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Step 1 2019 First Aid Flashcards > Micro FA Systems p178 - 186 > Flashcards

Micro FA Systems p178 - 186 Flashcards

1
Q

T or F Neonates delivered by C section have no bacterial flora

A

T - Neonates delivered by C-section have no flora but are rapidly colonized after birth

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2
Q
A
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3
Q

Which bact cause fast and furious food poisoning? (starts and ends quickly)

A

B. cereus

S. aureus

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4
Q
A
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5
Q
A
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6
Q

Pathogens causing bloody diarrhea

A

Campylobacter, E. histolytica, EHEC, EIEC, Salmonella, Shigella, Y. enterocolitica

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7
Q

bact causing watery diarrhea

A

C Diff, C perfringens, ETEC, V cholerae

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8
Q

Protozoa causing watery diarrhea

A

Giardia, Cryptosporidium

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9
Q

Viruses causing watery diarrhea

A

Rotavirus, norovirus, enteric adenovirus

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10
Q

Most common cause of pneumonia in neonates (<4wk)

A

Group B streptococci E coli

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11
Q

Most common cause of pneumonia in children?

A

Viruses (RSV)

  • *M**ycoplasma
  • *C** trachomatis (infants–3 yr)
  • *C** pneumoniae (school-aged children)
  • *S p**neumoniae

Runts May Cough Chunky Sputum

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12
Q

Most common cause of pneumonia in adults (18-40)

A

Mycoplasma C pneumoniae S pneumoniae Viruses (eg, influenza

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13
Q

Pneumonia in adults (40-65)

A

S pneumoniae H influenzae Anaerobes Viruses Mycoplasma

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14
Q

Causes on pneumonia in elderly

A

S pneumoniae Influenza virus Anaerobes H influenzae Gram ⊝ rods

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15
Q

Causes of pneumonia in Alcoholics

A

Klebsiella, anaerobes usually due to aspiration (eg, Peptostreptococcus, Fusobacterium, Prevotella, Bacteroides)

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16
Q

Pneumonia in IV drug users?

A

S pneumo

S aureus

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17
Q

Aspiration pneumonia cause

A

anaerobes

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18
Q

Causes of atypical pneumonia

A

Mycoplasma, Chlamydophila, Legionella, viruses (RSV, CMV, influenza, adenovirus)

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19
Q

Pneumonia in CF pts

A

Pseudomonas, S aureus, S pneumoniae, Burkholderia cepacia

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20
Q

Immunocompromised pts - causes of pneumonia

A

S aureus, enteric gram ⊝ rods, fungi, viruses, P jirovecii (with HIV)

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21
Q

Nosocomial pneumonia

A

S aureus
Pseudomonas
other G- enteric rods

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22
Q

Post viral pneumonia

A

S pneumo
S aureus
H influenzae

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23
Q

What do we give for meningitis? What do we add if Listeria is suspected?

A

Give ceftriaxone and vancomycin empirically (add ampicillin if Listeria is suspected).

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24
Q

Viral causes of meningitis?

A
  • enteroviruses (Polio, Echo, Coxsackie virus),
  • HSV-2 (HSV-1 = encephalitis), VZV.
  • HIV,
  • West Nile virus (also causes encephalitis),
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25
Q

Common causes of meningitis in newborns (0-6mo)

A

Group B streptococci
E coli
Listeria

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26
Q

Meningitis causes in children (6mo - 6yr)

A

S pneumoniae
N meningitidis
H influenzae type b
Enteroviruses

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27
Q

Meningitis causes in 6-60yrs

A

S pneumoniae
N meningitidis
Enteroviruses
HSV

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28
Q

Number 1 cause of meningitis in teens

A

Neisseria

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29
Q

Meningitis causes in elderly (60 +)

A

S pneumo
G- rods
Listeria

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30
Q

CSF findings in meningitis

A
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31
Q

Most common causes of brain abscess

A

viridans streptococci
S aureus

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32
Q

Where do temporal lobe & cerebellum / frontal lobe abscesses transfer from?

A

otitis media and mastoiditis –> temporal lobe and cerebellum; sinusitis or dental infection –> frontal lobe

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33
Q

Brain abscess in AIDS pt caused by?

A

Toxoplasma activation

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34
Q

Most common cause overall of osteomyelitis

A

S aureus

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35
Q

Osteomyelitis in sexual active person?

A

Neisseria gon (but rare)

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36
Q

Sickle cell osteomyelitis

A

Salmonella
S aureus

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37
Q

Prosthetic joint replacement osteomyelitis

A

S aureus and S epidermidis

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38
Q

Osteomyelitis in the vertebrae

A

S aureus

Pott disease (Myco Tb)

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39
Q

Osteomyelitis assoc w/ cat/dog bite

A

Pasteurella

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40
Q

Osteomyelitis assoc w/ IV drug use

A

S aureus
Pseudomonas
Candida

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41
Q

Testing for Osteomyelitis

  1. Lab values
  2. Imaging
A

Elevated ESR and CRP sensitive but not specific. Radiographs are insensitive early but can be useful in chronic osteomyelitis MRI is best for detecting acute infection and detailing anatomic involvement

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42
Q

Sx of UTI

A

Cystitis presents with dysuria, frequency, urgency, suprapubic pain, and WBCs (but not WBC casts) in urine

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43
Q

Presentation of pyelonephritis

A

. Ascension to kidney results in pyelonephritis, which presents with fever, chills, flank pain, costovertebral angle tenderness, hematuria, and WBC casts.

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44
Q

Risk factors for UTI`

A

obstruction (eg, kidney stones, enlarged prostate), kidney surgery, catheterization, congenital GU malformation (eg, vesicoureteral reflux), diabetes, pregnancy.

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45
Q

The leading cause of UTI? What growth medium is it grown on? What do the colonies look like?

A

Escherichia coli - Leading cause of UTI. Colonies show strong pink lactose-fermentation on MacConkey agar

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46
Q

⊕ Leukocyte esterase in UTI indicates what?

A

evidence of WBC activity

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47
Q

⊕ Nitrite test indicates what in UTI?

A

reduction of urinary nitrates by gram ⊝ bacterial species (eg, E coli).

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48
Q

Which UTI bugs produce urease

A

S saprophyticus, Proteus, Klebsiella

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49
Q

2nd/ 3rd leading cause of UTI ?

A

s. saprophyticus
K pneumoniae

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50
Q

2 nosocomial causes of UTI

A

Serratia marscescens

Enterococcus
Pseudomonas

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51
Q

Motility causes “swarming” on agar; associated with struvite stones.

A

Proteus

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52
Q

Blue-green pigment and fruity odor;

A

Pseudomonas

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53
Q

Thin white vaginal discharge with fishy odor and bubbles

A

Gardnerella vaginalis

54
Q

What are clue cells?

A

vaginal epith cells covered with bacteria

55
Q

Tx for Bact vaginosis

A

Metronidazole

Clindamycin

56
Q

strawberry cervix, Frothy, yellow-green, foulsmelling discharge - Pathogen? shape of it?

A

Motile pear-shaped trichomonads (Trichomonas vaginalis)

57
Q

tx for Trichomonas?

A

Metronidazole

58
Q

strawberry cervix and Thick, white, “cottage cheese” discharge

A

Candida vulvovaginitis

59
Q

What makes one more prone to Candida infections?

A

DB, Antibiotic use, douches, pregnancy

60
Q

Diff in pH b/w Bact vaginosis, Trichomonas, and Candida

A

Normal pH in Candida

pH>4.5 in the other two

61
Q

Which of the TORCHES infections more commonly spreads via delivery > pregnancy?

A

HSV2

62
Q

Parvo B19 causes what in utero?

A

hydrops fetalis

63
Q

Sx of Toxoplasma in mom/baby? Mode of maternal transmission?

A

Cat feces or ingestion of undercooked meat
Maternal - Usually asymptomatic; lymphadenopathy (rarely)
Neonate - Classic triad: chorioretinitis, hydrocephalus, and intracranial calcifications, +/− “blueberry muffin” rash

64
Q

Rubella - MoT? Maternal Sx? Neonate Sx?

A

Respiratory droplets
Maternal - Rash, lymphadenopathy, polyarthritis, polyarthralgia
Neonate - Classic triad: abnormalities of eye (cataracts B) and ear (deafness) and congenital heart disease (PDA); ± “blueberry muffin” rash. “I (eye) ♥ ruby (rubella) earrings”

65
Q

CMV - MoT? Maternal Sx? Neonate Sx?

A

Sexual contact, organ transplants
Maternal - Usually asymptomatic; mononucleosis-like illness
Neonate - Hearing loss, seizures, petechial rash, “blueberry muffin” rash, chorioretinitis, periventricular calcifications C

66
Q

HIV - MoT? Maternal Sx? Neonate Sx?

A

Sexual contact, needlestick
Maternal - Variable presentation depending on CD4+ cell count
Neonate - Recurrent infections, chronic diarrhea

67
Q

HSV2 - MoT? Maternal Sx? Neonate Sx?

A

Skin or mucous membrane contact
Maternal - Usually asymptomatic; herpetic (vesicular) lesions
Neonate - Meningoencephalitis, herpetic (vesicular) lesions

68
Q

Syphilis - MoT? Maternal Sx? Neonate Sx?

A

Sexual contact
Maternal - Chancre (1°) and disseminated rash (2°) are the two stages likely to result in fetal infection
Neonate - Often results in stillbirth, hydrops fetalis; if child survives, presents with facial abnormalities (eg, notched teeth, saddle nose, short maxilla), saber shins, CN VIII deafness

69
Q

Present with rashes of palms and soles

A

TSST of S aureus
Syphilis
Rocky Mountain Spotted Fever
Coxsackie A

70
Q

Oval-shaped vesicles on palms and soles A; vesicles and ulcers in oral mucosa

A

Coxsackievirus type A Hand-foot-mouth disease

71
Q

Asymptomatic rose-colored macules appear on body after several days of high fever; can present with febrile seizures; usually affects infants

A

Human herpesvirus 6
Roseola (exanthem subitum)

72
Q

Confluent rash beginning at head and moving down; preceded by cough, coryza, conjunctivitis, and blue-white spots on buccal mucos

A

Measles virus
Measles (rubeola)

73
Q

Coxsackie A - what family? DNA/RNA? What type? Envelope?

A

Picorna
SS+ linear RNA
Naked
Icosahedral capsid

74
Q

HHV6 - family? envelope? DNA/RNA?

A

dsDNA linear, enveloped, Herpes family

75
Q

Measles virus - Family? DNA/RNA? envelope?

A

Paramyxo; -SS linear enveloped, helical capsid

76
Q

Parvovirus - enveloped? DNA/RNA?

A

ss linear DNA naked virus

77
Q

Pink macules and papules begin at head and move down, remain discrete –> fine desquamating truncal rash; postauricular lymphadenopathy

A

Rubella

78
Q

Rubella - family? DNA/RNA? envelope?

A

Togaviridae

SS+ linear RNA enveloped, icosahedral capsid

79
Q

Flushed cheeks and circumoral pallor on face; erythematous, sandpaper-like rash from neck to trunk and extremities; fever and sore throat

A

S. pyogenes

80
Q

S pyogenes -
Catalase +/-?
what type of hemolysis?
sensitive to what?

A

Catalase neg
Beta hemolytic
Bacitracin sensitive

81
Q

Vesicular rash begins on trunk; spreads to face and extremities with lesions of different stages

A

VZV

82
Q

Neonatal conjuctivitis - 1-2 days. Nonpurulent watery discharge.

A

Chemical - Irritation from antibiotic ointment.

83
Q

Neonate - 2-5+ days. Hyperacute conjunctivitis, marked conjunctival injection, lid swelling, profuse purulent discharge. Rapid corneal involvement may be blinding. May disseminate.

A

Gonorrhea

84
Q

Neonatal conjunctivitis - 5-14 days. Most common etiology. Mild to severe hyperemia, thick mucopurulent discharge, possibly bloody.

A

Chlamydia

85
Q

Neonatal conjunctivitis - Days to 6 weeks. Conjunctival injection, nonpurulent discharge; keratitis, vesicular skin lesions, disseminated infection.

A

HSV

86
Q

Painful genital ulcer with exudate, inguinal adenopathy

A

H. ducreyi chancroid

87
Q

Urethritis, cervicitis, epididymitis, conjunctivitis, reactive arthritis, PID

A

Chlamydia trachomatis (D–K)

88
Q

Genital warts, koilocytes

A

Condylomata acuminata
HPV 6, 11

89
Q

Painful penile, vulvar, or cervical vesicles and ulcers; can cause systemic symptoms such as fever, headache, myalgia

A

HSV2 (HSV1)

90
Q

Urethritis, cervicitis, PID, prostatitis, epididymitis, arthritis, creamy purulent discharge

A

Neisseria gonorrhoeae

91
Q

Painless, beefy red ulcer that bleeds readily on contact

A

Granuloma inguinale
Klebsiella (Calymmatobacterium) granulomatis

92
Q

What are Donovan bodies?

A

macrophages that are large and vacuolated centrally - bipolar staining - in Klebsiella granulomatis

93
Q

Infection of lymphatics; painless genital ulcers, painful lymphadenopathy (ie, buboes

A

Lymphogranuloma venereum

C trachomatis (L1–L3)

94
Q

Vaginitis, strawberry cervix, motile in wet prep

A

Trichomonas vaginalis

95
Q

most common bacterial STI in the United States

A

Chlamydia trachomatis

96
Q

cervical motion tenderness, adnexal tenderness, purulent cervical discharge

A

C trachomatis PID

97
Q

infection and inflammation of liver capsule and “violin string” adhesions of peritoneum to liver

A

Fitz-Hugh–Curtis syndrome - perihepatitis

98
Q

Most common causes of nosocomial infections

A

E coli (UTI) and S aureus (wound infection) are the two most common causes.

99
Q

Watery diarrhea, leukocytosis rel to Antibiotic use, pathogen? Tx?

A

C. Diff , Metronidazole

100
Q

Right lower lobe infiltrate or right upper/ middle lobe (patient recumbent); purulent malodorous sputum - disease? cause?

A

Aspiration pneumonia
Polymicrobial, gram ⊝ bacteria, often anaerobes

101
Q

Decubitus ulcers, surgical wounds, drains - puts one at risk for infections with?

A

S aureus (including MRSA), gram ⊝ anaerobes (Bacteroides, Prevotella, Fusobacterium

102
Q

Intravascular catheters - pathogens?

A

S aureus (including MRSA), S epidermidis (long term), Enterobacter

103
Q

New infiltrate on CXR, Inc sputum production; sweet odor in pt wtih mech ventilations

A

Pseudomonas

104
Q

Pt with mech ventilators are also at risk for?

A

Klebsiella, Acinetobacter, S aureus

105
Q

Urinary Cath infection - pathogens?

A

Proteus spp, E coli, Klebsiella (infections in your PEcKer)

106
Q

Disease assoc with water aerosols?

A

Legionella

107
Q

Two rashes that affect unvacc children?

A

Rubella, Measles

108
Q

3 pathogens that can lead to neuro sx in unvacc children?

A

H influ
Polio
C. tenani

109
Q

Fever with dysphagia, drooling, and difficulty breathing due to edematous “cherry red” epiglottis; “thumbprint sign” on x-ray in unvacc child

A

H. influ type B

110
Q

Low-grade fevers, coryza, inspiratory stridor, post-tussive vomiting in unvacc child

A

Bordetella Pertussis

111
Q

grayish membrane on throat, that bleeds when disturbed in unvacc child

A

C. diphteriae

112
Q

Asplenic patients

A

Encapsulated microbes, especially SHiN (S pneumoniae >> H influenzae type b > N meningitidis

113
Q

Branching rods in oral infection, sulfur granules

A

Actinomyces israelii

114
Q

Chronic granulomatous disease

A

Catalase ⊕ microbes, especially S aureus

115
Q

“Currant jelly” sputum

A

Klebsiella

116
Q

Dog or cat bite

A

Pasteurella multocida

117
Q

Facial nerve palsy (typically bilateral)

A

Borrelia burgdorferi (Lyme disease)

118
Q

Sinus/CNS infection in diabetics

A

Mucor or Rhizopus spp.

119
Q

Neutropenic patients

A

Candida albicans (systemic), Aspergillus

120
Q

Organ transplant recipient

A

CMV

121
Q

PAS ⊕

A

Tropheryma whipplei (Whipple disease)

122
Q

Pediatric infection

A

Haemophilus influenzae (including epiglottitis)

123
Q

Pneumonia in cystic fibrosis, burn infection

A

Pseudomonas aeruginosa

124
Q

Puncture wound, lockjaw

A

Clostridium tetani

125
Q

Pus, empyema, abscess

A

S aureus

126
Q

Rash on hands and feet

A

Coxsackie A virus, T pallidum, R rickettsii

127
Q

Sepsis/meningitis in newborn

A

Group B strep

128
Q

Surgical wound

A

S aureus

129
Q

Traumatic open wound

A

Clostridium perfringens

130
Q
A

Step 1 2019 First Aid Flashcards (63 decks)

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