q

Lymphogranuloma venereum - C.trachomatis subtypes?

A

L1-L3.

134
Q

1o syphilis - features?

A

PainLESS chancre

135
Q

2o syphilis - features?

A
  1. Fever
  2. Lymphadenopathy
  3. Skin rashes
  4. Condylomata lata
136
Q

3o syphilis - features?

A
  1. Gummas
  2. Tabes dorsalis
  3. General paresis
  4. Aortitis
  5. Argyll-Robertson pupil
137
Q

Trichomoniasis - features?

A
  1. Vaginitis
  2. Strawberry cervix
  3. Motile in wet prep
138
Q

PID - Top bugs?

A
  1. Chlamydia trachomatis ==> Subacute + Often UNDIAGNOSED.

2. N.gonorrhoeae ==> ACUTE.

139
Q

PID features?

A
  1. Chandelier sign = cervical motion tenderness.

2. Purulent cervical discharge

140
Q

PID may include which conditions?

A
  1. Salpingitis
  2. Endometritis
  3. Hydrosalpinx
  4. Tubo-ovarian abscess
141
Q

C.trachomatis + N.gonorrhoeae –> which syndrome?

A

Fitz-Hugh-Curtis syndrome –> Infection of the liver CAPSULE and “violin string” adhesions of PERITONEUM to liver.

142
Q

Salpingitis - risk factor for?

A
  1. Ectopic pregnancy
  2. Infertility
  3. Chronic pelvic pain
  4. Adhesions
143
Q

Major nosocomial infections?

A
  1. C.albicans
  2. CMV, RSV
  3. E.coli
  4. P.mirabilis
  5. HBV
  6. Legionella
  7. P.aeruginosa
144
Q

Nosocomial infection (NI) - C.albicans - risk factor?

A

Hyperalimentation

145
Q

NI - CMV, RSV - Risk factors?

A

Newborn surgery

146
Q

NI - E.coli, P.mirabilis - Risk factors?

A

Urinary catheterization.

147
Q

2 MCC of NI are?

A
  1. E.coli (UTI)

2. S.aureus (wound infection)

148
Q

NI - HBV - Risk factor?

A

Work in renal dialysis unit.

149
Q

Bugs affecting unimmunized children - dermatologic - pathogens?

A
  1. Rubella virus

2. Measles virus

150
Q

Asplenic patient

A

Encapsulated microbes - SHiN

S.pneumoniae&raquo_space; H.influenza B > N.meningitidis

151
Q

Branching rods in oral infection

Sulfur granules

A

Actinomyces israelii

152
Q

Chronic granulomatous disease

A

Cat (+) microbes - esp. S.aureus

153
Q

“Currant jelly” sputum

A

Klebsiella

154
Q

Dog or cat bite

A

P.multocida

155
Q

Facial nerve palsy

A

Borrelia burgdorferi (Lyme disease)

156
Q

Fungal infection in diabetic or immunocompromised

A

Mucor or Rhizopus spp.

157
Q

Health care provider

A

HBV - from needle stick.

158
Q

Neutropenic patients

A

C.albicans (systemic)

Aspergillus

159
Q

Organ transplant recipient

A

CMV

160
Q

PAS (+)

A

Tropheryma whipplei

161
Q

Pediatric infection

A

Haemophilus influenza (including epiglottitis).

162
Q

Pneumonia in CF

Burn infection

A

P.aeruginosa

163
Q

Pus
Empyema
Abscess

A

S.aureus

164
Q

Rash on hands and feet

A

Coxsackie A
Treponema pallidum
Rickettsia rickettsii

165
Q

Sepsis/meningitis in newborn

A

Group B strep

166
Q

Surgical wound

A

S.aureus

167
Q

Traumatic open wound

A

C.perfringens

Microbiology (46 decks)

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