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infections Flashcards

1
Q

lyme ds causes by

A

borrelia burgdorferi

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2
Q

lyne ds transmitted by

A

tick

should be present in body for 24 hrs

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3
Q

characteristic lesion of lyme ds

A

erythema migrans

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4
Q

wht is erythma migrans

A

characteristic expanding skin lesion in lyme ds
red macule papule at the site of tick bite
annular lesion with partial central clearing target center
not often painful

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5
Q

stages of lyme ds

A

stage 1 localised infection
erythema migrans
stage 2 disseminated inf
secondary annular skin lesion
meningitis ,cranial neuritis ,carditis ,AV block
migratory musculoskeletal pain
stage 3 persistent inf
intermittent or persistent arrthris
polyneuropathy
acrodermatiits chronica atrophicans

post lyme syndrome / chronic lyme ds
subjective pain due to cognitive manisfestations , fatigue syn confusion with chronic fatigue syn and fibromyalgia

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6
Q

acrodermatiits chronica arophicans

A

late skin manifeststions of lyme ds stage 3
acral surface of arms and legs
red violaceous discolouration becomes atrophic or sclerotic

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7
Q

drug of choic of lyme ds

A

skin jt heart and some nervous involvement
doxycycline if > 9 yrs
amoxicillin if < 9yrs

some nervous , 3rd degree av block
iv ceftrixone

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8
Q

characteristic feature of relapsing fever

A

2 or more fever episodes varying periods of well being

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9
Q

cause of relapsing fever

A

antigenic variations of spirochetal surface

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10
Q

spirochetes gram behaviour

A

gram - ve but not seen under gram staining easily

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11
Q

endoflagella seen in

A

spirochetes

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12
Q

vector for relapsing fever

A

tick / louse
•tick- bites
•louse - rubbing of feces into bite site with fingers in response irritation
inoculation into conjuctiva or into open wound

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13
Q

clinical manifestations of relapsing fever

A

•sudden onset fever ends in crisis
due to killing be antibodies
for 15-30 min rigor increase in temp and dec in BP followed by profuse diaphoresis dec in temp and hypotension
• headache , neck stiffness , arthragia , myalgia

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14
Q

drug of choice for relapsing fever

A

tick borne 10 days treatment
louse borne single dose

less than 9yrs erythromycin
more than 9yrs doxycycline

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15
Q

weils ds caused by

A

leptospira

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16
Q

which spirochete has hooked ends

A

leptospira

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17
Q

transmission of leptospira

A

reservior rodents ( rats )
transmission direct contact with urine , blood, tissue from infected animal , environmental contamination
bacreria enters through cuts abraded skin , mucous membrane ( conjuctiva , oral mucosa )

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18
Q

phases of leptospiroses

A

biphasic
• leptospiremic phase 3-10 dys oraganism cultured from blood
• immune phase resolution of symptoms appearence of antibody

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19
Q

clinical manifestations of leptospiroses

A

mild leptospiroses flu like symptoms

severe leptospiroses weils syndrome

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20
Q

weils syndrome

A

severe form of leptospiroses triad

hemorrage
jaundice
acute kidney injury

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21
Q

loss of Mg is associated with ____ nephropathy

leptospira

A

nonoliguric hypokalemic renal insufficiency is characteristic of early leptospiroses

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22
Q

typical characteristic electrolyte disturbance of leptospiroses

A

hypokalemia hypomagnesimia hyponatremia

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23
Q

typical characteristic electrolyte disturbance of leptospiroses

A

hypokalemia hypomagnesimia hyponatremia

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24
Q

spirochetes include ___

A 
4 genera
leptospira 
borrelia 
treponema 
brachyspira
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25
clinical manifestations of syphilis
``` •primary syphilis typical primary chanchre + regional inguinal lymphadenopathy painless •secondary syphilis mucocutaneous lesion ( CONDYLOMATA LATA ) generalised non tender lymphadenopathy constitutional symptoms •latent syphilis absent of clinical manifestations + positive serolgy + normal CSF •tertiary syphilis ▪cardiovascular ▪GUMMA •congenital syphilis ```
26
neurosyphilis
can occur at stage •symptomatic meningeal , meningiovascular , stroke , parenchymal involvement ( paresis) tabes dorsalis charcot joints ,Argyll robertson pupil • asymptomatic
27
tabes dorsalis
syphlitic myelopathy late manifestations of syphilis demylination of dorsal column and root ganglia
28
charcot joints
trophic joint degeneration due to loss of pain
29
linaer calcifiation of aorta on chest xray seen in
syphlitic aortits
30
cardiovascular syphilis
endarteritis obliterans of vasa vasorum which | complete it
31
mnemonic paresis
``` p personality a affect r reflexes hyperactive e eye arygyl robertson s sensorium ( illusion , delusions i intellect ( memory, orienration, calculations, judgement) s speech ``` SEEN IN PARENCHYMAL DAMAGE OF NEUROSYPHILIS
32
GUMMA ?
granulomatous inflammation with central necrosis due to endarterits obliteratans can occur at any site most common skin and skeleton
33
congential syphilis
early ( within 2yrs ) are infectious resemble secondary syphilis in result rhinitis snuffles mucocutaneous lesions bone lesions osteitis osteochondritis periostetis hepatosplenomegaly late 8th nerve deafness , keraitis cluttons joint bilateral knee effusion classic stigmata hutinchon teeth mulberry molars saddle nose saber shin
34
hutchinson teeth
seen in congenital syphilis residual stigmata centrally notched widely spaced peg shaped upper central incisors
35
test for syphilis
treponemal test for syphilis FTA ABS flourescent treponemal absorption test TPPA TREPONEMAL particle agglutination , EIA/CIA treponemal enzyme immunoassays
36
initial test for examing csf for syphilis
VDRL | RPR easy to perform no heating required
37
principle of non treponemal and treponemal tests
igG and igM against cardiolipin lecithin cholesterol antigen conplex treponemal test - ??
38
?
as treponemal test r likely to remain reactive even after adequate treatment
39
features of syphilis test
RPR / VDRL screening , diagnosis quantitative measurement of ab to assses clinical syphilis activity to monitor response to therapy FTA ABS TPPA EIA/CIA Confirmation of syphilis dx in a patient with reactive ?
40
test used to monitor therapy in syphilis
?
41
treatment of syphilis
primary, sec , early latent PENICILLIN G ( if allergic tetracycline) late latent PENICILLIN G ( if allergic tetracycline) neurosyphilis PENICILLIN G if allergic desentization and then penicillin pregnancy same as neurosyphilis is csf abnormal in any phase treat as neurosyphilis
42
ghons focus
lesion of lung parenchyma after initial infection usually perifery
43
ghons complex
ghons focus + regional lymphadenopathy
44
why post latent inf of tb localise to apical and posterior segments of upper lobes
due higher mean oxygen tension favors aerobic mycobacterial growth
45
areas most common involved primary tb
because most inspired air is to middle and lower lung lobe
46
lymph nodes tb
painless swelling most common cervical and supraclavicular discrete initially matted later nontender may develop fistulous tract draining caseous material
47
meningeal invovlement in tb is pronunced in which region
base of brain
48
most common gi involved site in tb
terminal ileum and caecum
49
ACID FAST ORGANISMS
``` mycobacteria nocardia rhodococcus leigonella isospora cryptosporidium ```
50
whipple ds caused by
trophyrema whippli
51
classic whipple ds manifestations as
combinations of arthalgia arthiritis , weigt loss, abdominal pain , fever
52
gram behaviour of trophyrema whippli
weakly gram +ve
53
clinical manifestations of whipples ds
``` intestinal rheumatogic arthritis others neurological cardial endocarditis pulmonary lymphatic ( mesentric retropeeitoneal if intestinal mediastinal in pulmonary ocular uveitis dermatologic hyperpigmentation ```
54
clinical manifestations of actinomycetes
``` actinomycosis orocervical orocervical facial sites thoracic abdominal cns brain abscess musculoskeletal soft tissue ```
55
lesions of actinomycosis
???? chronic indolent face lesions multiple lesions central necrosis consisting of neutrophils fibrotic walls over time sinus tract to skin adjacent organ or bone
56
mode of infections of actinomycosis
colonize mouth colon vagina | mucosal disruption may lead to infection at any site
57
bisphonates r associated with ___ inf
actinomycosis
58
DOC for actinomycosis
PENICILLIN
59
clinical manifestations of nocardiosis
pneumonia most common
60
actinomycetoma
begins as nodular swelling most common at feet and hands nodules break fistula appears fistulas tend to come and go with new one forming as old one disppeaes discharge serous or purulent may be bloody andoften contains white granules systemic symptoms minimal
61
granules in nocardiosis
these r microcolonies extendendung radially from central core found in actinomycetoma but never in discharges in lesion of other form nocardiosis
62
actinomycetoma caused by
nocardia not actinomycetes
63
clinical manifestations of catscratch ds
numerous extranodal involving various
64
transmission of catscratch ds
major reservior cats | inoculation via contaminated flea feces usually result from cat scratch , bite
65
clinical manifestations of typical cats scratch ds
primary lesion small painless erythematosus papule or pustule at inoculation site lymphadenopathy- enlarged painful granuloma formation overlying erythema suppration axillary epitrochlear most common ( head and neck , inguinal, femoral also) constitutional- fever malaise anorexia night sweats
66
cause of trnch fever
bartonell qintana
67
5 day fever
trench fever / quintan fever
68
vector for trench fever
human body louse
69
ds by louse
trench fever | relapsing fever ??????
70
clinical manifestations of classical trench fever
fever is often periodic lasting 4-5 days (range 3- 8 days )interval bw episodes other symptoms HEADACHE back and limb pain profuse sweating shivering myalgia arthralgia spelnomegaly
71
___ r most common organisms in culture-ve endocarditis
coxiella burnetti | bartonella
72
bacillary angimatosis and peliosis
bartonella
73
wht bacillary angiomatosis & peliosis
bacillary angiomatosis lobular proliferation of small blood vessels lined by larged endothelial cells interspersed with mixed infiltration of neutro and lympho peliosis small blood filled cystic space partially lined by endothelial cells mainly liver both r ds of immunocompromised
74
orya fever by
bartonella
75
carrion ds consist of
oroya fever initial febrile bactremic phase with/ without sudden onset anaemia ( due to erythrocyte hemolysis due to bartonella reinvasion ) verruga peruana red hemangioma like cuteneus lesion
76
carrion ds vector
sandfly
77
ds by tick
``` relapsing fever ( also by louse ) lyme ds ???? ```
78
ds caused by bartonela
``` catscratch trench fever endocarditis carrion ds ( oroya veruga peruana) bacillary angiomatosis peliosis ```
79
F1 ANTIGEN found in
yersenia pestis
80
vector for plague
xenopsella cheopsis ratflea
81
clinical manifestations of plaque
•bubonic replication of bacteria inregional lymph nodes depending on site of bite tense tender swelling most common inguinal ( due to bite ) •primary septicemic (due to bite ) without preceding LDN pneumonic PRIMARY - Inhalation SECONDARY- hematogenous meningitis pharyngitis meat inhaltion
82
morphology of yersenia
GRAM - VE bipolar coccobacilli close safety pin APPEARANCE
83
clinical manifestations of nocardiosis
respiratory tract : pneumonia extrapulmonary ds : due to dissemination MC site is brain but can involve any site or organ typical manifestations is in form of subacute abscess following transcutaneus inoculation cellulitis lymphocutaneous ds Actinomycetoma
84
clinical manifestations of tularemia
oropharyngeal( ingestion) acute exudative membranous pharygnitis ulcerative intestinal lesion pulmonary (inhaltion) ulceroglandular (tick bite ) skin lesion - ulcer at site erythematosus indurated punched out black base regional lymphadenopathy depending on the site of inoculation oculoglandular ( eyes contamination) purulent conjuctivitis with regional lymphadenopathy depending
85
doc of tularemia
gentamycin
86
clinical manifestations of cholera
``` sudden onset of watery diarrhoea vomit fever absent muscle cramps due to electrolyte disturbances stool rice water stool nonbilious gray slighly cloudy with flecks of mucus no blood somewht fishy inoffensive odour r ```
87
doc of cholera
erythromycin/ azithromycin
88
vibro parahemolyticus
halophilic marine environment consumption of improper cooked sea food or food contaminated with sea water cause gastroenteritis - watery diaarhoea dysentery less commonly wound infection normal individual r at risk can be infected
89
vibrio vulnificus
halophilic sea water marine environment cause primary sepsis in immunocompromised with underlying liver ds / hemochromatosis primary wound infection even in healthy
90
selective medium for vibrio
taurocholate tellurite gelatin | thiosulfate citrate bile salt sucrose tcbs
91
___ cause HEMOLYSIS on wagatsuma agar
vibrio parahemolyticus
92
kanagawa phenomenon
hemolysis on wagtsuma agar by vibrio parahemolyticus linked to its enteropathogenicity
93
darting motility seen in
campylobacter | vibrio
94
clinical manifestations of campylobacter jejuni
gastroenteritis contaminated food and water prodrome fever arthrits myalgia malaise intestinal phase loose stools to grossely bloody abdominal pain
95
___ inf mimic ulcerative colitis and chrons ds
•campylobacter jejuni biopsy finding same • shigella
96
doc campylobacter
erythromycin/ ciprofloxacin
97
transport medium of vibrio
cary blair | alkaline peptone water
98
clinical manifestations of shigella
4 phases incubation period watery diarrhoea dysentry small volume of bloody mucopurulent stools with increased tenesmus and abdominal cramps cause acute colitis mailnly distal colon and rectum can cause toxic megacolon inflammation extending to smooth muscle layer postinfectious phase
99
ekiri syndrome
toxic encephalopathy with bizzare posturing , cerebral edema, fatty
100
complications of shigella inf
toxic megacolon | HUS
101
HUS CAUSED BY
ecoli enterohamerragic | shigella dysentry type 1 shiga toxin
102
?
shigella dysentry shigatoxin
103
doc of shigella
ciprofloxacin
104
enteric fever caused by
salmonella typhi | salmonella parathphi
105
clinical manifestations of enteric fever
fevr + gastrointestinal symptoms fever •most prominent prolonged fever can continue upto 4 wks headache, chils , cough sweating , myalgia malaise arthralgia anorexia abdominal pain, nausea,vomiting, diarrhoea, rose spots ``` physical examination coated tongue rose spots neurological disorders hepatosplenomegaly abdominal tenderness relative bradycardia at peak of fever ```
106
rose spots
faint salmon colored blanching maculopapular on trunk and chest
107
doc of enteric fever
azithromycin | ciprofloxacin
108
colonic character of pseudomonas
pigment production yellow green blue shiny gun metal appearance fruity odour
109
ds caused by pseudomonas aeroginosa
effect anysite rarely initiate infection in absence of host compromise most commonly cause respiratory inf most common cause of ventilator associated pneumonia chronic infection in structural lung ds cystic fibrosis bronchiectasis due to altered mucociliaery clearence
110
ecthyma gangrenosum
it is distinctive skin lesion by pseudomonas painful reddish maculopapular black necrotic differentiates pseudo sepsis from other gram - ve sepsis occur exclusively in neutopenic or AIDS
111
pathogenesis of duodenal ulceration , gastric ulceration
•duodenal ulceration dec in somato producing D cells no inhibition of gastrin inc gastrin inc acid (from a relatively spared gastic corpus ) •gastric ulceration and adenocarcinoma inflammation in corpus + acid less despite hypergastrinemia ulcer at antral corpus junction
112
clinical manifestations of h pylori
peptic ulcer ds gastric adenoca lymphoma
113
test for hpylori
endoscopy biospsy urease test histology culture non invasisve urea breath test stool antigen test
114
treatment for hyplori
1 PPI + 2/3 antimicrobial for 7- 14 days
115
regimens for hpylori
TOMS metronidazole+ omeprazole +TETRACYCLINE + bismuth subsalicylate COAT CLATHIROMYCIN + OMEPRAZOLE +AMOXICILLIN +TINIDAZOLE OMEPRAZOLE +AMOXICILLIN OMEPRAZOLE + CLATHIROMYCIN + METRONIDAZOLE
116
acenitobacter infections
???
117
ds caused by ecoli
intestinal and extraintestinal ``` intesstinal mneumonic STIPA EXTRAINTESTINAL UTI •pneumonia mostly in hospital acquired • abdominal and pelvic inf •meningitiis one of leading cause of neonatal meningitis other being streptococcus cellulitis musculoskeletal bactremial ```
118
STIPA MNEMONIC? INTESTINAL PATHOGENIC ECOLI
STEC/EHEC/STEAEC shiga toxin producing enterohamerragic/ shiga toxin producing enetroaggregative causes HUS / hemolytic colitis ETEC ENTEROTOXIGnic causes travellers diarrhoea EPEC enteropathogenic causes watery diarrhoea , persistent diarrhoea EIEC enteroinvasive cause dysentry EAEC enteroaggregative causes travellers diarrhoea, acute diarrhoea, persistent diarrhoea STEC AND EIEC bloody stools STEC no fever EIEC mucus blood inflammatory cells , abdominal pain, tenesmus , fever
119
STEC
enterohamerragic ecoli
120
HUS and hemorragic colitis caused by
EHEC
121
mechanism of enterohamerragic ecoli enterotoxin
consist of heat labile toxin LT activates adenylate cyclase inc cyclic AMP consist of 2 subunits A and B subunit A cause ribosylation of adp B binds to GM1 ganglioside receptors for entry of subunit A AND heat stable ST activates guanylate cyclase inc cyclic GMP
122
antibiotic not recommended for EHEC WHY?
may increase incidence of increased production of shiga toxin
123
doc of ecoli
floroquinolones | azithromycin
124
?
•klebsiella oxytoca hospital setting •klebsiella pneumonie subsps rhinoscleromatous causes rhinoscleroma granilomatous mucosal uri tht progresses slowly cause necrosis and obstruction of nasal pathway klebsiella ozeane - atrophic rhinitis PNEUMONIA UTI ABDOMINAL INFECTION HPKP common cause of monomicrobial community acquired pyogenic liver abscess
125
swarming motility on agar plate seen by
proteus
126
ds caused by proteus
produce urease hydrolyse urea to ammonia alkanization of urine stones struvite formation of biofilm on catheters
127
medium of bordetella
bordet gengue | regenlowe
128
clinical manifestations of pertusis
•catarrhal indistinguishable from common cold coryza , lacrimation, mild cough, low grade fever , malaise after 1-2 wks whooping cough •paroxymal whooping cough associated with protuding tongue , cyanosis , post tussive vomiting •convulsant after 2-4 wks gradual resolution of coughing episodes ``` complications subconjuctival hrges abdominal hernia hemothorax facial truncal petechiae ```
129
clinical manifestations of pertusis
•catarrhal indistinguishable from common cold coryza , lacrimation, mild cough, low grade fever , malaise after 1-2 wks whooping cough •paroxymal whooping cough associated with protuding tongue , cyanosis , post tussive vomiting •convulsant after 2-4 wks gradual resolution of coughing episodes
130
doc of bordetella
macrolide
131
leignellosis
consist of 2 clinical syndrome pontaic fever acute febrile self limiting fever leegionnairs ds ( pneumonia ) abdominal pain , nausea ,vomiting
132
BCYE MEDIUM IS FOR
legionella | buffered charcoal yeast extract
133
mode of transmission of leigonella
aquatic reservoir ie water distribution systems devices filled with tap water nebulizer humidifier mist machine aerosolization and direct instillation most common aspiration from oropharyngeal colonisation or drinking of contaminated water
134
pontaic fever
acute febrile self limited fever caused by leigonella
135
leigonella ds
diffrential diagnosis of atypical pneumonia
136
doc of leigonella
macrolide | respiratory flouroquinolones
137
most common bacterial cause of exacerbation of COPD
h influenzae | moraxella catarrhalis
138
clinical manifestations of moraxella
nasal manifestations common in children otitis media sinusitis COPD exacerbation
139
hemophilus ducryi
characterised by genital ulceration + inguinal adeniits painful nonindurated ulcer bleeds easily inguinal adeniits is tender suppurate
140
hockey puck sign
used to differntiate moraxella catarrhalis from commensal neisseral colonies tht r part of upper airways moraxella colonies can slid across agar surface without disruption
141
ribosyl ribitol phosphate is found in
capsule of h influenzae
142
clinical manifestations of h influenzae
meningitis manifests at <2yrs epiglottis at 2-7 yrs cellulitis not so important pneumonia
143
most common cause of childhoods otitis media
hinfluenzae strep pneumonie moraxella catarrhalis
144
drugs for hemophilus
ceftrixone CEPHALOSPORIN
145
pathogenesis of neisseria meningitis
``` endothelial injury can lead increased vascular permeability loss of resistance intravascular myocardilal dysfunction ? ```
146
clinical manifestations of neisseria meningitis
meningitis meningiococcal septicemia rash - initially blanching in nature then becomes petechial and then finally purpuric
147
common causes of petechial or purpuric rash
``` enterocviris measeles EBV parvovirrus deficiency of protein C and S platelet disorders connective tissue disoreders pneumococcal streptococcal staphylocca ```
148
identification of neisseria on thoraot swab not of value because ?
component of normal flora
149
traumatic gas gangrene caused by?
clostridium perferngis due to anaerobic environment?
150
pathogenesis of gas gangrene
extracellular toxin alpha - occlusion of blood vsels by herotopic aggreagetes of lympho and ? theta toxin - form ring like spores
151
treatment of gas gangrene
penicillin and clindamycin
152
histopathalogy of gas gangrene
paucity of leumocytes in infected tissue | accumulation of leulocytes in adjacent vsels
153
doc for listeria
ampicillin
154
clinical manifestations of listeria
gastroenteritis and septicemia most common bacteremia meningitis aseptic meningitis in older and debeliated meningioencephalitis focal abscess inf in pregnant and neonate nonspecific acute or subacute febrile illness with myalgia malaise arthralgia backache preterm granulomatosis infantiseptica ( listerial fetal infection with military microabsess and granulomas in skin, liver,spleen)
155
mode of transmission of listeria
food borne contamination
156
bacteria seen in form of clusters of parallel rays
corynebacterium refereed to as chinese letter appearence
157
corynebacteriophage
responsible for toxigenic conversion of tox- ve coryne into tox+ coryne
158
mechanism of action of diphteria toxin
A and B fragment delivery of A fragment into cell cytosol result in irreversible inhibition of protein synthesis by NAD dependant ADP Ribosylation of elongation factor 2
159
inhibtion of ef-2 done by
diptheria
160
characteristic finding od diptheria
mucosal ulcer with pseudomembranous coating it is composed of inner band of fibrin and luminal band of neutrophils mucosal ulcers result from necrosis of epithelium
161
why call pseudomembrane in diptheria
because tightly adhrent and attempt to dislodge cause bleeding
162
leading causes of pharyngitis
``` viral rhinovirius influenza parainfluenza corona adeno stereptococcal atypical mycoplasma pneumonie chlamydia pneumonie ```
163
clinical manifestations of diptheria
``` respiratory sore throat low grade fever pseudomembranous bulls neck ( massive edema of submamdibular and paratracheal region) cutaneus punched out ulcerative lesion systemic manifestations ```
164
complications of diptheria
airway obstruction polyneuropathy myocarditis
165
treatment of diptheria
procaine PENICILLIN G/ PENICILLIN V OR ERTHROMYSIN
166
most common cause of bacterial endocarditis
streptococcus viridans
167
leading causes of bacterialsepsis and meningitis in new born
grp b strep
168
lancefield grp
A STREP PYOGENUS beta hemolytic B strep agalactiae beta hemolytic C,G STREP DYSGALACTiae beta hemolytic D enterococci e. faecium ; e faecalis non hemolytic variableor nongrpable , strep viridans alpha hemolytic anaerobivlc
169
alpha hemolytic strep
streptococcus viridans
170
major surface protein of GAB
``` M PROTEIN resist phagaocitic killing by binding ok fibrrinogen to m protein polysaccharide capsule stretolysin Sand O sterptokinase, DNASES SOME ERYTHROGENIC TOXIN ```
171
clinical manifestations of GAS
``` pharyngitis cellulitis scarlet fever impetigo nectrotising fasicitis ```
172
scarlet fever
due to streptococcus pyrogenic exotoxin rash upper trunk spread to involve extremities spares palm and soles minute papules giving sand paper feeling circumoral pallor strawberry tongue ( enlarged papillae coated tongue which becomes denuded) pastia line ( accentuation of rash in skin folds ) subsidence of rash in 1 week followed by desquamation later on sparing pams aoles
173
inpetiga
begin as red papules which form veasiclethen pusular tht break down and colalese to for honeycomb painless no fever also caused by staph but more extensive thn it
174
? erysipelas
? warm to touch may be tender shiny swollen peud orange cluster involvement of superficial lymphatics fever and chills occur over malar area of face and extremities
175
grp b sterp?
s agalctiae
176
CAMP FACTOR BY?
streptococcus agalactiae | phospholipase tht cause synergistic hemolysis with b lysin prodeuced by staph
177
typical inf caused by GBS
neonatal sepsis due to colonisation of maternal genital tract or rectum neonatal meningitis purpureal infection causes uti endocarditis
178
grp d sterep
enterococcus | strep gallolyticus
179
strep galolyticus endocarditis
often association with malignalcy of gi tract | most common colon or polyp
180
clinical manifestations of strep viridans
endocarditis brain absesces dental abscess ? liver abscess
181
difference bw enterococcus and strep gallolyticus
enterococcus hydrolyse PYR
181
difference bw enterococcus and strep gallolyticus
enterococcus hydrolyse PYR
182
clinical manifestations of enterococcal infection
``` uti prostatities bactremia endocarditis meningitis ```
183
most common cause of septic arthritis in native joints
staph aureus
184
most common cause of surgical wound infection
staph aureus
185
toxin mediated ds by staph
enterotoxin - food poisoning heat stable, short incubation period , vomiting diffrential diagnosis is bacillus cerus fever is less toxic shock syn- toxic shock syn exfolitive toxin - staphylococcal scalded skin syndrome
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organisms responsible for rht sided tricuspid valvular endocarditis in iv drug absures
staph aureus
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pressence of staph aureus in urine generally suggests
hematogenous as staph infrequent cause of uti
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anterior nares and is primary site of colonisation by
staph aureus | can colonise damaged skin , vagina, groin, oropharynnmx
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difference between staph aureus and other staph species
coagulase enzyme tht convert fibrinogen to fibrin
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colonies of staph aureus
golden beta hemolytic but CONS white non hemolytic
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clinical manifestations of staph aureus
``` skin and soft tissue folliculitis faruncle carbuncle cellulitis masitiis surgical wound ( most common cause) musculoskeletal septic arthritis pyomyositis osteomyleitis HEMATOGENOUS OSTEOMYLEITIS IF ADULT -- VERTEBRA IF CHILD -- LONG BONES psoas abscess respiratory ventillator postviral empyema septic pulmonary emboli bactremia sepsis , septic shock ``` ``` infective endocarditis iv drug use native valve prosthetic nisocomial device related infection toxin mediated toxic shock syn food poisoning SSS invasive infection necrotizing fascitis waterhouse friderichsen syn necrotizing pneumonia purpura fulminans ```
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alpha hemolytic strep
sterp virians | strep pneumonie
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quelling reaction showm by
strep pneumonie ie capsule swell in p ressence of specific antiserum
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clinical manifestations of streptococcus pneumonia
otitis media sinusitis pneumonia meningitis
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capsular polysaccharide vaccine of streptococcus pneumonia
capsular polysaccharide ppsv 23 23 valent 2-64 yrs of age who hve underlying medical condition polysaccharide protein conjugate vaccine for infants and young children
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rickettsial ds
``` RMSF by rickettsia ricketsse LOUSE BORNE TYPHUS SCRUB TYPUS ORIENTIA psupsugamushi MURINE TYPUS R typhi Mediterranean fever R conorii rickktisial pox mite borne by mites epidemic typus louse borne by R prowazekii endemic typhus flea borne by R typhi ```
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RMSF TRANSMISSION BY
tick
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fundamental basis for tissue and organ injury of in rmsf
increased vascular permeability resulting in edema, hypovolemia, ischemia consumption of platelets result in thrombocytopenia
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clinical manifestations of RMSF
rash tht first appears wrist and ankles and then appears on remainder of extremities and the trunk involvement of palms and soles tht r diagnostically important hypovolemia ???
200
scrub typhus caused by
orientia tsutsugamushi
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louse borne typhus
epidemic typhus
202
brill zinsser ds
recrudescent ds occuring yrs after acute epidemic typhus prowaskii remains latent for yrs its reactivation result in ds leading sporadic cases in louse free populations or epidemic in louse infested populations
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endemic fever rash skin lesion lack necrotic area or crust surrounded by erythema
rickettsial spotted fever
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doc for rickettsia
doxycycline
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HME AND HGA
human monocytotropic ehrlichosis tick borne human granulocytotropic anaplasmosis tick borne both effects haematopoeitic cells
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erythema migrans seen in
HGA
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morulae seeen in?
HGA HME intracellular inclusion
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q fever caused by
coxiella burnetti
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mode of transmission of q fever
inhaltion or ingestion of contaminated milk parturiation percutaneous transmissiom
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clinical manifestations of q fever
acute fever fever , headache , fatigue etc post q fever fatigue noninfective afyer q fever chronic q fever always impleis endocardities
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vegetation of q fever
different from infective endocarditis | manifesting as endothelium covered nodules on valves
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most common chronic manifestations of q fever
endocarditis
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clinical manifestations of mycoplasma
respiratory infections myco pneumonie | genitourinary infections by mycoplasma others
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most common bacterial cause atypical pneumonia
mycoplasma pneumonia | leigonella
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treatment for mycoplasma
macrolides | doxycycline
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clinical spectrum of herpes simplex virus
mucocutaneous orofacial gingivostomatoties pharyngitis herpes labialis most common manifestations of reactivation •genital infections- multiple extremly painful punched out various stages confluent shallow ulceres on edematous base •herpetic whitlow- finger infection from oro/ genital herpes or direct inoculatiom CNS encephalitis especially temporal lobe autonomic radiculopaythy neonatal acquired perinatelly infected secretion of genitalia visceral esophagiits ( diret speard of oropharyngeal or reactivation and spread via vagus ) lung , liver disseminated erythema multiforme eyes - keratitis most xause of corneal blindness in US
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treatment of HSV
acyclovir valcyclovir famcyclovir
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treatment of infection of acyclovir resistant hsv
foscarnet
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clinical manifestations of varicella zoster
``` infectious 48hrs before the onset of rash during the period of vesicle formation untill all vesicles r crusted 4-5 days •rash maculopapular vesicles scabs in various stages of evolutiom lesion also in mucosa pharynx vaginal older chilren more vesicles •low grade fever ``` •malaise
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complications of varicella
sec bacterial superinfection of skin cns meningitis, encephalitis varicella pneumonie most serious complications onset 3- 5 days perinatal varicella 5 days before the delivery within 2 days thereafter congenital varicella skin - streptococcus pyogenous staph aureus on scratch
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clinical manifestations of herpes zoster
•rash unilateral, vesicular dermatomal mostly in thoracic and opthalmic divisions of mandibular nerve pain in dermatomal region 2- 3 days before •zoster sine hepatica-- localised dermatomal pain + serological evidence but no rash •ram say hunt -- geniculate ganglia of sensory branch of facial nerve pain and vesicles on ext auditory canal, loss of taste sensation in ant2/3 of tongue with ipsilateral facial paralysis •post herpetic neuralgia some degree of pain in involved dermatome for mnths after resolutio cns
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ramsay hunt syn
triad of ipsilateral , facial paralysis , ear pain , vesicles in ext auditory canal and auricle due to reactivation of herpes zoster in geniculate ganglia lower motor neuron lesion of facial nerve inabilty to move some muscle of face
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treatment of varicella
acyclovir famcyclovir valcyclovir
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characteristic of EBV
``` hetrophile +ve fever sore thorat lymphadenopathy atypical lymphocytosis ```
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mode of transmission of ebv
salivary secretion s via kissing
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clinical manifestations of ebv
``` •fever low grade fatigue •myalgia •malaise •lymphadenopathy posterior cervical or generalised tender symmetrical not fixed •pharyngitis or tonsillitis •splenomegaly • hepatomegaly •rash papular or morbiliform ```
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atypical lymphocytes found in which inf
``` ebv enlarged lymphocytes abdundant cytoplasm vacuoles indentation of cell membrane ```
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complications of ebv
* cns -- meningitis and encephalitis * blood autoimmune hemolytic anaemia, cytopenial * spleen rupture
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oral hairy leukoplakia caused by ebv in hiv adults
ebv in hiv adults white corrogative lesion on tongue

internal medicine ishani (9 decks)

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