Micro Flashcards
viral CNS inftn
CSF lab values for viral meningitis
- glucose
- protein
- total WBC
- glucose = 10-45 mg/dL
- protein = 50-250 mg/dL
- total WBC = cells/microL
viral CNS inftn
WNV meningeoencephalitis occurs in __% of WNV inftns (high risk popn = cancers, DM, htn, CKD)
1%
hint: recovery in wks-mo’s; permanent neuro effects
viral CNS inftn
Name the virus
- transmitted by mosquito/ticks vectors
- attenuated vax for yellow fever + japanese encephalitis
- more common in summer
Flavivirus
hint: adesus = urban only; culex = forest, urban
viral CNS inftn
3 points of entry for ____ in CNS include:
- nasal vacity
- retrograde axonal travel
- intact transcytosis (endoth cells/leaky pores)
arborvirus
hint: humans= dead end, incidental host
viral CNS inftn
____ (virus) is chrs by the following patho phys
- fecal oral transmission
- esophageal/skin entry
- serum Abs block spread –> viral shedding in GI tract
- high asympto inftn rate
- no vax/licensed antivirals
Enterovirus (Picornavirus)
hint: fecal-oral; exposure to poor sanitation; common in summer
viral CNS inftn
out 68, 70, 71 - which enterovirus causes:
severe resp dz?
enterovirus 68
viral CNS inftn
out 68, 70, 71 - which enterovirus causes:
paralutics dz, acute hemorr conjunctivitis?
viral CNS inftn
out 68, 70, 71 - which enterovirus causes:
paralytic dz, encephalitis, meningitis, hand-foot-mouth dz
enterovirus 71
viral CNS inftn
____ (virus) chrs include:
- replication in muscle
- wk-mo’s of incubation deps on distance from CNS
- retrograde travels from peripheral nerves
- prevention = post exposure vax (dt long incubation)
Rabies (rhabdovirus)
hint: spreads to non human salivary glands
viral CNS inftn
reproduction of _____ in the brain causes:
- hydrophobia
- seizures
- hallucinations
- paralysis
- coma + death
viral CNS inftn
____(virus) encephalitis is chr by
- trigeminal N spread
- unilateral temporal lobal abn’s (see pic)
- most common cause of sporadic viral enceph

HSV1
viral CNS inftn
Treat HSV + VZV aggressivley with _____
ayclovir
viral CNS inftn
HSVV1, HSV2, VZV are _____ which are neurotropic
alphaherpesviruses
viral CNS inftn
cytolytic enceph occurs ___ after inftn
1-2 weeks
viral CNS inftn
ddx meningitis from enceph - 2
encephalitis has
- intracerebral hemorrhage
- altered mental status (incl personality + poor judgement)
brudzinski sign (flexed knees when neck is flexed) is positive for
meningitis
hint: mental status intact
Pneumonia
These are all prevention for what inftn?
- Acellular vaccine
- whole heat killed vax
- prophx maroclide (erythromycin)
B. Pertussis
hint: both vax req 10 year boosters
Pneumonia
toxigenisis of the B. pertussis - 4
- PTX (AB toxin, 2˚ attachment, leukocytosis)
- Adenylate Cyclase toxin (mø apop, IR evasion)
- Tracheal cytotoxin (cough)
- LPS (inflamm)
Pneumonia
_____ is mainly responsible for atachment of B. pertussis to cilia (resp epith cells)
Filamentous hemagglutinin
hint: others responsb = PTX, fimbriae, pertactin, trach colonizn factor
Pneumonia
Whats the bug?
- highly contagious short G- rod with inadeq vax coverage
- cultured on regan Lowe Media
B pertussis
hint: abroad vax (killed cell) >> US vax (short lived, acellular)
Pneumonia
_____ causes
- neonatal + p/partum sepsis
- CF pneumonia
- systemic complication p/local mucosal inftn (IMNS)
NTHi (Unencaps H flu)
hint: not vax covered
Pneumonia
Hib and NTHi versions of H flu share what in common? - 3
- IgA protease
- pili
- adhesins
Pneumonia
G- pleomorphic (cocci + rod) microbe with rapid bacteremia that leads to celluliltus epilogttis, septic arthritis and lethal meningitis
H. influenzae
Pneumonia
lab Dx for what organism?
- cultured on chocolate agar (heated-blood) ± factors V (hemin) and X (NAD)
- quelung rxn ddx’s serotype
H. flu
Pneumonia
Surgical drainage + batrim/cerfuroxime, axetil, cefixime, macrolides, or fluoroquinolones are used to treat ____(manifestation) of Hib inftn
Cellulitis, Pericarditis, Septic Arthritis
Pneumonia
How would you tx the inftn below? - 3

Hib Meningitis
- ceftriaxone
- dexamethasone (if > 2 mo)
- supportive care
hint: monitor for sensitivity
Pneumonia
Tx for upper resp Hib inftn? - 2 combos
- amoxicillin + clavulanate
- Bactrim (TMP-SMX)
Pneumonia
Describe tx for Hib manifestations below:
- Epiglottitis
- Otitis Media
- inutbation/trach + ABx
- amoxicillin
Pneumonia
Properties of what two bugs? - 2
- human restricted and fastidious to culture
- required factors X + V in vitro
- resp droplet transmission
- pediatric contagious resp intn
- vax, abx, and supp care
H flu + Bordetella
Pneumonia
Virulence factors that determine pathogenicity of _____?
- LOS endotoxin
- IgA protease
- meningococcus capsule
- gonococcus pilli
- porins
- Opa
Neisseria
hint: capsule resistts phagocytosis; VIP vax component
Pneumonia
What should you use to culture Neisseria on mucosal sites vs sterile sites? -2
- Thayer-Martin medium for mucosal (GU, nasal)
- Blood agar for sterile (CSF, blood)
Pneumonia
G- diplococci, facultative aerobe, human-restricted, oxidase + catalase pos; ferments maltose (malt liquor)

Neisseria Meningitidis
Pneumonia
Host defenses against N. menigitidis? - 2
- IgG enh complement
- PMNs
Pneumonia
____ predisposes pts to Neisseria complications
complement defc
hint: C5-9 VIP for poking holes
Pneumonia
aysmpto/untreated ____ in women leads to PID
gonoccocus
Pneumonia
even tho are neonates are passibely protected from meningococc they still need prophx eye ointment for ____
gonococcus
Pneumonia
N. meningitidis treatment includes? -2
- ceftriaxone/cefixime
- rifampin (prophx)
DO NOT USE STEROIDS!!!!
hint: prevention = meningcocc vax + gonococc condoms
Pneumonia
meningococcemia with higher fever, shock, widespread purpura, and DIC
Waterhouse-Friderichen Syndrome
Pneumonia
G+, catalase⊖, diplococci that form chains in culture
Pneumococcus (Step pneumoniae)
Pneumonia
How would you treat?
Strep pneumonia that sinusitis, otitis media, mild pneumonia
outpt amoxicillin
Pneumonia
how would you tx severe strep pneum w. rusty sputum, lobar consoldn, ↑procalcitonin (labs: xray and urine Ag⊕)? - 3
admit for
- amoxicillin,
- flouroquins,
- a/o vanco
(after sensitivity testing)
Pneumonia
risk factors fr invaseive pneumococc dz? - 2
- ø vax coverage
- ↓/ø spleen fx
Pneumonia
Gram stain + culture would be positive in spinal tap unless?
abx tx began >4 hrs prior
Pneumonia
If pneumococc came back resisant (toxic MIC), and you couldnt tx with vanco + ceftriaoxne/cefotaxime, what would you use? - 3
- rifampin
- meropenem
- chloramphenicol
hint: use steroids sparingly
what vax prevents pneumococc invasive disease? Why did they step it up? - 2
- Prevnar13 (formally7)
- dt replacement dz after herd immunity established