ID 5 Flashcards by Ned Jones

what is emetic type of b cereus usually caused by? characteristics?

1) rice and pasta

2) nausea and vomiting within 1-5 hours

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what causes emetic type of food poisoning caused by b cereus?

Cereulide, a preformed toxin

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characteristics of diarrheal type of food poisoning caused by b cereus?

watery, non bloody diarrhea + GI pain within 8-18 hours

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rises sardonicus presentation

Raised eyebrows and open grin

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tetanus treatment

1) antitoxin +/- vaccine booster
2) diazepam (for muscle spasm)
3) wound debridement

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tetanus prophylaxis

tetanus vaccine

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floppy baby syndrome?

botulism in babies

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what are local botox injections used for?

1) focal dystonia
2) achalasia
3) muscle spasms

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sources of botulism

juice and honey

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stability of c perfringens toxin?

spores can survive in undercooked food

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c perfringens toxin

heat-labile enterotoxin

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AB structure of c diff

A = enterotoxin that binds to brush border of the gut
B = cytotoxin that causes cytoskeletal disruption via actin depolymerization

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what else is c diff associated with?

PPI use

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How do you diagnosis c diff?

Detection of one or both toxins in stool by PCR.

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diphtheria toxin encoded by…

beta-prophage

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other symptoms of diphtheria…

1) myocarditis

2) arrhythmias

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appearance of diphtheria on culture?

Black colonies on cystine-tellurite agar

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diphtheria diagnosis

1) metachromatic (blue and red) granules

2) elek ttest positive

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listeria causes…

1) amnionitis
2) septicemia
3) spontaneous abortion in pregnant women
4) granulomatosis infantiseptica
5) neonatal meningitis
6) meningitis in immunocompromised
7) gastroenteritis in healthy

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where is nocardia found?

soil

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TB mimic?

nocardia

Nocardia causes

1) pulmonary infection in immunocompromised similar to TB presentation
2) cutaneous infections after trauma in immunocompetent

nocardia treatment

sulfonamides (TMP-SMX)

where is actinomyces found?

Normal oral, reproductive, and GI flora

what else can actinomyces cause?

PID with IUDs

actinomyces treatment

penicillin

Negative PPD means..

1) no infection | 2) *sarcoidosis

other TB test?

Interferon-gamma release assay (IGRA)

characteristic findings with secondary TB?

1) caseating granulomas with central necrosis | 2) Langerhans giant cells

ghon complex =

Hilar nodes + Ghon focus

what happens after primary TB?

1) over 90% heal by fibrosis and calcification. BUT can reactivate to secondary TB 2) 10% progress (usually in AIDS patients or malnourished people)

Presentation of secondary/reactivated TB?

Fibrocaseous cavitary lesion (usually upper lobes)

what can secondary TB progress to?

1) localized destructive disease with *caseation in kidneys or lungs. 2) OR bacteremia

Where does bacteremic TB infect?

1) meninges 2) vertebra 3) lymph nodes 4) lungs 5) liver 6) spleen 7) adrenal gland 8) joints and long bones

When do you need M avid prophylaxis?

CD4 less than 50

m scrofulaceum causes...

cervical lymphadenitis in children

cord factor appearance

"serpentine cord" appearance

cord factor MOA

Inhibits macrophage maturation + induces release of TNF-alpha

other virulence factor of TB

sulfatides

sulfatides MOA

Inhibit phagolysosomal fusion.

lepromatous leprosy presentation

1) diffuse over skin 2) leonine (lion-lake) facies 3) can be lethal

lepromatous immune response

humoral Th2

tuberculoid immune response

High cell-mediated immunity with a largely Th1-type response

what do you add for lepromatous form?

clofazimine

tuberculoid treatment

dapsone + rifampin

comma-shaped rods?

1) campylobacter 2) cholera 3) h pylori

coccobacilli?

1) h flu 2) pasteurella 3) brucella 4) b pertussis 5) francisella

maltose utilization characteristic of...

n meningitidis

fast lactose fermenters?

1) klebsiella 2) e coli 3) enterobacter

H2S production on TSI agar?

1) salmonella | 2) *proteus

mycobacterium leprae characteristics

acid-fast bacillus that likes cool temperatures