micro Flashcards
woman with a painful vaginal ulcer and bilateral inguinal lymphadenopathy. negative tzanck and VDRL.
dx and tx?
haemophilus ducreyi, chancroid
tx - ceftriaxone or azithromhcin
virus with the leading risk for developing hepatocellular carcinoma?
hepatitis b
kaposi sarcoma belongs go which viral family?
hhv 8
herpes viruses incl hsv1 hsv2 and roseola (hhv6), EBV, CMV, and varicella
CSF for bacterial meningitis will have what characteristics?
high opening pressure
high protein
pleocytosis with PMN predominance
low glucose
previously healthy pt with a history significant only for mitral valve prolapse presenting with endocarditis like symptoms
strep viridans:
s. mutans
s. sanguinis
s. oralis
s. mitis
tx for hhv8?
alpha interferon
oxidasd negative motile GNR that is beta hemolytic on macconkey agar but light green with black centers on hektoen agar
salmonella
pt with new palpitations, chest pain, systolic murmur (mitral regurg), elevated cardiac enzymes. bx would show diffuse myocardial defeneration and necrosis with inflammatory infiltrate
cozsackie virus
naked ssrna
h. pylori infection is a risk factor for?
gastric adenocaecinoma and b-cell hodgkin gastric lymphoma (AKA MALT lymphoma)
most h. pylori infections are asymptomatic (not manifesting as PUD in the majority)
what PPE is recommended in a ptmwith c. diff?
non sterile gloves and gown
also must use soap and water to wash hands. alcohol based sanitizer is not sufficient
a pt with chronic granulomatous dz are at increased risk of infection with organisms with which feature?
catalase positive organisms
pt is NADPH osidase deficient
s. aureus, burkholderia cepacia, serratia, nocardia, aspergillus
what is burkholderia cepacia?
catalase positive, non lactose fermenter, gram neg cocobaccilli
opportunistic pathogen causing pneumonia in immune compromised hosts(cf, cgd)
a pt presents with mycoplasma pneumonia and anemia. he is given azithromhcin and both symptoms improve. why?
m. pneumoniae can cause intravascular hemolytic anemia due to similar Ags and cold agglutinins. the anemia resolves when the cold agglutinin IgM levels lower.
m. pneumo is also associated with stevens-johnson syndrome, arthralgia, encephalitis, arrythmia, and bullous myringitis
an infant presents to the er following a seizure and a 12 hour history of fever. 3 days after discharge she develops a maculopapular rassh on her trunk. dx?
roseola (hhv6)
the key is a high fever followed by a maculopapular rash on the trunk 3-5 days later
tx = supportive
unvaccinated kid presents with fever, runny nose, cough, bilateral conjunctival injection, and small white spots with erythematous base on buccal mucosa. dx and likely to develop what additional symptom?
rubeola (measles)
maculopapular rash
a pt with a history of smoking and alcohol abuse presents with malaise and cough with 2 month duration. yellow sputum with streaks of blood. poor dentition, ginivitis, and large submandibular nodes. ronchi in right upper lobe.
actinomycosis
systemic infection occurs when mucosa is disrupted (poor dentition)
pulmonary actinmycosis can follow aspiration.
dx - filamentous branching pattern
tx -penicillin
a kid presenting with epiglottitis probably has what in his history?
missed his H. flu vaccine.
presence of pyrrolidonyl arylamidase is associated with?
Strep pyogenes
PYR positive
pt on chemo presents with skin patches with an ulcerated appearance and occasional necrotic center.
increased PTT, neutropenia
psuedomonas aeruginosa
ecthyma gangrenosum is caused by psuedomona bacteremia
pt is newly diagnosed with CML and begins tx. later presents with HA and an eye problem. PE shows tenderness of paranasal sinus, left orbit swelling, cellulitis, mild proptosis, ptosis. bx shows hyphae with acute angles
aspergillus fumigatus
Nicotinic blockade (diplopia, dysphagia) and muscarinic blockade (dry mouth) is suggestive of
The 3 D’s suggests Ingestion of C. botulinum toxin
Inhibits ACh release
Can be partially overcome by high-rate repetitive nerve stimulation (CMAP)
Tx of a pt with a recent heart valve replacement pt that has cultures poitive for cat + coag - Staph
Staph epidermidis
Vanco
Kidney transplant patient with pleuretic chest pain, cough, and low grade fever. Infiltrate in lower lobe of lung. Not responding to abx. Brnchoalveolar lavage reveals red round organism on mucicarmine staining
Cryptococcus neoformans
This is the only pathogenic fungi with a polysaccharid capsule (virulence factor). Stains red with mucicarmine
Can present as meningoencephalitis or lung dz in immunocompromised
Characteristics of scarlet fever (S. pyrogenes
fever, pharyngitis, sandpaper-like rash, circumoral pallor, strawberry tongue