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FIM Pathogens Flashcards

1
Q

A patient presents with folliculitis, pneumonia, necrotising fasciitis and a carbuncle. What pathogen is most likely responsible for this presentation?

A

Staph Aureus

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2
Q

A patient presents with osteomyelitis, endocarditis, gastroenteritis and a furuncle. What do you expect to see on the gram stain?

A

Staph Aureus

gram +ve cocci in clusters

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3
Q

A patient presents with septic arthritis, cellulitis, impetigo and pneumonia. What is the expected result of a catalase test for this causative pathogen?

A

Staph Aureus

catalase +ve

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4
Q

A patient presents with folliculitis, gastroenteritis, an abscess and pneumonia with patchy infiltrates. What is the expected result of a coagulase test for this causative pathogen?

A

Staph Aureus

coagulase +ve

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5
Q

A patient presents with folliculitis, gastroenteritis, a wound infection and pneumonia with patchy infiltrates. What agars (2) would facilitate the growth of this causative pathogen and what would be observed?

A

Staph Aureus
blood agar - golden/yellow crust
mannitol - yellow

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6
Q

A patient presents with folliculitis, pneumonia, necrotising fasciitis and a carbuncle. The patient was given flucloxacillin but his symptoms were not resolved. what would you prescribe?

A

Staph Aureus

vancomycin or teicoplanin

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7
Q

A patient presents with folliculitis, pneumonia, necrotising fasciitis and a carbuncle. Protein A is one of the virulence factor of this pathogen. What is its importance?

A

Staph Aureus

binds to Fc of IgM - prevents phagocytosis

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8
Q

A patient presents with folliculitis, pneumonia, necrotising fasciitis and a carbuncle. The pathogen displays no resistance. What would you prescribe?

A

Staph Aureus

flucloxacillin

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9
Q

What virulence factor is responsible for toxic shock syndrome for a staph aureus infection?

A

Staph Aureus

TSS exotoxin

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10
Q

What virulence factor is responsible for scalded skin syndrome?

A

Staph Aureus

exfoliative toxin

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11
Q

A patient presents with osteomyelitis, endocarditis, necrotising fasciitis and a furuncle.The patient was given flucloxacillin but his symptoms were not resolved. what mechanism was responsible for this resistance?

A

Staph Aureus

altered pbp-2a binding site

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12
Q

A patient presents with osteomyelitis, endocarditis, gastroenteritis and a furuncle. Would you treat his gastroenteritis with Abx? why?

A

No - it is caused by a preformed toxin and Abx treatment would allow for increased toxin release

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13
Q

what is nikolsky’s sign?

A

low pressure shedding of necrotic epidermis in scalded skin syndrome.

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14
Q

A patient presents with endocarditis, ventriculitis, peritonitis and has a catheter in. What pathogen is most likely responsible for this presentation?

A

staph epidermidis

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15
Q

A patient presents with endocarditis, ventriculitis, peritonitis and has a catheter in. What do you expect to see on the gram stain?

A

staph epidermidis

gram +ve cocci in clusters

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16
Q

A patient presents with endocarditis, ventriculitis, peritonitis and has a catheter in. What is the expected result of a catalase test for this causative pathogen?

A

staph epidermidis

catalase +ve

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17
Q

A patient presents with endocarditis, ventriculitis, peritonitis and has a catheter in. What is the expected result of a coagulase test for this causative pathogen?

A

staph epidermidis

coagulase -ve

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18
Q

A patient presents with endocarditis, ventriculitis, peritonitis and has a catheter in. What is the expected result of a novobiocin test for this causative pathogen?

A

staph epidermidis

susceptible

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19
Q

A patient presents with endocarditis, ventriculitis, peritonitis and has a catheter in. What agar would facilitate the growth of this causative pathogen and what would be observed?

A

staph epidermidis

blood agar - white/ grey

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20
Q

A patient presents with endocarditis, ventriculitis, peritonitis and has a catheter in. How would you treat this patient?

A

staph epidermidis
vancomycin or teicoplanin
remove catheter or prosthetic material

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21
Q

A patient presents with endocarditis, ventriculitis, peritonitis and has a catheter in. What Abx resistance is displayed?

A

staph epidermidis

intrinsically resistant to flucloxacillin

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22
Q

A patient presents with dysuria, increased frequency and a lower UTI with cystitis. What pathogen is most likely responsible for this presentation?

A

Staph saprophyticus

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23
Q

A patient presents with dysuria, increased frequency and a lower UTI with cystitis. What do you expect to see on the gram stain?

A

Staph saprophyticus

gram +ve cocci in clusters

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24
Q

A patient presents with dysuria, increased frequency and a lower UTI with cystitis. What is the expected result of a catalase test for this causative pathogen?

A

Staph saprophyticus

catalase +ve

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25
Q

A patient presents with dysuria, increased frequency and prostatitis. What is the expected result of a coagulase test for this causative pathogen?

A

Staph saprophyticus

coagulase -ve

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26
Q

A patient presents with dysuria, increased frequency and prostatitis. What agar would facilitate the growth of this causative pathogen and what would be observed?

A

Staph saprophyticus

blood agar - white/ grey

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27
Q

A patient presents with dysuria, increased frequency and prostatitis. What is the expected result of a novobiocin test for this causative pathogen?

A

Staph saprophyticus

resistant

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28
Q

A patient presents with dysuria, increased frequency and a lower UTI with cystitis. How would you treat this patient?

A

Staph saprophyticus

Trimethoprim

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29
Q

A patient presents with pharyngitis, scarlet fever (blanching, sandpaper textured rash), impetigo and otitis media. What pathogen is most likely responsible for this presentation?

A

strep pyogenes

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30
Q

A patient presents with cellulitis, necrotising fasciitis, acute rheumatic fever and glomerulonephritis. What is the expected result of a catalase test for this causative pathogen?

A

strep pyogenes

catalase -ve

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31
Q

A patient presents with pharyngitis, scarlet fever (blanching, sandpaper textured rash), impetigo and otitis media. What is the expected result of a bacitracin test for this causative pathogen?

A

strep pyogenes

bacitracin sensitive or susceptible

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32
Q

A patient presents with cellulitis, necrotising fasciitis, acute rheumatic fever and glomerulonephritis. What do you expect to see on the gram stain?

A

strep pyogenes

gram +ve cocci in chains

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33
Q

A patient presents with cellulitis, necrotising fasciitis, acute rheumatic fever and glomerulonephritis. What is the expected result of a ASOT test for this causative pathogen?

A

strep pyogenes

ASOT +ve (streptolysin O)

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34
Q

A patient presents with cellulitis, necrotising fasciitis, acute rheumatic fever and glomerulonephritis. How would you treat this patient?

A

strep pyogenes

IV Benzylpenicillin

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35
Q

What virulence factor is responsible for toxic shock syndrome in a strep pyogenes infection?

A

strep pyogenes

Pyrogenic exotoxin

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36
Q

What virulence factor is responsible for necrotising fasciitis in a staph aureus infection?

A

staph aureus

PVL

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37
Q

What virulence factor is responsible for necrotising fasciitis in a strep pyogenes infection?

A

strep pyogenes

M Protein

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38
Q

method of acquisition of staph aureus?

A

ingestion (fecal-oral) for gastroenteritis

direct contact

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39
Q

method of acquisition of staph epidermidis?

A

medical device contamination

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40
Q

method of acquisition of staph saprophyticus?

A

direct skin contact

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41
Q

A patient presents with cellulitis, necrotising fasciitis, acute rheumatic fever and glomerulonephritis. What is the method of acquisition of this causative pathogen and what precautions should be taken?

A

strep pyogenes
inhalation and droplet transmission
droplet precaution
isolation for first 24 hours of Abx therapy

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42
Q

A patient presents with cellulitis, necrotising fasciitis, acute rheumatic fever and glomerulonephritis. what haemolysis is observed and what agar was used?

A

strep pyogenes

Beta on blood agar (clear)

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43
Q

A patient presents with cellulitis, necrotising fasciitis, acute rheumatic fever and glomerulonephritis. What is the expected result of the lancefield test for this causative pathogen?

A

strep pyogenes

group A

44
Q

A neonate presents with sepsis and meningitis. The causative pathogen was found to be bacitracin resistant. what is this pathogen and how is it transmitted? what gram stain is expected?

A

strep agalactiae - congenital (vertical)

gram +ve cocci in chains

45
Q

A neonate presents with sepsis and meningitis. The causative pathogen was found to be bacitracin resistant. What is the expected result of the lancefield test for this causative pathogen?

A

strep agalactiae

group B

46
Q

A neonate presents with sepsis and meningitis. The causative pathogen was found to be strep agalactiae. What is the expected result of the bacitracin test for this causative pathogen?

A

strep agalactiae

resistant

47
Q

A neonate presents with sepsis and meningitis. The causative pathogen was found to be bacitracin resistant. what haemolysis is observed and what agar was used?

A

strep agalactiae

Beta on blood agar (clear)

48
Q

A neonate presents with sepsis and meningitis. The causative pathogen was found to be bacitracin resistant. How would you treat this patient?

A

strep agalactiae

IV Benzylpenicillin

49
Q

A patient presents with CAP, sinusitis, meningitis and otitis media. What is the causative pathogen?

A

strep pneumoniae

50
Q

A patient presents with CAP, sinusitis, meningitis and otitis media. What haemolysis is expected and what agar is used?

A

strep pneumoniae

alpha on blood agar (green)

51
Q

A patient presents with CAP, sinusitis, meningitis and otitis media. What is the gram stain observed

A

strep pneumoniae

gram +ve diplococci

52
Q

A patient presents with CAP, sinusitis, meningitis and otitis media. what is the expected result of an optochin test?

A

strep pneumoniae

sensitive

53
Q

A patient presents with CAP, sinusitis, meningitis and otitis media. what is the bile solubility of this pathogen?

A

strep pneumoniae

bile soluble

54
Q

A patient presents with CAP, sinusitis, meningitis and otitis media. How is this pathogen transmitted?

A

strep pneumoniae

inhalation/ droplet

55
Q

A patient presents with CAP, sinusitis, meningitis and otitis media. What is the expected result of a catalase test for this causative pathogen?

A

strep pneumoniae

catalase -ve

56
Q

A patient presents with CAP, sinusitis, meningitis and otitis media. how would you treat this patient’s CAP?

A

strep pneumoniae

macrolide (clarithromycin)

57
Q

A patient presents with CAP, sinusitis, meningitis and otitis media. how would you treat this patient’s meningitis?

A

strep pneumoniae

ceftriaxone

58
Q

A patient presents with CAP, sinusitis, meningitis and otitis media. what vaccine is recommended?

A

PCV-13 (children)

PPV-23 (adults)

59
Q

A patient presents with CAP, sinusitis, meningitis and otitis media. What Abx resistance is displayed by this pathogen and what is the mechanism of resistance?

A

B-lactams

altered pbp2

60
Q

a patient presents with an alpha haemolytic strep which is optochin resistant. what is the pathogen?

A

strep viridans

61
Q

a patient presents with strep viridans. what is the result of the optochin test?

A

strep viridans

resistant

62
Q

which strep viridans is responsible for causing colon cancer?

A

strep bovis

63
Q

which strep viridans is responsible for causing dental problems?

A

strep mutans

64
Q

which strep viridans is responsible for causing infective endocarditis?

A

strep mitis

65
Q

Is strep viridans encapsulated?

66
Q

a patient presents with aspiration pneumonia, an intraabdominal abscess and pelvic inflammation. this strep is anaerobic. what is the pathogen?

A

peptostreptococcus

67
Q

A patient presents with a UTI, infective endocarditis and a wound infection. the pathogen is bile soluble and grows on MacConkey agar. what is the causative pathogen?

A

enterococci

68
Q

what agar is used to grow enterococci? what is special about this agar?

A

enterococci

macConkey agar - 6.5% NaCl

69
Q

A patient presents with a UTI, infective endocarditis and a wound infection. the pathogen is bile soluble and grows on MacConkey agar. What is the expected gram stain?

A

enterococci

gram +ve cocci in short chains

70
Q

A patient presents with a UTI, infective endocarditis and a wound infection. the pathogen is bile soluble and grows on MacConkey agar. what is the result of the oxidase test?

A

enterococci

-ve

71
Q

A patient presents with a UTI, infective endocarditis and a wound infection. the pathogen is bile soluble and grows on MacConkey agar. what is the result of the catalase test?

A

enterococci

-ve

72
Q

A patient presents with a UTI, infective endocarditis and a wound infection. the pathogen is bile soluble and grows on MacConkey agar. what is the result of the coagulase test?

A

enterococci

-ve

73
Q

A patient presents with a UTI, infective endocarditis and a wound infection. the pathogen is bile soluble and grows on MacConkey agar. how would you treat this patient empirically?

A

enterococci

amoxicillin

74
Q

A patient presents with a UTI, infective endocarditis and a wound infection. the pathogen is bile soluble and grows on MacConkey agar. how would you treat this patient if the pathogen was B lactam resistant?

A

enterococci

vancomycin

75
Q

A patient presents with a UTI, infective endocarditis and a wound infection. the pathogen is bile soluble and grows on MacConkey agar. how would you treat this patient if the pathogen was VRE?

A

enterococci

linezolid

76
Q

which patients are at increased risk of acquiring and enterococci infection? (taking certain Abx)

A

enterococci

cephalosporin or an aminoglycoside

77
Q

method of acquisition of enterococci?

A

contact

ingestion (fecal-oral)

78
Q

A patient presents with a UTI with cystitis and peritonitis. a urine sample is sent to the lab and plated on Macconkey agar. a pink colour was observed. what is the most likely causative agent?

79
Q

A patient presents with a UTI with cystitis and peritonitis. a urine sample is sent to the lab and plated on Macconkey agar. a pink colour was observed. what is this pink colour?

A

e coli

lactose fermentation

80
Q

A patient presents with a UTI with cystitis and peritonitis. a urine sample is sent to the lab and plated on Macconkey agar. a pink colour was observed. what is the expected result from a catalase and coagulase test?

A

e coli
catalase -ve
coagulase +ve

81
Q

A patient presents with a UTI with cystitis and peritonitis. a urine sample is sent to the lab and plated on Macconkey agar. a pink colour was observed. what is observed on the gram stain?

A

e coli

gram -ve bacilli

82
Q

A patient presents with gastroenteritis with watery diarrhea. a urine sample is sent to the lab and plated on Macconkey agar. a pink colour was observed. what is the expected pathogen?

A

e coli

ETEC

83
Q

A patient presents with gastroenteritis watery diarrhea. a urine sample is sent to the lab and plated on Macconkey agar. a pink colour was observed. What body site is this pathogen found?

A

ETEC

small intestine

84
Q

A patient presents with gastroenteritis watery diarrhea. a urine sample is sent to the lab and plated on Macconkey agar. a pink colour was observed. what virulence factor causes this presentation?

A

ETEC

heat labile or cholera exotoxin

85
Q

A patient presents with gastroenteritis with bloody diarrhea and vomiting. a urine sample is sent to the lab and plated on Macconkey agar. a pink colour was observed. what is the expected pathogen?

A

VTEC (O157:H7)

86
Q

A patient presents with gastroenteritis with bloody diarrhea and vomiting. a urine sample is sent to the lab and plated on Macconkey agar. a pink colour was observed. What body site is this pathogen found?

A

VTEC (O157:H7)

colon

87
Q

A patient presents with gastroenteritis with bloody diarrhea and vomiting. a urine sample is sent to the lab and plated on Macconkey agar. a pink colour was observed. what virulence factor causes this presentation?

A

VTEC (O157:H7)
shiga exotoxin
heat labile and/or stable

88
Q

what pathogen causes hemolytic uremic syndrome?

A

VTEC (O157:H7)

89
Q

what virulence factor of e coli is responsible for causing neonatal meningitis?

A

K antigen (capsule)

90
Q

A patient presents with VAP and a UTI. An endotracheal aspirate was sent to the lab and a pink colour was observed on macconkey agar. what is the most likely causative agent and the gram stain?

A

klebsiella pneumoniae

gram -ve bacilli

91
Q

A patient presents with a lower UTI with cystitis and peritonitis. a urine sample is sent to the lab and plated on Macconkey agar. a pink colour was observed. how would you treat this patient?

A

E coli
co-amoxiclav and cefuroxime
lower UTI - trimethoprim
complicated UTI - gentamicin and cefuroxime

92
Q

A patient presents with VAP and a UTI with cystitis and red jelly-like sputum. is this pathogen motile?

A

klebsiella pneumoniae

NOPE

93
Q

A patient presents with necrotising VAP and a UTI with cystitis and red sputum. what agar would this pathogen be grown on?

A

klebsiella pneumoniae

MacConkey

94
Q

A patient presents with necrotising VAP and a UTI. An endotracheal aspirate was sent to the lab and a pink colour was observed on macconkey agar. what does this pink colour indicate?

A

klebsiella pneumoniae

lactose fermenting

95
Q

A patient presents with VAP and a UTI with cystitis and red jelly-like sputum. How would you treat this patient?

A

klebsiella pneumoniae
Amoxicillin or co-amoxiclav (empiric)
fluoroquinolone

96
Q

is e coli encapsulated?

97
Q

is klebsiella pneumoniae encapsulated?

A

YES you bitch - mucopolysaccharide capsule

98
Q

klebsiella pneumoniae is developing resistance to B lactams including cephalosporins. what is this mechanism of resistance?

99
Q

A patient presents with a UTI and renal calculi. he has a catheter in place. The cultures have a fishy smell. what is the expected pathogen and gram stain?

A

Proteus mirabilis

gram -ve bacilli

100
Q

A patient presents with a UTI and renal calculi. he has a catheter in place. The cultures have a fishy smell. what is expected on macConkey agar?

A

Proteus mirabilis

non-lactose fermenting (colourless)

101
Q

A patient presents with a UTI and renal calculi. he has a catheter in place. The cultures have a fishy smell. What is expected on blood agar? Why?

A

Proteus mirabilis

Swarming (concentric circles) due to peritrichous flagella

102
Q

A patient presents with a UTI and renal calculi. he has a catheter in place. The cultures have a fishy smell. How would you treat this patient?

A

Proteus mirabilis

co-amoxiclav or cefuroxime

103
Q

what is the result of a catalase test of klebsiella?

104
Q

what is the result of a catalase test of proteus?

105
Q

is proteus mirabilis encapsulated?

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