High Yield Flashcards
What is HTLV-1 and HTLV-2 associated with?
HTLV-1 —> Tropical spastic paraparesis (Caribeean) and T-cell Leukemia (Japan)
HTLV-2 –> Hairy cell leukemia
Rash on the trunk and neck that spares the face is associated with what gram-positive bacteria?
Streptococcus pyogenes (group A) –> Scarlet Fever
Which bacteria causes subacute bacterial endocarditis vs. acute bacterial endocarditis?
- Subacute –> Strep Viridans and Group D Streptococci (**Enterococcus) –> slow growth and piling of bacteria on the heart valve
- Acute –> Staph Aureus –> rapidly binds to and destroys heart valves
If a Streptococcus intermedius (aka anginosus species) group bacteria grows in the blood what should you suspect and what actions should you take?
This group of bacteria is a subgroup of which bacterial class?
- Suspect that an abscess is hiding in an organ and you should consider investigating with a CAT scan
- Subgroup of the Streptococcus Viridans
There is an increases risk of colonic malignancy if which bacteria is present on bacterial culture?
S. bovis
*BOVIS in the BLOOD better beware, CANCER in the BOWEL
Exotoxin release by Staph aureus causes what 3 pathologies?
1) Gastroenteritis (food poisoning): vomiting > diarrhea bc of mayo/potato salad
2) Toxic shock syndrome: release of TSST-1 –> MHC class II –> cytokine strom from TNF and IL-1: Vomiting + watery diarrhea + high fever + diffuse rash + desquamation of palms/soles + septic shock
3) Scalded skin syndrome: exfoliative toxin A and B –> cleavage of middle epidermis in neonates (recently severed umbilicus) and kids
How can Staph aureus develop methicillin resistance?
Acquired chromosomal DNA segment encoding a new penicillin binding protein 2A, which takes over the job of peptidoglycan cell wall assembly when the normal PBP (transpeptidase) is inhibited
What bacterium is unique in that it is the only bacterium w/ a capsule composed of protein (poly-D-glutamic acid)?
Function of this capsule?
- Bacillus anthracis
- Capsule prevents phagocytosis
What are the enterotoxins associated w/ Bacillus cereus?
How do you treat food poisoning caused by this bacteria?
- Heat-labile toxin: nausea, abdominal pain, diarrhea ( for 12-24 hours)
- Heat-stable toxin: severe nausea and vomiting, w/ limited diarrhea
*Supportive! DON’T give antibiotics, because these symptoms are caused by the toxins that were in food, NOT by the bacteria itself.
While working in the pediatric ED, you see a child w/ a sore throat and fever. There is a dark/greyish inflammatory exudate on the child’s pharynx, which appears darker and thicker than that of strep throat.
What bacteria do you suspect?
Which culture will you use to confirm?
- Corynebacterium diptheriae (gram-positive rods) –> Diptheria!
- Culture on potassium tellurite agar and Loeffler’s coagulated blood serum media
How are the exotoxins produced by Corynebacterium diptheriae similar to that of Group A beta-hemolytic streptococci?
Must first be lysogenized by a temperature bacteriophage to assert their effect
The finding of gram-positive, mostly intracellular bacilli in the CSF is virtually diagnostic of?
Listeria monocytogenes
What is the classic “clue” for an invasive meningococcal infection
Petechial rash
A 21 yo military recruit presents to the ED w/ symptoms of shock, with an abrupt onset of hypotension, tachycardia, and rapidly enlarging petechial skin lesions. He later develops DIC and falls into a coma before passing away after being in the hospital only a few hours.
What is the culprit and disease process?
- Neisseria meningitidis
- Fulminant meningococcemia (Waterhouse-Friderichsen syndrome): bilateral hemorrhage of the adrenal glands –> adrenal insufficiency
PID, endometritis, salpingitis, oophritis, pain with sexual intercourse, and a purulent vaginal discharge is associated w/ what bacteria?
Neisseria Gonorrhea
An infection by Neisseria gonorrhea or following Chlamydial PID of the capsule surrounding the liver causing a patient to complain of RUQ pain and tenderness is called?
Fitz-Hugh-Curtis syndrome
What is the most common kind of septic arthritis in young, sexually active individuals?
Gram stain and culture of the synovial fluid will show what to confirm your diagnosis?
- Gonococcal arthritis
- Gram-negative diplococci within the WBCs
Which serious eye infection can develop in a newborn as a result of transmission of Neisseria Gonorrhea from mother during delivery?
When do sx’s of this disease manifest and if not treat what kind of damage occurs?
- Opthalmia neonatorum, tx w/ erythromycin eye drops!
- This eye infecton usually occurs on the first or second day of life and can damage to cornea –> blindness
Kingella kingae of the neisseriaceae family can cause what kind of infections?
- Septic arthritis and osteomyelitis in children
- Endocarditis of native and prostheic valves in adults and children
A strain of EHEC, called E. coli 0157:H7 is assoicated with what serious infection?
Hemolytic uremic syndrome (HUS) - anemia, thrombocytopenia, and renal failure (thus uremia)
Most common cause of UTIs and gram-negative sepsis?
E. coli
After culturing bacteria from a hospitalized patient w/ a UTI you witness colonies swarm over the entire culture plate. Examination of urine shows a high pH (alkaline).
What is the culprit?
Proteus mirabilis
A patient presents w/ bloody diarrhea, anorexia, fever, headache, and RLQ pain that seems to be appendicitis like. During PE you find rose spots on the patients abdomen.
What do you suspect?
- Typhoid fever (Salmonella typhi)
What 2 bacteria can cause RLQ that mimics appendicitis?
1) Salmonella typhi
2) Yersinia enterocolitica
What are 2 complications that can arise from a Campylobacter jejuni infection?
1) Reactive arthritis, primarily in pts w/ HLA-B27
2) Guillain-Barre syndrome: ascending, flaccid paralysis
Which bacteria has a sweet, grape-like scent and can turn infected wound dressing a greenish-blue coloration?
Pseudomonas aeruginosa
Which gram-negative bacteria part of our normal flora can go wild in the peritoneal cavity, forming abscesses after a trauma to the intestine (i.e., car crash, GSW, appendicitis rupture, etc..)?
Bacteroides fragilis
Main cause of meningitis in children 6 months - 3 yo and also the most common cause of septic arthritis in infants?
Haemophilus influenza type b
How do you distinguish Haemophilus ducreyi infection from Syphilis and Lymphogranuloma venerum?
- Haemophilus produces chancroid (painful genital ulcer) w/ unilateral swollen inguinal nodes
- Syphilis has a painless ulcer and adenopathy is bilateral
- Lymphogranuloma venereum has painless matted suppurative inguinal nodes that develop more slowly. The primary ulcer dissapears before the nodes enlarge, whereas chancroid they coexist
What are included in Category A, Category B, and Category C of Agents of Bioterrorism?
- Category A: Small pox, botulism, plagu, tularemia, viral hemorrhagic fever
- Category B: Brucella, Vibrio cholerae, and ricin
- Category C: emerging infectious disease: Hantavirus and Naphavirus
Pt presents w/ pneumonia, fever w/ pulse temperature dissociation (high fever, low HR). severe headache, myalgias, hyponatremia, hypophosphatemia, and elevated liver enzymes (ALT, AST).
What do you suspect based on the sx’s?
Legionnaires disease - Legionella pneumonia
*Found in AC systems!
How can you differentiate the presentation from a Rickettsia rickettsii infection and a Rickettsia prowazekii infection?
What is the reservoir and vector for each?
Rickettsia rickettsii - RMSF - fever, conjunctival injection, severe headche, rash on wrists, ankles, soles and palms initially. Reservoir = dogs, rabbits, rodents; Vector = dermacentor tick
- Weil-Feil: Positive OX-19 and OX-2
Rickettsia prowazekii - EPIdemic typhus - abrupt fever/headache, rash which SPARES the palms, soles and face. Reservoir = humans, flying squirrels; Vector = human body louse (Pediculus corporis)
- Weil-Feil: Positive OX-19
What causes Bacillary angiomatosis, Bactermia, and Endocarditis in AIDS patients?
Bartonella henslae (Cat-scratch disease)
What makes Coxiella burnetii so unique?
- Gram-negative that has an endospore form; resistance to heat/drying
- NON-arthropod transmission; found on cow hides; aerosol transmission
- Q-fever: fever and soaking sweats along w/ pneumonia, but NO rash (only rickettsial disease that causes pneumonia w/ NO rash)
What is the very specific treponemal test commonly used in diagnosis of syphilis?
Indirect immunofluorescent treponemal Antibody Absorption (FTL-ABS) test
Which mycoside of mycobacterium prevents the phagosome from fusing with the lysosome?
Sulfatides
What makes up a Ghon focus and a Ghon complex?
- A calcified tubercle in the middle or lower lung zone = Ghon focus
- A Ghon focus + perihilar LN calcified granulomas = Ghon complex
Mycobacterium avium-complex (MAC) including M. avium and M. intracellulare are commonly seen in?
Most common cause of and presentation in males/females?
- AIDS patients w/ CD4 counts <50
- Most common cause of Nontuberculosis mycobacteria LUNG DISEASE
- Upper cavitary disease predominantly in male smokers
- Lower and middle lungs w/ bronchiectasis and nodular infiltrates in middle-aged non-smoking women
The cold agglutinins diagnostic test is useful for what bacteria?
Why?
- Mycoplasma pneumoniae
- Pts develop monoclonal IgM Abs directed at common RBC Ag called “I” Ag, which is modified (making it antigenic) with infection, these Abs bind to RBC and cause thm to agglutinate
