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First Aid Diseases > Micro > Flashcards

Micro Flashcards

1
Q

2 bac w/ weird cell walls?

A

Mycoplasma - contains sterols, no cell wall

Mycobacteria - contains mycolic acid, high lipid content

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2
Q

Bugs that don’t Gm stain well

A

“These Rascals May Microscopically Lack Color”
Treponema (to thin, use fluorescent Ab)
Rickettsia (IC)
Mycobac (high lipid content, use carbolfuchsin in acid-fast stain)
Mycopl (no cell wall)
Legionella (mainly IC, use silver stain)
Chlamydia (IC, no muramic acid in cell wall)

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3
Q

Do Giemsa stain on…

A

“Certain Bugs Really TRY my Patience”

Chlamydia, Borrelia, Rickettsiae, TRYpanosomes, Plasmodium

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4
Q

PAS stains what?

- used to dx?

A

“PAS the sugar”
glycogen, mycopolysaccharides
- Whipple’s dz (Tropheryma whipplei)

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5
Q

Ziehl-Neelsen (carbol fuchsin) stains?

A

acid-fast org’s (Nocardia, Mycobac)

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6
Q

India ink stains?

- Can also use for this bug?

A

Cryptococcus neoformans

- mucicarmine to stain thick polysacch. cap red

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7
Q

Silver stain is used for?

A

Fungi (PCP), Legionella, H. pylori

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8
Q

How do you culture H. influenzae?

A

chocolate agar w/ factors V (NAD+) and X (hematin)

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9
Q

How do you culture Neisseria (gonorrhoeae and meningitidis)?

A

Thayer-Martin (or VPN) media:
Vanc (inhib’s Gm+)
Polymixin (inhib’s Gm- except Neisseria)
Nystatin (inhib’s fungi)

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10
Q

How do you culture B. pertussis?

A

Bordet-Gengou (potato) agar

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11
Q

How do you culture C. diphtheriae?

A

Tellurite plate, Loffler’s media

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12
Q

How do you culture M.Tb?

A

Lowenstein-Jensen agar

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13
Q

How do you culture M. pneumoniae?

A

Eaton’s agar

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14
Q

How do you culture lac-fermenting enterics?

- Can also grow E.coli on?

A

Pink colonies on MacConkey’s agar (fermentation makes acid to turn it pink)
- On EMB (eosin-methylene blue) agar as colonies w/ green metallic sheen

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15
Q

How do you culture Legionella?

A

charcoal yeast extract agar buffered w/ Cys and Fe

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16
Q

How do you culture fungi?

A

“SAB’s a FUN GUY”

Sabouraud’s agar

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17
Q

Obligate aerobes?

Obligate anaerobes?

A

“Nagging Pests Must Breathe”
Nocardia, Pseudomonas, MTb, Bacillus

“Can’t Breathe Air”
Clostridium, Bacteroides, Actinomyces

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18
Q

Obligate IC bugs

A

Rickettsia and Chlamydia

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19
Q

Facultative IC bugs

A

“Some Nasty Bugs May Live FacultativeLY”

Salmonella, Neisseria, Brucella, Mycobac, Listeria, Francisella, Legionella, Yersinia pestis

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20
Q

Positive quelling rxn is for who?

A

Encap’d bac (cap’s swells w/ antisera)
“SHiNE SKiS”
Strep. pneumo, Hib, Neisseria meningitidis, E. coli, Salmonella, Klebsiella, GpBStrep

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21
Q

Cat(+) bugs

A

“PLACESS for your cats”
Pseudomonas, Listeria, Aspergillus, Candida, E.coli, S.aureus, Serratia
and Nocardia

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22
Q

Urease-pos bugs

A

“CHuck norris hates PUNKSS”

Cryptococcus, H.pylori, Proteus, Ureaplasma, Nocardia, Klebsiella, S.epidermidis, S.saprophyticus

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23
Q

Protein A virulence factor:

exp’d by who? does what?

A

S.aureus

- binds Fc of Ig to prevent opsonization and phagocytosis

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24
Q

IgA protease virulence factor:
exp’d by who? does what?

these org’s also have ability to?

A

SHiN = S.pneumo, HiB, Neisseria
- cleaves IgA -> can colonize resp mucosa

  • take up naked DNA = transformation = competence
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25
Q

M pr virulence factor:
exp’d by who? does what?
- Abs to it can cause what?

A

GAS

  • helps prevent phagocytosis by inhib’ing C’
  • RF
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26
Q

Diphtheria toxin -> ?

A

inact’s EF2 -> inhib’s pr syn via ADP-ribosylation of EF2 -> pharyngitis w/ pseudomem’s in throat and severe lymphadenopathy (bull neck)
- AB toxin

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27
Q

Pseudomonas Exotoxin A -> ?

- also has what other toxin?

A

inact’s EF2 -> host cell death (AB toxin)

- endotoxin -> F, shock

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28
Q

Shigella Shiga toxin -> ?

A

inact’s 60S by removing A from rRNA -> GI mucosal damage, dysentery; cytokine release -> HUS

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29
Q

EHEC O157:H7 Shiga-like toxin (SLT) -> ?

A

inact’s 60S by removing A from rRNA -> cytokine release causing HUS; doesn’t invade host cells (unlike Shigella)

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30
Q

ETEC (enterotoxigenic E.coli) LT (heat-labile toxin) -> ?

A

incr’d cAMP -> incr’d Cl and H2O out into gut -> watery D
[Labile in the Air (cAmp)]
- AB toxin

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31
Q

ETEC ST (heat-stable toxin) -> ?

A

incr’d cGMP -> decr’d reab’n of NaCl and water in gut -> watery D
[Stable on the Ground (cGmp)]
- AB toxin

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32
Q

Bacillus anthracis Edema factor -> ?

Lethal factor also contributes to this sx

A

like AC, incr’s cAMP -> edematous borders of black eschar in cut anthrax

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33
Q

Vibrio cholerae, Cholera toxin -> ?

A

permanently act’s Gs -> incr’d AC and cAMP -> incr’d Cl and water efflux into gut -> “rice-water D”
- AB toxin

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34
Q

Bordatella pertussis, pertussis toxin -> ?

A

disable’s Gi -> incr’s AC and cAMP -> impairs phagocytosis -> Whooping cough
- AB toxin

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35
Q

Clostridium tetani, tetanospasmin -> ?

A

cleaves SNARE pr needed for nt release -> m. rigidity and lock jaw bc prevents release of inhib GABA and Gly nt’s from Renshaw cells in SC

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36
Q

Clostridium botulinum, Botulinum toxin -> ?

A

heat labile toxin that cleaves SNARE pr needed for nt release -> flaccid paralysis (floppy baby) bc prevents release of ACh at NMJ

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37
Q

Clostridium perfringens, alpha toxin -> ?

A

phospholipase (lecithinase) that degrades tissue and cell mem’s -> degrades phospholipid C -> myonecrosis (gas gangrene) and hemolysis (2x zone of hemolysis on bl agar)

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38
Q

Strep.pyogenes, Streptolysin O -> ?
- ASO Abs used to dx?

Strep.pyogenes, Exotoxin A -> ?

A

pr that degrades cell mem -> lyses RBCs (b-hemolysis)
- RF

brings MHC-II and TCR together -> release of IFN-g and IL-2 -> shock (F, rash, shock)

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39
Q

S.aureus, TSST-1 -> ?

  • sx?
  • exfoliative toxin ->
  • enterotoxin ->
A

brings MHC-II and TCR together -> polyclonal Tcell act’n -> release of IFN-g and IL-2 -> shock

  • sx: F, rash, shock
  • scalded skin syndrome
  • food poisoning
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40
Q

Endotoxin (LPS on Gm-):

  • act’s Mphage ->
  • act’s C’ ->
  • act’s TF ->
A
  • IL-1 (F), TNF (F and hypotension), NO (hypotension)
  • C3a (hypotension, edema), C5a (N’s)
  • coag cascade -> DIC
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41
Q

Endotoxin -> what sx?

A

“ENDOTOXIN”

Edema, NO, DIC/Death, Outer mem, TNF-a, eXtremely heat stable, IL-1, N chemotaxis

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42
Q

5 bac toxins encoded in a lysogenic phage:

A 
"ABCDE"
ShigA-like toxin (EHEC O157:H7)
Botulinum toxin
Cholera toxin
Diphtheria toxin
Erythrogenic toxin of S.pyogenes (Streptolysin O, brks dwn cell mem's, inc'ing of RBCs)
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43
Q

S. pneumo is most common cause of?

A 
"MOPS"
Meningitis
Otitis media in kids
Pneumonia
Sinusitis
44
Q

Scarlet fever

  • caused by?
  • sx?
A

S. pyogenes (GAS)
- scarlet sandpaper-like rash sparing face, strawberry (scarlet) tongue after white exudate peels off, scarlet sore throat, F

45
Q

GBS makes CAMP factor which does what?

- Test for GBS?

A

Enlarges area of hemolysis formed by S.aureus

- hippurate test positive (can hydrolyse sodium hippurate)

46
Q

Bac for meningitis <2yo?, for adults?

A

Listeria > E.coli > GBS

N. meningitidis > H.flue

47
Q

How do you dx C. diphtheriae?

- grows on?

A

Gm+ rods w/ metachromatic (blue and red) granules and Elek’s test for exotoxin
- blk colonies on cystine-tellurite agar OR on Loeffler’s coag’d bl serum then stain w/ methylene blue to see bac

48
Q

C. diphtheriae properties?

A 
ABCDEFG
ADP-ribosylation (of EF2 to inact it)
B-prophage (carries exotoxin)
Corynebacterium
Diphtheria
EF2 (what exotoxin inact's) (Elek's test for it toxin)
Granules (metachromatic)
49
Q

Which Gm+ bac form spores (found in soil)?

What are 3 others?

A

Bacillus anthracis, C.perfringens, C.tetani

- B.cereus, C.botulinum, Coxiella burnetii

50
Q

Only bac w/ polypep capsule (containing D-Glutamate)?

A

Bacillus anthracis

51
Q

Woolsorters’ dz =

A

inhal of B. anthracis (anthrax) spores from contaminated wool; flu sx that rapidly progress to pulm hemorrhage, mediastinitis and shock

52
Q

Actinomyces vs. Nocardia

  • air? acid fast?
  • found in?
  • causes?
  • trt w/?
A
  • anaerobe vs. aerobe; no vs. partially
  • nl oral flora vs. soil
  • oral/facial abscesses that drain thr sinus tracts -> yellow sulfur granules VS. pulm infec’s in immcomp’d and cut infec’s post trauma in nl ppl
  • Pn vs. sulfonamides
53
Q

Mycobac:

  • M. kansaii causes?
  • M.avium-intracellulare causes? drug?
  • Cord factor inhib’s?
  • Sulfatides inhib?
A
  • pulm TB-like sx
  • disseminated non-TB dz in AIDS; prophylaxis w/ azithromycin
  • inhib’s Mphage maturation and induces release of TNF-a
  • are surface gp’s that inhibs phagolysosomal fusion
54
Q

Mycobac leprae

  • infects where?
  • which type has pos lepromin skin test?
  • trtmt
A
  • likes cool T’s -> infec’s skin and superficial n’s -> glove and stocking loss of sensation
  • Tuberculoid type bc high CMI and lg Th1 response vs. low CMI w/ humoral Th2 response in lepromatous
  • Tuberculoid: dapsone + rifampin for 6mo
    Lepromatous: dapsone + rifampin + clofazimine for 2-5yrs
55
Q

Lactose fermenting bac (pink on MacConkey’s agar) (5 bac)

- on EMB agar they grow as?

A

CEKES lactose
Citrobacter, Enterobacter, Klebsiella, E.coli, Serratia
- purple/blk colonies; E.coli grows purple w/ green sheen

56
Q

What abx do not work on Gm- bugs? Which do?

A

PnG and vanc (can’t X outer mem)

- Pn deriv’s like amp/amox

57
Q

Trtmt of N. meningitidis vs. N. gonorrhoeae?

A

Ceftriaxone or PnG AND trt close contacts w/ rifampin, cipro or ceftriaxone
vs. Ceftriaxone (+ azithromycin or doxycycline for possible Chlamydia coinfec)

58
Q

H.flue

  • Causes?
  • Non typable strains cause?
  • Grow it on?
  • Trt w/?
A
  • HaEMOPhilus: Epiglottitis, Meningitis, Otitis media, Pneumo
  • mucosal infec’s: otitis media, conjunctivitis, bronchitis
  • “When you get the flu, mom goes to the 5&dime to buy chocolate” = Chocolate agar + Factor V (NAD+, S.aureus can make) and X (hematin)
  • Meningitis w/ ceftriaxone and rifampin to close contacts
59
Q

Legionella

  • grows on?
  • labs show?
  • trt w/
A
  • charcoal yeast extract w/ Fe and Cysteine
  • hypoNa
  • quinolone or macrolide
60
Q

Pseudomonas can cause?

- Trtmt?

A

BE PSEUDDO = Burn wound infec’s, Endocarditis, Pneumo (esp in CF, biofilm), Sepsis (blk lesions on skin), Ext. otitis media, UTI (pyelo), Drug use, Diabetic Osteomyelitis
- aminoglycosides + big Pn (Piperacillin, ticarcillin)

61
Q

3 E.coli VFs?

A

1) fimbriae (cystitis and pyelo)
2) K capsule (pneumo, neonatal meningitis)
3) LPS endotox (septic shock)

62
Q

4 A’s of Klebsiella:

A

Aspiration pneumo
Abscess in lungs/liver
Alcoholics
di-A-betics

63
Q

Typhoid F

  • caused by?
  • sx?
  • can stay in?
A
  • Salmonella typhi
  • rose spots on ab, F, HA, D
  • GB -> carrier state (Typhoid Mary)
64
Q

3x tx for H.pylori

- pt’s w/ it are at incr’d risk for?

A

PPI, clarithromycin, amox or metronidazole

- PUD, gastric adenoca, lymphoma

65
Q

What are the 3 spirochetes?

How do you visualize them?

A

BIG = Borrelia (Big size), Leptospira, Treponema

  • Borrelia - aniline dye (Wright’s or Giemsa stain)
  • Treponema by dark-field microscopy
66
Q

Leptospirosis presents as?

- Severe form is?

A

flu-like sx w/ jaundice and photophobia w/ conjunctivitis (surfers and tropics bc is from animal urine in water)
- Weil’s dz = jaundice and azotemia (bad liver and kidney), F, hemorrhage, anemia

67
Q

Lyme dz: 3 stages?

Trtmt?

A

1) erythema chronicum migrans (red rash w/ central clearing), flu sx
2) neuro (facial n. palsy) and cardiac (AV node block)
3) MSK (chronic monoarthritis and migratory polyarthritis), neuro (encephalopathy and polyneuropathy), and cut sx
- Doxycycline or ceftriaxone

68
Q

Congenital syphilis presents as?

- Passes to fetus, when?

A

Saber shins, saddle nose, CN VIII deafness, Hutchinson’s teeth, mulberry molars
- after 1st trimester

69
Q

VDRL tests for?

  • used to dx?
  • false pos’s?
A

nonsp Ab that rcts w/ beef cardiolipin

  • syphilis
  • VDRL: Viruses (mono, hepatitis); Drugs, Rheumatic f., Lupus/Leprosy
70
Q

Jarisch-Herxheimer rxn =

A

flu-like synd immediately after starting abx due to killed bac releasing pyrogens

71
Q

Syphilis: Rule of 6s:

A 
Six - Sexual trans
6 axial filaments
6 wk incubation 
6 wks for ulcer to heal
6 wks after ulcer heals progresses to 2* syph
6 wks for 2* syph to resolve
66% of latent stage pt's have resolution
6 yrs to develop 3* syph (at least)
72
Q

RMSF =

  • Bac needs what to grow?
  • classic triad?
  • rash is?
A

From Rickettsia rickettsii; obligate IC org

  • CoA and NAD+
  • HA, F, rash (vasculitis)
  • starts at wrists/ankles, spreads to trunk, palms and soles
73
Q

Typhus

  • Endemic type spread by?
  • Epidemic type spread by?
  • Rash is?
A
  • R. typhi on fleas
  • R. prowazekii from human body louse
  • Starts centrally on trunk, spreads out but NOT to palms and soles
74
Q

Ehrlichiosis

  • spread by
  • histo shows
A

spread by tick

- monocytes w/ morula (berry-like inclusions) in cyto

75
Q

Anaplasmosis

  • spread by
  • histo shows
A

spread by tick

- granuloctes w/ morula in cyto

76
Q

Q fever

  • spread by
  • caused by
  • presents as
A

spread by tick feces and cattle placenta releasing spores that are inhaled

  • caused by Coxiella burnetii
  • presents as pneumo
77
Q

Chlamydiae

  • how to dx?
  • cell wall does not have?
A
  • cyto inclusions (contain lots of reticulate bodies) on Giemsa or fluorescent Ab-stained smear
  • no muramic acid
78
Q

Chlamydia trachomatis serotypes:
A,B,C =
D-K =
L1, L2, L3 =

A
  • ABC=Africa/Blindness/Chronic infec (blind from follicular conjunctivitis)
  • everything else! urethritis/PID, ectopic preg, neonatal pneumo (staccato cough) or conjunctivitis
  • lymphogranuloma venereum
79
Q

Mycoplasma pneumoniae

  • high titer of?
  • grown on?
  • bac mem contains?
  • trtmt?
A

cold agglutinins (IgM) which can agglutinate or lyse RBCs

  • Eaton’s agar
  • sterols for stability
  • macrolide or FQ
80
Q

Enterobius, Ascaris, Trichinella

  • are what?
  • how do they infect?
A

nematodes

- ingested

81
Q

Strongyloides, Ancylostoma, Necator

  • are what?
  • how do they infect?
A

nematodes

- thr skin

82
Q

Brain cysts, seizures -> ? parasite

A

Taenia solium (cystericersosis) (pork tapeworm -> praziquentel)

83
Q

Liver cysts -> ? parasite

A

Enchinococcus granulosus (dog tapeworm -> praziquantel; allergic to fluid in cysts)

84
Q

VitB12 defic -> ? parasite

A

Diphyllobothrium latum (from raw freshwater fish -> praziquantel)

85
Q

Biliary tract dz, cholangioca -> ? parasite

A

Clonorchis sinensis (from undercooked fish -> praziquantel)

86
Q

Hemoptysis -> ? parasite

A

Paragonimus westermani (from undercooked crab meat -> lung inflamm and 2* bac infec -> praziquantel)

87
Q

Portal HTN -> ? parasite

A

Schistosoma mansoni (from freshwater snails, eggs in liver/spleen -> fibrosis and inflamm -> praziquantel)

88
Q

Hematuria, bladder ca -> ? parasite

A

Schistosoma haematobium (from freshwater snails -> lives in bladder -> eggs cause fibrosis and inflamm -> praziquantel)

89
Q

Microcytic anemia -> ? parasite

A

Ancylostoma, Necator (hookworms, suck bl from GI wall -> anemia -> -bendazoles, pyrantel pamoate)

90
Q

Perianal pruritus -> ? parasite

A

Enterobius (pinworm -> GI infec -> lay eggs at night outside anus -> Scotch tape test -> mebendazole or pyrantel pamoate)

91
Q

Four vaccines for encap’d bugs?

A

pneumovax (PPV-23) has no conj’d pr, just polysacch (Strep.pneumo, >2yo at risk); Prevnar-13 is conj’d (kids d

92
Q

JONES criteria for RF:

A

Jts (polyarthritis), Heart (carditis), Nodules (subcut), Erythema marginatum, Syndenham’s chorea

93
Q

Yersinia enterocolitica

- causes what 2 things?

A

day-care outbreaks of bl’y D

pseudoappendicities (actually is mesenteric adenitis)

94
Q

Common causes of pneumo:

  • in neonates?
  • in kids 4wk - 18yrs
A
  • GBS, E.coli

- Mycopl, Chlamydia trachomatis (infants-3yrs), C. pneumo (school kids), S. pneumo

95
Q

Common causes of pneumo:

  • 18-40yo
  • 40-65yo
  • elderly
A
  • Mycopl, C.pneumo, S.pneumo
  • S.pneumo, H.flue, anaerobes, viruses, mycopl
  • S.pneumo, influenza virus, anaerobes, H.flue, GNRs
96
Q

Pneumo in:

  • nosocomial?
  • CF?
  • post-viral?
A
  • Staph, enteric GNRs
  • Pseudomonas, S.aureus, S.pneumo
  • Staph, H.flue, S.pneumo
97
Q

Common causes of meningitis:

  • 0-6mo
  • 6mo-6yrs
  • 6-60yrs
  • 60+ yrs
A
  • GBS, E.coli, Listeria
  • S.pneumo, N.meningitis, HiB (if unvaccinated), enteroviruses
  • S.pneumo, N.meningitis (#1 in teens), enteroviruses, HSV
  • S.pneumo, GNRs, Listeria
98
Q

Trtmt of meningitis?

A

Ceftriaxone + vanc empirically, add amp if Listeria is suspected

99
Q

Viral causes of meningitis?

A

Enteroviruses (esp. coxsackie), HSV-2 (HSV-1 = encephalitis), HIV, WNV, VZV

100
Q

Causes of meningitis in HIV+?

A

Cryptococcus, CMV, toxoplasmosis (brain abscesses), JC virus (PML)

101
Q

Chancroid =

- caused by?

A

painful genital ulcer, inguinal adenopathy

- Haemophilus ducreyi

102
Q

Trichomonas vaginalis causes?
vs.
Gardnerella vaginalis causes?

A
  • Vaginitis: strawberry-colored mucosa, motile in wet prep, STD
  • Vaginosis: no inflamm, bad fishy smell d/c, pos whiff test, clue cells, not and STD
103
Q

7 bugs that cause bl’y D?

A 
Can't Stop Shitting E ErYthrocytEs:
Campylobacter
Salmonella
Shigella
EHEC
EIEC
Yersinia
Entamoeba
104
Q

4 bac, 2 protozoa and 2 viruses that cause watery D?

A

ETEC, V.cholerae, C.dif, C.perfringens
Giardia, Cryptosporidium
Rotavirus, norovirus

105
Q

Neutropenic pt’s will get?

A

Candida albicans (systemic), Aspergillus

First Aid Diseases (16 decks)

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