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All the Small Things > Micro II > Flashcards

Micro II Flashcards

1
Q

What are the criteria to diagnose sepsis?

A
  1. infection + SIRS (2 s/sx)

2.

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2
Q

How many s/sx of SIRS are needed to diagnose sepsis? What are they?

A
  • Tachycardia
  • Hypo or hyperthermia
  • Tachypnea (hypocapnia)
  • WBC (less than 4 or more than 12)

Need 2+

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3
Q

What is the MOA of vanco? Is it bacteriostatic or bactericidal?

A

Inhibits cell wall peptidoglycan formation by binding D-ala, D-ala portion of the cell wall precursors

Bactericidal

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4
Q

What are the two major components of the cell wall of bacteria?

A

NAM and NAG

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5
Q

What is the MOA of TMP-SMX?

A
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6
Q

What are the morphological features of strep pyogenes?

A

Gram positive cocci in chains.

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7
Q

What is the role of the M protein of strep pyogenes? What role does this play in rheumatic fever?

A

Inhibits phagocytosis and complement activation

Similar to heart proteins = rheumatic fever

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8
Q

What type of hypersensitivity reaction is rheumatic fever?

A

Type II

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9
Q

What type of hypersensitivity reaction is acute glomerulonephritis 2/2 strep pyogenes?

A

Type III

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10
Q

What is the reservoir of strep pyogenes?

A

Human throat and skin

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11
Q

How is strep pyogenes transmitted?

A

Respiratory aerosols

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12
Q

What is the toxin that strep pyogenes produces to cause scarlet fever?

A

Erythrogenic toxin–pyrogenic toxin (TSST)

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13
Q

What is the treatment for strep pyogenes infection?

A
  • PCN G

- All beta lactam abx

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14
Q

What are the two toxins that strep pyogenes that causes cellulitis?

A

Hyaluronidase

Streptokinase

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15
Q

What are the jones criteria for strep pyogenes caused scarlet fever?

A
  • Joints
  • Heart
  • Nodules
  • Erythema marginatum
  • Sydenham chorea
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16
Q

What are the s/sx of scarlet fever? (3)

A
  • Sandpaper like rash
  • Strawberry tongue
  • circumoral pallor
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17
Q

What are the histological findings of rheumatic heart disease?

A

Aschoff bodies (granulomatous response to strep)

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18
Q

Nephrotic or nephritic syndrome: strep?

A

Nephritic

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19
Q

What are the s/sx of strep nephritis?

A

H2O

HTN
Hematuria
Oliguria

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20
Q

What can be measured in the serum to monitor for strep therapy?

A

Rise in ASO titers

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21
Q

What is the toxin that strep produces to lyses RBCs?

A

Streptokinase

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22
Q

What is the function of streptolysin O of strep pyogenes?

A

Immunogenic (lyses RBCs and PMNS)

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23
Q

What is the function of streptokinase that strep pyogenes produces?

A

dissolves clots

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24
Q

What is the function of hyaluronidase that strep pyogenes produces?

A

Dissolves CT

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25
Q

What is the function of erythrogenic toxin that strep pyogenes produces?

A

Scarlet fever

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26
Q

What is the 1 cause of bacterial pharyngitis?

A

Strep pyogenes

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27
Q

What is the pathogenesis of rheumatic fever?

A

Ab formation to M protein cross reacts with heart tissue in a type II hypersensitivity rxn, activates the complement system to create aschoff bodies

28
Q

Which more commonly precedes poststreptococcal glomerulonephritis: strep throat, or impetigo

A

Impetigo

29
Q

How long after strep pharyngitis rheumatic fever kicks in?

A

3 weeks ish

30
Q

The top two causes of pharyngitis are viral and strep. What Is the rapid test to r/i strep?

A

Identifies a specific carb antigen in GAS

31
Q

What are the characteristics cell findings in the granulomas from strep pyogenes? (5)

A
  • Lymphocytes and plasma cells
  • Macrophages
  • FIbroblasts
  • Giant cells
  • Epithelioid macrophage
32
Q

What are the macrophages in the kidney?

A

Mesangial cells

33
Q

What are the joints that are affected with rheumatic fever? How?

A

Large joints, one at a time

34
Q

Where are the nodules found with rheumatic fever?

A

On bony surfaces

35
Q

What are the characteristics of the rash with rheumatic fever?

A

Circular rash that worsens in the heat

36
Q

What are the 8 S’s of scarlet fever?

A 
Strep
Sydenham
Sore throat
She
Sed rate
See (C) reactive protein
Subcutaneous nodules
St. Vitus dance
37
Q

In which gender are the sydenham chorea more common in?

A

Women

38
Q

Which gender is more affected with reactive arthritis?

A

Men

39
Q

What are the two inflammatory markers that are elevated with rheumatic fever?

A

CRP

Sed rate

40
Q

What is migratory arthritis? What is it classically seen in?

A

Rheumatic fever

One large joint at a time

41
Q

What are anitschkow cells?

A

Multinucleated giant cells in the heart

42
Q

What are the structural lesions of rheumatic heart disease? (4)

A
  • Commissural fusion of valve
  • Aschoff bodies
  • Anitschkow
  • Thickening of the chordae tendinae
43
Q

What are the top two valves affected by rheumatic fever?

A
  1. Mitral
  2. Aortic
  3. Tricuspid
44
Q

What is the fish mouth deformity with rheumatic fever?

A

Stenotic mitral valve 2/2 rheumatic dz fibrosis causes a fish like appearance

45
Q

What is the only heart chamber not affected with mitral stenosis?

A

Left ventricle

46
Q

What happens to the left atrium in mitral stenosis 2/2 rheumatic fever?

A

Enlargement and formation of mural thrombi d/t stasis along the sides of the atrium

47
Q

What is the pathophysiology of post streptococcal glomerulonephritis?

A

Impetigo infx produces antigen-antibody complexes that deposit in the glomeruli / engulfed by macrophages (type III hypersensitivity rxn)

48
Q

Where in the glomeruli are strep antigen-ab complexes deposited in the glomeruli?

A

Subendothelial

49
Q

What causes the HTN with poststreptococcal GMN?

A

Thrombosis of the renal arteries cause a release of ANG II

50
Q

Casts in the urine come from where: kidney or bladder?

A

Kidney–from the tubules

51
Q

What are the two organs affected with Reye’s syndrome? What is the relation between these two?

A

Liver and brain

BUN builds up, causing a hepatic encephalopathy

52
Q

What happens to BUN with liver disease?

A

Low

53
Q

What happens to BUN with kidney disease?

A

High

54
Q

Where does the urea cycle occur in the liver?

A
  • Starts in mito

- Ends up in the cytoplasm

55
Q

What is the metabolic abnormalities in Reye’s syndrome?

A

Metabolic alkalosis from NH4)

56
Q

What is the effect of ammonia on neurons?

A

Neurotoxic

57
Q

What is the complication of chlamydia?

A

Reactive arthritis

58
Q

What is the classic complication of H Pylori infx?

A

PUDs and gastritis

59
Q

What is the classic complication of campylobacter jejuni?

A

Guillain-Barre syndrome

60
Q

What is the classic complication of Strep pyogenes

A

Rheumatic fever

GN

61
Q

What is the classic complication of meningococcal?

A

Waterhouse friderichsen syndrome

62
Q

What is the classic complication of varicella or flu + ASA?

A

Reye’s syndrome

63
Q

What is the classic complication of EHEC?

A

HUS

64
Q

What causes the schistocytes from HUS?

A

Toxin from EHEC causes roughening of the glomeruli

65
Q

What is the classic complication of lyme disease?

A

Bell’s palsy

66
Q

How many days after the first disease may the associated s/sx show up?

A

4 days - 4 weeks

All the Small Things (29 decks)

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