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ABBEY MSII Unit 2 > Micro 4 part 1 and 2 > Flashcards

Micro 4 part 1 and 2 Flashcards

1
Q

Stroptococcal Pharyngitis Symptoms

A

inflammation of pharynx, tonsils, uvula with exudate, cervical lymphadenopathy, fever

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2
Q

What percentage of pharyngitis is due to Group A streptococci?

A

30%

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3
Q

How is group A streptococci diagnosed?

A

family/social history, rapid antigen detection (fale negative), bacterial culture (slow)

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4
Q

What does bacterial culture of group A streptococci show?

A

gram + cocci that grow in chains, beta-hemolyitc, bacitracin-sensitive, react with Lancefield group-a antiserum

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5
Q

What are group A streptococci toxins? Effect of each toxin?

A

streptokinase (tissue lysis); streptodornase (digests DNA); hyaluronidase (digests connective tissue; pyrogenic toxin (fever, super antigen, toxic shock); erythrogenic toxin (skin rash)

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6
Q

Steptolysin O

A

Group A strep - not virulence but used for identification. highly antigenic, inducing short-lived IgM

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7
Q

What are complications of group A strep?

A

tonsillitis, peritonsillar abscess, Ludwig’s angina (no airway because floor of mouth swollen - die), middle ear infections, meningitis, mastoiditis, scarlet fever, rheumatic fever

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8
Q

Scarlet Fever

A

due to exotoxin encoded by bacteriophage that carries gene for the erythrogenic toxin. skin rash and strawberry tongue

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9
Q

What is prevention for group A strep?

A

no vaccine, prophylactic antibiotics for patients with post-strep diseases, treatments for carriers NOT recommended, tonsillectomy reduces risk of future infection

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10
Q

Treatment of group A strep?

A

no essential (self-limiting) - use systemic penicillin G, amoxicillin, erythromycin, cephalosporins if needed - drug resistance not a problem

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11
Q

Rheumatic fever etiology

A

post-strep condition (3 weeks later) - autoimmune condition with fever, polyarthritis, and inflammation of the heart leading to permanent deformations

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12
Q

At risk groups for rheumatic fever

A

children 6-15

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13
Q

Rheumatic fever diagnosis

A

clinical features (triad of fever, polyarthritis, inflammation of heart) with IgM anti-streptolysin O antibody - no bacteremia

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14
Q

Rheumatic fever pathogenesis

A

autoimmune

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15
Q

Which types of strep are more likely to be associated with rheumatic fever?

A

M protein 3 and 5

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16
Q

What is a complication of rheumatic fever carditis?

A

fibrosis/calcification of endocardium with permanent valve distortion (will need antibiotics at times of likely bacteremia)

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17
Q

Treatment of Rheumatic fever

A

anti-inflammatory drugs (aspirin/steroids) - no antibacterial therapy indicated. sometimes replacement of heart valves

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18
Q

Rheumatic fever prevention

A

aggressive anti-bacterial therapy in the event of later strep infections

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19
Q

Dental Caries etiology

A

infection of viridian’s streptococci - alpha hemolytic and optochin resistant

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20
Q

What is the pathogenesis of dental caries?

A

produce high molecular weight carbohydrates that form biofilm on tooth surfaces - break down sugars to make acid that demineralizes enamel and dentin

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21
Q

Diagnosis of dental caries

A

6-monthly dental exams show early demineralization - lab testing doesn’t help because bacteria are part of normal flora in 100% of people

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22
Q

Virulence factors of dental caries

A

extracellular polysaccharides and acid (decalcifies)

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23
Q

Prevention of dental caries

A

optimal flouride concentration of drinking water during dental enamel formation - topical fluorides to tooth surfaces, low sugar diet

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24
Q

Complications of dental caries

A

pulpitis (inflammation of dental pulp tissue where the blood vessels, nerves, and connective tissue are), abscesses, cellulitis

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25
Q

treatment of dental caries

A

dental treatment to remove decalcified tissue - acute abscesses can be treated temporarily with penicillin, erythromycin, cephalosporins - dental extraction most effective

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26
Q

Endocarditis etiology

A

previous rheumatic fever leads to turbulent blood flow - any stick bacteria attach and replicate - continuous damage and persistent infection

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27
Q

Which bacteria normal cause endocarditis?

A

viridans streptococci (staph aureaus in drug users/infected IV)

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28
Q

Diagnosis of endocarditis

A

variable clinical features, cardiac exam. satellite infectious foci (splinter hemorrhages) under fingernails and conjunctiva - blood culture positive for causative organisms

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29
Q

Endocarditis treatment

A

prolonged antibiotics, replacement of heart valves

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30
Q

Endocarditis prevention

A

antibiotic coverage of dental treatment, cath, at-risk patients (prophylactic)

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31
Q

Periodontal disease

A

chronic inflammation in oral tissues that are in contact with dental plaque (early = gingivitis)

32
Q

What is the pathogenesis of periodontal disease?

A

over years, gingiva detach from tooth creating a pocket where microorganisms proliferate - becomes deeper, alveolar bone is destroyed, mature plaque becomes calcified - eventually teeth become loose and bye

33
Q

What organism is responsible for periodontal disease?

A

complex mix of anaerobic organisms

34
Q

Diphtheria etiology

A

infection of the pharyngeal mucous membrane causing necrosis and membrane with respiratory obstruction

35
Q

Virulence factor of diphtheria

A

diphtheria toxin (encoded by bacteriophage) - causes systemic muscle paralysis (including myocarditis and death)

36
Q

Transmission of diptheria

A

air-borne droplets

37
Q

Diagnosis fo diphtheria

A

growth of corynebacterium diphtheria on tellurite plates (gram + rods with clubbed end and internal beads) - labs = toxin or toxin gene

38
Q

Diphtheria treatment and prevention

A

treatment: antitoxin (penicillin and erythromycin also help) prevention: diphtheria vaccine (toxoid)

39
Q

Impetigo organism and site

A

mixture of streptococci and staphylococci on the surface of skin

40
Q

Diagnosis of impetigo

A

clinical appearance and history - smears from pus may show gram + cocci in clumps or chains

41
Q

Bullous impetigo is associated with what?

A

staph aureus due to exfoliatin

42
Q

Treatment of mild impetigo

A

mupirocin ointment topically - OTC antibiotic creams less likely to be effective

43
Q

Treatment of severe cases of impetigo

A

penicillinase-resistant penicillins (nafcillin or oxacillin) or amoxicillin with penicllinase-inhibitor, or cephalosporin

44
Q

Prevention of impetigo

A

cover lesions and discard dressings appropriately, isolate children, no sharing shit, wash hands

45
Q

How does impetigo appear?

A

yellow crusted skin lesions - near nostrils typically - can spread across face and appear on trunk and limbs - more common in children - ver contagious

46
Q

Infected piercings/catheters etiology

A

entry site of foreign materials can be infected by biofilms that contain large numbers of bacteria (typically start with attachment of low-grade pathogens from the normal skin flora that stick to the foreign material

47
Q

Which organism most often appears in infected piercings/catheters? Virulence factor?

A

staphylococcus epidermidis (attaches to nylon and plastic) - has biofilm to protect organisms from immune system

48
Q

Diagnosis of infected piercing/catheter?

A

clincial features - lab = gram + cocci growing in clumps, catalase positive, coagulase negative, non-hemolytic

49
Q

Treatment of infected piercings/catheters?

A

remove infected device

50
Q

Prevention of infected piercings/catheters?

A

change all indwelling cathers, IV lines on a regular schedule - use gold or surgical stainless steel for decorative piercings - no plastic

51
Q

Scabies bug

A

sarcoptes scabei (mite) - burrows into skin and lays eggs

52
Q

Transmission of scabies

A

personal contact or fomites

53
Q

Scabies diagnosis

A

clinical findings, observation of mites in skin scrapings

54
Q

Scabies prevention

A

hygiene - change clothes and don’t share gross shit

55
Q

Treatment for scabies

A

steroids for itching and permethrin to kill mites

56
Q

Skin abscess etiology

A

localized collection of pus - can be deep or superficial, infected or sterile

57
Q

furunculitis

A

abscess - superficial sweat gland or follicle infection

58
Q

carbuncle

A

abscess - multiple abscesses fused sub-cutaneously

59
Q

acne

A

abscess - mixed infection involving increased susceptibility of the skin to infection - small abscesses and superficial inflammation of the surface and sebaceous glands

60
Q

Organism responsible for skin abscesses

A

staph aureus (propionobacterium acnes for acne - anaerobic)

61
Q

Diagnosis of skin abscesses

A

clinical appearance and history - smears from pus show mixed bacterial population including some gram + shit - coagulase positive and beta hemolytic - DNAse positive, salt resistant

62
Q

Treatment of skin abscesses

A

drain (remove all dead tissue),, mupirocin ointment for mild cases, systemic antibiotics if sever case (nafcillin or oxacillin)

63
Q

Prevention of skin abscesses

A

public health measures - remove carriers fro ICUs, operating rooms and newborn nurseries

64
Q

Scalded skin syndrome

A

widespread exfoliation due to a localized infection by staph aureus - exfoliation toxin causes separation between epidermal cells - usually seen in newborns

65
Q

Toxic Shock syndrome

A

systemic immune reaction to the super-antigen toxic shock syndrome toxin or streptococcal toxic shock syndrome toxin

66
Q

Erysipelas/cellulitis/necrotizing fasciitis etiology

A

infections beneath the surface of the skin that spread in a diffuse manner

67
Q

Erysipelas

A

superficial

68
Q

Cellulitis

A

deep and associated with lymphadenopathy, fever, bacteremia

69
Q

Necrotizing fasciitis

A

starts as minor skin infection which becomes rapidly extensive - spreading through the subcutaneous fascia with widespread necrosis and gangrene of extremities

70
Q

What organism is responsible for erysipelas/cellulitis/necrotizing fasciitis?

A

S. pyogenes

71
Q

Which bacteria is termed “flesh eating bacteria”? What do that have that enables this?

A

necrotizing fasciitis - potent protease enzyme

72
Q

Diagnosis of Erysipelas/cellulitis/necrotizing fasciitis

A

clinical features - cultures often negative - streptococcal therefore assumed

73
Q

Treatment for erysipelas/cellultis

A

penicillin or cephalosporin

74
Q

Treatment for necrotizing fasciitis

A

rapid surgical internvention, including amputation of affected limb

75
Q

Surgical site infection - cause, what are symptoms similar to, and treatment

A

casue: staph/strep. similar to cellulitis. treatment: local excision and drainage

ABBEY MSII Unit 2 (19 decks)

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